Current Issue : April - June Volume : 2017 Issue Number : 2 Articles : 6 Articles
Background: We sought to verify the efficacy and safety of transconjunctival 23-\ngauge pars plana vitrectomy (PPV) alone by our bimanual technique for the removal\nof dense posteriorly dislocated crystalline lens. Methods: A retrospective, noncomparative,\ninterventional study of 31 consecutive cases of patients who underwent\n23-gauge PPV alone for the removal of dense posteriorly dislocated crystalline lens\nfollowing complicated cataract surgeries using our bimanual technique was conducted.\nThe main outcomes measured included best-corrected visual acuity (BCVA),\npreoperative intraocular pressure (IOP), postoperative IOP and postoperative complications.\nResults: In all 31 cases included in this study, those dense posteriorly dislocated\ncrystalline lenses were successfully removed. The enrolled patients consisted\nof 17 males and 14 females with a mean age of (75.84 �± 6.17) years (range 59 - 90).\nThe mean follow-up length was (7.61 �± 1.87) months with a range of 6 months to 1\nyear. The mean preoperative BCVA was 0.22 �± 0.11 logMAR system, and the postoperative\nBCVA was 0.33 �± 0.07 logMAR system after 6 months of follow-up. The\nmean operative time was 46.32 �± 4.80 minutes with a range of 38.00 to 57.00 minutes.\nAll of the conjunctival incisions self-closed within the first week with no wound\nleakage or hemorrhage. The postoperative complications were relatively rare. Conclusions:\nThe removal of dense posteriorly dislocated crystalline lens might be a challenge\nfor micro-incision vitrectomy. Our bimanual technique was proved to be an effective\nand safe method for those particular dense lenses using 23-gauge alone....
Purpose. To investigate the effect of uneventful cataract surgery on macular ganglion cell-inner plexiform layer (mGC-IPL)\nthickness in glaucoma patients. Methods. This retrospective study included 65 eyes of 65 subjects who underwent uneventful\ncataract surgery, including 13 glaucoma eyes and 52 normal eyes. Using spectral domain optical coherence tomography, the mGCIPL\nthickness was measured and compared between glaucoma and normal eyes preoperatively as well as 1 month and 3 months\npostoperatively. Linear regression analysis was used to determine the factors associated with postoperative change in mGC-IPL\nthickness. Results. The mean mGC-IPL significantly increased in both groups 1 month and 3 months after surgery (all P values\nequal to or less than 0.001). The postoperative changes between groups were not significantly different (...
Background: Colour Doppler analysis of ophthalmic vessels has been proposed as a promising tool in the diagnosis\nof various eye diseases, but the available diagnostic evidence has not yet been assessed systematically. We\nperformed a comprehensive systematic review of the literature on the diagnostic properties of Colour\nDoppler imaging (CDI) assessing ophthalmic vessels and provide an inventory of the available evidence.\nMethods: Eligible papers were searched electronically in (Pre) Medline, Embase and Scopus, and via crosschecking\nof reference lists. The minimum requirement to be included was the availability of original data\nand the possibility to construct a two-by-two table. Study selection, critical appraisal using the QUADAS II\ninstrument and extraction of salient study characteristics was made in duplicate. Sensitivity and specificity\nwas computed for each study.\nResults: We included 11 studies (15 two-by-two tables) of moderate methodological quality enrolling 820\nparticipants (range 30 to 118). In 44.4% participants were female (range 37ââ?¬â??59% in specific subgroups). CDI\nwas assessed for internal carotid stenosis, diabetic retinopathy, glaucoma, and branch or central retinal vein\nocclusion diagnosis. There was insufficient data to pool the results for specific illnesses. For the assessments\nof ophthalmic arteries, mean sensitivity was 0.69 (range 0.27ââ?¬â??0.96) with a corresponding mean specificity of 0.\n83 (range 0.70ââ?¬â??0.96). Mean sensitivity of the central retinal artery assessments was 0.58 (range 0.31ââ?¬â??0.84) and\nthe corresponding mean specificity was 0.82 (range 0.63ââ?¬â??0.94).\nConclusions: Robust assessments of the diagnostic value of colour Doppler analysis remain uncommon,\nlimiting the possibilities to extrapolate its true potential for clinical practice.\nPROSPERO 2014:CRD42014014027....
Background: To examine the influence of posterior corneal astigmatism on postoperative refractive astigmatism in\npseudophakic eyes after cataract surgery.\nMethods: The study enrolled 64 pseudophakic eyes of 50 patients (71.8 �± 9.9 years old, mean �± standard deviation)\nwho had undergone phacoemulsification with non-toric IOL implantation. Refractive astigmatism was measured\nusing an auto ref-keratometer with a 0.01- diopter (D) scale. Two types of corneal astigmatism were calculated\nusing anterior segment optical coherence tomography; keratometric and total corneal astigmatism. Keratometric\nastigmatism was obtained based on anterior corneal curvature alone and total corneal astigmatism was calculated\nusing both anterior and posterior corneal curvatures. The difference between refractive and corneal astigmatism\nwas computed as the vector difference using 1) refractive and keratometric astigmatism and 2) refractive and total\ncorneal astigmatism.\nResults: The mean refractive, keratometric, and total corneal astigmatism was 0.92 �± 0.48 D, 0.87 �± 0.44 D,\nand 0.94 �± 0.46 D, respectively. The difference between refractive and keratometric astigmatism (0.70 �± 0.40 D, mean\nvector of 0.30 D axis 164�°) was significantly larger than the difference between refractive and total corneal astigmatism\n(0.63 �± 0.38 D, mean vector of 0.12 D axis 137�°) (P = .019).\nConclusions: The difference between refractive and total corneal astigmatism, calculated using both anterior\nand posterior corneal curvatures, was significantly smaller than the difference between refractive and keratometric\nastigmatism using anterior corneal astigmatism alone, implying that the latter overestimates the true postoperative\nrefractive astigmatism and can cause cylindrical inaccuracy after cataract surgery....
The aim of the study was to report postoperative corneal and surgically induced astigmatism (SIA) in patients with preoperative\nagainst-the-rule (ATR) astigmatism who underwent superior approach manual small incision cataract surgery (MSICS). 58 eyes\nof 58 cataract patients with preoperative ATR astigmatism were involved in this study. All patients had operable cataracts and\nunderwent superior approachMSICS. Keratometric (...
Background: To identify success predictors and to study the role of the fellow untreated eye as a co-variable for\nadjustment of intraocular pressure (IOP) outcomes following selective laser trabeculoplasty (SLT) in early open-angle\nglaucoma (OAG) patients.\nMethods: A case series was carried out. Patients with uncontrolled early OAG or ocular hypertension (inadequate\nIOP control requiring additional treatment) underwent SLT (one single laser session) performed by the same\nsurgeon in a standardized fashion. The same preoperative medical regimen was maintained during follow-up\nfor all patients. Post-treatment assessments were scheduled at week 1 and months 1, 2, and 3. In order to\naccount for possible influence of IOP fluctuation on laser outcomes, post-laser IOP values of the treated eye of each\npatient were also analyzed adjusting for IOP changes (between visits variation) of the untreated fellow eye (adjusted\nanalysis). Pre and post-laser IOP values were compared using paired t-test. Factors associated with the magnitude of\nIOP reduction were investigated using multiple regression analysis.\nResults: A total of 45 eyes of 45 patients were enrolled. Mean IOP was reduced from 20.8 Ã?± 5.1 to 14.9 Ã?± 2.\n9 mmHg at month 3 (p < 0.001). Adjusted success rate (defined as IOP reduction ââ?°Â¥ 20%) was 64% and mean\npercentage of IOP reduction was 23.1 Ã?± 14.3% at last follow-up visit. Considering unadjusted post-laser IOP\nvalues, it was found a 20% greater absolute IOP reduction (median [interquartile range] 6 mmHg [4ââ?¬â??7] vs\n5 mmHg [3ââ?¬â??7]; p = 0.04), with a success rate of 76%. Although baseline IOP was significantly associated with\nboth adjusted and unadjusted post-laser IOP reduction, a stronger association was found when unadjusted\nIOP values were considered (p < 0.001 and R2 = 0.35; p < 0.001 and R2 = 0.67, respectively). Age, mean deviation\n(MD) index, central corneal thickness and type of glaucoma were not significant predictors (p ââ?°Â¥ 0.150).\nConclusions: In this group of patients with early OAG or ocular hypertension, our short-term results confirmed SLT\nas a safe and effective alternative for IOP reduction. Although better outcomes were found in eyes with\nhigher preoperative IOP, this effect was mitigated when results were adjusted to the fellow untreated eye\n(to the influence of between visits-IOP fluctuations)....
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