Background: The study aimed to evaluate outcomes of epiretinal membrane (ERM) peeling in patients with asteroid hyalosis (AH) and to compare them with those from controls without AH. Methods: This is a retrospective matched cohort study of 1,104 consecutive patients who underwent surgery for ERM between January 2004 and February 2014. Patients with AH were included in the study group and were matched for preoperative visual acuity, age, gender, date of surgery, and axial length with control patients without AH selected from the same cohort. The best-corrected visual acuity (BCVA) and central macular thickness (CMT) on optical coherence tomography were measured at baseline and postoperatively with a minimum follow-up period of 12 months. Results: A total of 44 patients were included in the AH group and 44 in the control group. The mean initial BCVA was 0.53 ± 0.21 LogMAR for the AH group vs. 0.49 ± 0.20 LogMAR for the control group, and the mean initial CMT was 419 ± 74 vs. 423 ± 75 µm, respectively. During the follow-up, no significant difference was found regarding the final BCVA at 6 months (0.23 ± 0.14 vs. 0.24 ± 0.17) LogMAR (p = 0.87) and 12 months (0.16 ± 0.09 vs. 0.17 ± 0.12) LogMAR (p = 0.92), despite a tendency toward slower visual recovery for the AH group at 1 month, with a mean BCVA of 0.36 ± 0.12 vs. 0.28 ± 0.18 LogMAR (p = 0.08). No difference was found regarding the progression of CMT at 1.6 and 12 months with a mean CMT of 396 ± 47 vs. 378 ± 55 µm (p = 0.39), 356 ± 39 vs. 365 ± 41 µm (p = 0.48), and 349 ± 68 vs. 352 ± 53 µm (p = 0.87), respectively. Conclusion: Vitrectomy with ERM peeling in patients with AH was beneficial and showed similar functional and anatomical outcomes in both groups. AH does not seem to affect visual improvement or the complication rate after ERM peeling. Therefore, the indications for vitrectomy in case of ERM should not be prompted by the presence of AH.
PurposeTo evaluate anatomical and functional results of epiretinal membrane peeling for patients with asteroid hyalosis (AH) comparing with those of a control population without AH.MethodsRetrospective, case‐control study, of a cohort of 1104 patients operated from an epiretinal membrane(EM) between January 2002 and February 2014. Forty four consecutive patient were included in the EM associated with AH group and were compared to 44 control patient without AH, matched for: age, sex, date of surgery, and axial length. The best corrected visual acuity (BCVA) and central macular thickness on OCT (CMT) were measured at baseline and postoperatively at 1, 6 and 12 months. intraoperative and/or postoperative complications were also analyzed.Results34 men and 10 women were included in the AH group. Respectively, the mean initial BCVA was 0.49 +/‐ 0.21 logMar for the AH group Vs 0.44 +/‐ 0.21 logMAR for the control group (p = 0.2), and the mean initial CMT was 415 +/‐ 71 µm Vs 422 +/‐ 73 µm (p = 0.6). No significant difference was found regarding the final BCVA, with respectively a mean of 0.37 Vs 0.24 logMAR(p = 0.26) at 1 month, 0.27 Vs. 0.23 logMAR(p = 0.5) at 6 months, and 0.17 Vs 0.2 log MAR(p = 0.26) at 12 months. Also, no difference was found regarding the evolution of CMT, with respectively a mean of 368 Vs 353 µm (p = 0.5) at 1 month, 347 Vs 358 µm (p = 0.61) at 6 months, 345 Vs 349 µm (p = 0.87) at 12 months. Only a single macular hole was recorded in the AH group in the follow up.ConclusionsThe presence of asteroid hyalosis does not constitute a factor of poor prognosis for visual recovery after epiretinal membrane peeling.
Purpose To evaluate the difference in visual recovery between Descmet’s Stripping Automated Endothelial Keratoplasty (DSAEK) and Penetrating Keratoplasty (PK). Methods Retrospective cohort study of 42 eyes. 21 eyes underwent PK compared to 21 eyes underwent DSAEK for a Fuchs’ dystrophy or pseudophakic bullous keratopathy. Preoperative and postoperative best spectacle‐corrected visual acuity (BSCVA) was recorded at 1, 3, 6 and 12 month. The PK and DSAEK procedures were performed by the same experienced surgeon with the same donor and similar recipient criteria. All patients underwent a standardized examination that included tonometry, visual acuity (distance and near) and biomicroscopic examination at 1 month, 3 month, 6 month and 12 month. Improvement in BSCVA between each point time was evaluated using paired‐samples t tests. Results The donor and recepient demographics were comparable in the PK and DSAEK groups. In the PK group, the visual recovery was significant after 12 month (1,71 logMAR +/‐ 0,33 to 1,25 logMAR +/‐ 0,58; P=0,023). The mean distance gain was 4,53 lines and the mean near gain was 3,89 lines. In the DSAEK group, the visual recovery was significant after 3 month (1,05 logMAR +/‐ 0,50 to 0,68 logMAR +/‐ 0,38; P=0,025). The mean distance gain was 4,25 lines and the mean near gain was 5,7 lines. The mean distance gain was equivalent between the two groups (P=0,91), and the mean near gain was statistically superior in the DSAEK group (P=0,47). Conclusion There is a faster visual recovery and a more significant near gain after DSAEK surgery for Fuchs’ endothelial dystrophy or pseudophakic bullous keratopathy.
PurposeTo investigate preoperative aqueous flare as a predictive factor for proliferative vitreoretinopathy (PVR) leading to relapse in patients with primary rhegmatogenous retinal detachment repear.MethodsPreoperatively, the aqueous flare of 100 consecutive patients with unilateral rhegmatogenous retinal detachement (RD) was measured with Kowa FM‐500 laser flare‐cell meter. All patients were evaluated at 1 month and 6 months or just after recurence.ResultsTwenty eyes underwent redetachment secondary to PVR developpement. The mean value of flare of patients that redetached was 48.12 pc/ms versus 17.74 pc/ms for those who did well (p = 0.002). We observed that 17/20 recurrences with PVR (85%) and 24/76 that did well (31.6%) had flare greater than 15 pc/ms (p = 0.0355). Moreover in patients without preoperative clinical signs of PVR, the sensitivity of the laser cell flare to predict post operative PVR when flare reached 15 pc/ms was 100% with 77.5% specificity and 31.25% positive predictive value.ConclusionsOur study shows the effectiveness of the laser flare cell meter in detecting eyes at risk of developing post operative PVR leading to recurrences. The laser flare‐cell meter is a non invasive tool that informs the surgeon on the potential severity of the detachment.
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