Deep artificial neural networks show impressive performance on classification of retinal OCT scans. After training on historical clinical data, machine learning methods can offer the clinician support in the decision-making process. Care should be taken not to mistake neural network output as treatment recommendation and to ensure a final thorough evaluation by the treating physician.
Purpose:
To identify potential risk factors related to the opacification of a hydrophilic–hydrophobic acrylic intraocular lens (IOL) model.
Setting:
University Hospital Regensburg, Department of Ophthalmology, Regensburg, Germany.
Design:
Cross-sectional study.
Methods:
All patients with a Lentis LS-502-1 IOL implanted at the Department of Ophthalmology were identified. Existing medical records and information from the treating ophthalmologists were reviewed to determine the IOL status (clear or opacified). Potential risk factors were analyzed using binary logistic regression models.
Results:
A total of 223 IOLs of 199 patients were included. Sixty-seven (30.0%) opacified (calcified) IOLs were identified and compared with a control group of 156 IOLs. Statistical analyses revealed age at IOL implantation (odds ratio [OR] = 1.05, P = .012) to be associated with an increased risk of calcification. Posterior capsulotomy (OR = 0.45, P = .011) was found to have a protective influence. No other ophthalmic or systemic condition showed a significant association. Mean corrected distance visual acuity diminished significantly under opacification from 0.21 ± 0.25 logarithm of the correct minimum angle of resolution (logMAR) to 0.42 ± 0.32 logMAR (P < .001). IOL exchange in 55 of 67 cases at 45.8 ± 20.5 months after initial implantation yielded significant visual recovery (P = .001).
Conclusions:
Age at implantation might be a risk factor of IOL calcification, whereas posterior capsulotomy might be a protective factor. Calcification of the LS-502-1 IOL might be caused by the interaction of 3 main factors: IOL material traits, manufacturing-associated contamination, and patients’ individual factors altering intraocular ion concentrations.
PurposeThe aim of this study was to evaluate risk factors for the anatomical and functional outcomes of macular hole (MH) surgery with special emphasis on the experience of the surgeon.MethodsA total of 225 surgeries on idiopathic MHs (IMHs) performed by 6 surgeons with a mean follow-up period of 20.5 months were reviewed in this retrospective study. Outcome parameters focused on IMH closure, complications and visual acuity improvement. The results of MH surgeries performed by experienced surgeons were compared to those of surgeons in training.ResultsThe average MH size was 381 µm (standard deviation [SD]=168). Brilliant blue G (BBG) for internal limiting membrane (ILM) staining was used in 109 (48%) eyes and indocyanine green (ICG) in 116 (52%) eyes. As endotamponade, 20% SF6 was used in 38 (17%) cases, 16% C2F6 in 33 (15%) cases and 16% C3F8 in 154 (68%) cases. IMH closure was achieved in 194 eyes (86%). Mean preoperative visual acuity was 0.84 logarithm of the minimum angle of resolution (log MAR; SD=0.29, range: 0.3–1.5); surgery led to a mean improvement of 0.40 (SD=0.37) log MAR. Although the MH closure rate was the same using BBG or ICG for ILM peeling, visual acuity improvement was better in eyes peeled with BBG compared to eyes peeled with ICG (log MAR: BBG: 0.38 [95% CI: 0.32, 0.44] vs ICG: 0.48 [95% CI: 0.42, 0.54], P=0.029). Surgeons with previous experience in vitreoretinal surgery of ≥6 years achieved better visual outcomes compared to surgeons with 0–3 years of experience, regardless of the MH size, preoperative visual acuity, time to follow-up or dye used for ILM peeling (0–3 years [0.27, Δlog MAR] vs ≥6 years [0.43, Δlog MAR], P=0.009).ConclusionOur results indicate that vitrectomy with ILM peeling performed by non-experienced surgeons is a safe procedure leading to good anatomical and functional results. Very experienced surgeons may achieve even better functional outcomes.
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