We found a trend toward lower IOP that, if permanent, raises serious implications about the necessity of combined procedures in patients with both glaucoma and cataract.
The surgical method resulted in stable corneal curvature by 2 weeks after surgery at which time the patient is ready for final spectacle prescription and can be discharged from acute postoperative ophthalmologic care in the absence of complicating factors. The shortened recovery time is beneficial for the patient and has significant potential effects on the global costs of cataract rehabilitation and the reimbursement schemes for postoperative management.
We report the results of using the small-diameter corneal inlay to create a bifocal cornea. The inlay was implanted in five eyes in January 1993. At 12 months postoperatively, uncorrected near vision had improved from J4 to better than J2 in four of the five. The results indicate that the corneal inlay improves near vision and is compatible within the cornea.
We compared the reliability of measurements of three keratometers and keratometry readings from a corneal topography system to determine if they were as accurate as the "gold standard" Javal-Schiotz keratometer. Same-day measurement of the steepest and flattest powers of the central 3 mm of the corneas of 200 eyes (100 patients) revealed no statistically significant difference in reliability between the newer keratometers and the Javal-Schiotz. In addition, the newer machines are more convenient and efficient in some clinical settings.
A 78-year-old woman who had intracapsular cataract extraction and anterior chamber intraocular lens implantation 8 years earlier presented with decreased visual acuity (20/400) and discomfort of 2 years duration in the operated eye. Penetrating keratoplasty was done to improve visual function and reduce discomfort; however, at 6 months postoperative, visual acuity was 20/800, due in part to retained opacified host corneal tissue. A retrograft (duplicate) membrane was identified at the posterior aspect of the graft/host junction. The neodymium:YAG laser was used to create a central 3.5 mm circular opening in the duplicate membrane. There were no complications from the laser treatment. The donor cornea remained thin and clear, and visual acuity improved to 20/40 with spectacle correction. It is imperative to confirm complete removal of host corneal tissue before implanting donor tissue; however, vision can be restored, and a corneal graft can remain clear following laser membranotomy.
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