Current surgical removal of sphenoorbital meningiomas (SOM) mainly aims at reduction of proptosis and restoration of visual function; some stages of the surgical technique are controversial. In this study, we aim to present a surgical decision-making algorithm for SOM. A retrospective study of 27 patients who underwent resection of SOM in our center (2005-2014) was conducted. The primary outcomes evaluated were postoperative visual function and radiological exophthalmos. In our study, clinical proptosis was the most common presenting sign (92%), followed by visual loss (37%). Our surgical algorithm includes (1) extracranial stage; (2) extradural stage, including removal of the anterior clinoid process only in cases of tumor invasion (22% of our cases); (3) intradural stage; (4) intraorbital stage, including opening of the periorbita only in the presence of resectable intraorbital tumor; and (5) reconstruction, including rigid orbital reconstruction only if the periorbita was violated (22%) and placement of a fat graft in the epidural space in most cases (85%). Complete tumor resection was achieved in 51.8%. The extent of resection was limited mainly due to invasion to the cavernous sinus (61.5%) and the superior orbital fissure (84%). Surgery achieved significant visual improvement in 80% and exophthalmos reduction in 77% of the patients. Preoperative visual deficit (P = 0.0001) and optic canal involvement (P = 0.04) appeared to predict postoperative improvement of visual function. Surgical complications were mainly transient cranial nerve deficits. Based on our results, we concluded that the proposed surgical algorithm leads to successful visual, cosmetic, and oncologic outcomes.

Carisbamate (CRS) exhibits broad acute anticonvulsant activity in conventional anticonvulsant screens, genetic models of absence epilepsy and audiogenic seizures, and chronic spontaneous motor seizures arising after chemoconvulsant-induced status epilepticus. In add-on phase III trials with pharmacoresistant patients CRS induced Ͻ30% average decreases in partial-onset seizure frequency. We assessed the antiepileptogenic and antiepileptic performance of subchronic CRS administration on posttraumatic epilepsy (PTE) induced by rostral parasaggital fluid percussion injury (rpFPI), which closely replicates human contusive closed head injury. Studies were blind and randomized, and treatment effects were assessed on the basis of sensitive electrocorticography (ECoG) recordings. Antiepileptogenic effects were assessed in independent groups of control and CRS-treated rats, at 1 and 3 months postinjury, after completion of a 2-week prophylactic treatment initiated 15 min after injury. The antiepileptic effects of 1-week CRS treatments were assessed in repeated measures experiments at 1 and 4 months postinjury. The studies were powered to detect ϳ50 and ϳ40% decreases in epilepsy incidence and frequency of seizures, respectively. Drug/vehicle treatment, ECoG analysis, and [CRS] plasma determination all were performed blind. We detected no antiepileptogenic and an equivocal transient antiepileptic effects of CRS despite [CRS] plasma comparable with or higher than levels attained in previous preclinical and clinical studies. These findings contrast with previous preclinical data demonstrating large efficacy of CRS, but agree with the average effect of CRS seen in clinical trials. The data support the use of rpFPI-induced PTE in the adolescent rat as a model of pharmacoresistant epilepsy for preclinical development.

PURPOSE: To evaluate the optical performance and quality of vision of a novel optical design of a new trifocal intraocular lens (IOL) using a proprietary modified algorithm. METHODS: In this prospective, non-randomized, single-armed, single-center, open-label study, a total of 20 patients (40 eyes) who were candidates for multifocal lens implantation were recruited for implantation with the multifocal Intensity SL IOL (Hanita Lenses). Evaluation performed at 1 and 7 to 10 days and 1 and 3 months after implantation included corrected and uncorrected distance visual acuities at far, intermediate (80 cm), and near (40 cm). Monocular and binocular visual acuities, defocus curves, and contrast sensitivity were measured and questionnaires for grading subjective visual quality, satisfaction, and visual function were provided. RESULTS: Three months postoperatively, monocular uncorrected visual acuity for distance, intermediate, and near averaged 0.03 ± 0.11, 0.09 ± 0.09, and −0.22 ± 0.09 logMAR, respectively (Snellen 20/21.4, 20/24.6, and 20/12). Corrected monocular visual acuity for distance, intermediate, and near averaged −0.07 ± 0.06, 0.03 ± 0.09, and −0.25 ± 0.07 logMAR (20/17, 20/21.4, and 20/11.2), respectively. Binocular corrected visual acuity for distance, intermediate, and near was −0.1 ± 0.06, −0.02 ± 0.09, and −0.28 ± 0.04 logMAR (20/15.8, 20/19, and 20/10.5), respectively. Contrast sensitivity was similar to the normal population in photopic and mesopic conditions. Defocus curves showed that this IOL provided visual acuity of 20/28.9 or better between a defocus of +1.00 and −3.50 diopters. The Visual Function Index-14 questionnaire showed that patients reported high satisfaction. Patients specifically noted good quality of vision at near and intermediate distances. CONCLUSIONS: The Intensity SL IOL can provide good quality distance, intermediate, and particularly strong near vision after cataract surgery and independence from spectacles with good patient satisfaction. [ J Refract Surg . 2022;38(3):150–157.]

Purpose: To analyze the top 100 most-cited papers on pars intravitreal injections. Methods: Literature search using the bibliographic databases of the ISI Web of Knowledge for all types of publications on intravitreal injections published between 1965 and 2019 in peer-reviewed journals. Results: Eighty-three of the top 100 papers on intravitreal injections were published in ophthalmology journals, their majority in the top five Q1 leading journals in the field. They originated from 16 different countries, predominantly from the USA (n=52), and were all published in English. These manuscripts cover a wide spectrum of topics but were mostly focused on retinal diseases (n=60) and the use of anti-VEGF or steroid agents (n=75). Discussion: This bibliographic study provides a unique perspective on the evolution and assimilation of intravitreal injections, from their introduction, through their present role as the most common therapeutic procedure in ophthalmology, to future developments.

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