INTRODUÇÃO Edema macular (EM) permanece sendo a causa mais frequente de baixa visão após cirurgia de catarata (1,2). O EM desenvolve-se devido à quebra da barreira hematorretiniana causando acúmulo de líquido no espaço extracelular da retina e formação de cistos nas camadas plexiforme externa e nuclear interna (3,4). A incidência de EM à angiografia (3-70%) e de EM clinicamente relevante (0-22%) variam substancialmente na literatura, dependen-do da sua definição, técnica da cirurgia, método diagnóstico utilizado e comorbidades associadas (1,2,5-7). A incidência de EM pós-operatório aumenta quando a cirurgia de catarata é acompanhada no intraoperatório de rotura de cápsula RESUMO Objetivo: Avaliar o edema macular após cirurgia não complicada de facoemulsi-ficação com implante de lente intraocular por meio da tomografia de coerência óptica spectral domain (OCT-SD). Métodos: Foi realizado estudo prospectivo em 62 olhos de pacientes submetidos à facoemulsificação com implante de lente intraocular. Os pacientes foram avaliados antes e após a cirurgia, no primeiro dia, e na primeira, segunda e quarta semanas. Acuidade visual (AV), células na câmara anterior e tomografia de coerência óptica macular cubo 200x200 foram medidos. Resultados: Após a cirurgia de facoemulsificação houve melhora da acuidade visual, inflamação decrescente, e a espessura e o volume macular aumentaram. Ocorreu um caso de edema macular cistoide. Houve correlação inversa fraca entre a acuidade visual e a espessura macular central, e entre a acuidade visual e o volume macular. Foi observada correlação direta fraca entre a inflamação e o volume macular. Conclusão: Edema macular subclínico desenvolve-se mesmo após cirurgia de catarata não complicada em pacientes não predispostos. A tomografia de coerência óptica spectral domain foi capaz de detectar pequenos aumentos na espessura macular no período avaliado. Descritores: Facoemulsificação; Edema macular; Tomografia de coerência óptica; Implante de lente intraocular; Período pós-operatório; Acuidade visual ABSTRACT Purpose: To evaluate macular edema after uncomplicated phacoemulsification with implantation of intraocular lens by spectral domain optical coherence tomography (OCT). Methods: Prospective study was conducted in 62 eyes of patients underwent phaco-emulsification with implantation of intraocular lens. Patients were evaluated before surgery and after surgery at day 1, week 1, week 2 and week 4. Visual acuity (VA), anterior chamber cells and 200x200 macular cube optical coherence tomography were measured. Results: After phacoemulsification there was an improvement in visual acuity, de creasing inflammation, and increased macular thickness and macular volume. There was one case of cystoid macular edema. There was a weak inverse correlation between visual acuity and central macular thickness, and between visual acuity and macular volume. We observed a week direct correlation between inflammation and macular volume. Conclusion: Subclinical macular edema develops even after uncomplicated cataract s...
Both combined ICRSI-CXL and ICRSI-only groups experienced favorable outcomes, without statistical difference in any studied effect of both treatment strategies.
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Purpose: This study determined to assess the degree of agreement between anterior chamber depth (ACD) measurements obtained using three different devices and to analyse the relationship between ACD and spherical equivalent (SE) refraction.
Methods: In this cross‐sectional study, 42 eyes of 42 patients with a mean SE of − 4.69 ± 4.61 D (range 0.00 D to − 14.88 D) were analysed. Measurements of ACD between the corneal epithelium and the anterior surface of the crystalline lens, obtained using the Pentacam, Orbscan IIz and IOLMaster, were compared. The relationships between SE and ACD measurements obtained with different devices were also investigated. The results were analysed using Bland−Altman analyses, single‐sample t‐test and Pearson’s correlation test.
Results: Orbscan ACD measurements were an average of 0.05 mm less than Pentacam measurements (p = 0.01). IOLMaster measurements were an average of 0.06 mm less than Orbscan measurements (p < 0.001). None of the ACD values measured by any of the devices were correlated with increasing SE (p > 0.05 for all). There was a weak positive correlation between SE and the difference in ACD measurements with Pentacam and Orbscan (p = 0.04); however, the differences between Pentacam and IOLMaster ACD measurements and Orbscan and IOLMaster ACD measurements seemed to be independent of SE (p = 0.17 and p = 0.54, respectively).
Conclusions: The ACD in clinically normal eyes is measured differently by various non‐ultrasonic devices. However, the observed mean error between these modalities is too small to create any noticeable difference in refractive outcome. No significant relationship was found between SE and ACD measurements obtained by Pentacam, Orbscan or IOLMaster.
We report the normal values of corneal endothelial characteristics in Caucasian Turkish eyes. Over the age of 20, the MCD of Caucasian eyes is more than the Indian and Iranian eyes and less than the Chinese eyes. Caucasian population's cell density in under the age of 20 is 3101 ± 268 cell/mm.
PurposeTo compare the efficacy of low-fluence photodynamic therapy (PDT) and PDT with half-dose verteporfin in chronic central serous chorioretinopathy (CSC).Patients and methodsThe medical records of 64 eyes from 60 patients with chronic CSC were retrospectively reviewed; 36 eyes received low-fluence PDT (25 J/cm2) and 28 eyes received half-dose verteporfin PDT (3 mg/m2). The primary outcome measure was the proportion of eyes with complete resolution of subretinal fluid. Secondary outcome measures were the changes in best corrected visual acuity (BCVA) and central foveal thickness, and the proportion of eyes that showed an increase of ≥5 letters in BCVA at the last visit.ResultsThe mean follow-up period was 12.5±4.3 months and 13.1±4 months in the low-fluence group and half-dose group, respectively (P=0.568). Thirty-three eyes (91.6%) in the low-fluence group and 26 eyes (92.8%) in the half-dose verteporfin group showed complete resolution of subretinal fluid (P=0.703). BCVA increased by a mean of 7.4 letters and 4.8 letters in the low-fluence group and half-dose group, respectively (P=0.336). Seventeen eyes (52.8%) in the low-fluence group and 14 eyes (50%) in the half-dose group experienced a gain of ≥5 letters in BCVA (P=0.825). In the low-fluence and half-dose verteporfin group, the mean baseline central foveal thickness was 351±90 μm and 341±96 μm, and significantly decreased to 188±61 μm and 181±47 μm, respectively (P<0.01).ConclusionBoth treatments resulted in complete subretinal fluid resolution in most of the eyes, with significantly better visual acuity outcomes compared to baseline at the last visit.
Purpose To investigate and compare the efficacy of botulinum toxin-A injection in the lacrimal gland and conjunctivodacryocystorhinostomy surgery for the treatment of epiphora caused by proximal lacrimal system obstruction. Methods Charts of the patients with proximal canalicular obstruction who had undergone conjunctivodacryocystorhinostomy with permanent tube insertion (18 patients, group 1) or 4 units of botulinum toxin-A injection in the palpebral lobe of the lacrimal gland (20 patients, group 2) were reviewed retrospectively. The upper lacrimal system obstruction was diagnosed by lacrimal system irrigation. Schirmer-1 test and Munk epiphora grading for evaluation of epiphora were performed before the interventions and on tenth day, first, third, and sixth months after the interventions. Results Improvement of epiphora was statistically significant at all visits when compared with values before injection (Po0.001) in both of groups. When two techniques were compared, difference in degree of epiphora before and after intervention was not statistically significant (Po0.05). In group 2, none of the patients had punctate epitheliopathy, although there was a significant decrease in Schirmer test results (Po0.001, paired t-test). In group 1, 9 cases (50%) had tube dislocation, 4 cases (22.2%) had obstruction, and granuloma formation. Five cases (25%) had ptosis in group 2.
ConclusionConjunctivodacryocystorhinostomy requires surgical experience, special postoperative care, and multiple revisions. As botulinum toxin-A injection in the lacrimal gland is technically easy, less-invasive, safe, with reversible effects, it can be considered as an alternative treatment in patients with proximal lacrimal system obstruction.
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