Enlarging the size of the chevron incision up to 7.0 mm resulted in a small increase in induced astigmatism. The enlarged incision simplified the operative technique.
We present a technique for planned manual extracapsular cataract extraction (ECCE) incorporating a modification of mini-nuc ECCE in which the scleral tunnel is made wide enough to allow a nucleus of any size to settle in the tunnel. A 5.0 mm, inverted-V chevron incision is used in which the exposed part of the nucleus lodged in the scleral pocket can be manually picked and fragmented until it is small enough to be removed through the incision. The chevron incision is flexible enough to allow a medium-sized nucleus to be extracted without fragmentation and implantation of a rigid 6.0 mm poly(methyl methacrylate) lens. Vector analysis of preoperative and 3 month postoperative keratometric results in 30 patients showed that the surgically induced vector was 0.54 diopter (D) +/- 0.58 (SD). Mean reduction in astigmatism was 0.08 +/- 0.39 D. The sutureless technique is fast and safe, allows a nucleus of any size to be extracted through a constant size 5.0 mm incision, and results in minimal postoperative astigmatism.
Dipyridamole was introduced decades ago as a treatment for angina, subsequently found to inhibit platelet aggregation. It is most commonly used, and approved for use in thromboembolism prevention, following surgery. Some of its recognized effects such as adenosine uptake inhibition, elevation of cAMP and cGMP levels, vasodilation, and tissue perfusion are important in various ocular disorders. For this reason, dipyridamole represents an interesting candidate as a therapeutic target for the treatment of eye disorders affecting different ocular structures. The aim of this article is to review the evidence and current understanding of the mechanisms by which dipyridamole exerts its effects on different ocular tissues, discuss the role of dipyridamole in clinical practice, and highlight areas of use and routes of administration.
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