We have studied the global risk of retinopathy in a Mediterranean population of type 2 diabetes mellitus (T2DM) patients, according to clinical, biochemical, and lifestyle biomarkers. The effects of the oral supplementation containing antioxidants/omega 3 fatty acids (A/ω3) were also evaluated. Suitable participants were distributed into two main groups: (1) T2DMG (with retinopathy (+DR) or without retinopathy (−DR)) and (2) controls (CG). Participants were randomly assigned (+A/ω3) or not (−A/ω3) to the oral supplementation with a daily pill of Nutrof Omega (R) for 18 months. Data collected including demographics, anthropometrics, characteristics/lifestyle, ophthalmic examination (best corrected visual acuity, ocular fundus photographs, and retinal thickness as assessed by optical coherence tomography), and blood parameters (glucose, glycosylated hemoglobin, triglycerides, malondialdehyde, and total antioxidant capacity) were registered, integrated, and statistically processed by the SPSS 15.0 program. Finally, 208 participants (130 diabetics (68 +DR/62 −DR) and 78 controls) completed the follow-up. Blood analyses confirmed that the T2DMG+DR patients had significantly higher oxidative stress (p < 0.05), inflammatory (p < 0.05), and vascular (p < 0.001) risk markers than the T2DMG−DR and the CG. Furthermore, the A/ω3 oral supplementation positively changed the baseline parameters, presumptively by inducing metabolic activation and ameliorating the ocular health after 18 months of supplementation.
RESUMENObjetivos: Evaluar los hallazgos postquirúrgicos y el éxito tras cirugía combinada mediante facoemulsificación e implante Ex-PRESS comparado con cirugía combinada con trabeculectomía estándar. Métodos: En esta serie prospectiva de 40 ojos consecutivos comparamos 20 ojos de 17 pacientes tratados mediante facoemulsificación combinada con cirugía filtrante de glaucoma con implante de vál-vula Ex-PRESS bajo un colgajo escleral con 20 ojos controles en 20 enfermos que fueron sometidos a facoemulsificación combinada con trabeculectomía estándar. Resultados: El tiempo de seguimiento medio fue de 9,7 meses (rango: 4,5-15) en el grupo Ex-PRESS y 10,3 meses (rango 3,5-14,5) en el grupo trabeculectomía. La PIO media fue significativamente superior en el postoperatorio precoz en el grupo Ex-PRESS comparada con el de trabeculectomía. La tasa de complicaciones en dicho período resultó superior en el grupo sometido a trabeculectomía. No se objetivaron diferencias significativas en la tasa de éxito entre ambos grupos más allá de la primera semana.
ABSTRACTPurpose: To evaluate postoperative outcomes and success after combined phacoemulsification and glaucoma surgery with Ex-PRESS miniature implant compared with combined surgery with standard trabeculectomy. Methods: In this prospective series of 40 consecutive eyes we compared 20 eyes in 17 patients treated with combined phacoemulsification and glaucoma filtering surgery with the Ex-PRESS miniature glaucoma implant under a scleral flap with 20 matched control eyes in 20 patients who underwent combined cataract and glaucoma surgery with trabeculectomy. Results: The average follow-up was 9.7 months (range 4.5 to 15) for the Ex-PRESS group and 10.3 months (range 3.5 to 14.5) for the trabeculectomy group. The mean IOP was significantly higher in the early postoperative period in the Ex-PRESS group compared with the trabeculectomy group. Complications rate in the early postoperative period was significantily higher in the trabeculectomy group. No significant differences were objectified in success between both groups after the first week.
We believe that the intrusion of viscoelastic material into the supradescemetic was a consequence of the high-pressure during the high-density hyaluronate injection. Hemorrhagic DMD management is mainly determined by its location, size and evolution. In our case, the posterior endothelial micropuncture and descematopexy by means of 20% SF6 injection into the anterior chamber was useful in resolving this complication.
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