Aim:To assess the efficacy of focal photocoagulation of capillary macroaneurysms (CMA) to reduce the burden of intravitreal injections (IVI) in patients with macular edema (ME). Materials and Methods: Retrospective multicenter study in patients with diabetic ME or ME secondary to retinal vein occlusion (ME-RVO). CMA associated with ME were selectively photocoagulated. Patients were followed for one year after photocoagulation. Results: 93 eyes of 76 patients were included in this study. At 6 months after the laser (n = 93), there was a significant decrease in mean macular thickness (from 354 µm to 314 µm, p < 0.001) and in mean IVI number (from 2.52 to 1.52 at 6 months, p < 0.001). The mean BCVA remained stable (0.32 and 0.31 logMAR at baseline and 6 months, p = 0.95). At 12 months (n = 81/93), there was a significant decrease in mean macular thickness (from 354 µm to 314 µm, p < 0.001) and in mean IVI number (from 4.44 to 2.95 at 12 months, p < 0.001), while the mean BCVA remained stable (0.32 and 0.30 logMAR at baseline and 12 months, p = 0.16). Conclusion: Focal laser photocoagulation of CMA seems to be effective and safe for reducing the burden of IVI in patients with ME. Their screening during the follow-up should be considered closely.
PURPOSE:
To assess the impact of the use of artificial tears during the preoperative work-up performed before age-related cataract surgery, when a toric intraocular lens (IOL) was indicated.
METHODS:
This was a monocentric prospective study assessing 73 eyes of 51 patients, included consecutively after a preoperative work-up performed without artificial tears (no artificial tears group), when a toric IOL was indicated. Each included patient underwent a second series of examinations: biometry using the IOLMaster 700 (Carl Zeiss Meditec AG) and topography using the OPD-Scan II (Nidek), 1 minute after artificial tears instillation (artificial tears group; hyaluronate de sodium 0.15%, threalose 3% [Théalose; Théa]). Changes in anterior corneal astigmatism and subsequent changes in toric IOL calculation were analyzed. The error in predicted residual astigmatism was calculated.
RESULTS:
Anterior corneal astigmatism and total corneal astigmatism measured with the IOLMaster 700 were significantly modified when artificial tears were instilled before the examinations (1.51 ± 0.57 diopters [D], range: 0.75 to −3.55 vs 1.42 ± 0.63 D, range: 0.42 to 3.35 D;
P
= .043 and 1.59 ± 0.54 D, range: 0.87 to 3.48 vs 1.51 ± 0.59 D, range: 0.56 to 3.27 D,
P
= .038, respectively). This modification led to a change in IOL cylinder calculation in 43.8% of cases and to a change in implantation axis greater than 10° in 17.7% of cases. These changes were significantly greater in patients with a breakup time (BUT) less than 5 seconds (57.5% and 27.8%, with
P
= .009 and .029, respectively). In the subgroup of patients with a BUT of less than 5 seconds, the mean absolute error in predicted astigmatism was significantly lower after artificial tears instillation (0.48 ± 0.50 D, range: 0.00 to 2.79 vs 0.37 ± 0.25 D, range: 0.00 to 1.10 D,
P
= .048).
CONCLUSIONS:
Dry eye significantly impacted toric IOL calculations and should be taken into account during the preoperative assessments. Using artificial tears reduced the number of refractive errors.
[
J Refract Surg
. 2021;37(11):759–766.]
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