Significantly lower ACD values were found in the hyperopia group than in the other 2 groups. There was no difference in ACD between the emmetropia and myopia groups even though the AL in the myopia group was 4.0 mm longer. No statistical difference in ACD measurements was found between the Orbscan II and IOLMaster.
The repeated Orbscan II measurements showed SD in the micrometer range for anterior elevation and pachymetry but values between 0.48 D and 0.97 D for keratometric data. Patients with astigmatism and especially hyperopia showed significantly higher SD values in peripheral zones for anterior elevation and keratometry, indicating a lower reliability, compared with the emmetropic cohort. However, the different ages of the patients could also be a possible explanation for these findings. Therefore, the Orbscan II seems to be a predictable and useful device for measuring corneal topography.
.
Purpose: Characterization of persistent diffuse subretinal fluid using optical coherence tomography (OCT) after successful encircling buckle surgery for inferior macula‐off retinal detachment in young patients.
Methods: Institutional retrospective review of six young patients (mean age 31 ± 6 years; five female, one male) with spontaneous inferior rhegmatogenous macula‐off retinal detachment. All patients were treated with encircling buckle surgery and five out of six underwent additional external drainage of subretinal fluid. Mean follow‐up was 37 ± 25 months (range 17–75 months) and included complete ophthalmic and OCT examination.
Results: At 6 months, 100% of patients showed persistence of subretinal fluid on OCT. Four patients had diffuse fluid accumulation, whereas two patients showed a ‘bleb‐like’ accumulation of fluid. This fluid was present independent of whether or not patients had been treated with external fluid drainage. Subretinal fluid only started to disappear on OCT between 6 and more than 12 months after surgery.
Conclusion: Young patients with inferior macula‐off retinal detachments and a marginally liquefied vitreous may show persisting postoperative subclinical fluid under the macula for longer periods of time than described previously.
The measurement methods presented here are easy to use and provide reliable results. Examiners must have basic knowledge of the computer programs used. Also, these methods depend on good quality of the retroilluminated photographs.
A larger capsulorhexis with less CCC-optic overlapping gave better near visual outcomes. Results indicate that an overlap between 25% and 35%, which correlates with a CCC between 4.5 mm and 5.0 mm, provides the best capsule strength without compromising accommodation with the single-piece 1CU IOL.
Background
To evaluate if a combination therapy with micropulse diode laser (MPL) shows non-inferiority on visual acuity (BCVA) within 12 months in comparison to standard therapy, i.e. intravitreal injection of ranibizumab alone.
Setting
Institutional. Prospective randomized single-center trial
.
Methods
Patients with diabetic macular edema (DME) received three intravitreal injections of 0.5 mg ranibizumab during the upload phase and were then randomised 1:1 to receive either the same dosage of ranibizumab (0.5 mg) injections pro re nata alone (IVOM-Group;
n
= 9), or with two additional treatments with micropulse diode laser (IVOM+Laser-Group;
n
= 10). The primary endpoint was change in BCVA after 12 months. Secondary endpoints were change in central macular thickness and overall number of ranibizumab injections.
Results
BCVA increased significantly in both groups (IVOM: + 5.86,
p
< 0.001; IVOM+Laser: + 9.30; p < 0.001) with corresponding decrease in central macular thickness (IVOM: − 105 μm,
p
< 0.01; IVOM+Laser: − 125 μm; p < 0.01). Patients with additional laser treatment had better visual improvement (group comparison
p
= 0.075) and needed fewer ranibizumab injections (cumulative proportion of injections 9.68 versus 7.46 in IVOM-Group and IVOM+Laser-Group, respectively).
Conclusion
Non-inferiority of combination therapy in comparison to standard therapy alone could be demonstrated. Patients with additional laser therapy needed fewer ranibizumab injections.
Trial registration
Registered 10 February 2014 on ClinicalTrials.gov;
NCT02059772
.
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