The purpose of this study was to evaluate the effectiveness of intravitreal ranibizumab (Lucentis, Genentech, South San Francisco, Calif, USA) combined with cataract surgery for the prevention of clinically significant macular edema (CSME) in patients with diabetic retinopathy (DR). This prospective interventional case series included fifty-four eyes of 54 patients with a previous diagnosis of nonproliferative diabetic retinopathy (NPDR) without macular edema preoperatively. Subjects were assigned in a 1 : 1 ratio to receive an intraoperative intravitreal ranibizumab injection (n = 27) or not (control group, n = 27) associated with standardised phacoemulsification surgery. The main outcome measure was the incidence of CSME one and three months after surgery. One month after surgery the incidence of CSME in the control group was 25.92% and 3.70% in the treatment group and at three months was 22.22% and 3.70%, respectively. Short-term results suggest that intravitreal ranibizumab immediately after phacoemulsification prevents CS ME in patients with NPDR.
Purpose:To evaluate the efficacy and safety of the pars plana clip (PPC) in the Ahmed valve tube inserted via the pars plana in patients with secondary refractory glaucomas.Methods:Prospective and interventional case series that included 10 patients with secondary refractory glaucoma. The pars plana vitrectomy and the implant of the modified tube were performed during the same surgery. Control of intraocular pressure (IOP) and the development of intra- and postoperative complications were evaluated during the follow-up.Results:Follow-up time was twelve months in all the patients. Control of IOP was achieved in 90% of patients, and 70% needed no antiglaucoma treatment. The complications that occurred were transient hypotony in three cases, choroidal detachment in two cases, and one case of intraocular hemorrhage. No case of tube extrusion or tube kink was observed.Conclusions:Our data suggests that implantation of the Ahmed tube modified with the PPC via the pars plana is safe and effective in patients with secondary refractory glaucomas.
A 39-year-old man presented to the ophthalmology emergency room complaining of decreased visual acuity and metamorphopsia on his left eye after undergoing Nd:YAG facial hair epilation without wearing proper eye protection. Fluorescein angiography showed a foveal staining initially, with an increase in foveal leakage over late phases. On optical coherence tomography, a subfoveal retinal pigment epithelial detachment with associated subretinal fluid and no signs of choroidal neovascularization or cystoid macular edema was observed. Observation with monthly follow-ups was adopted. By the fourth month, the subretinal fluid had already disappeared and visual acuity had returned to 20/20. Over one-year follow-up, the retinal pigment epithelial detachment experienced a decrease in its size. Conservative management may be a valid option in assessing accidental foveal photocoagulation when choroidal neovascularization or cystoid macular edema is absent. The use of wavelength specific goggles is mandatory for the patient and the aesthetician operating the cosmetic laser, especially when operating on the face or around the eyes.
RESUMENObjetivo: Determinar si la inyección intravítrea de plasmina es efectiva en el tratamiento del edema macular diabético difuso (EMDD). Diseño: Estudio piloto prospectivo, comparativo, de intervención, serie de casos. Pacientes: Dieciocho pacientes con edema macular diabético bilateral, recibieron como primera actuación terapéutica una inyección intravítrea de plasmina en un ojo, sirviendo el ojo contralateral como control. Tratamiento: Inyección intravítrea de 0,2 ml de plasmina autóloga bajo anestesia tópica. La plasmina fue obtenida por un metodo simplificado. Principales medidas: Engrosamiento macular central (EMC) medido por tomografía de coherencia óptica (OCT) y agudeza visual (escala LogMAR), al mes y los 3 meses. ABSTRACTPurpose: To determine whether intravitreal injection of plasmin is effective in treating diffuse diabetic macular edema (DDME). Design: A prospective, comparative, interventional case study. Patients: Eighteen patients with bilateral DDME received, as their primary therapeutic treatment, an intravitreal injection of plasmin in one eye, with their contralateral untreated eye serving as a control. Intervention: Intravitreal 0.2 ml of autologous plasmin injected under topical anesthesia. The plasmin was obtained by a simplified method. Main Outcome Measures: Central macular thickness (CMT), determined by optical coherence tomography (OCT), and Best Corrected Visual Acuity (LogMAR), assessed at one and three months of follow-up. Results: All patients completed the 3-month follow-up assessments. Before the injection, the CMT was 525.22 SD 80.12 µm [mean ± standard deviation (SD)] in the eyes to be injected, compared to 525.44 SD 78.13 µm in the control eyes. One
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