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Using a dosage of approximately 20 mg of intravitreal TA, visual acuity temporarily increases for 6 months after injection.

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This review was conducted to compare the physical effect of aspheric IOL implantation on wavefront properties with that of spherical IOL implantation. The peer-reviewed literature was systematically searched in Medline, Embase, Web of Science, Biosis, and the Cochrane Library according to the Cochrane Collaboration method. Inclusion criteria were randomized controlled trials comparing the use of aspheric versus spherical monofocal IOL implantation that assessed visual acuity, contrast sensitivity, or quality of vision. A secondary outcome was ocular wavefront analysis; spherical aberration, higher-order aberrations (HOAs), coma, and trefoil were evaluated. Effects were calculated as standardized mean differences (Hedges g) and were pooled using random-effect models. Thirty-four of 43 studies provided data for wavefront analysis. Aspheric monofocal IOL implantation resulted in less ocular spherical aberration and fewer ocular HOAs than spherical IOLs. This might explain the better contrast sensitivity in patients with aspheric IOLs.

<h4>PURPOSE</h4><p>To compare adhesion strength of flaps created with a mechanical microkeratome and the IntraLase femtosecond laser as well as to analyze the effect of different side-cut configurations.</p> <h4>METHODS</h4><p>A flap was created in four groups of New Zealand white rabbits—microkeratome group (Amadeus II microkeratome, Ziemer Group AG [5 eyes; 9-mm suction ring and 140-µm head]), and three IntraLase groups (IntraLase iFS 150 kHz femtosecond laser, AMO Inc [9-mm diameter and 120-µm flap each]): normal energy side-cut (4 eyes; side-cut angle 70°, side-cut energy 0.8 µJ); high energy side-cut (4 eyes; side-cut angle 70°, side-cut energy 1.6 µJ); and inverted side-cut (4 eyes; side-cut angle 140°, side-cut energy 0.8 µJ). Flap adhesion strength was measured 75 days after surgery using a tension meter to dehisce the flaps.</p> <h4>RESULTS</h4><p>In the microkeratome group, mean force was 210±89 <i>g</i> (range: 151 to 360 <i>g</i>); 492±46 <i>g</i> (range: 439 to 540 <i>g</i>) in the normal energy side-cut group; 444±13 <i>g</i> (range: 426 to 455 <i>g</i>) in the high energy side-cut group; and 687±105 <i>g</i> (range: 552 to 797 <i>g</i>) in the inverted side-cut group. Differences between the microkeratome and all IntraLase groups were highly significant (<i>P</i>=.001), and differences between the inverted side-cut group and the standard 70° side-cut groups were statistically significant (<i>P</i>=.01).</p> <h4>CONCLUSIONS</h4><p>Flap adhesion is significantly stronger with the IntraLase femtosecond laser than with the Amadeus mechanical microkeratome, and an inverted side-cut increases flap adhesion significantly compared with a standard side-cut. [<cite>J Refract Surg.</cite> 2008;24:875-878.]</p> <h4>AUTHORS</h4> <p>From FreeVis LASIK Zentrum (Knorz) and the Department of Ophthalmology (Vossmerbaeumer), Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany.</p> <p>Dr Knorz is a consultant to AMO, Irvine, Calif. Dr Vossmerbaeumer has no proprietary interest in the materials presented herein.</p> <p>This study was supported by an unrestricted educational grant from AMO Inc, Irvine, Calif.</p> <p>The authors thank Drs Melvin Sarayba and Tes Ignacio for their support during the rabbit surgery.</p> <p>Correspondence: Michael C. Knorz, MD, FreeVis LASIK Zentrum, Theodor Kutzer Ufer 1-3, 68167 Mannheim, Germany. Tel: 49 160 53 88 080; Fax:49 621 383 1984; E-mail: <a href="mailto:knorz@eyes.de">knorz@eyes.de</a></p> <p>Received: February 26, 2008</p> <p>Accepted: July 8, 2008</p> <p><b>Posted online: August 29, 2008</b></p>

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Background: Intravitreal triamcinolone acetonide has been discussed as treatment for exudative age-related macular degeneration (AMD). Objectives: To give an updated report on repeated intravitreal injections of triamcinolone acetonide (IVTA) for the treatment of exudative AMD. Methods: The case-series study included 24 patients (24 eyes) with progressive exudative AMD who had shown an increase in, or stabilization of, visual acuity after a first IVTA, and who eventually experienced a deterioration of visual acuity. The 24 (6.5%) eyes were selected out of a total group of 369 eyes who had received IVTA for exudative AMD within the last 5 years. All patients of the study received a second IVTA (approximately 20 mg) 3.7–38.5 months after the first injection. Main outcome measure was visual acuity. Results: After the first injection, best corrected visual acuity improved significantly (p = 0.001) from 0.75 ± 0.34 logMAR to a minimum of 0.58 ± 0.30 logMAR during follow-up, with 10 (42%) eyes improving in visual acuity by two or more Snellen lines. Towards the end of follow-up after the first injection, best corrected visual acuity decreased significantly (p = 0.03) compared with the baseline value. After the second injection, visual acuity did not change markedly from baseline to a mean maximal visual acuity during follow-up. Comparing the last postoperative examination at the end of the follow-up after the second IVTA with the preoperative examination, a significantly (p = 0.001) higher number of eyes lost in visual acuity [19 (79%) eyes] than gained in visual acuity [3 (12%) eyes]. Conclusions: In selected eyes with an increase in visual acuity after a first IVTA (20 mg), repeated IVTA temporarily stabilizes visual acuity with a drop in visual acuity towards the end of follow-up.

BackgroundPrimary congenital glaucoma (PCG) and early onset glaucomas are one of the major causes of children and young adult blindness worldwide. Both autosomal recessive and dominant inheritance have been described with involvement of several genes including CYP1B1, FOXC1, PITX2, MYOC and PAX6. However, mutations in these genes explain only a small fraction of cases suggesting the presence of further candidate genes.MethodsTo elucidate further genetic causes of these conditions whole exome sequencing (WES) was performed in an Italian patient, diagnosed with PCG and retinal detachment, and his unaffected parents. Sanger sequencing of the complete coding region of COL1A1 was performed in a total of 26 further patients diagnosed with PCG or early onset glaucoma. Exclusion of pathogenic variations in known glaucoma genes as CYP1B1, MYOC, FOXC1, PITX2 and PAX6 was additionally done per Sanger sequencing and Multiple Ligation-dependent Probe Amplification (MLPA) analysis.ResultsIn the patient diagnosed with PCG and retinal detachment, analysis of WES data identified compound heterozygous variants in COL1A1 (p.Met264Leu; p.Ala1083Thr). Targeted COL1A1 screening of 26 additional patients detected three further heterozygous variants (p.Arg253*, p.Gly767Ser and p.Gly154Val) in three distinct subjects: two of them diagnosed with early onset glaucoma and mild form of osteogenesis imperfecta (OI), one patient with a diagnosis of PCG at age 4 years. All five variants affected evolutionary, highly conserved amino acids indicating important functional restrictions. Molecular modeling predicted that the heterozygous variants are dominant in effect and affect protein stability and thus the amount of available protein, while the compound heterozygous variants act as recessive alleles and impair binding affinity to two main COL1A1 binding proteins: Hsp47 and fibronectin.ConclusionsDominant inherited mutations in COL1A1 are known causes of connective tissues disorders such as OI. These disorders are also associated with different ocular abnormalities, although recognition of the common pathology for both features is seldom being recognized. Our results expand the role of COL1A1 mutations in different forms of early-onset glaucoma with and without signs of OI. Thus, we suggest including COL1A1 mutation screening in the genetic work-up of glaucoma cases and detailed ophthalmic examinations with fundus analysis in patients with OI.Electronic supplementary materialThe online version of this article (doi:10.1186/s13023-016-0495-y) contains supplementary material, which is available to authorized users.