Showing papers in "European Journal of Ophthalmology in 2014"
TL;DR: The AT LISA trifocal IOL provides excellent uncorrected distance, intermediate, and near visual outcomes and Difficulties associated with photic phenomena decreased significantly over time.
Abstract: PurposeTo evaluate visual and refractive outcomes, contrast sensitivity, and quality of vision after cataract surgery with the implantation of a new modality of trifocal intraocular lens (IOL).Meth...
91 citations
TL;DR: The study shows that roughly 50% of the eyes have more than 1 D of astigmatism, which can help hospitals plan and analyze the amount and costs of using toric IOLs in patients with cornealAstigmatism.
Abstract: PurposeTo analyze and quantify the pattern of corneal astigmatism in patients awaiting cataract surgery to provide information for cataract surgeons and intraocular lens (IOL) manufacturers and to ...
66 citations
TL;DR: The literature points to SICS being more useful for intumescent and hard cataracts and is the preferred technique for less-resourced settings, and small-incision cataract surgery is comparable to Phaco in almost all aspects except postoperative astigmatism.
Abstract: PurposeTo compare the safety, efficacy, and cost-effectiveness of manual sutureless small-incision cataract surgery (SICS) and phacoemulsification (Phaco) as treatment options for cataract surgery with focus on intumescent, mature, and hypermature lenses (white cataracts).MethodsA systematic search of research articles was conducted to develop an internal database for the investigators' appraisal. Literature searches were conducted by using key words and MeSH terms including cataracts, phacoemulsification, small-incision cataract incision, visual acuity, costs, training, time, and barriers to cataract surgery. The final synthesis included 42 manuscripts.ResultsAll studies show that both Phaco and SICS are safe and effective techniques to rehabilitate cataract patients, but Phaco is costlier, with its pre-operative and postoperative medicines, anesthetic agents, viscoelastic materials, disposables, instrumentation, and intraocular lens (IOLs), and had a steeper learning curve. Small-incision cataract surge...
60 citations
TL;DR: Repeated injections of Ozurdex are effective and have a favorable safety profile, and in current practice, the retreatment interval with OzurdEx injections might be too long, precluding the full therapeutic potential of this treatment modality.
Abstract: Purpose: To review the current practice of retreatment with Ozurdex injections in patients with macular edema (ME) secondary to retinal vein occlusion (RVO), and to recommend simple guidelines for Ozurdex reinjection in management of RVO. Methods: This was a multicenter retrospective study of patients who received more than 2 Ozurdex injections for the treatment of ME in RVO. Recorded parameters included percent of patients with a 15-letter gain, visual acuity (VA) improvement from baseline, change in central macular thickness (CMT), time to reinjection, and occurrence of any complications. results: A total of 128 patients were included, 58 (45.3%) with central RVO (CRVO) and 70 (54.7%) with branch RVO (BRVO). Mean interval for Ozurdex reinjection was 5.9 months following the first injection and 8.7 months following the second. A >15-letter gain in VA was observed in 34 (48.8%) patients with CRVO and 16 (28%) patients with BRVO. Mean overall VA improvement at month 6 did not show significance (p>0.05); however, a significantly better mean VA improvement was seen in treatment-naive eyes (p<0.03). The CMT was significantly reduced compared to baseline. The mean CMT decreased by 214.6 µm in eyes with BRVO (n = 53) and by 355.1 µm in eyes with CRVO (n = 63) (p = 0.002). Complication rates were very low. conclusions: Repeated injections of Ozurdex are effective and have a favorable safety profile. In current practice, the retreatment interval with Ozurdex injections might be too long, precluding the full therapeutic potential of this treatment modality. A strategy for managing RVO patients treated with Ozurdex on an as-needed basis is provided.
56 citations
TL;DR: After inadvertent injection of Ozurdex® into the crystalline lens, cataract surgery with removal of the implant should be performed as soon as possible in order to avoid IOP increase and so that the underlying condition may be treated adequately.
Abstract: PurposeTo describe the side effects and management after inadvertent injection of a dexamethasone implant (Ozurdex®) into the crystalline lens.MethodsTwo case reports.ResultsTwo patients with macular edema due to unilateral retinal vein occlusion were scheduled for an intravitreal injection of Ozurdex®. During the procedure, the implant was accidentally injected into the crystalline lens. Both patients developed cataracts during the course of several weeks and in both there was an intraocular pressure (IOP) increase, which required treatment with topical hypotensives. Macular edema improved only slightly. Cataract surgery with uneventful removal of the implant was performed 3 (case 1) and 6 months (case 2) after the injection.ConclusionsAfter inadvertent injection of Ozurdex® into the crystalline lens, cataract surgery with removal of the implant should be performed as soon as possible in order to avoid IOP increase and so that the underlying condition may be treated adequately.
46 citations
TL;DR: The present results may contribute to help surgeons decide on the type of IOL most suitable for each patient by taking into consideration the individual needs for critical distance and near vision, both in terms of visual acuity and contrast sensitivity.
Abstract: PurposeA prospective, randomized, double-masked, clinical trial was designed to evaluate distance and near contrast sensitivity (CS) in patients symmetrically, and randomly, implanted with 4 different multifocal intraocular lens (MIOL) designs (ReSTOR SN6AD1, ReSTOR SN60D3, ReZoom NXG, and Tecnis ZMA00) and a monofocal control group (Tecnis ZA9003), 6 months after cataract intervention.MethodsPhotopic, mesopic, and mesopic with glare distance CS, as well as photopic near CS, was evaluated with the CSV-1000 CS test and the Vistech VCTS 6000 system, respectively, in a group of 180 patients attending the ophthalmology department of Sant Pau Hospital, Barcelona, for cataract intervention and lens implantation.ResultsStatistically and clinically significant differences were found between the monofocal and multifocal lens groups at all spatial frequencies and illumination conditions, both during distance and near CS evaluation (all p<0.05), with the monofocal lens offering the best performance in all cases. Con...
43 citations
TL;DR: Treatment of TTO was found to be associated with preventing recurrence of chalazion associated with Demodex infestation, and the possibility of demodicidosis should be considered in adults presenting with recurrent Chalazia.
Abstract: Purpose:To report Demodex infestation in adult recurrent chalazion and its clinical response to weekly lid scrub with 50% tea tree oil (TTO) and daily lid scrub with tea tree shampoo.Methods:This i...
40 citations
TL;DR: Choroidal thickness measurements obtained by EDI-OCT showed good repeatability for healthy Turkish subjects; EDI -OCT examinations of choroid are reliable in healthy eyes.
Abstract: Purpose:To assess intraobserver and interobserver reproducibility of the measurement of choroidal thickness by using enhanced depth imaging optical coherence tomography (EDI-OCT)Methods:A prospect
39 citations
TL;DR: The combination of HA and TS-polysaccharide appears to be effective in improving the symptoms of dry eye, opening new scenarios in possible treatment of the disease by combining different molecules.
Abstract: Purpose:Synergistic interactions between hyaluronic acid (HA) and tamarind seed polysaccharide (TS-polysaccharide) have been demonstrated by means of nuclear magnetic resonance spectroscopy. This s...
37 citations
TL;DR: At 4-6 months following the first injection, 4 monthly injections of IVB in eyes with macular edema after plaque radiotherapy of uveal melanoma decreased macularEdema in 56% and improved BCVA in 42% of the treated eyes.
Abstract: Purpose:To examine the efficacy of monthly injections of intravitreal bevacizumab (IVB) for macular edema after iodine-125 plaque radiotherapy of uveal melanoma.Methods:We studied 36 patients with ...
37 citations
TL;DR: Axial length changes rapidly in the first 18 months of life, and the normal data found here at different ages may assist in interpreting perioperative measurements in patients with unilateral congenital cataracts.
Abstract: PurposeA key issue in managing children with cataract is to determine whether the eye is of normal axial length for the age of the child. This is important in both prognostication and selection of ...
TL;DR: The results provide strong evidence of the utility of cefuroxime as prophylaxis of endophthalmitis after cataract surgery after the introduction of the ESCRS protocol in 2007.
Abstract: PurposeTo present the results of a retrospective comparative unicentric institutional study of the incidence of postcataract surgery endophthalmitis before and after the introduction of the Europea...
TL;DR: All 3 types of IOLs allowed greater distance visual acuity; however, multifocal I OLs produced better DCIVA and DCNVA and more pseudoaccommodation and spectacle independence and neither accommodative nor multifocalIOLs reduced CSVA.
Abstract: PurposeTo compare the performance of accommodative, multifocal, and monofocal intraocular lenses (IOLs).MethodsIn this clinical control study, 3 types of IOL were implanted in 128 eyes of 86 patien...
TL;DR: Bow and arrow injury caused the maximum cases of traumatic cataracts; cataract extraction resulted in significant visual improvement; and CGI tended to have better prognosis in pediatric traumatic catARacts.
Abstract: PURPOSE: To study epidemiology and intermediate-term outcomes of open- and closed-globe injuries (CGI) in traumatic childhood cataract.METHODS: In this retrospective interventional case series, demographic parameters and history including type of injury of 57 children younger than 16 years with traumatic cataract were recorded; ocular examination included best-corrected visual acuity (BCVA), slit-lamp biomicroscopy, and posterior segment evaluation. Patients underwent cataract surgery with or without intraocular lens (IOL) implantation. Main surgical outcomes at 6 months comprised BCVA, residual refractive spherical error (SE), and postoperative complications, namely visual axis opacification (VAO) and amblyopia.RESULTS: Bow and arrow was the most common causal agent. Open-globe injury (OGI) was 3 times more frequent than CGI. There was a significant visual gain from baseline in both groups after cataract surgery (pCONCLUSIONS: Bow and arrow injury caused the maximum cases of traumatic cataract; cataract extraction resulted in significant visual improvement; and CGI tended to have better prognosis in pediatric traumatic cataracts. Language: en
TL;DR: Although the disease in patients with treated PD was more severe than in the untreated group, no significant difference in the thickness of retina was found between the 2 groups and it was thought that levodopa might have a protective effect on retina in Patients with PD.
Abstract: PurposeTo evaluate the effects of levodopa on retina, we assessed retina with optical coherence tomography (OCT) in Parkinson disease (PD).MethodsThirty-five patients with PD (17 with levodopa mono...
TL;DR: Hormonal changes during pregnancy may not affect corneal biomechanics, which may be due to the balanced effect of the various hormones on the cornea during pregnancy.
Abstract: PurposeTo evaluate the variation in biomechanical properties and central corneal thickness (CCT) for each trimester during pregnancy and to compare the values with those in nonpregnant women.Method...
TL;DR: This study suggests a role of TSDLC as an effective, safe, and rapid method of treatment in patients with good vision over a 24-month period, and the loss of VA in some patients is similar to previously reported studies in patients having cyclodiode, trabeculectomy, or tube surgery.
Abstract: PURPOSE To study the effect on central vision of transscleral diode laser cyclophotocoagulation (TSDLC) for the reduction of intraocular pressure (IOP) in patients with visual acuity (VA) better than 6/18. METHODS Retrospective chart review was conducted of patients undergoing cyclophotocoagulation between 2000 and 2008. Patients who underwent TSDLC with VA of 6/18 or better and at least 24 months follow-up were included. Primary outcome was decrease of 2 or more lines at 24 months. Secondary outcome was IOP control with or without treatment. RESULTS A total of 46 eyes of 44 patients were included with VA ranging from 6/18 to 6/5 (median VA 6/12). Mean IOP was 24 mm Hg (range 12-35). A mean of 1.3 treatments were given per eye, with 12 eyes (26%) requiring retreatment. At 24 months, the median VA was 6/18 (range light perception-6/5). Eighteen eyes (39.1%) retained the same VA, 35 eyes (76.1%) retained VA of 6/18 or better, in 7 eyes (19.4%) VA was <6/60. Loss of ≥2 lines was recorded in 11 eyes (23.9%), and loss of 1 line in 13 eyes (28.3%). Mean IOP at 24 months was 17.2 mm Hg (range 12-28). Thirty-nine (84.8%) patients had IOP ≤21 mm Hg. CONCLUSIONS This study suggests a role of TSDLC as an effective, safe, and rapid method of treatment in patients with good vision over a 24-month period. The loss of VA in some patients is similar to previously reported studies in patients having cyclodiode, trabeculectomy, or tube surgery.
TL;DR: The adjunctive use of riboflavin/UVA photochemical therapy has a positive effect on refractory infectious keratitis and should be considered as part of the first-line therapy in severe cases of infectious ker atitis.
Abstract: Purpose To describe the antibacterial activity of treatment with riboflavin and ultraviolet A light (UVA) in cases of severe infectious keratitis. Methods A retrospective analysis was performed of an interventional case series in which 6 eyes of 6 patients with severe infectious keratitis, all of whom were refractive to multidrug conventional therapy, were treated with riboflavin/UVA. The procedure was conducted according to the standardized protocol of corneal collagen crosslinking (CXL) for keratoconus. Best spectacle-corrected visual acuity and clinical outcomes were evaluated before and during the follow-up period. Results Five of the 6 patients showed rapid reduction in symptoms and decreased infiltrate size after riboflavin/UVA photochemical therapy. Signs of infection and inflammation mostly resolved within 1 to 2 weeks after the treatment. Despite this therapy, one patient continued to deteriorate, and penetrating keratoplasty was performed. Conclusions The adjunctive use of riboflavin/UVA photochemical therapy has a positive effect on refractory infectious keratitis. The treatment seems to be safe and effective and should be considered as part of the first-line therapy in severe cases of infectious keratitis.
TL;DR: In infantile esotropia, the left cingulate gyrus, bilateral precuneus, and left angular gyrus visual cortex may compensate for the fusion dysfunction, and these insights may help improve the diagnosis and treatment of strabismus.
Abstract: PurposeFunctional magnetic resonance imaging (fMRI) is popular in the field of neuroimaging. The aim of this study was to explore the neural basis of infantile esotropia and locate the cortical reg...
TL;DR: The early increase of NGF in diabetic retina might be an endogenous response for protecting RGCs from degeneration, and this protective mechanism is impaired at 11 weeks following diabetes induction, and results in a marked RGC degeneration that is improved by exogenous NGF administration and worsened by anti-NGF.
Abstract: Purpose:To investigate if the survival effects of nerve growth factor (NGF) eyedrops on retinal ganglion cell (RGCs) are related to vascular endothelial growth factor (VEGF) in a rat model of diabe...
TL;DR: A 78-year-old man treated for persistence of cystoid macular edema with Ozurdex intravitreal implant is presented in which the procedure was complicated by the injection of the dexamethasone implant into the lens body.
Abstract: PURPOSE Dexamethasone intravitreal implant is an approved preparation in the treatment of macular edema. The most common adverse reactions are increased intraocular pressure and cataract but the inadvertent injection of the dexamethasone implant into the capsular bag is an extremely rare event. METHODS We present a case of a 78-year-old man treated for persistence of cystoid macular edema (CME) with Ozurdex intravitreal implant in which the procedure was complicated by the injection of the dexamethasone implant into the lens body and discuss the management. RESULTS The patient underwent phacoemulsification of the lens, replacement of the Ozurdex, and implant of a 3-piece lens in the posterior chamber. CONCLUSIONS The injection of an intravitreal dexamethasone implant (Ozurdex) into the lens body is an extremely rare complication that can be effectively and successfully managed with the surgical extraction of the implant from the lens body and implant of a 3-piece intraocular lens in the sulcus.
TL;DR: Elevated fasting HCY levels, low vitamin B12 levels, and hypertension are associated with a risk of RVO, especially for CRVO, while the data suggest that only hypertension is associated with BRVO risk.
Abstract: PurposeTo evaluate total plasma homocysteine (HCY) during fasting and post methionine load test (MLT), serum folate, serum vitamin B12, and methylenetetrahydrofolate reductase (MTHFR) mutation in p...
TL;DR: The different behavior of inflamed tissue with respect to UVA irradiance could be the main point to understand the different postoperative outcome of CXL procedures in patients infected by a severe fungal corneal infection.
Abstract: PurposeAnterior segment optical coherence tomography (OCT) is a relevant diagnostic tool in the evaluation of corneal changes following corneal crosslinking (CXL) treatment in patients infected by ...
TL;DR: Toric ICL implantation after sequential ICRS implantation and CXL is an effective and safe option for correcting high residual refractive error and improving visual acuity in patients with moderate to severe keratoconus.
Abstract: PURPOSE To evaluate the safety and clinical outcome of Visian toric implantable collamer lens (TICL) implantation for the treatment of residual refractive errors 6 months after sequential intracorneal ring segments (ICRS) and corneal collagen UVA crosslinking (CXL) in stable keratoconus. METHODS This retrospective study examined the results of a 3-step ICRS-CXL-TICL in 11 eyes of 7 patients with moderate to severe keratoconus. The 2 procedures (ICRS-CXL) were performed sequentially at an interval of 4 weeks and TICL implantation was performed at least 6 months after CXL. Data were collected preoperatively, at the 6-month follow-up visit after sequential ICRS-CXL, and at the 6-month follow-up visit after TICL implantation. RESULTS The ICRS-CXL induced a significant decrease in keratometry, increase in visual acuity, and decrease in refraction. At 6-month follow-up after ICRS-CXL, mean Kflat was 45.19 ± 3.98 D vs 48.51 ± 4.26 D preoperatively (p = 0.022) and mean Ksteep was 50.41 ± 4.32 D vs 54.24 ± 4.96 D preoperatively (p = 0.032). Uncorrected distance visual acuity (UCVA) significantly improved from 1.47 ± 0.38 logMAR before ICRS-CXL to 0.27 ± 0.20 logMAR 6 months after (p = 0.002). Corrected distance visual acuity (CDVA) significantly improved from 0.50 ± 0.22 logMAR to 0.29 ± 0.23 logMAR (p = 0.001). At 6 months post TICL implantation, UCVA improved significantly to 0.27 ± 0.20 logMAR and the CDVA was 0.19 ± 0.11 logMAR. No intraoperative or postoperative complications occurred. CONCLUSIONS Toric ICL implantation after sequential ICRS implantation and CXL is an effective and safe option for correcting high residual refractive error and improving visual acuity in patients with moderate to severe keratoconus.
TL;DR: A good success rate with air tamponade and limited laser allows for quicker VA recovery associated with a rapid disappearance of air, and may benefit patients who live at higher altitudes.
Abstract: Purpose To determine whether air can be used as a reliable tamponade agent after pars plana vitrectomy in selected primary retinal detachment (RD). Methods Twelve eyes with fresh RD were included. Exclusion criteria were presence of fibrosis, fixed folds, proliferative vitreoretinopathy of grade C or greater, and giant retinal tears. The number, location, and types of breaks, extension of RD, and whether the macula was attached were documented. A 25-gauge 3-port pars plana vitrectomy was carried out. Central and peripheral vitreous was removed to eliminate traction and relieve tractional forces provoked by the air bubble injected at the end. Argon endolaser or cryotherapy was applied around all breaks. Filtered air was used as an internal tamponade. Patients were followed up at 24 hours, 1 week, and 1, 3, 6, and 12 months. Results Air bubble took 10.7 days (range 7-15 days) to resolve. Visual acuity (VA) improved from 1.35 ± 1.21 logMAR preoperatively to 0.20 ± 0.25 after a follow-up time of 12 months. We achieved a primary postoperative success rate of 100% at 1 month and 91.6% at 12 months. Conclusions We achieved a good success rate with air tamponade and limited laser. This approach allows for quicker VA recovery associated with a rapid disappearance of air. This may benefit patients who live at higher altitudes.
TL;DR: Both 23-G and 25-G MIVS have comparable visual and anatomic results for diabetic TRD; however,25-G surgery may be associated with less postoperative pain and discomfort than 23-Gs, and both groups showed a significant improvement in vision after surgery.
Abstract: PurposeTo compare the efficacy, outcomes, and complications of 23-G and 25-G microincision vitrectomy surgery (MIVS) in cases of diabetic tractional retinal detachment (TRD).MethodsThis is a prospe...
TL;DR: Treatment and follow-up regimens in real-world settings seem to have a major role in determining outcome, and lower age and BCVA at baseline were associated with better response to treatment.
Abstract: PurposeTo verify the safety and efficacy of ranibizumab in neovascular age-related macular degeneration (nAMD) and factors influencing the outcome in a real-world setting.MethodsRetrospective 12-mo...
TL;DR: Intravitreal injection of both ranibizumab and bevacIZumab provided a significant decrease in CRT; however, the agents caused no significant change in choroidal thickness.
Abstract: Purpose: To evaluate and compare the effects of single intravitreal injection of ranibizumab and bevacizumab on central retinal and choroidal thickness in patients with neovascular age-related macular degeneration (AMD). Methods: Forty eyes of 40 patients with neovascular AMD that underwent intravitreal injection of vascular endothelial growth factor inhibitors (anti-VEGFs) were included. Patients were randomized into 2 groups: 20 eyes received ranibizumab and 20 eyes received bevacizumab injection. Central retinal and choroidal thicknesses of all eyes at baseline and 1 month postinjection scans were measured with Fourier-domain optical coherence tomography (OCT). Student t test and Mann-Whitney U test were used to compare the data. Results: The mean central retinal thickness (CRT) showed significant decrease after single injection of ranibizumab (from 345.0 µm to 253.5 µm, p<0.01) and bevacizumab (from 329.5 µm to 251.0 µm, p<0.01) at the first month, respectively. There was no significant difference regarding the CRT change between groups (p = 0.39). The mean choroidal thickness decreased from 158.6 µm (115-317) to 155.5 µm (111-322) in the ranibizumab group and from 211.5 µm (143-284) to 201.5 µm (93-338) in bevacizumab group. The decrease was not significant between groups (p = 0.35). Conclusions: Intravitreal injection of both ranibizumab and bevacizumab provided a significant decrease in CRT; however, the agents caused no significant change in choroidal thickness. Additionally, no difference between ranibizumab versus bevacizumab was observed related to macular edema inhibition.
TL;DR: Evidence is provided that the success rate at 24 months is higher in patients treated with the JRP + LTS procedure compared with JRP alone, and there is some disagreement as to which approach is the best surgical intervention.
Abstract: Purpose:Involutional entropion is a common lower lid malposition. Addressing both the horizontal and the vertical lower eyelid laxity in patients with involutional entropion seems to have a more lo...
TL;DR: In PEX syndrome, there is choroidal thinning subfoveal, temporal, and nasal to the fovea on EDI-OCT.
Abstract: Purpose To measure choroidal thickness in patients with pseudoexfoliation (PEX) syndrome and to compare the values with control eyes using enhanced depth imaging optical coherence tomography (EDI-OCT). Methods Thirty-four patients with PEX syndrome and 30 age- and sex-matched healthy subjects were included in this study. Only one eye of each of the patients was included. Choroidal thickness was measured manually from the outer border of the retinal pigment epithelium to the inner scleral border at the subfovea, 3 mm temporal to the fovea, and 3 mm nasal to the fovea using EDI-OCT. Results A total of 34 eyes from 34 consecutive patients with PEX syndrome (19 women and 15 men; mean age 75.3 ± 6.6 years) were included in the analysis. The mean subfoveal, temporal, and nasal choroidal thickness was significantly thinner in the PEX syndrome group compared with the control group (pl0.05, at all points). The mean choroidal thickness in the PEX syndrome group was as follows: 259 ± 33 µm, 211 ± 29 µm, and 106 ± 24 µm, subfoveal, temporal, and nasal to the fovea, respectively. In comparison, the mean choroidal thickness in the control group was 274 ± 23 µm, 225 ± 17 µm, and 117 ± 17 µm, at the subfovea, 3 mm temporal to the fovea, and nasal to the fovea, respectively. Conclusions In PEX syndrome, there is choroidal thinning subfoveal, temporal, and nasal to the fovea on EDI-OCT. Decreased choroidal thickness, probably due to increased vascular resistance, and reduced blood flow, is seen in PEX syndrome.