Postoperative Visual Outcome Research Articles

One-month Outcomes of Wavefront-guided LASIK for Low to Moderate Myopia With the VISX STAR S4 Laser in 32,569 Eyes

To determine the safety and efficacy of wavefront-guided LASIK for the correction of low to moderate myopia, as performed by surgeons employed by Optical Express, a large corporate provider. Data were extracted from the Optical Express central database on 22,900 patients (42,143 eyes) who underwent primary LASIK to treat low to moderate myopia and/or astigmatism. All treatments used a wavefront-guided ablation profile and had a refractive target of emmetropia. Outcomes were evaluated using 1-month follow-up data, which were available for 32,569 eyes of 17,713 patients (77% follow-up). Complications were tabulated using all available data. The mean manifest spherical equivalent (MSE) was reduced from -2.97 +/- 1.33 diopters (D) (range: -0.37 to -6.00 D) to -0.03 +/- 0.29 D (range: -3.50 to +4.50 D) 1 month after surgery. Ninety-four percent of eyes were within 0.50 D of the intended correction, and the correlation coefficient of the attempted versus achieved MSE was 0.96. Uncorrected visual acuity (UCVA) of 20/20 or better was achieved in 92% of eyes; 99% of eyes achieved UCVA of 20/40 or better. Among patients who had bilateral laser vision correction, 98% achieved 20/20 uncorrected binocular vision. Average best spectacle-corrected visual acuity (BSCVA) improved slightly 1 month after surgery (mean change: +0.01 logMAR). There were 210 (0.67%) eyes that lost 2 or more lines of BSCVA; however, all eyes were 20/40 or better. Intraoperative complications occurred in 25 eyes (0.06%; 1:1686), and postoperative complications occurred in 210 eyes (0.64%; 1:155). The most common complications were dry eye (n=58; 0.18%; 1:562) and mild diffuse lamellar keratitis (grade 1 or 2) (n=58; 0.18%; 1:562). Wavefront-guided LASIK can safely and effectively correct low to moderate myopia, as demonstrated by 1-month postoperative visual outcomes from a large number of patients.

Prevalence of Cataract Surgery and Postoperative Visual Outcome in Greater Beijing: The Beijing Eye Study

To determine the prevalence of cataract surgery and the postoperative visual outcome in the adult Chinese population living in rural and urban regions of Greater Beijing. Population-based study. The Beijing Eye Study 2006 included 3251 subjects (73.3%) (aged 45+ years) of 4439 subjects who participated in the 2001 survey and returned for reexamination. The prevalence of surgical pseudophakia/aphakia was assessed, and postoperative visual acuity and reasons for decreased postoperative vision were examined. Visual impairment was defined by a presenting visual acuity (PVA) <6/18 or a best-corrected visual acuity (BCVA) <6/18. Prevalence of cataract surgery, lens status, and causes of visual impairment. Of the 3215 (98.9% of 3251) subjects for whom data on the lens status were available, 92 (41 male, 133 eyes) had undergone cataract surgery in 1 or both eyes (prevalence rate, 2.86%; 95% confidence interval [CI], 2.28-3.44). In multivariate analysis, this rate was statistically associated with higher age (P<0.001), presence of angle-closure glaucoma (P = 0.02), and higher level of hemorrhagic retinopathy (P<0.001). The prevalence of postoperative visual impairment was 27/133 (20.3%), as defined by a PVA <6/18, and 14/133 or 10.5%, as defined by a BCVA <6/18. Aphakia (odds ratio [OR], 6.71; P = 0.02) and rural residence (OR, 4.05; P = 0.01) were significantly associated with postoperative visual impairment. The most common causes of postoperative visual impairment were uncorrected refractive error followed by hemorrhagic retinopathy and posterior capsule opacification. By comparing 2001 with 2006, the rate of cataract surgery increased, and the rate of postoperative visual impairment decreased significantly (P = 0.049). In the adult population of Greater Beijing, approximately 3% of the population aged 45+ years underwent cataract surgery, the prevalence of which was associated with age, angle-closure glaucoma, and hemorrhagic retinopathy. One of 10 subjects who underwent cataract surgery had a BCVA visual of less than 6/18, and 1 of 5 subjects had a PVA of less than 6/18. Low postoperative visual acuity was associated with rural region, undercorrection of refractive error, and hemorrhagic retinopathy.

Visual and anatomic outcomes of vitreoretinal surgery: results at the Boston VA and a review of the literature.

The veteran population presents unique challenges in the management of vitreoretinal disorders. We compiled the surgical outcomes for the most common visually significant vitreoretinal diagnoses. Those results were then compared to visual and anatomic outcomes established in the literature. Medical records over a three-year time period, from January 2005 through December 2007, were reviewed for 208 persons who underwent vitreoretinal surgery for vitreous hemorrhage, retained lens fragment, rhegmatogenous and tractional retinal detachment, macular hole, and macular pucker at the Jamaica Plain Campus of the Veterans Affairs Boston Healthcare System in Boston, MA. A comprehensive search of the literature was conducted on Medline. Data from several large case series and meta-analyses were compared to results obtained at the VA Boston. A total of 208 veterans underwent vitreoretinal surgery from January 2005 to December 2007. After excluding those with rare diagnoses and lack of adequate follow-up data, the outcomes of 181 vitreoretinal procedures were included in this study. Overall, veterans at a regional referral center in Boston demonstrate postoperative visual and anatomic outcomes comparable to outcomes reported in the ophthalmic literature.

Vitrectomía pars plana, facoemulsificación e implante de lente intraocular para el manejo de catarata y retinopatía diabética proliferativa: comparación de técnica quirúrgica combinada versus en dos tiempos

To report the intra-and postoperative complications and visual acuity outcomes in pars plana vitrectomy (PPV), phacoemulsification and intraocular lens (IOL) implantation in patients with cataract and proliferative diabetic retinopathy (PDR). A comparison of the combined versus two-step surgical approach is given. Retrospective uncontrolled interventional clinical trial. Forty-eight eyes of 48 consecutive patients with PDR were included. Twenty-eight (58.3%) eyes with combined surgery and 20 (41.7%) eyes with sequential surgery were analyzed. Postoperative follow-up time was between 6 and 63 months (mean: 18 months). 1) Combined surgery: Preoperative best-corrected visual acuity (BCVA) ranged from 20/200 to hand motions, and postoperative BCVA ranged from 20/30 to hand motions. BCVA improved in 17 eyes (60.7%), while in 7 (25%) eyes there was no change (> or =2 ETDRS lines) in VA, and in 4 (14.3%) eyes BCVA decreased. Postoperative complications included vitreous hemorrhage (VH) in 10 (35.7%) eyes, and fibrinous exudation in 9 (32.1%) eyes. 2) Two-step surgery: Preoperative BCVA ranged from 10/200 to light perception, and from 20/40 to light perception in the postoperative period. Best-corrected visual acuity improved in 15 (75%) eyes, remained the same in 4 (20%) eyes, and decreased in 1 (5%) eye. Postoperative complications included fibrinous exudation in 6 (30%) eyes, and VH in 3 (15%) eyes. Combined PPV, phacoemulsification and IOL implantation as well as the two-step procedure are safe and effective for the management of cataract in PDR. Sequential surgery could be advantageous to BCVA outcomes by minimizing postoperative VH, which is significantly more frequent after combined surgery.

Surgical outcomes of transconjunctival sutureless 23-gauge vitrectomy with silicone oil injection

AimsTo evaluate the outcomes and complications of 23-gauge transconjunctival sutureless vitrectomy (TSV) with Silicone oil (SO) tamponade in complex vitreoretinal diseases.Settings and DesignEge university hospital ophthalmology department. Retrospective case series.Materials and MethodsForty eyes of 40 patients with diabetic tractional retinal detachment (DTRD) and proliferative vitreoretinopathy (PVR) were included in the study. Vitrectomy using 23-gauge system with SO endotamponade was performed. Peroperative and postoperative complications, anatomical and visual results were evaluated.Statistical analysis usedPaired Student's t-test.ResultsSimultaneous cataract surgery was performed in 17 eyes. Peroperative complications were posterior capsule rupture during phacoemulsification in one patient, vitreous and retinal incarceration in one patient. One eye required suture placement at the end of surgery due to SO leakage. Postoperatively, a small subconjunctival SO bubble in three patients, and hypotony in one patient (6 mmHg) were observed. Recurrent retinal detachment under SO occurred in one patient. Mean follow-up was 6.5 months (±2.7). Pre- and postoperative mean visual acuity was 2.22±0.91 logMAR and 1.11±0.8 logMAR, respectively (P<0.001). Mean intraocular pressure (IOP) on the first postoperative day was lower than preoperative IOP (11.3 ±3.2 versus 14.0 ±2.4 mmHg) (P<0.001).ConclusionsTwenty-three gauge instrumentation seems to be feasible, effective and safe for vitrectomy with SO injection in DTRD and PVR, and can be considered in the surgical management of these complex vitreoretinal diseases.

Thin-flap (sub-Bowman keratomileusis) versus thick-flap laser in situ keratomileusis for moderate to high myopia: Case-control analysis

To compare the refractive and visual outcomes of sub-Bowman keratomileusis (SBK) and thick-flap laser in situ keratomileusis (LASIK) for moderate to high myopia and evaluate the effect of corneal flap thickness on outcomes. Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA. Two studies were performed. In the first study, the refractive and visual outcomes in 33 eyes that had SBK (flap thickness 82 to 120 microm) and 62 eyes that had thick-flap LASIK (flap thickness >or=160) were retrospectively analyzed. Inclusion criteria were spherical equivalent -4.0 to -10.0 diopters (D), astigmatism 3.0 D or less, and follow-up 3 months or more. In the second study, the influence of flap thickness was evaluated. A case-control matched study (21 pairs) that controlled for residual stromal bed (RSB) thickness was performed. The mean flap thickness was 110.2 microm+/-9.2 (SD) in the SBK group and 179.2+/-19.5 microm in the thick-flap LASIK group. There were no significant differences in visual outcomes. In the second study with equivalent RSB thickness, case-control matched comparisons between SBK (mean 108.6+/-8.0 microm) and thick-flap LASIK (mean 165.7+/-12.6 microm) showed no differences in preoperative and postoperative refractive and visual outcomes. Comparison of the intended versus achieved correction showed no significant differences between the 2 groups. Retrospective analyses showed that the safety, efficacy, and predictability of SBK were similar to those of conventional thick-flap LASIK in corneas with equivalent RSB thickness.

Posterior lamellar keratoplasty—comparison of deep lamellar endothelial keratoplasty and Descemet stripping automated endothelial keratoplasty in the same patients: a patient’s perspective

Aim:To evaluate patients’ perspectives on endothelial keratoplasty and to compare the outcomes of deep lamellar endothelial keratoplasty (DLEK) and Descemet stripping automated endothelial keratoplasty (DSAEK), performed in the same patients.Methods:A...

High incidence of optic canal involvement in clinoidal meningiomas: rationale for aggressive skull base approach

Literature specifically focusing on clinoidal meningiomas is scant, particularly with regards to the postoperative visual outcome. In this study, we aimed to document the incidence of optic canal involvement (OCI) by the tumor, its management using a skull base technique, and its significance with relation to the visual outcome. Fifty-two patients with clinoidal meningiomas were retrospectively analyzed. In 47 patients, skull base technique consisting of extradural anterior clinoidectomy with falciform ligament and optic nerve sheath opening was performed. Pre-operative visual status and post-operative outcome were analyzed with respect to OCI. The incidences of OCI was present in 19 (36%) and pre-operative visual deficit (VD) in 24 (46%) patients. With regard to pre-operative visual status, OCI was seen in 14 (58%) of 24 patients with VD, as compared to five (18%) in 28 patients without (p = 0.004). Among the 22 patients with VD and detailed postoperative neuro-ophthalmological evaluation, 17 (77%) had visual improvement, and in five patients (23%), vision was unchanged. In the presence of OCI in 11 patients, vision improved in seven (64%), and remained unchanged in four patients (36%), whereas all but one of the 11 patients (91%) without OCI improved and in the remaining one (9%), remained unchanged. Simpson Grade I and II resection was achieved in 71%. OCI is observed in 36% of clinoidal meningiomas, and it correlates well with pre-operative visual status. With the use of the skull base technique, without which the tumor in the optic canal could not have been removed completely and safely, visual improvement of 77% and stability of 23% was achieved.

Prevalence of cataract surgery and post-surgical visual outcomes in an urban Asian population: the Singapore Malay Eye Study

Aim:The aim of the study was to describe the prevalence and visual outcomes of cataract surgery in an urban Asian population.Methods:This was a population-based study of 3280 Singapore Malays aged...

Comparison of Collamer toric contact lens implantation and wavefront-guided laser in situ keratomileusis for high myopic astigmatism

To compare the postoperative visual outcomes after implantation of a Collamer toric implantable contact lens (ICL) and after wavefront-guided laser in situ keratomileusis in high myopic astigmatism. Department of Ophthalmology, Kitasato University, Kanagawa, Japan. This study comprised 30 eyes (18 patients) having toric ICL implantation and 24 eyes (17 patients) having wavefront-guided LASIK (Technolas 217z) to correct high myopic astigmatism (manifest spherical equivalent [SE] <or=-6.0 diopters [D]; manifest refractive cylinder >or=1.0 D). The safety, efficacy, predictability, stability, and adverse events were assessed preoperatively and 1 week and 1, 3, and 6 months postoperatively. At 6 months, the mean safety index was 1.28+/-0.25 (SD) in the ICL group and 1.01+/-0.16 in the LASIK group and the mean efficacy index, 0.87+/-0.15 and 0.83+/-0.23, respectively. All eyes in the ICL group and 71% of eyes in the LASIK group were within +/-1.00 D of the targeted SE correction at 6 months. The mean change in manifest refraction from 1 week to 6 months was -0.04+/-0.24 D in the ICL group and -0.60+/-0.49 D in the LASIK group. There were no significant complications in the ICL group; 2 eyes (8.3%) in the LASIK group required enhancement ablations. Toric ICL implantation was better than wavefront-guided LASIK in eyes with high myopic astigmatism in almost all measures of safety, efficacy, predictability, and stability, suggesting that toric ICL implantation may become a viable surgical option to treat high myopic astigmatism.

Comparison Between Three- and Six-month Postoperative Refractive and Visual Results After Laser Epithelial Keratomileusis With Mitomycin C

To compare the residual refraction and visual results between the three- and six-month postoperative visits to detect the optimal moment for enhancement after myopic laser epithelial keratomileusis (LASEK) with mitomycin C (MMC). Nonrandomized, interventional, prospective study. One hundred and forty-one consecutive eyes that underwent LASEK with MMC to correct their myopia using the Esiris excimer laser (Schwind Eye Tech Solutions, Kleinostheim, Germany), and that showed three months postoperatively a residual defect or a suboptimal uncorrected visual acuity (UCVA) or best spectacle-corrected visual acuity (BSCVA) were included in the study. We compared the residual spherical refraction and cylinder, the UCVA, and the BSCVA between the three- and six-month postoperative examinations. Preoperative spherical refraction was -5.2 +/- 2.90 diopters (D). Preoperative cylinder was -1.66 +/- 1.20 D. The residual sphere was +0.43 +/- 0.90 D three months and +0.21 +/- 0.90 D six months after surgery (P = .0001). The cylinder was -0.71 +/- 0.60 D and -0.67 +/- 0.60 D, respectively (P = .4). The UCVA was 0.75 +/- 0.2 and 0.81 +/- 0.2 (P = .0001) and the BSCVA was 0.94 +/- 0.1 and 1.01 +/- 0.1 (P = .0001), respectively. Those patients with a myopic defect (sphere or cylinder) three months postoperatively did not show any significant change in UCVA or refractive defect six months after surgery, while those with a hyperopic defect (sphere or cylinder) showed an improvement in UCVA and residual refraction six months postoperatively (P < .05). Our results suggest that retreatment after myopic LASEK with MMC may be performed three months after surgery when the residual refraction is myopic, but it seems wise to wait at least six months after surgery when the residual refraction is hyperopic.

Cataract extraction after retinal detachment repair by vitrectomy : visual outcome and complications

To determine the intraoperative and postoperative complications and visual outcome of eyes undergoing cataract extraction after previous retinal detachment repair by pars plana vitrectomy (PPV). Retrospective analysis of 72 patients who had cataract extraction by phacoemulsification having had retinal detachment repair by vitrectomy and internal tamponade. Best-corrected visual acuity (BCVA) had improved in 53 (74%) of eyes at 3 weeks after cataract surgery and 65 (90%) at final follow-up. Fifty-three eyes (74%) attained 6/12 visual acuity at final follow-up compared with 19 (26%) eyes with a preoperative vision better than 6/12. There was a significant improvement in BCVA after cataract extraction (P<0.001). Poor vision was usually related to retinal comorbidity.Intraoperative events occurred in nine eyes (12.5%) including capsulorrhexis tears, zonular dehiscence and vitreous loss. Postoperative events occurred in 15 eyes (20.8%). Retinal re-detachment occurred in four eyes (5.6%). Cataract extraction after retinal detachment surgery by vitrectomy generally results in a significant visual improvement, however, there is an increased intraoperative and postoperative complication rate. The risk of retinal re-detachment may previously have been underestimated.

Surgical and visual outcomes for posterior polar cataract

Aims:The aims of this study were to report the surgical and visual outcomes of posterior polar cataract and to assess the risk factors for posterior capsule rupture.Method:Medical records of 81...

Foveal anatomical status and surgical results in vitrectomy for myopic foveoschisis

Myopic foveoschisis (MF), a major cause of visual loss in highly myopic patients, shows varied foveal anatomic characteristics. We determined how the foveal status is related to surgical results in MF. Forty-four eyes underwent vitrectomy for MF, including internal limiting membrane (ILM) peeling and gas tamponade. The eyes were divided into three groups depending on the preoperative foveal anatomy: foveal detachment (FD, n = 17), retinoschisis (RS, n = 16), and macular hole (MH, n = 11). Best-corrected visual acuity (BCVA) and optical coherence tomographic findings preoperatively and 3, 6, and 12 months postoperatively were obtained and compared. BCVA improved two lines or more in 81% of the FD group, 50% of the RS group, and 45% of the MH group 12 months postoperatively. The FD group had significantly improved vision (P < 0.01). Visual improvement was borderline in the RS group (P = 0.057) and not significant in the MH group. Visual improvement was significantly better in FD eyes than in RS (P < 0.05) or MH (P < 0.01) eyes. In FD and RS eyes, the postoperative BCVA was significantly correlated with age (P < 0.05) and preoperative BCVA (P < 0.01), whereas visual improvement was correlated with symptom duration (P < 0.05) and preoperative BCVA (P < 0.01). Vitrectomy including ILM peeling and gas tamponade is safe and effective for MF. Patients with FD showed the most visual improvement postoperatively and therefore can obtain the most benefit from the surgery. Surgery also benefits RS and MH patients by preserving vision. The foveal status, age, duration of symptoms, and preoperative BCVA are key factors determining postoperative visual outcome in MF.

Repair of Primary Rhegmatogenous Retinal Detachment Using 25-Gauge Transconjunctival Sutureless Vitrectomy

: To evaluate the anatomical and visual outcomes of primary rhegmatogenous retinal detachment repairs performed using 25-gauge transconjunctival sutureless vitrectomy. : A retrospective, noncomparative interventional case series including 53 consecutive eyes of 52 patients who underwent 25-gauge transconjunctival sutureless vitrectomy to repair primary rhegmatogenous retinal detachment was performed. Variables collected for the study were patient demographics, lens status, preoperative visual acuity, and macular status. Outcome measures included single-operation anatomical success rate, final anatomical success rate, postoperative visual acuity, and surgical complications. : The retina was reattached with a single operation in 39 (74%) of 53 eyes. The final anatomical success rate was 100%. The mean time to redetachment was 72 days (range, 13-334 days). Proliferative vitreoretinopathy (64%) and development of new retinal breaks (43%) were the most common reasons associated with redetachment. Mean visual acuity improved from 20/100 to 20/60 (P = 0.001); 55% of eyes had final vision of 20/40 or better. Three eyes (6%) developed postoperative choroidal hemorrhage. Three eyes (6%) developed visually significant macular pucker that required surgery. No postoperative hypotony or endophthalmitis was observed. : Repair of primary rhegmatogenous retinal detachments using 25-gauge transconjunctival sutureless vitrectomy resulted in excellent final anatomical success rate and postoperative visual outcomes. However, redetachments due to new tears and/or proliferative vitreoretinopathy resulted in a lower single-operation success rate than those reported with 20-gauge systems.

Long-Term Results of a Suture Burial Technique

To report the long-term (minimum 24 months of follow-up) results of a scleral suture fixation technique. Surgical databases from one surgeon were reviewed for consecutive cases from March 2003 to August 2005 in which the scleral suture fixation technique was used and a minimum follow-up of 24 months was completed. In this study, by knotting the suture onto itself, the author has buried the end and the knot of the suture into the sclera for scleral fixation, to stay put within the sclera. Intraoperative technical complications, postoperative visual outcomes, intraocular pressures, and suture-related complications were evaluated for each patient. A total of 150 scleral-sutured free suture ends were evaluated after a minimum 24 months of follow-up in 75 eyes of 75 patients. No technical or suture-related complications (suture exposure, irritation, granulomas, giant papillary conjunctivitis, suture abscess) were recorded throughout the follow-up period. Long-term follow-up of the suture burial technique - which allows avoidance of scleral incision, flap, or tunnel formation, as well as patch grafts for scleral fixation of intraocular lenses - showed it to be safe and effective.

Combined rhegmatogenous and traction retinal detachment in proliferative diabetic retinopathy: clinical manifestations and surgical outcome

Background: Combined rhegmatogenous and traction retinal detachment (combined detachment) is a serious complication in proliferative diabetic retinopathy. The common clinical findings and surgical results of this complication were investigated. Methods: Forty eyes of 36 consecutive patients with combined detachment undergoing pars plana vitrectomy at a teaching hospital in a 4.5-year period were retrospectively reviewed. All cases had been followed up for at least 6 months. Results: Only 10 of the 40 cases had a preoperative visual acuity better than finger counting vision. Extensive proliferation with multiple, thickened, plaque-like vitreoretinal adhesions and large areas of detachment were noted in 38 cases, 19 cases showing predominantly fibrous tissue and 19 cases presenting with predominantly active fibrovascular proliferation. Two cases had minimal fibrovascular proliferation. Retinal breaks were identified in 7 eyes (17.5%) before surgery and in 33 eyes (82.5%) during surgery. Thirty-seven eyes (92.5%) achieved long-term retinal reattachment. Silicone oil was used in 23 eyes (57.5%). Visual acuity improved in 28 eyes (70%), was unchanged in 6 (15%), and became worse in 6 (15%). In 19 eyes postoperative vision was better than 20/400. Multiple regression analysis showed preoperative visual acuity as the single factor associated with postoperative visual outcome. Interpretation: Combined retinal detachment in proliferative diabetic retinopathy may occur during the stage of active fibrovascular proliferation or as a late complication. It is frequently associated with tightly adherent preretinal tissue and extensive detachment. Preoperative visual acuity best predicts visual prognosis.

Influence of Intraoperative Course on Visual Outcome after an RPE–Choroid Translocation

In a previous study, preoperative variables were correlated with postoperative visual outcome after the translocation of a free RPE-choroid graft. The present study was conducted to investigate whether the intraoperative course was an independent factor influencing visual outcome in these patients. This was a prospective interventional case series of 48 patients with exudative AMD treated with an RPE-choroid translocation. Preoperative and postoperative evaluation included ETDRS visual acuity (VA) and fixation testing by a masked examiner. Four critical surgical steps were evaluated, and the intraoperative course was graded from 0 (uncomplicated surgery) to 5 (most complicated surgery). The relationship between intraoperative course adjusted for preoperative delay/lesion composition and visual outcome at 3 months and 1 year after surgery was analyzed with multivariate analysis. The mean VA (logMAR) improved slightly from 0.99 before surgery to 1.00, 0.94, 0.89, and 0.91 after 3, 6, 9, and 12 months, respectively. Foveal fixation on the graft was present in 34 (71%) of the eyes at 1 year after surgery. The intraoperative course was statistically significantly associated with the DeltaVA (logMAR) at 3 months (P = 0.037) and at 1 year after surgery (P = 0.020) and if measured as gain or loss of > or =2 ETDRS-lines (odds ratio [OR] 1.8, 95% confidence interval [CI] 1.7 to 2.8, P = 0.027) and > or =3 ETDRS lines (OR, 2.2, 95% CI 1.9-3.5, P = 0.003); better surgery was associated with visual gain whereas eventful surgery was associated with visual loss. The intraoperative course adjusted for preoperative variables had a statistically significant influence on postoperative visual outcomes in patients treated with a free RPE-choroid translocation. Refining the surgery could improve results.

Phacoemulsification in Pseudoexfoliation Syndrome

Purpose: To compare the incidence of intraoperative and early postoperative complications (IEPC), visual outcomes, and change in intraocular pressure (IOP) between eyes with and without pseudoexfoliation syndrome (PEX) having cataract extraction by phacoemulsification. Material and Method: 800 eyes with PEX and 1,600 eyes without PEX having cataract extraction by phacoemulsification were included in this retrospective study. Evaluated parameters were incidence of IEPC, visual outcomes and change in IOP. χ² and Student’s t test were used for statistical analysis. Results: There were no significant differences in the incidence of IEPC and visual acuity gain between the two groups (p > 0.05). Rise in IOP in the early postoperative period was significantly higher in the PEX group (p < 0.02). Conclusion: Patients with PEX who have phacoemulsification can achieve results similar to patients without PEX. IOP control in the early postoperative period seems to be more important in patients with PEX.

Correlation of Preoperative Optical Coherence Tomography with Preand Postoperative Visual Acuity of Macular Hole

Purpose: To evaluate the correlation between preoperative optical coherence tomography (OCT) parameters and pre- and post-operative visual acuity after macular hole surgery. Methods: Twenty-five eyes of 24 patients who underwent macular hole surgery with a postoperative follow-up longer than 6 months were studied. On enhanced preoperative horizontal and vertical OCT scans, various parameters including hole diameter, base diameter, total lesion diameter, and hole height were measured. Hole form factor (HFF) and macular hole index (MHI) were calculated. The correlation between the parameters and pre- and post-operative visual acuity, as well as visual acuity change, was analyzed. Results: There was a significant correlation between hole height and preoperative visual acuity (p=0.018). Better postoperative visual outcome was correlated with a smaller hole diameter, smaller total lesion diameter, and greater hole height (p=0.002, 0.043 and 0.037). HFF and MHI were correlated with visual acuity change (p=0.024 and