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January 31, 2007
Progression of Intermittent, Small-Angle, and Variable Esotropia in Infancy
Investigative Ophthalmology and Visual Science.Jan,2007
Esotropia (ET) in infancy may initially manifest as a small-angle, variable-angle, or intermittent deviation. Some patients experience spontaneous resolution and become orthophoric. Others progress to constant large-angle ET and require surgery. The authors examined factors that may be associated with risk for progression to constant large-angle ET.
CONCLUSIONS. Abnormal stereoacuity and occlusion therapy pose significant risks for progression from intermittent to constant large-angle ET. Intermittent ET that develops during the first year of life has a high likelihood of spontaneous resolution, whereas constant small-angle or variable-angle ET seldom resolves.
Posted by afarahi at 08:27 PM | Comments (0)
Role of Parental Myopia in the Progression of Myopia and Its Interaction with Treatment in COMET Children
Investigative Ophthalmology and Visual Science.Jan, 2007
The present study investigated the relationship between parental refractive error and myopia progression in their offspring and the interaction between parental ametropia and the effects of wearing progressive-addition (PALs) or single-vision (SVLs) lenses on the progression of myopia in children enrolled in the Correction of Myopia Evaluation Trial (COMET).
CONCLUSIONS. Parental refraction was related to myopia progression and changes in axial length. Among COMET children with two myopic parents, myopia progression and increases in axial length were slower in the group wearing PALs than in those wearing SVLs, by a statistically significant but clinically minor amount. Because this study was ancillary to COMET and the present analyses are based on a subset of participants, conclusions must be regarded as suggestive.
Posted by afarahi at 08:13 PM | Comments (0)
Botox use in DSAEK may avoid complications
Eyeworld Jan 2007
A novel use of botulinum toxin may help patients scheduled for corneal transplants improve the likelihood of graft acceptance, according to one surgeon. Furthermore, because of the lingering effects of the Botox injection the patient can be injected up to a week before keratoplasty is scheduled.
Garth A. Wilbanks, M.D., a corneal surgeon at Eastern Maine Eye Associates, Bangor, Maine, said patients with both frank benign essential blepharospasm and “blepharospastic tendency” are at increased risks of intraoperative complications during Descemet’s stripping automated endothelial keratoplasty (DSAEK), and post-op graft dehiscence during the early post-op period. In general, severe bilateral essential blepharospasm occurs in 300 of every 1 million people, but blepharospastic tendency—which has the capacity of dislodging a DSAEK graft—occurs in almost 5% of those undergoing DSAEK,Peribulbar block or general anesthesia is used on this patient population, but does not address the patients’ post-op blepharospasm with an increased risk of graft dehiscence during the first one to two weeks postop, he said. In a small case series, three of 60 patients undergoing DSAEK required re-bubbling. In two patients, uncomplicated DSAEK had been performed; both patients had mild blepharospasm and sub-Tenon’s block was used. On post-op day one, both patients had full graft dehiscence, Dr. Wilbanks said. By post-op week one, however, both had 100% graft dislocation. One patient required one re-bubble and the other patient needed two re-bubbles.
The third patient required a peribulbar block one hour before surgery, presented with full graft adherence on post-op day 1, but also had 100% graft dislocation on post-op week one. The patient needed three re-bubbles over the course of the next month to ensure permanent graft adherence. Dr. Wilbanks administered a Botox injection for blepharospasm 1 week before the third re-bubble. With six months follow-up after the last re-bubble, the graft has done well, he said. As a result, Dr. Wilbanks now administers pre-op Botox blepharospasm lid injections. On his last three DSAEK patients, all received the injection and all have had “excellent results,” he said
Posted by mehdi khanlari at 03:47 PM | Comments (0)
January 30, 2007
No-history method of intraocular lens power calculation for cataract surgery after myopic laser in situ keratomileusis
JCRS Pages 31-36 (January 2007)
H. John Shammas, MD, Maya C. Shammas, MD
To prospectively evaluate the no-history method for IOL power calculation in 15 cataractous eyes that had previous myopic LASIK and for which the pre-LASIK K-readings were not available.
The predicted IOL power was calculated in each case. Also calculated were the mean arithmetic and absolute IOL predictor errors, range of the prediction errors, and number of eyes in which the error was within ±1.00 diopter (D).
The mean arithmetic IOL prediction error was −0.003 D and the mean absolute IOL prediction error was 0.55 D .Fourteen eyes (93.3%) were within ±1.00 D. The results of the Shammas post-LASIK formula compared favorably to the results obtained with the optimized Holladay 1 (P = .42), Hoffer Q (P = .25), Haigis (P = .30), and Holladay 2 (P = .19) formulas and were better than the results obtained with the optimized SRK/T formula (P = .0005).
Conclusion
The no-history method is a viable alternative for IOL power calculation after myopic LASIK when the refractive surgery data are not available.
Posted by alireza habibollahi at 07:36 PM | Comments (0)
Determining corneal power using Orbscan II videokeratography for intraocular lens calculation after excimer laser surgery for myopia
JCRS Pages 21-30 (January 2007)
To assess the accuracy of Orbscan II slit-scanning videokeratography for intraocular lens (IOL) calculation in eyes with previous photorefractive surgery for myopia.
Corneal power (K) was measured by manual keratometry, Placido-based videokeratography (Atlas), slit-scanning videokeratography (Orbscan II), and contact lens overrefraction in 21 post-photoablation eyes having cataract surgery. Postoperative data collected after phacoemulsification were used to back-calculate corneal power (BCK). The BCK values were statistically compared at 3.0 to 6.0 mm central Orbscan II curvature and power measurements, including total axial power, total tangential power, total mean power, and total optical power. Similar comparisons were made to Atlas curvature at the 0.0 to 10.0 mm zones.
Results
The mean corneal power after refractive surgery based on BCK values using the Holladay 2 formula (BCK H2) was 39.35 diopters (D) ± 2.58 (SD). The mean manual value (40.52 ± 1.95 D) and Atlas-based values were statistically higher than BCK H2 values (P<.001). The mean corneal power calculated from historical data was 39.33 ± 2.70 D (P = .83 to BCK H2; n = 19) and from contact lens overrefraction, 41.38 ± 3.11 D (P = .19; n = 5). Orbscan II parameters (n = 21) of the total mean power (3.0 mm, 39.10 ± 2.63 D), total tangential power (3.0 mm, 39.11 ± 2.60), total axial power (5.0 mm, 39.19 ± 2.55 D), and total optical power (3.0 mm, 39.08 ± 2.78 D; 4.0 mm, 39.39 ± 2.76 D) were statistically similar to both the historical and BCK H2 values (P>.11). If used prospectively, 80.9% of eyes would have been within ±0.50 D of the targeted refraction using a 4.0 mm total optical power, 76.2% using a 5.0 mm total axial power, and 42.1% using the historical method.
Conclusion
The Orbscan II 5.0 mm total axial power and 4.0 mm total optical power can be used to more accurately predict true corneal power than the history-based method and may be particularly useful when pre-LASIK data are unavailable.
Posted by alireza habibollahi at 07:09 PM | Comments (0)
Injection of an intraocular lens in an eye without capsular support
JCRS Pages 15-18 (January 2007)
20 of 53
We describe a technique that can be used to facilitate posterior chamber intraocular lens (IOL) placement with iris fixation in cases with compromised capsular support. This procedure allows injection of an IOL through an unenlarged clear corneal incision. A safety net suture is temporarily fixed in the posterior chamber to act as a surrogate capsule. This suture supports the IOL while the surgeon injects it and secures it to the iris. The addition of this single step facilitates the remainder of the procedure and potentially makes it safer.
Posted by alireza habibollahi at 06:57 PM | Comments (0)
Preoperative simulation of postoperative iris-fixated phakic intraocular lens position and simulation of aging using high-resolution Scheimpflug imaging
JCRS Pages 11-14 (January 2007)
To increase postoperative safety after implantation of iris-fixated phakic intraocular lenses (pIOLs), optimal preoperative evaluation and patient selection is mandatory. We present a new software tool in a high-resolution Scheimpflug imaging device that precisely simulates the postoperative position of an iris-fixated pIOL and also simulates the effect of aging on the pIOL's position.
Posted by alireza habibollahi at 06:53 PM | Comments (0)
Cigarette Smoking, CFH, APOE, ELOVL4, and Risk of Neovascular Age-Related Macular Degeneration
Archives of Ophthalmology, January 2007
This prospective study within the Nurses’ Health Study and the Health Professionals Follow-up Study finds that those who carried two copies of the CFH gene mutation and were obese had a 12-fold increased risk, compared to non-obese non-carriers, and nearly a 9-fold increased risk if they also smoked, compared to non-smoking non-carriers. For the other mutation, LOC387715, risk increased more than 22-fold for carriers who smoked. A separate study finds that people who smoked a pack a day for 10 years or more who also have CFH CC genotype face about a 144-fold increased risk, compared with those who smoked less and have the CFH CT or TT genotype.
Posted by afarahi at 12:31 PM | Comments (0)
No-History IOL Power Calculation After LASIK
Eyeworld Jan 2007
For cataract patients who have previously undergone LASIK for myopia it can be difficult to determine needed IOL power, in cases where no pre-surgery readings are available. To evaluate a new way of calculating such IOL powers, dubbed the “no-history method,” investigators here prospectively evaluated 15 eyes of cataract patients who had previously undergone LASIK and who had no pre-LASIK K-readings on hand. With the method results were calculated using the Shammas post-LASIK formula. Investigators found that the mean IOL prediction error was 0.55 D. They determined that 93% of eyes were within 1 D of intended correction. They also found that results with the Shammas post-LASIK formula were favorable when compared with the optimized Holladay 1, the Hoffer Q, the Haigis, and the Holladay 2 formulas and surpassed results calculated with the optimized SRK/T formula. Investigators concluded that when no refractive surgery data is available, then the no-history method with the Shammas formula is a viable alternative for calculating IOL power after myopic LASIK
Posted by mehdi khanlari at 01:32 AM | Comments (0)
Intacs for the Correction of Keratoconus
Eyeworld Jan 2007
The objective of this two–year prospective study was to examine the long-term safety and efficacy of INTACS (Addition Technology, Des Plaines, Ill.) for the treatment of keratoconus. In this study, which included 100 keratoconic eyes with clear central corneas and contact lens intolerance, investigators were looking to see if INTACS could help to resolve intra- and post-operative complications, improve visual outcomes, and restore contact lens tolerance, in addition to inhibiting disease progression. At the two year mark they found that with the INTACS, UCVA improved by 80.5% and BCVA by 68.3%. While just 22% of eyes had a BCVA of 20/40 or better at baseline, this improved to 51.2% at the one year mark, and 53.7% at two years. In addition, investigators determined that initial keratoconic readings of 50.1 D dropped to 46.4 D at one year and 46.8 D at two years. With the aid of the INTACS, postoperatively 80% of patients were also now able to tolerate contact lenses. In four cases the INTACS were removed without incident. The conclusion reached here was that not only were the INTACS safe and effective for keratoconus, but the treatment also brought with it an improvement in visual outcomes and a restoration of contact lens tolerance.
Posted by mehdi khanlari at 01:31 AM | Comments (0)
Pseudophakic Dysphotopsia with 2 IOL Models
Eyeworld Jan 2007
Investigators in this prospective randomized study considered the relative incidence of dysphotopsia occurrences between the AcrySof SN60–AT IOL (Alcon, Fort Worth, Texas) and the Akreos Adapt lens (Bausch & Lomb, Rochester, N.Y.)—two biconvex, acrylic double square-edged IOLs. The 61 cataract patients included in the trial were asked to rate occurrences of unwanted light images both at the one-week mark and again at a minimum of six weeks. Investigators here determined that at one week, 37% of patients with the SN60–AT IOL experienced both negative and positive dysphotopsia compared with just 24.1% of those with the Akreos Adapt IOL. This difference was significant. Also, when it came to negative dysphotopsia alone, significantly more patients had this complaint with the SN60-AT IOL at one week than with the other lens. By the eight-week mark, incidence of positive and negative dysphotopsia had dropped to 31.3% with the SN60–AT IOL and 20.7% with the Akreos Adapt lens—a difference that was no longer statistically significant. Investigators concluded that the initial difference in unwanted light images found between the two lenses was mostly the result of a higher incidence of negative dysphotopsia with the SN60–AT IOL. By the eight-week mark, the dysphotopsia phenomenon had dissipated significantly in both groups.
Posted by mehdi khanlari at 01:24 AM | Comments (0)
Incorporating Advanced Perimetry Into Clinical Practice
Eyeworld Jan 2007
In fact, there is not always good agreement between SWAP and FDT. Some patients with early glaucoma may have an abnormal SWAP and a normal FDT, while for others, the opposite may be true.
“Each of these tests identifies a different group of early defects,” .... the two devices may be complementary in the evaluation of patients with glaucoma. “If you add the two together, you find most people with glaucoma. And when the two tests are both abnormal, the defect is in the same test location in 95% of cases.”
Therefore, she suggested that high-risk glaucoma suspects might benefit from testing on each device periodically. If one test becomes abnormal, using the other test to confirm the defect may help distinguish between true and false positive results.
“You can both identify and confirm defects using these two technologies
Posted by mehdi khanlari at 12:48 AM | Comments (0)
January 26, 2007
Top 50 Ophthalmology Medical Articles of 2006
MDLinx
This list is based on the aggregated articles most read by professionals in your specialty(Oculoplastic,Pediatric Ophthalmology,Neuro-Ophthalmology). Some of the most interesting articles come from traditionally excellent sources such as JAMA, NEJM, and BMJ, although there are also several other quality sources on the list which you may not reference regularly. To find out the 2006 Top 50 articles your peers thought were most valuable for your specialty, please click here!
Posted by afarahi at 05:26 PM | Comments (0)
Ten-Year Incidence and Progression of Age-Related Maculopathy: The Blue Mountains Eye Study
Ophthalmology, 2007
To assess the 10-year incidence of age-related maculopathy (ARM) in an older Australian cohort, 3654 Blue Mountains Eye Study participants ≥49 years old were examined. The diagnosis of incident late ARM was given if neovascular ARM or geographic atrophy was detected at either follow-up examination in persons free of these lesions at baseline. Incident early ARM was diagnosed if early ARM (soft indistinct or reticular drusen or combined soft distinct drusen and retinal pigment abnormality) was present in persons free of early and late ARM at baseline. After age standardization to the Beaver Dam Eye Study population, our 10-year incidences of late and early ARM were 2.8% and 10.8%, respectively. Baseline age and early ARM lesion characteristics and severity were strong predictors of late ARM incidence. Long-term follow-up of this older population confirms that the risk of ARM progression is related strongly to the severity of early-stage lesions. The study provides evidence-based criteria for identifying persons at high risk of developing late ARM.
Posted by kjalali at 07:03 AM | Comments (0)
Safety of prophylactic intracameral moxifloxacin 0.5% ophthalmic solution in cataract surgery patients
JCRS, January 2007
To determine the safety of prophylactic intracameral moxifloxacin 0.5% ophthalmic solution (Vigamox) in patients having cataract surgery; preoperative and 1-month postoperative anterior chamber reaction, corneal endothelial cell density, and corneal thickness were assessed in 65 eyes that had cataract surgery with intracameral moxifloxacin. All eyes received 0.1 mL intracameral moxifloxacin 0.5% ophthalmic solution containing 500 μg of moxifloxacin as the last step of phacoemulsification. Different ophthalmologists conducted the postoperative evaluation in an observer-masked fashion. A P value less than 0.05 was considered significant. Intracameral Vigamox 0.5 mg/mL appeared to be nontoxic in terms of visual rehabilitation, anterior chamber reaction, pachymetry, and corneal endothelial cell density.
Posted by kjalali at 06:41 AM | Comments (0)
Long-term Retinal Toxicity of Intravitreal Commercially Available Preserved Triamcinolone Acetonide (Kenalog) in Rabbit Eyes
Investigative Ophthalmology & Visual Science, January 2007
Twelve weeks after 10 rabbit eyes were injected with 4 mg of intravitreal Kenalog, researchers observed no demonstrable electroretinographic or histologic changes that would suggest immediate or delayed widespread retinal toxicity.
Posted by kjalali at 06:39 AM | Comments (0)
Outcomes and complications: PPV for diffuse nontractional diabetic macular edema
SPECIALTY NEWS
There were 43 eyes of 39 patients enrolled in the a prospective, comparative, nonrandomized study that evaluated the efficacy of pars plana vitrectomy (PPV) for primary diffuse nontractional macular edema, grouped as follows: Group 1, PPV with internal limiting membrane (ILM) peeling (12 eyes); Group 2, PPV and intravitreal injection of 8 mg of triamcinolone acetonide (TA) (11 eyes); and Group 3, PPV with ILM peeling and 8 mg of intravitreal TA injection (20 eyes). Follow up was a mean of 12 months (range 3–42 months). The researchers found no differences between the groups in the preoperative variables evaluated, including visual acuity, fundus fluorescein angiography, and optical coherence tomography. Postoperatively, there was a significant improvement in foveal thickness at 1, 3, and 6 months for all 3 groups, but these improvements disappeared after 12 months, such that there was no lasting difference in foveal thickness outcome between the 3 groups. Despite the temporary structural improvement, no significant visual improvement was detected at any time during follow up, with a mean preoperative Snellen BCVA of 0.23 and a postoperative BCVA of 0.2. Complications included cataract formation (39%), intraocular pressure elevation (19%), mild vitreous hemorrhage (14%), RPE atrophy (12%), and endophthalmitis (2%). The Figueroa et al conclude that PPV with either ILM peeling or intravitreal injection of TA temporarily improves macular thickness but has no long-term benefit on foveal thickness or visual acuity in diffuse nontractional diabetic macular edema.
Posted by kjalali at 06:34 AM | Comments (0)
January 21, 2007
Promising early results for new wet AMD treatment
INDUSTRY NEWS
A feasibility trial shows half of the patients who received Lucentis combined with radiation (Epi-Rad 90) experienced improved visual acuity by greater than three lines. NeoVista plans to enter into a definitive clinical study early this year.
Posted by kjalali at 05:20 AM | Comments (0)
ASCRS establishes international database on postoperative ectasia
SPECIALTY NEWS
Located at www.ectasiaregistry.com, the registry allows physicians to input relevant data on ectasia cases they encounter. The American Society of Cataract and Refractive Surgery (ASCRS) hopes to use the database to develop prospective observational studies that may determine the incidence of ectasia and identify risk factors.
Posted by kjalali at 05:18 AM | Comments (0)
APOE gene influences development of AMD, even in older people
Archives of Ophthalmology, January 2007
An evaluation of participants (age 65 and older) in the Cardiovascular Health Study shows that after accounting for age, sex, cigarette smoking and other potentially confounding factors, white adults carrying APOE-2 had a 2.5-fold higher likelihood of developing late AMD.
Posted by kjalali at 05:15 AM | Comments (0)
January 19, 2007
Large Diurnal Variation of Intraocular Pressure Despite Maximal Medical Treatment in Juvenile Open Angle Glaucoma.
Journal of Glaucoma.January, 2007
Conclusions: Wide diurnal variation should be suspected in JOAG patients, even when receiving maximal medical treatment; this is especially important in cases with temporary blurred vision and/or progression of visual field defect despite apparently well-controlled IOP. Trabeculectomy was more effective in reducing diurnal IOP variation than medical treatment.
Posted by afarahi at 08:21 PM | Comments (0)
Long-term Resolution of Chronic Dry Eye Symptoms and Signs after Topical Cyclosporine Treatment
Ophthalmology, January 2007
This retrospective review finds that for a majority of patients, symptoms and/or signs of dry eye returned after discontinuing a six-month course of treatment. But some patients were symptom and sign-free for a year or more after discontinuing treatment. The authors suggest prescribing topical cyclosporine for patients with mild chronic dry eye because it may prevent some patients from progressing to moderate or severe dry eye.
Posted by afarahi at 07:46 PM | Comments (0)
Intraocular lens opacification after nonpenetrating glaucoma surgery with mitomycin-C
Journal of Cataract & Refractive Surgery Volume 33, Issue 1 , January 2007, Pages 139-141
A 58-year-old woman had successful phacoemulsification with intraocular lens (IOL) implantation in January 2001. Two years later, nonpenetrating glaucoma surgery with mitomycin-C (MMC) 0.02% was performed for uncontrolled glaucoma. Two months later, opacification of the anterior IOL surface was observed. The IOL was removed and a hydrophobic acrylic AcrySof IOL (Alcon) implanted. The opacified IOL was studied by flame atomic absorption spectrometry, which showed the presence of calcium carbonate. A new IOL of the same model was placed in an aqueous solution with calcium carbonate and basic pH, and the same opacification developed. We hypothesize that the change in aqueous humor pH after glaucoma surgery and the characteristics of the IOL precipitated deposition of calcium.
Posted by mmiraftab at 06:15 PM | Comments (0)
Excimer laser exacerbation of Avellino corneal dystrophy
Journal of Cataract & Refractive Surgery Volume 33, Issue 1 , January 2007, Pages 133-138
review the clinical, histopathological, and ultrastructural findings and DNA phenotyping of a patient with Avellino corneal dystrophy exacerbated by laser in situ keratomileusis. The findings are reported and interpreted in the context of a literature review. The case highlights the possible difficulty of recognizing subtle dystrophic findings, as well as the importance of avoiding refractive surgical intervention in patients with Avellino corneal dystrophy to avoid exacerbation of dystrophic deposits in the cornea and subsequent reduction in vision.
Posted by mmiraftab at 06:12 PM | Comments (0)
Effect of inferior-segment Intacs with and without C3-R on keratoconus
Journal of Cataract & Refractive Surgery Volume 33, Issue 1 , January 2007, Pages 75-80
A retrospective nonrandomized comparative case series comprised 12 eyes of 9 patients who had inferior-segment Intacs placement without C3-R (Intacs-only group) and 13 eyes of 12 patients who had inferior-segment Intacs placement combined with C3-R (Intacs with C3-R group). The 2 groups were matched preoperatively. All patients had inferior-segment Intacs placed with the incision in the steep axis of manifest refraction. Corneal collagen cross-linking with riboflavin was performed after the Intacs segments were inserted. Outcome measures were topographic keratometry values and the lower–upper (L–U) ratio, which is a topographic measure of the degree of keratoconus. Preoperative data were compared to results 1 day postoperatively and measurements at the last postoperative visit.
Results
The Intacs with C3-R group had a significantly greater reduction in cylinder than the Intacs-only group (P<.05). Steep and average keratometry were reduced significantly more in the Intacs with C3-R group (P<.05). There was a greater reduction in L–U ratio in the Intacs with C3-R group (P<.05).
Conclusion
The addition of C3-R to the Intacs procedure resulted in greater keratoconus improvements than Intacs insertion alone.
Posted by mmiraftab at 06:09 PM | Comments (0)
No-history method of intraocular lens power calculation for cataract surgery after myopic laser in situ keratomileusis
Journal of Cataract & Refractive Surgery Volume 33, Issue 1 , January 2007, Pages 31-36
To prospectively evaluate the no-history method for intraocular lens (IOL) power calculation in 15 cataractous eyes that had previous myopic laser in situ keratomileusis (LASIK) and for which the pre-LASIK K-readings were not available.
Methods
The predicted IOL power was calculated in each case. Also calculated were the mean arithmetic and absolute IOL predictor errors, range of the prediction errors, and number of eyes in which the error was within ±1.00 diopter (D).
Results
The mean arithmetic IOL prediction error was −0.003 D ± 0.63 (SD), and the mean absolute IOL prediction error was 0.55 ± 0.31 D (range −0.89 to +1.05 D). Fourteen eyes (93.3%) were within ±1.00 D. The results of the Shammas post-LASIK formula compared favorably to the results obtained with the optimized Holladay 1 (P = .42), Hoffer Q (P = .25), Haigis (P = .30), and Holladay 2 (P = .19) formulas and were better than the results obtained with the optimized SRK/T formula (P = .0005).
Conclusion
The no-history method is a viable alternative for IOL power calculation after myopic LASIK when the refractive surgery data are not available.
Posted by mmiraftab at 06:07 PM | Comments (0)
January 12, 2007
Anisometropic Amblyopia Treated with Spectacle Correction Alone: Possible Factors Predicting Success and Time to Start Patching
American Journal of Ophthalmology ,January ,2007
Conclusions:With spectacle correction alone, 3- to 7-year-old children with previously untreated anisometropic amblyopia achieved approximately four-line improvement and resolved nearly in half. The nearly two-month plateau periods during improvement of VA should be noticed. After four months with no improvement in VA, occlusion therapy or atropine penalization may be considered.
Posted by afarahi at 05:45 PM | Comments (0)
Intraoperative Relaxed Muscle Positioning Technique for Strabismus Repair in Thyroid Eye Disease
Ophthalmology,Dec,2006
Charts of all patients who underwent rectus muscle recession surgery using a relaxed muscle technique between 1997 and 2004 were reviewed. Twenty-four of 28 patients had more than 2 months of follow-up and were included. The extent of recession was determined by marking where the tendon naturally fell while the relaxed muscle rested freely on the globe with the eye in the primary position. The muscle was sutured to the globe at the mark. Linear regression was used to determine the correlation between the degree of strabismus and the amount of recession required to eliminate diplopia.
Twenty-four patients underwent 60 muscle recessions. Nine had diplopia without a history of orbital decompression, 8 had diplopia before decompression, and 7 developed diplopia only after orbital decompression. Twenty-one patients (87.5%) had an excellent final outcome. A clinically acceptable (excellent or good) final outcome was achieved in 24 of 24 patients (100%) after an average of 1.08 surgeries. All 7 patients who developed diplopia only after decompression had an excellent outcome. Linear regression did not show good correlation between the degree of strabismus and the amount of recession required to eliminate diplopia (maximum R2 = 0.7292). There were no complications.
Conclusions:The relaxed muscle technique provides excellent ocular alignment and relief from diplopia in a majority of patients with TRO-associated strabismus. Patients who develop diplopia only after orbital decompression may have a higher success rate.
Posted by afarahi at 05:34 PM | Comments (0)
The Influence of Eyelid Morphology on Normal Corneal Shape
Investigative Ophthalmology and Visual Science.Jan, 2007
Corneal topography data and digital images of the anterior eye were acquired for 100 young adult subjects. The corneal topography data and palpebral fissure images were analyzed to determine a range of parameters describing the shape of the cornea and the morphology of the palpebral fissure. A number of highly significant correlations were found between the best-fitting corneal spherocylinder and the eyelid morphology parameters. The corneal best-fit sphere (M) was significantly correlated with the horizontal palpebral fissure width .Corneal astigmatism power vector J45 was significantly correlated with the angle of the palpebral fissure. The axis of corneal astigmatism was also found to be significantly correlated with the angle of the palpebral fissure.
CONCLUSIONS. A number of significant associations exist between the corneal spherocylinder and the morphology of the eyelids in a normal adult population.
Posted by afarahi at 04:39 PM | Comments (0)
January 09, 2007
Clinical evaluation of cornea pseudoguttata
British Journal of Ophthalmology 2007;91:22-25
Methods: In 3521 consecutive patients seen at a local eye clinic, eyes were examined with a slit-lamp biomicroscope in specular illumination. When guttate appearance was found, specular microscopy was performed.
Results: Cornea pseudoguttata was found in 44 eyes of 40 patients (1.1%). All patients had some form of anterior-segment ocular diseases, including keratitis (corneal infiltration) with contact lens wear (n = 16), epidemic keratoconjunctivitis (n = 8), corneal epithelial defect (n = 6), superficial punctate keratitis (n = 4), corneal foreign body (n = 3), keratitis of unknown causes (n = 3), corneal ulcer (n = 2), herpetic keratitis (n = 1), and iritis (n = 1). Six eyes were lost to follow-up, but in the remaining 38 eyes, cornea pseudoguttata completely resolved as the primary anterior-segment diseases subsided. Specular microscopy, measured after resolution of cornea pseudoguttata, showed that corneal endothelial cell density was not different between the affected and contralateral healthy eyes.
Conclusion: Cornea pseudoguttata is commonly found in cases with corneal infiltration and inflammation. These results indicate that cornea pseudoguttata is reversible in its nature and resolves completely without any damage to the corneal endothelial cells.
Posted by mmiraftab at 05:22 PM | Comments (0)
January 06, 2007
Intravitreal Prednisolone Sodium Succinate Reduces Diabetic Macular Edema Without Intraocular Pressure Rise
AJO, January 2007
To evaluate the six-month results of patients treated with intravitreal prednisolone sodium succinate injections for persistent diabetic macular edema, in a retrospective, noncontrolled, clinical case series, nineteen eyes had intravitreal injections with prednisolone sodium succinate. Mean visual acuity at six weeks, three months, and six months after injection was significantly better than the mean preoperative visual acuity (P = .015, P = .004, and P = .031, respectively). In none of the studied eyes intraocular pressure exceeded 22 mm Hg. No other adverse events, such as endophthalmitis or retinal detachment, occurred.
Posted by kjalali at 09:24 PM | Comments (0)
January 05, 2007
Higher complication rate for 25-gauge vitrectomy compared with 20-gauge surgery
SPECIALTY NEWS & VIEWS
In a large, retrospective review presented at the 2006 Retina Subspecialty Day meeting, auther suggests the incidence of retinal detachment may be five times higher with 25-gauge surgery. While there were three cases of endophthalmitis and two cases of hypotony after 25-gauge surgery, there were no such adverse events after 20-gauge surgery.
Posted by kjalali at 09:17 AM | Comments (0)
Patients with recalcitrant ocular inflammation appear to respond better to infliximab
Ophthalmology, December 2006
This small retrospective analysis shows 59 percent of infliximab-treated patients experienced a significant decrease in recurrence after starting therapy, while none of the etanercept-treated patients responded initially. After one year of treatment and at final visit, more infliximab-treated patients continued to experience an improvement. Infliximab-treated patients also required less treatment with topical steroids.
Posted by kjalali at 09:13 AM | Comments (0)