Author: Am J Ophthalmol

Intraocular Pressure after Implantation of the Visian Implantable Collamer Lens With CentraFLOW Without Iridotomy – Corrected Proof

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Purpose: To compare the intraocular pressure (IOP) values during a 3-month period after implantation of the new Visian Implantable Collamer Lens (ICL; STAAR Surgical Company, Nidau, Switzerland) V4c design with CentraFLOW technology without iridotomy using a standard procedure followed by implantation of the conventional ICL V4b model.Design: Retrospective cohort study.Methods: This study included 17 eyes implanted with the ICL V4b model and 18 eyes implanted with the ICL V4c model. The mean preoperative spherical equivalent refractions were −7.48 ± 5.00 diopters and −8.66 ± 4.2 diopters, respectively. We compared the best-corrected distance visual acuity before surgery with the uncorrected distance visual acuity after surgery. The intraocular pressure (IOP) was measured 1 week, 1 month, and 3 months after surgery. The central vault at 3 months was measured using optical coherence tomography.Results: Three months after surgery, the mean uncorrected distance visual acuities were −0.09 ± 0.12 logarithm of the minimal angle of resolution units with the V4b and −0.07 ± 0.11 logarithm of the minimal angle of resolution units with the V4c. The mean distances between the ICL and the anterior crystalline lens surface were 557 ± 224 μm and 528 ± 268 μm for the V4b and V4c, respectively (P = .73). After 1 week and 1 month, the mean IOPs were 13.7 and 13.3 mm Hg and 14.7 and 15.1 mm Hg, respectively. There were no significant differences in IOP within or between groups during the follow-up period (P > .05, for all comparisons).Conclusions: The new ICL with the CentraFLOW design seems to provide similar results as its predecessors for the correction of moderate to high myopia and maintenance of safe IOP levels without iridotomy.

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Vitrectomy With or Without Preoperative Intravitreal Bevacizumab for Proliferative Diabetic Retinopathy: A Meta-Analysis of Randomized Controlled Trials

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Purpose: To compare safety and functional outcomes of vitrectomy with or without preoperative intravitreal bevacizumab (IVB) for proliferative diabetic retinopathy (PDR).Design: A meta-analysis of randomized controlled trials.Methods: PubMed, Medline, EMBASE, and Cochrane Controlled Trials Register were searched to identify potentially relevant randomized controlled trials. A total of 394 participants with 414 eyes in 8 trials were analyzed using RevMan 5.1 software. The primary measures included intraoperative bleeding, total surgical time, and early and late recurrent hemorrhage.Results: Vitrectomy with IVB pretreatment achieved shorter overall surgical time (mean difference = −26.89 minutes, 95% confidence interval [CI] −31.38 to −22.39, P < .00001) and smaller number of endodiathermy applications (mean difference = −3.46, 95% CI −6.43 to −0.49, P = .02) compared to vitrectomy alone. The IVB group was also associated with less intraoperative bleeding (odds ratio [OR] = 0.10; 95% CI 0.02 to 0.46; P = .003) and recurrent vitreous hemorrhage within first month (OR = 0.35; 95% CI 0.21 to 0.58; P < .0001), but the proportion of recurrent vitreous hemorrhage after the first month was comparable between both groups. There were no significant differences in other complication rates between the 2 groups, with the exception of iatrogenic retinal break, which was more likely with the vitrectomy-alone group (OR = 0.27, 95% CI 0.12 to 0.63, P = .003). Results were robust to sensitivity analyses.Conclusions: Adjuvant intravitreal injection of bevacizumab prior to vitrectomy in PDR patients significantly eased the procedure, diminished intraoperative complications, and reduced early postoperative hemorrhage without increasing the risk of vision-threatening complications. Further trials should determine the optimal interval and dosage for IVB injection.

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Color Atlas & Synopsis of Clinical Ophthalmology, Wills Eye Institute, Cornea, Second Edition

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Media Type: Textbook Synopsis: Recognizing signs and symptoms of anterior segment disorders is essential in making accurate diagnosis and rendering appropriate treatment. The Color Atlas & Synopsis of Clinical Ophthalmology provides a comprehensive review of over 150 clinical entities involving conjunctiva, cornea, sclera, and iris. Each condition is succinctly summarized including etiology, symptoms, signs, diagnostic evaluation, differential diagnosis, treatment, and prognosis. Clinical photographs accompany each entity. Traumatic injuries as well as surgical complications are also included. This second edition builds on the success of the first edition, but expands to include new management options as well as new surgical techniques and complications.

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I read with great interest Zabalza and associates’ commentary in response to my article and Dr Ryan’s accompanying editorial. I thank the authors for sharing their experience in Spain and Portugal through the Retina 1 Project, and for contributing to o…

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We thank Dr Kocatürk and associates for their thoughtful correspondence regarding our manuscript. First, inflammation plays a critical role in the development of corneal neovascularization; therefore, inflammation received careful consideration in t…

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