Category: Peer-reviewed

Three-Year Incidence and Factors Associated With Posterior Capsule Opacification After Cataract Surgery: The Australian Prospective Cataract Surgery and Age-related Macular Degeneration Study – Corrected Proof

Purpose: To assess 3-year incidence and associated factors of posterior capsule opacification (PCO) after phacoemulsification surgery.Design: Cohort study.Methods: A total of 1934 consecutive patients aged ≥64 years undergoing phacoemulsification sur…

Evaluation of Levator Function for Efficacy of Minimally Invasive and Standard Techniques for Involutional Ptosis – Corrected Proof

Purpose: To evaluate clinical and anatomic outcomes of surgery for involutional ptosis using standard-length or small incisions in relation to preoperative levator function.Design: Retrospective study.Methods: Sixty-three patients diagnosed with involutional ptosis who underwent surgical correction using a small or standard-length incision between November 2010 and December 2011 were reviewed; a single surgeon performed surgery using a small incision (8 to 10 mm) in 22 patients and a standard-length incision (20 to 22 mm) in 34 patients. All patients underwent standard preoperative ptosis evaluation with margin-to-reflex distance 1 and 2 measurements and levator function assessment. Patients were divided into 2 groups according to levator function (moderate: 5 to 10 mm; and good: >10 mm). Surgical success was evaluated based on the British Oculoplastic Surgery Society criteria.Results: Of 83 upper eyelids of 63 patients, surgery was performed using a small incision in 40 and a standard incision in 43. In patients with good levator function, surgical success was achieved with a small incision in 18 eyelids (94.7%) and a standard incision in 20 eyelids (95.2%; P = .91). In patients with moderate levator function, surgical success was achieved with a small incision in 14 eyelids (66.7%) and with a standard incision in 18 eyelids (81.8%; P = .04).Conclusions: These findings indicate a similar surgical success rate in patients with good levator function, regardless of incision length. The surgical success rate in patients with moderate levator function was lower when using a small incision, perhaps because of decreased visualization and anatomic access.

Metamorphopsia and Optical Coherence Tomography Findings After Rhegmatogenous Retinal Detachment Surgery – Corrected Proof

Purpose: To investigate the relationship between metamorphopsia and macular morphologic changes after successful repair of rhegmatogenous retinal detachment (RD).Design: Prospective, interventional, consecutive study.Methods: The study included 129 eyes of 129 patients who had undergone successful retinal reattachment surgery. The severity of metamorphopsia was recorded using M-CHARTS and foveal microstructure was assessed with spectral-domain optical coherence tomography (OCT) at 6-12 months postoperatively.Results: The mean metamorphopsia score was 0.30 ± 0.46, and 50 of 129 patients (39%) had metamorphopsia. Metamorphopsia was more severe in eyes with macula-off rhegmatogenous RD than those with macula-on (P < .001). Eighteen of 50 eyes with metamorphopsia exhibited abnormal structures in the macular region (epiretinal membrane, disruption of the photoreceptor inner and outer segment junction, cystoid macular edema, macular hole, or subretinal fluid), whereas the other 32 eyes showed no morphologic changes with OCT. In these 32 eyes, the horizontal metamorphopsia score (0.86 ± 0.50) was significantly higher than the vertical metamorphopsia score (0.62 ± 0.39, P < .05). Nine of 69 eyes with preoperative macula-on rhegmatogenous RD developed postoperative metamorphopsia. Of the 9 eyes, 6 showed abnormal macular structures and the other 3 had normal-appearing OCT. The macula briefly detached during vitrectomy in these 3 cases.Conclusions: In eyes that remained macula-on throughout surgery and had normal-appearing OCT, metamorphopsia did not develop. In some cases, the reason for metamorphopsia was anatomically obvious. In other cases that were preoperative and intraoperative macula-off, postoperative retinal vertical displacement could cause predominantly horizontal metamorphopsia.

Leprosy and the Germ Theory

The germ theory of disease, one of the great accomplishments of science, was not established for two centuries after Anton van Leeuenhoek in 1674 saw microscopic, motile “animalcules” in stagnant pond water. These were relatively large single-celle…

This Issue At A Glance

Tozer et al (p. 2029) evaluated the effectiveness of rescue therapy in eyes with neovascular age-related macular degeneration (AMD) that failed monotherapy with intravitreal injections of bevacizumab or ranibizumab. They found that the combination of …

Reply

Thank you very much, Dr. Khawaja Khalid Shoaib, for your interest in our article, Posterior Iris-claw Aphakic Intraocular Lens Implantation in Children. We agree with Dr. Shoaib regarding the rather short 31-month average follow-up in our study. The…

Author reply

Dear Editor: We thank Drs Bateman and Silva for their comments. We share their belief in the importance of genetic counseling and written documentation when caring for families affected with genetic diseases, which is why we included genetic counseli…

A Simple Vista en Este Número

Tozer y otros (p. 2029) evaluaron la efectividad de la terapia de rescate en ojos con degeneración macular neovascular relacionada con la edad (AMD) que no respondía a la monoterapia con inyecciones de bevacizumab o ranibizumab a intervalos. Determin…