Cataract surgery is a common procedure in older adults. It is becoming more common not only by virtue of increasing age of the population, but also because of trends in ophthalmic practice and higher prevalence and incidence of late age-related macular degeneration (AMD) in persons who have had cataract surgery as has previously been reported. In the study by Klein et al, the maximally adjusted odds ratio (OR) for incidence of late AMD after cataract surgery compared with eyes with ≥1 type of cataract was 1.96 (95% confidence interval, 1.28–3.02). Including the presence and severity of early AMD lesions in the model somewhat attenuated the overall OR; however, the effect of surgery remained significant (P<0.05). Knowledge of the approximate doubling of the odds of late AMD is of limited use when making recommendations or decisions in clinical practice because this does not place the increased odds in the context of the actual risk. In the current report, we have described the adjusted attributable risk (AR) estimate and number needed to harm (NNH) to provide a measure of absolute risk when evaluating the effect of cataract surgery on incidence of late AMD.
Category: Peer-reviewed
Author reply
We are grateful to Dr Sangtam for the interest in our article, and for raising 2 interesting issues for further discussion. Based on previously available data, we find it hard to draw a simple conclusion that advanced and medically uncontrolled chron…
Endoscopic Transethmoidal Approach with or without Medial Rectus Detachment for Orbital Apical Cavernous Hemangiomas – Corrected Proof
Purpose: To determine the indications for the addition of a transcaruncular approach along with detachment of the medial rectus muscle during the removal of small apical cavernous hemangiomas using an endoscopic transethmoidal approach.Design: Retrospe…
Risk of Lens Opacity in Patients with Diabetes Mellitus
I read the paper entitled “Risk factors for incident cortical, nuclear, posterior subcapsular, and mixed lens opacities: the Los Angeles Latino Eye Study” with interest. The same authors also reported a population-based, cross-sectional study targe…
Intravitreal Bevacizumab in Myopic Neovascular Membranes: 24-Month Results
Intravitreal antiangiogenic drugs have been used recently to treat subfoveal myopic choroidal neovascularization (CNV) with good results. Several papers have reported on the outcome of intravitreal bevacizumab (IVB) in the short term, but very few have…
Retained Lens Fragments after Cataract Surgery: Outcomes of Same-Day versus Later Pars Plana Vitrectomy – Corrected Proof
Purpose: To compare visual acuity outcomes and adverse events in patients with retained lens fragments who underwent same-day versus later pars plana vitrectomy (PPV).Design: Retrospective, interventional case series.Methods: Single-center study evalua…
Author reply
We appreciate the interest of Heindl et al in our recent article in which we report the presence of ciliary body lymphatics in all melanoma eye cases studied. Our group was the first to identify lymphatics in the ciliary body of the normal human eye. T…
Streptococcal Endophthalmitis in Pediatric Keratoprosthesis
The first Boston type I keratoprosthesis used in a child was reported in 2006. Since then, others have advocated for early and primary keratoprosthesis implantation in young patients.
Scheimpflug Corneal Power Measurements for Intraocular Lens Power Calculation in Cataract Surgery – Corrected Proof
Purpose: To compare the keratometric (K) readings from the Pentacam-HR (High Resolution) unit with the automated K values from the IOLMaster keratometer (KIOLM), and to evaluate them in the commonly used intraocular lens (IOL) power calculation formulas for routine cataract surgery.Design: Prospective, comparative observational study.Methods: setting: Private practice, Lynwood, California. study population: Fifty cataractous eyes scheduled for surgery between July and August 2012. observation procedure: The K readings from the Pentacam-HR unit taken at the 2-, 3-, 4-, and 5-mm zones and the 2-, 3-, 4-, and 5-mm rings, respectively, from 3 different maps: sagittal corneal front (KF), true net power (KTNP), and total refractive power (KRP) are compared with KIOLM. IOL power calculations were performed with each of the 25 sets of K readings. main outcome measures: The IOL prediction median absolute error (MedAE) obtained with each measurement.Results: KF averaged 0.03-0.13 diopter (D) higher than KIOLM (P > .05), KTNP averaged 1.16-1.21 D lower than KIOLM (P > .001), and KRP averaged 0.23-0.72 D lower than KIOLM (P > .001), with large variations in the measurements. The MedAE obtained with the different Pentacam K readings ranged from 0.44-0.64 D vs 0.52 D obtained with KIOLM (P > .05). MedAE was lower in all categories when the pupil was 3 mm or smaller.Conclusion: The Pentacam KF values were the closest to KIOLM and the KF readings from the 2-mm ring yielded the best results for IOL power calculation.
August 2012 Cover Photo Is Not Coats’ Disease
We were interested to see the cover photo on the August 2012 edition of Ophthalmology showing a fluorescein angiogram with findings attributed to macular telangiectasia type 1 (Coats’ disease). The wide field fluorescein angiogram very nicely demonstra…
Prevention of Neovascular Glaucoma
Neovascular glaucoma (NVG) is defined by the occurrence of neovascularization (NV) of the iris and/or anterior chamber angle associated with increased intraocular pressure (IOP). Optic disc changes are not specific and cupping of the optic nerve head i…
期刊一览
Richoz 等人 (p. 1354) 的一项长期随访研究发现角膜胶原交联术 (CXL) 可以有效阻止 LASIK 或准分子激光角膜切削术 (PRK) 术后角膜扩张的进展. 这一方法改善了患者最佳矫正远视力 (CDVA) 及最大K值 (Km…
Molecular Analysis of Uveal Melanoma
Onken et al report a prospective evaluation of a gene expression profiling (GEP)-based assay, designed around 15 genes, that assigns uveal melanoma (UM) to 2 prognostic subgroups: Classes 1 and 2, which respectively are associated with low and high ris…
Adaptive Optics Imaging of Idiopathic Epiretinal Membranes
Idiopathic epiretinal membrane (ERM) is the most common vitreomacular interface pathology in adult population. Prevalence of idiopathic ERM has been estimated to be >10% among those >70 years; its development is usually preceded by posterior vitreous detachment. It is composed of nonvascularized tissue growth along the retinal inner limiting membrane, and many different cellular (hyalocytes, glial cells, fibroblasts) and extracellular components (collagen, fibronectin, neurites) have been identified in immunocytochemical studies.
This Issue At A Glance
Long-term results from a study by Richoz et al (p. 1354) show that corneal collagen cross-linking (CXL) effectively halts the progression of ectasia that has occurred after LASIK or photorefractive keratectomy (PRK). The procedure improves the correcte…
Author reply
We appreciate the opportunity to respond to the letter by Coupland and Damato regarding our 2012 article. Contrary to their claim, the gene expression profile (GEP) prognostic test for uveal melanoma has undergone much greater validation than any other…
Adenoid Cystic Carcinoma of the Lacrimal Gland: Rare … Lethal … Cured?
There are few more difficult conversations in ophthalmology than that between a surgeon and a patient with newly diagnosed adenoid cystic carcinoma of the lacrimal gland. The results of conventional treatment, most commonly orbital exenteration followe…
Author reply
In response to the letter by Chen et al, we disagree with many of their assumptions and statements. We respond point-by-point to their concerns. In our published study, endophthalmitis was defined by the presence of positive intraocular cultures in a…
A Simple Vista en Este Número
Los resultados a largo plazo de un estudio realizado por Richoz y otros (p. 1354) muestran que el enlace cruzado de colágeno corneal (CXL) detiene efectivamente la progresión de la ectasia producida después de LASIK o de queratectomía fotorrefracti…
Author reply
We appreciate the interest shown by Carifi et al regarding our article. The volume of intracameral phenylephrine (IPH) injected (0.6 ml), means we can be sure that enough amount of drug is administered, because part of the drug will be released through…