The study looked at patients who elected to undergo surgical monovision with LASIK between January 2000 and January 2003 and assessed the success of surgical monovision in presbyopic patients. It analyzed preoperative and postoperative defocus spherical equivalent, whether the patient underwent enhancements, whether the patient underwent a preoperative monovision trial with contact lens, and whether the patient underwent monovision reversal.
Thirty patients underwent a contact lens trial of monovision before LASIK, and none of those patients elected monovision reversal. There were 52 patients who did not undergo a contact lens monovision trial before LASIK monovision, and two of these patients underwent monovision reversal. Monovision success in this population was 97.6 percent.
Of the 82 patients who underwent LASIK for monovision, mean preoperative spherical equivalent in the distance-corrected eye was -4.07 (standard deviation: 2.49); for the eye corrected for near vision, mean preoperative spherical equivalent was -4.10 (SD: 2.56). Postop spherical equivalent in the distance eyes was -0.01 (SD: 0.38) and in the near eyes -1.24 (SD: 0.91). There were six enhancements in the near eyes (7 percent) and 17 enhancements in the distance vision eyes (21 percent). This difference was statistically significant (p=0.007).
(Cornea 2006;25:136-138)
Reilly CD, Lee WB, Alvarenga L, Caspar J, Garcia-Ferrer F, Mannis MJ.
Study Finds Fugo Blade Can Be of Use in Corneal Surgery
AN ANIMAL STUDY SUGGESTS THAT THE Fugo Blade, currently approved for anterior capsulotomy, Transciliary Filtration and peripheral iridotomy, may have additional uses in corneal surgery. In animal tissue, the blade produced resistance-free cuts in corneal tissue.
Researchers evaluated the performance of the Fugo Blade both in vitro and in vivo, making corneal incisions on pig eyes and evaluating the histologic characteristics. They performed similar cuts on rabbit corneas in vivo and compared with cuts performed with mechanical blades. The rabbits were euthanized, and the corneas received histopathologic examination 14 days after surgery.
Slit-lamp examinations and histologic findings showed that the Fugo Blade can produce sharp cuts in the cornea with minimal tissue damage beyond the edges of the incisions. It cuts without resistance and permits normal wound healing.
(Cornea 2006;25:206-208)
Peponis V, Rosenberg P, Reddy SV, Herz JB, Kaufman HE.
Intravitreal Bevacizumab Shows Promising Results for CRVO Patients
RESEARCHERS HAVE FOUND INTRAVITreal bevacizumab (Avastin, Genentech) resulted in a significant decrease in macular edema and improvement in visual acuity in patients with central retinal vein occlusion. Initial treatment results of patients with macular edema secondary to CRVO did not reveal any short-term safety concerns. However, the number of patients in the pilot study was limited and the follow-up is too short to make any specific treatment recommendations. Nevertheless, the favorable short-term results suggest further study in this area is needed.
The study included patients with macular edema due to CRVO, and they were treated with at least one intravitreal injection of bevacizumab 1.25 mg in 0.05 mL. Patients underwent Snellen visual acuity testing, optical coherence tomography imaging, and ophthalmoscopic examination at baseline and follow-up visits.
There were 16 eyes of 15 consecutive patients with a mean age of 76.1 years (SD: 9.8 years). Intravit-real triamcinolone had been previously administered to nine patients, but all of these patients either had no improvement or had excessive intraocular pressure caused by the triamcinolone, the researchers report. The patients received a mean of 2.8 injections of bevacizumab per eye. No adverse events were observed, including endophthalmitis, clinically evident inflammation, increased IOP, retinal tears, retinal detachment or thromboembolic events, the researchers report. The mean central macular thickness at baseline was 887 µm and de-creased to a mean of 372 µm at one month (p<0.001). The mean baseline acuity was 20/600 (logMAR=1.48) and the mean acuity at one month was 20/200 (logMAR=1.05), a difference that was highly significant (p=0.001).
At the last follow-up, a mean of three months after the first injection, the mean visual acuity was 20/138 (logMAR=0.84), which was significantly better than baseline (p<0.001). Visual acuity improvement, defined as a halving of the visual angle, was seen in 14 of the 16 eyes, the researchers report.
(Retina 2006;26:279-284)
Iturralde D, Spaide RF, Meyerle CB, Klancnik JM, Yannuzzi LA, Fisher YL, Sorenson J, Slakter JS, Freund KB, Cooney M, Fine HF.
Initial Small-Incision DLEK Results Encouraging
THE INITIAL, ENCOURAGING VISual results of the small-incision deep lamellar endothelial keratoplasty procedure indicate it is a safe process that provides healthy donor endothelial cell count and function postoperatively.
This non-comparative case series was designed to evaluate the results of replacing the posterior stroma and endothelium, using small-incision DLEK surgical technique, in patients with corneal endothelial dysfunction, according to re-searchers in this 2004 study conducted in India.
The study included 15 eyes of 15 patients (six males and nine females) with endothelial dysfunction. Through a 5-mm scleral incision, a deep lamellar pocket was created across the cornea, followed by excision of an 8-mm disk of posterior lamellar corneal tissue. A same-size lamellar donor disk was prepared, then placed in position without suture fixation. Best spectacle-corrected visual acuity, refraction, endothelial cell density, corneal topography and corneal thickness were analyzed.
The average BSCVA preop was 20/200 (range: 20/40 to hand movements), improving to 20/50 (range 20/20 to 20/120) at a mean follow-up of 7.2 months. Average refractive astigmatism at last follow-up was 1.46 ±1.21 D (range: 0 to 4 D). The preop average donor endothelial cell density was 2,047 ±311 cells/mm2, and at last follow-up was 1732 ±514 cells/mm2. The preoperative average pachymetry was 801.4 ±211.3 µm, improving to 553 ±90.4 µm at the last follow-up.
(Am J Ophthalmol 2006;141:346-351)
Fogla R, Padmanabhan, P.
Patient-Reported Problems with Glaucoma Medications
PATIENT ADHERENCE TO GLAUcoma medication regimen could be improved among patients receiving adjunctive therapy, according to a recent cross-sectional survey. The study suggests ophthalmologists and their clinical colleagues should discuss patients' problems and concerns in taking their glaucoma medications to improve adherence.
A survey was distributed to glaucoma patients in four geographically distinct ophthalmology practices and patients using only one glaucoma medication were excluded. The survey was completed by 324 patients.
The study's objectives were to describe the different patient-reported problems with adjunctive therapy and to examine the relationship between these problems and patient adherence. For each patient, average percent adherence to his glaucoma medication regimen was calculated. Logistic regression was used to examine how patient characteristics and problems in using glaucoma medications were related to reported adherence.
Sixty percent of patients reported one or more problems with taking their glaucoma medications. Fourteen percent of patients reported being less than 100 percent adherent to their glaucoma regimen medications during the previous week. Patients who had difficulty remembering to take their glaucoma medications and those who reported that they had other problems or concerns with their glaucoma medications were significantly less likely to be 100 percent adherent.
(Ophthalmology 2006;113:431-436)
Sleath B, Robin AL, Covert D, Byrd JE, Tudor G, Svarstad B.
