Assessment for Macular Thickness after Uncomplicated Phacoemulsification Using Optical Coherence Tomography

Purpose@#Macular edema including cystoid macular edema is one of the main causes of unfavorable visual outcomes after cataract surgery. The macular thickness and the occurrence of macular edema after uncomplicated cataract surgery was evaluated using optical coherence tomography (OCT) in this study. @*Methods@#Macular map images were taken by OCT before surgery and at 1 week, 1 month, and 2 months postsurgery. The subjects were classified into two groups (group 1, patients with no macular edema; group 2, patients with macular edema). Group 2 was defined as increase in central macular thickness (CMT) by 30% compared with that before surgery. The risk factors for macular edema were evaluated. Group 2 was divided into two subgroups: subclinical macular edema (group 2A) and cystoid macular edema (group 2B) and they were assessed in terms of the clinical course of best-corrected visual acuity and CMT. @*Results@#A total of 376 patients were enrolled in this study, of which 36 (9.57%, group 2) showed macular edema measured by OCT after the surgery. Univariate analysis for group 1 and 2 revealed that intracameral injection of epinephrine during phacoemulsification was associated with the development of macular edema. In group 2, five patients (1.33%) developed cystoid macular edema. Statistically significant differences in the clinical course of CMT were observed at 2 months (201.2 ± 23.1, 250.0 ± 29.8, and 371.0 ± 160.3 in group 1, group 2A, and group 2B, respectively; p 0.2 with CMT in the normal range. @*Conclusions@#The intracameral injection of epinephrine may cause macular edema after uncomplicated cataract surgery. Examination of CMT using OCT is recommended for the early detection of macular edema.

Laser Iridotomy-Induced Bullous Keratopathy in Korea: Clinical Features and Comparison with Pseudophakic Bullous Keratopathy

PURPOSE: To investigate the clinical features and prevalence of patients with laser iridotomy-induced bullous keratopathy in Korea. METHODS: Using a retrospective study, the patients with laser iridotomy-induced bullous keratopathy who underwent penetrating keratoplasty were selected. We investigated the duration from iridotomy to corneal decompensation, preoperative anterior chamber depth, axial length, keratometry, and survival time of the grafted cornea. The data were compared with the data of patients with pseudophakic bullous keratopathy as controls. RESULTS: Laser iridotomy-induced bullous keratopathy was found in 17 eyes, which represented 2.3% of penetrating keratoplasty cases (727) and 8.5% of bullous keratopathy cases (201), with a mean age of 66.9 years. The laser iridotomy-induced bullous keratopathy group showed a higher female ratio (15 out of 17), shorter mean axial length (22.09 +/- 0.79 mm) and anterior chamber depth (1.91 +/- 0.36 mm) than the control group (15 out of 50, 24.30 +/- 2.54 mm and 3.27 +/- 0.66 mm, respectively) with a statistical significance (p = 0.002, p < 0.001 and p < 0.001, respectively). Mean survival time of the grafted cornea was 39.9 +/- 8.6 months in the group of laser iridotomy-induced bullous keratopathy, which was shorter than the control group (47.8 +/- 3.1 months) without statistical significance (p = 0.47). CONCLUSIONS: In Korea, laser iridotomy-induced bullous keratopathy shows non-negligible prevalence and should be further investigated.

Therapeutic Effects of 0.03% Tacrolimus Eye Drops for Chronic Ocular Graft-Versus-Host Disease

PURPOSE: To evaluate the therapeutic effects of 0.03% tacrolimus eye drops on dry eye associated with chronic ocular graft-versus-host disease (GVHD). METHODS: This study included 24 eyes of 12 patients with refractory dry eye associated with chronic ocular GVHD who were unresponsive to topical steroid and 0.05% topical cyclosporine. The topical steroid and cyclosporine were discontinued for 2 weeks before treatment and 0.03% tacrolimus eye drops were applied twice a day for 1 month. Artificial tears, ointment, and lid cleanser were used in the same manner before initiating tacrolimus treatment. Ocular staining score, tear break-up time, ocular surface disease index (OSDI), and Schirmer I test score were evaluated. RESULTS: Ocular staining score, tear break-up time, and OSDI improved with statistical significance (p < 0.05) after 28 days of treatment. Schirmer I test did not show statistical improvement after treatment. CONCLUSIONS: The use of 0.03% tacrolimus eye drops were effective for refractory dry eye associated with chronic ocular GVHD.