ABSTRACT
Purpose@#To investigate the impact of uncomplicated cataract surgery on the measurement of Bruch’s membrane opening-minimum rim width (BMO-MRW) and retinal nerve fiber layer thickness (RNFLT) using spectral domain optical coherence tomography (SD-OCT) in primary open-angle glaucoma (POAG) patients. @*Methods@#This retrospective study included 63 eyes of 63 patients, including 32 POAG eyes and 31 normal eyes who underwent uneventful cataract surgery and follow-up for at least 6 months. Using SD-OCT, BMO-MRW and RNFLT were measured preoperatively and postoperatively at 6 months. Paired t-test was used to compare intraocular pressure (IOP), BMO-MRW, RNFLT, and image quality before and after surgery. These parameters and their changes were compared between POAG and normal groups. Univariate and multivariate linear regression analyses were performed to determine the factors associated with the postoperative change (Δ) in RNFLT and BMO-MRW. @*Results@#BMO-MRW and RNFLT were significantly increased and IOP was decreased after phacoemulsification in both groups (p < 0.001, respectively). The ΔRNFLT was significantly greater in POAG eyes compared with the normal eyes (p < 0.001). The ΔRNFLT was associated with the postoperative IOP reduction and glaucoma diagnosis (p < 0.001 and p = 0.001, respectively). In the normal group, only the ΔIOP had a significant influence on the ΔRNFLT (p = 0.003), but in the POAG group, not only the ΔIOP (p = 0.044) but also preoperative visual field mean deviation (p = 0.029) showed a significant influence. The ΔBMO-MRW showed no difference between POAG and normal eyes. @*Conclusions@#The postoperative increase of RNFLT was significantly greater in the POAG group, and the postoperative increase of RNFLT was associated with the preoperative visual field mean deviation and ΔIOP in POAG eyes and with the ΔIOP in normal eyes. Our results imply that RNFLT is more affected than BMO-MRW in POAG eyes compared to normal eyes by cataract surgery.
ABSTRACT
Purpose@#To investigate the safety of single and combined use of epinephrine and indocyanine green during cataract surgery by evaluating the effects on corneal endothelial cells. @*Methods@#From January 2017 to October 2021, 121 patients (132 eyes) who underwent cataract surgery were enrolled. Patients were divided into 4 groups: epinephrine (n = 20), indocyanine green (n = 49), epinephrine and indocyanine green combination (n = 12), and control (n = 51). Retrospective medical chart findings and endothelial cell count change data were compared among study groups before and after operation. @*Results@#Endothelial cell count change (△ECC) decreased for all groups; however, a significant difference among groups was not observed (p = 0.822). Univariate linear regression showed that △ECC was associated with postoperative hexagonality, nuclear sclerosis grade, ultrasound time, and cumulative dissipated energy (beta = -0.216, 0.254, 0.368, 0.351 and p = 0.013, p = 0.003, p < 0.001, p < 0.001). Multivariate linear regression showed that △ECC was associated with postoperative hexagonality and ultrasound time (beta = -0.215, 0.367, p = 0.010, p < 0.001). @*Conclusions@#Factors closely associated with postoperative endothelial cell loss were postoperative hexagonality and ultrasound time. No significant damage to the corneal endothelium was observed when epinephrine and indocyanine green were used alone or in combination. Thus, these agents appear safe for use in this context.
ABSTRACT
PURPOSE: To investigate the changes in intraocular pressure (IOP) and associated systemic factors over 7 years in a healthy Korean population. METHODS: This longitudinal study included healthy subjects with no history of ocular disease and who had been receiving health examinations seven years apart at the Konkuk University Medical Center, Healthcare Center. The participants completed lifestyle questionnaires and underwent general health examinations (blood pressure, height and weight, and blood biochemical tests) and ocular examinations including noncontact tonometry and fundus photography. Subjects with abnormal fundus photography findings and ocular hypertension were excluded. Changes in IOP and systemic factors over 7 years were analyzed. RESULTS: Of 524 possible subjects, 469 were enrolled (55 subjects were excluded: 50 due to abnormal fundus photography and 5 for missing data). The left eye was analyzed in all patients. In all subjects, initial IOP (mean 14.50 ± 3.14 mmHg) was not significantly different from final IOP (14.72 ± 3.38 mmHg) (paired t-test, p = 0.074). In male patients, the final IOP was significantly higher than the initial IOP (paired t-test, p = 0.035). Lifestyle questionnaire variables were associated with a final IOP that was significantly higher than the initial IOP (smokers, alcohol drinkers and less exercisers, paired t-test; p = 0.014, 0.010 and 0.024, respectively). A linear mixed-effects model analysis showed that the change in IOP was negatively associated with age, but this was not statistically significant. Changes in systolic blood pressure (SBP), body mass index (BMI), total cholesterol (T.Chol) and low density lipoprotein (LDL) were positively correlated with change in IOP. CONCLUSIONS: A linear mixed-model analysis showed IOP decreased with age but this was not statistically significant. Changes in SBP, BMI, T.Chol and LDL were significantly positively correlated with change in IOP.