Frequency of retinal detachment after cataract surgery in highly myopic patients

To determine the potential risk factors for retinal detachment after cataract surgery. In this retrospective cohort study, medical records of patients operated on between 2000 and 2010 at the Department of Ophthalmology, King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia were retrospectively reviewed for both demographic and clinical data. Cases were identified as having an ocular axial length >/=25 mm, while a control group of 500 eyes [axial length range; 22-24 mm] was sampled. Data were analyzed to compare both groups, and to assess potential risk factors for post-cataract retinal detachment. We reviewed 852 eyes of 721 patients; 352 eyes with documented high myopia were compared with 500 control eyes. After a mean follow up of 45.1 +/- 27.9 months, the postoperative mean LogMAR visual acuity significantly differed; 0.51 +/- 0.48 for cases and 0.38 +/- 0.41 for controls [p<0.0001]. Controls showed significantly better postoperative vision as measured by LogMAR [0.92 +/- 0.7] than cases [0.71 +/- 0.61] [p<0.0001]. Twelve eyes [1.4%] had retinal detachments postoperatively. The RD prevalence was significantly higher among cases [10 [2.8%]] than controls [2 [0.4%]] [p=0.007]. High axial length was the only significant risk factor for retinal detachment [p=0.005] even after multivariate adjustment [p=0.019]. High axial length among myopic cataract patients may increase the risk of postoperative retinal detachment

Corneal flap thickness in laser in situ keratomileusis using Moria M2 130 Micron single use plastic head and it's relationship with age, corneal thickness, keratometry and refraction

To determine the predictability of flap thickness in laser in situ keratomileusis [Lasik] using the newly introduced disposable plastic head intended to make 130 micron flaps. To identify relationship of obtained flap thickness with different variables like preoperative corneal thickness, spherical equivalent refraction, mean keratometry, age of the patient and size of the microkeratome ring used during the procedure. Prospective non-comparative interventional case series. Sixty four eyes of thirty six patients underwent laser in situ keratomileusis. In all cases Moria M2 microkeratome with single use 130 micron head was used to create the flap. Manufacturer provided nomogram were used for suction ring selection. Laser ablation was performed with Allegretto Wavelight Eye-Q 400 Htz excimer laser. Central flap thickness was calculated by subtraction pachymetry using DGH-500 pachymeter. The obtained flap thickness was correlated with the age of the patient, preoperative pachymetry, spherical equivalent refraction, mean keratometry, and size of the keratometry ring. Mean flap thickness obtained was 130.7 +/- 27.35 micro m [range 69 to 188 micro m]. Flap thickness directly correlated with preoperative pachymetry [p = 0.001]. There was no correlation between flap thickness and age, mean keratometry, spherical equivalent refraction or the suction ring size. The Moria M2 130 micro m single use head gives flaps with wider standard deviation than previously reported. We recommend that the target flap thickness should be set at 160 micro m for residual bed calculation. In patients with calculated residual stromal bed of less than 275 micro m intra-operative pachymetry should be performed