Wavefront-guided Versus Standard Laser in situ Keratomileusis in Myopia Using a 213 nm Wavelength Solid-state Laser: Comparison of Higher-order Aberrations.

Purpose: To assess the accuracy, efficacy, stability and safety of laser in situ keratomileusis (LASIK) for myopia and compare the pre- and post-operative changes in higher-order aberrations after wavefront-guided (WF) and standard (STD) LASIK done using the Pulzar Z1, a 213-nm wavelength solid-state laser, and determine their effects on visual acuity and refractive outcomes. Methods: This a retrospective case series composed of 80 eyes (40 patients) that had LASIK in an out-patient refractive surgery center in Manila, Philippines. Outcome measured were pre and post-operative manifest refraction spherical equivalent (MRSE), uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity (CDVA), keratometry, root-mean-square (RMS) values, flap and ablation related complications. Results: The mean UDVA improved from 20/400 pre-operatively to 20/25 post-operatively. Thirty six of the 40 eyes (90%) treated with STD LASIK and 39 of the 40 eyes (97.5%) treated with WF LASIK had UDVA of 20/30 or better at 1 year post-operatively. There was a significant decrease in spherical equivalent manifest refraction post-operatively in all patients. The average spherical equivalent at 1 year is -0.43D±0.64. After twelve months of follow-up, 85.5% (34 out of the 40 eyes) of those who underwent STD LASIK and 77.5% (31 out of 40 eyes) who underwent WF LASIK had postoperative manifest refractive spherical equivalent (MRSE) of -1.0 to +1.0D. The mean difference in the attempted versus achieved refraction was not significant between the 2 groups (p = 0.32). At 12 months post-operatively, seven eyes (17.5%) gained 1 line in the WF-guided LASIK, while the rest of the eyes either showed no change in CDVA or lost 1-2 Snellen lines. The total RMS generally increased postoperatively for WF LASIK while decreased for STD LASIK, but the mean RMS difference from the pre- and post-operative values between the 2 groups were not statistically significant. None of the eyes developed flap complications during the follow-up period. Conclusion: Refractive surgery using the Pulzar Z1 213-nm wavelength solid-state laser is an effective and safe procedure in the treatment of myopia. Wavefront-guided LASIK offers no advantage over STD LASIK in improving higher-order aberrations and in achieving better visual and refractive outcomes.

Bilateral Endogenous Endophthalmitis in an Asian Female

Aims: To report a case of bilateral endogenous endophthalmitis in an elderly Asian female. Presentation of Case: An elderly Filipino female complaining of sudden blurring of vision of the right eye sought consult at our institution. Ophthalmologic examination, and vitreous tap were done for both eyes and systemic work-up was facilitated to localize the source of infection. Vitreous sample of the right eye yielded positive for Klebsiella pneumoniae, but cultures were sterile on the left. Systemic work-up revealed a complicated nephrolithiasis. Within 24 hours of her admission, vision rapidly deteriorated to no light perception. There was no return in vision despite systemic and topical antibiotic treatment. Discussion: Endogenous endopthalmitis is a relatively rare condition. Among Asians, the patient at highest risk for endogenous endophthalmitis is a diabetic with Klebsiella hepatobiliary infection. However, this patient was found to have a urinary tract infection. Conclusion: Klebsiella pneumoniae endopthalmitis confers a poor prognosis necessitating a high index of suspicion and early intervention.

Comparative study on the use of conjunctival autograft with or without mitomycin-C in pterygium surgery

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To compare the recurrence rate after conjunctival autograft alone versus conjunctival autograft with mitomycin-C in the treatment of primary and recurrent pterygium.<br /><strong>METHODS:</strong> This was a prospective, randomized, interventional comparative study of patients with primary and recurrent pterygium who were randomized to receive either simple excision with conjunctival autograft (CA) or simple excision with CA and mitomycM-C applied. They were followed up for 6 months and observed for recurrence of the pterygium. Statistical analyses were used to compare the 2 groups.<br /><strong>RESULTS:</strong> Fifty-eight patients (62 eyes) diagnosed with primary and recurrent pterygium were evaluated. The mean age was 44.81 ± 12.35 years (range 25 to 70 years). Thirty eyes were treated with conjunctival autograft (15 primary, 15 recurrent) and 32 eyes (17 primary, 15 recurrent) with conjunctival autograft combined with Mtraoperati-ve application of low-dose raitomycin. -C (0.02% for 3 minutes). The mean follow-up period was 25 ± 1.40 months (range 24 to 28 months). There was a 3.22% recurrence rate (2 eyes) from the recurrent pterygium group. There was no significant difference 11.1  the rate of recurrence (p = 0.53) between the 2 treatments for both primary and recurrent pterygium. No mitomycM C-related complication was observed during the length of the study.<br /><strong>CONCLUSION:</strong> Conjunctival autograft surgery alone for primary and recurrent pterygium is effective and safe in reducing the recurrence rate of pterygium within" 6 months.</p>