Scleral Fixation of a Hydrophobic Acrylic Intraocular Lens with Eyelets Using 8-0 Polypropylene Suture

Purpose@#To report clinical outcomes of a scleral fixation technique of a hydrophobic acrylic intraocular lens with eyelets using 8-0 polypropylene suture. @*Methods@#Nine eyes of nine patients who underwent combined pars plana vitrectomy and sclera fixation of an intraocular lens using this technique were analyzed. @*Results@#The mean follow-up period was 7.11 months (range, 6–12 months), and there was a significant visual improvement at 6 months after surgery. The mean logarithm of the minimum angle of the resolution changed from 0.54 at baseline to 0.29 at postoperative 6 months (p = 0.016). The mean postoperative spherical equivalent at 6 months was -0.90 ± 0.90 diopters, and the mean predictive error was -0.49 ± 0.62 diopters. @*Conclusions@#Postoperative visual and refractive outcomes were favorable, and the positions of intraocular lenses were well centered in all cases. This technique could be a useful alternative for surgeons without easy access to Gore-Tex suture.

Surgical Management of Superior Oblique Muscle Palsy in Hypertropia 16 Prism Diopters or More

PURPOSE: Isolated inferior oblique weakening procedure is an effective treatment for patients with superior oblique muscle palsy who had up to 15 prism diopters (PD) of vertical deviation in the primary position, but 2-muscle surgery is needed for patients with larger deviations. Herein, we report the surgical results of simultaneous 2-extraocular muscle surgery for large primary position hypertropia 16 PD or more caused by superior oblique palsy. METHODS: This study was a retrospective review of the records of patients who presented with central gaze hypertropia 16 PD or more and underwent simultaneous 2-extraocular muscle surgery between January 2003 and June 2014 in Severance Hospital. The patients were divided into 3 groups: 43 patients who underwent inferior oblique (IO) myectomy and contralateral inferior rectus (IR) recession (Group 1), 10 patients who underwent IO myectomy and superior rectus (SR) recession (Group 2), and 8 patients who underwent SR recession and contralateral IR recession (Group 3). Criteria for success included correction of head posture and a primary position alignment within 5 PD of vertical deviation. RESULTS: Mean preoperative alignment at primary gaze was 25.5 ± 7.1 PD (range, 16-60 PD) compared to the postoperative value of -1.3 ± 6.8 PD (range, -20~25 PD) (p < 0.001). Surgery was successful in 49 (80%) patients. Nine (15%) patients were overcorrected and the other 3 (5%) patients were undercorrected. Success rate was the highest in subjects who underwent IO myectomy and contralateral IR recession. Among the 24 patients who did not receive combined horizontal muscle surgery, horizontal deviations decreased from 10.4 ± 2.7 PD to 1.5 ± 5.5 PD (p < 0.001) CONCLUSIONS: Two-muscle surgery can be effective in patients with large hypertropia 16 PD or more. Additionally, horizontal deviations are more likely to be resolved with vertical muscle surgery alone. However, IO myectomy combined with ipsilateral SR recession can cause overcorrection postoperatively, so surgical dose should be reduced when performing weakening procedure of two elevators in one eye.

Effect of Co-Implantation of a Capsular Tension Ring on Clinical Outcomes after Cataract Surgery with Monofocal Intraocular Lens Implantation

PURPOSE: The objective was to evaluate the effect of co-implantation of a preloaded capsular tension ring (CTR) and aberration-free monofocal intraocular lens (IOL) on clinical outcomes and visual quality after cataract surgery. MATERIALS AND METHODS: Patients who underwent cataract surgery were randomized into two groups that were implanted with a CTR and IOL (group 1, 26 eyes) or an IOL only (group 2, 26 eyes). At 1 and 3 months after surgery, visual acuity, refractive errors, refractive prediction errors, ocular aberrations, and modulation transfer function (MTF) were analyzed. At 3 months postoperatively, anterior chamber depth (ACD) and contrast sensitivity were evaluated. RESULTS: Group 1 showed greater hyperopic shift, which caused the refractive prediction error at 3 months after surgery to be significantly different between the two groups (p=0.049). Differences in ACD between the preoperative and postoperative periods tended to be greater in group 1 than in group 2. At 3 months postoperatively, internal MTF values at 20, 25, and 30 cycles per degree were significantly better in group 1 than in group 2 (p=0.034, 0.017, and 0.017, respectively). Contrast sensitivity showed comparable results at almost all spatial frequencies between the groups. CONCLUSION: Regarding visual acuity and quality, both groups showed comparable results. Co-implantation of a CTR and aberration-free monofocal IOL was associated with hyperopic refractive outcomes. Surgeons should consider the position of the IOL when planning co-implantation of a CTR and IOL.

Intravitreal Bevacizumab for the Treatment of Optic Disc Edema in a Patient with POEMS Syndrome

No abstract available.