Comparison of Short-Term Clinical Outcomes between Intravitreal Ranibizumab and Aflibercept in Retinal Angiomatous Proliferation

PURPOSE: To evaluate the 6-month outcomes of intravitreal ranibizumab and aflibercept treatment for patients with retinal angiomatous proliferation (RAP). METHODS: A retrospective review of medical records of 28 patients (31 eyes) diagnosed with RAP was performed. All patients were initially treated with 3 consecutive intravitreal ranibizumab or aflibercept injections after diagnosis. Additional treatment was performed when exudation recurred. The best-corrected visual acuity (BCVA) and central foveal thickness were measured before the first injection and 3 and 6 months after the first injection. The values measured before the treatment were compared with those after treatment. RESULTS: Sixteen eyes were treated with ranibizumab and 15 eyes with aflibercept. The logarithm of minimal angle of resolution (log MAR) values of BCVA before the first injection and 3 and 6 months after the first injection were 0.78 +/- 0.50, 0.47 +/- 0.30 and 0.59 +/- 0.41 in the ranibizumab group and 0.96 +/- 0.52, 0.83 +/- 0.52 and 0.74 +/- 0.56 in the aflibercept group, respectively. Central foveal thickness was 315.75 +/- 115.44, 188.38 +/- 57.33 and 218.50 +/- 96.49 microm in the ranibizumab group and 249.00 +/- 74.88, 143.73 +/- 32.73 and 196.73 +/- 94.08 microm in the aflibercept group, respectively. BCVA was significantly improved and central foveal thickness was significantly reduced at 6 months (p < 0.05) compared to measurements before the first injection in both groups. However, BCVA improvement and central foveal thickness were not significantly different between the 2 groups. CONCLUSIONS: Both intravitreal ranibizumab and aflibercept treatments were beneficial for both normalizing macular thickness and improving visual acuity in patients with RAP. The efficacy of the 2 drugs was not noticeably different.

Primary 23 Gauge Transconjunctival Sutureless Vitrectomy With Air Tamponade for Simple Rhegmatogenous Retinal Detachment

PURPOSE: To evaluate the surgical outcomes of primary 23-gauge (23G) transconjunctival sutureless vitrectomy (TSV) with air tamponade in patients with idiopathic simple rhegmatogenous retinal detachment (RRD). METHODS: A chart review of 38 eyes with idiopathic simple RRD which underwent primary 23G TSV with air tamponade and without prone positioning by a single vitreoretinal surgeon was retrospectively performed. All cases were followed up for a minimum of 3 months after the operation. RESULTS: The primary anatomical success rate was 94.7% (36/38 eyes). Preoperative mean logMAR (Snellen) best corrected visual acuity (BCVA) was 0.81 +/- 0.13 and improved to 0.63 +/- 0.37 and 0.48 +/- 0.37 at postoperative 1 week and 3 months (p < 0.05), respectively. The mean 21.35% amount of air bubble remained in the vitreous cavity at postoperative 1 week and the residual air bubble was completely absorbed at postoperative 2 weeks. Complications were sclerotomy site leakage (1 eye), cataract (3 eyes), vitreous hemorrhage (1 eye), epiretinal membrane (2 eyes) and increased intraocular pressure (3 eyes). CONCLUSIONS: The use of 23G TSV with air tamponade in cases with idiopathic simple RRD may be an effective and safe surgical technique.

Clinical Features Associated With Outcomes of Canalicular Laceration Repair

PURPOSE: To evaluate clinical characteristics and outcome of repair of canalicular laceration with Crawford stent. METHODS: All 40 patients who underwent canalicular laceration repair from 2004 to 2007 in the hospital were retrospectively reviewed. Demographics, cause of canalicular injury, surgical management with Crawford stent, and its outcome were analyzed RESULTS: Most cases were male with step wound (34 cases 85%). Average age of fourty patients was 41.7 years old. Outcome had varied depending on the time of surgery, the location of laceration, the suture method, the wound condition, and the duration for stent. Maintaining silicone tube more than three months, and surgical approach within forty-eight hours resulted in statistically significant results. CONCLUSIONS: The outcome of canalicular laceration was better when surgical approach was done within forty-eight hours and silicone tube was maintained more than three months.