Comparison of corneal endothelial changes following phacoemulsification in diabetic and non-diabetic patients

Purpose: To study corneal endothelial changes post phacoemulsification in diabetic and non?diabetic patients. Methods: A comparative, prospective, observational study was conducted on 100 diabetic and 100 non?diabetics who underwent phacoemulsification. All patients were operated by the same surgeon by using the phaco chop technique to exclude any surgeon?related bias. Endothelial cell count, CCT, and coefficient of variance (CV) were measured with a specular microscope along with BCVA preoperatively and at 1 week, 4 weeks, and 3 months postoperatively. For statistical analysis, data were analyzed by using SPSS (version 27.0; SPSS Inc., Chicago, IL, USA). Data were summarized as mean and standard deviation for numerical variables and count and percentages for categorical variables. Chi square test, independent sample T test, and paired T test were used to compare the data. P ? 0.05 was considered statistically significant. Results: Postoperatively at 1 week, 4?week, and 3 months follow?up intervals, the mean endothelial cell count and coefficient of variance were significantly higher, and the mean percentage of hexagonal cells was significantly lower in non diabetic as compared to the diabetic group. A significant difference in mean central corneal thickness of the two groups was observed at 1?week and 4?weeks postoperative intervals; at both these intervals, the mean value was significantly higher in non diabetic as compared to the non?diabetic group. However, at 3?months post?operative interval, the difference between the two groups was not significant statistically. Mean BCVA values were significantly higher in diabetic as compared to the diabetic group at all three follow?up intervals. Conclusion: The findings of the present study show that endothelial cell characteristics are adversely affected in diabetic eyes as compared to non?diabetic patients undergoing phacoemulsification; this might also have an effect on the visual outcomes.

Relationship between BCVA and macular morphology in patients with diabetic macular edema / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To explore the relationship between the parameters of macular integrity assessment(MAIA), best corrected visual acuity(BCVA)and macular morphology in patients with diabetic macular edema. <p>METHODS: From March 2018 to January 2020, a total of 43 patients(74 eyes)with diabetic macular edema were randomly selected for treatment in the department of ophthalmology in our hospital.To compare the relationship between MAIA micro field meter parameters and the integrity of macular external membrane, junction of inner and outer photoreceptors(IS/OS)layer and hard exudation. Pearson correlation test was used to analyze the relationship between retinal thickness and retinal sensitivity. Pearson correlation test was used to analyze the correlation between retinal thickness, retinal sensitivity and BCVA in the intact and defect groups of IS/OS layer.<p>RESULTS: Compared with the IS/OS layer defect group, the levels of BCVA(LogMAR), central retinal thickness(CRT), elliptical area of binary contour 63(BCEA63), elliptical area of binary contour 95(BCEA95)and macular integrity index(MI)in the IS/OS layer intact group were lower, and the levels of average threshold(AT)and P2 were higher(all <i>P</i><0.01), but there was no significant difference in the levels of central retinal volume(CRV)and P1 between the two groups(all <i>P</i>>0.05). Compared with the external membrane defect group, the levels of BCVA(LogMAR), CRT and MI in the external membrane intact group were lower(all <i>P</i><0.05), but there was no significant difference in the levels of CRV, AT, P1, P2, BCEA63 and BCEA95 between the two groups(all <i>P</i>>0.05). Compare the group with and without hard exudation, there was no significant difference in eye parameters between the two groups(<i>P</i>>0.05).There was a significant negative correlation between retinal thickness and sensitivity in temporal, central and nasal sides of fovea(<i>P</i><0.05), but no significant correlation in the upper and lower parts of fovea(<i>P</i>>0.05). In the complete group of IS/OS layer, AT was significantly negatively correlated with CRT and BCVA, while CRT was significantly positively correlated with BCVA(all <i>P</i><0.05). In the IS/OS layer defect group, there was a significant negative correlation between AT and BCVA(<i>P</i><0.05).<p>CONCLUSION:MAIA in the diabetic macular edema is closely related to the morphology and structure of macular area, especially the integrity of IS/OS layer and outer membrane. MAIA may be an important index to evaluate the visual function of patients with diabetic macular edema.

Efficacy of intravitreal Conbercept combined with laser photocoagulation for macular edema secondary to ischemic retinal vein occlusion / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the effects of intravitreal conbercept combined with peripheral laser photocoagulation for ischemic RVO-ME.<p>METHODS: A retrospective clinical study. Totally 39 patients(39 eyes)were included in this study since 2014-10 to 2018-11, who were diagnosed ischemic RVO-ME in Eye Hospital of Wenzhou Medical University. There were 14 CRVO and 25 BRVO. All patients were given intravitreal conbercept combined with peripheral laser photocoagulation. BCVA, OCT were examined before and after treatment. <p>RESULTS:BCVA of 1, 2, 3, 6mo(0.67±0.49, 0.56±0.41, 0.62±0.52, 0.47±0.40)after treatment was significantly improved compared to base line(0.99±0.57)(<i>P</i><0.05). CMT of 1, 2, 3, 6mo(299.5±188.1, 254.8±127.6, 294.1±174.9, 228.8±64.45μm)after treatment was significantly decreased compared to base line(608.4±214.7μm)(<i>P</i><0.05). BCVA of 6mo was positively correlated with base line BCVA(<i>r</i>=0.78, <i>P</i><0.05),while there was no correlation with base line CMT(<i>r</i>=0.25, <i>P</i>=0.13).<p>CONCLUSION: Intravitreal conbercept combined with peripheral laser photocoagulation is a effective approach for ischemic RVO-ME, which can significantly improve BCVA and decrease CMT.

A clinical study of congenital cataract and its visual outcome at regional eye hospital, Warangal, Telangana

Background: Congenital cataracts present very important ophthalmological and socio economic problem. It is one of the causes of blindness continuous to receive emphasis as a school health problem throughout the world. Aim: Clinical evaluation and visual outcome following surgery in congenital cataract. Materials and methods: It was a clinical study on the patients who have attended out-patient department of Ophthalmology for a period for a period of 2 year. 50 cases under the age of 12 years who were operated by SICS with PCIOL (PMMA) and Phaco with foldable IOLs were included in study. All the cases were followed for a period of 3 months. Results: Among the 50 cases, positive family history of congenital cataract was present in 6%. Systemic and ocular abnormalities were present in 3 (6%) and 10 (20%) cases of congenital cataract. Majority of children presented with visual acuity of PL. Majority of children got vision between 6/36 to 6/24. 48% presented with total cataract followed by lamellar cataract 36%. Most of the children had amblyopia followed by squint and optic atrophy. Most of the intra operative complications were posterior capsular rupture followed by premature rupture, hyphema and iridodialysis. Posterior capsular opacification was common followed by iritis, shallow AC and corneal edema. IOL implantation was done in 90% of congenital cataract cases and in 5 % of cases secondary IOL is implanted. Mean IOL power calculated was + 18.00D. Conclusion: Early diagnosis and meticulous management of congenital cataract may give satisfactory vision with minimal complications.

Correlation between macular thickness and volume with visual acuity in diabetic macular edema by using domain optical coherence tomography.

Introduction: To investigate the correlation between Macular thickness and Volume with Bestcorrected visual acuity (BCVA) in eyes with Diabetic macular edema and Type 2 diabetes. Materials and Methods: A retrospective study including 60 eyes of 60 patients evaluating Retinal thickness and macular volume measured with Spectral Domain Optical Coherence Tomography and best corrected visual acuity was measured with the Snellens Chart. Results: There is significant increase in the macular thickness and macular volume with decrease in the best corrected visual acuity. Conclusion: Diabetic macular edema causes decrease in visual acuity due increase in macular thickness and volume.

Outcome of laser surgery for mild myopia and myopic astigmatism / Шинэ санаа Шинэ нээлт

LASIK is the most popular treatment method for correction of the refractive errors of ophthalmology its development in 1990 and number of patients has continued to increase.The safety and efficacy of LASIK surgery have been reported several times by numerous researchers and doctors, but all studies have made abroad. This time we have summarized postoperative outcomes of LASIK surgery, which have performed in our country. Consequently 103 patients (206 eyes) who underwent LASIK surgery in “Bolor-Melmii” eye clinic between 2007 and 2011 were enrolled. The retrospective method of study was used to evaluate postoperative outcomes. Preoperative UCVA of 0.04-0.4 improved to 0.5-1.2(decimal) at 1 day after surgery and during 1 year after surgery revealed minimal but wasstable. Preoperative mean sphere equivalent of 2.2+/-0.72D improved at the 1 year by +/-0.5D in 161 eyes (78.15%), by +/-1.0D in 39 eyes (18.9%) and by +/-2.0D in 6 eyes (2.9%)after surgery. Mean sphere equivalent and astigmatism improved to -0.46 +/-0.4D and -0.43+/-0.34D respectively at 1 year after surgery. Improvement of the sphere equivalent and its stability during a year period of study proves that LASIK surgery is an effective with stable improvements and safe procedure for correcting myopia/myopic astigmatism. No severe complications occurred during and after surgery.

Study of Fundus Fluorescein Angiography: a Diagnostic Tool in Retinal and Choroidal Pathologies.

To evaluate epidemiology of retinal and choroidal diseases and to calculate the Foveal Avascular Zone(FAZ), diameter and its variation with different diseases and analyse its impact on BCVA(Best corrected visual acuity) using Fundus fluorescein Angiography as diagnostic tool. Materials and methods: The study was conducted in 100cases of retinal and choroidalpathologies undergoing FFA Out of 100 patients maximum were in the age group 50-60 yrs with Diabetic Retinopathy as maximum incidence. FAZ in within normal eyes were in the range of 0.400mm-0.500mm while it increased in Diabetic retinopathy, BRVO,CRAO and hypertensive retinopathy. Eyes with larger FAZ had lower BCVA.

Photodynamic Therapy for Chronic Central Serous Chorioretinopathy: Multicenter Study of 65 Cases

PURPOSE: To determine the effect of photodynamic therapy (PDT) on patients with chronic central serous chorioretinopahty (CSC). METHODS: This was a retrospective multicenter study. We collected demographic and ophthalmic data for patients with chronic CSC who were treated with PDT from 16 institutions in Korea. The best corrected visual acuity (BCVA), ophthalmoscopic finding and optical coherence tomography at baseline and follow-up visits were compared longitudinally. RESULTS: Sixty-five eyes of 65 patients were recruited. Males (51 patients, 78.5%) outnumbered females (14 patients, 21.5%). The mean age was 46.4+/-10.0 years of age (28~69). By 1 month, mean BCVA improved from 0.47 to 0.37 (logarithm of the minimum angle of resolution) (P <0.01). This BCVA increased throughout 6 months. Subretinal fluid resolved partially or completely in 89.1% of the patients. Central macular thickness (CMT) decreased from 303.4 to 168.7 micrometer. The amount of change in CMT after PDT was correlated to the female sex and prePDT CMT. At 3 months after PDT, the amount of change in BCVA was significantly related to that of change of CMT (p <0.05). Adverse events were reported in 4 cases, however, most were mild. CONCLUSIONS: PDT was effective and safe for treating chronic CSC.

Intravitreal Triamcinolone Injection with or Without Bevacizumab for Diabetic Macular Edema

PURPOSE: To compare the effect of intravitreal triamcinolone injection with and without bevacizumab for diabetic macular edema. METHODS: Of 69 patients (69 eyes) diagnosed with diabetic macular edema without any history of other intraocular disease or intraocular operation, 45 eyes (45 patients) were injected with intravitreal triamcinolone (4 mg) and the remaining eyes (24 patients) were injected with triamcinolone (2 mg) and bevacizumab (1.25 mg). The visual acuity and central macular thickness of treated eyes from both groups was measured using OCT, and these measurements were compared between the two groups. RESULTS: There were no statistical differences between the two groups with respect to baseline data. Central macular thickness (CMT) was reduced in both groups, and BCVA improved in both groups. No significant differences were detected in changes in CMT or BCVA between the two groups. CONCLUSIONS: Intravitreal injection of triamcinolone had a beneficial effect on DME in terms of CMT reduction and BCVA improvement. Addition of three consecutive intravitreal bevacizumab injections, however, did not show any significant addictive effect during the follow-up period.

Loss of Best Corrected Visual Acuity after LASIK

Loss of best corrected visual acuity(BCVA)is a landmark of safety, as one of important complications of refractive surgery. To evaluate causes of 2 lines or more loss of BCVA after laser in situ keratomileusis(LASIK), 206 eyes of 139 patients, who had undergone LASIK and had been followed up for 6 months or more, were included in this study. During the follow-up, nineteen eyes(9.2%, 19/206)showed 2 lines or more loss of BCVA postoperatively. The causes of BCVA were irregular astigmatism(15 eyes, 7.3%), retinal complications(3 eyes, 1.5%), and infectious keratitis(1 eye, 0.5%). All irregular astigmatisms had occured within 1 month postoperatively and 13 eyes of all 15 eyes spontaneously recovered after postoperative 3 months. The persistent loss of BCVA occurred in 5 eyes(2.4%, 5/206). Three cases of all 5 persistent losses of BCVA were due to retinal complications. In conclusion, our results suggest that the most common cause of loss of BCVA after LASIK is irregular astigmatism. Irregular astigmatism is a temporary situation which has a tendancy of spontaneous recovery. Thus careful observation is recommended in irregular astigmatism after LASIK. The retinal complications of LASIK may lead to permanent loss of BCVA. Therefore it is needed to examine preoperative fundus closely and to explain possible postoperative complicaitons to the patients and their family.

Flap Complications of LASIK

Laser in situ keratomileusis[LASIK]for myopia reduces the risk of corneal haze but adds to the risk of flap complications. We assessed the incidence of flap complications overall, the management, the impact of the complications on best corrected visual acuity[BCVA], and the trend in these complications during the surgeon's learning curve in the series of 621 eyes undergoing LASIK.Twenty[3.2%]of 621 eyes had flap-related complications.The incidence of intraop-erative complications was fourteen eyes[2.2%], and it included irregular keratectomy in ten eyes[1.6%], incomplete keratectomy in four eyes[0.6%].The incidence of postoperative complications was six eyes[1.0%], and it included epithelial ingrowth in five eyes[0.8%], and diffuse lamellar keratitis in one eye[0.2%].There weren't grave complications such as infectious keratitis or corneal perforation.There was no change between preoperative and postoperative BCVA in seventeen eyes[85%].No eye lost 2 or more lines of BCVA because of flap complications. In conclusion, flap complications after LASIK were relatively uncommon, and rarely lead to a permanent decrease in visual acuity.Physician experience with the microkeratome and the careful handling of the corneal flap may be important to decrease the incidence of flap mplications.But even though it occurs, proper management and treatment will result in good surgical outcomes without grave visual impairment.