ABSTRACT
Aim: This study aims to assess central macular thickness (CMT) using optical coherence tomography (OCT) in diabetic patientsbefore and after phacoemulsification.Materials and Methods: A prospective study on 90 diabetic patients conducted from February 2018 to February 2019, whowere all operated for cataract by phacoemulsification. Complete ophthalmological evaluation was done preoperatively. CMTwas measured preoperatively using spectral-domain (SD) OCT. Patients were followed at the 1st post-operative day and at 1, 4,and 6 weeks postoperatively. OCT was done during the 6th week of post-operative period.Results: The mean central 1 mm subfield macular thickness, preoperatively and 6th week postoperatively was 205.12 ± 24.85 µmand 212.79 ± 28.29 µm, respectively. The difference between pre-operative and 6th week post-operative CSMT was significantin all the three groups (no diabetic retinopathy (DR), mild non-proliferative DR [NPDR], and moderate NPDR) (P = 0.001).Conclusion: SD-OCT detected statistically significant increase in mean CMT at 6-week postoperatively in diabetic patientsundergoing phacoemulsification. Precise surgical technique, in the bag implantation of intraocular lens and good post-operativecare, blood sugar control reduces the occurrence of macular edema, resulting in good visual outcome.
ABSTRACT
[Purpose]Acupuncture stimulation is known to improve visual acuity. Since this improvement was frequently disassociated with refractive change, we determined the mechanism by examining the patients without lens accommodation. <BR>[Methods]Patients (n = 30) receiving cataract surgery in 2005 at Meiji University of Oriental Medicine Hospital were examined (mean age: 73.0). Bilateral LI4, Taiyang and shang-jingming points were stimulated by acupuncture needles for 10 min (acupoints stimulation). On a different day, the same patients received sham points stimulation at 1 cm above or lateral from the above-mentioned acupoints. Both uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) was measured with a logMAR scale at pre-and post-acupuncture stimulations. Furthermore, the patients with improved UCVA and BCVA typically (n = 4) received topical tropicamide eyedrops for suppression of pupil diameter change. UCVA and BCVA were measured at pre-and post-acupuncture stimulation.<BR>[Results]Acupoints stimulation significantly improved both UCVA (0.39 to 0.30, p < 0.0006) and BCVA (0.15 to 0.08, p < 0.0001). Although sham points stimulation also significantly improved both UCVA (0.38 to 0.32, p < 0.02) and BCVA (0.14 to 0.09, p < 0.0001), there was no significant difference in comparison with acupoints stimulation controls. Under mydriasis after tropicamide eyedrops, acupuncture stimulation did not improved UCVA, and the variation of BCVA was significantly different from control (p < 0.013).<BR>[Discussion]Acupuncture stimulation improved UCVA and BCVA even in elderly patients that lack accommodation. Our results imply that as pupil diameter changes, a subsequent pinhole effect may be a critical mechanism for UCVA and BCVA improvement by acupuncture stimulation. In addition, the phenomena are not specific effects of acupoints and imply a response via sensory nerves.
ABSTRACT
El uso profiláctico de antibióticos y antiinflamatorios post cirugía oftálmica es una práctica común. La tobramicina es aminoglicósido con espectro de gram negativos y alguns gram positivos. Ciprofloxacino tiene un mayor espectro. Objetivo: Comparar la eficacia y seguridad de la combinación colirio y ungüento de cirpofloxacino/dexametasona versus tobramicina/dexametasona. Pacientes y métodos: Se estudio en forma randomizada y doble ciego, 64 pacientes durante 15 días. Se realizaron 3 controles donde se registró agudeza visual, presión intraocular y una escala subjetiva y objetiva. Resultados: 60 pacientes completaron el estudio. El prurito fue menor en el grupo tratado con ciprofloxacino (0.26 v/s 0.47; p<0,05). Conclusiones: El estudio demostró eficacia y seguridad antibiótica equivalente entre ambas combinaciones. Considerando el mayor espectro antibacteriano de ciprofloxacino y la menor incidencia de prurito se plantea que el uso de esta combinación en pacientes post cirugía de catarata entregaría una protección antibiótica segura y con espectro más amplio.
The prohylactic use of antibiotics and anti-inflammatories drugs is a common practice in ophthalmic surgery. Tobramycin is an aminoglycoside with gram negative spectrum, covering some gram positive bacteria. Ciprofloxacin has a broader spectrum of effectivity. Purpose: To compare effectiveness and safety of eye drops and ointments of ciprofloxacim/dexamethasone versus tobramysin/dexamethasone combinations. Patients and methods: Random and doubled masked study, performed in 64 patients who had cataract surgery. In a 15 days follow up, the effectiveness of both antibiotic combinations were tested. Visual acuity, intraocular pressure, objective and subjective scale were performed. Results: 60 patients (93.4 percent) completed the follow up. Itching presented a significant difference between both groups, being lower in the ciprofloxacin/dexamethasone combination (0.26 vs 0.47. p<0.05). Conclusions: The study shows an equivalent effectiveness and safety of both antibiotic combinations. Considering the broader spectrum of ciprofloxacin and the lower frequency of itchness, ciprofloxacin/dexamethasone combination seems to be a good choice for post operative treatment in cataract surgery.