ABSTRACT
PURPOSE: To investigate the outcomes of quantitative lens nuclear opalescence change after pars plana vitrectomy and intravitreal gas injection in patients with idiopathic epiretinal membrane and macular hole. METHODS: All patients were divided into two group according to the kinds of injected gases, either Group 1 (fluid/air exchange) or Group 2 (20% SF₆ gas injection). Lens nuclear opalescence according to the classification of Lens Opacities Classification System (LOCS) III, mean nuclear density and maximal nuclear density of Pentacam® scheimpflug image changed by image J, besides refractive errors were evaluated before surgery and 1, 2, 4, 6, and 12 months after surgery. RESULTS: Out of 40 eyes of 40 patients included in the analysis, 21 received only fluid/air exchange (Group 1) and 19 received 20% SF₆ gas injection (Group 2). There were significant changes in lens nuclear opalescence between the study and control (unaffected) eyes. In both groups, the study eyes experienced significant progression of cataract compared with the control eyes, in terms of mean nuclear density, maximal nuclear density and LOCS III. In comparison according to the kinds of injected gases, there was a significant difference in mean nuclear density after 4 months, maximal nuclear density after 2 months and 4 months, LOCS after 2 months and 4 months, and refractive error after 1, 2, 4, and 6 months between both groups (p = 0.003). CONCLUSIONS: After vitrectomy and intravitreal gas injection, changes in postoperative lens nuclear opalescence of the study eyes progressed more rapidly compared with the control eyes. This study identified that lens nuclear opalescence of Group 2 progressed rapidly, but after 12 months there was no significant difference of lens opacity between the kinds of injected gases.
Subject(s)
Humans , Cataract , Classification , Epiretinal Membrane , Gases , Iridescence , Refractive Errors , Retinal Perforations , VitrectomyABSTRACT
Objetivo: evaluar la efectividad de la iridoplastia periférica con Nd YAG láser doblado mediante imágenes de Scheimpflug y gonioscopia.Métodos: estudio longitudinal descriptivo prospectivo en 40 ojos (23 pacientes) con cierre angular residual (grado 0-2 según Shaffer) por bloqueo pupilar (n=30) o por síndrome de iris plateau (n=10). La presión intraocular, gonioscopia e imágenes de Scheimpflug (Oculus Pentacam) fueron obtenidas antes de la cirugía y 1 semana después, y luego comparadas.Resultados: 70 porciento de los ojos con bloqueo pupilar (p=0,00) y 100 porciento con iris plateau mostraron gonioscópicamente ángulos grado 2-3 (según Shaffer) en el posoperatorio. Las imágenes de Scheimpflug no evidenciaron modificación de la abertura angular posquirúrgica (p=0,696, p=0,572, bloqueo pupilar; p=0,053, p=0,113, iris plateau). El volumen medio de la cámara anterior (p=0,001 y p=0,008) y el diámetro pupilar (p=0,002, bloqueo pupilar) se incrementaron significativamente. Se obtuvo una reducción posoperatoria de la presión intraocular de 2,4 mmHg (p=0,004, bloqueo pupilar) y 3,6 mmHg (p=0,011, iris plateau). Las complicaciones fueron mínimas y fueron resueltas con tratamiento tópico.Conclusiones: la iridoplastia con Nd YAG láser es efectiva y segura. Las imágenes de Scheimpflug no son útiles para adquirir mensuraciones precisas de la amplitud del ángulo camerular
Objective: to assess the effectiveness of double-frequency Nd YAG laser peripheral iridoplasty using Scheimpflug images and gonioscopy.Methods: longitudinal prospective and descriptive study of 40 eyes (23 patients) with residual angle-closure (Shaffer´s grade 0-2) due to pupillary block (n=30) or plateau iris syndrome (n=10). The gonioscopy, Scheimpflug images (Oculus Pentacam) and intraocular pressure were obtained preoperatively and one week postoperatively and then compared.Results: of the surgical eyes, 70 per cent with pupillary block (p=0,000) and the 100 per cent with plateau iris were Shaffer´s grade 2-3 postoperatively. The Scheimpflug images did not show changes on angle openness after surgery (p=0,696, p=0,572, pupillary block; p=0,053, p=0,113, plateau iris). The mean volume of anterior chamber (p=0,001 and p=0,008) and the pupil diameter (p=0,002 in pupillary block) significantly increased The intraocular pressure reduction of 2,4 mmHg (p=0,004, pupillary block) and 3,6 mmHg (p=0,011, plateau iris) was obtained. Complications were minimal and responded well to topical treatment.Conclusion: the Nd YAG laser peripheral iridoplasty is effective and safe. Scheimpflug images are not useful for precise measurements of angle openness