Resultados refractivos y visuales en pacientes operados de miopía con técnicas de superficies / Refractive and visual results in patients operated on for myopia with surface techniques

Objetivo: Comparar los resultados visuales y refractivos pre- y posoperatorios en pacientes miopes operados con técnicas de superficie y perfil de ablación asférico. Métodos: Se realizó un estudio experimental controlado aleatorizado abierto, tipo de equivalencia y no inferioridad, en 160 pacientes (320 ojos). En el estudio se formaron dos grupos: el primero quedó constituido por 80 pacientes (160 ojos), a quienes se les realizó queratectomía fotorrefractiva más mitomicina C, y el segundo fue conformado por 80 pacientes (160 ojos), a quienes se les realizó LASEK más mitomicina C. Resultados: Predominaron en ambos grupos las mujeres con miopía leve y edades entre 21 y 29 años. A los tres meses el grupo queratectomía fotorrefractiva más mitomicina C tenía agudeza visual sin corrección de 0,97 ± 0,09; esfera 0,003 ± 0,21; cilindro -0,09 ± 0,30 y equivalente esférico -0,04 ± 0,23. En el grupo LASEK más mitomicina C, la agudeza visual sin corrección fue de 0,96 ± 0,11; la esfera -0,007 ± 0,24; el cilindro -0,08 ± 0,25 y el equivalente esférico -0,06 ± 0,26. Conclusión: Ambas técnicas quirúrgicas mejoraron significativamente los resultados refractivos y visuales, pero no hubo diferencia entre ellas(AU)

Objective: Compare the pre- and postoperative visual and refractive results in myopic patients operated with surface techniques and aspheric ablation profile. Methods: An open randomized controlled experimental study, equivalence and non-inferiority type was carried out in 160 patients (320 eyes). In the study, two groups were formed: the first group was made up of 80 patients (160 eyes), who underwent Photorefractive keratectomy - mitomycin C, and the second group made up of 80 patients (160 eyes), underwent LASEK - mitomycin C. Results: Women with mild myopia and ages between 21 and 29 years old predominated in both groups. At three months, the Photorefractive keratectomy - mitomycin C group had AVSC 0.97 ± 0.09; sphere 0.003 ± 0.21; cylinder -0.09 ± 0.30 and spherical equivalent -0.04 ± 0, 2. 3. In the Photorefractive keratectomy - mitomycin C group, AVSC 0.96 ± 0.11; sphere -0.007 ± 0.24; cylinder -0.08 ± 0.25 and spherical equivalent -0.06 ± 0.26. Conclusion: Both surgical techniques improved significantly refractive and visual results, but there was no difference between them(AU)

Efectividad del implante de lente fáquica ACR-128 tras un año de seguimiento / Effectiveness of an ACR-128 phakic lens implant after one year's follow-up

Introducción: La corrección de ametropías moderadas-severas mediante lentes fáquicas permite conservar la acomodación, además, de obtener una mejor calidad óptica, reversibilidad del procedimiento y la opción de corregir defectos refractivos residuales mediante cirugía corneal mínima invasiva. Objetivo: Determinar la efectividad de los lentes fáquicos ACR-128 en la corrección de la alta miopía tras un año de su implante. Método: Se realizó un estudio transversal en 67 ojos de 36 pacientes con miopía corregida con lente fáquica ACR-128. Se determinaron las características biométricas y refractivas por ojo, relación entre el componente esférico esperado y el observado, distribución por ojos el componente esférico esperado y el observado, relación entre cilindro queratométrico pre y posoperatorio y relación entre la agudeza visual sin corrección y la agudeza visual mejor corregida en el pre y posoperatorio. Resultados: La edad media fue 28,06 ± 6,14(25 mujeres, 11 hombres) el equivalente esférico preoperatorio OD promedio de -10,77 ± 4,23 dioptrías y OI promedio de -10,77 ± 3,72 dioptrías. El componente esférico en dioptrías esperado (-0,56 ± 0,38) y observado (-0,43 ± 0,69) sin diferencias estadísticamente significativas (p = 0,14). El cilindro queratométrico en dioptrías, pre (1,41 ± 0,74) y posoperatorio (1,24 ± 0,88) sin astigmatismo inducido (p = 0,12). El 100 por ciento tenía agudeza visual sin corrección preoperatoria ≤ 0,1 y posoperatoria ≥ 0,5. Conclusiones: Un año después del implante de lente fáquica ACR-128 en la corrección de la alta miopía el tratamiento continúa efectivo, pues reduce el componente esférico al deseado y mantenerlo, no inducir astigmatismo y mantener mejor agudeza visual(AU)

Introduction: Correction of moderate-severe ametropia with phakic lenses makes it possible to preserve accommodation and provides better optical quality, reversibility of the procedure and the option of correcting residual refractive defects by minimally invasive corneal surgery. Objective: Determine the effectiveness of ACR-128 phakic lenses for high myopia correction one year after implantation. Method: A cross-sectional study was conducted of 67 eyes of 36 patients with myopia corrected with ACR-128 phakic lenses. Determination was made of the biometric and refractive characteristics of each eye, the relationship between the expected and the observed spherical component, the distribution of the expected and the observed spherical component per eye, the relationship between the pre- and postoperative keratometric cylinder, and the relationship between pre- and postoperative uncorrected and best corrected visual acuity. Results: Mean age was 28.06 ± 6.14 (25 women, 11 men). Average preoperative spherical equivalent was -10.77 ± 4.23 diopters RE and -10.77 ± 3.72 diopters LE. Spherical component in diopters: expected (-0.56 ± 0.38) and observed (-0.43 ± 0.69), without statistically significant differences (p= 0.14). Keratometric cylinder in diopters: preoperative (1.41 ± 0.74) and postoperative (1.24 ± 0.88), without induced astigmatism (p = 0.12). In 100 percent visual acuity without correction was #8804; 0.1 preoperative and ≥ 0.5 postoperative. Conclusions: One year after ACR-128 phakic lens implantation for high myopia correction, the treatment remains effective, reducing the spherical component and maintaining it at the desired level, not inducing astigmatism and preserving best visual acuity(AU)

Resultados visuales en la corrección de la alta miopía con implante de lente fáquica ACR-128 / Visual results of correction of high myopia with ACR-128 phakic lens implantation

RESUMEN Objetivo: Describir los resultados visuales en la corrección de la alta miopía con implante de lente fáquica ACR-128. Métodos: Se realizó un estudio descriptivo, observacional longitudinal y prospectivo en 60 ojos de 32 pacientes con miopía corregida con lente fáquica ACR-128. Se determinó el componente esférico esperado y observado, el cilindro queratométrico, las agudezas visuales sin corrección y mejor corregidas en el pre y en el posoperatorio y el astigmatismo inducido. El análisis estadístico se realizó con la Prueba T para datos pareados, con una significación del 95 por ciento. Resultados: La edad media fue 27,41 ± 5,91 años, el equivalente esférico preoperatorio -11,54 ± 3,20 dioptrías y el 68,75 por ciento eran femeninas. El componente esférico en dioptrías esperado (-0,53 ± 0,37) y observado (-0,42 ± 0,47) sin diferencias (p= 0,0742). Entre ± 1,00 el 91,67 por ciento y entre ± 0,50 el 70 por ciento. Ningún ojo quedó por encima de +0,50 dioptrías. El cilindro queratométrico en dioptrías, pre (1,44 ± 0,76) y posoperatorio (1,49 ± 0,84) sin astigmatismo inducido (p= 0,6377). El 100 por ciento tenía agudeza visual sin corrección preoperatoria ≤ 0,1 y posoperatoria ≥ 0,3. Después de la cirugía el 10 por ciento alcanzaba 1,0 y 71,6 por ciento ≥ 0,5. Solo el 28,33 por ciento tenía la unidad en el preoperatorio, y el 70 por ciento en el posoperatorio (98,33 por ciento ≥ 0,7). Conclusiones: El implante de lente fáquica ACR-128 proporciona corrección refractiva y predictibilidad favorables para el paciente, al reducir el componente esférico al deseado, no inducir astigmatismo y mejorar la agudeza visual, todo lo que se traduce en un adecuado resultado visual(AU)

ABSTRACT Objective: Describe the visual results of correction of high myopia with ACR-128 phakic lens implantation. Methods: An observational descriptive longitudinal prospective study was conducted of 60 eyes of 32 patients with myopia corrected with the ACR-128 phakic lens. Determination was made of the expected and observed spherical component, the keratometric cylinder, uncorrected and best corrected visual acuity in the pre- and postoperative periods, and induced astigmatism. Statistical analysis was based on the paired T-test with a significance level of 95 percent. Results: Mean age was 27.41 ± 5.91 years, preoperative spherical equivalent was -11.54 ± 3.20 diopters, and 68.75 percent of the patients were female. Spherical component in diopters expected (-0.53 ± 0.37) and observed (-0.42 ± 0.47) without differences (p= 0.0742). Between ± 1.00 diopters 91.67 percent and between ± 0.50 diopter 70 percent. No eye was above +0.50D. Keratometric cylinder in diopters, preoperative (1.44 ± 0.76) and postoperative (1.49 ± 0.84) without induced astigmatism (p=0.6377). In 100 percent visual acuity without correction ≤ 0.1 preoperative and ≥ 0.3 postoperative. After surgery 10 percent reached 1.0 and 71.6 percent ≥ 0.5. Only 28.33 percent had the unit corrected in the preoperative period and 70 percent in the postoperative period (98.33 percent ≥ 0.7). Conclusions: ACR-128 phakic lens implantation provides patients with favorable refractive correction and predictability. This is achieved by reducing the spherical component to desired values, not inducing astigmatism and improving visual acuity, all of which leads to an adequate visual result(AU)

Long-term Visual Results of Vitrectomy in Proliferative Diabetic Retinopathy

PURPOSE: This study investigated the long-term anatomic and visual results in patients having vitrectomies for proliferative diabetic retinopathy complications by comparing the results of postoperative 6 months and the results of 3 years or later. Subject and Method : Medical records of 139 eyes which had undergone pars plana vitrectomy for proliferative diabetic retinopathy complications and had been followed more than 3 years were reviewed. RESULT: Eighty eight of 139 eyes (63.3%) showed better visual acuity at 6 months postoperatively than at baseline, 24 eyes (17.3%) had same visual acuities, and 27 eyes (19.4%) had poorer vision. At the last follow-up vision improved in 90 eyes (64.7%), remained same in 23 eyes (16.5%), and decreased in 26 eyes (18.7%). Compared with the visual acuity of postoperative 6 months, vision of the last follow-up was better in 22 eyes (15.9%), same in 94 eyes (67.6%), and poorer in 23 eyes (16.5%). Of 112 eyes which had anatomic success at the 6 months postoperatively, 99 eyes (88.4%) remained to have anatomic success at the last follow-up. CONCLUSION: In patients undergoing vitrectomies for proliferative diabetic retinopathy complications, postoperative visual acuity and anatomic success at the 6 months were maintained at the longer follow-up of 3.7 years in average.

Complications of Vitrectomy for Proliferative Diabetic Retinopathy: Incidence and Management

More intraoperative and postoperative complications of diabetic vitrectomy may result in poor visual prognosis. Sixty eye (49 patients) underwent vitrectomy for complications of proliferative diabetic retinopathy. Iatrogenic retinal breaks occurred in 6 (10%) of 60 eyes. Postoperative vitreous emorrhage was complicated in 13 (21%) of 60 eyes. Postoperative vitreous hemorrhage cleared spontaneously in one eye. Fluid-air exchange alone was successful in clearing the vitreous cavity in 4 eyes. Two eyes in which clearing does not occur in the postexchange period underwent repeated vitrectomy. Remaining 6 eyes required repeated vitrectomy. Choroidal effusion occurred in 4 eyes (7%) and resolved spontaneously within one week. Neovascular glaucoma occurred in 4 eyes (7%) and was treated with glaucoma implant surgery in 2 eyes, trabeculectomy with Mitomycin C in 1 ye, and cyclophotocoagulation in 1 eye. Retinal detachment developed postoperatively in 3 eyes (5%) and was treated successfully. Corneal epithelial defect persisting more than one week was present in 2 eyes (3%). Accidental mechanical lens damage occurred in one eye. The anatomical success rate was 98% (59 eyes). Visual acuity of 0.025 or better was obtained in 49 eyes (82%). Minimizing intraoperative complications as well as properly managing postoperative complications produced better surgical results.