Automated lamellar therapeutic keratoplasty for surgical treatment of keratoconus

To evaluate the visual and refractive outcomes of automated lamellar therapeutic keratoplasty [ALTK] in patients with keratoconus. In this prospective noncomparative clinical trial, ALTK was performed in 14 eyes of 14 patients with moderate to severe keratoconus. All patients were spectacle and contact lens intolerant. Uncorrected visual acuity [UCVA]. best corrected visual acuity [BCVA], spherical equivalent refraction [SE], and refractive, keratometirc and topographic astigmatism were evaluated preoperatively and at one, three, and six months postoperatively and also at least 2 months after complete suture removal. Minimum duration of follow up was 8 months. The study included 9 male and 5 female subjects with mean age of 26.2 +/- 5.5 years [18-36 years]. Mean UCVA was 1.2 +/- 0.16 LogMAR [20/300] preoperatively and 0.55 +/- 0.2 LogMAR [20/70] at the last visit. [P<0.001] Mean BCVA was 0.8 +/- 0.2 LogMAR [20/120] preoperatively and reached 0.34 +/- 0.15 LogMAR [20/40] at the last visit. [P<0.001] Mean SE was -6.0 +/- 2.4 diopter preoperatively and -2.6+2.0 diopter at last visit. [P<0.001] BCVA >/= 20/40 was achieved in 64.3% of the cases and refractive astigmatism was within 4 diopter in 57% of the subjects at last visit. Although ALTK can be used for lamellar keratoplasty in patients with keratoconus, high post-op astigmatism is the major drawback

[Visual outcomes and complications of phacoemulsification and intraocular lens implantation]

To evaluate the prevalence of concomitant systemic and ocular diseases in patients scheduled for phacoemulsification and intraocular lens implantation [PE+PC IOL] and post surgical visual outcomes and complications in 1253 cases. Medical records of all patients of a private clinic who underwent PE+PC IOL from 1999 to 2003 were reviewed. All operations were performed by as single surgeon [MAJ]. Among 1253 operated eyes, 95.9% had senile cataracts. Mean age was 61 years and mean follow up was 10 +/- 12.5 months. Incidence of systemic hypertension, diabetes mellitus [DM], ischemic heart disease, pseudoexfoliation syndrome [PXF], and glaucoma were 16%, 11.5%, 7.7%, 3.1%, and 2.7%, respectively. After the operation 71.9% and 90.4% of the eyes gained UCVA and BCVA of 20/40 or better, respectively. The most important intraoperative and postoperative complications were sterile uveitis [4.8%], vitreous loss [0.23%], endophthalmitis, CME, RD and, corneal decompensation each in one eye [0.08%]. Significant posterior capsule opacity requiring Nd: YAG capsulotomy occurred in 5.8% of the eyes. PE+PC IOL is a safe and effective procedure in patients with cataract. Systemic hypertension and DM are important concomitant systemic disorders in this group of patients