Four-flanged Technique for Scleral Fixation of a Dislocated Four-eyelet Intraocular Lens

Purpose@#To define and evaluate the short-term clinical outcomes of the four-flanged technique for scleral fixation of a dislocated four-eyelet intraocular lens (IOL). @*Methods@#Eleven eyes of 11 patients who underwent scleral fixation of dislocated four-eyelet intraocular lenses using a four-flanged technique were studied retrospectively. We measured the best-corrected visual acuity (BCVA), corneal endothelial cell density, intraocular pressure (IOP), spherical equivalent, astigmatism, IOL tilt and decentration, and postoperative complications. @*Results@#The BCVA was 0.25 ± 0.11 logarithm of the minimal angle of resolution (logMAR) before surgery and 0.14 ± 0.12 logMAR 6 months later (p < 0.001). The corneal endothelial cell count was 2,427 ± 384 and 2,367 ± 298/mm2 before and after surgery, respectively (p = 0.285). The spherical equivalent was 6.02 ± 4.90 and 0.11 ± 0.36 before and after surgery, respectively. There was no significant difference in astigmatism before and after surgery. The mean IOL tilt and decentration were 2.44 ± 1.68° and 0.23 ± 0.09 mm, respectively. The refractive difference was 0.11 ± 0.24 diopters (D). Postoperative complications occurred in one eye; one flange lay outside the scleral tunnel, triggering hyperemia and conjunctival inflammation. @*Conclusions@#The four-flanged scleral fixation technique for a dislocated four-eyelet IOL improved the BCVA but did not significantly affect corneal endothelial cell loss. The procedure significantly reduced postoperative IOL tilt, decentration, and astigmatism, and may be a useful alternative to scleral fixation of a dislocated four-eyelet IOL.

Central Serous Chorioretinopathy Following High G-force Exposure in a Fighter Pilot

Purpose@#To report a case of central serous chorioretinopathy (CSC) after high G-force exposure in a fighter pilot with rapid remission.Case summary: A 28-year-old male patient was transferred from a local clinic with metamorphopsia in the left eye. His visual acuity was 20/20 in both eyes. Fundus examination of his left eye showed serous retinal detachment. Fluorescein angiography revealed leakage, which led to a diagnosis of CSC. As a fighter pilot, he had been exposed repeatedly to high g-forces before symptoms occurred. His flying was then stopped, and a follow-up examination was scheduled. After two weeks, a fundus examination showed resolution of the subretinal fluid. @*Conclusions@#CSC can develop after high g-force exposure, with a rapid clinical course. When making a CSC diagnosis, the physician should confirm potential causative environments by performing a thorough review of the patient’s occupational history and promptly terminate the likely causes.

The Effect of a 0.1% Bromfenac Solution on Diabetic Macular Edema

Purpose@#The short-term outcomes of patients with diabetic macular edema (DME) treated with 0.1% Bromfenac eyedrops were evaluated. @*Methods@#We included 14 eyes of 14 patients diagnosed with persistent macular edema after intravitreal bevacizumab injection to treat DME. Bromfenac sodium hydrate 0.9 mg/mL eyedrops were administered to the affected eye twice daily for 3 months. The best corrected visual acuity (BVCA) and central macular thickness (CMT) were measured before treatment and at 1, 2, and 3 months after treatment. We noted no adverse drug reaction such as corneal toxicity. @*Results@#After 2 months of intravitreal bevacizumab and before Bromfenac eyedrops treatment, the logarithm of the minimal angle of resolution (logMAR) BCVA and the CMT were 0.40 ± 0.29 and 337 ± 97.3 μm, respectively. The logMAR BCVA decreased from 0.40 ± 0.29 to 0.39 ± 0.29 after 1 month, to 0.38 ± 0.24 after 2 months, and to 0.34 ± 0.21 after 3 months of Bromfenac treatment, but statistical significance was not attained (p = 0.93, p = 0.62, and p = 0.36 respectively). The CMT improved significantly from 337 ± 97.3 μm to 331 ± 67.9 μm after 1 month, 311 ± 89.1 μm after 2 months, and 282.9 ± 76.7 μm after 3 months (p = 0.47, p = 0.08, and p = 0.04, respectively). Treatment was well-tolerated; we noted no topical or systemic side-effect. @*Conclusions@#Topical bromfenac may play a useful role in terms of reducing DME.

The Effect of a 0.1% Bromfenac Solution on Diabetic Macular Edema

Purpose@#The short-term outcomes of patients with diabetic macular edema (DME) treated with 0.1% Bromfenac eyedrops were evaluated. @*Methods@#We included 14 eyes of 14 patients diagnosed with persistent macular edema after intravitreal bevacizumab injection to treat DME. Bromfenac sodium hydrate 0.9 mg/mL eyedrops were administered to the affected eye twice daily for 3 months. The best corrected visual acuity (BVCA) and central macular thickness (CMT) were measured before treatment and at 1, 2, and 3 months after treatment. We noted no adverse drug reaction such as corneal toxicity. @*Results@#After 2 months of intravitreal bevacizumab and before Bromfenac eyedrops treatment, the logarithm of the minimal angle of resolution (logMAR) BCVA and the CMT were 0.40 ± 0.29 and 337 ± 97.3 μm, respectively. The logMAR BCVA decreased from 0.40 ± 0.29 to 0.39 ± 0.29 after 1 month, to 0.38 ± 0.24 after 2 months, and to 0.34 ± 0.21 after 3 months of Bromfenac treatment, but statistical significance was not attained (p = 0.93, p = 0.62, and p = 0.36 respectively). The CMT improved significantly from 337 ± 97.3 μm to 331 ± 67.9 μm after 1 month, 311 ± 89.1 μm after 2 months, and 282.9 ± 76.7 μm after 3 months (p = 0.47, p = 0.08, and p = 0.04, respectively). Treatment was well-tolerated; we noted no topical or systemic side-effect. @*Conclusions@#Topical bromfenac may play a useful role in terms of reducing DME.

Tear Eosinophil Cationic Protein Levels in Allergic Keratoconjunctivitis

PURPOSE: To evaluate tear eosinophil cationic protein (ECP) as a severity marker for atopic keratoconjunctivitis (AKC) and seasonal/perennial allergic conjunctivitis (SAC/PAC). METHODS: Tear ECP levels were measured by chemiluminescent immunometric assay in 7 eyes of 7 patients with AKC, 13 eyes of 13 patients with SAC/PAC, and 10 eyes of 10 healthy control subjects. All AKC and SAC/PAC patients underwent conjunctival injection and papillary formation grading. Tear ECP levels were investigated with reference to the clinical parameters of allergic conjunctivitis (papillary formation and conjunctival injection scoring). RESULTS: Tear ECP levels in patients with AKC were significantly higher than those in patients with SAC/PAC and in control subjects (p = 0.012 and p = 0.003, respectively). The number of patients with papillary formation scores of 2-3 was significantly higher in the AKC group than in the SAC/PAC group (p = 0.016). The number of patients with conjunctival injection scores of 2-3 did not significantly differ between the AKC and SAC/PAC groups (p = 0.128). All AKC patients obtained papillary formation scores of 2-3, and tear ECP levels in patients with conjunctival injection scores of 2-3 were significantly higher than in patients with scores of 0-1 in the AKC group (p < 0.001). In the SAC/PAC group, tear ECP levels in patients with papillary formation scores of 2-3 were significantly higher than in patients with scores of 0-1 (p = 0.046). CONCLUSIONS: This study suggests that tear ECP was a useful marker to diagnose and assess the severity of disease in patients with AKC as well as SAC/PAC. It would be useful to monitor therapeutic outcome in allergic conjunctivitis.

Comparison of Ocular Biometry Measured Using Four Applanation Ultrasonographic Biometry Devices

PURPOSE: To compare ocular biometry measured using 4 applanation ultrasonographic biometry devices and evaluate the accuracies of the refractive outcomes after cataract surgery. METHODS: A total of 60 eyes in 60 patients who received cataract surgery were included in the present study. The axial length was measured using applanation ultrasonographic biometry devices (Aviso(R), Hi-Scan(R), UD-6000(R), P37-II(R)). Additionally, keratometry was measured using an autokeratometer (Topcon KR 8000) and the SRK/T formula was used to calculate intraocular lens (IOL) power. Two months after cataract surgery, the refractive outcome was determined, and results from the 4 different applanation ultrasonographic biometry devices were compared. RESULTS: Axial lengths were 23.52 +/- 1.45 mm, 23.51 +/- 1.04 mm, 23.54 +/- 1.58 mm, and 23.52 +/- 1.38 mm measured using Aviso(R), Hi-Scan(R), UD-6000(R), and P37-II(R), respectively with no statistically significant differences observed (p = 0.92). The mean absolute error (MAE) of the Aviso(R), Hi-Scan(R), UD-6000(R), and P37-II(R) was 0.41 +/- 0.32 diopter (D), 0.40 +/- 0.30 D, 0.36 +/- 0.26 D, and 0.39 +/- 0.26 D, respectively. The mean numerical error (MNE) was 0.39 +/- 0.37 D, 0.36 +/- 0.32 D, 0.26 +/- 0.29 D, and 0.38 +/- 0.32 D, respectively. The differences between the 4 different applanation ultrasonographic biometry devices were not statistically significant (p = 0.90, p = 0.81). CONCLUSIONS: The ocular biometric measurements and prediction of postoperative refraction using Aviso(R), Hi-Scan(R), UD-6000(R), P37-II(R) showed no significant differences.