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Purpose@#To evaluate the proportion of bevacizumab and the reason for its usage in wet age-related macular degeneration (AMD). @*Methods@#Retrospective analysis of medical records was performed for 1,541 patients who received ranibizumab, aflibercept, or bevacizumab injection to treat wet AMD. The proportion of bevacizumab among the entire set of injections was identified. The reason for selecting bevacizumab was additionally identified. @*Results@#During the study period, a total of 2,929 anti-vascular endothelial growth factor (anti-VEGF) injections were performed; 2,236 (76.3%) were ranibizumab or aflibercept injections and 693 (23.7%) were bevacizumab injections. The most common reason for bevacizumab usage was ‘having a 0.1 or worse best-corrected visual acuity or being unable to assure reimbursement due to the development of extensive scarring or geographic atrophy’ (297 bevacizumab injections, 42.9%). The second most common reason was ‘the inability to assure reimbursement such as extrafoveal choroidal neovascularization (CNV) or early CNV without definite fluid in the foveal region’ (201 bevacizumab injections, 29.0%). @*Conclusions@#Bevacizumab was used in 23.7% of the anti-VEGF injections to treat wet AMD. When analyzing patients’ treatment burden and financial impact, the results of the present study may provide useful information. Further multi-center studies are required to evaluate more precisely the usage of anti-VEGF drugs.
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Purpose@#We compared clinical outcomes between combined laser-assisted subepithelial keratomileusis and accelerated collagen cross-linking (Avedro-LASEK), and LASEK alone. @*Methods@#This retrospective study analyzed 38 eyes of 19 patients who had undergone Avedro-LASEK, and 34 eyes of 17 patients who received LASEK alone. Uncorrected distance visual acuity (UDVA), spherical equivalent (SE), keratometry, and corneal inflammation were evaluated preoperatively, and at 1 week, 1, 3, and 6 months, and 1 and 2 years after surgery. @*Results@#The Avedro-LASEK group had a higher preoperative SE (p < 0.05) and thinner central cornea compared with the control group (p < 0.05). There was no significant difference in UDVA, SE stability or keratometry between the two groups during the 2-year follow-up period. At the 2-year follow-up, the SE was ± 0.25 diopter (D) in 92% of the Avedro-LASEK patients and ± 0.5 D in 90.2% of the LASEK patients. Both groups showed high levels of refractive predictability. There was no significant difference between the flat K (p = 0.38) and steep K (p = 0.56) rates over time between the two groups. Corneal haze was observed in 21% of eyes in the Avedro-LASEK group, but neither decreased vision nor ectasia was observed during the follow-up period. @*Conclusions@#During the 2-year follow-up period, there were no significant differences in any parameters between the Avedro-LASEK and LASEK patients, and both procedures are considered effective for myopia correction because of their stability and effectiveness.
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Purpose@#To evaluate the proportion of bevacizumab and the reason for its usage in wet age-related macular degeneration (AMD). @*Methods@#Retrospective analysis of medical records was performed for 1,541 patients who received ranibizumab, aflibercept, or bevacizumab injection to treat wet AMD. The proportion of bevacizumab among the entire set of injections was identified. The reason for selecting bevacizumab was additionally identified. @*Results@#During the study period, a total of 2,929 anti-vascular endothelial growth factor (anti-VEGF) injections were performed; 2,236 (76.3%) were ranibizumab or aflibercept injections and 693 (23.7%) were bevacizumab injections. The most common reason for bevacizumab usage was ‘having a 0.1 or worse best-corrected visual acuity or being unable to assure reimbursement due to the development of extensive scarring or geographic atrophy’ (297 bevacizumab injections, 42.9%). The second most common reason was ‘the inability to assure reimbursement such as extrafoveal choroidal neovascularization (CNV) or early CNV without definite fluid in the foveal region’ (201 bevacizumab injections, 29.0%). @*Conclusions@#Bevacizumab was used in 23.7% of the anti-VEGF injections to treat wet AMD. When analyzing patients’ treatment burden and financial impact, the results of the present study may provide useful information. Further multi-center studies are required to evaluate more precisely the usage of anti-VEGF drugs.
RESUMEN
Purpose@#We compared clinical outcomes between combined laser-assisted subepithelial keratomileusis and accelerated collagen cross-linking (Avedro-LASEK), and LASEK alone. @*Methods@#This retrospective study analyzed 38 eyes of 19 patients who had undergone Avedro-LASEK, and 34 eyes of 17 patients who received LASEK alone. Uncorrected distance visual acuity (UDVA), spherical equivalent (SE), keratometry, and corneal inflammation were evaluated preoperatively, and at 1 week, 1, 3, and 6 months, and 1 and 2 years after surgery. @*Results@#The Avedro-LASEK group had a higher preoperative SE (p < 0.05) and thinner central cornea compared with the control group (p < 0.05). There was no significant difference in UDVA, SE stability or keratometry between the two groups during the 2-year follow-up period. At the 2-year follow-up, the SE was ± 0.25 diopter (D) in 92% of the Avedro-LASEK patients and ± 0.5 D in 90.2% of the LASEK patients. Both groups showed high levels of refractive predictability. There was no significant difference between the flat K (p = 0.38) and steep K (p = 0.56) rates over time between the two groups. Corneal haze was observed in 21% of eyes in the Avedro-LASEK group, but neither decreased vision nor ectasia was observed during the follow-up period. @*Conclusions@#During the 2-year follow-up period, there were no significant differences in any parameters between the Avedro-LASEK and LASEK patients, and both procedures are considered effective for myopia correction because of their stability and effectiveness.
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Purpose@#This study aimed to investigate the surgical outcomes of nonadjustable Harada-Ito surgery under general anesthesia. @*Methods@#Twenty-two patients who underwent nonadjustable modified Harada-Ito surgery under general anesthesia were reviewed retrospectively. Among them, 21 out of the 22 patients who were followed up for 6 months after surgery were included in this study. Subjective cyclotorsion (double Maddox rod test) and objective cyclotorsions (fundus photography) were measured. Success of the surgery was defined as follows: success (the patients do not acknowledge diplopia at any direction), partial (the patients feel diplopia at a specific direction, but they do not feel discomfort in routine life), and fail (the patients feel diplopia in primary gaze, hence requiring a thorough investigation). @*Results@#The mean age of the patients (18 male and 3 female) was 56.5 years (range, 40–77 years). Based on the alternate prism cover test, the patients had 4.2 ± 3.0 prism diopters of vertical deviation. The corrected amounts of cyclotorsion based on the double Maddox rod test and fundus photography were 14.8° ± 7.5° and 9.8° ± 7.9°, respectively, and were significantly different between the two methods (p = 0.006). After the surgery, 20 out of the 21 patients (95.2%) completely recovered from diplopia in the primary gaze. However, among the 20 patients, seven complained of diplopia in the secondary gaze (down gaze, four patients; head tilt gaze, three patients). The success group had a smaller preoperative subjective excyclotorsion than the partial and fail groups (12.6° ± 2.5° and 21.0° ± 8.9°, respectively; p = 0.046). @*Conclusions@#Nonadjustable modified Harada-Ito surgery under general anesthesia has favorable success rate, and preoperative subjective excyclotorsion can be a prognostic factor in patients with bilateral superior oblique palsy.