ABSTRACT
PURPOSE: To assess and compare preoperative refractive, aberrometric, topographic, and contrast sensitivity (CS) measurements with postoperative values after corneal collagen cross-linking (CXL) in patients with progressive keratoconus. METHODS: Twenty-two eyes of 11 patients with keratoconus were enrolled in this prospective study. Uncorrected distance visual acuity (UDVA), best spectacle corrected visual acuity (BSCVA), CS, and higher order aberrations (HOAs) were evaluated at baseline and 1, 3, 6, and 8 months after surgery. RESULTS: The mean total HOAs of the included patients were 2.24, 2.34, 2.28, 2.17, and 2.03 µm before and 1, 3, 6, and 8 months after CXL, respectively. A significant reduction in corneal HOAs including vertical coma, vertical and horizontal trefoil and spherical aberration was observed 6 and 8 months after CXL. UDVA and BSCVA improved significantly in all patients who completed the follow-up period (P = 0.001). Although mean CS declined significantly 1 month postoperatively, it improved significantly after 3, 6, and 8 months (P<0.001). Maximum keratometry was significantly lower 8 months postoperatively compared to the preoperative value. (P = 0.006). CONCLUSIONS: CXL seems to improve UCVA, BSCVA, and CS and reduce most corneal HOAs in progressive forms of keratoconus.
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PURPOSE: To compare the results of narrow encircling band surgery with standard encircling scleral buckling for retinal detachments (RDs) with intrabasal or unseen breaks. METHODS: In a retrospective study, eyes with intrabasal or unseen breaks underwent narrow band implantation (group N) or standard encircling buckling plus wide tire placement (group W) and were followed for at least one year. RESULTS: A total of 112 eyes including 39 eyes in group N and 73 eyes in group W were studied. Preoperatively visual acuity of eyes in group N was significantly better (1.55 ± 0.9 vs. 1.93 ± 0.9 logMAR, P = 0.043). The two study groups (N and W) were comparable in terms of the extent of RD (2.8 ± 0.96 vs. 2.8 ± 0.93 quadrants), interval to surgery (88.3 ± 176.4 vs. 71.9 ± 135.4 days) and percentage of visible breaks (56.4% vs. 63%), respectively (all P values > 0.05). More atrophic holes were present in group W and more dialyses were reported in group N. The single operation success rate at 12 months was 69.2% in group N and 74% in group W (P = 0.1). The single operation success rate for eyes with unseen breaks was also comparable (66.7% vs. 85.7%, P = 0.157). Final corrected visual acuity was also similar (0.63 ± 0.44 vs. 0.85 ± 0.69 log MAR). The only factor influencing success rate was the type of retinal breaks (P = 0.04). Type of scleral buckling did not affect the single operation success rate (P = 0.460). CONCLUSION: Narrow encircling band surgery is a possible option with acceptable single operation success rate for RDs with intrabasal or unseen breaks.
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OBJECTIVES: In the current study, we systematically searched and analyzed the available literature on the prognostic value of semi-quantitative (18)F-FDG PET imaging (SUVmax/mean) in patients with endometrial cancer and presenting the results in a meta-analytic format. METHODS: Pubmed, SCOPUS, and ISI Web of Knowledge were searched using "endometr* AND PET" as the search algorithm. All studies evaluating the (18)F-FDG PET performance in pre-operative risk stratification or its prognostic value in patients with endometrial cancer were included. Statistical pooling of diagnostic accuracy indices was performed using random effects model. Cochrane Q test and I(2) index were used for heterogeneity evaluation. RESULTS: Ten studies (771 patients) were included in the systematic review. Pooled average SUVmax values in patients with risk factors [grade III, lymphovascular invasion (LVI), cervical invasion (CI), myometrial invasion (MI)≥50%] were statistically higher than those in patients without risk factors. Pooled HR of pre-operative SUVmax for disease free survival was 7.415 [2.892-19.432] (p=0.000046). CONCLUSION: Despite higher average SUVmax in the high-risk group compared to the low-risk group of patients with endometrial cancer, the usefulness of (18)F-FDG PET SUVmax in classifying patients into pre-defined risk groups seems to be limited. However, pre-operative SUVmax of endometrial tumors seems to be an independent prognostic marker of recurrence and death. Further large multicenter studies with adequate follow-up are needed to confirm our findings.
Subject(s)
Endometrial Neoplasms/diagnostic imaging , Fluorodeoxyglucose F18 , Radiopharmaceuticals , Endometrial Neoplasms/diagnosis , Female , Humans , Positron-Emission Tomography , Prognosis , Risk FactorsABSTRACT
PURPOSE: To compare the anatomical and visual outcomes of three different scleral buckling techniques and to explore the effect of cryotherapy and subretinal fluid drainage (SRFD) on outcomes of surgery. METHODS: This retrospective study was performed on 111 eyes of 109 patients undergoing scleral buckling for rhegmatogenous retinal detachments (RRDs) by a single surgeon. Pre-, intra- and postoperative data were retrieved from hospital records. RESULTS: Buckles were radial in 27 (24.3%), circumferential (segmental) in 16 (14.4%) and encircling in 68 (61.3%) eyes. Anatomical and visual results were comparable with all three buckling techniques. Application of cryotherapy, the spot number, and SRFD did not affect anatomical and visual results. The only preoperative factor associated with poorer anatomical results was the presence of multiple retinal breaks (P=0.006). The following preoperative factors affected visual outcomes on univariate analysis: extent of retinal detachment (r=0.417, P=0.011) and relative afferent pupillary defect (r=0.423, P=0.02). Preoperative macular status (attached vs detached) also had a significant effect on visual outcomes (P<0.001). Based on multivariate analysis however, only preoperative macular status was significantly correlated with visual results (P=0.022). Silicone sponges placed for non-encircling surgery were removed due to ocular dysmotility in 4 (3.6%) eyes, cosmetic reasons in 3 (2.7%) cases and extrusion in 2 (1.8%) eyes. One encircling tire was also removed due to extrusion. CONCLUSION: Surgical technique and performing cryotherapy or SRFD do not seem to influence the anatomical and visual outcomes of scleral buckling. Postoperative complications seem to be more prevalent with non-encircling techniques.
