A clinical comparison of SI40NB and MA60BM IOLs: One year result

PURPOSE: To evaluate and compare the clinical results of implantation of foldable silicone(SI40NB, PhacoFlexIITM, AMO) intraocular lenses(IOLs) and acrylic(MA60BM, AcrySofTM, Alcon) IOLs. METHODS: Seventy eyes of 35 healthy senile cataract patients who had uneventfully implanted silicone IOL in one eye and acrylic IOL in the other eye were observed on their best corrected visual acuities(BCVA) and postoperative complications such as posterior capsule opacification(PCO) with its incidence and site. RESULTS: Mean postoperative follow-up period was 17.6month +/-2.08(S.D.)(range 13 to 20 months). Postoperative BCVA, with the measurement of above 0.8 was 29% in SI40NB-IOL implanted group(S group) and 37% in MA60BM-IOL implanted group(M group), above 0.5 was 88.4% in S group and 100% in M group. PCO was 19 eyes(54.3%) in S group and 5 eyes(14%) in M group. Anterior capsular contracture was 3 eyes(8.6%) in S group and 1 eye(2.9%) in M group. Two eyes(5.7%) of capsular capture and 3 eyes(8.6%) of decentration(1<1.5 mm) were only in S group. Eight eyes(22.9%) of microvacuole were only in M group. A eye of S group with severe PCO had taken Nd:YAG posterior capsulotomy. To evaluate the PCO character, posterior capsule was imaginary divided into central part and peripheral part at IOL's optic edge. In M group, among 5 eyes(14.3%) of peripheral part opacification, a eye(2.9%) was progressed into central part. In S group, among 19 eyes(54.3%) of peripheral part opacification, 11 eyes(31.4%) were progressed into central part. There was 20% central progression rate in M group and 57.9% in S group. CONCLUSIONS: MA60BM-IOL showed good visual outcome and fewer postoperative complication than SI40NB-IOL, especially in central PCO which is closely related visual outcome.

The Effects of EMLA on Pain Associated with Retrobulbar Injection

A prospective study was undertaken to assess the efficacy of the anesthetic cream EMLA (Eutectic Mixture of Local Anesthetics)in alleviating the pain of retrobulbar injection in patients undergoing cataract surgery.One-hundred forty-three patients who had undergone cataract surgery under local anesthesia in Korea Veterans Hospital from July 1999 to February 2000 were selected randomly into three groups and each of them had no significant difference in their age, sex and underlying conditions.Fifty-seven patients received the EMLA cream, 43 patients received the placebo and the remaining 43 patients received nothing.Among three groups, the EMLA group and the placebo group were double masked.The pain assessed subjectively by the patient was expressed in 11 scales (0-10).And the reactions of the patients to needle insertion, which had been objectively assessed by the one operator, were graded into 4 scales (0-3).No patient experienced serious side effects in each treatment group.In subjective grading, the EMLA group which had been graded as 2.91 +/-1.93 was proven to be more effective in reducing pain than the placebo group (6.2 +/-2.02)and the not-treated group (6.56 +/-1.64).In objective grading, the EMLA group (0.44 +/-0.63)was superior to the placebo group (0.98+/-0.99)and the no treated group (1.4 +/-0.13).In conclusion, local pretreatment using the EMLA cream to alleviate the pain on retrobulbar injection is one of good methods for enhancing the patient cooperation in cataract surgery with reduced anxiety.

The Objective Personality Characteristic of the Dry Eye Syndrome Patients

To investigate personality characteristic of dry eye patient, an investigation on objective personality characteristics of 41 dry eye syndrome patients was performed with MMPI (Minnesota Multiphasic Personality Inventory). Of 41 patients tested, 14 (34.1%)patients had at least one MMPI clinical scale more than 70 point of T-score, abnormality greater than 70 point of T-score occurred most frequently in the scales for ypochondriasis, psychasthe-nia, depression, hysteria, social introversion.In the group profile study, mean T-scores on each clinical scale were within normal range, and the highest scales in rank order were hypochondriasis, depression, psychasthenia. In the relation between results of TBUT and Schirmer test and T-scores of each clinical scale, correlation coefficient is insignificantly low (r0.4). Therefore we recommend comprehension of their emotional condition and an additional psycholgical management with classical treatment as dry eye syndrome management.