Posterior capsular opacification in highly myopic eyes with an endocapsular equator ring.

PURPOSE: Closed 9.5-mm-diameter endocapsular equator rings (E-rings) prevent posterior capsular opacification (PCO). However, in our research, some highly myopic patients unexpectedly developed late, extensive PCO that required capsulotomy. We also report for the first time how the capsule reacted to neodymium-doped yttrium aluminium garnet (Nd:YAG) laser shots. METHODS: Sixty-two eyes (39 patients; average age, 48 ± 13.2 years) were implanted with a closed, square-edged silicone E-ring (outer diameter, 9.5 mm) and an intraocular lens between April 16, 2008, and November 30, 2011. RESULTS: During the postoperative, minimal 2-year follow-up, PCO requiring Nd:YAG laser capsulotomy developed in six (9.7 %) of 62 eyes, of which five had -8.75 to -12.5 diopters (D) of myopia preoperatively. The axial lengths of those eyes ranged from 25.86 to 29.97 mm. However, none of the 13 eyes with higher myopia had severe PCO that required capsulotomy. All capsulotomies were performed uneventfully. CONCLUSION: The standard 9.5-mm-diameter closed E-ring does not prevent extensive PCO in eyes with preoperative myopia ranging between -8.75 and -12.5 D and an axial length between 25.86 and 29.97 mm. Posterior capsulotomies were performed safely. Further study is needed to determine why PCO did not occur in more high myopic eyes (larger axial length eyes).

Long-term study of posterior capsular opacification prevention with endocapsular equator rings in humans.

OBJECTIVE: To confirm the effect of a square-edged, closed endocapsular equator ring (E-ring) for preventing posterior capsular opacification (PCO) after cataract extraction. METHODS: Fifty-one eyes underwent cataract surgery associated with E-ring implantation between October 2002 and March 2008. Group 1 included 14 patients (14 eyes) who received an E-ring and intraocular lens (IOL) in 1 eye before March 2006. Their fellow eyes received only an IOL as controls. Group 2 included 23 patients (37 eyes) who received an E-ring and IOL in 1 or both eyes after March 2006 and another 37 age-matched control eyes with only IOL implants. After cataract removal, the E-ring (1.0 mm wide and thick and 9.0 or 9.5 mm long) was implanted in the capsule and an IOL was fixed in the ring. In the control eyes, only an IOL was implanted. The follow-up periods were 2 to 7 years. The PCO value was determined using the Hayashi method. RESULTS: Two years postoperatively in group 1, the PCO value in the central area of the eyes with an E-ring was significantly lower than in the controls (4.4 vs 11.4, respectively; P = .005). No eyes with an E-ring required Nd:YAG laser posterior capsulotomy postoperatively compared with 23 of 51 control eyes (45%). The posterior capsule in the eyes with an E-ring remained transparent without touching the IOL optic. The 9.5-mm ring fit all eyes. CONCLUSION: The 9.5-mm E-ring, which fit all eyes, prevented PCO in human eyes 2 to 7 years postoperatively.

Infero-eyebrow blepharoplasty for the upper eyelids of elderly patients.

AIMS: To describe a procedure for removing excess wrinkles from the upper lids of elderly patients. METHODS: Excess wrinkles were resected with a razor blade and scissors or CO(2) laser along the lower eyebrow margin. Ninety-five patients (average age 74 ± 8.1 years) (157 eyes) underwent this procedure and were followed for at least 6 months postoperatively. RESULTS: The average size of the excised skin was 40 ± 9.7 × 12 ± 3.9 mm. Complications included under-resection, which required another resection in six eyes (4%) and a subcutaneous haemorrhage in two eyes (1%). All patients expressed satisfaction with the final cosmetic results. The incision faded almost completely by 6 months postoperatively without camouflage. CONCLUSION: The design and technique were extremely uncomplicated. The main drawbacks were the long incision line under the eyebrow, a slightly slimmer eyebrow and postoperative brow drop. However, all incision lines faded almost completely by 6 months postoperatively, and brow drop was not problematic in bilateral surgeries. This procedure does not replace the current popular procedure for lid crease formation. However, general ophthalmologists can perform the current simple procedure to remove excess wrinkles from the upper lids of elderly patients.

Quantitative analyses of cytomegalovirus genome in aqueous humor of patients with cytomegalovirus retinitis.

PURPOSE: To investigate copy numbers of cytomegalovirus (CMV) in CMV retinitis patients during ganciclovir treatment using real-time polymerase chain reaction (PCR). METHODS: Thirteen aqueous humor samples obtained from 6 patients with clinically diagnosed CMV retinitis were analyzed. As controls, aqueous humor samples were obtained at the time of surgery from patients with senile cataracts. RESULTS: The CMV genome was detected in the range from 10(1) to 10(4) copies/microL of aqueous humor before antiviral treatment. The samples obtained from retinitis patients showing widespread retinal changes contained much higher copy numbers than those from patients with focal lesions. After treatment, the copy number decreased to one hundredth of that observed prior to treatment, but the CMV genome was detectable for 4 to 8 weeks after ganciclovir administration to 4 patients. CONCLUSION: These results revealed the correlation between the copy numbers of the CMV genome and the extent of the area affected by CMV retinitis before antiviral treatment, and the prolonged retention of CMV genome after antiviral treatment. Quantitation of the viral genome after the start of therapy will be of value in determining whether to continue or intensify the dosage of antiviral agents.