The corticosteroids effect on corneal endothelial cell in pulse therapy, specific to the cataract surgery.

RATIONALE: We suspect a protective role of corticosteroids in pulse therapy in cataract surgery Objective: The monitoring of the corticosteroids effect in pulse therapy after cataract surgery, associated with conventional therapy drugs on endothelial cells. METHODS: According to the effective phacoemulsification time (EPT), we have created a lot with hard cataract (EPT>10s) and a lot with soft cataract (EPT<10s). Each lot had a control group treated with local steroids and a study group treated with local steroids to which steroids in pulse therapy were associated postoperative for 3 days. Results We noticed a smaller loss of endothelial cell in the study group with soft cataract compared to the control group but without statistic significance. In the study group with hard cataract the recovery of the visual function is faster than in the control group. The loss of endothelial cell compared to the EPT is similar at one week in both of the examined groups in patients with hard cataract (39.1 ± 13.2 cells/mm2/s study group and 41.51 ± 18.5 cells/mm2/s control group). In the 1 month postoperative examination, we could find a significantly bigger loss in the control group (40.18 ± 16.6 cells/mm2/s) compared to the study group (24.48 ± 7 cells/mm2/s) (p<0.05). CONCLUSIONS: The administration of corticosteroids in pulse therapy associated to topic therapy seems to be benefic in the limitation of the loss of endothelial cell specific to cataract surgery. The major benefit of pulse therapy appears in patients with hard cataract and in patients with a lower endothelial reserve in whom surgery is mandatory.

Tobacco-alcohol optic neuropathy--clinical challenges in diagnosis.

Part of the large group of nutritional and toxic optic neuropathies, tobacco-alcohol optic neuropathy is a disease often underdiagnosed or detected at a stage when the full recovery of vision is not possible. This article summarizes its signs and symptoms, describes the pathophysiological processes involved and provides the necessary information for diagnosis and treatment of the entity previously known as tobacco-alcohol amblyopia, reporting in the end, a challenging case along with its findings.