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We report the case of a 60-year-old woman with a congenital anterior polar cataract who presented with a lens fragment within the anterior chamber of her left eye, without a medical history of surgery or trauma. Uneventful phacoemulsification with simultaneous removal of the lens fragment followed. Postoperatively, the patient's visual acuity improved from a perception of light to 20/100. Histological examination of the lens fragment revealed persistent fetal vasculature, as well as fibrous metaplasia and extensive collagenesis. To our knowledge, this is the first report of spontaneous rupture of both the anterior capsule and the lens.
ABSTRACT
INTRODUCTION: To compare the anatomical and functional outcome and changes in the quality of life (QoL) over time of the lateral tarsal strip (LTS) versus the Quickert everting sutures (ES) for the repair of primary involutional lower eyelid entropion. METHODS: Forty-five patients (54 eyes) with primary involutional lower eyelid entropion were recruited in a prospective randomized clinical trial over 3-year period. Twenty-six eyes were randomized to the LTS technique and 28 to the ES procedure. Primary outcome was the anatomical correction of the eyelid at the final assessment in 1 year. Secondary outcomes were function and symptoms assessment with a QoL questionnaire at 6 months. Fisher's exact test was used for the statistical analysis of success rate and gender study and Mann-Whitney U test and logistic regression analysis were used for age study. The Wilcoxon and Mann-Whitney U tests were used for the analysis of the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25). RESULTS: At the 6-month follow-up, 25 eyes (96.2%) of the LTS group and 20 (71.4%) of the ES group had favorable outcome (P = 0.025). There were one and eight eyes, respectively, with early recurrence. At the final 12-month evaluation, 23 eyes (88.5%) in the LTS group and 16 eyes (57.1%) in the ES group were successful. Three (11.5%) and 12 (42.9%) eyes respectively showed postoperative recurrence. There was a statistically significant difference between the two groups (P = 0.015) for the primary outcome, whereas age and gender did not influence success. The NEI VFQ-25 showed statistically significant subjective improvement from baseline in most categories of the QoL. No significant difference between the two procedures was detected at 6 months. CONCLUSION: This study suggests that the LTS procedure has a superior surgical success rate and reduction of symptoms compared with the ES for the repair of involutional lower eyelid entropion. Both procedures showed similar improvement of the postoperative QoL. TRIAL REGISTRATION: International Clinical Trials Registry Platform identifier: ACTRN12616000620426.
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Abstract?AIM:To report the incidence of post-operative c ystoid macular edema ( pCME ) in patients with or without diabetes and its correlation with c umulative dissipated energy ( CDE ) and phaco -time after uncomplicated phacoemulsification.?METHODS:In the study 116 nondiabetic ( Group A) and 101 d iabetic patients ( Grou p B) underwent phacoemulsification.Preoperatively none of the groups ( A+B ) had signs of maculo pathy or diabetic macular edema documented by spectral-domain optical coherence tomography ( SD -OCT ) and fundus fluore scein angiography ( FFA ) . Phaco metrics were documented after surgery.FFA was performed two months after each operation . Patients with indications of pCME were reassessed with SD-OCT.?RESULTS: The incidence o fpCME after uncomplicated pha coemulsification was statistically significant difference between the two groups (15.8% in Group B versus 6.9%in Group A, P =0.03 <0.05).The subclinical pCME appeared in 19 out of 24 patients.There was a significant correlatio n between parametric values ( CDE, phaco -time, hardness of the lens ) and pCME occurrence. Glycosylated Hemoglobin ( HbA1c ) blood level s was statistically significant difference ( P =0.005 <0.05 ) between the patients who developed or not pCME. Cystoid mac ular edema did not correlate with the axial length of the eye.? CONCLUSION: There was statis itcally significant differen ce in the incidence of pCME after uneventful phacoemulsification between nondiabetic subjects and diabetics. Most of these patients with pCME had subclinical appearance.CDE and phaco-time data were important factors and predictors to pCME.Good glycemic controls prevent the incidence of pCME.
