Comparison of two different ultrasound methods of phacoemulsification.

PURPOSE: To compare the safety and efficacy of microcoaxial phacoemulsification surgeries performed with the OZil Intelligent Phaco torsional mode (Alcon Laboratories, Inc., Fort Worth, USA) and combined torsional/longitudinal ultrasound mode using 45 degree aperture angled tips. DESIGN: Prospective randomized clinical trial. METHODS: setting: Maltepe University, Istanbul. patient population: Eighty eyes of 80 cataract patients were randomly assigned to 2.2 mm microcoaxial phacoemulsification using the OZil Intelligent Phaco torsional mode (Group 1) or combined torsional/longitudinal ultrasound mode (Group 2). observation procedure: Intraoperative fluid and energy usage and postoperative examinations were evaluated. main outcome measures: Ultrasound time, cumulative dissipated energy, longitudinal and torsional ultrasound amplitudes, mean operation time, mean volume of fluid used, and surgical complications. RESULTS: Both groups included 40 eyes. Mean ultrasound time, cumulative dissipated energy, and longitudinal and torsional ultrasound amplitudes in Group 1 were 58.21±33.81 seconds, 7.74±6.23, 0.45±0.30, and 26.30±12.60%, respectively, and these parameters in Group 2 were 64.75±30.23 seconds, 12.61±6.21, 26.32±5.85, and 40.98±8.33%, respectively. Cumulative dissipated energy and longitudinal and torsional amplitudes were found to be significantly lower in Group 1 (P=.001, P<.001, P<.001). Mean volumes of fluid used in Groups 1 and 2 were 73.30±19.87 cc and 107.07±21.82 cc, respectively (P<.001). CONCLUSION: With the aid of a 45 degree aperture angled tip, the OZil Intelligent Phaco torsional mode provided more effective lens removal than the combined torsional/longitudinal ultrasound mode, with a lower cumulative dissipated energy and volume of fluid used.

Outcomes of torsional microcoaxial phacoemulsification using tips with 30-degree and 45-degree aperture angles.

PURPOSE: To compare the safety and efficacy of Ozil Intelligent Phaco torsional microcoaxial phacoemulsification surgeries performed using 30-degree and 45-degree aperture angled tips. SETTING: Maltepe University School of Medicine Department of Ophthalmology, Istanbul, Turkey. DESIGN: Comparative case series. METHODS: Eyes were assigned to 2.2 mm microcoaxial phacoemulsification using the torsional mode with a 45-degree (Group 1) or 30-degree (Group 2) aperture angled tip. A quick-chop surgical technique was used. The primary outcome measures were ultrasound time (UST), cumulative dissipated energy (CDE), longitudinal and torsional ultrasound (US) amplitudes, mean surgical time, mean balanced salt solution volume used, and mean central corneal thickness (CCT) changes. RESULTS: The mean UST, CDE, and longitudinal and torsional US amplitudes were 58.21 seconds ± 33.81 (SD), 7.74 ± 6.23, 0.45 ± 0.30, and 26.30 ± 12.60 in Group 1 and 63.83 ± 23.42 seconds, 12.36 ± 6.75, 0.23 ± 0.26, and 44.65 ± 14.38 in Group 2, respectively. The mean CDE and torsional amplitudes were significantly lower in Group 1 (P=.002 and P=.001, respectively). The mean balanced salt solution volume was 73.30 ± 19.87 cc in Group 1 and 74.30 ± 19.44 cc in Group 2 (P=.821). The mean CCT change was 52.40 ± 38.08 µm and 99.35 ± 47.14 µm, respectively (P<.001). CONCLUSION: Torsional phacoemulsification performed with a 45-degree aperture angled tip provided more effective lens removal with a lower CDE and less CCT change than a 30-degree aperture angled tip.

Quantitative analysis of subfoveal choroidal thickness using enhanced depth imaging optical coherence tomography in normal eyes.

To evaluate subfoveal choroidal thickness of normal eyes with the use of the enhanced depth imaging technique of optical coherence tomography (EDI-OCT) and correlation of choroidal thickness with patient age. A retrospective analysis of 123 healthy eyes was performed. Age, gender, refractive state and spheric equivalencies were noted. Subfoveal choroidal thickness was measured and noted manually by two independent observers. A total of 72 patients (123 eyes) were included in this study. The mean age of the patients was 47.47 (15-84). The mean spheric equivalent of the refractive error was -0.24 D. According to LogMAR, the mean visual acuity was -0.006. The mean subfoveal choroidal thickness was 280.23 µm (SD ± 81.15, range 124-527 µm). The choroidal thickness showed a negative correlation with age for the subfoveal location (p = 0.000(a)). Regression analysis showed that subfoveal choroidal thickness decreased 3.14 µm for each year of age. The regression formulation was choroidal thickness = 429 - 3.14 × age. When we compared eyes according to their spheric equivalencies, there was no statistically significant correlation between spheric equivalency and subfoveal choroidal thickness. (p = 0.14). In this study, we report choroidal thickness measurement among healthy eyes within the Turkish population to demonstrate that EDI-OCT imaging can give cross-sectional information regarding the choroid, thereby facilitating quantitative imaging.

Hemorrhagic age-related macular degeneration managed with vitrectomy, subretinal injection of tissue plasminogen activator, gas tamponade, and upright positioning.

BACKGROUND AND OBJECTIVE: To investigate the outcomes of vitrectomy, subretinal tissue plasminogen (tPA) injection, gas tamponade, and upright positioning in patients with hemorrhagic neovascular age-related macular degeneration (AMD). PATIENTS AND METHODS: Retrospective, noncomparative case series. Records of patients who were diagnosed with submacular hemorrhage secondary to neovascular AMD and underwent treatment with the combined method between 2004 and 2010 were reviewed. The main outcome measure was the difference between preoperative and post-operative best corrected visual acuity (BCVA). RESULTS: In 10 eyes of 10 patients, mean preoperative and postoperative BCVA values were 1.75 and 1.23 logMAR, respectively (P = .011), after a mean follow-up time of 38.7 ± 26.5 months (range: 10 to 71 months). Eight of 10 patients (80%) gained at least three lines. CONCLUSION: In patients with hemorrhagic neovascular AMD, treatment with vitrectomy, subretinal tPA injection, gas tamponade, and upright positioning was associated with better visual outcomes than those reported for patients with untreated disease.