Low-dose ranibizumab as primary treatment of posterior type I retinopathy of prematurity.

OBJECTIVE: The aim of this study was to evaluate the visual and structural outcomes of eyes that received ranibizumab as treatment for retinopathy of prematurity (ROP). METHODS: This was a retrospective case series of infants who received a 0.2 mg (0.02 mL) intravitreal injection of ranibizumab as the primary treatment for type 1 ROP. Outcome measures included regression or recurrence of ROP, complications of treatment, and assessment of visual acuity and refractive error. RESULTS: Forty-two eyes of 21 infants (13 male) were included. Mean gestational age and birth weight were 24.6 ± 1.3 weeks and 613 ± 91 g, respectively. Mean age at injection was 37.4 ± 2.2 weeks postmenstrual age, and mean follow-up period was 10.1 ± 7 months. Active neovascularization regressed rapidly, and anatomical outcomes were favourable in all eyes. Twelve eyes of 6 infants received supplemental laser photocoagulation at a mean post-menstrual age (PMA) of 72.0 ± 27.3 weeks when vascularization had not advanced beyond zone II. Visual acuity was measurable in 28 of 42 eyes. Mean visual acuity was 0.94 ± 0.36 logMAR. Mean spherical equivalent was +1.00. There were no ocular or systemic complications in these patients and no cicatricial complications were observed with no progression to stage 4 or 5 disease. CONCLUSIONS: A single intravitreal dose of 0.2 mg (0.02 mL) ranibizumab showed favourable anatomical and functional outcomes in eyes with type 1 ROP.

Rate of retinal tear and detachment after neodymium:YAG capsulotomy.

PURPOSE: To determine the rate of retinal tear and retinal detachment (RD) after neodymium:YAG (Nd:YAG) laser capsulotomy for posterior capsule opacification (PCO) after cataract surgery. SETTING: Province-wide outpatient and hospital settings, Alberta, Canada. DESIGN: Database study. METHODS: Eleven years of billing records data were collected to assess the rate of retinal tear and/or RD after Nd:YAG laser capsulotomy. A period of 90 days from Nd:YAG was considered the at-risk period, although statistics for 10 years of data were included in the study. Risk was calculated as a rate (%) of retinal tear or RD after Nd:YAG laser capsulotomy. RESULTS: The study comprised 92 654 discrete billing records yielding 73 586 ocular procedures for the analysis of the rate of retinal tear and/or RD after Nd:YAG laser capsulotomy. There were 67 287 Nd:YAG capsulotomies for PCO performed during the study. The 90-day risk for retinal tear after Nd:YAG was 0.21%; 720 retinal tears occurred in the study population at some point after the procedure. The rate of RD was 0.60%, with 2219 RDs occurring at some point after Nd:YAG capsulotomy. The cumulative risk for retinal tear or detachment at 3, 6, 9, and 12 months was 0.21%, 0.30%, 0.36%, and 0.43% and 0.60%, 0.96%, 1.19%, and 1.39%, respectively. The rates of retinal tear and detachment varied significantly between age categories. CONCLUSIONS: There was an increased risk for RD in the first 5 months after Nd:YAG, with a return to a baseline plateau thereafter. As such, the rate of retinal tear after Nd:YAG capsulotomy at 5 months was 0.29%, whereas the rate of RD was 0.87%.

Reprint of: Relationship between cataract severity and socioeconomic status.

OBJECTIVE: To determine the relationship between cataract severity and socioeconomic status (SES). DESIGN: Retrospective, observational case series. A total of 1350 eyes underwent phacoemulsification cataract extraction by a single surgeon using an Alcon Infiniti system. Cataract severity was measured using phaco time in seconds. SES was measured using area-level aggregate census data: median income, education, proportion of common-law couples, and employment rate. Preoperative best corrected visual acuity was obtained and converted to logarithm of the minimum angle of resolution values. For patients undergoing bilateral surgery, the generalized estimating equation was used to account for the correlation between eyes. Univariate analyses were performed using simple regression, and multivariate analyses were performed to account for variables with significant relationships (p < 0.05) on univariate testing. Sensitivity analyses were performed to assess the effect of including patient age in the controlled analyses. RESULTS: Multivariate analyses demonstrated that cataracts were more severe when the median income was lower (p = 0.001) and the proportion of common-law couples living in a patient's community (p = 0.012) and the unemployment rate (p = 0.002) were higher. These associations persisted even when controlling for patient age. CONCLUSION: Patients of lower SES have more severe cataracts.

Relationship between cataract severity and socioeconomic status.

OBJECTIVE: To determine the relationship between cataract severity and socioeconomic status (SES). DESIGN: Retrospective, observational case series. A total of 1350 eyes underwent phacoemulsification cataract extraction by a single surgeon using an Alcon Infiniti system. Cataract severity was measured using phaco time in seconds. SES was measured using area-level aggregate census data: median income, education, proportion of common-law couples, and employment rate. Preoperative best corrected visual acuity was obtained and converted to logarithm of the minimum angle of resolution values. For patients undergoing bilateral surgery, the generalized estimating equation was used to account for the correlation between eyes. Univariate analyses were performed using simple regression, and multivariate analyses were performed to account for variables with significant relationships (p < 0.05) on univariate testing. Sensitivity analyses were performed to assess the effect of including patient age in the controlled analyses. RESULTS: Multivariate analyses demonstrated that cataracts were more severe when the median income was lower (p = 0.001) and the proportion of common-law couples living in a patient's community (p = 0.012) and the unemployment rate (p = 0.002) were higher. These associations persisted even when controlling for patient age. CONCLUSION: Patients of lower SES have more severe cataracts.