ABSTRACT
PURPOSE: To examine the efficacy of photodynamic therapy with verteporfin (VPDT) for treatment of subfoveal choroidal neovascularization (CNV) in patients with pathologic myopia. METHODS: In a prospective study, adult patients (18 years of age or older) with new onset subfoveal CNV were treated in two tertiary centers with the standard protocol of VPDT. Snellen best-corrected visual acuity was measured at baseline and at 1 month, 3 months, 6 months, 12 months, 15 months, 18 months, and 24 months after VPDT. Stratified analyses for single and multiple treatments and different age groups were performed by paired t-tests, and the results were compared with baseline findings. RESULTS: Thirty-three patients with single VPDT and 13 patients with multiple treatments were enrolled for analysis. Significant improvement in measurement of visual acuity was found after 24 months of follow-up for the group with single therapy. For patients receiving multiple treatments, an improving trend was not as clear. In prognosis analysis by age groups in the single-treatment group, the younger group had better mean visual acuity at the end of the 24-month study period than the older group. Improvement was much more evident in the younger group, although it was not statistically significant at every follow-up time point. CONCLUSION: In patients with response to single VPDT, visual acuity significantly improved over a 2-year period. In patients receiving multiple treatments, improvement was not as distinctive, suggesting alternative treatment options might be relevant for this subgroup.
Subject(s)
Choroidal Neovascularization/drug therapy , Myopia, Degenerative/complications , Photochemotherapy , Photosensitizing Agents/therapeutic use , Porphyrins/therapeutic use , Adult , Aged , Aged, 80 and over , Choroidal Neovascularization/ethnology , Choroidal Neovascularization/etiology , Female , Follow-Up Studies , Fovea Centralis , Humans , Male , Middle Aged , Myopia, Degenerative/etiology , Prospective Studies , Taiwan , Verteporfin , Visual AcuityABSTRACT
AIMS: The aim of this study was to assess the risk of postoperative endophthalmitis associated with different prophylactic protocols, using povidone-iodine disinfection of the skin and conjunctiva in patients undergoing cataract surgery over an 8-year period at Chang Gung Memorial Hospital (Kaohsiung, Taiwan). METHOD: This was a retrospective, comparative, case-controlled study. Data were collected on patients who received different prophylactic disinfection protocols prior to extracapsular cataract extraction with intraocular lens implantation between January 1992 and January 2000. Possible risk factors for the occurrence of postoperative endophthalmitis were analyzed. RESULTS: Medical charts for a total of 10,614 extracapsular cataract extraction surgeries performed during the 8-year period were reviewed, and 12 eyes that developed postoperative endophthalmitis were identified and analyzed. Another 120 eyes matched for age and gender of the patient were randomly selected as controls. Skin preparation with 5% povidone-iodine was associated with an increased risk of postoperative infection, compared to that of 10% povidoneiodine. On the conjunctiva, a lack of 5% povidone-iodine disinfection was associated with an increased risk of postoperative infection, compared to 5% povidone-iodine disinfection. CONCLUSIONS: Preoperative skin disinfection with 10% povidone-iodine and conjunctival disinfection with 5% povidone-iodine significantly reduced the relative risk of postoperative endophthalmitis.
