Comparison of immediate small-incision lenticule extraction after suction loss with uneventful small-incision lenticule extraction.

PURPOSE: To evaluate and compare the predictability and safety of immediate small-incision lenticule extraction, also known as SMILE, after suction loss during the procedure with those of uneventful small-incision lenticule extraction. SETTING: Nunemiso Eye Center, Seoul, South Korea. DESIGN: Retrospective case series. METHODS: Patients who had immediate small-incision lenticule extraction using reapplied suction (study group) or uneventful small-incision lenticule extraction (control group) for myopia or myopic astigmatism were included. All patients were followed for at least 12 months. Demographic as well as visual and refractive outcomes were compared between the 2 groups. RESULTS: Twenty-three eyes were enrolled in the study group and 48 eyes in the control group. The overall cumulative incidence of suction loss was 0.2% (28 of 11 762 eyes). Twenty-two eyes (96%) in the study group had unchanged or improved decimal Snellen corrected distance visual acuity (CDVA). At 12 months, the mean uncorrected distance visual acuity, CDVA, and manifest refraction defocus equivalent in the study group and control group were 0.99 ± 0.17 (SD), 1.11 ± 0.14, 0.75 ± 0.50 diopters (D), and 1.25 ± 0.22 D, 1.26 ± 0.21 D, 0.35 ± 0.26 D, respectively (P = .000, P = .007, and P = .000, respectively). The correlation between the achieved and the attempted spherical equivalent refraction was slightly better in the control group (R2 = 0.972) than in the study group (R2 = 0.933). CONCLUSIONS: Immediate small-incision lenticule extraction using reapplied suction resulted in safe and clinically predictable long-term outcomes. However, predictability was lower for immediate than for uneventful small-incision lenticule extraction.

Optic disc and peripapillary retinal nerve fiber layer characteristics associated with glaucomatous optic disc in young myopia.

PURPOSE: To explore optic disc and peripapillary retinal nerve fiber layer (RNFL) features associated with glaucomatous optic disc (GOD) in young myopia. METHODS: Presence of GOD, optic disc tilt, and disc torsion were determined using fundus photographs. If the measured disc tilt ratio was >1.3, the optic disc was classified as tilted. Optic disc torsion was defined as a >15° deviation in the long axis of the optic disc from the vertical meridian. The average and four quadrants RNFL thicknesses were assessed using spectral domain optical coherence tomography (SD-OCT). Logistic regression analyses were performed to identify factors associated with the presence of GOD. RESULTS: Nine hundred and sixty myopic subjects were recruited from four refractive surgery clinic databases. The mean age was 26.6 ± 5.7 years and spherical equivalent (SE) was -5.5 ± 2.5 diopters. Among 960 eyes, 26 (2.7%) received GOD group classification. Among 934 normal eyes, 290 (31.0%) had titled optic discs. Eighteen eyes (69.2%) in the GOD group had tilted optic discs. When compared to normal eyes, the GOD group had significantly higher tilt ratios (1.4 ± 0.2 vs. 1.2 ± 0.1, p < 0.001) and less SE (-7.8 ± 2.7 vs. -5.4 ± 2.5 diopters, p < 0.001). Greater tilt ratio (odds ratio (OR) = 4.9, p < 0.001), less SE (OR = 0.708, p < 0.001), and thinner average RNFL (OR = 0.910, p = 0.001) were significantly associated with GOD. Among 934 normal eyes, 366 (39.2%) displayed disc torsion, while among 26 glaucomatous eyes, eight (30.8%) displayed disc torsion. CONCLUSIONS: Optic disc tilt was found in approximately one-third of young myopic eyes and was independently associated with the presence of GOD.

Small-incision lenticule extraction in posterior polymorphic corneal dystrophy.

UNLABELLED: We present the case of a 37-year-old man with posterior polymorphic corneal dystrophy who had small-incision lenticule extraction surgery to correct myopic refractive errors. The subjective refraction was -2.62 in the right eye and -2.50 -0.25 × 80 in the left eye. Slitlamp biomicroscopy revealed a band-like lesion in the corneal endothelium of the right eye. The endothelial cell count was 1745 cells/mm(2) in the right eye and 2945 cells/mm(2) in the left eye. Small-incision lenticule extraction was performed to correct the myopic refractive errors in both eyes. Twelve months after surgery, the uncorrected distance visual acuity in both eyes was 20/20 and the posterior polymorphic corneal dystrophy lesion had not progressed. The case suggests that small-incision lenticule extraction surgery can be performed successfully and safely in patients with posterior polymorphic corneal dystrophy. FINANCIAL DISCLOSURE: None of the authors has a financial or proprietary interest in any material or method mentioned.

Immunoreactivity of CD99 in stomach cancer.

CD99 is characteristically expressed in Ewing's sarcoma/primitive neuroectodermal tumor. Recently its immunoreactivity has also been reported in other tumors. However, the significance of CD99 isoforms expressed in these tumors has not been elucidated. In this study, we evaluated the expression of CD99 isoforms and its relationship with histopathologic parameters in gastric adenocarcinomas. Paraffin sections of 46 gastric adenocarcinomas were stained with an anti-CD99 monoclonal antibody, YG32. Twelve (26.1%) cases of 46 gastric adenocarcinomas showed immunoreactivity to YG32. The CD99 expression was also seen both in non-neoplastic foveolar epithelial cells and infiltrating lymphocytes. In addition, Western blot and RT-PCR analyses revealed that the type I is the predominant isoform of CD99 in non-neoplastic and neoplastic gastric tissues. The CD99 expression was usually seen in the intestinal type adenocarcinoma, while rarely in the diffuse type. The CD99 immunoreactivity decreased in MMP-2-overexpressing adenocarcinomas (p=0.028). Our results suggest that the type I is the major isoform of CD99 expressed in non-neoplastic gastric mucosa and gastric adenocarcinomas and its downregulation in gastric adenocarcinoma may be associated with cellular dedifferentiation and/or MMP-2 overexpression.