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Aims: To evaluate both donor and recipient features involved in visual acuity restoring and complication insurgence in eyes that have undergone Descemet stripping automated endothelial keratoplasty (DSAEK). Methods: In this retrospective study, charts of 111 eyes of 96 patients (mean age 70.25 ± 8.58 years) that underwent DSAEK were evaluated. Only Fuch's Distrophy (FD) or Bullous Keratopathy (BK) due to cataract surgery eyes were included. A complete ophthalmic check with endothelial cell density (ECD) and central corneal thickness (CCT) measurement was performed before surgery and at 1, 3, 6, and 12 months follow-up. Each DSAEK was performed by the same well-trained surgeon; only pre-cut lenticules, provided by same Eye Bank, were implanted. Results: A total of 48 (43%) complications have been observed (most of them were 22 partial graft detachments and 17 IOP spikes). At the last follow-up (mean: 8.58 ± 4.09 months), a significant increase (p < 0.05) of best corrected visual acuity (BCVA) was detected. Overall mean BCVA of the eyes evaluated was 0.40 ± 0.43 LogMAR with BK eyes showing a significantly higher improvement (p < 0.05) compared to FD eyes. The only factor showing a significant correlation (p < 0.05) with visual acuity enhancement was the implant of a lenticule thinner than 100 µm. Recipient features significantly (p < 0.05) associated with complications observed after surgery were glaucoma and diabetes mellitus. Conclusion: The use of a graft thinner than 100 µm can provide better visual acuity recovery while recipients affected by glaucoma or diabetes mellitus are more prone to develop complications after surgery.
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Aims: To study the neuroprotective effect of oral citicoline (CT) therapy in primary open-angle glaucoma (POAG). Methods: This study included one eye each of 60 POAG patients. Patients were randomly divided into two groups (A and B) of 30 participants each. Only patients of group A were administered with CT therapy. Age, sex, and disease duration were matched between groups. Despite a stable intraocular pressure (IOP), a slow disease progression-assessed by standard automated white-on-white perimetry (SAP) in the previous 3 years-occurred in all patients. All patients underwent a complete eye examination, including IOP measurement, SAP, retinal nerve fiber layer (RNFL) thickness, and ganglion cell complex (GCC) thickness measurements with optical coherence tomography (OCT), before starting CT treatment and at 6, 12, 18, and 24 months' follow-up. Parameter differences between groups were evaluated at each eye check. Results: After 18 months, mean values of SAP mean deviation (MD) of group A were significantly (p = 0.039) higher (-7.25 db) than those of group B (-8.64 db). Moreover, they appeared stable in the following visits, whereas in group B, mean MD values continued to significantly (p < 0.001) decrease (-9.28 db) over time. Mean RNFL and GCC thickness in group A were significantly (p < 0.01) higher (70.39 and 71.19 µm, respectively) than in group B (64.91 and 65.60 µm, respectively) after 12 months of CT therapy. Furthermore, they appeared to be stable over the later visits, whereas they thinned significantly (p < 0.001) over time in group B. Conclusion: These findings suggest that CT therapy seems to be effective in slowing POAG progression. Further studies on a larger population and with a longer follow-up are needed to confirm this pilot investigation.
RESUMO
BACKGROUND: To improve accuracy of IOLMaster (Carl Zeiss, Jena, Germany) in corneal power measurement after myopic excimer corneal refractive surgery (MECRS) using multivariate polynomial analysis (MPA). METHODS: One eye of each of 403 patients (mean age 31.53 ± 8.47 years) was subjected to MECRS for a myopic defect, measured as spherical equivalent, ranging from - 9.50 to - 1 D (mean - 4.55 ± 2.20 D). Each patient underwent a complete eye examination and IOLMaster scan before surgery and at 1, 3 and 6 months follow up. Axial length (AL), flatter keratometry value (K1), steeper keratometry value (K2), mean keratometry value (KM) and anterior chamber depth measured from the corneal endothelium to the anterior surface of the lens (ACD) were used in a MPA to devise a method to improve accuracy of KM measurements. RESULTS: Using AL, K1, K2 and ACD measured after surgery in polynomial degree 2 analysis, mean error of corneal power evaluation after MECRS was + 0.16 ± 0.19 D. CONCLUSIONS: MPA was found to be an effective tool in devising a method to improve precision in corneal power evaluation in eyes previously subjected to MECRS, according to our results.
