Functional Profile of a Customized Wound Parameter in Femtosecond Laser-Assisted Corneal Incision for Cataract Surgery.

Purpose: To evaluate the performance of optimized parameters of femtosecond laser for cataract surgery corneal incisions regarding opening, patency and surgically induced astigmatism (SIA). Patients and Methods: Patients scheduled for femtosecond laser-assisted cataract surgery between May 2018 and December 2018 were enrolled. Inclusion criteria were a healthy preoperative cornea and uneventful FLACS. Exclusion criteria were preoperative corneal astigmatism over 1.0 D, previous corneal trauma or pathologies. Clinical data were obtained from the electronic medical records. Surgical planning was based on Scheimpflug tomography images for keratometric data. At postoperative day 60, new keratometric evaluation was performed, obtained using the same device. Results: 101 eyes (61 patients) matched the criteria for SIA analysis. Overall mean SIA was 0.44 ± 0.33 D (0-1.55 D). Axis and size did not have any statistically significant effects on SIA. The overall centroid of the SIA was 0.11. For the opening analysis, was included 156 eyes (79 patients). Successful opening in 87.7% of cases (137 eyes). Temporal incisions had the highest success rate (98.36%). Conclusion: These femtosecond laser parameters showed high opening rates with low opening times. These optimized parameters led to a low incidence of SIA and high predictability regardless of incision site and size. The association between incision opening and SIA was not statistically significant. There was, however, an association between incision opening success and site.

Second-wave hydrodissection for aspiration of cortical remains after femtosecond laser-assisted cataract surgery.

We describe the technique of second-wave hydrodissection (the first wave being the initial cortical cleaving hydrodissection) performed after the removal of the cataract nucleus in femtosecond laser-assisted cataract surgery. After femtosecond laser application, the cortex is typically found adhered to the anterior capsule. Under high magnification, a steady stream of a balanced salt solution is directed toward the anterior capsule using a hydrodissection cannula. Full cleavage of the remaining cortex is observed by noting the appearance of a dark inner circle by the capsulotomy edge once the balanced salt solution wave has separated the cortex from the capsule. Irrigation/aspiration (I/A) of the cortical remains after the second wave is faster than I/A without this step in femtosecond laser-assisted cataract surgery.

Safety and efficacy of intracameral moxifloxacin injection for prophylaxis of endophthalmitis after phacoemulsification.

PURPOSE: To evaluate the safety and efficacy of 0.05 mL intracameral injection of moxifloxacin in patients who underwent phacoemulsification and intraocular lens (IOL) implant. METHODS: Retrospective study comprising patients who underwent phacoemulsification and IOL implant between January 2009 and December 2013. Patients were divided into two groups. Group A followed standard endophthalmitis prevention protocol and group B followed the same protocol plus intracameral injection of 0.05 mL of moxifloxacin hydrochloride at 5.45 mg/mL, immediately after IOL implant. RESULTS: Medical records from 7,195 eyes of 3,751 patients (median age: 67.8 ± 8.96, range: 48-83 years, 53.8% female) were evaluated. Group A included 3,515 eyes of 1,838 patients and group B included 3,680 eyes of 1,913 patients. The incidence of endophthalmitis in group A was 0.22% (8:3,515 eyes) and in group B was 0.03% (1:3,680 eyes, p=0.0198, Fischer's exact test). No toxicity or inflammation related to the use of moxifloxacin was observed. CONCLUSIONS: There was a 7.3-fold lower ratio of endophthalmitis in the group that received moxifloxacin intracameral injection. This study provides further evidence that moxifloxacin is an effective intracameral prophylactic antibiotic.

Safety and efficacy of intracameral moxifloxacin injection for prophylaxis of endophthalmitis after phacoemulsification / Segurança e eficácia na injeção intracameral de moxifloxacino para profilaxia da endoftalmite após a facomeulsificação

ABSTRACT Purpose: To evaluate the safety and efficacy of 0.05 mL intracameral injection of moxifloxacin in patients who underwent phacoemulsification and intraocular lens (IOL) implant. Methods: Retrospective study comprising patients who underwent phacoemulsification and IOL implant between January 2009 and December 2013. Patients were divided into two groups. Group A followed standard endophthalmitis prevention protocol and group B followed the same protocol plus intracameral injection of 0.05 mL of moxifloxacin hydrochloride at 5.45 mg/mL, immediately after IOL implant. Results: Medical records from 7,195 eyes of 3,751 patients (median age: 67.8 ± 8.96, range: 48-83 years, 53.8% female) were evaluated. Group A included 3,515 eyes of 1,838 patients and group B included 3,680 eyes of 1,913 patients. The incidence of endophthalmitis in group A was 0.22% (8:3,515 eyes) and in group B was 0.03% (1:3,680 eyes, p=0.0198, Fischer's exact test). No toxicity or inflammation related to the use of moxifloxacin was observed. Conclusions: There was a 7.3-fold lower ratio of endophthalmitis in the group that received moxifloxacin intracameral injection. This study provides further evidence that moxifloxacin is an effective intracameral prophylactic antibiotic.

RESUMO Objetivo: Avaliar a segurança e a eficácia da injeção intracameral de 0,05 mL de moxifloxacina em pacientes que realizaram facoemulsificação e implante de lente intraocular. Métodos: Estudo retrospectivo envolvendo pacientes submetidos a facoemulsificação e implante de lente intraocular entre janeiro de 2009 a dezembro de 2013. Os pacientes foram divididos em dois grupos. O grupo A seguiu o protocolo padrão de prevenção de endoftalmite e o grupo B seguiu o mesmo protocolo associado à injeção intracameral de 0,05 mL de cloridrato de moxifloxacino a 5,45 mg/mL, imediatamente após o implante de lentes intra-oculares (LIO). Resultados: Foram avaliados registros clínicos de 7.195 olhos de 3.751 pacientes (mediana de idade de 67,8 ± 8,96, faixa de 48-83 anos, 53,8% de mulheres). O grupo A incluiu 3.515 olhos de 1.838 pacientes e o grupo B incluiu 3.680 olhos de 1.913 pacientes. A incidência de endoftalmite no grupo A foi de 0,22% (8:3.515 olhos) e no grupo B de 0,03% (1:3.680 olhos, p=0,0198, teste exato de Fischer). Não foi observada toxicidade ou inflamação relacionada com o uso de moxifloxacino intracameral. Conclusões: Houve uma proporção 7,3 vezes menor de endoftalmite no grupo que recebeu injeção de moxifloxacino. Este estudo fornece mais evidências que o moxifloxacino intracameral é um antibiótico profilático intracameral eficaz.

Correçäo da miopia pela ceratotomia radial com quatro e seis incisöes / Radial keratotomy: comparison of results four and six incisions

Foram acompanhados 28 olhos de 14 pacientes submetidos a certotomia radial no período de um ano. Todos os pacientes apresentavam miopia entre -1,50 D e -3,00 D com no máximo -0,75 dioptrias cilíndricas(DC) em ambos os olhos. A idade variou entre 24 e 38 anos (média de 29,2 anos). Cada paciente foi submetido a quatro incisöes radiais em um dos olhos (grupo I) e seis incisöes radiais no olho contra-lateral (grupo II), realizadas pelo mesmo cirurgiäo. O seguimento variou de 11 a 13 meses (média de 11,4 meses). A acuidade visual ao final do acompanhamento foi de 2040 ou mais em todos os olhos. Näo houve diferença estatisticamente significante quanto à correçäo da miopia nos dois grupos. O astigmatismo ao final de um ano pós-operatório no grupo I foi -0,39 DC e no grupo II foi de -0,23 DC, sendo estatisticamente significante. A diferença da média ceratométrica entre os grupos também foi significante, havendo um maior aplanamento corneano no grupo II. Apesar desta análise apresentar diferenças estatísticas, clinicamente ambos os grupos foram semelhantes. Nenhum paciente fez uso de lentes corretoras até o final do seguimento

Ceratocone e retardo mental entre irmäos / Keratoconus and mental retardation among siblings

Apresentamos dois irmãos com a associação de retardo mental e ceratocone bilateral, filhos de pais consagüíneos, onde a avaliação genealógica sugere um padrão de herança autossômica recessiva. Uma nova síndrome monogênica pode ser sugerida. Um dos pacientes foi submetido a transplante de córnea penetrante e evoluiu com úlcera corneana infecciosa, com boa resposta ao tratamento clínico. Bons resultados podem ser obtidos se a indicação de transplante de córnea em retardados mentais for criteriosa.