Bilateral pseudoexfoliation deposits on intraocular lens implants.

We present a rare case of bilateral pseudoexfoliative deposits on both intraocular lens (IOL) implants in an 83-year-old woman with no other associated pathology, 5 years after cataract surgery. Pseudoexfoliation syndrome is the most common cause of secondary open-angle glaucoma worldwide and these deposits are usually found on the natural lens. The fact that pseudoexfoliative deposits have been found on IOL implants implies the need for a thorough examination in pseudophakic patients, for it could be the only sign of secondary glaucoma.

Endonasal endoscopic scalpel-forceps dacryocystorhinostomy vs endocanalicular diode laser dacryocystorhinostomy.

Purpose. To compare the efficacy of endonasal endoscopic dacryocystorhinostomy and endocanalicular diode laser dacryocystorhinostomy. Materials and methods. A total of 126 dacryocystorhinostomies were performed in 111 patients with epiphora. In 55% of cases (69/126) we performed an endonasal endoscopic dacryocystorhinostomy and in 45% (57/126) we carried out an endocanalicular dacryocystorhinostomy using diode laser. The mean age at diagnosis was 63 years. The mean age was higher in the endocanalicular group than in the endonasal endoscopic group: 64 versus 62 years. There were 25 men (23%) and 86 women (77%). Results. Successful results were achieved in 73% of patients (92/126). In the endonasal endoscopic group, 83% of patients (57/69) were symptom free compared to 62% of patients (35/57) in the laser diode group. A bicanalicular nasal silicone tube was left in place for a mean of 2.32 months in the endoscopic endonasal group and for 2.82 months in the laser diode group (p=0.164). Median time of recurrence after removal of the tube was 3.56 months (range 0-9.6): 2.84 months in the laser diode group and 4.87 months in the endonasal endoscopic group (p=0.069). Conclusions. The endonasal endoscopic approach achieved better results for nasolacrimal obstruction than the endocanalicular laser diode technique.

Posology, efficacy, and safety of epidermal growth factor eye drops in 305 patients: logistic regression and group-wise odds of published data.

The aim of this article is to investigate clinical research on indications, posology, efficacy, and safety of epidermal growth factor (EGF) eye drops in the treatment of some human corneal disorders. Methods used include systematic search and selection of series of cases and clinical trials in Medline database up to January 2012, kappa index (K) to validate retrieval information, cumulative Mantel-Haenszel-stratified meta-analysis, 2×2 contingency table of randomized EGF-vehicle-controlled treated groups, and statistical program SPSSv12. Our results indicate that EGF eye drops appear to be a very effective treatment of acute heterogeneous corneal diseases, without significant adverse effects, with a 86.8% clinical efficacy reported by authors, a 98% (P<0.05) probabilistic expected efficacy, and 51.3 (17.4-148.7 confidence interval 95%; P<0.05) odds ratio EGF/vehicle. However, clinical trials are scarce, with low sample sizes and serious inconsistencies in EGF posology. EGF eye drops (50-1,000 ng, 2-3 times/day) could be a useful treatment for promoting postoperative refractive surgery, reversing cases of keratopathy secondary to systematic EGF receptor inhibitors, diabetic keratopathy, and other corneal and conjunctival disorders.

Cirugia del vitreo / Vitreous surgery

La cirugía del vítreo tiene ya en el momento actual un lugar importante en la práctica diaria de todo centro especializado. Con ella se mejoran los resultados operatorios de un buen número de intervenciones complicadas y se resuelven también muchos casos antes condenados a la ceguera. Sin embargo, los resultados no siempre son satisfactorios y los fracasos ocasionan muchas veces el desánimo. El desarrollo de una nueva instrumentación, cada vez más perfeccionada, la elección más apropiada de los líquidos de perfusión y de los substitutos del vítreo, y la puesta al día de técnicas más sofisticadas para trabajar en la cavidad endoocular, unidas a la mayoir experiencia conseguida con el paso de los años, hacen este tipo de cirugia más seguro y permiten resolver cada vez casos más difíciles. De esta forma, la cirugía del vítreo tiene cada vez más clara su aplicación ante un caso concreto, y se determinan con más precisión los ojos que necesitan de otros cuidados asociados (fotocoagulación, diatermia, procedimientos clásicos de desprendimiento de retina, extracción del cristalino, tratamiento médico) (AU)