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PURPOSE: To evaluate the effect of lens status on intraocular pressure (IOP) in siliconized eyes and also on the emulsification of silicone oil. PATIENTS AND METHODS: A total of 31 eyes of 31 patients with retinal detachment were operated on with pars plana vitrectomy and silicone oil injection: 16 phakic (Group A) and 15 pseudophakic (Group B). During the 6-month follow-up period, IOP was measured: 1 day postoperative, then at 1 week, 1 month, 2 months, 3 months, and 6 months postoperative. At the end of the follow-up period, gonioscopy was carried out to check emulsified silicone at the anterior chamber angle and also the presence of emulsified silicone on the back of the cornea when the patient was lying down. RESULTS: There was no significant difference between both groups until the first week (P value = 0.15). Starting from the first month, the difference was statistically significant, with mean IOPs in Groups A and B of 14.9 mmHg and 18.2 mmHg, respectively, up to the sixth month (P value = 0.002), with a mean IOP in Groups A and B of 14.4 mmHg and 19.4 mmHg, respectively. Emulsified silicone was clinically stated in twelve cases (80%) in Group B and in three cases (19%) in Group A. CONCLUSION: There is a higher incidence of increased IOP and emulsification of silicone oil in pseudophakic eyes than in phakic eyes.
RESUMO
PURPOSE: To compare torsional versus combined torsional and conventional ultrasound modes in hard cataract surgery regarding ultrasound energy and time and effect on corneal endothelium. SETTINGS: Kasr El Aini hospital, Cairo University, and International Eye Hospital, Cairo, Egypt. METHODOLOGY: Ninety-eight eyes of 63 patients were enrolled in this prospective comparative randomized masked clinical study. All eyes had nuclear cataracts of grades III and IV using the Lens Opacities Classification System III (LOCS III). Two groups were included, each having an equal number of eyes (49). The treatment for group A was combined torsional and conventional US mode phacoemulsification, and for group B torsional US mode phacoemulsification only. Pre- and post-operative assessments included best corrected visual acuity (BCVA), intraocular pressure (IOP), slit-lamp evaluation, and fundoscopic evaluation. Endothelial cell density (ECD) and central corneal thickness (CCT) were measured preoperatively, 1 day, 7 days, and 1 month postoperatively. All eyes were operated on using the Alcon Infiniti System (Alcon, Fort Worth, TX) with the quick chop technique. All eyes were implanted with AcrySof SA60AT (Alcon) intraocular lens (IOL). The main phaco outcome parameters included the mean ultrasound time (UST), the mean cumulative dissipated energy (CDE), and the percent of average torsional amplitude in position 3 (%TUSiP3). RESULTS: Improvement in BCVA was statistically significant in both groups (P < 0.001). Comparing UST and CDE for both groups revealed results favoring the pure torsional group (P = 0.002 and P < 0.001 for UST; P = 0.058 and P = 0.009 for CDE). As for %TUSiP3, readings were higher for the pure torsional group (P = 0.03 and P = 0.01). All changes of CCT, and ECD over time were found statistically significant using one-way ANOVA testing (P < 0.001). CONCLUSION: Both modes are safe in hard cataract surgery, however the pure torsional mode showed less US energy used.
RESUMO
BACKGROUND: Lagophthalmos is a condition that results from facial paralysis causing functional as well as esthetic problems. This condition can be treated by a range of techniques, including tarsorrhaphy, facial slings, and canthopexies. Gold plates provide a solution for temporary or permanent lagophthalmos resulting from facial paralysis. This study discusses the use of gold plates in the treatment of lagophthalmos but with the introduction of gold plates in two different positions in the upper lids. METHODS: Group 1 (38 eyes) had a low level of placement (2 mm from the lid margin) of gold plates, while Group 2 (23 eyes) had a high level of placement (5 mm from the lid margin). RESULTS: Noticeable bulge was seen in 18.4% of Group 1 eyes compared with 13% in Group 2, and migration of the plate occurred in 2.6% and 0% of eyes in Group 1 and Group 2, respectively, as well as ptosis (7.8% and 4.3%) and conjunctival perforation (0% and 4.3%). The degree of improvement of eyelid closure, keratopathy, and visual acuity were the same for both techniques. CONCLUSION: Placement of gold plates at a higher level could avoid some of the drawbacks of lower level placement of these plates, such as upper eyelid bulge and ptosis, especially given the thinning of the eyelids and orbicularis muscles that occurs in facial palsy.
