Clinical validity of macular ganglion cell complex by spectral domain-optical coherence tomography in advanced glaucoma.

PURPOSE: To evaluate the repeatability and diagnostic power of macular ganglion cell complex (mGCC) thickness and peripapillary retinal nerve fiber layer (pRNFL) thickness using a spectral domain-optical coherence tomography in advanced glaucoma. PATIENTS AND METHODS: Forty advanced glaucoma patients were enrolled. Patients were divided into 2 groups of 20 patients each, according to the MD between -20 and -10 dB, and <-20 dB. The thickness of mGCC and pRNFL were measured with spectral domain-optical coherence tomography in both the groups. The repeatability of each parameter was assessed in both the groups, and the diagnostic power of each parameter was compared with the normal controls. RESULTS: Comparison of diagnostic power between the pRNFL and mGCC parameters revealed that the area under the receiver operating characteristic curve was not significantly different in patients with advanced glaucoma. The repeatability of pRNFL parameters was similar, irrespective of the severity of glaucoma. However, the repeatability of mGCC parameters became lower as the severity increased in patients with advanced glaucoma. CONCLUSIONS: In advanced glaucoma, the measurement of mGCC thickness has similar diagnostic power as the measurement of pRNFL thickness. However, the measurement of mGCC thickness showed a lower repeatability as MD decreased.

Clinical effect of a mixed solution of sodium hyaluronate and sodium carboxymethylcellulose during the transconjunctival approach for orbital wall reconstruction.

This study aimed to evaluate the anti-adhesive effect of a mixed solution of sodium hyaluronate and sodium carboxymethylcellulose (HACMC, Guardix-sol®) during the transconjunctival approach to orbital wall reconstruction. Eighty-seven patients who underwent orbital wall reconstruction by the transconjunctival approach were enrolled in this prospective study. We applied HACMC between the orbicularis oculi muscle and the orbital septum after surgery in 47 patients and did not use it in 40 patients. Lower lid retraction and marginal reflex distance 2 (MRD(2)) were measured to analyze the degree of postoperative adhesion at 1 week and 1, 3, and 6 months. The degree of MRD(2) showed clinically significant differences at postoperative 1 week and 1 month between the HACMC and control groups (p<0.05). Lower lid ectropion developed in two patients (5.0%) in the control group but did not occur in the HACMC group. In orbital wall reconstruction by the transconjunctival approach, the HACMC mixture solution is effective for preventing adhesion and lower lid ectropion during the early postoperative period.