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Background: Endophthalmitis is a rare but a high morbid complication after cataract surgery, and a gold standard treatment is not recommended yet. In this study, we aim to evaluate the effect of early vitrectomy on the visual acuity of patients with postcataract endophthalmitis. Materials and Methods: This study was a single-arm clinical trial on 27 patients with postcataract surgery endophthalmitis. Early vitrectomy was the intervention. Visual acuity as the primary outcome was evaluated and compared at baseline, at discharge, and 1 and 3 months after the intervention. Results: From 27 patients who included in our study, six patients gain favorable visual acuity of 5/10 and above (success rate = 22%), and four of them have no improvement in their visual acuity. Retinal detachment was reported as a complication in just one case. Negative culture was a predictor for success in terms of visual acuity after the surgery. All patients who gain favorable results, presented in the first 15 days after the cataract surgery. Conclusion: The result of our study showed that, considering complete, early vitrectomy for the treatment of postcataract surgery endophthalmitis, especially for those who presented in the first 15 days of cataract surgery and for those who have negative culture is promising.
RESUMO
BACKGROUND: Pterygium is a common disorder of the ocular surface. It causes vision impairment -usually irregular type astigmatism- through different mechanisms. In addition, it is believed that surgical excision of the pterygium improves visual problems. The appropriate method to investigate irregular astigmatism is using wavefront analysis. This study was aimed to evaluate wavefront analysis pre and post pterygium surgery. MATERIALS AND METHODS: This study was performed on 32 patients who underwent surgical excision of pterygium in January 2012. Data were recorded and compared after pre and postoperative comprehensive ophthalmologic examinations including uncorrected and best corrected visual acuity, Orbscan, wavefront analysis and autorefraction to figure out the effects of surgery on different parameters. RESULTS: Comparison of pre and postoperative parameters showed that surgical treatment of the pterygium improves numerous parameters significantly including uncorrected and best corrected visual acuity, spherical and cylinder refractive error, higher order aberration, quadrafoil (Z440), corneal astigmatism and 3 and 5 mm central zone corneal irregularity (all P-values < 0.0001). In addition, it improves vertical coma (P:0.003) and secondary astigmatism (Z420) (P:0.004). CONCLUSION: It is concluded that surgical excision of the pterygium improves visual acuity, refractive errors and most of the corneal topographic indices and wavefront analysis parameters.
RESUMO
BACKGROUND: Correcting the pre-existing astigmatism is an optimal goal in cataract surgery. The aim of this study is to compare the astigmatic correcting effect of a single regular 3.2 mm clear corneal incision (CCI) with paired opposite CCI in cataract patients and effect of these incisions on optical aberrations using the wavefront quantitative analysis. MATERIALS AND METHODS: This was a randomized controlled trial study undertaken in an ophthalmology referral center on 50 patients planned for cataract surgery who were randomized to either single 3.2 mm CCI or paired opposite CCI group. Post-operative evaluation was performed at 12 weeks and included refraction, keratometery, corneal topography and wavefront analysis. Corneal astigmatism and post-operative values were compared in two groups. RESULTS: The mean pre-operative corneal astigmatism was 2.58 ± 1.03 D in the single incision group and 2.70 ± 0.94 D in the paired opposite incisions group. After 12 weeks of surgery, the corneal astigmatism was reached to 2.15 ± 0.82 D in single incision group and 1.63 ± 1.21 in the paired opposite incisions group. There was a statistically significant difference in two arms of treatment regarding to surgically induced astigmatism after 3 months. The mean post-operative total and higher order aberrations and values were not significantly different in two groups. CONCLUSION: The results of our study showed that paired opposite incisions is an effective procedure for reducing pre-existing corneal astigmatism in cataract surgery. Paired incisions did not show any beneficial effect regarding wavefront aberrations compared with conventional single incision method.
