bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing Viscocanalostomy with Trabeculectomy
Authors: Carassa Roberto G ,   Director, Italian Glaucoma Center
Published: October 2015

Viscocanalostomy is a non-penetrating procedure aimed at increasing the outflow facility by creating significant morphologic changes at the trabecular meshwork level. It is an effective procedure in lowering intraocular pressure (IOP) in open-angle glaucomatous eyes. Compared with trabeculectomy, meta-analysis studies have shown that final IOPs are significantly higher. Nevertheless, viscocanalostomy is a safer technique with significantly fewer complications compared with trabeculectomy. Viscocanalostomy is therefore a better option in eyes where target IOPs are in the mid–high teens, or in eyes at high risk of complications with trabeculectomy.
Sub-1 Millimeter—700 Micron Cataract Surgery
Authors: Kumar Dhivya Ashok , Agarwal Amar ,   Doctor,   Professor, Dr Agarwal’s Eye Hospital and Eye Research Centre, Chennai
Published: October 2015

We have reviewed the surgical technique, advantages, and limitations of sub-1 mm–700 micron cataract surgery or ‘microphakonit.’ The small clear corneal incision is made with the 0.8 mm microphakonit knife and the instruments, such as the phacoemulsification needle, irrigating chopper, and bimanual irrigation aspiration set, are made with a 0.7 mm diameter. We have also reviewed some of the work done by the authors in 700 micron cataract surgery and our analysis of microphakonit wound architecture has been explained. The clear corneal wound architecture in microphakonit has been evaluated with anterior segment optical coherence tomography and the healing process has been assessed. The microphakonit has proven to have early wound healing and less post-operative astigmatism as compared with the wound with extension.
Childhood Visual Impairment and Unmet Low-vision Care in Blind School Students in Ghana
Authors: Ntim-Amponsah Christine Teki ,   Professor, Ophthalmology Unit, Department of Surgery, University of Ghana Medical School
Published: October 2015

Most causes of childhood blindness in Ghana are avoidable. Over 40 % of the students in the school for the blind in Ghana have functional residual vision that requires low-vision care. Corneal blindness is the commonest form, followed by cataract. Retinal blindness is rare and is usually from hereditary or congenital causes. The Expanded Program of Immunization (EPI) in the Ghana health service has been very successful, with measles coverage for under one-year-olds of 95 %. This should now translate into a decline in measles-related corneal blindness, a common preventable occurrence. This then brings challenges in cataract management into focus. Provision of sustainable intervention services for low-vision care in children is a priority for the Prevention of Childhood Blindness program in Ghana. Barriers to access range from parents’ negative perceptions, societal/cultural misconceptions, and inadequate resources, to absence of collaboration and coordination between low-vision care providers and weak national support. Clients usually come from families within the lower socioeconomic groups and often find the low-vision devices unaffordable. A successful program for intervention is more likely to succeed when it is subsidized, at least until a reasonable impact has been made. One must, however, strike a good balance between cost recovery, which is more likely to ensure sustainability of the program, and subsidization.
Cultivated Limbal Stem Cell Transplantation—The Surgical Technique
Authors: Sangwan Virender S ,   Head of Cornea Service, and Associate Director, LV Prasad Eye Institute, Hyderabad
Published: October 2015

Limbal stem cell deficiency (LSCD) is characterized by loss of limbal palisades of Vogt, ingrowth of conjunctiva on to the cornea, and recurrent or persistent epithelial defects of the cornea. This results in pain, watering, decrease in vision, and light sensitivity. LSCD is most commonly caused by ocular injury, immune-mediated ocular surface diseases, and aniridia. A variety of surgical techniques have been described to treat LSCD, but cultivated limbal stem cell transplantation seems the most promising. In this technique a small biopsy is harvested from healthy limbus, either of the same eye or the other eye. The limbal tissue is shredded into small pieces and seeded on to de-epithelialized human amniotic membrane. The human corneal epithelial medium is used to grow the cells. Twelve to 14 days of culture gives enough cells for clinical transplantation.
Are There Problems with Non-penetrating Glaucoma Surgery?
Authors: Dubois Vincent , Goldberg Ivan ,   Glaucoma Fellow, Sydney Eye Hospital,   Head, Glaucoma Unit, Sydney Eye Hospital and Clinical Associate Professor, Discipline of Ophthalmology, University of Sydney and Director, Eye Associates
Published: October 2015

Non-penetrating glaucoma surgery (NPGS) has been around in various guises for 50 years, yet its acceptability among the ophthalmological community is variable. This article aims to debunk some of the myths associated with NPGS and to explain the differences in NPGS techniques. Once these differences have been explained, we scrutinize and meaningfully compare the good-quality research that has been published on the subject. In doing so, we aim to help readers determine which techniques work best and why. Finally, we hope to show the readers where NPGS has a place in the glaucomatologist’s armamentarium.
Review of Bromfenac Ophthalmic Solution 0.09 % Once-daily
Authors: Cable Melissa Morrison ,   Discover Vision Centers, Kansas City
Published: October 2015

Bromfenac ophthalmic solution 0.09 % (BROMDAY™, ISTA Pharmaceuticals, Inc., Irvine, CA) is the first and only once-daily topical ophthalmic non-steroidal anti-inflammatory drug (NSAID) approved by the Food and Drug Administration for the treatment of post-operative pain and inflammation following cataract surgery. Topical NSAIDs are important following surgery to enhance patient comfort and limit inflammation, which may otherwise restrict visual rehabilitation. In a recently published study looking at Early Treatment Diabetic Retinopathy Study (ETDRS) acuities and macular optical computed tomographies (OCTs) in the post-operative period, bromfenac had lower post-operative macular volumes and retinal thicknesses compared with nepafenac, which correlated with a separate retrospective study that found fewer clinical cases of cystoid macular edema (CME) following uneventful phacoemulsification. Since regulatory approval in Japan (2000) and the US (2005 and 2010), bromfenac has been shown to be a safe and effective medication, with more than 26 million ophthalmic uses. Once-daily dosing may confer improvements in compliance and reduce exposure to preservatives, which have been shown to lead to corneal toxicity.
Management Options in Pediatric Cataract
Authors: Vasavada Abhay R , Shah Sajani K , Vasavada Vaishali ,   Director,   Consultant, Iladevi Cataract and IOL Research Center, Ahmedabad,   Consultant, Iladevi Cataract and IOL Research Center, Ahmedabad
Published: October 2015

Pediatric cataract surgery remains a very important and difficult problem to manage and involves a team effort, the most important members of which are parents. While dramatic advances have occurred in this field during the past 10 years, some technical aspects of surgery, changing refraction, and functional outcome continue to pose significant problems. Manual capsulorhexis remains the gold standard for a successful outcome of pediatric cataract surgery as well as in deciding intraocular lens (IOL) placement. Primary management of the posterior capsule with or without anterior vitrectomy is mandatory depending on age of the child at surgery. Primary implantation of the IOL after cataract removal is gaining popularity, even for infants and young children. Predicting axial growth and the refractive change that accompanies it is one of the major challenges for the long-term care of children after surgery. The evaluation of rate of axial growth and its correlation with age at surgery, laterality, aphakia/pseudophakia, and visual axis obscuration is a positive step in this direction. Finally, appropriate visual rehabilitation and amblyopia therapy are the cornerstones for the child’s final visual development.
Alternative Pharmacotherapy Paradigm to Cataract Surgery
Authors: Duong Hon-Vu Q ,   Clinical Instructor of Ophthalmology, Westfield-Nevada Eye and Ear Center, Las Vegas, and Lecturer of Neuroscience, Anatomy and Physiology, Nevada State College, Henderson
Published: October 2015

Cataracts are the leading cause of reversible blindness worldwide and cataract extraction is the treatment of choice and leads to an improvement in the quality of life. Surgical techniques are refined and complex and yield an extremely high rate of success with a short recovery period. To further maximize surgical outcomes, post-operative treatments of uncomplicated cataract extraction include three topical pharmaceutical agents: an antimicrobial, a potent corticosteroid, and a non-steroidal anti-inflammatory drug (NSAID). Studies have shown the importance of antimicrobial prophylaxis in reducing ocular infection and endophthalmitis with the use of the newer generation of fluoroquinolones. Furthermore, the usages of topical corticosteroids and NSAIDs have reduced and prevented anterior chamber inflammation and macular edema, respectively. The regimen, however, varies among ophthalmologists because of a lack of published data that establishes the optimal regimen. Although the technological advances in cataract extraction and intraocular lens (IOL) development are well documented, the pre-, peri-, and post-operative treatment paradigm since the 1970s and 1980s has not deviated much until recently, with the European Society of Cataract and Refractive Surgery endophthalmitis study and other studies addressing the necessity of topical steroid. Also rising costs, better surgical technologies, and advancements in IOL development, should ophthalmologists maintain a three-drug regimen post-surgery or tailor the post-operative management to the individual patient?
Uveal Melanoma—Clinical and Pathological Update
Authors: Corrêa Zélia Maria S , Augsburger James Jay ,   Mary Knight Asbury Chair of Ophthalmic Pathology and Associate Professor,   E Vernon and Eloise C Smith Chair, Professor, and Chairman, Department of Ophthalmology, University of Cincinnati College of Medicine
Published: October 2015

Although ocular treatments of the primary uveal melanoma are effective to eradicate the primary tumor locally, its impact on survival remains unclear. The reason we believe local treatment has limited or no impact on survival is because, despite the increase in diagnostic accuracy over the past several decades and development of globe-sparing treatments, the mortality rates of patients with uveal melanomas of any given size have not changed appreciably during this period. Development of metastases is a complex multi-step process that occurs almost exclusively via a hematogenous route. Due to the complexity of this process it is difficult to isolate individual events in patients that are important in the overall progression of the disease from primary tumor to metastasis. Because most uveal melanomas are currently managed by eye-preserving methods that do not yield a pathologic specimen, a number of investigators are currently performing biopsy (usually fine needle aspiration biopsy) of these tumors prior to, or at the time of, ocular treatment to obtain representative tumor specimens for cytopathologic, cytogenetic, and/or molecular biologic analysis. Many new discoveries about the cytogenetic and molecular biologic abnormalities in uveal melanoma cells, and the ways these features influence development and prognosis of metastatic tumors have been published. Hopefully these findings will help us understand the process and improve patient survival since the impact of surveillance testing for metastasis and systemic therapy on the survival of patients with metastatic uveal melanoma is still uncertain.
Vitamin B2 in Corneal Surgery—Riboflavin and Collagen Cross-Linking
Authors: Thornton Spencer ,   Clinical Professor of Ophthalmology, University of Tennessee, Memphis, US
Published: October 2015

Cross-linking of collagen refers to the ability of collagen fibrils to form strong chemical bonds with adjacent fibrils. Corneal collagen cross-linking (CXL) with vitamin B2 activated by ultraviolet offers a new method for stabilization of unstable or weakened corneal tissue in cases of ectasia, dystrophy and irregular post-surgical healing.
Scanning Laser Ophthalmoscope in the Management of Age-related Macular Degeneration
Authors: Scripsema Nicole K , Rosen Richard B ,   Retinal Photographer, The Retina Center, Department of Ophthalmology, New York Eye & Ear Infirmary, New York, US,   Medical Student, Department of Ophthalmology, New York Medical College, New York, US,   Vice Chairman, Suregon Director, Chief of Retinal Service and Director of Research, The Retina Center, Department of Ophthalmology, New York Eye & Ear Infirmary, New York, US,   Professor of Ophthalmology, Department of Ophthalmology, New York Medical College, New York, US
Published: October 2015

Recent advances in retinal imaging have improved the evaluation and prognostication of age-related macular degeneration. The development and modification of the scanning laser ophthalmoscope (SLO) has played a pivotal role in our understanding of the disease. SLO has led to improved methods of visualizing characteristics of the disease, such as drusen and alterations in autofluorescence, and also provided a platform for the quantification of structural and functional changes occurring as a result of the disease process. This article provides a review of the current literature on the impact and clinical utility of SLO devices for infrared viewing, fundus autofluorescence, microperimetry, and as integraded multimodal imaging systems such as optical coherence tomography and SLO.
Advances in the Surgical Management of Glaucoma—The Role of the EX-PRESS® Glaucoma Filtration Device
Authors: Cope David W , Fechtner Robert , Jong Leo de , Kahook Malik , Moster Marlene , Goldberg Ivan ,   Touch Medical Communications, London, UK,   Professor of Ophthalmology, Institute of Ophthalmology and Visual Science, New Jersey Medical School, Newark, US,   Professor of Ophthalmology, Academic Medical Center, Amsterdam, the Netherlands,   Associate Professor of Ophthalmology, Department of Ophthalmology, University of Colorado, US,   Professor of Ophthalmology, Wills Eye Institute, Philadelphia, US,   Clinical Associate Professor, Glaucoma Unit, Sydney Eye Hospital and Discipline of Ophthalmology, University of Sydney, Australia
Published: October 2015

By reducing intraocular pressure (IOP), we aim to arrest the glaucomatous process. Our strategies include medical, laser, and surgical techniques. Trabeculectomy is the gold standard drainage surgery to achieve this; as there can be a high degree of variability in the procedure and its success depends on bleb creation, with the challenges of wound healing modulation, results remain unpredictable. Several devices are being assessed to try to achieve ‘minimally invasive glaucoma surgery’. While results will take some years to evaluate rigorously, it seems IOP levels by these means lie in the mid-teens. These minimally invasive glaucoma surgery techniques therefore would appear to be destined for patients whose glaucomatous damage is relatively mild to moderate and whose target IOPs fall into this range. To simultaneously achieve lower IOPs for patients with more advanced visual loss, efforts have been made to ‘fine-tune’ trabeculectomy. Use of the EX-PRESS® Glaucoma Filtration Device (GFD) under a scleral flap is one such approach. How does the EX-PRESS® GFD benefit the conventional trabeculectomy procedure? What tips and tricks contribute to its success? How safe is it? Is the additional cost to our health systems justifiable? This symposium, sponsored by Alcon, set out to try to answer these questions.
Evaluation of the Optic Nerve and Retinal Nerve Fiber Layer in Myopic Individuals
Authors: Aref Ahmad A , Budenz Donald L ,   Assistant Professor, University of Illinois Eye and Ear Infirmary, Chicago, US,   Professor and Chairman, Department of Ophthalmology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, US
Published: October 2015

Clinical discrimination between myopic tilted optic discs and glaucomatous optic neuropathy is often challenging, especially when considering that myopia is a risk factor for the development of glaucoma. Myopic tilted discs are usually larger than average, with associated relative cupping and thinner neuroretinal rim tissue. Histopathologic study has revealed thinner parapapillary retinal tissue in these eyes. Optical coherence tomography (OCT)-measured average retinal nerve fiber layer (RNFL) thickness has been found to decrease with longer axial length and higher myopic refractive error. Parapapillary RNFL quadrant and clock-hour analyses result in a higher false-positive rate in myopic eyes. Careful slit-lamp examination, quality baseline stereoscopic disc photographs, and frequent serial visual field testing are essential to the follow-up of myopic individuals with suspected glaucoma. A novel diagnostic parameter, OCT-derived ganglion cell analysis, may prove to be useful in the diagnosis and follow-up of these individuals.
Femtosecond Lasers in Ophthalmology
Authors: Raoof-Daneshvar Duna , Shtein Roni M ,   Kellogg Eye Center, University of Michigan, Michigan, US,   Kellogg Eye Center, University of Michigan, Michigan, US
Published: October 2015

The use of the femtosecond laser in ophthalmic surgery over the last decade has resulted in the development of innovative procedures. The ultra-short infrared laser pulses of the femtosecond laser can be applied precisely and predictably with minimal collateral tissue damage, making it an ideal tool for highly precise ophthalmic surgery. Flap creation in laserin situkeratomileusis (LASIK) is the most common use of this laser. It can also be used for other corneal refractive procedures, lamellar and full-thickness corneal transplantation, and cataract surgery. This article summarizes recent advanced applying femtosecond laser technology in ophthalmology.
Imaging of the Human Fundus in the Clinical Setting: Past, Present and Future
Authors: Calcagni Antonio , Gibson Professor Jonathan ,   Clinical Research Fellow,   Professor pf Ophthalmology, School of Life and Health Sciences, Aston University, Birmingham, UK
Published: October 2015

The human fundus is a complex structure that can be easily visualized and the world of ophthalmology is going through a golden era of new and exciting fundus imaging techniques; recent advances in technology have allowed a significant improvement in the imaging modalities clinicians have available to formulate a diagnostic and treatment plan for the patient, but there is constant on-going work to improve current technology and create new ideas in order to gather as much information as possible from the human fundus. In this article we shall summarize the imaging techniques available in the standard medical retina clinic (i.e. not limited to the research lab) and delineate the technologies that we believe will have a significant impact on the way clinicians will assess retinal and choroidal pathology in the not too distant future.
Loose Lens Surgical Management
Authors: Kaplowitz Kevin , Loewen Nils ,   Assistant Professor of Ophthalmology, Department of Ophthalmology, Stony Brook University, Stony Brook, NY, US,   Assistant Professor of Ophthalmology, Department of Ophthalmology, UPMC Eye Center, Eye and Ear Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, US
Published: October 2015

The loose lens has numerous etiologies, of which trauma and pseudoexfoliation syndrome are the most common. In addition to history, numerous signs observed at the slit-lamp should be recognized and evaluated. Proper identification and surgical planning can help avoid complications during cataract extraction. The surgical indications for lens extraction, surgical techniques to improve stability throughout the entire case, and reported results of these measures will be discussed. With an appropriate approach and settings, phacoemulsification can successfully be performed with a loose lens. Specific adjunctive measures discussed include capsular tension rings and capsule hooks. Through a thorough evaluation and knowledge of various surgical techniques to stabilize the lens, the postoperative outcomes for phacoemulsification of the loose lens can be significantly improved.
Retinal Effects of Resveratrol
Authors: Jarratt Ross A , Bartlett Hannah , Eperjesi Frank ,   Research Fellow,   Senior Lecturer in Optometry,   Associate Professor in Optometry, Ophthalmic Research Group, School of Life & Health Sciences, Aston University, Birmingham, UK
Published: October 2015

Resveratrol is a plant polyphenol that has potent anti-inflammatory and anti-oxidant properties. Age-related macular degeneration is a degenerative condition characterized by elevated levels of oxidation triggered cell damage and a subsequent inflammatory cascade. Resveratrol prevents activation of inflammatory pathways and is also a potent scavenger of reactive oxygen species and free radicals. Experiments using the mouse model have demonstrated that resveratrol reduces angiogenesis. The evidence suggests that resveratrol would be a useful inclusion in ocular nutritional supplements.
Simultaneous Bilateral Cataract Surgery in Premature Babies With and Without Retinopathy of Prematurity
Authors: Astle William F , Papp Andrea , Stifter Eva , Sanders Emi ,   Division Chief of Ophthalmology, The Alberta Children’s Hospital, Canada,   Privatdozent,   Associate Professor, Department of Ophthalmology and Optometry, Division of Pediatric Ophthalmology and Strabismus, Medical University of Vienna, Austria,   Research Coordinator, Pediatric Ophthalmology, The Alberta Children’s Hospital, University of Calgary, Division of Ophthalmology, Calgary, Alberta, Canada
Published: October 2015

Background:Four premature babies (eight eyes) undergoing simultaneous bilateral cataract surgery are presented and discussed.Methods:All four babies underwent simultaneous bilateral cataract surgery. Three babies (six eyes) had primary implantation of posterior chamber intraocular lenses (IOLs) and one baby (two eyes) had primary lensectomies with secondary visual correction with contact lenses. Results: In all eight eyes, there was no endophthalmitis and no spontaneous choroidal hemorrhages. All eyes experienced large myopic shifts, as high as –15.00 D. All six eyes with IOLs required secondary membranectomies, which did not reoccur. Case 4 had Lowe’s syndrome, was bilaterally aphakic post-op, and subsequently developed glaucoma requiring bilateral glaucoma surgery. Conclusions: Simultaneous bilateral cataract surgery in severely premature babies can be successful in restoring vision over the long term. Strategies to successfully deal with the timing of surgery, IOLs, secondary membranes, secondary glaucoma, appropriate IOL powers, and IOL formulas is discussed. Successful long-term successful visual outcomes are now possible in this complex group of premature babies.
First Postoperative Day Visual Outcome Following 6 mm Manual Small Incision Cataract Surgery Using Intratunnel Phacofracture Technique
Authors: Singh Sudhir ,   Senior Consultant and Head, Department of Ophthalmology, JW Global Hospital & Research Centre, Mount Abu, Rajasthan, India
Published: October 2015

Object:To study first postoperative day visual outcome following 6 mm manual small incision cataract surgery (MSICS) using intratunnel phacofracture technique.Design:Retrospective design.Setting:Tertiary eye care centre.Participants:A total of 216 patients who underwent MSICS performed by a single surgeon at the JW Global Hospital & Research Centre, Mount Abu, India from April 2012 to March 2013. Cataract patients with any other ocular comorbidity were not included. One hundred and thirty-six cataract patients (72 male/64 female) with a mean age of 59.75 years (range 40–80 years) were included in the study. All surgeries were performed by a single surgeon using the 6 mm MSICS intratunnel phacofracture technique.Outcome measures:The first postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and rates and types of complications were recorded.Results:A total of 136 surgeries were performed using the 6 mm MSICS intratunnel phacofracture technique. All the surgeries were performed by a single experienced surgeon. The mean UCVA and mean BCVA at first postoperative day were 0.367 (Snellen equivalent 20/46) and 0.226 (Snellen equivalent 20/33) log MAR units, respectively. No serious peri- and postoperative complications were encountered.Conclusions:The 6 mm MSICS is a safe, fast, and low-cost cataract extraction technique. It is an effective alternate to costly phacoemulsification.
Detecting Visual Field Progression in Glaucoma—Using the Right Tools for the Job
Authors: Saunders Luke J , Russell Richard A , Crabb David P ,   Full-time PhD student, Department of Optometry and Visual Science, City University London, UK,,   Post-doctoral Research Fellow in both Department of Optometry and Visual Science and NIHR Biomedical Research Centre for Ophthalmology, London, UK,,   Professor of Statistics and Vision Research, NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
Published: October 2015

Monitoring disease progression is at the centre of managing a patient with glaucoma. This article focuses specifically on how visual field measurements from standard automated perimetry (SAP) can be monitored over time. Various options for analysis on the Humphrey and Octopus perimeters are discussed, from summary indices to event and trend-based analyses, and their respective merits and flaws are evaluated. It is strongly recommended that quantitative analysis methods and software are used in assessing progression, as variability in threshold measurements makes detecting true deterioration non-trivial. Recommendations on the frequency of visual fields that should be taken per year are also discussed. The article concludes by putting the spotlight on new research being undertaken to improve the methods of measuring and predicting progression, as well as relating visual fields to patient visual disability and quality of life.
Diabetic Retinopathy—Update on Prevention Techniques, Present Therapies, and New Leads
Authors: Marozas Lauren M , Fort Patrice E ,   Undergraduate Student,   Assistant Professor, Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, US
Published: October 2015

Diabetic retinopathy is the major ocular complication associated with diabetes, and represents the leading cause of legal blindness in the working-age population of developed countries. Although classically diagnosed based on abnormalities of the retinal microvasculature, diabetic retinopathy is now widely recognized as a neurovascular disease. While all patients with diabetes are at increased risk for eye disease including diabetic retinopathy, proactive measures, and timely intervention can prevent or delay subsequent vision loss. Systemic management of diabetes by combined control of glycemia, blood pressure, and serum lipid levels remains the most important method of preventing diabetic retinopathy onset and progression. Once detected, surgical and medical interventions including photocoagulation, vitrectomy, and intravitral drug injection can help preserve vision. However, the need for improved detection methods and therapies that will allow earlier diagnosis and treatment remains apparent. This review summarizes current techniques for the prevention and intervention for diabetic retinopathy, and examines ongoing developments in the search for new endpoints and therapies as they apply to preventing vision loss associated with diabetes.
Intracorneal Inlays—Special Focus on the Raindrop
Authors: Güell José L , Barrada Omar A ,   Director, Cornea and Refractive Surgery Unit, Ocular Microsurgery Institute, Barcelona and Associate Professor of Ophthalmology, Autonoma University of Barcelona, Barcelona, Spain,   Fellow, Cornea and Refractive Surgery Unit, Ocular Microsurgery Institute, Barcelona and Autonoma University of Barcelona, Barcelona, Spain,   Consultant Ophthalmogist, Ophthalmology Department, Cairo University Medical School, Cairo, Egypt
Published: October 2015

Presbyopia remains the last frontier for refractive surgeons. With increased demand for spectacle independence at all ages, ophthalmologists are exploring different approaches for presbyopia correction. The idea of adding synthetic material to the cornea for the management of presbyopia has come a long way since its inception. The Raindrop® (ReVision Optics®), KAMRA™ Inlays (AcuFocus™), and the Flexivue Microlens™ (Presbia™) are three very different inlays that attempt to reverse presbyopia through different mechanisms. The Raindrop changes the curvature of the anterior cornea in the plane of the pupil, the KAMRA uses the principle of the pinhole to increase depth of focus, while the Flexivue is a refractive annular add lenticule that creates a paracentral zone for near vision. The decreased incidence of complications, ease of insertion, reversibility, and potential applicability to patients with various refractive statuses make inlays a powerful addition to the armamentarium in the management of presbyopia.
Case Report of Isolated Schwannoma—A Rare Eyelid Tumor
Authors: Singh Sudhir , Saraf Subodh , Goswami Divyesh , Singh Sumit ,   Senior Consultant and Head of Department, Department of Ophthalmology, JW Global Hospital & Research Centre, Mount Abu, Rajasthan, India,   Ophthalmology Registrar, Global Health Institute of Ophthalmology, Sirohi, Rajasthan, India,   Consultant Pathologist, JW Global Hospital & Research Centre, Mount Abu, Rajasthan, India,   Consultant Ophthalmologist, Mathura, Uttah Pradesh, India
Published: October 2015

Schwannoma (neurilemmoma) is a benign tumor of the peripheral nerve arising from Schwann cells that form the neural sheath. Schwannoma of ophthalmic interest is rare. Although it has been reported in relation to the orbit, and less frequently with the uveal tract and conjunctiva, instances of eyelid Schwannoma are extremely uncommon. We report a case of a 18-year-old male who developed eyelid Schwannoma. The mass was surgically removed by excisional biopsy. The histopathologic examination showed Schwannoma.
Treatment of Postoperative Endophthalmitis
Authors: Spadea Leopoldo ,   Associate Clinical Professor of Ophthalmology, Department of Medical-Surgical Sciences and Biotechnology, “Sapienza” University of Rome, Latina, Italy
Published: October 2015

Endophthalmitis is a feared complication of trauma, surgical procedures, and septicemia. The rates of postoperative endophthalmitis have been low for many years, but recent reports suggest that this type of ocular infection may be on the rise. Fluctuations in the number of cases appear to correlate with the type of intraocular surgery performed. Postoperative endophthalmitis has been reported as a consequence of nearly every type of ocular surgery, but is most common following cataract surgery. Numerous reports have demonstrated that Gram-positive bacteria cause the vast majority of postoperative endophthalmitis cases. Coagulase-negative staphylococcal isolates are the most common. Most intraocular infections resulting from infection with coagulase-negative staphylococci can be treated with antibiotic and anti-inflammatory agents, resulting in restoration of partial or complete vision. However, the more virulent the bacterial strain, the more devastating the visual outcome. Intraocular infections withStaphyloccus aureus, enterococci,Bacillus, or Gram-negative strains are often intractable, and blindness or loss of the eye itself is not uncommon. The therapeutic success of treating postoperative endophthalmitis depends largely on accurate and prompt diagnosis. Antibiotic therapy can be topical, sub conjunctival, systemic, or intravitreal. Vitrectomy must be reserved for patients who present with initial visual acuity of light perception. Only in these cases has vitrectomy been shown to be more advantageous in terms of the intravitreal antibiotic injection.
Age-related Macular Degeneration—Disease, Risk Factors, and Treatments
Authors: Schultz Clyde ,   Adjunct Professor of Biology, Department of Biological Science, University of Calgary, Calgary, Alberta, Canada
Published: October 2015

Age-related macular degeneration (AMD) is a progressive disease of the posterior segment of the eye. It is has been diagnosed worldwide and primarily affects individuals over 50 years of age. The incidence of the disease increases with age and with the presence of certain genetic factors, which may indicate a disposition for disease progression. In addition to genetic factors and age, other factors may be involved in developing AMD. These include obesity and smoking, which are also linked to various cardiovascular conditions. There are two forms of AMD: wet and dry. Both forms may involve the build-up of drusen deposits in the posterior segment of the eye, but the wet form tends to be more severe due to the proliferation of blood vessels into the macula and retinal areas of the back of the eye, thus causing an individual’s vision to become ‘blocked’ or ‘shaded’ usually beginning at the center of the visual field. There are a variety of treatment options for AMD including surgery in the form of laser or photo therapy. The most current treatment options involve the injection of a biologic into the posterior segment of the eye. There are some severe adverse events with this approach but they tend to be rare.
Femtosecond Laser-assisted Cataract Surgery
Authors: Lawless Michael , Bala Chandra ,   Ophthalmic Surgeon, Vision Eye Institute, Chatswood, New South Wales and Clinical Associate Professor, Sydney Medical School, University of Sydney, Sydney, Australia,   Surgical Director, PersonalEyes, Sydney, and Clinical Senior Lecturer, Macquarie University, New South Wales, Australia
Published: October 2015

Despite improvements in surgical technique, certain aspects of manual cataract surgery are performed with limited precision. Femtosecond laser technology enables precise incisions in the cornea and minimizes manipulations and energy required to fragment and emulsify the lens, resulting in less damage to surrounding tissues compared with manual techniques. The technique also results in superior geometric precision and centration, with reported better capsule strength compared with manual capsulotomy. Femtosecond laser-assisted cataract surgery (FLACS) is particularly advantageous in difficult cases, including hypermature and white cataracts. However, it is still not known how technical advantages translate into functional benefits. Over the past 2 years, four unique laser platforms have been introduced. This article summarizes current literature relating to the efficacy and safety of FLACS and compares currently available laser platforms.
The LENSAR® Laser System–fs 3D for Femtosecond Cataract Surgery
Authors: Packer Mark , Klyce Stephen D , Smith Craig ,   Clinical Associate Professor, Oregon Health and Science University, Oregon, US,   Adjunct Professor of Ophthalmology, Mount Sinai School of Medicine, NY, US,   Principal Systems Engineer, LENSAR® Inc., Orlando, Florida, US
Published: October 2015

The LENSAR® Laser System’s ergonomic design permits flexible functionality in any operating environment. Its low-pressure liquid interface eliminates corneal compression and facilitates accurate and complete capsulotomy construction. The Augmented Reality™ imaging system utilizes a variable super luminescent diode for scanning structured illumination to provide high-contrast, high-definition targets, which guide the laser. Real-time imaging adjustments compensate for minute degrees of tissue displacement, permitting unrivalled precision in corneal incision architecture. Precise laser spot application allows fragmentation of all grades of cataract, without the need for unnecessarily large safety margins. Iris registration compensates for cyclotorsion in the construction of arcuate incisions by aligning preoperative corneal biometry to intraoperative imaging. The ability to define the cataract grade intraoperatively facilitates efficient phacofragmentation by permitting surgeon-specified preset patterns for the full range of nuclear densities. The LENSAR Laser System represents the state of the art in femtosecond cataract surgery.
Doses de fósforo na cultura do feijão-caupi na região nordeste do Estado do Pará.
Authors: Coutinho Pablo Wenderson Ribeiro , Silva Deymeson Mateus Soares da , Saldanha Eduardo Cézar Medeiros , Okumura Ricardo Shigueru , Silva Júnior Mário Lopes da
Published: October 2015

O feijão-caupi é uma leguminosa cultivada predominantemente por pequenos produtores, representa uma das mais importantes fontes de renda e ocupação de mão de obra no meio rural do Nordeste Paraense. Objetivou-se com o presente trabalho avaliar o crescimento e a produtividade do feijão-caupi em resposta a doses de fósforo em Latossolo Amarelo. O delineamento experimental utilizado foi o de blocos ao acaso, com cinco repetições, sendo os tratamentos constituídos pelas seguintes doses: 0, 100, 200 e 300 kg ha-1 de P2O5, aplicados no sulco de semeadura, por meio da fonte superfosfato triplo (46% P2O5). As variáveis avaliadas foram altura da planta, diâmetro do caule, número de folhas, número de vagens por planta, número de grãos por vagem, massa de mil grãos e a produtividade de grãos. A adubação fosfatada teve influência positiva em todas as variáveis avaliadas, sendo que para a produtividade de grãos observou-se que quando aplicaram doses elevadas de P2O5, maiores foram os resultados. Enquanto a altura de planta, número de folhas, número de grãos por vagem e massa de mil grãos de feijão-caupi, verificou que maiores doses de P2O5 proporcionaram menor desempenho das plantas. As doses de máxima eficiência econômica foram de 156,67 à 222,22 kg ha-1 de P2O5 para as variáveis altura de planta, número de folhas, número de grãos por vagens e massa de mil grãos. Doses superiores a 300 kg ha-1 de P2O5 devem ser previstas em estudo de curva de resposta de feijão-caupi ao fósforo para as condições edafoclimáticas da região de Capitão Poço
Pegadas hídricas em sistemas agropecuários na região semiárida do Nordeste do Brasil.
Authors: Carvalho André Luiz de , Menezes Rômulo Simões Cezar
Published: October 2015

A disponibilidade de água é um aspecto de relevância global nos dias atuais. O setor agropecuário é responsável pelo consumo da maior parte dos recursos hídricos utilizados pela humanidade, portanto é essencial verificar o efeito das tecnologias no consumo de água pelas plantas. A pegada hídrica avalia as necessidades de água para as culturas, bem como os fluxos de água virtual relacionados ao comércio de produtos vegetais. Assim, objetivou-se com esse trabalho determinar a pegada hídrica de diferentes culturas agrícolas da região semiárida do Nordeste brasileiro, cultivadas sob diferentes tipos de manejo, como adubação e densidades de plantio. As culturas agrícolas analisadas nesse trabalho foram: palma forrageira (Opuntia sp.), capimbuffel (Cenchrus ciliares L.), milho (Zea mays L.) e sorgo (Sorghum bicolor L. Moench). A pegada hídrica foi calculada através de dados de produtividade das culturas e pela quantidade de precipitação pluvial ocorrida durante o período de crescimento dessas culturas. A palma teve pegada hídrica reduzida com aumento da densidade de plantio e aumento da quantidade de fósforo no solo (53%). No capim-buffel a redução ocorreu devido ao uso de adubo químico (23%) e esterco bovino (28%). No milho o consumo foi reduzido utilizando adubação com gliricídia (38%) e esterco (50%). No sorgo, a redução atribuiu-se à utilização de variedades híbridas mais adaptadas (75%). O conjunto de estudos avaliados indica que há grande potencial para reduzir a pegada hídrica das culturas agrícolas da região, com o uso de técnicas de manejo agrícolas como adubação, densidade de plantio e formação de híbridos.
Crescimento e marcha de absorção de micronutrientes para a cultivar de melancia Crimson Sweet.
Authors: Almeida Edmilson Igor Bernardo , Nóbrega Gabriel Nuto , Corrêa Márcio Cleber de Medeiros , Pinheiro Everton Alves Rodrigues , Araújo Neimar Arcanjo de
Published: October 2015

Para a sustentabilidade na produção da melancia é importante que sejam atendidas as suas exigências nutricionais, especialmente e durante a época em que ocorre maior demanda por nutrientes. Objetivou-se neste trabalho, avaliar o crescimento e marcha de absorção de micronutrientes pela melancia, cultivar Crimson Sweet. O experimento foi desenvolvido no perímetro irrigado do Baixo Acaraú, situado na região norte do estado do Ceará. As épocas de amostragem iniciaram-se no vigésimo quarto dia após a emergência (DAE), e foram realizadas em intervalos regulares de 10 dias, sendo assim representados: 24, 34, 44, 54 e 64 DAE. Constatou-se que o período de maior acúmulo de massa seca ocorre entre os 44 e 64 DAE, sendo que aos 64 DAE, a massa seca total da planta foi estimada em 1.131,72 g; a ordem decrescente dos micronutrientes acumulados foi: Fe>Zn>Mn>Cu; aos 64 DAE, a parte aérea exportou: 495,35 mg kg-1 de Fe, 166,71 mg kg-1 de Zn, 63,71 mg kg-1 de Mn e 14,09 mg kg-1 de Cu; os frutos acumularam 26,29; 29,05; 15,59; 31,51% da quantidade total de Fe, Zn, Mn e Cu, respectivamente exportada pela parte aérea. O período compreendido entre 44 e 64 DAE foi identificado como sendo o de maior requerimento de micronutrientes.
Sazonalidade e variação espacial do índice de estado trófico do açude Orós, Ceará, Brasil.
Authors: Batista Adriana Alves , Meireles Ana Célia Maia , Andrade Eunice Maia de , Izidio Naiara Sâmia de Caldas , Lopes Fernando Bezerra
Published: October 2015

Objetivou-se com o presente trabalho avaliar a qualidade das águas do açude Orós, estudando os atributos físicoquímicos e biológicos quanto à sua contribuição para com o processo de eutrofização, bem como identificar o nível trófico das águas usando o Índice de Estado Trófico Médio (IET-M). As coletas foram realizadas em sete pontos de amostragem em caráter bimestral durante o período de jun/2008 a abr/2010, com total de 11 coletas, sendo seis foram correspondentes ao período chuvoso e cinco ao período de estiagem. As variáveis analisadas foram: transparência da água, concentrações de fósforo total e clorofila “a”. De acordo com os resultados concluiu-se que a presença de sedimentos carreados pelo escoamento superficial foi determinante para a redução da transparência da água, o que classificou o reservatório em hipereutrófico nos dois períodos avaliados. Os pontos P1 e P6 são os mais críticos no reservatório, no período seco, quanto aos teores de fósforo, sendo suas águas classificadas em supereutróficas. As maiores transparências contribuíram para aumento na concentração de clorofila “a” no período chuvoso e, no período de estiagem os menores valores de clorofila “a” coincidiram com a menor transparência da água. O Índice de Estado Trófico Médio das águas do reservatório foi classificado em mesotrófico, para o período das chuvas e em eutrófico, no período de estiagem.
Agregação de um Latossolo em função de diferentes ciclos de cultivo de cana-de-açúcar sob colheita mecanizada
Authors: Rossetti Karina De Vares , Teixeira Daniel De Bortoli , Reis Iolanda Maria Soares , Centurion José Frederico
Published: October 2015

O tamanho dos agregados e o estado de agregação podem modificar a estrutura do solo, principalmente quando ocorre o manejo intensivo desse com o cultivo da cana-de-açúcar. Objetivou-se com esse estudo avaliar a influência de ciclos de cultivos de um canavial na agregação em diferentes profundidades de um Latossolo Vermelho distrófico típico, situado em Bebedouro (SP). Foram selecionados em março de 2012, três talhões de cana-de-açúcar colhida mecanicamente, sem queima, sendo: cana soca de um ciclo (C1), cana soca com sete ciclos (C7) e cana soca com oito ciclos (C8), e uma área adjacente de mata nativa (MN). O delineamento experimental foi em blocos casualizados com parcelas subdivididas, com quatro repetições. As áreas consistiram de parcelas e subparcelas sendo formadas pelas profundidades 0-0,10; 0,10-0,20 e 0,20-0,30 m. As variáveis avaliadas: diâmetro médio geométrico (DMG), diâmetro médio ponderado (DMP), índice de sensibilidade dos agregados (IS) e teor de matéria orgânica do solo. O ciclo C8 apresentou maiores DMG e DMP, mas semelhantes teores de MO em comparação com os demais ciclos de cana-de-açúcar, demonstrando que o tratamento C8 não foi prejudicial à estrutura do solo. O diâmetro médio geométrico apresentou pior correlação com a matéria orgânica do solo na camada de 0,10-0,20 m.
Cálculo do fator LS da Equação Universal de Perdas de Solos (EUPS) para a bacia do Rio da Prata, Castelo-ES
Authors: Coutinho Luciano Melo , Cecílio Roberto Avelino , Garcia Giovanni De Oliveira , Xavier Alexandre Cândido , Zanetti Sidney Sára , Moreira Michel Castro
Published: October 2015

A erosão é apontada como a principal causa do depauperamento de terras agrícolas, o que gera prejuízos anuais aproximados da ordem de bilhões de dólares no Brasil. A erosão hídrica é a mais comum, ocasionada pela precipitação efetiva em bacias, que devido ao seu potencial erosivo é o principal agente de remodelagem do terreno. A Equação Universal de Perdas de Solos (EUPS) mostra-se de grande aplicabilidade para estimar a erosão de bacias hidrográficas a partir de seus elementos físicos e geográficos (PS=R*K*L*S*C*P). A intensidade da erosão pode sofrer influência do perfil da encosta, avaliada pelo comprimento (L) e grau do declive (S). O fator topográfico (LS) da EUPS é o de mais difícil obtenção para áreas grandes e/ou de relevo diversificado. Realizou-se a espacialização do mapa de fator LS da bacia da Prata (Castelo-ES) a partir do processamento de dados cartográficos em ambiente de Sistemas de Informação Geográfica (SIG). O relevo da área de estudos foi representado via interpolação de curvas de nível com suporte de hidrografia mapeada, obtendo-se o Modelo Digital de Elevação Hidrologicamente Consistente (MDEHC) e o mapa de declividade. Para geração do fator LS utilizou-se a equação desenvolvida por Bertoni e Lombardi Neto (2005), adequada para encostas de comprimento e declividade distintos. A bacia do Rio da Prata apresenta relevo diversificado, marcado por áreas planas e de declividade acentuada, o que indica vulnerabilidade erosiva. Os principais valores de LS identificados foram mínimo (0), médio (8,2) e máximo (80,5).