bluuebunny/crossref_metadata_2025 huggingface dataset:
Sutureless and glue free conjunctival autograft in pterygium surgery
Authors: DE WIT DW , MOORE J
Published: September 2009

Purpose To review the safety and efficacy of sutureless and glue free conjunctival autografting for the treatment of primary pterygium

Methods Retrospective case notes review of 8 consecutive patients undergoing primary pterygium excision performed by a single surgeon over a 1 year period. Excision of the pterygium was followed by reconstruction using suture and glue free conjunctival autograft.

Results Mean follow up was 14 months (range 12 to 24). There were no transplant dislocations, failures or recurrences (0 of 8 eyes) after one year. The average operating time was 14+/‐2(SD) minutes. One patient had transient graft oedema. Visual acuity was unaltered in seven patients, one patient with significant pterygium‐induced astigmatism gained 3 Snellen lines. No major complications occurred and all patients approved of their cosmesis at their final visit.

Conclusion Sutureless and glue free autologous conjunctival grafting for primary pterygium surgery appears safe and efficacious and may aid in preventing complications attributed to the use of foreign materials.
Effect of phacoemulsification on the primary open angle glaucoma control after trabeculectomy: a case‐control study
Authors: AZIZ S , SPIRES N , JAY J
Published: September 2009

Purpose In this retrospective and comparative study, we analyzed the influence of phacoemulsification (PE) on the glaucoma control in case patients (trabeculectomy‐phacoemulsification [CE]) compared with the control that underwent trabeculectomy (T) alone in eyes with primary open angle glaucoma (POAG).

Methods Twenty one patients who underwent PE subsequent to T were identified, and 41 who underwent T alone were matched. Visual acuity (VA), intraocular pressure (IOP), bleb appearance, vertical cup disc ratio (VCDR), visual field (VF), glaucoma medications, iris manipulation and complications were documented. Mean follow up was 12 months. Success was defined when IOP ≤ 21 mmHg with the abscense of glaucoma medication and/or further surgical intervention.

Results Patients in CE group had no significant change in IOP from pre‐operative measures to 12 months post‐operative (p=0.001). The mean IOP reduced from 15.3 mm Hg to 14.7 mmHg postoperatively. The control group showed an average IOP reduction of 6 mm Hg in the last visit. In CE group, 19% required 1 or 2 glaucoma medications at one year fellow‐up vs 19.5% in the control group. In CE group 9.5% showed flattening of previously formed bleb in the last visit (P<0.001), 9.7 % ended with flat bleb in the T group. The increase in VCDR for the CE group was statistically significant when compared to the control group (p<0.001). Patients in CE group were more likely to exhibit a change in VF (47.6% versus 7.3% respectively). The study is limited by the small number of cases available.

Conclusion Corneal PE in eyes with filtering blebs does not adversely affect long‐term glaucoma control in patients with POAG.
Inflammation assessment after selective laser trabeculoplasty (SLT) treatment
Authors: AYALA M , LANDAU HöGBECK I , CHEN E
Published: September 2009

Purpose Glaucoma is a progressive neuropathy, reducing intraocular pressure (IOP) seems to be the only treatment to stop progression in glaucoma. There are several methods to reduce IOP: medical treatment, laser and surgery. Selective Laser Trabeculoplasty (SLT) is a new treatment alternative. SLT selectively targets the pigmented cells of the trabecular meshwork without causing thermal or collateral damage to the surroundings structures. The aim of the present study was to assess inflammation after SLT treatment.

Methods 40 patients (80 eyes) were included in the study. Inclusion criteria: Glaucoma (POAG, pigmentary and pseudoexfoliative glaucoma)/ OHT patients that will be treated with SLT in just one eye, both with and without eye‐drops. Exclusion criteria: patients suffering from ocular or systemic inflammatory diseases or treated with cortisone or immunosuppressive drugs. Inflammation was measured in 2 different ways: 1) clinically with a slit lamp and classified 0‐4; 2) with a “Laser flare meter (Kowa FM 500)”. Measurements were done before, 2 hours after, 1 week and 1 month after SLT treatement, both eyes were evaluated. IOP was also checked in the same way. SLT treatment was performed in 90° with the SLT Solo Ellex laser.

Results inflammation before and after SLT showed no significant difference measured both clinically with slit lamp and objectively with the laser flare meter. No inflammation was found in the untreated eyes. No IOP peaks after SLT treatment were found.

Conclusion SLT treatment seems not to induce inflammation in the anterior chamber when 90° were treated. SLT treatment might be considered as a first choice treatment against high intraocular pressure.
Oculopalatal tremor
Authors: BORRUAT FX
Published: September 2009

Oculopalatal tremor is a rare but disturbing acquired motor disorder. It is a delayed complication of a brainstem lesion (usually infarction or hemorrhage) interrupting the so‐called "Mollaret's triangle" (dentato‐olivary pathway). Clinically, patients complain of vertical oscillopsia due to a rhythmical vertical pendular movement of the eyes. Other muscles can be involved, namely soft palate, pharynx, larynx, head, face, diaphragm. Hypertrophy of the inferior olivary nucleus is the hallmark of oculopalatal tremor, by MRI or by pathology. This presentation will review the current knowledge regarding the anatomic bases of this syndrome, as well as its clinical presentations, MRI findings, treatment options and pathophysiologic hypotheses.
Transthyretin levels in the vitreous correlate with change in visual acuity after vitrectomy
Authors: VAN AKEN E , VECKENEER M , DERYCKE L , DELANGHE J
Published: September 2009

Purpose Little is known about biochemical markers related to change in visual acuity after vitrectomy. We investigated the potential use of transthyretin (TTR), a carrier of the retinol/retinol‐binding protein, as a biochemical marker protein.

Methods We measured TTR using immunonephelometry in a group of patients (n=77) in longstanding (> 1 week) retinal detachment (n=29), fresh (< 1 week) retinal detachment (n=17), macular holes (n=20), or diabetic retinopathy (n=11). Vitreous samples were taken at the start of every vitrectomy procedure. For reference values, cadaver specimens (n=73) were used.

Results Reference values for vitreous TTR (median 18 mg/l; IQR 4‐24 mg/l) comprised 2.2% of reference values for vitreous protein levels (median 538 mg/l; IQR 269‐987 mg/l). Vitreous TTR values of patients were comparable in all disorders. Vitreous TTR values were higher in phakic (median 22.5 mg/l; IQR 10‐27 mg/l) than in pseudophakic patients (median 12 mg/l; IQR 8‐19 mg/l)(p=0.06). Postoperative change in visual acuity correlated well with vitreous TTR values found peroperatively (rs=0.408; p=0.012). Both change in visual acuity and lens status were the only variables which proved to explain the variance of TTR (multiple correlation coefficient: 0.494; phakic status: t=2.767; p=0.0084; and change in visual acuity t=2.924: p=0.0056).

Conclusion Vitreous fluid concentrations of TTR can be regarded as a biochemical marker for retinal function.
The different domains of the point spread function ‐ Small angle vs large angle
Authors: VAN DEN BERG TJTP , COPPENS JE , FRANSSEN L
Published: September 2009

Purpose The Point‐Spread‐Function peaks at 107, and drops off to 10‐2 at 90 degrees, a dynamic range of 109. Important changes in the PSF already occur within the first 1 minute of arc, so spatially the dynamic range is 105. Very different experimental techniques are needed to describe the small angle (aberrometry, double pass) and the large angle (straylight) domains. What optical irregularities achieve such PSF?

Methods Literature models for the aberration structure of the human eye media, in particular Thibos et al. JOSA A 2002 were used to derive the PSF. The Thibos et al. model was extrapolated to allow inclusion of the high orders of aberration not normally included in aberrometry, but potentially visible with double pass, so as to encompass as much as possible from the PSF.

Results The modeled aberration structures of the eye covers the central part of the PSF up till about 0.3 degrees if extreme high orders were included. For angles >1 degree predicted values were far below the actual values of the PSF. On the other hand, double pass techniques grossly overestimate PSF values at angles of 0.3 degree and above. Using an alternative model for the aberration structure of the eye the PSF could be described up till 1 degree. Small particle scattering was essential to predict the PSF for angles above 1 degree.

Conclusion In the assessment of disturbances to the optical media two domains must be discriminated: the aberration domain and the small particle domain, with corresponding parts (small angle vs large angle) to the PSF. Straylight originates from irregularities of small characteristic size (10 micrometer and below), as opposed to disturbances to the central part of the psf (<0.3 degrees), originating from large scale irregularities.

Commercial interest
Challenges in optical measurement of scatter
Authors: GINIS H
Published: September 2009

Purpose Measurement of scattered light in biological media and particularly the optical media of the human eye is associated with two main challenges: The extremely low intensity of the scattered light and artefacts associated to tissue handling and preparation.

Methods Our strategies in reducing the errors associated with the above mentioned challenges include the utilisation of properly designed illumination schemes and appropriate procedures and devices for excising and mounting the specimens.

Results Appropriate techniques that incorporate precise knowledge of the optical PSF of the system may prove useful for the accurate measurement of scatter light. Diffraction through the utilisation of narrow (e.g. 0.5mm) diaphragms may prove useful for the broadening of the optical PSF (while preserving knowledge of its shape) and therefore allow optical measurements of a wider range of angles.

Conclusion Optical measurements of scatter may prove useful not only for the macroscopic characterisation of the optical quality of the optical media of the eye but also for the extraction of information concerning the microscopic structure of the irregularities causing the loss of transparency.
Corneal biomechanics study : relationship between corneal aberration – hysteresis
Authors: PEREZ GARCIA D , IBANEZ J , VALYI Z , CASAS P , CRISTOBAL JA
Published: September 2009

Purpose To determinate the relatioship between corneal aberration and a biomechanical parameter: the corneal hysteresis.

Methods 122 eyes of 61 patients were included in a prospective and transversal study. Range of age was between 18 and 60 years. The following measurements were realised: Corneal topography with KERATRON (Optikon) to obtain the root mean square (RMS) of corneal aberration and measurement with Ocular Response Analyzer (ORA) (Reichert) to obtain the Corneal Hysteresis (CH). The correlation between RMS – CH was calculated by SPSS 12.0 (Statistical Package for the Social Sciences, Chicago, IL) using the correlation of Pearson for quantitative and independent variables.

Results No statistically significant correlation could be demonstrated between RMS and CH analysing both eyes as well as left and right eyes separately.

Conclusion The relationship between CH and each Zernike coefficient separately could be analysed as other studies found a correlation between intraocular pressure and high order aberrations. The importance of corneal biomechanical parameters like CH and CRF, values determined by the ORA, is not well defined yet; however the influence of these factors not only on intraocular pressure but also on corneal pathologies should be considered.
Corneal biomechanics study (1): Central corneal thickness versus corneal resistance factor
Authors: VALYI Z , IBANEZ J , PEREZ GARCíA D , JIMENEZ DEL RIO B , CRISTOBAL JA
Published: September 2009

Purpose Study about the biomechanical characteristics of the cornea.

Methods We studied 122 eyes of 61 patients (33 women and 28 men) selected prospectively and consecutively. Range of age was between 18 and 60 years. The following determinations were carried out: Corneal topography with KERATRON (Optikon), measurement with ORA (Reichert) and ultrasonic pachymetry. The correlation between CCT ‐ CRF was calculated by SPSS 12.0 (Statistical Package for the Social Sciences, Chicago, IL) using the correlation of Pearson for quantitative and independent variables.

Results We found after statistical analysis of data, a statistically significant correlation between the corneal resistance factor determined by the ORA, and central corneal thickness measured by ultrasonic pachymetry. The results are similar analysing both eyes as well as left and right eyes separately.

Conclusion The importance of corneal biomechanical parameters like CH and CRF, values determined by the ORA, is not well defined yet; however the influence of these factors not only on intraocular pressure but also on corneal pathologies should be considered.
Heterogeneity in uveal melanoma assessed by multiplex ligation‐dependent probe amplification (MLPA)
Authors: DOPIERALA J , COUPLAND SE , DAMATO B
Published: September 2009

Purpose To study intratumour heterogeneity in primary uveal melanoma (UM) by MLPA in microdissected formalin‐fixed, paraffin‐embedded (FFPE) tissues.

Methods DNA was extracted from 2‐9 areas microdissected from 32 FFPE UMs. Thirty‐one loci on chromosomes 1p, 3, 6 and 8 were tested for copy number changes using the SALSA MLPA P027.B1 assay (MRC Holland). MLPA data were displayed as dosage quotients (DQs), which were classified to 5 ranges (0.35‐0.64 deleted; 0.65‐0.84 equivocal deletion; 0.85‐1.14 normal; 1.15‐1.35 equivocal amplification; >1.35 amplified). The tumour was considered heterogeneous at a locus, if a) the difference in DQs of any two areas was higher than 0.2 (value determined by ROC analysis), and b) the DQs of the areas belonged to different ranges.

Results Genetic abnormalities were detected in all 32 UMs. Monosomy 3, the most significant metastasis predictor, and gain of 8q genes MYC or DDEF1 were detected in at least 1 microdissected area of 22 (69%) and 28 (87%) of the tumours, respectively. The comparison of MLPA data obtained from different areas of UMs showed heterogeneity in 1‐24 loci across chromosomes 1p, 3, 6 and 8 in 26 (81%) tumours. Interestingly, trisomy 3 was observed in 3 (9%) UMs and these tumours showed the highest degree of heterogeneity (>23 heterogeneous loci). Intratumour heterogeneity of 3p12.2 (ROBO1) and 6p21.2 (CDKN1A) were most common and present in more than 35% of the tumours.

Conclusion Heterogeneity of chromosomal abnormalities of 1p, 3, 6 and 8 is present in many UM. Taking one random tumour sample for prognostic testing, therefore, may not be representative of the whole tumour.
Tear level of nerve growth factor in normal dogs
Authors: DODI PL , ZANOTTI C , ROSSI S , ALOE L
Published: September 2009

Purpose To evaluate tear level of nerve growth factor (NGF) in normal dogs.

Methods In the present study we investigated the presence and the level of NGF in the tear of 12 normal dogs (24 eyes) with different sex (5 males and 7 females) and age (ranging from 2 to 12 years old). Tears were collected by washing the eye surface 150 microliter of physiological salt after clinical examinations. Tear samples were stored at ‐20°C until tested for presence of NGF performed with a commercially available immunoenzymatic assay and expressed as pg/ml of sample.

Results All samples examined showed presence of NGF, suggesting that this growth factor is a constitutive biological mediator of the ocular surface. It was also found that the level of NGF in the right eye is different from the left eye. Thus, the average concentration in the tear of the right was 7,97 (ranging from 5.0 to 38.3 pg/ml), whereas the average in the left eyes was 15,79 (ranging from 5.0 to 67.5 pg/ml).

Conclusion Tear fluid is a secretion of lacrimal gland that lubrificates the eye surface and plays a critical role in response to eye irritation, by improving optical performance and the deficit induced by keratoconjuntivitis sicca. The observation that NGF is present in tear of dogs in a physiological relevant amount suggests that this molecule may be involved in the regulation of corneal homeostasis. Moreover, as NGF is known to play a role in emotional and anxiety‐like behaviour, and tear secretion is a widespread phenomena among vertebrates, the possibility exists that NGF might be also involved in these behaviour responses. Because cats rarely suffer from emotional behavioural and keratoconjuntivitis sicca further studies may help to understand the role of NGF in tear secretion.
Istopathological aspects of complications of DSAEK: our experience
Authors: PESCE G , VALENZANO E , MACINAGROSSA G , DI GESU I , MONTRONE F
Published: September 2009

Purpose Descemet–stripping automated endotelium Keratoplasty (DSAEK) is a selective tissue transplanation procedure in which only the deseaded endotelium and descemet membrane is replaced. The aim is to study the histopathologic features of DSAEK graft removed after graft failure and to correlate with relevant clinical features.

Methods Retrospective study of 2 cases of DSAEK graft failure in 22 patients who underwent DSAEK for Fuchs Endotelial Dystrophy and Bullous keratopathy. Perioperative clinical finding were correlated with pathologic finding of the explanted graft specimens. Anormalities in the DSAEK graft and in the interface between the recipient cornea and the DSAEK graft were studied.

Results All DSAEK procedures were uneventful. All graft failure occured in association with graft dethacment or more surgical manipolation. In 1 case the donor tessue detached in CA, in 1 cases the graft remained attached but failed to clear. By ligthmicroscopy, explanted donor tessue showed the presence of extentively damaged keratocytes in the deep posterior stroma and also in the interface at the graft‐ host junction. Histopatologic evaluation showed marked corneal edema and endotelial cell loss.

Conclusion The DSAEK proves to be a viable surgical technique in cases of imbalance corneal from endothelial problems. Rare are the cases of failure, in which histopathological study shows that the complication is due to bullous detachment between the two flaps, because of failure histopathological and clinical surgery
Surveillance cultures of contact lenses of patients with Boston KPRO type keratoprosthesis
Authors: DE LA CRUZ J , MCMAHON T
Published: September 2009

Purpose Patients with Type 1 Boston KPRO require the use of a contact lens to avoid complications of drying of the corneal tissue surrounding the KPro. Additionally, these patients require chronic use of topical antibiotics to reduce the ever‐present risk of endophthalmitis. This may promote the growth resistant organisms. The purpose of this study is to perform surveillance cultures of contact lenses of KPro patients to determine if organism growth may be detected prior to clinical presentation of infection.

Methods Cultures of contact lenses from Boston KPro type 1 patients were performed. All patients were maintained on a prophylactic antibiotic regimen including vancomycin. All contact lenses were removed 1 week to 1 month after insertion. Removal prior to 1 month was necessary when excessive protein deposits were noted on the lens. Lenses were removed cultured and analyzed under electron microscopy.

Results 45 patients with a KPro implanted in the last 18 months, the lenses of 15 patients were analyzed in the above manner. These 15 patients had various conditions including Stevens Johnson Syndrome, chemical burns, keratoconus, and multiple graft failures. Of the 15 lenses analyzed, one patient had cultures positive for streptococcus pneumonia, consistent with the patient's presentation of endophthalmitis. Three had cultures positive for coagulase negative staphylococcus although they did not present with any signs or symptoms of infection.

Conclusion Surveillance cultures appear to be an effective way to monitor the contact lenses of Boston KPro patients for possible organism growth. The detection of these organisms prior to the clinical presentation of infection could serve as a signal to change the patient's antibiotic regimen.
Limbal choristomas – analysis of surgical technique and postoperative results (3 case reports)
Authors: ASOKLIS R , BUTKIENE L , JUODKAITE G , MAKSELIS A , PETROSKA D , PAJAUJIS M
Published: September 2009

Purpose To present three case reports of the limbal choristomas.Analyse surgical technique, pathology slides, evaluate postoperative results by anterior optical coherence tomography (OCT) and keratotopography.

Methods Three patients with limbal choristomas were operated in Vilnius University Hospital. Location of the tumor was typical – inferiotemporal part of the limbus. All patients were admitted to the hospital lately after the time of diagnosis establishment. Patients were operated at the age of nineteen, six and fifteen years old. Case 1. Surgery was performed on the right eye of the nineteen years old lady. Visual acuity (VA) before the surgery 0,2 Case 2. Surgery was performed on the left eye of the six years old girl. VA before the surgery 0,8. Case 3. Surgery was performed on the right eye of the fifteen years old boy. VA before the surgery 0,2. Surgical technique‐excision of the limbal tumor and lamellar corneal graft transplantation.

Results In case 1 and case 3 visual acuity of the operated eyes remaned the same as it was before the surgery. In case 2 postoperative visual acuity improved by 2 lines. Excised tumors were evaluated by pathologist and diagnosis of the limbal dermoid was established. Postoperative results were evaluated by anterior (OCT)and keratotopography.

Conclusion 1.In purpose to prevent amblyopia scheduling of the surgery should be decided depending on the general health of the child and size of the tumor. 2.Appropriate surgical technique should be chosen after the evaluation of the size and location of the limbal dermoid. 3.Modern diagnostic tools such as OCT and keratotopography are important for the evaluation of postoperative results.
Importance of electron microscopy in neuronal ceroid lipofucinosis
Authors: HALFELD FURTADO DE MENDONCA R , KOK F , ROSEMBERG S , YUKIHIKO TAKAHASHI W
Published: September 2009

Purpose To describe the electroretinographic and ultra‐structural alteration in a very rare family case of Neuronal Ceroid Lipofucinosis (NCL).

Methods A 7‐year‐old boy and his brother a 5‐year‐old boy with NCL of juvenile type, underwent complete ophthalmological exams, including retinography, electroretinography and ultra structural study of the conjunctiva.

Results Both children presented optic nerve pallor and arteriolar narrowing. The fundoscopy of the oldest boy showed bone‐spicule changes. The ERG scotopic (rod and maximal) and photopic (cone) responses were absent. The flicker responses were absent in the oldest brother and severely reduced in the youngest brother. It could be a typical case of retinitis pigmentosa. The electron microscopy study of the conjunctiva, detected the curvilinear bodies typical from Neuronal Ceroid Lipofucinosis (NCL).

Conclusion The retinal and electroretinographic changes were typical from retinitis pigmentosa. The electron microscopy study is an important tool in LCN diagnosis.
Comparison of refractive cylinder and corneal cylinder in aphakic eyes
Authors: PADRICK T , PACKER, MD, FACS M
Published: September 2009

Purpose This paper compares the refractive cylinder in aphakic eyes measured with an intraoperative wavefront aberrometer to preoperative corneal cylinder values which have been corrected for an assumed magnitude of induced cylinder on the axis of the phaco incision. Such a difference could play a significant role in planning corrective cylinder procedures such as LRIs or Toric lens positioning during cataract surgery.

Methods Preoperative corneal cylinder was measured for 30 eyes undergoing standard cataract surgery. Using established cross cylinder calculation methods and assuming an induced cylinder of 0.5 D at the phaco incision axis, a modified corneal cylinder was calculated. These modified values were compared to aphakic refractive cylinder values measured with the ORange intraoperative wavefront aberrometer. These aphakic measurements were obtained with the globe re‐inflated with viscoelastic to an IOP of 20 ‐ 25 mm Hg. Three aphakic measurements were obtained for each eye and averaged.

Results The modified corneal cylinder should be nearly equal to the aphakic refractive cylinder if the anterior corneal surface represents the total corneal contribution to astigmatism as any affect of the natural crystalline lens on the refractive cylinder has been removed. Statistical differences were found between the modified corneal cylinder (from preoperative keratometry and induced cylinder) in ~15% of the 30 eyes. Differences occurred in both the magnitude and axis of the astigmatism.

Conclusion The use of an intraoperative wavefront aberrometer can significantly improve the outcomes of cylinder reducing procedures such as LRIs and Toric IOLs by correctly identifying the magnitude and axis of the patient's refractive corneal astigmatism during surgery.

Commercial interest
Dextran 70 solutions for the intra‐operative control of corneal hydration in rabbit corneas
Authors: PENTARI I , GINIS H , DIAKONIS V , KYMIONIS G , PALLIKARIS IG
Published: September 2009

Purpose In terms of excimer laser ablation, the cornea is water bound on an organic matrix. Corneal hydration might affect the excimer laser ablation rate, which could affect the accuracy of correction. It was the purpose of the study to investigate the use of Dextran solutions of varying concentrations to control corneal hydration in rabbit corneas.

Methods The corneal epithelium was removed by means of a rotating brush from both eyes of 10 anesthetized pigmented rabbits . The Dextran 70 solutions,with concentrations ranging from 1 to 7%, was topically applied to the eyes for two minutes. The thickness of the cornea in each eye was determined by ultrasound pachymetry after epithelial removal and immediately after rinsing. The Dextran concentration corresponding to zero change in pachymetry was determined by linear regression. In a different series of experiments, rabbit corneas were either overhydrated by means of rinsing with saline or left exposed to dehydrate. Following this artificial change in hydration the corneas were rinsed for 2 minutes with the previously determined iso‐osmotic concentration.

Results A strong negative correlation between Dextran concentration and change in pachymetry was observed. Rinsing with the isotonic concentration (2.6%) regulated pachymetry whithin 2% of the original value.

Conclusion Corneal hydration can be regulated intraoperatively by means of appropriate Dextran solutions. This may prove useful in cases that hydration is potentially different from normal such as in the case of extensive surgical manipulations prior to laser ablation.
LASIK surgery for myopia in Chinese patients
Authors: KACHANOV A , BALASHEVICH L , GOLOVATENKO S , TIEHUI Z , WANG X , BAUER S , ZIMIN B
Published: September 2009

Purpose To investigate the results of LASIK surgery for myopia in Chinese patients in Joint Russian‐Chinese Ophthalmic Center.

Methods We reviewed our consecutive 296 cases (148 chinese patients, including 92 women and 56 men) of LASIK surgery for myopia with the sphere from ‐1.0 to ‐13.5 D and the cylinder till ‐4.5 D. LASIK was performed by Russian surgeons with the NIDEK EC‐5000 excimer laser and microkeratomes LSK Evolution‐2 (“Moria”). Follow‐up period was up to 3 months. The age of our patients was 26.7+/‐6.2 years. Pre‐op UCVA and BCVA were 0.13+/‐0.08 and 0.97+/‐0.08 consequently. All patients had standard ophthalmic examinations, including pneumotonometry, refractometry etc. We performed statistical analysis by using "Statistica" programm.

Results Ablation depth was 89.3+/‐24.5 microns, ablation time was 47.53+/‐15.26 sec. Post‐op UCVA was 0.85+/‐0.24 in the first day, 0.97+/‐0.23 in the first week, 1.05+/‐0.20 in the first month and 1.10+/‐0.11 in the third month after LASIK. Pre‐op IOP was 15.6+/‐2.9 mm Hg. Post‐op IOP was 10.2+/‐2.7 in the first day, 10.5+/‐2.5 in the first week, 10.7+/‐2.9 in the first month and 9.1+/‐2.6 in the third month. UCVA was equal or more than 1.0 in 51.0% in the first day, 71.1% in the first week and 79.1% in the first month after LASIK. There were no serious complications in all cases.

Conclusion The results of LASIK surgery for myopia in Chinese patients in the Joint Russian‐Chinese Ophthalmic Center were effective and successful. LASIK surgery by using NIDEK EC‐5000 excimer laser gives predictable and good results in Chinese patients. None of the authors has no financial interest in this work.
Antioxidants reduce diabetic damage in bovine lenses in culture
Authors: DOVRAT A , BORMUSOV E , DOVRAT Y , CHEVION M
Published: September 2009

Purpose Background: There are several theories regarding possible mechanisms leading to diabetic cataract. Few of them include oxidation stress. Aims: Investigation of the mechanisms of cataract formation under diabetic conditions, and examination of the effects of N‐acetyl‐L‐cysteine (NAC), (which is a precursor of glutathione and an anti‐inflammatory agent) and derivatives of Desferrioxamine (DFO)(which is an iron chelator and reduces oxidative stress) on diabetic cataract.

Methods The experiments included 78 bovine lenses. The lenses were divided into eight different treatments including controls and lenses incubated with high glucose levels (450 mg %) with or without each one of the antioxidants. The intact lenses were incubated for a period of two weeks in our special organ culture conditions. Lens optical quality was analyzed every 24 hours. At the end of the culture period, oxidation was followed in the lens epithelial cells with dichlorofluorescein assay and lens proteins were analyzed by SDS and 2D gel electrophoresis.

Results High levels of glucose in the culture medium caused optical damage to bovine lenses, increased lens volume due to swelling, increased oxidation of lens epithelial cells, and caused changes in lens beta crystallin. The anti‐oxidants reduced this damage. NAC and Zn‐DFO protected the lenses better than DFO.

Conclusion Antioxidants can protect the lens from high glucose damage. This study was supported in part by a grant from the Esther and Chaim Coppel Trust and by the Guzik Ophthalmology Research Fund
Predictive factors of visual outcome in acute post‐cataract endophthalmitis
Authors: COMBEY‐DE LAMBERT A , THURET G , MAURIN M , BRON AM , CORNUT PL , CREUZOT C , VANDENESCH F , DENIS P , ROMANET JP , CHIQUET C
Published: September 2009

Purpose To study potential clinical and microbiological predictive factors of visual outcome in patients with acute endophthalmitis following cataract surgery.

Methods A prospective study included 100 patients in 4 University hospital.Factors related to the cataract surgery, the initial clinical presentation and the microbiological identification were analyzed according to the final visual outcome using univariate and multivariate (logistic regression) analysis.

Results 46% out of the patients had a final visual acuity less than or equal to 0.3 logMar (good visual outcome) at 6 months while 10% had only light perceptions. Patients with good visual outcome differed for the duration of cataract surgery, initial visual acuity, the visibility of fundus and the identification of a coagulase negative staphylococcus. In contrast, patients with a poor visual outcome were older, had more cornea oedema and a more important hypopion at the admission, more complications at the time of cataract surgery. Furthermore a bacterium was more frequently identified in this latter group. Multivariate analysis showed that age, complications at the time of cataract surgery, microbiological identification, pars plana vitrectomy were independent predictive factors.

Conclusion Factors of visual outcome in acute postcataract endophthalmitis identified in this prospective study were similar to that reported during the Endophthalmitis Vitrectomy Study 10 years ago. As part of the treatment, pars plana vitrectomy is associated with predictive factors of poor visual outcome. Identification of these predictive factors at presentation should allow a better management of patients needed an aggressive treatment.
IC3D classification of corneal dystrophies
Authors: MØLLER HU
Published: September 2009

The IC3D group, an international group of corneal specialists and ophthalmic pathologists, formed a few years ago to review known corneal dystrophies. Based on personal experience and literature studies the new IC3D classification of corneal dystrophies was published in December 2008 as a freely available supplement to the journal Cornea. The classification suggests new names for some dystrophies, suggests definitions when an entity could be called a dystrophy, and gives examples of typical slit lamp images. It is built in a way to accommodate new and variant dystrophies found in the future. The purpose of this symposium is to draw attention to this new classification with special emphasis on recent variant dystrophies associated with the TBFBI gene. The IC3D group urges authors and reviewers alike to require stringent criteria to be met before publication of a dystrophy as a new entity.
Overview of the TGFBI corneal dystrophies
Authors: KLINTWORTH GK
Published: September 2009

Several phenotypically distinct clinicopathologic entities involving the cornea are caused by mutations in the transforming growth factor beta induced (TGFBI) gene. These disorders include different types of granular corneal dystrophy (GCD): GCD type 1, GCD type 2 (Avellino corneal dystrophy), GCD type 3 (Reis‐Bücklers corneal dystrophy) as well variants of lattice corneal dystrophy type 1 and Thiel‐Benhke corneal dystrophy. Investigations of these inherited corneal diseases throughout the world strongly suggest that specific mutations in the TGFBI gene account for the specific phenotypes and that the corneal opacities that account for the clinical features of the different phenotypes result from the deposition of all or part of the mutated encoded protein. To date the mutated protein is only known to accumulate in the cornea eventhough the TGFBI is widely expressed throughout the body in experimental animals. This presentation will provide an overview of the TGFBI corneal dystrophies and offer a hypothesis to explain the different phenotypes caused by different mutations in TGFBI.
Internal limiting membrane staining
Authors: KATSIMPRIS J
Published: September 2009

Purpose To describe the different modalities of internal limiting membrane (ILM) staining for the treatment of idiopathic macular hole (IMH).

Methods Search of the MEDLINE database by using Medical Subject Heading search terms and key words related to ILM staining, macular hole surgery.

Results ILM removal has been closely related with increased closure rates. However, because of poor ILM visibility the surgical removal of ILM is very difficult and poses serious complications. To obtain better visibility of ILM some special techniques have been developed using specific dyes such as, trypan blue (TB), indocyanine green (ICG), infracyanine green or triamsinolone acetonide(TA). Anatomic success rates with one surgery have increased (>90%) however, concern for toxicity has emerged. Patients with ICG‐assisted ILM peeling appear to have a depressed recovery of visual acuity compared to those not using ICG. Concentrations of ICG that are <0.5 mg/mL have been shown to be non‐toxic in cultures of RPE cells. Infracyanine green is a similar molecule that does not contain iodine and is less likely to induce osmolarity related toxic effects on the PRE cells when compared to ICG. It has been used also for ILM staining in combination with trypan(TB). TB is a second generation vital dye that stains epiretinal membranes (ERMs) directly and ILM to a lesser extent. Thus TB is useful for both macular hole and macular pucker surgery. TA may be also used to help highlight the ILM, although it is not a dye. It does adhere to the posterior hyaloid, making the detection of ILM easier.

Conclusion This review largely reflects the great advent of different techniques for ILM staining. The use of ICG is more toxic when compared with TB. For TA long‐term effects have not been well studied.
Electrophysiology
Authors: HOLDER GE
Published: September 2009

Purpose To describe the diagnostic electrophysiological features associated with disorders that may present with positive phenomena.

Methods Standardised electrophysiological testing, performed to incorporate and exceed the Standards of the International Society for Clinical Electrophysiology of Vision.

Results Illustrative cases will be used to demonstrate diagnostic electrophysiological features in a variety of disorders.

Conclusion The objective functional data provided by electrophysiological testing are of considerable importance to the diagnosis and management of these conditions.
Superior oblique myokymia as a migraine motor aura
Authors: KIRK A
Published: September 2009

Purpose To do an epidemiological study of the proposal that superior oblique myokymia (SOM) is a migraine motor aura and propose a pathophysiological basis for the etiology of SOM. Migraine aura is a paroxysmal spreading depression of both excitatory and inhibitory neurons in the brain. These may be sensory neurons (numbness), motor neurons (dysarthria) and inhibitory neurons (chorea). Superior oblique myokymia is bursts of very rapid, jerky contrations of a superior oblique muscle causing shaking of one eye. Interfunctioning of the cortex and basal nuclei maintains stability of eye movements. Spreading depression of the cortex would cause inhibition of the inhibitory GABAergic fibres from basal ganglia to the midbrain which could result in paroxysmal firing of the 4th nerve neurons in SOM. A finely‐tuned homeostatic balance of GABAergic interneuron tone controls excitatory activation of CNS motorneurons. Small changes in GABAergic inhibition have profound effects on excitability. SOM, like auras, usually spontaneously disappears for years or permanently, which may account for the "success" of surgical treatments. The most effective treatment of SOM is gabapentin, a congener of GABA which enhances its activity.

Methods Thirty seven patients with superior oblique myokymia had detailed questioning about a history of migraine headaches and auras.

Results Every one of 37 patients with superior oblique myokymia had a history of migraine symptoms fulfilling all International Headache Society criteria. Every one had a history of migraine visual auras and many had also had sensory and dysphasic auras.

Conclusion Epidemiological correlation and a pathophysiological explanation support the proposal that superior oblique myokymia is a migraine motor aura.
Non‐viral strategies of intra‐ocular gene delivery
Authors: BEHAR‐COHEN F
Published: September 2009

Purpose Systemic anti TNF strategies are efficient to treat intraocular inflammation but require repeated injections and are associated to severe systemic side effects. Our aim was to develop a non viral gene transfer method to produce locally anti‐inflammatory proteins in a sustained and minimally invasive manner in the ocular media. For this purpose, we have transformed the ciliary muscle into a bioreactor, using an electrically assisted gene transfer technique.

Methods Electrotransfer (ET) of plasmids, encoding for different variants of TNF alpha soluble receptors, was performed in the ciliary muscle cells. Using toptimized conditions, soluble receptors were dosed in the ocular media up to 8 months after a single treatment. The technique has been applied in two models of intraocular inflammation: Endotoxin‐Induced Uveitis (EIU) and auto immune experimental uveitis (EAU) in rats.

Results When performed 8 days or 3 months before the LPS challenge, ET significantly reduced both clinical and histological signs of EIU. Particularly, iNOS, IL6 and TNF were down regulated while IL10 was upregulated. Importantly, systemic TNF alpha was not decreased demonstrating a local effect of the treatment. In EAU, ET significantly delayed the onset of EAU and deceased its severity. Similarly, a switch towards a Th2 cytokines profile was observed in the ocular media without any effect on systemic TNF alpha.

Conclusion ‐ ET is a safe and efficient non viral method to produce locally TNF alpha soluble receptors. ‐ Local anti TNF allows for a local intraocular immunomodulation, without affecting systemic TNF. ET could therefore be used to reduce systemic side effects of anti TNF and prevent repeated injections.
The effect of a yellow filter on visual performance of older subjects with low macular pigment optical density
Authors: PUELL MC , BARRIO AR , PEREZ‐CARRASCO MJ , PALOMO C
Published: September 2009

Purpose Macular pigment (MP) filters short‐wave light and it has been suggested that MP is related to visual performance. To increase the filtering properties of the eye, especially in subjects with low MP density, we can use a yellow filter that absorbs the amount of blue light striking the retina. This study was performed to relate MP density levels to variations in the mesopic visual function and light scattering provoked by the yellow filter in old subjects.

Methods Measurements were obtained from 88 healthy old subjects aged 70 ± 6.3 years. The optical density of the MP was estimated at the fovea using the Metropsis Test (Cambridge Research System). Two groups were established in function of the MP level: MP≤0.2(41 subjects)and MP>0.2(47 subjects. Visual acuity, contrast sensitivity and scattered light were measured in the right eye with and without a yellow filter under mesopic luminance conditions. Visual acuity was measured using high‐contrast (96%) and low‐contrast (5%) logMAR letter charts. Contrast sensitivity was determined using the Pelli‐Robson chart. Scattered light on the retina was measured using the C‐Quant straylight meter (Oculus).

Results Mean foveal MP optical density was 0.22 density units (SD 0.13; range 0.0 to 0.64). Mean mesopic high‐contrast and low‐contrast visual acuity, contrast sensitivity and log scatter recorded with a yellow filter did not show any significant improvement or worsening compared with no filter condition in both MP groups.

Conclusion In healthy old eyes with low macular pigment optical density mesopic visual function and intraocular light scattering did not improve from the use of a yellow filter.
Optical filters influence on pupil size according to their material and spectral characteristics
Authors: SANCHEZ RAMOS C , VINAS‐PENA M , PEREZ‐CARRASCO MJ , GOMEZ‐TORTUERO E , DIAZ‐SERRANO Y , SILLERO‐QUINTANA M
Published: September 2009

Purpose To evaluate pupil size variations induced by optical filter by using filters with different materials and spectral characteristics, focussing on UV and blue light transmission properties of the filters

Methods 220 pupil measurements (20 eyes, 20‐55 years old) were made using the pupillometer Procyon P2000SA at high Mesopic level (4.0lux). 10 filters of varying transmittance (visible, 4%‐65%, 5 filters UV‐transmitting and 5 filters UV‐absorbing) were used in a randomised way. 5 filters (UV‐transmitting) were dye‐coated polyester films with a substrate of PET (polyethylene terephthalate) and the another 5 filters (UV‐absorbing) were Ophthalmic CR39 lenses with a tinted coating in order to get the same absorbing characteristics than the PET filters. Measurements in the absence of a filter served as control

Results Significant results on pupil size variation were obtained with lower UV and blue light transmittance filters (F14, F15 and F16; p=0.00) for both materials, PET and CR39 (Mydriasis obtained: F14R=13.99%; F15R=17.57%; F16R=22.90%; F14E=23.95%; F15E=22.69%; F16E=29.87%). Also significant differences in mydriasis‐induced by the filter were obtained when materials and blue‐light transmission properties were compared for filters 14 and 16 (PET vs. CR39: F14 (p=0.006), F16 (p=0.0167)

Conclusion Filters with similar visible but different UV and/or blue‐light transmission properties significantly produce variations in pupil size at high Mesopic condition (4.0lux). Differences obtained in mydriasis‐induced by the filter depend not only on the material of the filter, but also the UV and/or blue‐light transmitted by the filter
Validation of Modified Grating Test as a visual acuity test in low vision patients with retinitis pigmentosa
Authors: GEORGI T , IVASTINOVIC D , HORNIG R , BRANDNER M , LANGMANN A , WEDRICH A , VELIKAY‐PAREL M
Published: September 2009

Purpose The Modified Grating Test is a newly designed test for visual acuity (VA) measurement in patients with retinitis pigmentosa (RP) with low vision. Freiburg Visual Acuity Test (FrACT) is a validated test for low vision, but no patients with RP were tested. In our study we tested RP patients investigating the consistency of the Modified Grating Test by comparing the results with those of the FrACT and the ETDRS charts.

Methods 16 eyes of 8 patients were tested and divided into 3 groups depending on their VA. Group 1 had a VA of hand motion (HM, n= 6), group 2 counting fingers (CF, n=6) and group 3 better than CF (n=4). The Modified Grating Test consists of a circle with black and white bars of the same width in a decreasing logarithmic order covering the range from 2.7 to 0.3 logMAR. The FrACT is a computerized test with Landoldt C in different directions and in decreasing order. ETDRS charts were used at a distance of 0.5m. Each test was performed 4‐5 times. The data were normally distributed. To compare the values we used the paired samples t‐test.

Results The mean VA in group 1 as measured by the Modified Grating Test was 1.3 logMAR and by FrACT 1.21 logMAR (p=0.21). In the group 2 the patients reached a mean VA of 0.7 logMAR with the Modified Grating Test and 0.6 logMAR with FrACT. 0.68 logMAR was measured with ETDRS charts (p=0.13).

Conclusion Our preliminary data suggest that the Modified Grating Test is a suitable test for the low vision range and might be beneficial for the follow up in patients undergoing a retinal prosthesis implantation.
Visual symptomology associated with workers using VDT: a review in the last decade
Authors: SEGUI CRESPO MM , LOPEZ NAVARRO A , RONDA PEREZ E
Published: September 2009

Purpose Reviewing epidemiological studies concerning the visual symptomology associated with workers using VDT.

Methods A literature search was carried out of articles published 1999‐2008 in the databases: MEDLINE, Biological Abstracts, INSPEC, PsycINFO, FSTA, CINAHL, CC Search, FRANCIS and The Cochrane Library. Papers published in Spanish, English, French and Italian was reviewed. The search procedure combined the MeSH descriptors asthenopia, computer terminals and work in addition the open expressions visual fatigue and computer vision syndrome. Various search equations were established, using Boolean operators, truncation and filters. Inclusion and exclusion criteria related to the target population, the research aims, and type of publication was defined. Research quality was assessed. A data collection protocol was developed in order to analyse the contents of the publications selected.

Results Sixteen original cross‐sectional articles were included. In 9 of these the term asthenopia was used to refer to this symptomology. A high level of repetition could be observed in the selection of symptoms but there was no agreement on definition of scores or global criteria for establishing whether a worker was suffering from asthenopia or not.

Conclusion It is necessary to develop an instrument capable of assessing occupational asthenopia associated with VDT which includes all of the ocular and visual symptoms found during the review. However, it is also necessary to carry out research to analyse the association between symptoms and exposure, thus justifying the greater importance given to some symptoms rather than others when deciding whether asthenopia is present or absent in these workers.