bluuebunny/crossref_metadata_2025_split huggingface dataset:
First Day Review after Uncomplicated Phacoemulsification: Is it Necessary?
Authors: Alwitry A , Rotchford A. , Gardner I. 
Published: January 2018

Purpose To determine whether first day follow-up is necessary after routine uncomplicated phacoemulsification cataract surgery. Methods Data collected prospectively at day 1 postoperative review. Results In 510 consecutive cases, serious complications occurred in 8 (1.6%) (wound leak [4], corneal abrasion [2], iris prolapse [1], hyphema [1]). Intraocular ptessure (IOP) >30 mmHg was found in 26 (5.1%) and was strongly associated with a diagnosis of pre-existing glaucoma or ocular hypertension (odds ratio [OR] 7.7). Symptoms of headache or ocular discomfort occurred in 40 (7.8%), mostly in association with raised IOP, and were also associated with pre-existing glaucoma or ocular hypertension (OR 4.7). Central corneal edema was found in 61 (12.0%). In the absence of corneal edema, IOP was >30 mmHg in only two cases (0.39%). Conclusions Few sight-threatening complications were detected on the morning after an uncomplicated procedure. First day follow-up may be safely omitted if adequate patient counseling is undertaken and there is provision of adequate access to eye services. Review prior to discharge on the day of surgery would provide an opportunity to detect these few surgical complications and for counseling. A diagnosis of glaucoma or ocular hypertension is a risk factor for significantly raised next day IOP and these patients are more likely to experience postoperative discomfort. They may benefit from prophylactic treatment.
A Case of Diabetic Retinopathy with both Retinal Neovascularization and Complete Posterior Vitreous Detachment
Authors: Shiraya T. , Kato S. , Fukushima H. , Tanabe T. 
Published: January 2018

Purpose Report of a case with retinal neovascularization developing in the setting of diabetic retinopathy despite complete posterior vitreous detachment (PVD). CASE REPORT. A 76-year-old man had had type II diabetes mellitus for more than 30 years. Weiss’ ring was detected by direct and indirect ophthalmoscopy. PVD was thus considered to be complete. On the other hand, fluorescein angiography showed two areas of hyper-fluorescence at the margin of the retinal nonperfusion area. Conclusions The present case underscores the importance of periodic follow-up using fluorescein angiography, given the probability of retinal neovascularization development and proliferative changes for many years even in diabetic retinopathy associated with complete PVD.
Changes in Medical and Surgical Treatments of Glaucoma between 1997 and 2003 in France
Authors: Kenigsberg P.-A. 
Published: January 2018

Purpose To analyze quantitative changes in glaucoma treatment strategies between 1997 and 2003 in France. Methods Numbers of ab externo trabeculectomies and other glaucoma surgeries were extracted from the national database of the French Diagnosis Related Group system, which includes data for both public and private hospitals. Numbers of patients treated per year were estimated from drug unit sales using defined daily doses for each drug. Results New medical treatments of glaucoma and ocular hypertension, introduced in France between 1997 and 2003, allowed treatment of 557,000 patients. In 2003, 63% of patients treated with these new medicines were receiving prostaglandins (39% latanoprost, 9% travoprost, 8% the fixed combination of latanoprost + timolol, and 7% bimatoprost), 13% brinzolamide, 13% the fixed combination of dorzolamide + timolol, and 11% brimonidine. During the same period, trabeculectomies declined by 38% (-48% in public hospitals and −32% in private clinics), while the total number of glaucoma surgeries declined by 22% (−34% in public hospitals and −14% in private clinics). Hospital days related to open-angle glaucoma surgery declined by 51%. There is a strong correlation (r2=-0.97) between the reduction of glaucoma surgery and the increase in the number of patients treated with prostaglandins during the study period. Conclusions Between 1997 and 2003, new glaucoma drugs, primarily prostaglandins, improved intraocular pressure control and delayed surgery, reducing glaucoma surgery by 22%.
Surgical Outcome following Breach Rhexis
Authors: Olali C.A. , Ahmed S. , Gupta M. 
Published: January 2018

Purpose Phacoemulsification cataract surgery is the gold standard for lens removal and continuous curvilinear capsulorhexis is one of the important first steps during the procedure. It is also one of the most difficult steps to master and so has a learning curve and capsulorhexis breach is therefore common among trainees. Once there is capsulorhexis breach, the surgeon could continue with the procedure or convert to extracapsular extraction, with each having its advantages and disadvantages. In our unit, the phacoemulsification procedure is usually continued with some modifications, and the results over a specified period are presented. To report the incidence of breach rhexis during phacoemulsification over a specific period, deduce reasons for the breach, as well as the surgical outcome including other intraoperative and postoperative complications directly resulting from the capsular tear. Interventional case series. Methods All patients who developed breach rhexis during routine phacoemulsification had all information regarding the procedure entered into a predesigned ProForma. These ranged from the instruments used for the capsulorhexis to subsequent surgical modification to reduce risk of further complications to the final surgical outcome. Results In the study period March 12, 2004, to March 30, 2005, the team carried out 358 phacoemulsifications, of which 20 (0.56%) had breach rhexis. The end of the breach was visible in 70% of cases and equatorial in the rest. None extended to the posterior capsule and so there was no vitreous loss in any of these cases. In most of the cases, the cause of the breach was attributed to inexperience or error of judgment (60%). However, modification of the surgery including the transfer of the procedure to a more experienced surgeon helped to reduce the rate of further complications. Eighty-five percent of the patients achieved a corrected visual acuity of 6/12 or better and those with worse vision had comorbidity. Conclusions In this study, the authors showed that, when properly managed, capsular breach during phacoemulsification has little or no effect on the final surgical outcome.
A Survey of Intraocular Lens Explantation: A Retrospective Analysis of 23 IOLs Explanted during 2005
Authors: Jirásková N. , Rozsíval P. , Kohout A. 
Published: January 2018

Purpose To evaluate the indications, lens styles, perioperative findings, and results of intraocular lens (IOL) explantation or exchange performed in the authors department in 2005. Methods The retrospective analysis comprised 22 patients (23 eyes). Twenty-one eyes had previous phacoemulsification and IOL implantation, one eye secondary aphakic IOL, and one eye phakic IOL implantation. The indications for IOL explantation/exchange and perioperative complications were evaluated. The best-corrected visual acuity (BCVA) before and after surgery was compared. Results Time from initial surgery to explantation/exchange varied from 1 to 121 months, median value was 46 months. The IOLs were explanted using local anesthesia and in 21 eyes replaced with new lens. Indications for IOL removal were opacification of the IOL in 12 eyes, malposition of the IOL in 5 eyes, postoperative refractive error in 2 eyes, recurrent toxic anterior segment syndrome in 1 eye, pseudophakic dysphotopsia in 1 eye, endothelial cell loss in phakic anterior chamber IOL in 1 eye, and visual discomfort with intraocular telescopic lens in 1 eye. The mean BCVA (decimal scale) before and after IOL explantation/exchange was 0.562±0.279 and 0.627±0.276, respectively. There was no significant difference in visual acuity before and after IOL exchange (Wilcoxon test). Conclusions The most frequent indications for IOL explantation/exchange were opacification of the IOL and IOL malposition. Surgeries were uneventful in most cases. Final visual results have been largely good. Long-term follow-up of patients with various types of IOLs should be maintained.
Risk Factors for Post-Traumatic Endophthalmitis in Patients with Positive Intraocular Cultures
Authors: Gupta A. , Srinivasan R. , Gulnar D. , Sankar K. , Mahalakshmi T. 
Published: January 2018

Purpose To determine the risk factors for post-traumatic endophthalmitis in patients with positive intraocular culture. Methods An institutional-based prospective nonrandomized interventional study of patients older than 15 years who presented for primary repair of open globe injury between June 2003 and April 2005 was undertaken. The main outcomes measured were initial and final visual acuity, type of injury, presence of uveal and vitreous prolapse, time interval between injury and primary repair of the globe, length of wound, location of wound, and virulence of organism. Statistical analysis tests used were Student t-test, Fisher exact test, and chi-square test. Results Fifty patients were included in the study. They were divided into two groups: Group 1 (n=19) patients, who developed clinically significant endophthalmitis; and Group 2 (n=31) patients, who did not develop clinically significant endophthalmitis. Delay in primary repair more than 36 hours (p=0.042), length of wound more than 8 mm (p=0.050), and isolation of organisms like fungus (p=0.006, OR=14), Bacillus cereus (p=0.01, OR=11.25), and Pseudomonas aeruginosa (p=0.05–0.10, OR=11.3) significantly increased the risk of endophthalmitis. Mean initial and final visual acuity was better in Group 2 but was not statistically significant (p=0.21). Conclusions Final visual outcome in the presence of positive intraocular culture is poor. Isolation of virulent organisms, longer length of laceration, and delayed primary repair of open globe injuries have high risk of developing endophthalmitis. Prophylactic intraocular antibiotics should be considered in cases with longer length of wound and delayed primary closure.
Domestic Ocular Injuries: A Case Series
Authors: Mansouri M. Reza , Mirshahi A. , Hosseini M. 
Published: January 2018

Purpose To determine the nature and types of domestic eye injuries. Methods The authors prospectively analyzed data of 100 consecutive patients with domestic eye injury (104 eyes) referred to the emergency room of Farabi Hospital during October 2003. Standardized international classification of ocular trauma (Birmingham Eye Trauma Terminology) was used for eye injury classification. Results Domestic ocular trauma represented 4.85% of all ocular emergencies (2061 patients) referred to the emergency room during that period. Male to female ratio was 1.13 and mean age of patients was 26±18 years (range, 1–73). Cornea was involved in 50.0% and sclera, lens, and retina each was involved in 4.8%. There was severe visual loss (best-corrected distance visual acuity <20/200 due to trauma) in 4% of the patients. The most frequent domestic ocular injury was globe injury (93.7%) including mechanical (72.1% closed and 4.8% open), chemical (14.4%), and thermal (1.9%) injuries. Conclusions Closed mechanical injuries were the most common type of domestic ocular injury in our series. Considering the high rate of domestic eye trauma among ocular emergency cases, more preventive measures should be taken at home.
Long-Term Follow-Up in Bietti Crystalline Dystrophy
Authors: Mansour A.M. , Uwaydat S.H. , Chan C.-C. 
Published: January 2018

Purpose To present a long-term follow-up of Bietti crystalline dystrophy. Methods Two brothers are presented including the clinical findings, fluorescein angiography, electrophysiology (electroretinography [ERG], electrooculography [EOG], adaptometry), optical coherence tomography (OCT), and transmission electron microscopy of bulbar conjunctiva and peripheral blood lymphocytes. The clinical findings were documented over a period of 25 years in one brother and 5 years in the other. Results The most striking features were deposits in the retina that were formed de novo with old ones replaced by choroidal atrophy in advanced stage of the disease. The light rise (EOG), rod- and cone-driven responses (ERG), and visual fields were affected progressively during the course. These changes of the retinal pigment epithelium and choriocapillaris were observed in the second decade and worsened gradually. OCT demonstrated preferential crystal accumulation in the inner retina. Cytoplasmic lipid crystalline inclusions were found in lymphocytes and conjunctival fibroblasts by transmission electron microscopy. Conclusions Bietti crystalline retinopathy is a progressive retinal disease characterized by retinal crystals gradually replaced by atrophy of the retinal pigment epithelium and gradual constriction of visual fields.
Single-action Implantation of SA60AT with Monarch II®
Authors: Iwase T. , Saeki A. , Sugiyama K. 
Published: January 2018

Purpose The authors have invented a method to implant the AcrySof® model SA60AT intraocular lens (IOL) with a single action to avoid complications in the recommended method. Methods After inversely inserting the SA60AT into the Monarch II® cartridge, the optic of the SA60AT is held with IOL forceps and rotated 90° counterclockwise. At this point, the haptics of the SA60AT are placed on the upper side of the optic within the cartridge. Next, the cartridge is inserted into the anterior chamber, and the main body of the Monarch II® injector rotated by 180° prior to pushing the plunger gradually. Once the front area of the SA60AT is inserted into the capsular bag, the remainder of the SA60AT can be slowly injected into the capsular bag. Aspiration of viscoelastic substances enables the haptics to expand in the capsular bag. The authors examined the complications in the invented method. Results The authors successfully implanted the SA60AT into the capsular bag in 226 consecutive patients (170 patients with cataract surgery alone and 56 patients with combined vitreous surgery) using the single-action method without any complications. Conclusions The method is simple and useful for the implantation of SA60AT with Monarch II® injector.
Molecular Scanning of the ABCA4 Gene in Spanish Patients with Retinitis Pigmentosa and Stargardt Disease: Identification of Novel Mutations
Authors: Stenirri S. , Battistella S. , Soriani N. , Bernal S. , Baiget M. , Ferrari M. , Cremonesi L. 
Published: January 2018

Purpose Among the 500 ABCA4 mutations identified so far in the retina-specific ABC transporter (ABCA4) gene, only 20 have been described in patients with autosomal recessive retinitis pigmentosa (arRP). In this study the gene was screened for mutations in a cohort of 25 patients of Spanish origin, to further assess ABCA4 involvement in retinal dystrophies. Methods The 50 exons of the ABCA4 gene have been analyzed through denaturing high performance liquid chromatography (DHPLC) and direct sequencing of samples displaying altered elution profiles. Results Four new and five known mutations were identified in our patients; except for one new deletion detected in a patient with Stargardt disease, all the remaining variations are single nucleotide substitutions resulting in missense mutations. Conclusions The results further underline the genetic heterogeneity of retinal disorders, suggesting that more than one gene could differentially contribute to at least some forms of retinal degeneration. Finding a high proportion of novel mutations merits the use of scanning methodologies to analyze the whole coding region of the ABCA4 gene.
Monitoring of Photodynamic Therapy Results in Age-Related Macular Degeneration by Means of Preferential Hyperacuity Perimeter
Authors: Wylegala E.A. , Pilat J. , Teper S.J. , Wroblewska-Czajka E. , Bartusek M. 
Published: January 2018

Purpose To describe changes revealed by Zeiss Preferential Hyperacuity Perimeter (PreView PHP) in age-related macular degeneration (AMD), before and after photodynamic therapy (PDT), and determine usefulness of such monitoring. Methods Forty patients (40 eyes) with subfoveolar choroidal neovascularization (CNV) and 20 volunteers with cataract (40 eyes) were examined in a prospective study. Control group was screened for false positive results to evaluate reliability of the test. Subfoveolar CNV was confirmed by fluorescein angiography and optical coherence tomography (OCT). Best-corrected visual acuity (BCVA) and macular visual field in the PHP (area and intensity of distortion) were assessed 1 day before and 1 week and 4 weeks after PDT. Results Four weeks after PDT there was improvement in PHP results in 20 eyes (50%), stabilization in 15 eyes (37.5%) and progression in 5 eyes (12.5%). At this time there was BCVA improvement in 9 eyes (22.5%), stabilization in 28 eyes (70%), and worsening in 3 eyes (7.5%). 1 week after PDT 30 eyes (75%) presented temporary progression in PHP but only 3 patients (7.5%) presented temporary decrease of visual acuity and progression in OCT. Correlation coefficient of BCVA and PHP results was low during whole study. There was no significant change in control group during observation. 17.5% false positive PHP results were obtained at baseline. In the PDT group no false negative results were noted. Conclusions Visual outcome after PDT cannot be predicted with use of PreView PHP. Temporary progression of changes in PHP 1 week after PDT can be expected in most cases.
Three-Port Lens-Sparing Vitrectomy for Aggressive Posterior Retinopathy of Prematurity: Early Surgery before Tractional Retinal Detachment Appearance
Authors: Ferrari T. Micelli , Furino C. , Lorusso V.V. , Dammacco R. , Sborgia G. , Sborgia L. , Besozzi G. 
Published: January 2018

Purpose Aggressive posterior retinopathy of prematurity (APROP) may suddenly develop into tractional retinal detachment (TRD), often resulting in poor vision if untreated. The aim of the current study is to examine the anatomic results and complications of lens-sparing vitrectomy (LSV) for stage 3 APROP, before TRD appearance. Methods A retrospective, noncomparative, consecutive case series of 13 eyes of 9 patients (mean gestational age 24.1±0.9 weeks [range: 23–25 weeks], mean birthweight of 725.8±107.9 grams [range: 598–897 grams]) with stage 3 APROP was carried out. The eyes did not respond to at least one session of retinal laser photocoagulation, showing signs of disease progression. All eyes underwent 20-gauge LSV before retinal detachment appearance. Results All eyes underwent 20-gauge three-port LSV and intraoperative additional laser photocoagulation. At the end of the surgery, five eyes were tamponaded with air; in eight eyes, a balanced salt solution was left in the vitreous cavity. After 13.5±5.3 months of follow-up (range: 4–22), the retina was completely attached in all eyes, without any signs of progression. The authors did not observe any intraoperative or postoperative complications. Conclusions Surgical approach to stage 3 APROP refractory to laser photocoagulation could be effective and safe in order to avoid the progression of the disease.
Intravitreal Bevacizumab for the Treatment of Feeder Vessel of Subfoveal Choroidal Neovascularization
Authors: Theodossiadis P.G. , Grigoropoulos V.G. , Emfietzoglou I. , Vergados J. , Chalkiadakis J. , Theodossiadis G.P. 
Published: January 2018

Purpose To report in a single case the effectiveness of bevacizumab in the treatment of feeder vessels (FVs) of subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). Methods One patient received intravitreal bevacizumab (Avastin) (1.25 mg) which was repeated 4 weeks after the first intravitreal injection. Fluorescein angiography and optical coherence tomography (OCT) were performed. Visual acuity (VA) was also checked. Results Occlusion of the FVs was observed 4 weeks after starting treatment. During the follow-up period and in the final examination 13 months after the first injection, the FVs remained occluded. Complete resolution of macular edema and improvement of the VA were noticed after the second bevacizumab intravitreal injection. Conclusions This report documents the successful occlusion of FVs of subfoveal neovascularization after two intravitreal bevacizumab injections in a patient who was followed up for 1 year after the occlusion. Further long-term investigation is warranted given the promising 12-month results.
Fixation Patterns Evaluation by Means of MP-1 Microperimeter in Microstrabismic Children Treated for Unilateral Amblyopia
Authors: Carpineto P. , Ciancaglini M. , Nubile M. , Di Marzio G. , Toto L. , Di Antonio L. , Mastropasqua L. 
Published: January 2018

Purpose The aim of the study was to evaluate the fixation patterns of microstrabismic children previously treated for unilateral amblyopia. Methods Thirty-three children (mean age 7.3±1.5 years) were included in the study. Visual acuity (VA) was measured using the Early Treatment of Diabetic Retinopathy Study charts. Fixation was assessed by MP-1 microperimeter. Differences in position and stability of fixation between the fellow and the microstrabismic eyes were calculated by using the percentage of the preferred fixation points within central fixation and the percentage of the fixation points within target fixation, respectively. For statistical analysis Mann-Whitney test was used. To evaluate the influence of age and duration of anti-amblyopic treatment on microstrabismic eyes fixation, linear regression analysis was performed. Results In the microstrabismic eyes VA was significantly reduced when compared to the fellow eyes (0.1236±0.0204 vs 0.0042±0.0032 logMAR; p<0.001). Position and stability of fixation were significantly better in the fellow eyes (93.21±0.65% vs 70.91±4.80%; p=0.002, and 89.88±0.94% vs 71.73±2.94%; p<0.001, respectively). A significant correlation was found between fixation stability and both the duration of anti-amblyopic treatment and pretreatment VA (p=0.024 and p=0.009, respectively) and between fixation centrality and pretreatment VA (p<0.001). Conclusions VA, centrality, and stability of fixation were significantly impaired in the microstrabismic eyes. Pretreatment VA was a risk factor for fixation impairment. The severity of fixation stability impairment was linked to the duration of anti-amblyopic treatment.
Ocular Manifestations of Chronic Graft-Versus-Host Disease in Patients Treated with Extracorporeal Photochemotherapy
Authors: Motolese E. , Rubegni P. , Poggiali S. , Motolese P.A. , Marotta G. , Russo L. , D'ascenzo G. , Carcagnì M.R. , Fruschelli M. , Motolese I. , Fimiani M. 
Published: January 2018

Purpose Eye involvement has long been appreciated in patients with chronic graft versus host disease (cGVHD). In particular, ocular complications are frequent and can be potentially severe in patients with steroid-refractory cGVHD, and therefore necessitate close monitoring. This prospective study was designed to describe eye manifestations of cGVHD in a large series of patients monitoring them before and after 1 year of extracorporeal photochemotherapy (ECP). ECP is a relatively new therapeutic approach based on the biological effects of psoralen 8-methoxypsoralen (8-MOP) and ultraviolet A light (UVA) on mononuclear cells collected by apheresis, and reinfused into the patient. Methods Only patients with steroid-refractory cGVHD under treatment with ECP, who developed cGVHD-related eye symptoms, were selected for the study. Ophthalmologic examination was repeated every 3 months. Only patients with complete recovery of the ocular manifestations and symptoms were considered responsive. Results In our study we observed eye alterations in 24 out of 140 patients (17%) with cGVHD. After 12 months of ECP, 10 out of 21 patients (48%) completely responded to the therapy. In all these cases the contribution of ECP was also essential in all the other organs subject to cGVHD. Conclusions Further studies are necessary to clarify the role of ECP in patients with cGVHD, especially in associated eye manifestations. Although our experience is limited, it suggests that ECP could be a safe and effective therapy for steroid-refractory eye manifestations of cGVHD.