bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preparation of Donor Corneas: A Study of the Endothelial Population
Authors: Bonci P. , Bonci P. , Della Valle V. , Lia A. 
Published: January 2018

Purpose To quantify the endothelial damage in corneal rim excisions prepared in different ways. Methods From the Imola branch of Eye Bank of Emilia Romagna, 24 corneal rim excisions which belonged to 12 pairs of enucleated eye globes were selected. The endothelial mortality was quantified by Trypan blue staining and counting the endothelial cells in a central area of about 5 mm2 of each cornea. The mate corneas of each pair were prepared in two different ways: one with an epithelium-endothelium cut using a Hanna trephine with an artificial chamber and the other with an endothelium-epithelium cut using a Hanna trephine with punch. After the cut the endothelium was studied again in the same way as described above. Results The cell mortality in the corneas before and after the epithelium-endothelium cut using the artificial chamber was increased by 0.9% and the percentage of endothelial loss was increased by 3.9±6.8%. In the corneas prepared with endothelium-epithelium cut using a punch the mortality before and after the cut increased by 8.8% and the percentage of endothelial loss was 20.7±10.9%. Conclusions The authors found that in terms of endothelial mortality and endothelial cell density there is less damage to the endothelial population using the epithelium-endothelium cut as compared to the endothelium-epithelium cut.
Topical Anesthesia versus Sub-Tenon Block for Cataract Surgery: Surgical Conditions and Patient Satisfaction
Authors: Rodrigues P.A. , Vale P.J. , Cruz L.M. , Carvalho R.P. , Ribeiro I.M. , Martins J.L. 
Published: January 2018

Purpose To compare the surgical conditions and complications and patient and surgeon satisfaction in cataract surgery by phacoemulsification under topical anesthesia (TA) versus sub-Tenon block (STB). Methods Prospective randomized comparative blind study, without placebo control. Patient satisfaction evaluated by the Iowa Satisfaction with Anesthesia Scale (ISAS). Results The authors prospectively enrolled 59 patients (61% female) in the study, who were randomized into groups: 26 in the TA group and 33 in the STB. There was no statistically significant difference between the groups in terms of age, sex, waiting time for surgery, ASA (American Society of Anesthesiologists) state, eye laterality, cataract density, pupillary dilation, or surgery duration, but patient collaboration was better in the STB group. We found a mean 2.2 mmHg post-anesthetic rise in intraocular pressure in the STB group, with normalization at 24 hours, and no rise in the TA group. Subconjunctival hemorrhage and chemosis were more prevalent in the STB group, and the improvement of visual acuity was similar in both groups. Subjective satisfaction with the anesthetic technique, both for the surgeon and for the patient, was more elevated in the STB group. The final ISAS scores were 1.87 in the TA group and 2.71 in the STB (p<0.005). Conclusions The data indicate that more significant anesthesia and analgesia was achieved with the STB, leading to more favorable surgical conditions and enhanced patient and surgeon satisfaction.
Postoperative Refraction Changes in Phacoemulsification Cataract Surgery with Implantation of Different Types of Intraocular Lens
Authors: Iwase T. , Tanaka N. , Sugiyama K. 
Published: January 2018

Purpose To examine postoperative refraction changes following phacoemulsification cataract surgery and to assess their influential factors, including intraocular lens (IOL) materials and anterior chamber depth (ACD) of the implanted IOL. Methods In this prospective study, 339 eyes were randomly assigned to receive a rigid polymethylmethacrylate (PMMA) IOL (811C or 824C), an acrylic IOL (MA60BM), or a silicone IOL (AQ110NV). All patients were followed for 48 weeks after surgery. Postoperative spherical equivalent refraction and ACD were measured by a refractometer and by an anterior eye segment image analyzer, respectively. Results In the silicone IOL group, statistically significant myopic shift was observed at 8 weeks after the surgery and continued throughout the follow-up period. Mean myopic shift at the end (48 weeks) was −0.53 D. Concomitantly shortened ACD was also confirmed at 12 weeks after the surgery. In the other groups, postoperative refraction and IOL position did not change after surgery. Conclusions The eyes with silicone IOL caused postoperative myopic shift due to the anterior IOL movement. It is important to be aware of the characteristics of each IOL and to take myopic shift into consideration when silicone IOL is implanted. Preferably the A-constant for silicone IOL should be reconsidered to obtain rather accurate postoperative refraction.
New Forceps and Spatula for Easy Retropupillary Implantation of Iris Claw Lenses in Aphakia: Experience in 4 Years of Use
Authors: Sekundo W. 
Published: January 2018

Purpose Retropupillary implantation of an iris claw lens offers a rapid and atraumatic approach for rehabilitation of aphakic eyes. The difficulty in the implantation process arises because of the possibility of losing the intraocular lens (IOL) into the vitreous cavity and the need to change the hand holding the forceps during the enclavation. Methods The new forceps design radically changes the method of grasping an IOL. It contains an extendable supporting plate with a hook-like end. The instrument achieves a horizontal three-point fixation at the edge of the implant in the 6 and 12 o'clock position in order to prevent slippage into the vitreous cavity during the inclination. The supporting plate also has a horizontal mark to facilitate the centration of the IOL behind the pupil level. A long vitreoretinal-type shaft has been turned 90° to exclude the possibility of an accidental release during implantation. A special slender long spatula with an internal twist enables one-hand enclavation through the same side port without the need to change the hand holding the forceps. Results The author has implanted over 100 iris claw IOLs during the last 4 years without any intra-or postoperative complications. Conclusions The new forceps and spatula enable safe, easy, and rapid implantation of iris claw IOLs into the retropupillary space.
Testing the Reliability of an Eye-Dedicated Triaging System: The Rescue
Authors: Rossi T. , Boccassini B. , Cedrone C. , Iossa M. , Mutolo M.G. , Lesnoni G. , Mutolo P.A. 
Published: January 2018

Purpose To calculate the reliability of an eye-dedicated triaging system named Rome Eye Scoring System for Urgency and Emergency (RESCUE). Methods There were four coding parameters: pain, redness, loss of vision, and risk of open globe. Each parameter is assigned a score, the sum of which allows color coding. There were 1000 consecutive patients divided into urgent (U) or non-urgent (NU) based upon diagnosis, need for treatment, hospitalization, and/or follow-up visit. Correlation between RESCUE triage scoring as assigned by the nurse on presentation and urgency as estimated retrospectively was calculated. Accuracy, sensitivity, and specificity have been calculated. False positives (FP) have been defined as patients assigned a RESCUE green or yellow code while retrospectively judged NU and false negatives (FN) have been defined as patients assigned a white code despite being considered U. Results Of 1000 patients, 332 (33.2%) were classified as U and 668 (66.8%) NU. The difference in RESCUE scoring between U and NU patients was significant (p<0.001), as well as the correlation between RESCUE scoring and urgency status. Accuracy was 95% with 9.3% FP and 2.7% FN. Sensitivity was 90.7% and specificity 97.2%. Positive predictive value was 94.6%, and negative predictive value was 95.2%. All 32 hospitalized patients and 147/198 (74.2%) patients given a return appointment properly received a yellow or green code. Conclusions RESCUE accuracy, sensitivity, and specificity yield encouraging results, confirming the system's ability to properly spot the most urgent cases. The concept of urgency in ophthalmology can be difficult to establish; nonetheless, an eye-dedicated triage can help in properly prioritizing urgent patients.
Macular Involvement in Secondary Systemic Amyloidosis
Authors: Altiparmak U.E. , Köklü B. , Ünlü N. , Yağci R. , Bayrak R. , Gul Yilmaz Çinar F. , Duman S. 
Published: January 2018

Purpose A patient with subretinal and pre-retinal hemorrhage after secondary systemic amyloidosis due to familial Mediterranean fever is presented. Methods Case presentation. Results A 30-year-old woman with secondary systemic amyloidosis secondary to familial Mediterranean fever presented with painless visual loss in the right eye. The examination demonstrated multiple subretinal and pre-retinal hemorrhages, massive deposits which may represent amyloid material at the left macular region. After 6 months, the hemorrhages disappeared, but deposits persisted. Conclusions The macular deposition and hemorrhage is an uncommon manifestation of secondary systemic amyloidosis secondary to familial Mediterranean fever. Further evidence is necessary to understand the nature of these deposits and their relevance to secondary systemic amyloidosis and/or familial Mediterranean fever.
Evaluation of Therapeutic Deep Anterior Lamellar Keratoplasty in Acute Ocular Chemical Burns
Authors: Singh G. , Singh Bhinder H. 
Published: January 2018

Purpose To evaluate the role of deep anterior lamellar keratoplasty (DALK) in acute ocular chemical burns. Methods The study was conducted in 50 eyes of 50 patients (24 male, 26 female) with average age of 38.3±14.3 years. DALK in 5 eyes (10%), DALK with quadrant conjunctivo-limbal graft in 25 eyes (50%), and DALK with amniotic membrane in 20 eyes (40%) were performed along with conventional medical therapy. Controls who were matched in all respects (50 eyes) were given medical therapy only as they refused surgical intervention. Results Follow-up of cases ranged from 6 to 48 months (mean 21.5±14.18 months). Forty-three eyes (86%) could be restored with clear cornea as compared to 6% in control group. The visual acuity improvement was seen in 100% with good score (0.49±1.46) in DALK group as compared to 18% with low score (0.03±0.01) in control group (p<0.0001). Visual acuity improvement in DALK was 6/12 in 19 eyes (38%), 6/24 in 28 eyes (56%), and 6/36 in 3 eyes (6%) but was 3/60–6/60 in 6 eyes (12%) and finger counting only in 3 eyes (6%) in control group. Eyes with advanced grade II and grade III showed better improvement than those with burns of grade IV (p<0.05). The discomfort was relieved and epithelial healing was achieved immediately in DALK as compared to a prolonged course in control group (p<0.0001). Vascularization presented in 38% in DALK with least score (0.13+0.15) as compared to 100% in control group with high score (2.8±0.30). Perforation of cornea was seen only in 2 cases (4%) in DALK with low score (0.03±0.10) as compared to 88% in control group (1.33±0.20). Symblepharon was seen in 2% in DALK group as compared to 62% in control group. Conclusions DALK with and without conjunctival or amniotic membrane transplantation is an effective technique in restoring the integrity of the eye with an excellent graft transparency in 86% and improvement in visual acuity in 100% of the acute chemical burns.
Ultrasound Biomicroscopic Measurement of Anterior Chamber Biometry between before and after Pupil Dilation in Children
Authors: Tsuchiya A.K. , Tanaka K. , Sakurada I. , Oba S. , Mizuki N. 
Published: January 2018

Purpose To evaluate anterior chamber biometry of the eyes of normal children using ultrasound biomicroscopy (UBM) and to evaluate the differences in biometry between children and adults, and before and after pupil dilation in children. Methods Anterior chamber depth (ACD) and trabeculariris angle (TIA) were measured in 94 normal children and 15 normal adults using UBM. Before and after pupil dilation were measured in 42 children with emmetropic and hyperopic eyes. Results In 66 emmetropic children, ACD and TIA were 2.93±0.18 mm and 34.42±4.02°, respectively. In 28 hyperopic children, ACD and TIA were 2.92±0.21 mm and 35.05±4.42°, respectively. There was no significant difference in anterior chamber biometry associated with the refraction. ACD did not differ between children and adults, but TIA in children was wider than in adults. There was no significant difference in ACD or TIA before versus after pupil dilation in any case. Conclusions Anterior chamber biometry in children showed no differences before and after pupil dilation. Also, there was no difference in ACD of children as compared to adults; however, TIA in children was significantly wider than in adults.
A Study on the Awareness of Cataract Disease and Treatment Options in Patients who Need Surgery in a Rural Area of Eastern China
Authors: Zhou J.B. , Guan H.J. , Qu J. , Yang X.J. , Peng D. , Gu H.Y. 
Published: January 2018

Purpose To investigate the awareness of cataract disease and treatment and to determine the major barriers for patients who need cataract treatment in a rural area of eastern China. Methods A total of 251 cataract patients were selected by means of eye disease screenings throughout Jiangyan County Questionnaires were administered after the doctor determined that the patient needed cataract surgery The patient's awareness questionnaire was developed by Fletcher and clinically validated at the Aravind Eye Hospital in India. Results A total of 89.6% of patients had been aware of their condition for more than 1 year. Only 49.8% of all patients had known for more than 1 year that their eye disease could be treated. The major barriers for those seeking eye treatment included residual functional vision (49.0%), financial problems (36.7%), no demand for the operation (8.8%), and skepticism about the operation (8.8%). Poor vision function grade and female gender were two significant factors associated with a longer awareness (>3 years) of the existence of cataracts. Patients with a history of eye disease and a longer awareness of eye disease were more likely to have known about the potential treatments for a longer period of time (>1 year). Conclusions The patients' awareness of the presence of cataract disease and potential treatment were unbalanced. The main treatment barriers were lower demand for vision improvement and financial problems. It is imperative to educate patients on eye health care and to provide low cost, but high quality, cataract surgery to these patients.
Macular Function by Multifocal Electroretinogram in Diabetic Macular Edema after Intravitreal Triamcinolone Acetonide Injection
Authors: Karacorlu M. , Ozdemir H. , Senturk F , Arf Karacorlu S. , Uysal O. 
Published: January 2018

Purpose The purpose of this study was to assess macular function by multifocal electroretinography (mfERG) in eyes with diabetic macular edema (DME) after intravitreal triamcinolone acetonide (IVTA) injection. Methods Fifteen eyes of 15 patients with DME scheduled for 4 mg IVTA injection were prospectively recruited. The response to treatment was monitored functionally by visual acuity (VA) measurement and mfERG and anatomically by foveal thickness measured by optical coherence tomography (OCT). The first-order kernel P1 mfERG responses from 0 to 7 degrees (central) and 7 to 25 degrees (peripheral) were grouped and analyzed. Changes in functional parameters (VAs and the P1 mfERG response amplitudes and peak latencies) and morphometric parameters (OCT foveal thickness) in eyes with DME 1 and 3 months after IVTA injection were compared with baseline values by Student t test. Results The mean baseline logMAR value for VAs of the patients before treatment was 0.49±0.26. After treatment, it was 0.27±0.23 at 1 month and 0.26±0.18 at 3 months, and differences from pretreatment values were significant (for each, p<0.001). There were statistically significant decreases in the mean foveal thickness at 1 and 3 months after treatment compared with pretreatment values (for each, p±0.001). There were also statistically significant increases in the mean P1 response amplitude for both central and peripheral groups at all examinations compared with pretreatment (for each, p±0.001). The mean P1 peak latencies for both the central and peripheral groups were shortened, but not significantly. Conclusions As well as the reduction in DME and improvement in VA, IVTA injection improves macular function as assessed by mfERG in diabetic patients.
Prognostic Prediction Ability of Postoperative Multifocal ERG after Vitrectomy for Diabetic Macular Edema
Authors: Leozappa M. , Micelli Ferrari T. , Grossi T. , Pace V. , Rinaldi M.L. , Battista D. , Micelli Ferrari L. 
Published: January 2018

Purpose Diabetic macular edema (DME) causes visual loss in diabetic patients. Multifocal electroretinograms (mfERGs) have been used to assess macular function pre- and postvitrectomy for DME. Methods A standard three-port pars plana vitrectomy with peeling of inner limiting membrane was performed in 25 eyes of 21 patients (13 male, 8 female) with DME. For each patient, visual acuity examination, measure of retinal thickness (using optical coherence tomography), and mfERGs were performed before and 1 week, 1 month, 3 months, and 6 months after vitrectomy. Results Mean postoperative visual acuity was significantly improved (p±0.05, t test), with mean increase of 0.17 logMAR units; mean retinal thickness was significantly (p±0.001) decreased after surgery (from 537 μm to 298 μm). The increase of normalized amplitude of central ring was not significant; the mean P1 wave-amplitude increased from 0.33 to 0.40 mV; mean P1 wave-implicit time decreased 2.88 ms. We divided the patients into two groups: Group 1 (13 eyes), in which the visual recovery was less than 0.20 logMAR, and Group 2 (12 eyes), in which the visual recovery was greater than 0.20 logMAR. ERG results were statistically significantly different between the groups (p±0.025), when we consider the response recorded from the central ring. In Group 2 there is a marked reduction in implicit time of both ERGs waves, which was statistically significant for N1 wave (p=0.01). The changes of parameters of mfERG observed 6 months after surgery were consistent with those recorded just 1 week after surgery. Conclusions Multifocal electroretinogram can be useful to predict functional prognosis in patients with diabetes who underwent vitrectomy for diabetic macular edema.
Ultrasound Biomicroscopy after Vitrectomy in Eyes with Normal Intraocular Pressure and in Eyes with Chronic Hypotony
Authors: Nehemy M.B. , Zisman M. , Marigo F.A. , Nehemy P.G. , Schachat A.P. 
Published: January 2018

Purpose To analyze the ultrasound biomicroscopy (UBM) features of eyes with chronic hypotony after pars plana vitrectomy (PPV) and compare them with the UBM features of eyes with normal intraocular pressure (IOP) after PPV. Methods This comparative (nonrandomized) interventional study included 64 eyes of 64 patients who underwent PPV. Group 1 included 20 eyes with less complex vitreoretinal diseases (VRD) that presented with normal IOP after PPV. Group 2 included 44 eyes with severe proliferative vitreoretinopathy (PVR) managed with PPV and silicone oil tamponade that presented with complete retina reattachment and chronic ocular hypotony. UBM was performed to study the anterior segment, ciliary body (CB), and peripheral retina. The UBM findings of the two groups were compared. Results In Group 1, 19/20 eyes presented with no CB alterations detected by UBM. In Group 2, 43/44 eyes presented with CB alterations that included tractional CB detachment (n=16); exudative CB detachment (n=11); tractional CB detachment/CB atrophy (n=7); CB hypotrophy (n=5); tractional CB detachment/exudative CB detachment (n=3); and CB edema (n=1). There was a strong relationship between IOP and CB findings revealed by UBM. Conclusions Eyes with hypotony following PPV have CB abnormalities that can be detected by UBM. These CB alterations were not found in eyes with normal IOP after PPV in this series.
Acute Visual Loss and Chorioretinal Infarction after Photodynamic Therapy Combined with Intravitreal Triamcinolone
Authors: Lo Giudice G. , De Belvis V. , Piermarocchi S. , Galan A. , Prosdocimo G. 
Published: January 2018

Purpose To report acute visual loss associated with dynamic vascular changes after photodynamic therapy (PDT) combined with intravitreal triamcinolone (IVTA) for the treatment of occult choroidal neovascularization (CNV). Methods An 86-year-old woman complained of visual loss in her left eye. Angiographic examination showed a serous pigment epithelium detachment complicated by CNV. She underwent combined treatment with IVTA (4 mg) followed by standard verteporfin PDT administered after a 5-day interval. Results The patient developed vision loss 1 day after PDT. Ophthalmoscopic examination disclosed an acute serous neurosensory retinal detachment. Fluorescein angiography showed a large area of early hypofluorescence in correspondence to and extending beyond the photodynamic spot. Neurosensory retinal vessels involvement with dilation of the retinal arterioles and capillary nonperfuion were also revealed. Indocyanine green angiography showed choroidal infarction within the collateral choroid included in the area of light exposure, with associated nonperfusion of medium and large choroidal vessels being revealed. Five days after PDT, spontaneous severe bleeding with breakthrough into the vitreous occurred, in addition to an RPE tear. Conclusions Acute loss of vision associated with vascular changes in retinal and choroidal circulation represents an uncommon but serious complication following combined PDT and IVTA. These risks should be carefully considered in combination therapies.
Vitreous Prolapse through the Scleral Wound in 25-Gauge Transconjunctival Vitrectomy
Authors: Shimada H. , Nakashizuka H. , Hattori T. , Mori R. , Mizutani Y. , Yuzawa M. 
Published: January 2018

Purpose To examine the effectiveness of excising peripheral vitreous until the cannula tip is exposed to prevent vitreous prolapse through the scleral wound in 25-gauge transconjunctival vitrectomy. Methods Twenty-five-gauge vitrectomy was performed in 60 consecutive eyes. Peripheral vitrectomy was conducted until the cannula tip was exposed in 30 eyes and with conservation of the vitreous around the cannula in 30 eyes. Vitreous prolapse through the scleral wound was examined using a suction stick. Results Vitreous prolapse through the scleral wound was transparent, fine and short, and detectable only with the suction stick. The incidence of vitreous prolapse through the scleral wound was 0% (0 of 30 eyes) when peripheral vitreous was excised until the cannula tip was exposed, and 20% (6 of 30 eyes) when the vitreous around the cannula was conserved, with a significant difference between two groups (p=0.0237). In two of six eyes with vitreous prolapse, the scleral wound was open, but there was no leakage of intraocular fluid and normal ocular pressure was maintained. Conclusions If peripheral vitrectomy is performed without excising the vitreous surrounding the cannula, there is a 20% risk of the vitreous prolapsing through the scleral wound. Vitreous prolapse through the scleral wound is difficult to detect because it is transparent, fine and short, and there is no intraocular fluid leakage. Therefore, detecting vitreous prolapse with a suction stick and appropriate intervention are important for preventing endophthalmitis.