European Journal of Implant and Refractive Surgery最新文献

Objective: Evaluation of corneal reinnervation after cryo-keratomileusis and keratomileusis. Study Design: Retrospective evaluation of corneal sensitivity after cryo-keratomileusis and in situ keratomileusis. The measurements were performed with the Draeger electromechanical optical-controlled aesthesiometer, which is very precise and independent of external changes in temperature and humidity. Three measuring points were on the lenticle and 2 at approximately 1 mm distance from the limbus. Setting: Instituto Barraquer, Bogota, Columbia (South America). Patients: Twelve patients after cryo-keratomileusis and 38 patients after in situ keratomileusis. Results: It was shown that the recovery of corneal sensitivity after cryo-keratomileusis is delayed due to the depth of the keratectomy and freezing procedure compared to in situ keratomileusis.

This article is the seventh in a series which describes the role of computerized videokeratoscopy and highlights its value in different clinical settings. It illustrates and describes the variety of topographic patterns seen with corneal disease. Essentially, there are 3 basic mechanisms by which pathological processes can disrupt the surface topography of the cornea. These include abnormalities of the epithelium, degradation of the stroma and external compression from lid or orbital masses. With the advent of computerized videokeratoscopy, we can now easily detect and quantify such abnormalities. The mechanisms by which corneal disease effects changes in the corneal topography are illustrated and discussed. The possible clinical applications of videokeratoscopy in the management of corneal disease are reviewed.

Objective: An investigation of the effect of prophylactic ocular hypotensive therapy in the early postoperative period after extracapsular cataract extraction (ECCE) using 2 different viscoelastic materials. Study Design: A prospective, randomized, single masked study measuring the intraocular pressure (IOP) before surgery and at day 1 and 7 after surgery. Setting: Department of Ophthalmology, Holbaek Hospital, Denmark. Patients: Ninety-eight consecutive patients (eyes) were operated on using either Healon® 1% or Methylcellulose 2% as viscoelastic agent. Main Outcome Measures: Early postoperative IOP and complications. Results: IOP was significantly decreased at day 1 and 7 postoperatively (P < 0.01). There was no statistical difference in IOP between the 2 groups pre- or postoperatively, P>0.05. At day 1 IOP elevations to>21 mmHg were seen in 1 eye in the Healon group (22 mmHg) and in 4 eyes in the methylcellulose group (22, 23, 24 and 25 mmHg). Elevations were not seen at day 7. Operative and early postoperative complications were low and comparable. Conclusion: A prophylactic hypotensive treatment at the end of surgery and during the 1st hours after surgery seems to eliminate the adverse IOP elevations in the early postoperative period, irrespective of which 2 viscoelastic agents were used.

Objectives: Combined method of surgery — ‘triple procedure’ (extracapsular cataract extraction, posterior chamber lens implantation and partial perforative keratoplasty) was used to restore visual functions of cataractous eyes with coincident corneal pathology. Additional surgeries (synechiolysis, trabeculectomy, pupiloplasty) were done in complicated cases. Patients: Postoperative results in 32 cataractous eyes of 31 patients (1 binocular case) having different kinds of corneal pathology were prospectively analysed. Main Outcome Measures: Complication rate, best corrected postoperative visual acuity after 3/6 months follow-up period. Results: Posterior capsular fibrosis (14%) cystoid macular oedema (7%), graft rejection (6%) and other complications (9%) were late complications. Postoperative visual acuity ≥ 0.4 was achieved in 51% after 3, and in 81% of patients after 6 months of postoperative follow-up. Strong corneal vascularization in 2 eyes compromised the graft, indicating rekeratoplasty. Conclusion: We find ‘triple procedure’ to be the method of choice for treatment of cataractous eye with associated corneal pathology. Additional surgeries (synechiolysis, trabeculectomy, pupiloplasty) help to solve complicated cases.

Objective: To determine indications for intraocular lens (IOL) explantation and to assess the influence of this procedure on the definite visual outcome. Retrospective analysis of 5 IOL explantations was performed from October 1992 to February 1994 by one surgeon. Setting: Kaunas Medical Academy. Methods: Repeated IOL fixation/repositioning, IOL explantation/reimplantation, corneal decompensation, penetrating keratoplasty (PKP), best corrected post-operative visual acuity. Results: Initial corneal decompensation occurred after surgical reintervention in two cases. Donor cornea 1 year after PKP remained clear, location of reimplanted anterior chamber IOL in all cases was stable. Best corrected visual acuity was 0.02–0.4. Conclusions: Positioning of additional iris-clips IOL fixation in cases of dislocation is of small value. Early iris-clips IOL removal is recommended in cases of dislocation.

An original technique of enhanced visualization of the anterior capsule in white cataract CCC using a coloration by an autologous haemoderivate is presented.

Objective: To record the frequency and type of complications that occur following photorefractive keratectomy (PRK) for myopia. Design: Prospective, with follow-up for 1 year. Setting: Mater Private Hospital Laser Clinic, Dublin, Republic of Ireland. Patients: One hundred and sixty one myopic eyes in 120 patients. Main Outcome Measures: Any complications occurring in the follow-up period. Patient satisfaction rating, on a graded scale, was recorded in the first 50 eyes in 50 consecutive patients at 1 year. Results: Of 161 eyes 22.4% had early complications of their procedure. These were most commonly caused by the use of routine post-laser medications. Furthermore, only 6% of 50 patients surveyed, failed to achieve their original aim (wholely or in part) in undergoing the treatment. In no case was the visual outcome compromised by non-refractive complications. Conclusions: PRK is safer than extended wear soft contact lens use.