Outcomes of a dispersive ophthalmic viscosurgical device

Objectives: The aim of this study was to evaluate clinical outcomes related to the protection of corneal endothelial cells and the safety of the Bio-Hyalur CS (Biotech Healthcare Group, Luzern, Switzerland) ophthalmic viscosurgical device (OVD) in routine cataract surgery. Methods: Patients who had undergone cataract surgery using Bio-Hyalur CS as an OVD and who had at least 3 months of follow-up data were included in the study. Endothelial cell density (ECD) and morphology (hexagonality, area, and coefficient of variation in cell size) as well as intraocular pressure were evaluated during 3 months of follow-up. Intraoperative and postoperative complications were recorded. Results: Sixty eyes of 44 patients were included in the study. The mean preoperative ECD was 2383.5±288.67 cells/ mm2 . The mean postoperative ECD was 2186.0±359.65 cells/mm2 and 2149.7±354.49 cells/mm2 at 1- and 3-month visits, respectively. The mean coefficient of variation in cell size was 29.1±5.04% and 30.9±5.79% at preoperative and postoperative 3-month visits, respectively. The mean cell area was 426.1±52.59 µm2 and 476.6±122.26 µm2 at preoperative and postoperative 3-month visits, respectively. No adverse events were reported during the study period. Conclusion: Bio-Hyalur CS provided good endothelial protection and has a favorable safety profile. However, comparative studies with other OVDs are necessary

Does the type of suturing technique used affect astigmatism after deep anterior lamellar keratoplasty in keratoconus patients?

Banu Torun Acar, Ece Turan Vural, Suphi AcarHaydarpasa Numune Education and Research Hospital, Ophthalmology Clinic, Istanbul, TurkeyPurpose: To compare the effect of three different suturing techniques on astigmatism after deep anterior lamellar keratoplasty (DALK) in patients with keratoconus.Methods: In this retrospective study, 54 eyes of 54 patients with advanced keratoconus underwent DALK with three suturing techniques: single running, interrupted running, and combined interrupted and running. Postkeratoplasty astigmatism was evaluated during examinations 1, 3, and 6 months postoperatively and 2 months after completing suture removal.Results: Twenty-four eyes had single running sutures, 16 eyes had interrupted sutures, and in 14 eyes the suturing technique used was combined interrupted and running sutures. Mean age was 25.6 ± 5.9 years, 27.3 ± 6.8 years, and 26.5 ± 5.7 years (P = 0.422), and postoperative astigmatism 1 month after surgery was 3.79 ± 1.19 D, 5.56 ± 1.78 D, and 4.21 ± 1.55 D in the three groups, respectively (P = 0.012). However, 2 months after completing the suture removal, final postoperative astigmatism was 3.43 ± 1.44 D, 3.87 ± 1.38 D, and 3.71 ± 1.46 D (P = 0.846). Final astigmatism less than 4 D was seen in 18 cases (75%) in the single running group, nine cases (56.2%) in the interrupted running group, and nine cases (64.2%) in the combined interrupted and running group (P = 0.08).Conclusion: Postkeratoplasty astigmatism is comparable with three different suturing techniques used in patients with keratoconus after completing suture removal in DALK. Due to earlier suture removal in DALK, the type of suturing technique used is not considerably important.Keywords: astigmatism, deep anterior lamellar keratoplasty, suturing techniqu

Effect of Cap-Lenticule Diameter Difference on the Visual Outcome and Higher-Order Aberrations in SMILE: 0.4 mm versus 1.0 mm

Purpose. To evaluate the effect of cap-lenticule diameter difference (CLDD) on the visual outcome and higher-order aberrations (HOAs) of small-incision lenticule extraction (SMILE). Methods. A total of 132 patients who had bilateral SMILE for myopia or myopic astigmatism were included. The CLDD was 0.4 mm in 54 patients (group 1) and 1.0 mm in 78 patients (group 2). The refractive parameters, uncorrected (UDVA) and corrected distance visual acuity (CDVA), and HOAs were determined preoperatively and during six months follow-up. Results. Group 1 had better CDVA (in logMAR) compared to group 2 at day 1 (−0.07 ± 0.07 versus 0.04 ± 0.07, resp.; p<0.001) and week 1 (−0.07 ± 0.07 versus –0.04 ± 0.07, resp.; p=0.001). The visual acuity improved more in group 1 than in group 2. The UDVA (in logMAR) was 0.07 ± 0.07 and 0.29 ± 0.09 at day 1 (p<0.001) and −0.08 ± 0.07 and −0.06 ± 0.06 at six months (p=0.038) in group 1 and group 2, respectively. Group 1 was associated with significantly less induction of HOAs (0.24 ± 0.08 μm and 0.32 ± 0.26 μm, resp.; p=0.002). Conclusions. In SMILE, 0.4 mm CLDD is associated with better visual outcome and less induction of HOAs than 1.0 mm. Narrow CLDD should be considered in SMILE to increase the visual acuity particularly in the early postoperative period

Usher syndrome associated with Fuchs’ heterochromic uveitis: a case report

We report a case of Usher syndrome in association with unilateral Fuchs’ heterochromic uveitis

Descemet Stripping Automated Endothelial Keratoplasty for Treatment of Pseudophakic Bullous Keratopathy

Pur po se: To evaluate the results and complications of Descemet stripping automated endothelial keratoplasty (DSAEK) in the treatment of pseudophakic bullous keratopathy (PBK). Ma te ri al and Met hod: Twenty eyes of 20 patients who underwent DSAEK with a diagnosis of PBK in our clinic between September 2010-January 2012 were included in this study. Pre- and postoperative best-corrected visual acuity (BCVA), refraction values, endothelial cell density, and graft position were analyzed. Complications and treatments were recorded. Re sults: The mean age of the 20 patients (11female, 9 male) was 71.44±7.55 years (range: 56-83 years) and the mean follow-up time was 11.35±3.90 months (range: 3-16 months). Preoperative mean BCVA was 0.04±0.044 and 12-month BCVA was 0.55±0.22 (p=0.001). Mean endothelial cell density was 1508.42±254.82 cell/mm² at 12-month follow-up visit. Dislocation of graft lenticule occurred in five patients and graft failure occurred in one patient. Dis cus si on: DSAEK, due to the more rapid rehabilitation, is an alternative to penetrating keratoplasty in the treatment of endothelial diseases despite the steep learning curve and different complications. (Turk J Ophthalmol 2012; 42: 263-68

Comparison of sulfur hexafluoride and air for donor attachment in descemet stripping endothelial keratoplasty in patients with pseudophakic bullous keratopathy

WOS: 000331530700001PubMed ID: 24452211Purpose:The aim of this study was to evaluate the clinical efficacy and safety of sulfur hexafluoride (SF6) as a tamponading agent after donor placement during Descemet stripping endothelial keratoplasty (DSEK) surgery and to compare the outcomes with those of air.Methods:Forty-four eyes of 44 consecutive patients who underwent DSEK were included in the study. Air was used in 22 eyes of 22 patients (air group), and SF6 was used in 22 eyes of 22 patients (SF6 group) to attach the donor lenticule. The complications, corrected visual acuity (CVA), and the endothelial cell density (ECD) results were compared between these 2 groups.Results:Six eyes had graft dislocation in the air group that underwent successful rebubbling on postoperative day 1. There was no graft dislocation in the SF6 group. There was no other complication observed in both the groups. The mean increase in the CVA was 1.09 0.36 logarithm of the minimum angle of resolution in the air group, whereas it was 0.80 +/- 0.57 logarithm of the minimum angle of resolution in the SF6 group. The mean increase in the CVA was not statistically different between the 2 groups (P = 0.060). Compared with the mean ECD in donor grafts, the mean decrease in the ECD was 222 +/- 86 (44%) cells per square millimeter in the air group and 178 +/- 52 (39%) cells per square millimeter in the SF6 group at the 1-year follow-up. The mean decrease in the ECD was statistically significantly higher in the air group compared with that in the SF6 group (P = 0.049).Conclusions:SF6 is comparable to air for attaching the donor graft as a tamponading agent in DSEK surgery