Progressive improvement of impaired visual acuity during the first year after transsphenoidal surgery for non-functioning pituitary macroadenoma

Improvement of visual field defects continues even years after the initial surgical treatment. Because this process of continuing improvement has not been documented for visual acuity, we audited our data to explore the pattern of recovery of visual acuity until 1 year after transsphenoidal surgery for non-functioning pituitary macroadenoma. Retrospective follow-up study. Forty-three patients (mean age 56 +/- 14 years), treated by transsphenoidal surgery for non-functioning pituitary macroadenoma, were included in this analysis. Visual acuity improved significantly within 3 months after transsphenoidal surgery. The mean visual acuity increased from 0.65 +/- 0.37 to 0.75 +/- 0.36 (P <0.01) (right eye), and from 0.60 +/- 0.32 to 0.82 +/- 0.30 (P <0.01) (left eye). Visual acuity was improved 1 year after transsphenoidal surgery compared to the 3 months postoperative values. The mean visual acuity increased from 0.75 +/- 0.36 to 0.82 +/- 0.34 (P <0.05) (right eye), and from 0.82 +/- 0.30 to 0.88 +/- 0.27 (P <0.05) (left eye). Visual acuity improves progressively after surgical treatment for non-functioning pituitary macroadenomas, at least within the first year after transsphenoidal surger

Kontinuierliche Augeninnendruckmessung : Erste Ergebnisse einer drucksensitiven Kontaktlinse

A prototype of a pressure-sensitive contact lens (CL-DCT) based on dynamic contour tonometry (DCT) has been developed for continuous intraocular pressure (IOP) monitoring. The purpose of the present study was to assess the clinical applicability of this CL-DCT. MATERIAL AND METHODS: In 24 healthy subjects continuous IOP recording with the CL-DCT for 100 s was accomplished including IOP monitoring during 2 consecutive Valsalva manoeuvres. The measurement procedure was repeated after 5 min on the same eye and compared with the initial measurement. RESULTS: Continuous pressure curves were recorded in 20 subjects. The CL-DCT revealed an individual increase in IOP from 0.74 to 8.26 mmHg during the Valsalva manoeuvres. Comparison of the 2 consecutive IOP measurements yielded a mean deviation of +/-0.4 mmHg. CONCLUSIONS: CL-DCT allows non-invasive and continuous measurements of IOP. The measured values are comparable to the expected ones. Further studies are necessary to compare the measurement accuracy of CL-DCT with that of slit lamp adapted DCT (SL-DCT)

Evaluation of correction formulas for tonometry

BACKGROUND Accurate determination of intraocular pressure (IOP) is essential for correct management of glaucoma. Goldmann applanation tonometry (GAT) is the gold standard for measuring IOP despite its limitations due to its dependence on corneal properties. With the aim of improving the accuracy of GAT readings, several correction formulas have been developed. OBJECTIVE The aim of this study was to investigate the accuracy and clinical relevance of five correction equations for GAT. MATERIAL AND METHODS Prospective study of 112 glaucoma patients at the University Hospital and Talacker Eye Center, Zurich, Switzerland. The IOP was measured with GAT and dynamic contour tonometry (DCT) in randomized order. The GAT readings were adjusted with five correction equations. The primary study endpoint was the degree of concordance between corrected GAT and DCT readings. A discordance of ≥2 mm Hg was defined as significant. The association between discordant IOP measurements and central corneal thickness (CCT) was the secondary study endpoint. RESULTS The mean patient age was 66 ± 13 years (60% females and 56% left eyes). The mean IOP was 17.0 mm Hg for GAT and 20.3 mm Hg for DCT, with a discordance of 3.3 mm Hg between GAT und DCT. The discordances between DCT and the corrected values ranged from 2.7 to 5.4 mm Hg. Spearman's rank testing showed a positive correlation between CCT and the discordances of all correction equations and a negative correlation between CCT and the discordance of DCT and GAT. CONCLUSION The use of GAT correction formulas involves the risk of creating significant error. The correction equations examined showed extensive scatter and resulted in mean IOP values that were lower than the IOP initially measured by GAT. Thus the use of any correction equation may delay diagnosis of glaucoma and should be avoided