Evaluation of the Ex-PRESS® P-50 implant under scleral flap in combined cataract and glaucoma surgery

Aim: To evaluate the efficacy and safety of glaucoma drainage device Ex-PRESS® P-50 for combined cataract surgery and glaucoma. Methods: Patients having cataract and open angle glaucoma or patients with open advanced glaucoma which needed two or more antiglaucoma medications were included. Combined cataract surgery and glaucoma with Ex-PRESS® P-50 model placed under scleral flap was performed. Results: Out of 40 eyes of 40 patients (55% male and 45% female) completed the study during one-year follow-up. The mean of age was 76.6±11.02y. The intraocular pressure (IOP) decreased significantly during the 12-month follow-up from 23.5 mm Hg to 16.8 mm Hg (Wilcoxon signed ranks test, P<0.001). A 59.5% of patients did not need any topical treatment, 10.8% of them needed one active principle, 27% needed two active principles, and 2.7% of them needed three active principles for successful IOP control (<21 mm Hg). Conclusion: Combined surgery of phacoemulsification with ExPRESS® P-50 lowers IOP from the preoperative baseline and reduces significantly the number of antiglaucoma active principles for IOP control after the operation

Assessment of corneal biomechanical properties and intraocular pressure in myopic Spanish healthy population

Purpose. To examine biomechanical parameters of the cornea in myopic eyes and their relationship with the degree of myopia in a western healthy population. Methods. Corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann correlated intraocular pressure (IOP), and corneal compensated IOP (IOPcc) were measured using the ocular response analyzer (ORA) in 312 eyes of 177 Spanish subjects aged between 20 and 56 years. Refraction was expressed as spherical equivalent (SE), which ranged from 0 to -16.50 diopters (D) (mean: -3.88 ± 2.90 D). Subjects were divided into four groups according to their refractive status: group 1 or control group: emmetropia (-0.50 = SE 0.05); nevertheless, IOPcc was significantly higher in the moderatelymyopic (15.47±2.47mmHg) and highlymyopic (16.14± 2.59mmHg) groups than in the emmetropia (15.15 ± 2.06mmHg) and low myopia groups (14.53 ± 2.37mmHg). No correlation between age and the measured parameters was found. CH and IOPcc were weakly but significantly correlated with SE (¿ = 0.171, ¿ = 0.002 and ¿ = -0.131, ¿ = 0.021, resp.). Conclusions. Present study showed only a very weak, but significant, correlation between CHand refractive error, with CH being lower in both moderately and highlymyopic eyes than that in the emmetropic and low myopic eyes.These changes in biomechanical properties of the cornea may have an impact on IOP measurement, increasing the risk of glaucom

Evaluation of lymphatic vessel dilatations by anterior segment swept-source optical coherence tomography: Case report

Background: Conjunctival lymphangiectasia is a rare condition presumably caused by the obstruction of lymphatic channels or by an abnormal connection between conjunctival lymphatic and blood vessels. Diagnosis is based on clinical appearance and histology. We report a case of conjunctival lymphangiectasia in which anterior segment optical coherence tomography (OCT) was used to assist the diagnosis and the planning of the biopsy location. Case presentation: A 31-year-old woman was referred with repeated episodes of conjunctival "hemorrhages" and chemosis with extended recovery periods over the last months. Other symptoms were dryness, redness, burning sensation and itching. Photo documentation, anterior segment OCT, ultrasound, computer tomography (CT) and magnetic resonance imaging (MRI) of the brain were performed. MRI revealed dilated atypical Virchow-Robin space (VRS). Conjunctival biopsy was taken and the location of the biopsy was selected based on OCT findings. Based on the clinical appearance we suspected the case to be conjunctival lymphangiectasia or lymphangioma. Histology and immunhistochemistry confirmed the diagnosis of conjunctival lymphangiectasia. Conclusions: Anterior segment OCT is a non-invasive tool, useful in the evaluation of conjunctival lesions and planning surgery. © 2017 The Author(s)

Pseudophakic cystoid macular edema: update 2016

Andrzej Grzybowski,1,2 Bartosz L Sikorski,3 Francisco J Ascaso,4,5 Valent&iacute;n Huerva6,7 1Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland; 2Department of Ophthalmology, Poznan City Hospital, Poznan, Poland; 3Department of Ophthalmology, Nicolaus Copernicus University, Bydgoszcz, Poland; 4Department of Ophthalmology, Hospital Cl&iacute;nico Universitario &ldquo;Lozano Blesa&rdquo;, Zaragoza, Spain; 5Instituto de Investigaci&oacute;n Sanitaria Arag&oacute;n (IIS Arag&oacute;n), Zaragoza, Spain; 6Department of Ophthalmology, Universitary Hospital Arnau de Vilanova, Lleida, Spain; 7IRB Lleida, Lleida, Spain Abstract: Pseudophakic cystoid macular edema (PCME) is the most common complication of cataract surgery, leading in some cases to a decrease in vision. Although the pathogenesis of PCME is not completely understood, the contribution of postsurgical inflammation is generally accepted. Consequently, anti-inflammatory medicines, including steroids and nonsteroidal anti-inflammatory drugs, have been postulated as having a role in both the prophylaxis and treatment of PCME. However, the lack of a uniformly accepted PCME definition, conflicting data on some risk factors, and the scarcity of studies comparing the role of nonsteroidal anti-inflammatory drugs to steroids in PCME prevention make the problem of PCME one of the puzzles of ophthalmology. This paper presents an updated review on the pathogenesis, risk factors, and use of anti-inflammatory drugs in PCME that reflect current research and practice. Keywords: Pseudophakic cystoid macular edema, cataract surgery, cataract surgery complications, retina, post-operative complication

Infliximab for peripheral ulcerative keratitis treatment

Biologic agents such as anti-TNFa have been employed in treatment paradigms for ocular inflammation. Peripheral corneal ulceration (PUK) is a devastating disorder consisting of a crescent-shaped area of destructive inflammation at the margin of the corneal stroma. It is associated with an epithelial defect, the presence of stromal inflammatory cells, and progressive stromal degradation and thinning, leading to ocular perforation and devastating visual loss. Macroulcerative PUK is usually a local manifestation of a systemic vasculitis. In many cases, the disease may be resistant to high doses of systemic corticosteroids and immunosuppressants. Chimeric anti-TNFa has been employed when all other treatments have failed. Isolated cases and short series of cases have been reported. This paper summarizes the available reports on the use, efficacy, and safety of infliximab in the treatment of PUK