Evaluation of efficacy and safety of new high-density dyes for chromovitrectomy

The purpose of this study is to evaluate the safety and efficacy of two novel heavy dyes for macular surgery: DoubledyneTM and TwinTM. One eye from each of 144 patients undergoing surgery for macular hole or macular pucker was included in the study. The eyes were randomly divided into two groups according to the dye used during surgery. Best correct visual acuity (BCVA), intraocular pressure (IOP) and retinal morphology assessed by ocular coherence tomography (OCT) were evaluated before and 1, 3, 6 and 12 months after surgery. Only one surgeon performed each operation and provided a score ranging from 1 (poor) to 10 (excellent) for quality of staining and comfort in surgery. Statistical analysis was carried out with SPSS to compare parameters before and after surgery and between the two groups. No statistical differences were recorded in quality of staining (p = 0.11), in surgery comfort (p = 0.17) and total time of surgery (p = 0.44) between the two groups. BCVA statistically improved and central macular thickness (CMT) statistically decreased after surgery in both groups (p < 0.05). No toxic dye-related complications or long-term ones affecting the retina were observed in either group. According to this data, although confirmation in further studies with larger populations and longer follow up is required, DoubledyneTM and TwinTM proved to be safe and effective dyes for macular surgery

Evaluation of Corneal Reflectance in Sjögren's Syndrome Dry Eye

Introduction: To measure corneal layers’ light reflectance (LR) in eyes affected by dry eye disease caused by Sjögren's syndrome (SSDE) with corneal confocal microscopy (IVCM) and to study the correlations with tear film tests. Materials and Methods: Thirty-six patients affected by SSDE and 36 healthy subjects (HS) were enrolled in this retrospective study, participants of both groups were age and sex matched. Each study participants had a complete eye visit and break up time (BUT), Schirmer test, with and without stimulation, at the end of the visit an IVCM scan was performed. LR measured by IVCM at Bowman membrane (BM) level and at 50 µm, at 100 µm and at 200 µm deeper was compared in the two groups of participants. The correlations between LR measurements and tear film test results were investigated. Results: In SSDE eyes, LR was significantly higher (p<0.001) in SSDE patients at BM level (+14.43 ± 3.27 LRU) and also in the other levels evaluated, compared with HP. Good correlations were observed between LR values at BM and Schirmer test ones with (r = -0.82) and without (r= -0.81) stimulation and BUT (r= 0.80) in SSDE eyes. Correlations values were Adecreasing the deeper corneal layers. Conclusion: Even if need to be verified in further studies with a larger population, results obtained in this study suggest that IVCM could be an interesting and effective tool in evaluating the SSDE patients and it could be adopted by physicians’ community because it seems very promising

Corneal Distortion and Corneal Morphological Parameters in Naïve Eyes Analyzed with a Scheimpflug Camera

Background: The study of the corneal biomechanical properties (CBP) is gaining always more interest, thanks to the applications to refractive surgery and to the overall management of several corneal diseases. Purpose: To analyze the eventual relationships between corneal distortion and morphologic features in healthy subjects. Methods: one eye of one hundred and fifty-two healthy participants, 87 women and 65 men, aging from 23 to 65 years old, were evaluated in this study. Every eye underwent a complete clinical examination, that included also a tomographic scan using Pentacam HR (Oculus, Wetzlar, Germany) and a biomechanical evaluation using Corvis ST (Oculus, Wetzlar, Germany). Linear regressions among refractive defect, corneal volume (CV), anterior corneal curvature and central corneal thickness (CCT) vs corneal biomechanical features provided by Corvis ST have been ran using SPSS software version 18.0. Results: Corneal distortion factors showed a low correlation both with corneal morphological parameters and with refractive defect. No significant correlations (p> 0.01) were found among morphologic and biomechanical features evaluated. Discussion: results observed in this study could help in recognize the healthy range of values of CBP parameters provided by CST. This information could be very useful in many ophthalmology topics such as the accurate IOP measurement, the early diagnosis of corneal degenerations, such as keratoconous, and the screening of subject undergoing refractive surgery. Conclusions: even if data of this study need to be confirmed in further ones with larger populations, results here observed suggest that Corvis ST is a device providing an evaluation of corneal distortion not influenced by morphological corneal factors. This information could help in better screening and managing the diseased corneas

Reliability of a new correcting factor in calculating intraocular lens power after refractive corneal surgery

Purpose: To test the reliability of a corneal radius correcting factor (R factor) in calculating intraocular lens (IOL) power in eyes that developed cataract after refractive surgery and compare it with the clinical history (CHM) and double-K (DKM) methods. Setting: Department of Ophthalmology, Second University of Naples, Naples, Italy. Methods: Nineteen eyes from the literature that underwent cataract extraction and IOL implantation after refractive surgery were used to compare actual postoperative and expected refractive errors utilizing the R factor, CHM, and DKM. Intraocular lens powers were calculated with 3 formulas: SRK/T, Hoffer Q and Holladay 1. The differences were evaluated with the Wilcoxon test and Spearman correlation. Results: With the R factor SRK/T and Holladay 1 formulas gave the best results; 16 (84.2%) and 17 (89.5%) eyes were within 62 diopters (D) of emmetropia. With CHM, the best results were obtained using the SRK/T and Holladay 1 formulas; with both formulas 12 (63.2%) eyes were within 62 D of emmetropia. With DKM, the best results were obtained using SRK/T and Holladay 1 formulas; with both formulas 10 eyes (52.63%) were in the range of 62 D from emmetropia. Conclusions: The R factor can be used with the SRK/T or Holladay 1 formula because this method seems comparable or superior to DKM and CHM

Echographic Evaluation of a Subconjunctival Cystic Lesion

Migration of intraocular silicone oil, used in the treatment of complicated retinal detachment, has been rarely described, but when it happens it can arise with a differential diagnosis with scleral buckling extrusion, tumor, dermoid, ocular cysticercosis, and abscess. The presence of silicone oil in the eye gives very ugly echographic pictures, but these kinds of pictures can be very useful in making a differential diagnosis in the above-mentioned cases. A 39-year-old white female complained of the presence of conjunctival hyperemia and tearing in the right eye (RE); her visual acuity was hand motion, and the intraocular pressure was 14 mmHg. In the upper nasal quadrant a dome shaped lesion was detected. Due to the lens opacities, the patient underwent an echographic examination, which revealed the presence of silicon oil both in the vitreous chamber and in a large subconjunctival space, corresponding to the lesion. This article in addition provides a possible explanation of such cystic formation and discusses the risk factors and the role of the echographic examination in such cases