Dexamethasone intravitreal implant (Ozurdex(A (R))) for pediatric uveitis

The purpose of this study was to investigate the safety and effectiveness of an intravitreally injected dexamethasone-containing implant (Ozurdex(A (R))) in the treatment of uveitis in children

Evaluating the accuracy of a cataract surgery simulation video in depicting patient experiences under conscious anesthesia.

PURPOSE: To evaluate the accuracy of a point-of-view cataract surgery simulation video in representing different subjective experiences of patients undergoing the procedure. METHODS: One hundred consecutive post-cataract-surgery patients were shown a short simulation video of the surgery obtained through a porcine eye model during the first postoperative week. Patients then answered a multiple-choice questionnaire regarding their visual and tactile intraoperative experiences and how those experiences matched the simulation. RESULTS: Of the patients surveyed (n = 100), 78% (n = 78) recalled visual experiences during surgery, 11% recalled pain (n = 11), and 6.4% (n = 5) recalled frightening experiences. Thirty-six percent of patients (n = 36) were interviewed after their second cataract surgery; there was no statistically significant difference between anxiety scores reported before the first eye surgery and second eye surgery (p = 0.147). Among all patients who recalled visual experiences (n = 78), nearly half (47.4%) reported that the video was the same/similar to their experience. Forty-eight percent of the patients recommended future patients to watch the video before their procedures, and more than a third (36%) agreed that watching the video before surgery would have helped them to relax. CONCLUSIONS: Our model reflects the wide range of subjective patient experiences during and after surgery. The high percentage of patients who found the video accurate in different ways suggests that, with more development, point-of-view cataract simulation videos could prove useful for educational or clinical use. Further research may be done to confirm the simulations utility, by screening the video for subjects before operations

Accuracy of IOL power calculations in the very elderly.

Background/objectivesTo analyze the refractive predictability and outcomes of cataract surgery in the very elderly (≥85 years old).Subjects/methodsA retrospective case-series performed at the Shiley Eye Institute, University of California San Diego, USA. Electronically pulled data of 2444 surgeries revealed 147 surgeries on 133 very elderly patients. Chart review was conducted for all very elderly and corresponding control patients (75-84 years old). The first operated eyes of patients with final best-corrected visual acuity ≥20/40, axial length (AL) 22-26 mm, and implanted SN60WF IOL were included. Patients with ocular comorbidities and/or intra- or post-operative complications were excluded. Prediction errors of refractive outcome and percentage of eyes within ±0.50D and ±1.00D were compared between the groups for the Holladay 1 and Barrett Universal II (Barrett) formulas. Logistic regression analysis for achievement of ±1.00D was conducted.ResultsFinal analysis included 90 eyes (n = 44, very elderly, n = 46, control patients). Median absolute refractive error (MedAE) with Holladay 1, but not Barrett formula, was significantly higher in the older group (p = 0.02 and p = 0.07, respectively). The MedAE in the older group was lower using the Barrett compared to Holladay 1 (p = 0.02). Fewer older patients than younger patients achieved refraction within ±0.50D and ±1.00D from goal, using the Holladay 1 (p = 0.049 and p = 0.002 respectively). Logistic regression analysis supported the relationship between Holladay 1 predictive refractive error of >1.00D and patient's age (p = 0.046).ConclusionsVery elderly patients undergoing cataract surgery may be prone to reduced refractive precision, particularly with utilization of the Holladay 1 formula

The Histone Deacetylase Inhibitor AN7, Attenuates Choroidal Neovascularization in a Mouse Model

Choroidal neovascularization (CNV) is a complication of age-related macular degeneration and a major contributing factor to vision loss. In this paper, we show that in a mouse model of laser-induced CNV, systemic administration of Butyroyloxymethyl-diethyl phosphate (AN7), a histone deacetylase inhibitor (HDACi), significantly reduced CNV area and vascular leakage, as measured by choroidal flatmounts and fluorescein angiography. CNV area reduction by systemic AN7 treatment was similar to that achieved by intravitreal bevacizumab treatment. The expression of vascular endothelial growth factor (VEGF), fibroblast growth factor (FGF-2), and the endothelial cells marker CD31, was lower in the AN7 treated group in comparison to the control group at the laser lesion site. In vitro, AN7 facilitated retinal pigmented epithelium (RPE) cells tight junctions’ integrity during hypoxia, by protecting the hexagonal pattern of ZO-1 protein in the cell borders, hence reducing RPE permeability. In conclusion, systemic AN7 should be further investigated as a possible effective treatment for CNV

Intraocular lens power calculation in the elderly population using the Kane formula in comparison with existing methods.

PURPOSE:To assess the accuracy of the Kane formula for intraocular lens (IOL) power calculation in comparison to established formulas in the elderly population. SETTING:Shiley Eye Institute, University of California San Diego, USA. DESIGN:Retrospective cohort. METHODS:Retrospective data from 90 patients ≥75 years old who underwent uneventful cataract surgery with SN60WF IOL implantation were evaluated. The first operated eyes of patients with final best-corrected visual acuity 20/40 or better and axial length 22-26 mm were included. Prediction errors were calculated for Barrett Universal II (BUII), Haigis, Hoffer Q, Holladay 1, Kane and SRK/T formulas. A subgroup analysis based on age (75-84 and ≥85 years old) was performed. RESULTS:Use of both BUII and Kane formulas resulted in the highest percentage of eyes with prediction errors within ±0.50 D (72% each) and significantly higher than Hoffer Q, Holladay 1 and SRK/T (p=0.001). Rates of predictability within ±0.25 D and ±1.00 D were 31%-38% and 87% -92%, respectively, with no significant differences between formulas. No statistically significant difference was seen between formulas in the median absolute error. These tendencies remained consistent in both age groups when analyzed separately. Subgroup analysis showed better predictability of all formulas in the younger age group. CONCLUSIONS:This is the first study evaluating the Kane formula exclusively in the elderly population. The Kane formula was found to be of equal accuracy to the BUII and superior to the Hoffer Q, Holladay 1 and SRK/T formulas. Very elderly patients may have reduced refractive precision using all formulas