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

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

Application of Artificial Intelligence in the Analysis of Features Affecting Cataract Surgery Complications in a Teaching Hospital

Aims: To evaluate the ocular and systemic factors involved in cataract surgery complications in a teaching hospital using artificial intelligence. Methods: One eye of 1,229 patients with a mean age of 70.2 ± 10.3 years old that underwent cataract surgery was selected for this study. Ocular and systemic details of the patients were recorded and then analyzed by means of artificial intelligence. A total of 1.25 billion simulations of artificial intelligence learning and testing were conducted on several variables and a customized model of analysis was developed. Results: A total of 73 complications were recorded in this study. According to the analysis performed, the main factors involved in cataract surgery complications were: a surgeon in training, axial length and intraocular lens power. The model predicted how long surgery would last with an error of <6 min compared to the effective time needed. Conclusions: According to the data here obtained, artificial intelligence could be an interesting option to build customized models able to prevent complications and to predict actual surgery time. The customized algorithm option allows the development of better models adaptable to different units as well as the possibility to be calibrated for the same unit along time

Health Status and Patient Satisfaction after Corneal Graft: Results from the Corneal Transplant Epidemiological Study

Purpose. To evaluate effects of corneal transplantation on the health-related quality of life and patients' satisfaction. Methods. Patients scheduled for elective penetrating or anterior lamellar keratoplasty completed by telephone interview the SF-12 Health Survey, before and one year after surgery, and a 6-item questionnaire on the satisfaction for graft outcomes. Results. The two questionnaires were answered by 1,223 patients. Transplantation did not influence the PCS-12 in males (ES = −0.01) and had a negative effect in females (ES = −0.18). Both sexes improved their MCS-12 (ES = 0.18 and 0.23, resp.). The majority of patients (83.1%) were satisfied by the outcome of the graft. Conclusions. This is the first report on the use of the SF-12 and one of the few that assess quality of life in patients after corneal transplantation. We showed that grafting improves patients' health-related quality of life results of patients, influencing mental health (i.e., psychological attitude, social interaction, and emotions) with minor effects on physical health (limitation, pain, and vitality)

Classification tree to analyze factors connected with post operative complications of cataract surgery in a teaching hospital

Background: Artificial intelligence (AI) is becoming ever more frequently applied in medicine and, consequently, also in ophthalmology to improve both the quality of work for physicians and the quality of care for patients. The aim of this study is to use AI, in particular classification tree, for the evaluation of both ocular and systemic features involved in the onset of complications due to cataract surgery in a teaching hospital. Methods: The charts of 1392 eyes of 1392 patients, with a mean age of 71.3 8.2 years old, were reviewed to collect the ocular and systemic data before, during and after cataract surgery, including post-operative complications. All these data were processed by a classification tree algorithm, producing more than 260 million simulations, aiming to develop a predictive model. Results: Postoperative complications were observed in 168 patients. According to the AI analysis, the pre-operative characteristics involved in the insurgence of complications were: ocular comorbidities, lower visual acuity, higher astigmatism and intra-operative complications. Conclusions: Artificial intelligence application may be an interesting tool in the physician’s hands to develop customized algorithms that can, in advance, define the post-operative complication risk. This may help in improving both the quality and the outcomes of the surgery as well as in preventing patient dissatisfaction

Aniridia Associated with Lens Coloboma and Secondary Glaucoma Treated with Transcorneal Argon Laser Ciliary Body Photocoagulation: A Case Report

PURPOSE: The aim of this study is to describe the management of cataract and refractory glaucoma in a case of congenital aniridia (AN)-1. METHODS: In an 18-year-old female patient affected by congenital AN, bilateral coloboma of the zonula and lens, cataract and glaucoma, pars plana vitrectomy, cataract extraction and subsequent transcorneal ciliary body argon laser photocoagulation were performed. RESULTS: Five years after laser treatment, the best-corrected visual acuity was 20/50 and the intraocular pressure was stable at 18 mm Hg with topical pharmacological management consisting of timolol 0.5% and latanoprost 0.005%. CONCLUSIONS: From our experience, transcorneal ciliary body photocoagulation after cataract extraction and vitrectomy could be a useful technique to manage high ocular pressure in eyes affected by congenital AN

Aniridia Associated with Lens Coloboma and Secondary Glaucoma Treated with Transcorneal Argon Laser Ciliary Body Photocoagulation: A Case Report

Purpose: The aim of this study is to describe the management of cataract and refractory glaucoma in a case of congenital aniridia (AN)-1. Methods: In an 18-year-old female patient affected by congenital AN, bilateral coloboma of the zonula and lens, cataract and glaucoma, pars plana vitrectomy, cataract extraction and subsequent transcorneal ciliary body argon laser photocoagulation were performed. Results: Five years after laser treatment, the best-corrected visual acuity was 20/50 and the intraocular pressure was stable at 18 mm Hg with topical pharmacological management consisting of timolol 0.5% and latanoprost 0.005%. Conclusions: From our experience, transcorneal ciliary body photocoagulation after cataract extraction and vitrectomy could be a useful technique to manage high ocular pressure in eyes affected by congenital AN