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BACKGROUND: This study aims to assess the effectiveness of the preoperative flash visual evoked potential (VEP) test in predicting postoperative visual acuity for monocular mature cataract cases when compared to the contralateral normal eye. METHODS: The study included 60 patients, each with a monocular mature cataract diagnosis, who underwent preoperative flash VEP testing showing no pattern VEP response. Subsequently, phacoemulsification was performed. The relationship between the flash VEP test latency values (P1, N2, P2) and amplitude value (N2-P2), and the degree of visual acuity recovery 3 months post-cataract surgery, was evaluated using the LogMAR scale. Furthermore, a linear regression analysis was conducted to explore the connection between preoperative flash VEP components and postoperative visual acuity. RESULTS: The average age of the patients was 65.4 ± 13.6 years, with a range of 43 to 87 years. The study included 36 males and 24 females. A significant disparity in visual acuity was observed between the preoperative and 3-month postoperative stages (p < 0.001). The preoperative flash VEP test for mature cataracts revealed significant delays in P1, N2, and P2 latency, as well as a reduction in N2-P2 amplitude potential when compared to the contralateral normal eye (p < 0.001). Notably, delayed P2 latency and reduced N2-P2 amplitude potential were particularly indicative of poor visual acuity prognosis after cataract surgery in the multiple regression analysis (p < 0.05). The N2-P2 amplitude potential was the important value that exhibited statistically significant results, with an area under the curve (AUC) of 80% sensitivity and 88% specificity, using a cutoff value of 6.07 µV. CONCLUSIONS: In cases of monocular mature cataract, a reduction in N2-P2 amplitude potential compared to the contralateral normal eye emerged as the most reliable predictor of postoperative visual prognosis following cataract surgery.
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OBJECTIVE: To compare the incidence of cystoid macular edema (CME) after vitrectomy and CME after phacovitrectomy in patients requiring epiretinal membrane (ERM) removal. DESIGN: A retrospective, comparative, interventional study. METHODS: Medical records of patients who had undergone vitrectomy or phacovitrectomy for ERM removal by a single surgeon were retrospectively reviewed. Phacovitrectomy was performed in all phakic eyes and vitrectomy was performed in all pseudophakic eyes. Increased macular thickness (IMT) was defined as an increase in macular thickness by more than 10% at the postoperative week 4 visit compared to the measurements at baseline. RESULTS: There were 214 and 53 eyes in the Phacovitrectomy group and the Vitrectomy group, respectively. IMT occurred in 15.4% of the Phacovitrectomy group, which was higher than the incidence of 3.8% in the Vitrectomy group (p=0.023). CONCLUSIONS: IMT, that is suspected to be a type of CME, was not uncommon (15.4%) after phacovitrectomy in phakic eyes but was uncommon (4.8%) after vitrectomy alone in pseudophakic eyes. Irvine-Gass syndrome appears to be triggered by crystalline lens removal itself rather than intraocular surgery or surgical trauma alone.
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AIM: To evaluate the pathogens in cultured Jones tubes used in lacrimal bypass surgery according to the postoperative periods and to obtain data for the prevention of infection of functional lacrimal stent invention. METHODS: Totally 71 patients (81 eyes) who underwent the removal of Jones tubes were enrolled in study. All the removed Jones tubes were cultured for bacterial and fungal identification and tested for bacterial antibiotic sensitivity. The results were analyzed according to the duration of the inserted Jones tube after lacrimal bypass surgery. RESULTS: Of the 81 eyes, bacteria were isolated from 69 eyes (85.2%) and fungi from 6 eyes (7.4%). Among 69 eyes, 40.6% showed Staphylococcus aureus (S. aureus), 11.6% were Pseudomonas aeruginosa (P. aeruginosa). Gram-positive bacteria were isolated more than Gram-negative bacteria, but Gram-negative bacteria showed a higher incidence in the Jones tube implanted for over 10y (P=0.035). The antibiotic sensitivity test showed that 46.4% of S. aureus were resistant to oxacillin. In terms of antibiotics commonly used in ocular clinical practice, vancomycin was sensitive to S. aureus and Streptococcus pneumoniae (S. pneumoniae), amikacin responded to P. aeruginosa and Proteus mirabilis (P. mirabilis). Trimethoprim/sulfamethoxazole (TMP/SMX) was all sensitive to S. aureus, S. pneumoniae and P. mirabilis except P. aeruginosa. CONCLUSION: S. aureus is the most commonly found organism in the Jones tube after lacrimal bypass surgery, and 46.4% of them are methicillin-resistant S. aureus (MRSA), sensitive to vancomycin. Especially, P. mirabilis responded with amikacin is dominantly detected in the Jones tubes implanted for more than 10y.