RESUMO
PURPOSE: To compare the clinical performance and safety of 2 ophthalmic viscosurgical devices (OVDs)-Twinvisc (OVD 1) and Duovisc (OVD 2)-in cataract surgery. SETTING: European multicenter study. DESIGN: Prospective randomized controlled study. METHODS: Patients with cataract had phacoemulsification and intraocular lens implantation in 1 eye. They were randomly assigned to receive OVD 1 or OVD 2. Preoperative and postoperative examinations over 3 months included mean intraocular pressure (IOP), incidence of IOP peaks (≥30 mm Hg and ≥24 mm Hg), endothelial cell count (ECC), corneal thickness, and intraocular inflammation. A subjective evaluation of the OVDs was performed. RESULTS: The study comprised 220 patients. The incidence of IOP peaks and the mean IOP were not statistically significantly different between the 2 groups at any of the follow-up visits. At 6 hours, the incidence of IOP spikes 30 mm Hg or higher was 6.5% and 7.2% in the OVD 1 and the OVD 2 groups, respectively (P = .846). For the IOP spikes 24 mm Hg or higher, the incidence was 16.8% and 25.2%, respectively (P = .128). Three months postoperatively there was no statistically significant difference in ECC and pachymetry between the 2 groups. Mild inflammation was noticed up to 7 days postoperatively after which it resolved in both groups. Subjectively, the OVD 2 was easier to use, whereas the OVD 1 had better cohesive and dispersive properties. CONCLUSIONS: Both OVDs have similar performance and safety profiles in phacoemulsification cataract surgery. No clinically relevant differences were found between the 2 devices regarding transient IOP spikes, mean IOP, corneal endothelium injury, or inflammation.
Assuntos
Sulfatos de Condroitina/administração & dosagem , Ácido Hialurônico/administração & dosagem , Implante de Lente Intraocular , Facoemulsificação , Viscossuplementos/administração & dosagem , Idoso , Idoso de 80 Anos ou mais , Câmara Anterior/efeitos dos fármacos , Contagem de Células , Sulfatos de Condroitina/efeitos adversos , Paquimetria Corneana , Combinação de Medicamentos , Endotélio Corneano/citologia , Feminino , Humanos , Ácido Hialurônico/efeitos adversos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Tonometria Ocular , Viscossuplementos/efeitos adversosRESUMO
PURPOSE: To analyze and compare the changes in visual function under mesopic and photopic conditions in different stages of keratoconus before and after Keraring intrastromal corneal ring segment (ICRS) implantation. SETTING: Clinico San Carlos Hospital and Faculty of Optics and Optometry, Complutense University, Madrid, Spain. DESIGN: Case series. METHODS: Keratoconic eyes were evaluated under mesopic (0.1 to 0.2 candelas [cd]/m(2)) and photopic (85 cd/m(2)) conditions. LogMAR high-contrast corrected distance visual acuity (CDVA) and low-contrast CDVA were assessed using the Bailey-Lovie test and logarithmic contrast sensitivity, using the Pelli-Robson test. RESULTS: The study evaluated 12 eyes with stage I keratoconus, 21 eyes with stage 2, and 14 eyes with stage 3. The mean change in photopic high-contrast CDVA was 0.16 logMAR ± 0.20 (SD) (P<.00001). Photopic low-contrast CDVA increased by a mean of 0.14 ± 0.26 logMAR (P=.0005), photopic contrast sensitivity by a mean of 0.09 ± 0.22 logMAR (P=.005), and mesopic high-contrast CDVA by a mean of 0.10 ± 0.26 logMAR (P=.03). There were no significant differences between stages. Surgery did not affect the mean changes in mesopic low-contrast CDVA or mesopic contrast sensitivity for any stage. CONCLUSIONS: Implantation of ICRS in keratoconic eyes increased photopic high-contrast CDVA, low-contrast CDVA, and contrast sensitivity. Under low luminance, the mean changes in high-contrast CDVA, low-contrast CDVA, and contrast sensitivity did not worsen after ICRS implantation performed 5.0 mm from the visual axis, despite the rings being partially superimposed on the mydriatic pupil.