Intravenous Ferric Carboxymaltose Improves Response to Postoperative Anemia Following Total Knee Arthroplasty: A Prospective Randomized Controlled Trial in Asian Cohort.

Background: Ferric carboxymaltose (FCM) is an intravenous (IV) high-dose iron that is effective in the treatment of iron deficiency anemia. This study was performed to determine whether postoperative FCM infusion is effective at improving hemoglobin (Hb) responders, Hb and iron profiles, and the patient's quality of life (QOL). Methods: A total of 110 patients with postoperative anemia, defined by a Hb < 10 g/dL within 3 days of unilateral primary TKA, between June 2018 and February 2020 were randomized into either the FCM or Control group. On postoperative day 3, the FCM group (55 patients) received IV FCM while the Control group (55 patients) did not. The Hb responders (Hb increase ≥ 2 g/dL compared to baseline), Hb level, iron profiles (ferritin, total iron-binding capacity (TIBC), transferrin saturation (TSAT)), and EQ-5D scores were compared at weeks 2, 4, and 8. Results: The FCM group demonstrated a significantly greater number of Hb responders (p < 0.001) and a higher Hb level (p = 0.008) at 2 weeks postoperative than did the Control group. The FCM group recovered its preoperative Hb level between 4 and 8 weeks. In contrast, the Control group did not recover its preoperative level until 8 weeks. The FCM infusion group also had higher serum ferritin, iron and TSAT, and lower TIBC levels than those of the Control group between 2 and 8 weeks (all p < 0.001). However, there was no significant difference in the postoperative transfusion rate (p = 0.741) or EQ-5D score between the two groups (all p > 0.05). Discussion: In postoperative anemia following TKA, IV FCM increases the Hb response and improves Hb and iron metabolism variables, however, it does not affect the transfusion rate or QOL.

Anterior Synechiolysis with Healon Needle and Ophthalmic Viscosurgical Devices after Anterior Lamellar Dissection in Penetrating Keratoplasty.

PURPOSE: We described a technique to perform anterior synechiolysis with a healon needle and Viscoat® ophthalmic viscosurgical devices (OVDs) through anterior lamellar dissection in penetrating keratoplasty. METHODS: OVDs were gently injected between iridocorneal adhesions with a healon needle to make a blunt dissection after anterior lamellar corneal dissection. Anterior synechiolysis at 360 degrees was completed with a healon needle and OVDs. Subsequently, the deep corneal lamella was cut with right and left Troutman-Katzin corneal scissors. 24 interrupted sutures were made with 10-0 nylon suture to implant the donor cornea. RESULTS: In two eyes from two patients, with corneal opacity and nearly total anterior synechiae, clear grafts and relatively deep anterior chambers were achieved. Penetrating keratoplasty with anterior synechiolysis was thus successful with a healon needle and OVDs through lamellar dissection. CONCLUSIONS: Anterior synechiolysis with a healon needle and OVDs through lamellar dissection is a safe and efficient technique for keratoplasty in patients with corneal opacity with anterior synechiae.

Comparison of treatment with preservative-free versus preserved sodium hyaluronate 0.1% and fluorometholone 0.1% eyedrops after cataract surgery in patients with preexisting dry-eye syndrome.

PURPOSE: To compare treatment with preservative-free and preserved sodium hyaluronate 0.1% and fluorometholone 0.1% eyedrops after cataract surgery in patients with preexisting dry-eye syndrome. SETTING: Bucheon St. Mary's Hospital, Catholic University of Korea, Seoul, Korea. DESIGN: Randomized controlled study. METHODS: Patients with cataract and dry-eye syndrome were randomly divided into 2 groups. Group 1 patients were treated with preservative-free sodium hyaluronate 0.1% and preservative-free fluorometholone 0.1% eyedrops 4 times a day in the first month and twice a day in the second month. Group 2 patients were treated with preserved eyedrops using the same schedule. Ocular Surface Disease Index (OSDI) score, tear-film breakup time (TBUT), Schirmer I test, corneal fluorescein staining, impression cytology, and antioxidant and inflammatory cytokine activities in tears were evaluated. RESULTS: Both groups comprised 40 patients. At 2 months, the OSDI score, TBUT, Schirmer I score, fluorescein staining score, impression cytology findings, and goblet cell count were significantly better in Group 1 than in Group 2 (P<.05). The interleukin-1ß and tumor necrosis factor-α concentrations were significantly less in the tears of Group 1 patients than in the tears of Group 2 patients, and catalase and superoxide dismutase 2 fluorescence intensities were significantly greater in the tears of Group 1 patients than in the tears of Group 2 patients (P<.05). CONCLUSIONS: Preservative-free sodium hyaluronate 0.1% and fluorometholone 0.1% eyedrops can improve the symptoms and signs of dry-eye syndrome after cataract surgery. Preservative-free fluorometholone eyedrops may have antiinflammatory and antioxidant effects in tears of patients with dry-eye syndrome. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.