Observational study of intraocular lens tilt in sutureless intrascleral fixation versus standard transscleral suture fixation determined by ultrasound biomicroscopy.

BACKGROUND: The position of the intraocular lens (IOL) is a major factor that affects the final visual acuity after cataract surgery. However, no prospective study has compared the IOL positions associated with the sutureless intrascleral technique and the standard transscleral suturing technique. The current study compared the IOL positions in the two techniques using ultrasound biomicroscopy (UBM) in vivo. METHODS: Twenty-one eyes of 21 patients were included in this observational study conducted between February and May 2015. Eleven patients underwent the sutureless intrascleral technique, and 10 patients underwent transscleral fixation with suturing. Ophthalmologic examination and UBM were performed in all patients. Optic tilt was measured in relation to the iris plane. The haptic location was defined. Mann-Whitney test and multiple linear regression were used to analyze the vertical and horizontal gradients. Significant differences were considered when p ≤ 0.05. RESULTS: The most common indication for scleral fixation was a complication during phacoemulsification (81.81% in the sutureless group and 60% in the suture group). The mean vertical and horizontal tilts were, respectively, 0.24 ± 0.21 and 0.25 ± 0.19 mm in the sutureless group and 0.14 ± 0.17 and 0.23 ± 0.16 mm in the suture group. No significant differences were seen in the vertical tilt and horizontal tilt (p = 0.888 and p = 0.148, respectively) between the groups. Gender (p = 0.835), age (p = 0.888), follow-up time (p = 0.915), and surgical duration (p = 0.094) were not associated with optic tilt. Of the 22 haptics in the sutureless group, 21 (95.45%) were in the intrascleral tunnel; of the 20 haptics in the suture group, 13 (65%) were posterior to the ciliary body, four (20%) anterior to the ciliary body, and three (15%) in the ciliary sulcus. CONCLUSION: This study showed that there are no significant differences in the IOL positions between the two techniques.

Choroidal thickness using EDI-OCT in adult-onset vitelliform macular dystrophy.

BACKGROUND: To compare choroidal thickness in patients with adult-onset foveomacular vitelliform dystrophy (AOFVD) with healthy subjects and to correlate choroidal thickness with age, gender and spherical equivalent. METHODS: A prospective, observational study of 37 eyes (15 eyes in AOFVD group and 22 eyes in control group) was conducted. Images were acquired by enhanced depth imaging optical coherence tomography (EDI-OCT). Choroidal thickness measurements were performed in the subfoveal region and at 500, 1000 and 1500 µm intervals from the foveal center to nasal and to temporal regions for subsequent averaging of values. RESULTS: The AOFVD group consisted of four male eyes (28.6 %) and 10 female eyes (71.4 %); age was 33-62 years; spherical equivalent (SE) ranged from -1.50 to 1.50 spherical diopters (SD); mean subfoveal thickness was 325.6 µm, ranging from 186 to 420 µm; and the average of thicknesses was 309.4 µm, ranging from 188 to 413 µm. The control group consisted of 12 male eyes (54.5 %) and 10 female eyes (45.5 %); age was 27-62 years; SE ranged from -2.50 to 0.50 SD; subfoveal thickness was 294.8 µm, ranging from 213 to 481 µm; and the average of thicknesses was 279.4 µm, ranging from 201 to 458 µm. CONCLUSIONS: The AOFVD group and the control group showed similar choroidal thickness by correcting for age, SE and gender. Not yet known, completely, which biochemical and vascular flow alterations of the choroid, and which functional RPE changes may play a role in the pathogenesis of this disease. EDI-OCT, incorporated in some SD-OCT devices, allows higher quality assessment of the choroid. In this article, choroidal thickness of patients with AOFVD, a rare disease with a not fully understood pathogenesis, was assessed.

Antibacterial analysis in vitro of ethyl-cyanoacrylate against ocular pathogens.

PURPOSE: To analyze the antimicrobial properties of ethyl-cyanoacrylate (Superbonder, Loctite, Brazil) in vitro in different microorganisms related to corneal infections. METHODS: We analyzed the following microorganisms: (1) Staphylococcus aureus (multiresistant); (2) S. aureus (ATCC 25923); (3) coagulase-negative Staphylococcus; (4) Streptococcus pyogenes; (5) Streptococcus pneumoniae; (6) Pseudomonas aeruginosa (multiresistant); (7) P. aeruginosa (ATCC 27853); (8) Escherichia coli (ATCC25922); and (9) Enterococcus faecalis (ATCC 29212). One drop of the glue was dropped directly into the nutrient broth. The plates were incubated at 35 +/- 2 degrees C and its growth examined after 24 hours. Bactericidal activity of the glue was verified by sampling inhibition zones when present. The samples were plated in blood agar an analyzed after 24 and 48 hours. RESULTS: The ethyl-cyanoacrylate inhibited the growth of every gram-positive microorganism tested and showed bactericidal effect over 70% for all of them. Among the gram-negative microorganisms, only the E. coli and the E. faecalis had its growth inhibited, and the bactericidal effect was 60% and 40%, respectively. CONCLUSION: The ethyl-cyanoacrylate has bacteriostatic and bactericidal action in vitro, mainly against gram-positive microorganisms.