RESUMEN
(1) Purpose: The aim was to analyze the outcomes of Descemet's membrane endothelial keratoplasty (DMEK) and Descemet stripping only (DSO) surgeries using a glasses-assisted NGENUITY® 3D visualization system (Alcon Laboratories, Fort Worth, TX, USA). (2) Methods: Five consecutive cases of DMEK surgery and four consecutive cases of DSO were performed using the NGENUITY® system in this prospective study carried out at the Arruzafa Hospital, Córdoba, Spain. Only one eye from each patient received surgery. Best corrected distance visual acuity (CDVA) using EDTRS charts, central corneal thickness using the Casia II optical coherence tomograph (Tomey Co., Nagoya, Japan), and endothelial cell count using the Tomey EM-4000 (Tomey Co., Nagoya, Japan) for DMEK cases or the Nidek CEM-530 (Nidek Co., Ltd., Gamagori, Japan) specular microscopes for DSO cases were recorded preoperatively and at 1 and 3 months postsurgery. (3) Results: DMEK cases included one male and four female subjects, with a mean age of 73.6 ± 9.5 years. Average improvement in CDVA 3 months after surgery was 0.46 ± 0.16 decimal. Average change in cell count between 1 and 3 months postsurgery was 360.75 ± 289.38 cells/mm2. DSO cases included four female subjects, with a mean age of 64.2 ± 9.7 years. The average improvement in CDVA 3 months after surgery was 0.09 ± 0.17 decimal. All cases also had phacoemulsification carried out. He average change in cell count between 1 and 3 months after surgery was 460 ± 515.69 cells/mm2. There were no associated complications during surgery or the follow-up period in any of the cases. (4) Conclusions: In addition to the known benefits of the use of a 3D visualization system during surgery, the present study shows that the system can be successfully used in both DMEK and DSO procedures with a very short learning curve for the surgeon.
RESUMEN
The main objective was to evaluate distance, intermediate, and near vision in patients who have undergone cataract extraction with bilateral implantation of a new trifocal diffractive intraocular lens (IOL), along with patient-reported outcomes (PRO). A total of 50 eyes from 25 patients after AsqelioTM Trifocal IOL (AST Products, Inc., Billerica MA, USA) implantation were assessed in this study. At 3 months after surgery, the photopic visual acuity (VA) at distance, intermediate, and near distances was measured. Binocular photopic defocus curves were also obtained. Three questionnaires to assess patients' visual satisfaction and spectacle dependence, among other items, were completed: the Catquest-9SF, the patient-reported spectacle independence questionnaire (PRSIQ), and the patient-reported visual symptoms questionnaire (PRVSQ). The average spherical equivalent was 0.21 ± 0.37 D at 3 months post-operation, and the average absolute tolerance to defocus was 3.64 ± 0.70 D. The mean binocular uncorrected VAs for distance, intermediate, and near vision were -0.02 ± 0.09, 0.06 ± 0.08, and 0.11 ± 0.07 logMAR, respectively. The best-corrected VA was better than 0.1 logMAR for the whole range from distance to near. PROs revealed spectacle independence and general satisfaction with vision, and the incidence of photic phenomena were low. This study shows that the new bi-aspheric diffractive trifocal IOL provides a good visual performance at different distances under photopic conditions, accompanied by patient satisfaction and spectacle independence.
RESUMEN
PURPOSE: To create a nomogram including the translational speed of the microkeratome blade, microkeratome head size and precut tissue thickness to predict the postcut thickness for Descemet stripping automated endothelial keratoplasty to obtain the thinnest possible graft. METHODS: This prospective study incorporated 48 grafts for DSAEK from March 2017 to June 2020. Corneal tissue for DSAEK was prepared by 3 experienced physicians using the Moria Evolution 3E (Moria Inc, Antony, France) microkeratome with 400, 450 and 500 µm head sizes. Precut central corneal thickness was measured with a DGH 550 handheld pachymeter (Pachette 2), taking an average of 3 readings. The microkeratome head was selected according to precut tissue thickness. The selected microkeratome head size was 150 µm less than the donor cornea thickness. Two translational speeds were used for the microkeratome cuts. One month after surgery, the central lenticular thickness was measured with a Visante® Optical Coherence Tomography caliper (Carl Zeiss Meditec Inc, Germany). A descriptive analysis was performed. RESULTS: Forty-eight donor grafts were prepared. Mean graft thickness was 97.58 ± 29.84 µm (range 39-176 µm). Of the 48 samples, central graft thickness was < 120 µm (81.3%) in 39, < 100 µm (58.3%) in 28 and < 80 µm (37.5%) in 18 at 1-month follow-up. There were no statically significant differences between translational speeds. CONCLUSIONS: A nomogram with an automated microkeratome to obtain thin grafts for DSAEK provided good graft thickness results without donor waste.
