Use of a new ocular insert versus conventional mydriasis in cataract surgery.

BACKGROUND: To compare the efficacy and safety of a new ocular insert versus conventional mydriasis in cataract surgery. METHODS: We selected 70 patients undergoing cataract surgery. Thirty five patients (Group 1) received instillation of mydriatic drops (tropicamide 1%, phenylephrine 10%, and cyclopentolate 1%) prior to surgery, and 35 patients (Group 2) had a Mydriasert insert (Théa Pharma) (0.28 mg of tropicamide and 5.4 mg of phenylephrine hydrochloride) placed in the inferior fornix. Pupil size before and after surgery, blood pressure, and heart rate were measured. RESULTS: Before surgery, pupil diameter was 9.44 ± 1.17 mm in Group 1 and 9.05 ± 1.54 in Group 2 (P > 0.05). Twenty four hours after surgery, pupil diameter was 5.20 ± 1.54 mm in Group 1 and 3.33 ± 1.15 in Group 2 (P < 0.001). There were no statistically significant differences in blood pressure or heart rate between groups. CONCLUSIONS: The effect of the Mydriasert insert was similar to conventional mydriatic agents. Pupil size was restored to normal faster when using the Mydriasert insert compared with conventional mydriatic agents for pupil dilation.

Agudeza visual a largo plazo en pacientes con degeneración macular asociada a la edad tratados con ranibizumab y persistencia de fluido subretiniano / Long-term visual acuity in patients with age-related macular degeneration and persistence of subretinal fluid after treatment with ranibizumab

Objetivo: Analizar la agudeza visual (AV) a largo plazo en pacientes con DMAE tratados con ranibizumab con persistencia de líquido subretiniano después del tratamiento de inducción y/o en los controles sucesivos. Método: Hemos revisado las historias clínicas, tomografías de coherencia óptica (OCT) y angiografías fluoresceínicas de los 216 pacientes tratados con ranibizumab entre enero de 2008 y abril del 2010, seleccionando aquellos que han presentado fluido subretiniano de forma persistente o recurrente a lo largo del seguimiento mínimo de un año. Resultados: Hemos incluido 36 ojos de 34 pacientes; 19 ojos (52,7%) presentaban persistencia y 17 (47,2%) recurrencia de fluido subretiniano a lo largo del seguimiento (media 29,06±9,28 meses).nLa media de inyecciones fue de 7,89 ± 3,2. El espesor macular central (EMC) inicial fue de 330 ± 84μm, a los 3 meses de 265,2 ± 62microm y de 294,5 ± 37μm al final del seguimiento. La AV media inicial fue de 0,3±0,2, a los 3 meses 0,43±0,2 (p<0,05) y al final del seguimiento de 0,41±0,22 (p<0,05). La aparición de hemorragias en las recurrencias se asoció con peor visión final en comparación con los que no las presentaron (p=0,004). Al final del seguimiento18 ojos (50%) continúan en tratamiento con ranibizumab, 16 ojos (44%) se mantienen en observación y 2 pacientes han fallecido. No existen diferencias entre AV y EMC entre ambos grupos. Conclusión: La persistencia o recurrencia de fluido macular subretiniano en pacientes tratados con ranibizumab no disminuye significativamente la ganancia visual obtenida después del tratamiento de inducción, a pesar de la interrupción del mismo durante el seguimiento. La aparición de hemorragias en las recurrencias se asoció con peor AV final(AU)

Objective: To analyse the long-term visual acuity (VA) in patients with age-related macular degeneration (ARMD) treated with ranibizumab, and who had persistent subretinal fluid after the induction therapy and/or in the successive controls. Materials and methods: We reviewed the medical records, optical coherence tomography (OCT) and fluorescein angiograms of 216 patients treated with ranibizumab between January 2008 and April 2010, selecting those who had persistent subretinal fluid or recurrent fluid for at least one year of follow-up. Results: A total of 36 eyes from 34 patients were included, with 19 eyes (52.7%) having persistent, and 17 (47.2%) recurrent subretinal fluid throughout the follow- up (mean 29.06±9.28 months). The average number of injections was 7.89±3.2. The central macular thickness (CMT) at the start of follow-up was 330±84μm, at 3 months 265.2±62micrem, and 294.5±37μm at the end of the follow-up. The initial mean VA was 0.3±0.2, at 3 months 0.43±0.2 (P<.05) and at the final review, 0.41±0.22 (P<.05). Haemorrhages in recurrences were associated with a worse final VA (P=.004). At the end of follow-up, 18 eyes (50%) continued with ranibizumab treatment, 16 eyes (44%) were kept under observation, and 2 patients died. There were no differences between VA and CMT between the groups. Conclusions: The persistence or recurrence of macular subretinal fluid in patients treated with ranibizumab does not significantly reduce the visual gain obtained after induction therapy, despite discontinuation of treatment during follow-up. Haemorrhages in the recurrences were associated with a worse final VA(AU)

[Long-term visual acuity in patients with age-related macular degeneration and persistence of subretinal fluid after treatment with ranibizumab]. / Agudeza visual a largo plazo en pacientes con degeneración macular asociada a la edad tratados con ranibizumab y persistencia de fluido subretiniano.

OBJECTIVE: To analyse the long-term visual acuity (VA) in patients with age-related macular degeneration (ARMD) treated with ranibizumab, and who had persistent subretinal fluid after the induction therapy and/or in the successive controls. MATERIALS AND METHODS: We reviewed the medical records, optical coherence tomography (OCT) and fluorescein angiograms of 216 patients treated with ranibizumab between January 2008 and April 2010, selecting those who had persistent subretinal fluid or recurrent fluid for at least one year of follow-up. RESULTS: A total of 36 eyes from 34 patients were included, with 19 eyes (52.7%) having persistent, and 17 (47.2%) recurrent subretinal fluid throughout the follow- up (mean 29.06±9.28 months). The average number of injections was 7.89±3.2. The central macular thickness (CMT) at the start of follow-up was 330±84µm, at 3 months 265.2±62µm, and 294.5±37µm at the end of the follow-up. The initial mean VA was 0.3±0.2, at 3 months 0.43±0.2 (P<.05) and at the final review, 0.41±0.22 (P<.05). Haemorrhages in recurrences were associated with a worse final VA (P=.004). At the end of follow-up, 18 eyes (50%) continued with ranibizumab treatment, 16 eyes (44%) were kept under observation, and 2 patients died. There were no differences between VA and CMT between the groups. CONCLUSIONS: The persistence or recurrence of macular subretinal fluid in patients treated with ranibizumab does not significantly reduce the visual gain obtained after induction therapy, despite discontinuation of treatment during follow-up. Haemorrhages in the recurrences were associated with a worse final VA.

Long term follow-up of the argon laser trabeculoplasty in eyes treated 180 degrees and 360 degrees of the trabeculum.

The results obtained with the Argon Laser Trabeculoplasty (ALT) on 196 eyes with an average follow-up period of 5.24 years (maximum 9 years) have been reviewed. Of the 123 eyes treated with 75-115 burns in the 360 degrees of the trabecular meshwork, 71 eyes were successful with a follow-up of 64.3 +/- 28.3 months (mean +/- SD). This treatment reduced the previous anti-glaucomatous medical treatment in 35 eyes (28.5%). The remaining 73 eyes were treated with 40-60 burns in 180 degrees of the trabeculum, 38.4% (28 eyes) were successful therapeutically with a follow-up of 56.5 +/- 23.1 months. The treatment reduced the additional medical treatment in 9 eyes (12.3%). The comparison of these results and the survival curves of both groups showed statistically significant differences in favour of the treatment on 360 degrees of the trabeculum.