[Comparison of the effectiveness of two different pharmacologic approaches to prevent intraoperative floppy iris syndrome]. / Comparación de la efectividad de dos estrategias farmacológicas para la prevención del síndrome de iris flácido intraquirúrgico.

OBJECTIVE: To compare the effectiveness of two strategies to prevent the appearance of intraoperative floppy iris syndrome (IFIS) in patients exposed to a-blockers. METHODS: We compared retrospectively the presence and severity of the appearance of IFIS in 29 patients subjected to cataract surgery, establishing two groups of 12 patients (22 eyes) and 17 patients (33 eyes). The strategy applied to group one consisted of suspending the exposure to a-blockers for at least one week prior to the intervention, the topical application of 1% atropine three times a day for two days before the intervention and the use of intracameral lidocaine. The strategy for group two consisted of suspending use of the drug for at least one week before the intervention and the intracameral application at the beginning of surgery of a solution of physiological serum, adrenaline and lidocaine. RESULTS: Six patients from group one showed no evidence of IFIS, 2 exhibited bilateral mild symptoms, 2 bilateral moderate and 2 unilateral severe symptoms of IFIS. In total, 45.5% eyes suffered from IFIS. In group two, only 3 eyes (9.1%) from 2 patients exhibited mild symptoms. Statistical analysis showed a significant difference between both groups (p=0.002). If only those exhibiting moderate and severe symptoms are taken into account the result was highly statistically significant (p=0.0002). CONCLUSION: The study shows a greater statistical effectiveness of the strategy applied to group two compared to the strategy applied to group one (Arch Soc Esp Oftalmol 2009; 84: 549-556).

[Intraocular lens power calculation in complicated cases: the "Silguero"method]. / Cálculo de lente intraocular en casos complicados: el método "Silguero".

PURPOSE: To report a new method for intraocular lens (IOL) calculation in patients treated by corneal refractive surgery, in whom the application of other methods is not possible because of the absence of necessary data. This method is also applicable in other situations where the IOL calculation is difficult and in cases of IOL exchange because of unexpected refractive difficulties. METHODS: We performed phaco-emulsifications, refracting the patient's eye before IOL implantation, using the refraction data in aphakia as the only variable for the application of the formula, which itself is based on the existing correlation between the graduation of glasses (12 mm) and the IOL power at the lens level. The formula has been applied in 3 patients in whom no other calculation method was applicable. RESULTS: After the appropriate intervention, the 3 patients presented a spherical equivalent below 1 diopter. CONCLUSION: We believe this formula is valid in some situations where other formulas cannot be applied because of the absence of the necessary variables.

[Repair of Descemet's membrane detachment after cataract surgery]. / Reparación del desprendimiento de membrana de Descemet tras cirugía de cataratas.

PURPOSE/METHODS: We present two cases of Descemet's membrane detachment, the first one after extracapsular cataract extraction with scleral tunnel incision and the other after clear corneal incision used for phacoemulsification cataract extraction. These two cases were treated with intracameral injection of 20% sulfur hexafluoride gas (SF(6)). RESULTS/CONCLUSIONS: Both cases responded satisfactorily to treatment. After four months of follow-up, the corneas remain clear with a visual acuity of 0.9 and 0.8, respectively. The relative facility of the 20% sulfur hexafluoride gas (SF(6)) technique, its safety, and good prognosis, makes it the treatment of choice in this disease.