[SPECULAR MICROSCOPY NORMATIVE DATA: DOES PATIENT AGE HAVE AN IMPACT ON CORNEAL ENDOTHELIUM FEATURES IN ELDERLY EYES?].

INTRODUCTION: Corneal endothelium is essential for adequate corneal hydration and transparency. Age and ethnicity- related variability in endothelial properties is known. OBJECTIVES: To determine specular microscopy trends in the elderly and to provide normative data of endothelial features of the sampled cohort of the Israeli population aged 55-88 years. METHODS: This is a retrospective cross-sectional study analyzing specular microscopy data of the Israeli population aged 55-88 years and the determination of correlation of age to specular microscopy features. A comparison of endothelial properties was conducted between age-based groups: 55-64 years, 65-74 years, and 75-88 years. RESULTS: One hundred and eighty eight eyes of 188 patients, mean age 71.05 ± 7.9 years, were included; Mean Cell Density 2549.53 ± 294.71 cells/mm²; Coefficient of variation (CV) 42.12 ± 6.9%; Hexagonality (Hexa) 49.15 ± 6.62%; Central Corneal thickness (CCT) 552 ± 47 µm. A weak correlation was observed between cell density and age [r = -0.169; p = 0.02); CV, Hexa, and CCT did not show any correlation with age. Group analysis did not reveal statistically significant differences between the following age groups: 55-64 years; 65-74 years; 75-88 years CONCLUSIONS: Normative data of endothelial properties of the sampled cohort of Israeli population aged 55-88 years is provided. Age has a weak correlation with cell density. DISCUSSION AND SUMMARY: Considering the aging of the population, endothelial properties do not justify the rejection of potential donors based on age alone.

New approach for pterygium removal using 20 % ethanol.

The aim of this study is to present a new method for pterygium removal using ethanol 20 % solution, applied to a retrospective consecutive case series conducted in the Department of Ophthalmology, Soroka University Medical Center, Beer-Sheva, Israel. The technique adopted the following procedure. After subconjunctival bupivacaine hydrochloride 0.5 % injection, a metal ring well, as used in laser-assisted subepithelial keratectomy, was placed above the head of the pterygium. A few drops of ethanol 20 % were applied inside the well and maintained in place for 40 s. The ethanol was then washed with Balanced Salt Solution. Pterygium was easily separated starting at 2 mm central to the head using a spatula. The apex was excised with further separation of the fibrovascular tissue towards the base. The base was excised and mitomycin C 0.02 % applied for 2.5 min. The ocular surface was profusely washed leaving the bare sclera. Records were reviewed of all the patients who underwent pterygium removal with ethanol between May 2006 and March 2007. The results showed that 68 eyes from 64 patients were operated on. There were no intraoperative complications. During follow-up periods of at least 12 months, no serious side effects were detected and only two cases (2.9 %) of recurrence were observed. The results obtained show that the Pterygium removal using alcohol 20 % solution is a simple procedure, creates a clear separation plane between the pterygium and the underlying cornea, and is a safe procedure.

Intravitreal bevacizumab (avastin) for subfoveal neovascular age-related macular degeneration.

OBJECTIVE: To report the visual and anatomic outcome of intravitreal bevacizumab (Avastin) injections in the treatment of subfoveal neovascular age-related macular degeneration (AMD). METHODS: Interventional, consecutive, retrospective case series. Sixty-five eyes of 65 patients with subfoveal neovascular age-related macular degeneration (AMD) received three intravitreal bevacizumab (1.25 mg) injections. Outcome measures included visual acuity (VA), central retinal thickness (CRT), and size of lesion at 24 or more weeks follow-up. RESULTS: Thirty-five eyes had prior treatment with photodynamic therapy (PDT). At presentation, VA was 1.12 +/- 0.62 logMAR, CRT was 305 +/- 115 microm, and greatest linear diameter (GLD) of the lesion was 4,902 +/- 1,861 microm. There was no statistically significant difference between previous PDT and naïve eyes in VA, CRT, and GLD at presentation. After three bevacizumab injections, VA, CRT, and GLD significantly improved (P < 0.0001 in all groups). There was no statistically significant difference between CRT and GLD outcomes and subfoveal neovascular membrane type or age. Eyes with better VA at baseline and without previous PDT treatment achieved better final VA (P < 0.0001 and P = 0.045, respectively). A classic membrane type and lower age were somewhat associated with better post-treatment VA. CONCLUSIONS: Short-term results suggest that intravitreal bevacizumab is well tolerated and associated with improvement in VA, decreased CRT, and decreased lesion size in most patients. The most important predictors of final VA outcomes were baseline VA and no previous PDT treatment. Further evaluation of intravitreal bevacizumab for the treatment of subfoveal neovascular AMD is warranted.