A novel index for predicting macular thickening after cataract surgery.

PURPOSE: In this study, we tried to investigate weather or not the preoperative anterior chamber depth, the lens thickness (LT) and the relation between these variables by the ratio (K) of the distance from the corneal peak to the posterior side of the lens (A) (K = A/LT) could be predictive for a surgically induced foveal thickening following uneventful cataract surgery in normal, emmetropic eyes. PATIENTS AND METHODS: A total amount of 45 eyes, 25 females and 20 males, were enrolled in this study and underwent uncomplicated phacoemulsification under topical anesthesia. A complete ophthalmological examination was performed preoperatively, including refraction, best corrected visual acuity, slit-lamp examination, biometry and optical coherence tomography of both eyes. These examinations, with the exception of the biometric examination, were repeated one day, one week and four weeks after surgery. RESULTS: The K ratio was positively correlated with the macular thickness changes after cataract surgery. The Pearson correlation analysis of K ratio and foveal thickness changes was 0.792 (y = 36.457x - 52.558, R2 = 0.6266). CONCLUSIONS: A novel ratio that incorporates preoperative ocular parameters has been described. It could be easily measured in a clinical setting, and appears to be strongly predictive for macular thickening following cataract surgery. Of course, further studies enrolling a larger amount of patients are necessary in order to confirm these preliminary data.

Changes in vital signs during cataract phacoemulsification by using peribulbar or topical anesthesia.

AIMS: To compare changes in vital signs and pain level experienced by patients during phacoemulsification and foldable intraocular lens (IOL) implantation using either topical/intracameral or peribulbar anesthesia. MATERIALS AND METHODS: In this prospective, parallel-group clinical study 46 consecutive patients (mean age 72.9 +/- 8.1 years) undergoing cataract surgery were randomized to receive topical/intracameral (group1) or peribulbar (group 2) anesthesia. Systolic, diastolic and mean blood pressures, hearth rate, oxygen saturation and pain level were recorded before and during the anesthesiological procedure and thereafter during each surgical step. RESULTS: Diastolic blood pressure during phacoemulsification and after surgery as well as mean arterial pressure after surgery were significantly higher in group 1 compared to group 2. Variability of systolic and mean arterial pressures across the study phases was significantly higher in group 2 compared to group 1. A significantly higher percentage of patients in group 2 compared to group 1 (35.3% vs 3.4%, p=0.007) showed a heart rate reduction greater than 10% from the anesthesiological to the following surgical phase. Higher incidence of moderate pain in group 2 was reported during the anesthesiological procedure (64.7% vs 3.4%, p<0.00001) while higher incidence of moderate pain was reported in group 1 during phacoemulsification (31% vs 5.9%, p=0.047) and IOL implantation (21.7% vs 2.2%, p=0.02). DISCUSSION: Our short study seems to recommend the use of topical/ intracameral anesthesia for cataract surgery due to more stable heart rate, diastolic and mean blood pressures. However, further studies enrolling a higher amount of patients are necessary to confirm our preliminary data.

Reliability of the IOLMaster in axial length evaluation in silicone oil-filled eyes.

PURPOSE: To assess the reliability of IOLMaster in axial length (AL) measurement in phakic silicone oil-filled vs pseudophakic saline-filled eyes. METHODS: Ten eyes of 10 patients, vitrectomized with silicone oil tamponade and scleral buckled with significant lens opacity were enrolled. Optical biometry with IOLMaster (Carl Zeiss Meditec AG, Germany) was performed 1 day before and 1 week after silicone oil removal and phacoemulsification with artificial intraocular lens (IOL) implantation in order to assess changes in AL measurements. RESULTS: Mean AL was 26.16+/-1.23 mm (range 24.64-28.8 mm) and 26.27+/-1.46 mm (range 25.26-29.6 mm), respectively, the day before and 1 week after silicone oil removal and cataract surgery, and the difference was not statistically significant (P=0.2). CONCLUSIONS: Presence vs absence of silicone oil tamponade as well as phakic vs pseudophakic status in buckled and vitrectomized eyes did not influence the AL measurement by means of no-contact optical biometry, suggesting that such eyes might be candidate for silicone oil removal and cataract surgery at one time.

[Use of cholinesterase inhibitors in Alzheimer disease]. / Impiego degli inibitori della colinesterasi nella malattia di Alzheimer.

According to the cholinergic theory of Alzheimer's disease, the cognitive failure depends on a deficit in acetylcholine. The study reported above examines the efficacy and tolerability of cholinesterase inhibitors, such as tetrahydroamino acridine (THA), for the management of this pathology.

[The use of interferon-beta in the treatment of essential mixed cryoglobulinemia]. / Impiego dell'interferone beta nel trattamento della crioglobulinemia mista essenziale.

The authors report two cases of essential mixed cryoglobulinemia (EMC) manifested by purpura, fatigue and arthralgia. After a corticosteroid treatment which proved a complete failure, beta-interferon therapy was started. This caused rapid improvement of the clinical picture without relevant side effects.

[A case of beriberi on the threshold of the year 2000]. / Un caso di Beri-beri alle soglie del 2000.

The authors report a case of beriberi due to a deficit in thiamine, which became apparent in a young Chinese woman with polyneuropathy, distal oedema and epigastralgia. Parenteral administration of thiamine lead to the virtually complete resolution of symptoms.