One-Year Results of Photorefractive Keratectomy for Myopia and Compound Myopic Astigmatism with 210 nm Wavelength All Solid-State Laser for Refractive Surgery.

BACKGROUND: To examine the 12-month clinical and refractive outcomes of PRK performed with a UV all-solid-state laser. METHODS: The study included healthy patients with myopia and/or compound myopic astigmatism enrolled for refractive surgery and treated with PRK using a 210 nm wavelength, 2 kHz repetition rate, UV all-solid-state laser (LaserSoft, Katana Technologies GmbH, Kleinmachnow, Germany). All subjects were examined at baseline and after 1, 3, 6, and 12 months after the treatment with a slit lamp, refraction, visual acuity assessment (logMAR chart), tonometry, ophthalmoscopy, and corneal tomography with a Scheimpflug camera. The outcome measures considered were uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, central corneal thickness, and transparency. The efficacy, safety, predictability, and stability were determined. RESULTS: The study included 34 eyes of 19 patients. The mean UDVA changed from 1.20 ± 0.43 to -0.05 ± 0.10 logMAR at 12 months, and the mean CDVA changed from -0.03 ± 0.06 to -0.06 ± 0.09 logMAR, respectively. The mean spherical equivalent (SE) changed from -4.90 ± 2.12 D to -0.01 ± 0.40 D and was within ±0.50 D of the intended correction in 91% of eyes and within ±1.00 D in 97% of eyes at 12 months. No eyes lost lines of visual acuity, and 64% of eyes gained one or more lines. CONCLUSIONS: PRK with the 210 nm wavelength, 2 kHz repetition rate, all-solid-state laser LaserSoft system proved to have good visual, refractive, and clinical outcomes after the follow-up at 12 months. The emerging gas-free, solid-state technology might be considered a valid alternative for the gas operating lasers for corneal refractive surgery.

Use of Lacrimal Symptoms Questionnaire After Punctoplasty Surgery: Retrospective Data of Technical Strategy.

ABSTRACT: The goal of this study is to evaluate postpunctoplasty symptoms with lacrimal symptoms questionnaire (Lac-Q). A retrospective study was conducted on 31 patients (14 men and 17 woman) with a diagnosis of canalicular stenosis: 26 patients with unilateral occlusion and 5 patients with bilateral occlusion. The Lac-Q was administered preoperative and at 1, at 3, and at 6 months following the surgery. Moreover, the Lac-Q questionnaire was administered by an independent observer (SI). The mono-lateral and bilateral postoperative Lac-Q score showed a significant improvement of symptoms at 1, 3, and 6 months than the preoperative results. The Lac-Q questionnaire is a way to evaluate the quality of outcomes after punctoplasty surgery. In this study, all patients showed a significant improvement of symptoms after surgery.

Corneal nerves in diabetes-The role of the in vivo corneal confocal microscopy of the subbasal nerve plexus in the assessment of peripheral small fiber neuropathy.

The cornea's intense innervation is responsible for corneal trophism and ocular surface hemostasis maintenance. Corneal diabetic neuropathy affects subbasal nerve plexus, with progressive alteration of nerves' morphology and density. The quantitative analysis of nerve fibers can be performed with in vivo corneal confocal microscopy considering the main parameters such as corneal nerve fibers length, corneal nerve fibers density, corneal nerve branching density, tortuosity coefficient, and beadings frequency. As the nerve examination permits the detection of early changes occurring in diabetes, the invivo corneal confocal microscopy becomes, over time, an important tool for diabetic polyneuropathy assessment and follow-up. In this review, we summarize the actual evidence about corneal nerve changes in diabetes and the relationship between the grade of alterations and the duration and severity of the disease. We aim at understanding how diabetes impacts corneal nerves and how it correlates with sensorimotor peripheral polyneuropathy and retinal complications. We also attempt to analyze the safety of the most common surgical procedures such as cataract and refractive surgery in diabetic patients and to highlight the specific risk factors. We believe that information about the corneal nerve fibers' condition obtained from the in vivo subbasal nerve plexus investigation may be crucial in monitoring peripheral small fiber polyneuropathy and that it will help with decision-making in ophthalmic surgery in diabetic patients.

The Application of a Venous Catheter for the Surgical Treatment of Punctal Occlusion.

PURPOSE: Presentation about advantages of a new surgical technique in 20 patients with punctal occlusion with a venous catheter during punctoplasty. METHODS: The arrangement of a 30-mm venous catheter used during puncoplasty surgery was performed in 10 patients with punctal occlusion. The venous catheter was removed after 15 to 45 days after surgery. RESULTS: The use of the venous catheter supports the recanalization of the lacrimal drainage system 15 days after surgery. The venous catheter is easy to find, not expensive, and easy to use. CONCLUSION: The technique is performed under regional anesthesia. Furthermore, after surgery, the recanalization of the lacrimal drainage system was observed with a significant reduction of the epiphora in 6 months after surgery.

Surgical Treatment of Dacryocystitis by Using a Venous Catheter.

PURPOSE: Aim of this work is to highlight the advantages of a new surgical technique performed over 15 patients affected dacryocystitis and treated by using a venous catheter.The arrangement of a 30 mm venous catheter used at the end of a dacryocystectomy (DCT) was performed in 15 patients with dacryocystitis. The venous catheter was removed at 30 days after the surgery.The use of the venous catheter allows washing the lacrimal drainage system, reducing the risk of postoperative infections and supports the recanalization of the lacrimal drainage system 30 days after surgery.The presented cases demonstrated how the technique is easy and it reduces the possibility of the post-operative infection. It could be performed under regional anesthesia. Furthermore, after the surgery the recanalization of the lacrimal drainage system with a significant reduction of the epiphora in 6 months after surgery has been observed.

Scleral pockets for an innovative technique of intrascleral fixation of intraocular lens.

The aim of this article is to report the results of an innovative technique for a scleral fixation of a posterior chamber intraocular lens using our new modified technique. We retrospectively reviewed the medical records of 15 eyes of 15 patients who underwent sutureless intrascleral intraocular lens fixation using our modified technique. We used a 23-gauge knife to perform sclerotomy and create two parallel scleral pockets for the haptics. The mean follow-up period was 3 years (3 ± 1). No complications were detected during the follow-up period. The creation of two parallel scleral pockets, parallel to the limbus, greatly simplifies the introduction of intraocular lens haptics.

The Use of a Venous Catheter as a Stent for Treatment of Acquired Punctal and Canalicular Stenosis.

PURPOSE: The aim of this study was to describe a simple technique to insert a venous catheter as a stent for the treatment of acquired punctal and canalicular stenosis. METHODS: We performed this technique using a central venous catheter as a stent for the treatment of acquired punctal and canalicular stenosis. RESULTS: The results show the easy availability of the material used for the intervention, its easy execution, and the low costs of materials. The goal of this technique is to have a lacrimal dot dilated and canalicular duct easy to irrigate. CONCLUSION: The use of a venous catheter as a stent for treatment of acquired punctal and canalicular stenosis seems to be simple, safe, repeatable, and noninvasive.

The Use of a Double Suture and Conjunctival Cuts in the Lateral Tarsal Strip: A New Approach to Involutional Ectropion.

PURPOSE: To describe the use of a double suture and conjunctival cuts in the lateral tarsal strip (LTS) and to evaluate postsurgical outcome in patients with severe involutional ectropion. METHODS: A prospective randomized study was conducted on 16 eyelids of 8 patients with symptomatic severe involutional ectropion. The 8 patients were between 62 and 79 years. They were distributed into 2 groups consisting of 4 patients each. The control group was treated with a conventional lateral tarsal strip (C-LTS), the second group underwent a modified lateral tarsal strip (M-LTS). The mean follow-up was 18 months. Success was defined as relief in lid laxity. The recurrence rate was also evaluated. RESULTS: Patients treated with M-LTS showed lower horizontal laxity (3.5 ±â€Š0.2) than patients treated with C-LTS (5.7 ±â€Š0.2). During the 18-month follow-up, a statistically significant difference was found between the 2 groups with P value <0.05. CONCLUSIONS: The use of a double suture and conjunctival cuts in the lateral tarsal strip proposed by Meduri showed a reduction of postsurgical ectropion's grade and postsurgical recurrences. This technique could be used for the treatment of patients with a severe ectropion.

Intraguild Interactions of Native and Introduced Coccinellids: The Decline of a Flagship Species.

The decline of Coccinella novemnotata Herbst, the ninespotted lady beetle, across North America has been attributed to the introduction of Coccinella septempunctata L. It has been suggested that C. septempunctata negatively impacted C. novemnotata through a combination of mechanisms. We investigated the effects of scramble competition and intraguild predation between groups of C. septempunctata and C. novemnotata. A novel aspect of these experiments for this species combination was that we provided beetles the option to cannibalize conspecifics or predate on heterospecifics (i.e. intraguild predation); thus, we were able to compare interspecific versus intraspecific competition. Increasing prey density resulted in significantly lower rates of intraguild predation on C. novemnotata by C. septempunctata. Percentage survival of C. novemnotata grouped with C. septempunctata at low and high aphid densities was 6 and 61%, respectively. For our second study, we increased the spatial complexity and volume of the assay system, and provided prey ad libitum. C. novemnotata survival from first-instar to adult was significantly lower than C. septempunctata survival when grouped heterospecifically (43 vs 61% survival, respectively). Finally, we conducted a study to determine if hungry larvae discriminate conspecific versus heterospecific larvae by testing whether they predated selectively on the basis of species, which they did not appear to do. We conclude that C. novemnotata larvae suffer greater rates of intraguild predation from C. septempunctata compared with cannibalism, that this difference appears to be due to size asymmetry between the two species, and that local conditions impact the severity of intraguild predation by C. septempunctata.