Scleral fixation using a hydrophilic four-haptic lens and polytetrafluoroethylene suture.

To assess the safety of scleral fixation using the Akreos AO60 intraocular lens (IOL) and Gore-Tex suture. Prospective evaluation of 20 patients who underwent scleral fixation of an Akreos AO60 with Gore-Tex. Patients presenting with aphakia or dislocated IOL without capsular support were enrolled in the study. Main outcome measures included visual acuity, endothelial cell density, and postoperative complications over 6 months of follow-up. Mean ± standard deviation (SD) uncorrected logMAR visual acuity improved from 1.92 ± 0.23 (20/1600 Snellen equivalent) preoperatively to 0.80 ± 0.56 (20/125) at 6 months postoperatively (p < 0.001). Mean ± SD best-corrected visual acuity (BCVA) logMAR was 0.43 ± 0.23 preoperatively and 0.37 ± 0.24 (20/50) at 3-6 months postoperatively (p = 0.312). The mean ± SD endothelial cell density was 1740.50 ± 522.92 cells/mm2 and 1187.19 ± 493.00 cells/mm2 (p < 0.001) pre and postoperatively, respectively. Mean ± SD postoperative spherical equivalent was - 1.12 ± 1.50D. Postoperative complications included exposure of suture in 40% of the patients, hypotony in 15%, ocular hypertension in 10%, transient vitreous hemorrhage in 10%, retinal detachment in 5%, and transient lens opacification in 5%. Scleral fixation with an Akreos AO60 and Gore-Tex appears generally safe. However, given the high incidence of suture erosion observed, the use of scleral flaps or rotating and burying the knots is recommended in order to reduce the risk of this complication.

Microperimetry differences in macular sensitivity threshold between first and second tested eyes / Diferenças no limiar de sensibilidade macular na microperimetria entre o primeiro e o segundo olhos testados

ABSTRACT Purpose: To comparatively assess the macular sensitivity threshold of microperimetry and the fixation stability between the first (right) and second (left) tested eye of normal participants. Methods: Thirty healthy patients were randomly assigned to two groups. The participants underwent microperimetry in the fast mode and expert mode in groups I and II, respectively. Each participant underwent a single test and the right eye was tested first. Results: The mean macular sensitivity threshold (± standard deviation [SD]) was 24.5 ± 2.3 dB and 25.7 ± 1.1 dB in the first (right) and second (left) eyes of group I, respectively (p=0.0415) and 26.7 ± 4.5 dB and 27.3 ± 4.0 dB in the first (right) and second (left) eyes of group II, respectively (p=0.58). There was no statistically significant difference between eyes in either group (p=0.1512). Regarding fixation stability (evaluated in the microperimetry expert mode group), the mean ± SD percentage of fixation points within the 1-degree central macula (P1) was 87.9 ± 11.5% in the right eye and 93.8 ± 6.6% in the left eye. The paired t-test did not show a statistically significant difference between eyes (p=0.140). Mean ± SD P2 value was 95.5 ± 4.9% in the right eye and 98.5 ± 2.1% in the left eye. The analysis demonstrated an increase in the percentage of fixation points in the second tested eye compared with the first one (paired t-test= 2.364; p=0.034). There was a negative correlation between the macular sensitivity threshold of the right eye and the duration of the examination for both groups (microperimetry expert mode: r=-0.717; p=0.0026; microperimetry in the fast mode: r=-0.843; p<0.0001). Conclusion: Mean macular sensitivity threshold was higher in the second tested eye in the microperimetry in the fast mode group and was similar in both eyes in the expert mode. Our data suggest that comprehension of the examination by the individual may impact the results of the microperimetry test.(AU)

RESUMO Objetivo: Avaliar comparativamente o limiar de sensibilidade macular da microperimetria e a estabilidade de fixação entre o primeiro (direito) e o segundo (esquerdo) olhos testados de indivíduos normais. Métodos: Trinta pacientes saudáveis foram divididos aleatoriamente em 2 grupos. Os participantes foram submetidos à microperimetria no "fast mode" e no "expert mode" no grupo I e II, respectivamente. Cada participante foi submetido a um único teste e o olho direito foi testado primeiro. Resultados: No grupo I, o limiar médio de sensibilidade macular (± DP) foi de 24,5 ± 2,3 dB e 25,7 ± 1,1 dB nos olhos direito e esquerdo, respectivamente (p=0,0415). No grupo II foi de 26,7 ± 4,5 dB e 27,3 ± 4,0 dB nos olhos direito e esquerdo, respectivamente (p=0,58). Não houve diferença estatisticamente significativa entre os olhos dos dois grupos (p=0,1512). Em relação à estabilidade de fixação (avaliada no grupo microperimetria no "expert mode"), a média das porcentagens dos pontos de fixação dentro do 1 grau central da mácula (P1) ± DP foi de 87,9 ± 11,5% no olho direito e de 93,8 ± 6,6% no olho esquerdo. O teste t pareado não mostrou diferença estatística entre os olhos (p=0,140). O valor médio de P2 ± DP foi de 95,5 ± 4,9% no olho direito e 98,5 ± 2,1% no olho esquerdo. Foi demonstrado um aumento na porcentagem de pontos de fixação no segundo olho testado quando comparado ao primeiro (teste t pareado= 2,364; p=0,034). Houve correlação negativa entre o limiar de sensibilidade macular do olho direito e a duração do exame nos dois grupos (microperimetria no "expert mode": r=-0,717; p=0,0026; microperimetria no "fast mode": r=-0,843; p <0,0001). Conclusão: O limiar médio de sensibilidade macular foi maior no segundo olho testado no grupo microperimetria no "fast mode" e foi semelhante nos dois olhos no "expert mode". Nossos dados sugerem que a compreensão do exame pelo indivíduo pode impactar nos resultados da microperimetria.(AU)

Microperimetry differences in macular sensitivity threshold between first and second tested eyes.

PURPOSE: To comparatively assess the macular sensitivity threshold of microperimetry and the fixation stability between the first (right) and second (left) tested eye of normal participants. METHODS: Thirty healthy patients were randomly assigned to two groups. The participants underwent microperimetry in the fast mode and expert mode in groups I and II, respectively. Each participant underwent a single test and the right eye was tested first. RESULTS: The mean macular sensitivity threshold (± standard deviation [SD]) was 24.5 ± 2.3 dB and 25.7 ± 1.1 dB in the first (right) and second (left) eyes of group I, respectively (p=0.0415) and 26.7 ± 4.5 dB and 27.3 ± 4.0 dB in the first (right) and second (left) eyes of group II, respectively (p=0.58). There was no statistically significant difference between eyes in either group (p=0.1512). Regarding fixation stability (evaluated in the microperimetry expert mode group), the mean ± SD percentage of fixation points within the 1-degree central macula (P1) was 87.9 ± 11.5% in the right eye and 93.8 ± 6.6% in the left eye. The paired t-test did not show a statistically significant difference between eyes (p=0.140). Mean ± SD P2 value was 95.5 ± 4.9% in the right eye and 98.5 ± 2.1% in the left eye. The analysis demonstrated an increase in the percentage of fixation points in the second tested eye compared with the first one (paired t-test= 2.364; p=0.034). There was a negative correlation between the macular sensitivity threshold of the right eye and the duration of the examination for both groups (microperimetry expert mode: r=-0.717; p=0.0026; microperimetry in the fast mode: r=-0.843; p<0.0001). CONCLUSION: Mean macular sensitivity threshold was higher in the second tested eye in the microperimetry in the fast mode group and was similar in both eyes in the expert mode. Our data suggest that comprehension of the examination by the individual may impact the results of the microperimetry test.