Eficacia en la prevención de la regresión posterior a la cirugía LASIK para hipermetropía / Efficacy of long-term topical steroid treatment to prevent regression after hyperopic LASIK

Evaluar la eficacia del tratamiento corticoideo tópico prolongado en pacientes operados con LASIK hipermetrópico. Material y métodos: Se realizó un estudio prospectivo, de observación y enmascarado. Los pacientes candidatos a cirugía LASIK para la corrección de baja y moderada hipermetropía fueron asignados aleatoriamente a recibir tratamiento tópico corticoideo (dexametasona) durante una semana (grupo control) o un mes (dexametasona, la primera semana, y fluorometalona, las tres siguientes),en el grupo de estudio. Se comparó la refracción final manifiesta en ambos grupos. Resultados:Analizamos 105 ojos en cada grupo (estudio y control). El equivalente esférico medio preoperatorioera 3.17 desviación estándar (DE) ± 2.82 DE y 3.39 DE ± 2.65 DE en los grupos de estudio y control, respectivamente (p = 0.6). La refracción final manifiesta a los tres meses fue 0.62 DE ± 0.68 DE y 0.6 DE± 0.3 DE en el grupo de estudio y control, respectivamente (p = 0.6). Conclusión: La regresión refractivatras el LASIK hipermetrópico no parece poder modularse por el mayor o menor tratamiento corticoideotópico...

Ultrasound biomicroscopy study of direct and oblique 25-gauge vitrectomy sclerotomies.

PURPOSE: To study 25-gauge sclerotomy healing process in vivo with ultrasound biomicroscopy (UBM) in direct and oblique incisions. DESIGN: Prospective interventional case series report. METHODS: At our institution, we performed UBM studies on 53 sclerotomies during the first 30 days after 25-gauge vitrectomy, looking for conjunctival bleb development, sclerotomy healing signs, and vitreous incarceration in the wound. RESULTS: Echographical healing signs were completed in 77% of patients by day 15 with no differences between direct and oblique sclerotomies. By day 30, all but one sclerotomy were closed. Conjunctival blebs developed over 64% of direct sclerotomies, and 25% of oblique (P = .0059), but all resolved spontaneously by day 15. Vitreous incarceration appeared in 72% of sclerotomies. CONCLUSIONS: Twenty-five gauge sclerotomies heal by day 15 in most cases with no difference between direct and oblique sclerotomy construction. Conjunctival blebs developed more frequently over direct than oblique sclerotomies.

Oblique sclerotomy technique for prevention of incompetent wound closure in transconjunctival 25-gauge vitrectomy.

PURPOSE: To develop a surgical incisional technique that helps overcome incompetent sclerotomy closure previously reported in sutureless 25-gauge vitrectomy. DESIGN: Prospective interventional case series report. METHODS: We performed this surgical technique in 12 eyes of 12 consecutive patients scheduled for 25-gauge vitrectomy. The sclerotomy was created performing an oblique incision, a structural modification that helps the closure stay watertight once the cannulas are removed. RESULTS: This technical variation resulted in no intraoperative leakage after cannula removal in any of the 36 sclerotomies performed. CONCLUSIONS: Incision construction using this technique may resolve the reported sclerotomy leakage that in some cases had to be solved by suturing.