Four-year to seven-year outcomes of advanced surface ablation with excimer laser for high myopia.

PURPOSE: We aimed to evaluate and compare outcomes after photorefractive keratectomy with cooling (cPRK) and laser-assisted subepithelial keratectomy (LASEK) for high myopia. METHODS: This was a retrospective, single-masked follow-up study of patients treated for myopia between 2007 and 2009 with cPRK or LASEK, using a high-frequency flying-spot excimer laser with eye-tracker (MEL80; Carl Zeiss, Jena, Germany). One eye of each patient was randomly chosen for analysis. Re-treated eyes were excluded. RESULTS: Forty-six cPRK patients and 35 LASEK patients were included. Spherical equivalent averaged -7.69 ± 1.47 diopters (D) in cPRK eyes and -7.98 ± 2.06 D in LASEK eyes (p = 0.31) before surgery. The average follow-up time was 4.6 years in cPRK patients and 6.0 years in LASEK patients (p < 0.05). At final follow-up, no cPRK eyes and one LASEK eye (p = 0.46) had lost two lines of corrected distance visual acuity (CDVA). No eyes had significant haze at final follow-up, although trace haze was found in four cPRK eyes and six LASEK eyes (p = 0.44). However, at 6 weeks after surgery, zero cPRK eyes and nine LASEK eyes (p < 0.05) had significant haze. At final follow-up, 63 % of cPRK eyes and 35 % of LASEK eyes (p = 0.17) were within ±1.0 D of intended refraction. Finally, 100 % of cPRK patients and 92 % of LASEK patients (p = 0.87) were satisfied or very satisfied with the surgery at final follow-up. CONCLUSION: cPRK and LASEK seemed safe and with high patient satisfaction 4 to 7 years after surgery for high myopia. However, cPRK was more effective than LASEK in reducing initial significant corneal haze.

[Chorioretinopathy as the first symptom of acute lymphoblastic leukaemia]. / Korioretinopati som første symptom på akut lymfoblastisk leukæmi.

Central serous chorioretinopathy (CSCR) is an ophthalmic disease characterized by a serous detachment of the macula. It is most often idiopathic and self-limiting. A 61-year-old patient presented with bilateral blurred vision and double vision. Ophthalmological examination showed bilateral CSCR, and a haematological examination led to the diagnosis of an underlying acute lymphoblastic leukaemia. Bilateral visual loss with fast onset should lead to subacute ophthalmological examination. Underlying heamatological disease must be considered in patients with atypical CSCR.

[Twiddler's syndrome as the cause of pacemaker electrode displacement]. / Twiddler-syndrom er en årsag til pacemakerelektrodedisplacering.

Twiddler's syndrome is a rare cause of pacemaker electrode displacement. The displacement is caused by the patient's manipulation with the pacemaker, so the electrode is retracted. We describe a case of a 79-year-old overweight woman with a known psychiatric anamnesis, who was admitted twice with twiddler's syndrome. Age and overweight are known risk factors for twiddler's syndrome; and in this case the patient's psychiatric habitus was probably an additional risk factor. Before performing a pacemaker implantation it is important to take the patient's risk factors into account, and thus consider submuscular implantation.