April 2009

 

OPINIONS AND COMMENTARY

 

In The Journal Of Cataract & Refractive Surgery April 2009


 

 

Pseudophakic monovision

Misae Ito, CO, Kimiya Shimizu, M.D., Ph.D., Rie Amano, M.D., Ph.D., Tomoya Handa, CO, Ph.D.

Investigators here set out to determine the role that age plays in how well people do with monovision. Included in the retrospective study were 82 monovision patients with ages ranging from 49 to 87. Monovision was achieved in these cases using monofocal intraocular lenses. At all distances, most patients enjoyed binocular uncorrected visual acuity of .10 logMAR or better. Between eyes there was a mean difference of 2.27 D. Investigators here found that 81 percent of patients were satisfied with their monovision results. As a rule, older patients tended to be happier. Just 64% of those under the age of 60 were satisfied with monovision, compared with 87% of those in the 60 to 70 age range, and 94% of those over 70. Investigators here concluded that while pseudophakic monovision is a reasonable option for handling the loss of accomodation that accompanies cataract surgery with monofocal lenses, it requires proper patient selection. They suggest reserving the approach for those over the age of 60.

Mitomycin-C in hyperopic photorefractive keratectomy

Antonio Leccisotti, M.D., Ph.D.

In this prospective, randomized study investigators considered how hyperopic photorefractive keratectomy (PRK) was effected by use of topical mitomycin-C (MMC). Of the 179 patients, 88 received MMC treatment following PRK, while 91 patients in the control group received and application of balanced salt solution instead. The MMC 0.2 mg/mL was applied to the stroma for 45 seconds. At the 18-month mark, mean best spectacle corrected visual acuity was 0.06 logMAR for those in the MMC group compared with 0.08 logMAR for those in the control group. In the MMC group two eyes lost more than .1 logMAR compared with 11 eyes for controls. For those in the MMC group 94% attained 20/40 acuity or better versus just 80% of controls. In terms of haze, just .05 of those in the MMC group had complaints compared with .23 of controls. Neither group suffered endothelial damage. Investigators concluded that there was improved predictability and efficacy with use of MMC.

Comparison of 2 microaxial phacoemulsification systems

Kyung-Min Lee, M.D., Hyung-Goo Kwon, MD, Choun-Ki Joo, M.D., Ph.D.

To determine how two microaxial phacoemulsification systems compared, investigators here evaluated how patients undergoing phacoemulsification fared with the Stellaris system, which required 1.8mm incision versus the Intrepid Infiniti system with a 2.2 mm one. Included in this prospective study were 86 eyes of 78 patients. Investigators found that both systems performed comparably in terms of best corrected visual acuity, surgically induced astigmatism, and amount of BSS used. With high density cataracts, for the 1.8 mm group, however, there was a greater change in incision size after completion of the procedure and these also required longer phacoemulsification time and resulted in greater corneal endothelial cell loss with the system. The conclusion reached here was that while both systems were safe and effective, for high-density nuclear cataracts the 2.2 mm Infiniti system was better and for the cortical type 1.8 mm Stellaris system was preferable.

In The Journal Of Cataract & Refractive Surgery April 2009 In The Journal Of Cataract & Refractive Surgery April 2009
Ophthalmology News - EyeWorld Magazine
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