December 2018


In the Journal of Cataract & Refractive Surgery December 2018

Transepithelial versus epithelium-off corneal crosslinking for corneal ectasia: a meta-analysis
Hidenaga Kobashi, MD, Shi Song Rong, MD, Joseph Ciolino, MD
In this review involving progressive corneal ectasia, investigators compared results of transepithelial corneal collagen crosslinking to epithelium-off crosslinking. Included were 505 eyes from seven randomized controlled trials. Investigators determined that during the 1-year observation period those in the epithelium-off crosslinking group had postoperative changes in maximum keratometry that were significantly better than those who had undergone transepithelial crosslinking. They more frequently found a postoperative demarcation line in eyes that had undergone the epithelial-off crosslinking technique. With the transepithelial technique post-treatment central corneal thickness was significantly greater and best spectacle corrected visual acuity showed more improvement. However, in terms of halting ectasia progression, it was determined that maximum keratometry with the transepithelial approach was lower than with the epithelium-off approach.

Efficiency of video presented information about excimer laser treatment on ametropic patients’ knowledge and satisfaction with the informed consent process – a randomized controlled trial
Philipp Baenninger, MD, Livia Faes, Claude Kaufmann, MD, Valentina Reichmuth, MD, Lucas Bachmann, MD, Michael Thiel, MD
The aim in this randomized controlled trial was to determine how offering patients informed consent for refractive excimer laser surgery as part of a video presentation compared with a conventional face-to-face interaction. In the study, 55 patients were given the video presentation while 58 had a conventional exchange. Investigators determined that in terms of knowledge, satisfaction with the consent process, and anxiety toward the surgery, both approaches were equivalent. For those who watched the video presentation total consultation time needed was significantly lower by 4.96 minutes. Investigators concluded that practice efficiency could be improved with use of the video approach to consent.

Comparison between primary and secondary intraocular lens implantation in traumatic cataract after open globe injury in pediatric age group
Pradhnya Sen, MBBS, Chintan Shah, DOMS, Alok Sen, MBBS, Elesh Jain, DO, Amit Mohan, MBBS
For pediatric patients with open globe injuries is it better for them to undergo primary or secondary IOL implantation? A recent retrospective cases series compared how 61 patients who had primary cataract extraction fared versus 78 who underwent a secondary IOL implantation procedure. Investigators determined that 49% of those who underwent primary implantation attained 20/40 acuity or greater versus 60% who had this done secondarily. When they considered achieving a desirable refractive outcome with a spherical equivalent of less than 2, investigators found that 66% of those who had primary implantation reached this level, as compared with 77% of those who had the secondary approach. The risk of poor refractive outcomes was highest in cases where the wound size was large. The most common postoperative complication in either group was fibrinous uveitis. Those who underwent primary implantation were more likely to have issues with pupillary optic capture and lens decentration versus those in the secondary group who had a higher occurrence of strabismus. While both techniques resulted in comparable visual and refractive outcomes, in cases of small peripheral corneal laceration primary IOL implantation may be chosen to help with early visual rehabilitation and to avoid repeated use of general anesthesia.

In the Journal of Cataract & Refractive Surgery December 2018 In the Journal of Cataract & Refractive Surgery December 2018
Ophthalmology News - EyeWorld Magazine
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