Eyeworld

UPDATE 15 In the journal Cataract surgery in patients with late-onset retinal degeneration Vasileios Papastavrou, MD, Shyamanga Borooah, FRCOphth, Jill O'Brien, BA(Hons), Neeta Ray-Chaudhuri, FRCOphth, Baljean Dhillon, FRCOphth, Rute Vieira, Andrew Browning, PhD In this retrospective case series, investigators examined the outcomes of phacoemulsification on those with long anterior lens zonular fibers, which is linked to late-onset retinal degeneration. Included here were 11 eyes. Investi- gators found the procedure to be completely safe in all cases, although when it came to the capsulorhexis, it was determined that the long anterior lens zonular fibers increased the difficulty for surgeons. They determined that in cases with intact foveal photoreceptors and retinal pigment epithelium, visual acuity im- proved postoperatively. However, as a result of progressive atrophy of the macula, with time, this slowly declined. But even those who at baseline had advanced disease saw subjective improvement in vision. Investigators concluded that there were no long-term complications for late-onset retinal degeneration patients who underwent phacoemulsification. However, only those with good foveal receptors enjoyed objective improvement in visual acuity. Comparison of refractive and keratometric astigmatism after microincision cataract surgery Atsushi Kawahara, MD, Yoshinori Takayanagi, MD How does microincision cataract surgery affect refractive and keratometric astig- matism? In this retrospective case series involving 90 eyes of 54 patients under- going phacoemulsification, investigators set out to determine this, using linear regression analysis. The procedure was performed entirely through a 2.0 mm temporal clear corneal incision. Postoperatively, they determined that the mean refractive Jackson cross-cylinder with-the-rule astigmatism was –0.29 D, and the mean postoperative refractive oblique astigmatism was –0.09 D. The model they used for with-the-rule cylinder was postoperative J0 = 0.75 × keratometric J0 + 0.21 × preoperative J0 – 0.23 and for oblique astigmatism was postoperative J45 = 0.85 × keratometric J45 − 0.03. Investigators concluded that after microincision cataract surgery there was a strong correlation between refractive and keratomet- ric astigmatism. Accelerated corneal crosslinking: Efficacy of different accelerated corneal crosslinking protocols in patients with progressive keratoconus Ebru Toker, MD, Eren Çerman, MD, FEBOphth, Deniz Özarslan Özcan, MD, Özge Begüm Seferoglu, MD The aim of this retrospective case series was to determine how progressive kera- toconus patients fared with different accelerated corneal crosslinking treatment protocols. Of the 134 eyes included here, 34 underwent conventional crosslink- ing, 45 underwent accelerated crosslinking done for 10 minutes using 9 mW, 28 underwent accelerated crosslinking for 4 minutes with 30 mW of continuous light, and the remaining 27 underwent accelerated crosslinking at 30 mW with the light pulsed at a rate of 1 second on and 1 second off. Investigators deter- mined that for both the 9 mW accelerated crosslinking group and the conven- tional one there was an improvement in uncorrected distance visual acuity and corrected distance visual acuity. For those that underwent 30 mW of continuous accelerated crosslinking, improvement was only seen in corrected distance visual acuity. No significant changes in either corrected or uncorrected distance visual acuity were seen for those who underwent the pulsed accelerated crosslinking. The most significant changes in keratometry readings were found for those who underwent the conventional crosslinking approach. Investigators concluded that while keratoconus progression may be stabilized with the 30 mW accelerated approach, when it comes to topographic improvement this is not as effective as conventional crosslinking. August 2017 Chang said. "The MacArthur Foun- dation wants to accelerate progress by leveraging a solution that has been successful on a smaller scale." He explained that HCP's proposal is to network several different ophthal- mic institutions and organizations in a collaborative partnership to de- velop teaching centers of excellence in developing countries. "The Tilganga Eye Institute in Kathmandu is one such proven model that is training general and subspecialist ophthalmologists, and is financially self-sustaining despite providing 60% of its services to the poor," Dr. Chang said. "Improv- ing the quality of training and the number of trainees is a prerequisite to solving needless blindness in developing countries, where cataract accounts for half of all blindness." The Tilganga Eye Institute sees about 1,000 patients a day for many differ- ent eyecare issues. The ASCRS Foundation would like to thank HCP for it long-time partnership in Ethiopia to address preventable blindness. HCP's selection as a semi-finalist for the MacArthur 100&Change grant will rightly focus the world's attention on the critical work needed to end preventable blindness. EW Contact information Chang: dceye@earthlink.net Zundel: nzundel@ascrs.org HCP staff and Ethiopian ophthalmologist in surgery Source: ASCRS

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