OCT 2012

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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Page 105 of 168

October 2012 versus delayed sequential and effectiveness" with diclofenac sodium 2 hours be- fore surgery followed by povidone- iodine 5% 3-5 minutes before surgery and conventional aseptic and antisepstic techniques. All pa- tients had a 2.7 mm incision with no sutures. In the ISBCS group, a new surgical field was arranged with new gloves, gowns, surgical instru- ments, and viscosurgical devices. A balanced saline solution containing vancomycin or a combination of gentamicin and adrenaline was used in cases of capsule rupture. Post-op all patients received topical ofloxacin and prednisolone drops every 2 hours for 1 week and tapered to four times a day for the second, third, and fourth weeks. Outcome measures included the incidence of intraoperative and post- op complications, uncorrected and best corrected visual acuity at 1 month post-op, and the Visual Function Index-14 (VF-14) question- naire at 1 month and 1 year post-op. To ensure safety to the study partici- pants, "a safety rule was initially adopted to halt the study if the overall complication rate of ISBCS surpassed the complication rate of DSBCS by 3%." Four hundred and thirty-nine patients were randomized to the ISBCS group and 406 patients were randomized to the DSBCS group. Twenty-two patients in the ISBCS group and 15 patients in the DSBCS group did not meet the inclusion criteria. There were no significant differences in gender, age, VF-14 questionnaire, and visual acuity measurements between the ISBCS and DSBCS groups pre-op. No statis- tically significant differences were found in the incidence of intraoper- ative or post-op complications in both groups (p>.999 and p=.154, respectively). No statistically significant differ- ences were found in uncorrected visual acuity and corrected visual acuity in the two groups. Patients in the ISBCS group had significantly better scores in the self-perceived changes in visual function question- naire (VF-14) at 1 month post-op when compared to the DSBCS group (p<.001). No differences were observed at 1 year after surgery. Immediate corneal edema was observed in 1.2% of eyes in the ISBCS group and 0.4% in the DSBCS group. Dry eye sensation was reported in 3.1% in the ISBCS group and 6.9% in the DSBCS group. In this multicenter, randomized clinical trial no cases of endoph- thalmitis, suprachoroidal hemor- rhage, or cystoid macular edema were reported. The incidence of endophthalmitis after conventional cataract surgery ranges from 0.08% to 0.26%.1-4 Sutureless corneal inci- sions permit inflow of extraocular fluid into the anterior chamber after phacoemulsification, and it has been reported as an important risk factor for endophthalmitis.5 The use of intracameral antibiotic agents after continued on page 104 EW RESIDENTS 103 Right On Target... The New A-Scan Plus®4.20 Meeting the Needs of Your Premium IOL Patient • Industry Leading Resolution • 100% Measurement Capability including dense cataracts • Automatic Alignment Detection • Simplified Personalization of Lens Constants • Unlimited patient data storage, recall, and transfer via USB Memory Stick Every purchase of an A-Scan Plus 4.20 comes with an on-site training program. Product #24-4200 Receive a Free Toric Marker with Purchase Visit us at AAO Booth #4221 3222 Phoenixville Pike, Malvern, PA 19355 • USA 800-979-2020 • 610-889-0200 • FAX 610-889-3233 • www.accutome.com

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