Vol 44: Issue: 7 Month: July 2018
Anterior or posterior chamber implantation?
Researchers compared anterior chamber implantation and posterior chamber implantation in 95 patients with absence of capsular support undergoing iris-claw IOL implantation. Fifty-seven patients had prepupillary implantation and 38 patients had retropupillary implantation. Regardless of location, the iris-claw IOL provided good visual outcomes with few complications. However, there was greater endothelial cell loss and CME (cystoid macular oedema) seemed to appear earlier with prepupillary IOL implantation than with retropupillary IOL implantation.
R Touriño Peralba et al., JCRS, “Iris-claw intraocular lens for aphakia: Can location influence the final outcomes?”, Volume 44, Issue 7, Pages 818-826.
New PREMED results
Subconjunctival triamcinolone acetonide effectively prevents the occurrence of CME after uneventful phacoemulsification in diabetic patients, whereas intravitreal bevacizumab had no significant effect, according to the latest report from the PREMED research group. The multi-centre study randomised diabetic patients having phaco to receive no additional treatment, a subconjunctival injection with 40mg triamcinolone acetonide, an intravitreal injection with 1.25mg bevacizumab or a combination of both. At six and 12 weeks postoperatively, the central subfield mean macular thickness was 12.3μm and 9.7μm lower, respectively, in patients who received subconjunctival triamcinolone acetonide than patients who did not. No patient who received subconjunctival triamcinolone acetonide developed CME. The risk of increased IOP linked with triamcinolone injection must to be taken into consideration.
LHP Wielders et al., JCRS, “Randomized controlled European multicenter trial on the prevention of cystoid macular oedema after cataract surgery in diabetics: ESCRS PREMED Study Report 2”, Volume 44, Issue 7, Pages 836-847.
FLACS for Fuchs’?
In eyes with Fuchs’ endothelial corneal dystrophy and cataract, femtosecond laser-assisted cataract surgery (FLACS) reduced the central cornea thickness and the rate of endothelial cell density loss more effectively than conventional phacoemulsification surgery. This approach could help to postpone the need for corneal transplantation in these patients, researchers suggest. This was based on a clinical study that evaluated 31 eyes undergoing one or the other procedure. Endothelial cell density loss was significantly higher in the phaco group from one to 12 months postoperatively. Central corneal thickness was significantly thicker in the phaco group one, three and six months postoperatively. In both groups, central corneal thickness at all follow-up visits was significantly greater than the preoperative level.
W Fan et al., JCRS, “Femtosecond laser–assisted cataract surgery in Fuchs’ endothelial corneal dystrophy: Long-term outcomes”, Volume 44, Issue 7, Pages 864-870.