Hobbshagen9352

PURPOSE To investigate the effect of 3 regimes on pain and wound healing after corneal crosslinking (CXL). SETTING Tertiary academic referral center, Utrecht, the Netherlands. DESIGN Prospective cohort study. METHODS Consecutive progressive keratoconus patients who underwent 9 mW/cm epithelium-off CXL were included. Patients received a bandage contact lens (n = 20), occlusive patch (n = 20), or antibiotic ointment (n = 20) after treatment. Pain scores and quality of life, measured by the McGill Pain Questionnaire and Visual Analogue Scale (VAS), were analyzed. Epithelial healing after 2 days, correlations between pain and psychological factors that influence pain perception (depression anxiety stress score and pain catastrophizing score), and oral pain medication were evaluated. RESULTS Sixty eyes of 52 patients were analyzed. On average, patients experienced considerable pain after CXL (median VAS score 6.2, range 0 to 10). The postoperative regimen did not significantly affect pain scores, although the antibiotic ointment group reported a higher VAS score (median VAS score 7.2 vs 6.7 and 6.0; P = .57). Occlusive patching showed a trend to quicker resolution of epithelial defects (85% completely healed vs 65% with lenses and 70% with antibiotic ointment; P = .43). Correlations with pain-modulating psychological factors were weak (R less then 0.3) and not significant. The use of pain medication corresponded poorly to the prescribed use. CONCLUSION This study demonstrated clinical equivalence of 3 regimes in combating postoperative pain after routine CXL. Wound healing appeared quicker in the occlusive patch group and therefore might be the best standard of care after CXL. The clinical tradition of using bandage contact lenses should be reevaluated.PURPOSE To compare small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) in terms of safety, refractive outcomes, visual quality, and biomechanical responses in correcting myopia with maximum myopic meridian exceeding 10 diopters (D). SETTING Zhongshan Ophthalmic Center, Sun Yat-sen University. DESIGN Prospective, randomized, comparative study. METHODS The study comprised 60 eyes (60 patients) with a maximum myopic meridian exceeding 10 D; 30 eyes were corrected using SMILE and 30 eyes were corrected using FS-LASIK. Patients received preoperative and 6-month postoperative examinations, including refractive outcomes, corneal curve, contrast sensitivity, ocular aberrometry, and corneal biomechanical responses. RESULTS At 6 months postoperatively, the uncorrected distance visual acuity was -0.01 ± 0.06 and -0.05 ± 0.10 in the SMILE and LASIK eyes, respectively (P = .08). The corrected distance visual acuity was -0.07 ± 0.07 and -0.08 ± 0.08 (P = .624), respectively. The postoperative spherical equivalent (SE) was -0.20 ± 0.25 D and -0.03 ± 0.20 D, respectively (P = .008). The posterior corneal curvature was unchanged after SMILE and FS-LASIK (P > .05). The measured corneal thickness was reduced by 137.40 ± 15.01 μm and 155.06 ± 17.43 μm (P less then .001). The change in the SE was -0.01 ± 0.26 and -0.13 ± 0.30 from 1 week (P = .103). Only the peak distance (the distance between the highest points of the nondeformed corneal parts) differed between the groups (1.06 ± 1.44 mm vs -0.26 ± 1.16 mm, P = .007). In the SMILE patients, changes in higher-order aberration (P = .018) and spherical aberration (P = .011) were smaller than in LASIK patients. CONCLUSIONS Compared with LASIK, SMILE might offer superior safety and objective visual quality, comparable stability and efficacy, and a little inferior predictability in correcting maximum myopic meridian exceeding 10 D.PURPOSE To confirm the presence of incomplete vitreolenticular adhesion via microscope-integrated intraoperative optical coherence tomography (iOCT) during cataract surgery and via diagnostic spectral-domain OCT (SD-OCT) postoperatively. SETTING S. Fyodorov Eye Microsurgery Complex State Institution, Moscow, Russia. DESIGN Prospective noninterventional single-center study. METHODS Clinical characteristics and surgical videos of 27 patients (28 eyes) who had cataract surgery were documented. Real-time iOCT integrated into the surgical microscope was directed to view the retrolenticular anatomy at the end of the surgery. Postoperatively, SD-OCT was also performed. RESULTS This study comprised 28 eyes of 27 patients. Berger space was identified in 21 cases (75%) intraoperatively via iOCT and in 23 cases (82%) postoperatively via stationary OCT. Depth dimensions varied from 33.5 ± 87.0 μm to 383.1 ± 226.3 μm. Hyperreflective dots and particles of different shapes and sizes were documented within Berger space in 16 cases (57%) intraoperatively and in 9 cases (32%) postoperatively. Capsular rupture occurred in 1 case due to excessive posterior capsular movement anteriorly. The posterior capsular rupture was converted into a posterior capsulorhexis, leaving the anterior hyaloid membrane intact. CONCLUSIONS iOCT confirmed the penetration of crystalline lens microfragments, cellular material, or medical suspension (triamcinolone) into the space between the posterior lens capsule and the anterior hyaloid membrane. This occurs due to discontinuity of both lenticular zonules and Wieger ligament attachment. A Wieger ligament rupture can also allow excessive Berger space hydration during phacoemulsification leading to anterior displacement of the posterior lens capsule increasing the risk of instrument touch and posterior capsule rupture.PURPOSE To investigate the association between cataract and cotinine-verified smoking status. SETTING Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, South Korea. DESIGN Retrospective study. METHODS Participants were randomly selected using data collected by the Korea National Health and Nutrition Examination Survey from 2008 to 2016. Simufilam Participants completed a questionnaire to self-report smoking status and a history of cataract, among other variables. To identify the relationship between cataract and smoking, a new variable was used to define smoking status, survey-cotinine-verified smoking status (SCS)-the combination of self-reported smoking status and cotinine-verified smoking status- and thus identify hidden smokers. RESULTS In total, 11 435 participants were eligible for final analysis. The study comprised 4925 men and 6510 women; the mean age was 52.86 ± 16.83 years (median 54 years). Of 2292 SCS smokers, 382 (16.7%) were nonsmokers according to their self-report. Notably, the ratio of the cotinine-verified to self-reported smoking rate of women was greater than that of men, 1.