Conventional and Pattern Scanning Pan-Retinal Photocoagulation Laser in Diabetic Patients' Visual Field

Introduction: In this study, we aimed to compare visual field defects in two different laser methods, namely conventional pan-retinal photocoagulation (PRP) and pattern scanning PRP, in patients with either proliferative diabetic or very severe non-proliferative diabetic retinopathy. Methods: This study was a randomized, single-blind, prospective clinical trial. Twenty patients with either proliferative or very severe non-proliferative diabetic retinopathy were enrolled in this study. Notably, only those patients with the same severity scores in both eyes were included. One eye underwent the conventional PRP laser and another eye underwent the pattern scanning PRP laser simultaneously. Swedish interactive threshold algorithms (SITA) standard perimetry was performed at baseline and one month after the treatment, and visual field defects were evaluated. Results: The pattern standard deviation (PSD) significantly increased in both the pattern and conventional PRP laser groups after one month. The change of the PSD at baseline and after the treatment was not significant between the groups. The mean deviation (MD) level significantly decreased in the conventional group after one month. The change in the MD level at baseline and after the treatment was not significant between the pattern and conventional groups. The change in the mean best corrected visual acuity (BCVA) between the groups was not significant. Conclusion: Changes in visual acuity and visual fields of the patients between the pattern and conventional PRP laser methods showed no significant difference; however, the pattern PRP method caused a smaller reduction in overall sensitivity in the patient's visual field.

Corneal biomechanical changes after trabeculectomy with mitomycin C in primary open-angle glaucoma and pseudoexfoliation glaucoma

PURPOSE

This study aimed to examine the effect of trabeculectomy with mitomycin C on corneal biomechanical characteristics in PEXG and POAG patients.

METHODS

In this prospective comparative case series study, 32 glaucoma patients of whom 17 patients were suffering from PEXG and 15 patients from POAG were enrolled. All patients underwent complete ocular examination, CCT using ultrasound pachymetry and corneal biomechanical study using ORA. The patients were hospitalized, and trabeculectomy surgery with mitomycin was done. Three months after surgery, patients were examined and ORA was obtained again.

RESULTS

The mean CH in patients with PEXG was lower compared to patients with POAG (5.66 ± 1.13, 7.49 ± 0.88, respectively) before surgery, which had a statistically significant difference (P < 0.001). CRF in patients with PEXG was significantly lower compared to patients with POAG (8.19 ± 1.48 vs. 9.35 ± 1.60, respectively) before surgery, with P = 0.049. CH remarkably increased and reached 6.69 ± 0.78 (P < 0.001) in the PEXG group after TBX + MMC surgery. CH increased in the POAG group after TBX + MIC surgery and reached 8.23 ± 1.09, which was statistically significant (P = 0.001). There was a significant relationship between CH and IOP_g changes in both PEXG and POAG groups (P < 0.001 and P = 0.01, respectively). Although TBX + MMC surgery changed the amount of CH in PEXG and POAG groups, no significant difference was shown in the parameters between the two groups comparing the CH changes (P = 0.33).

CONCLUSION

According to the results of this study, the biomechanical characteristics of cornea, particularly CH, shows certain changes following surgery and is increased, reflecting the dynamic nature of these parameters. Our knowledge of the biomechanical changes after glaucoma surgery can help us better understand the pathophysiology of glaucoma diseases and make the right decisions for follow-up of the patients.

Intraocular Foreign Body Removal by 23-Gauge Micro Incision Vitrectomy Surgery and Back Flush Flute Needle: A Case Series Study

<p><strong>BACKGROUND: </strong>This study aimed to consider a new technique to extract an intraocular foreign body by 23-gauge micro incision vitrectomy surgery (23G-MIVS).</p><p><strong>METHOD: </strong>This case series was done on Patients with intraocular foreign bodies and cataract during 2012-2015 in Tabriz University of Medical Sciences. Phacoemulsification and aspiration of lens nucleus, intraocular lens implantation, 23G-MIVS, and extraction of the foreign body were performed on patients. The foreign body was removed through a posterior capsulor hexis, anterior continuous curvilinear capsulorhexis, and a corneal incision. In all cases, the foreign body was safely removed through the corneal incision with back flush Flute Needle, and IOL was implanted and well positioned. The surgical incision did not require suturing.</p><p><strong>RESULTS:</strong> This technique was successful for the patients and the corneal endothelial cell density was maintained over 2000 cells/mm2 in all cases during recent follow-up examinations.</p><p><strong>CONCLUSION: </strong>We found that 23G-MIVS with this technique is suitable to remove the foreign body. It is safe, without complications, and can be used without enlarging the 23-gauge sclerotomy.</p>