L. Scorolli

Pseudoexfoliation Syndrome: A Cohort Study on Intraoperative Complications in Cataract Surgery

Our aim was to determine the rate of intraoperative complications induced by pseudoexfoliation syndrome (PSX) in cataract surgery. We report our experience regarding 1,052 consecutive patients who underwent phacoemulsification. Exact logistic regression was used to examine the role of PSX in intraoperative complications. Odds ratio for intraoperative complications (vitreous loss, capsular break, zonular break) was estimated to be 5.1 for PSX present as compared to when it is absent. PSX was associated with a statistically significant increase in intraoperative complications during cataract surgery (p < 0.0001).

Capsule contraction after continuous curvilinear capsulorhexis

Abstract We report two cases of capsular bag contraction that occurred within 1 month after continuous curvilinear capsulorhexis, phacoemulsification, and intraocular lens implantation. Neither patient had a known risk for this complication. Both patients had a neodymium:YAG laser anterior capsulotomy, which disrupted the capsulorhexis margin and led to prompt capsular bag distension.

Implantation and capsular bag stability of single-piece, foldable easacryl 1 intraocular lenses

Purpose: To assess the folding and implantation of the single‐piece EasAcryl 1 intraocular lens (IOL) and the maintenance of the tunnel structure and capsular bag stability after implantation. Setting: S. Orsola Hospital Department of Pathophysiologic Optics, University of Bologna, Bologna, Italy. Methods: This study comprised 300 cases of EasAcryl 1 IOL implantation. First, a 3.2 mm corneal incision was made according to preoperative astigmatism followed by a 5.5 mm ± 0.3 (SD) capsulorhexis. After sutureless phacoemulsification using a venturi pump, the 6.0 mm optic, 11.0 mm diameter IOL was implanted using a hexagonal cartridge. The IOLs were implanted using a 2‐step maneuver when the superior haptic was grasped with the forceps (first case) or a 1‐step maneuver when only the Microsert injector was used. The cartridge was never pushed beyond the tunnel. The preoperative and postoperative incision size and the corneal surgically induced astigmatism were recorded. The IOL rotation was measured 30 ± 5 days and 8 ± 1 months postoperatively. Results: No intraoperative complications occurred after the learning curve. No alteration in astigmatism was observed. The mean IOL rotation was 1.04 ± 0.5 degrees at 30 ± 5 days and 1.02 ± 0.2 degrees at 8 ± 1 months. Conclusions: The EasAcryl 1 was easily implantation through a 3.2 mm tunnel without altering the natural architecture. The unfolding of the IOL was well controlled, and the IOL remained well centered. A short learning curve is required.

Effect of Cysteine in Transgenic Mice on Healing of Corneal Epithelium after Excimer Laser Photoablation

Purpose: To evaluate the role of prepared cysteine per os in corneal epithelial healing in transgenic mice (B6(A)-Rpe65rd12/J) after excimer laser photoablation. Materials and Methods: In our prospective case series, 60 eyes of 30 mice had uneventful bilateral excimer laser photoablation. A first group, composed of 15 mice, received standard topical post-operative therapy with tobramycin, diclofenac and dexamethasone eyedrops, pluscysteine 5 mg 5 μg/10 μl phosphate-buffered saline (3 times a day for 1 week) per os or until corneal re-epithelialization was complete. The control group of 15 mice received standard post-operative therapy plus placebos. The mice were monitored daily, commencing the day after surgery, for 7 days to evaluate the corneal re-epithelialization rate using a video slit-lamp camera with a cobalt blue light. The mean diameters of corneal wounds were measured. Videotaped images were recorded and analysed by computer planimetry. Results: All the eyes of the mice treated withcysteine healed completely by day 5 after surgery, with a mean re-epithelialization time of 92 ± 10 h (SD); the mean re-epithelialization time was 125 ± 8 h in eyes that received the placebo. There were no statistically significant differences between the 2 groups in corneal haze presentation during follow-up, perhaps because the time period was too brief (7 days). However, corneal clarity in the study group was greater than in the control group, as shown on slit-lamp biomicroscopy. No side effects or toxic effects were documented. Conclusions: These data suggest that cysteine significantly accelerates epithelial healing after excimer photoablation. A further clinical study should be performed to confirm the results obtained in this study, and the long-term efficacy of cysteine in preventing corneal haze.

Effect of Cytochrome c Peroxidase on the Corneal Epithelial Healing Process after Excimer Laser Photo-Ablation in Transgenic Mice

Aim: To evaluate the role of commercially prepared cytochrome c peroxidase eye drops in corneal epithelial healing of transgenic B6(A)-Rpe65rd12/J mice after excimer laser photo-ablation. Materials and Methods: In our prospective animal series, 72 eyes of 36 mice had uneventful bilateral excimer laser photo-ablation. In each mouse, one eye received standard topical postoperative therapy with tobramycin, diclofenac, and dexamethasone eye drops plus cytochrome c peroxidase eye drops (two drops three times a day for 1 week or until corneal re-epithelialization was complete, corresponding to 15,000 IU/day). The fellow eye served as the control and received standard postoperative therapy plus placebo. The mice were monitored daily, commencing on the day after surgery, for 7 days to evaluate the corneal re-epithelialization rate using a video slit lamp camera with cobalt blue light. The mean diameter of the corneal wounds was measured. Videotaped images were recorded and analyzed by computer planimetry. Results: All eyes treated with cytochrome c peroxidase eye drops healed completely before day 5 after surgery, with a mean re-epithelialization time of 92 ± (SD) 10 h; the mean re-epithelialization time was 121 ± 8 h in the eyes receiving placebo (p < 0.05). There were no statistically significant differences between the two groups in corneal haze presentation during the follow-up period (p = 0.70), perhaps because the observation period was too short (7 days). However, the corneal clarity, on slit lamp biomicroscopy, in the study group was higher than that in the control group. No side effects or toxic effects were observed. Conclusions: These data suggest that cytochrome c peroxidase significantly accelerates epithelial healing after phototherapeutic keratectomy. Further clinical studies should be performed to prove the results obtained in this study and the long-term efficacy of cytochrome c peroxidase to prevent corneal haze.