S. Vinjamaram

TTO utility scores measure quality of life in patients with visual morbidity due to diabetic retinopathy or ARMD

PURPOSE To evaluate the utility scores in patients with varying degrees of visual morbidity due to diabetic retinopathy or ARMD. METHODS Patients with vision =20/40 in one eye due to diabetic retinopathy or ARMD were enrolled. Utility scores were measured by the time trade-off (TTO) method after stratifying the patient population with visual impairment in the better eye (group 1, 20/20 to 20/40; group 2, 20/50 to 20/100; group 3, 20/200 to no light perception). RESULTS Sub-group analysis revealed that subjects in group 1 were willing to give up a median of 1 year as compared to 3 years by the subjects in group 3 for perfect bilateral visual acuity (P < 0.05). The median utility score was 0.94 for group 1, 0.96 for group 2 and 0.80 for group 3. While the utility scores for groups 1 and 2 were comparable (P > 0.05), there was a significant difference in the utility scores between groups 1 and 3 and between groups 2 and 3 (P < 0.05). There was no significant effect on the utility scores of age, educational level or prior ocular surgery. CONCLUSION Substantial visual loss secondary to diabetic retinopathy or ARMD is associated with a significant decrease in utility scores. However, TTO scores were not sensitive enough to demonstrate a difference between subjects with mild (group 1) and moderate (group 2) visual loss in the better eye secondary to diabetic retinopathy or ARMD.

Small-gauge, sutureless pars plana vitrectomy to manage vitreous loss during phacoemulsification.

This technique manages vitreous prolapse associated with posterior capsule rupture during phacoemulsification by performing small-gauge pars plana vitrectomy with a sutureless, self-sealing incision performed in a closed chamber, maintaining normal intraocular pressure. A high-speed cutter exerts minimal traction on the vitreous. Accessibility to the vitreous through the pars plana is better, ensuring more complete removal of the vitreous and restoration of normal anatomy.