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975). The FISHF dislocation forces of the CT Lucia and LI61AO using 30-gauge needles were not significantly different from their haptic-optic disinsertion forces (P=.79 and .27, respectively). There were no differences in flange diameters between 1.0 mm and 2.0 mm haptic melt lengths across the IOLs (P=.15-.85).
These data strongly support the biomechanical stability of FISHF with the polyvinylidene fluoride haptics of the CT Lucia using small diameter instruments for the creation of an intrascleral tunnel. 1.0 mm of haptic may be the optimal melt length.
These data strongly support the biomechanical stability of FISHF with the polyvinylidene fluoride haptics of the CT Lucia using small diameter instruments for the creation of an intrascleral tunnel. 1.0 mm of haptic may be the optimal melt length.
The purpose of this research was to evaluate the incidence, risk factors, and complications of ocular graft-versus-host disease (GVHD) in a large single-center study.
Retrospective observational case series.
This study included 283 patients who underwent hematopoietic stem cell transplantation (HSCT) between 2005 and 2020. Ocular GVHD was diagnosed according to International Chronic Ocular GVHD Consensus Group criteria. Potential risk factors for ocular GVHD were evaluated using the Cox proportional hazards model.
The cumulative incidence of ocular GVHD was 19.7% at 1 year, 29.3% at 2 years, 40.7% at 3 years, 47.2% at 4 years, and 49.7% at 5 years. Ocular GVHD was significantly associated with recipient age (hazard ratio [HR] 1.228; 95% confidence interval [CI] 1.033-1.459; P=.020); female sex (HR 1.797; 95% CI 1.195-2.703; P=.005); peripheral blood stem cell use (PBSC) (HR 2.079; 95% CI 1.268-3.411; P=.004); and previous acute GVHD (HR 1.276; 95% CI 1.073-1.518; P=.006). Ocular complications after HSCT included cataract, corneal ulcer, corneal perforation, lacrimal obstruction, herpetic keratitis, and cytomegalovirus retinitis.
Half of patients developed ocular GVHD in the 5 years following HSCT. Older age, female sex, use of PBSC, and acute GVHD disease were significant predictors of ocular GVHD. Hematologists and ophthalmologists should be aware of its vision threating complications.
Half of patients developed ocular GVHD in the 5 years following HSCT. Older age, female sex, use of PBSC, and acute GVHD disease were significant predictors of ocular GVHD. Hematologists and ophthalmologists should be aware of its vision threating complications.
To determine the relationship between glaucoma severity and rate of falls, fear of falling, and avoidance of activities at-risk for falls.
Cross-sectional study.
Patients with glaucoma (n=138) 55 to 90 years of age with mild (n=61), moderate (n=54), or advanced (n=23) glaucoma in the better eye based on the Glaucoma Staging System and age-matched control subjects (n=50) were recruited from the Eye Clinics at Washington University, St. Louis, MO. Participants completed questionnaires regarding falls, the fear of falling, and the avoidance of activities at-risk for falls.
Of the glaucoma participants, 36% reported ≥1 fall in the previous 12 months compared with 20% of control subjects (adjusted odds ratio [OR] 2.7 [95% confidence interval CI 1.18-6.17]; P=.018). Compared with control subjects, the mild glaucoma group trended toward a higher fall risk (adjusted OR 2.43 [95% CI 0.97-6.08]; P=.059) and the advanced group had the highest fall risk (adjusted OR 7.97 [95% CI 2.44-26.07]; P=.001). A greater falling and avoidance of at-risk activities. find more Reducing falls, the fear of falling, and the avoidance of at-risk activities may lower morbidity and mortality and improve emotional and social well-being of patients with glaucoma. Am J Ophthalmol 2021;221•••-•••. © 2021 Elsevier Inc. All rights reserved.
To assess the in vivo physiology of retinal reattachment in humans using swept-source optical coherence tomography (SS-OCT) in real time.
Prospective case series.
Fifteen consecutive patients with fovea-involving rhegmatogenous retinal detachment were undergoing pneumatic retinopexy. SS-OCT was performed at presentation and frequent intervals immediately after pneumatic retinopexy. The primary outcome was longitudinal assessment of early postoperative SS-OCT to establish stages of reattachment.
Most patients (93.3%, 14/15) achieved successful reattachment at the median follow-up duration of 13 weeks (interquartile range 7.5-18.0). Reattachment occurred in 5 specific stages 1) redistribution of fluid and approach of the neurosensory retina toward the retinal pigment epithelium occurred in 100% (15/15); 2) reduction in cystoid macular edema and improvement of outer retinal corrugations was achieved in 100% (15/15); 3) initial contact of the neurosensory retina to the retinal pigment epithelium occurred in 5 specific stages. Delayed progression through certain stages was characterized by postoperative anatomic abnormalities. Am J Ophthalmol 2021;221•••-•••. © 2021 Elsevier Inc. All rights reserved.
To characterize and compare patient-reported recovery of function after cataract or glaucoma surgery using a novel visual analog scale.
Prospective observational cohort study.
Daily for 2 weeks and weekly thereafter, patients recovering from trabeculectomy, tube shunt implantation, or cataract extraction (CE) completed a diary-style questionnaire including visual analog scales (VASs; scored 0-100) grading pain and global function. Clinical examination data and medical histories were collected. Generalized estimating equation models evaluated associations between VAS function scores and pain or visual acuity (VA) and compared scores between surgery types.
Among 51 participants followed for 12 weeks, tube shunt placement reduced postoperative day 1 (POD1) function by 47 of 100 points vs CE (P=.006), while trabeculectomy did not reduce POD1 function vs CE (P=.33). After CE, trabeculectomy, and tube shunt placement, average VAS function scores increased 13.94 per week for 2 weeks (P < .001), 4.18 per wh VA and pain, but neither fully explains reported impairment. A VAS for function may efficiently capture postoperative recovery.
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