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• W4240966968 abstract "The Goldmann applanation tonometer remains the gold standard to measure intraocular pressure (IOP). Calibration errors do occur with use, but only the manufacturer can reset the error to zero. This may cause challenges in situations where resources or accessibility limit the ability to obtain timely tonometer recalibration. Sandhu et al (p. 9) conducted a study to determine whether IOP measured by tonometers with known small calibration errors could be adjusted to reflect true IOP, thus allowing continued clinical use if necessary. The researchers compared a gold standard zero-error tonometer and tonometers with known calibration errors ranging to +5 mmHg. They found that while a relationship does exist between calibration error and clinical error in measured IOP, it is not a one-to-one relationship. If a tonometer has a calibration error of less than + 3 mmHg, it would not overestimate IOP by more that 2 mmHg – a finding the authors believe may be clinically acceptable in situations where limited resources prevent regular recalibration of tonometers. Masselos et al (p. 25) have found that corneal indentation (CI) represents a rapid, portable, and effective method of reducing intraocular pressure (IOP) in patients with acute angle closure (AAC). Although the previous report of CI in the literature dates back to 1979, the authors contend the technique's value and simplicity are worth revisiting. In this report, they detail 7 case studies (8 eyes) of patients who underwent CI as part of their early management of AAC. In this series, IOP was significantly reduced, with an average reduction of 20.9 mmHg, and 3 of 4 patients with severe acute pain reported early resolution of pain following CI. All patients subsequently were treated with laser peripheral iridotomies or lensectomy using phacoemulsification. The authors conclude that CI relieves the pain caused by the raised IOP. In addition, by reducing corneal edema, the angle can be visualized, and a peripheral iridotomy can be performed safely. CI can also be performed in rural settings when access to resources is limited. Brown et al (p. 57) have found that ranibizumab administered as monthly intravitreal injections of 0.3 mg or 0.5 mg for 24 months was effective and superior to verteporfin photodynamic therapy (PDT) in maintaining or improving visual acuity (VA) in patients with predominantly classic subfoveal neovascular age-related macular degeneration (AMD). These results represent the culmination of the 2-year, phase III ANCHOR (Anti-VEGF Antibody for the Treatment of Predominantly Classic Choroidal Neovascularization in AMD) trial. The VA benefit from ranibizumab proved both rapid and sustained. The superiority of ranibizumab to PDT was evident by 1 month after starting treatment, increased to a plateau by the end of the first year and then continued through the 24th month. The authors conclude that these results constitute a major breakthrough in the treatment of predominantly classic choroidal neovascularization secondary to AMD. A 3-year extension study called HORIZON is currently under way in which patient follow-up and retreatment are flexible and based on individual patient response and investigator discretion. In a prospective, multicenter, nonrandomized clinical trial, Boixadera et al (p. 100) demonstrate that using photodynamic therapy (PDT) with the standard age-related macular degeneration (AMD) protocol is an effective treatment of symptomatic circumscribed choroidal hemangioma (CCH). The study involved 31 eyes of 31 patients who underwent the standard PDT protocol for AMD. Of these participants, 82.8% required 1 PDT treatment, 13.8% 2 PDT treatments, and 3.4% 3 PDT treatments to eliminate exudative retinal detachment. Visual acuity increased from a mean of 20/60 to 20/35, with 69% of patients experiencing visual recovery. Cystoid macular edema regressed in all cases, and exudative macular detachment disappeared in all but 2 cases. Visual fields demonstrated resolution of central scotomas. The authors conclude that standard AMD PDT with verteporfin is an effective minimally invasive treatment alternative for CCH with localized retinal detachment in terms of resolving exudative subretinal fluid and recovery of visual acuity. The authors call for long-term follow up to evaluate the recurrence after successful elimination of subretinal fluid. A retrospective, interventional case series of 82 patients (85 eyes) by Lane et al (p. 135) found that “sutureless” repair of orbital floor and rim fractures may be a viable alternative to multilayered periosteal and conjunctival closure. Patients with isolated floor fractures and those with more complex orbital fractures were included in the study. The surgical method involved a transconjunctival incision below tarsus, which provided preseptal access to the inferior orbital rim. The periosteum was then incised for exploration and repair of the orbital floor fractures. Forced ductions were performed after release of entrapped tissue and placement of an orbital floor implant, and the conjunctiva was re-approximated with forceps and draped into the inferior fornix. The operation was associated with a low incidence of postoperative complications; there were no cases of postoperative implant exposure, infection, or migration. The authors conclude that the “sutureless” transconjunctival approach to orbital floor and rim fractures provides adequate surgical exposures and acceptable aesthetic results with a low rate of complications." @default.
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• W4240966968 date "2009-01-01" @default.
• W4240966968 modified "2023-09-25" @default.
• W4240966968 title "This Issue At A Glance" @default.
• W4240966968 doi "https://doi.org/10.1016/j.ophtha.2008.10.030" @default.
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