Abstract: Corneal collagen-crosslinking (CXL) has been widely investigated in the adult population. There is still little available in the literature, however, on the effects of CXL in children. A review of the literature on CXL in the pediatric population is presented here, with a particular emphasis on the refractive effects. Although several studies demonstrate promising results, most studies have small sample sizes with relatively short follow-up periods. Further investigation on the effects of CXL in the pediatric population is required to better understand long-term effects.
Background: The purpose of this study is to summarize the application of day surgery combined with fast track program in strabismus operation under general anesthesia.
Methods: The clinical data of 2,000 cases of strabismus patients who had underwent surgery in day surgery or traditional hospitalization in the duration from 2015 to 2016 was retrospectively analyzed. The safety and efficacy were assessed by comparing the average length of stay in hospitals, anesthesia recovery time, patient satisfaction and number of adverse events.
Results: Compared with the traditional group, the average length of stay in hospital and recovery time in day surgery group were significantly lower (P<0.001) and the satisfaction of patient was improved (P<0.05), which were statistically significant difference. Moreover, no adverse events occurred among these patients.
Conclusions: The application of day surgery in strabismus operation under general anesthesia is feasible, which can reduce the recovery time and shorten the hospital stay of patients safely and effectively, and their satisfaction was improved at the same time.
Abstract: High speed and small gauge vitrectomy systems have made surgical intervention in complications of diabetic retinopathy (DR) safer. The availability of anti-vascular endothelial growth factor (anti-VEGF) compounds for use in DR has significantly improved intraoperative and postoperative outcomes. This review discusses the indications for surgical intervention in DR. The role of anti-VEGF compounds is discussed as surgical adjuvants with an emphasis on timing of treatment before surgery.
Abstract: Deep anterior lamellar keratoplasty (DALK) is preferred over conventional penetrating keratoplasty (PKP) for the treatment of anterior corneal opacities or ectasias due to decreased risk of endothelial rejection. However, DALK remains surgically challenging, largely due to challenges associated with achieving consistent pneumo-dissection of posterior stroma from the underlying pre-Descemet’s or Descemet’s membrane (DM). Air must be injected at sufficient depth in the corneal stroma in order to achieve successful pneumo-dissection, but advancing a needle too deep into the cornea can lead to perforation of DM. We describe here a novel technique using a handheld slit lamp (Eidolon model 510L, Eidolon Optical LLC, Natick, MA, USA) to assist in creation of the big-bubble in DALK surgery. Use of a handheld slit beam intraoperatively is a safe, relatively inexpensive, and effective technique for increasing the success of big-bubble formation in DALK procedures.
Abstract: Diabetic retinopathy (DR) is a complex multifactorial disease and one of the leading causes of visual impairment worldwide. DR pathogenesis is still not completely understood and, even if studies performed in the past focused on microvascular dysfunction as the main event, growing body of scientific evidence has demonstrated an important role of inflammation and neurodegeneration in the onset and progression of DR. This review summarizes current literature on the role of inflammation in the pathogenesis and progression of DR. In particular, it focuses on clinical inflammatory biomarkers detectable with non-invasive retinal imaging, suggestive of a local inflammatory condition. Current available treatments are applicable only at advanced stages of disease, therefore, there is the need to detect biomarkers of subclinical or early DR that can help in DR management before irreversible damage occurs. A better understanding of inflammatory pathways involved in DR may permit to implement more specific and personalized therapeutic strategies and clinical biomarkers may be a helpful tool in the everyday clinical practice to direct the patient to the most appropriate treatment option.
Abstract: Despite appropriate management of the systemic disease, patients with diabetes may develop severe forms of diabetic retinopathy that require surgery. Non-clearing vitreous haemorrhage (VH), traction retinal detachment involving the macula, combined traction and rhegmatogenous retinal detachment, progressive fibrovascular proliferation (PFP) and rubeosis with acute VH represent the main indications for surgery. Vitrectomy techniques and surgical tools have developed dramatically in the last decade in order to help the surgeon succeed in these challenging cases.
