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  1. Harminder S Dua,
  2. Arun D Singh, Editors-in-Chief

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Infero-eyebrow upper eyelid blepharoplasty

Hara et al describe a procedure for removing excess wrinkles from the upper lids of elderly patients. Excess wrinkles were resected with a blade and scissors or laser along the lower eyebrow margin in 157 eyes (95 patients, average age 74 years). Underresection was noticeable in 6 eyes (4%), which required another resection. All patients expressed satisfaction with the final cosmetic results. See page 109

Protective effect of ophthalmic viscoelastics

den Bruel et al compared ophthalmic viscoelastics in protecting the cornea from endothelial cell loss during cataract surgery by performing a systematic review of 21 randomised controlled trials (1769 patients). The outcome measure was loss in endothelial cell density 3 months after surgery. Direct comparison meta-analysis showed that viscoadaptives lead to a lower loss in cell density compared with very low viscosity dispersives and super viscous cohesives. The soft shell technique, showed a lower loss compared with viscous cohesives. However, the absolute observed difference in endothelial cell density loss of <100 cells/mm2, is not clinically relevant in most patients. See page 5

RNFL evaluation with OCT and GDx

Pablo et al compared the accuracy of scanning laser polarimetry with variable corneal compensation (GDx-VCC) and Stratus OCT for detecting RNFL glaucomatous damage observed in red free digital photographs of 181 eyes with ocular hypertension (OHT; IOP >22 mm Hg). 128 OHT subjects without and 53 OHT subjects with RNFL defects were studied. They observed that OCT and GDx have similar diagnostic accuracy for identifying early glaucomatous defects. See page 51

Anti-VEGF therapy for retinal vein occlusion

Pece et al evaluated the efficacy of intravitreal ranibizumab (0.5 mg of Lucentis) in 17 patients with treatment-naive retinal vein occlusion (9 CRVO and 8 BRVO). All subjects were followed for a minimum of 12 months. In patients with CRVO, BCVA improved to 36.7 letters with a gain of 6.4 lines, and a mean reduction in CMT of 360 μm. In patients with BRVO, the mean CMT reduction was 275 μm. The authors conclude that intravitreal ranibizumab restores the integrity of the inner blood-retinal barrier, reduces CMT, and significantly improves visual function in retinal vein occlusions. See page 56

Selective retina therapy for CSR

Klatt et al evaluated selective retina therapy (SRT) as a treatment of acute CSR. 14 eyes were randomised to SRT group (Q-switched Nd:YLF laser, spot diameter 200 μm) and 16 eyes to a control group. After 3 months, patients in the control group with persistence SRF were allocated to a cross-over group, treated with SRT and followed for further 3 months. The mean improvement of BCVA with significantly greater decrease in SRF was observed after SRT than in the control group. The authors conclude that SRT appears to expedite functional recovery and the re-absorption of SRF. See page 83

Ultrasound velocity in heavy ocular tamponade

Siddiqui et al evaluated the ultrasound velocity in 5 tamponade agents (SO 1000, SO 5000, Oxane HD, Densiron 68 and F-Decalin). Time of flight (T1) was measured between a ultrasound transducer and the bottom of a container of the agent, and remeasured (T2) after reducing the separation by 1 cm. They observed that the speed of sound ranged from 64568 m/s to 976610 m/s depending on the tamponade agent. In Densiron 68 and F-Decalin, the speed of sound was markedly reduced to 914610 m/s and 64568 m/s, respectively. The authors conclude that variability in the ultrasound velocity should be adjusted for various tamponade media when calculating intraocular lens power. See page 142

KERARINGS and corneal collagen cross-linking

El-Raggal et al evaluated the efficacy of combined intracorneal ring segments (KERARINGS) insertion and corneal collagen cross-linking (CXL) performed in one session (concurrent) or two sessions (sequential) in 16 eyes (10 patients) with progressive kertaoconus. In randomly divided groups; Group 1 (sequential, 9 eyes) and Group 2 (concurrent, 7 eyes), there was statistically significant improvement in uncorrected and corrected distance visual acuity with reduction in refractive error and keratometric values. There was no difference between groups regarding the visual acuity and refractive error. However, group 2 patients revealed greater reduction in keratometric values and stromal haze. The authors conclude that the concurrent procedure appears to be more effective in improving the corneal shape. See page 37

Triamcinolone and tPA for CRVO

Yamamoto evaluated the efficacy of simultaneous intravitreal injection of triamcinolone acetonide (4 mg) and tissue plasminogen activator (tPA, 25 μg) for macular oedema associated with CRVO 20 in eyes (20 patients). The BCVA improved three lines or more in 65% and 53% of eyes and the mean macular thickness decreased from 1072 mm to 455 and 409 μm at 1 and 12 months, respectively. Fifteen (75%) of the 20 eyes required at least one additional injection to prevent a recurrence of macular oedema. The intraocular pressure increased in 4 eyes. The authors conclude that a randomised clinical trial is necessary to evaluate the efficacy of this treatment. See page 69

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