We thank Dr Perera [1] for his interest in our article.[2] We do agree with him that the
results of partial flaps without ablation and good flaps with ablation
are
not comparable, which in fact was not the aim of the study.
The primary
aim of the study was to evaluate the changes in the posterior corneal
elevation after the partial flaps. We, in this article, attempted to
evaluate the changes i...
We thank Dr Perera [1] for his interest in our article.[2] We do agree with him that the
results of partial flaps without ablation and good flaps with ablation
are
not comparable, which in fact was not the aim of the study.
The primary
aim of the study was to evaluate the changes in the posterior corneal
elevation after the partial flaps. We, in this article, attempted to
evaluate the changes in posterior corneal elevation after partial flaps
in
cases that were planned to have LASIK surgery. Based on our results we
concluded that the inadvertent occurrence of partial flap during LASIK
procedure does not contribute to an additional increase in posterior
corneal elevation.
Further, we only suggested, but did not conclude that evaluation of the
posterior corneal surface topographic changes after partial flaps
without
ablation may help us to understand the contribution of the flap (even if it is partial) to the corneal elasticity. This is more so as raising a
flap alone in the absence of photo ablation for the purpose of studying
the mechanism of posterior corneal elevation may be not be practical and ethical.
References
(1) Perera S. Partial flaps during LASIK [electronic response to Sharma et al. Posterior corneal topographic changes after partial flap during laser in situ keratomileusis] bjophthalmol.com 2003 http://bjo.bmjjournals.com/cgi/eletters/87/2/160#121
(2) N Sharma, A Rani, R Balasubramanya, R B Vajpayee, and R M PandeyPosterior corneal topographic changes after partial flap during laser in situ keratomileusis. Br J Ophthalmol 2003;87:160-162.
Editor,
Could you please provide a reference for Bell's phenomenon and the occurrence of optical zone intrusion as well as the ability to control spontaneous eye movements during the procedure?
We read with interest the article by Muhtaseb et al. on the
development of a system for preoperative stratification of cataract
patients according to their risk of intraoperative complications. [1] In their article the authors have analyzed
1441 cataract surgeries in order to determine factors that would
increase
the risk of surgical complications.
We read with interest the article by Muhtaseb et al. on the
development of a system for preoperative stratification of cataract
patients according to their risk of intraoperative complications. [1] In their article the authors have analyzed
1441 cataract surgeries in order to determine factors that would
increase
the risk of surgical complications.
We have previously described a similar simple grading system for
assessing the risk of cataract surgery which we called "the cataract
surgery risk score" and found it to be useful for residents and
beginning
surgeons.[2] Our risk score is composed of individual points attributed to
risk factors that are believed to increase complications during surgery.
The advantage of such a system is that it allows the selection of cases
from easy to more difficult ones, as the surgeon's skills improve. It
also allows the beginning surgeons to focus on important details in the
ocular examination that are often overlooked.
References
1. M Muhtaseb, A Kalhoro, and A Ionides. A system for preoperative stratification of cataract patients according to risk of intraoperative complications: a prospective analysis of 1441 cases. Br J Ophthalmol 2004; 88: 1242-1246.
2. Najjar DM, Awwad ST. Cataract surgery risk score for residents
and beginning surgeons. J Cataract Refract Surg. 2003 Oct;29(10):2036-7.
Kotter et al. refer to some problems, such as fabrication of authorship, data and ethical transgressions,[1] in our article published in The Lancet[2] on February 19, 2000. However, they do so without knowing the current facts about an ongoing process. They cite accusations that rely on an unfinalised investigation from the year 2000. As we are now in 2003, I do feel that I have to present updated cor...
Kotter et al. refer to some problems, such as fabrication of authorship, data and ethical transgressions,[1] in our article published in The Lancet[2] on February 19, 2000. However, they do so without knowing the current facts about an ongoing process. They cite accusations that rely on an unfinalised investigation from the year 2000. As we are now in 2003, I do feel that I have to present updated correct information.
Before I do that, however, I would like to note that the best scientific evidence against fabrication of the results, is its reproducibility by other groups. The results of Kotter et al. show the beneficial effect of interferon in Behcet's disease just as our results did,[2] and our results are being increasingly reproduced.
The fact that the accusations were made on the basis of an unfinalised investigation was clear in the editorial [3] and letter [4] written about our article in The Lancet [2] at the time. The editor of The Lancet stated that: "... further investigations are in progress"3 and the Dean of our medical school stated that "... the issue will be finalised ... in a court of law". [4]
I would like to report on the decisions made by courts of law during the three-year-period since then.
First of all, during ongoing inquires about the article,[2] it was established without doubt by an investigating commission that all my coauthors had already known that their names were included as coauthors before the article was published. None of the coauthors had objected to the inclusion of his/her name at the time. It was not until after two months after the publication that some of the coauthors claimed that they were unaware of inclusion of their names. It is noteworthy that they did so only after an ethical inquiry was embarked upon. The issue of fabricated authorship was brought to a court, accusing me of forging signatures. The Court unambiguously declared my innocence at its first session on the matter on April 3, 2003, concluding that there was no forging of signatures and that it cannot be imagined that the coauthors had been unaware of the article given the totality of the circumstances surrounding the issue.[5] This conclusion is supported independently by decisions of two other separate administrative courts.[6,7] As attested by those court decisions, there is no fabrication of authorship.
I was also accused of possible fabrication of the patients.[4] However, in a declaratory action taken by another court, it was definitely established that all 135 patients mentioned in The Lancet article2 were officially registered at the Hacettepe University Medical School.[8]
At the same time, the highest administrative court, The State Council of Turkey issued a stay order against any administrative act due to the claimed ethical transgressions,[9] in favour of me. This decision was further approved at a plenary session held at The State Council of Turkey with the involvement of members from all administrative chambers of the Court.[10]
Kotter et al. are unintentionally perpetuating incorrect accusations about me in the Journal.[1] I am hoping the impropriety of those accusations is clear in light of all the independent court decisions I describe above. Judicial decisions should be respected by everyone who believes in upholding the supremacy of law. It is my natural right to response and the readers of the Journal deserve to be informed by updated correct information.
There is no indication that either authorship or the results reported in The Lancet article [2] were fabricated. Besides judicial decisions, the best scientific evidence that the data are not fabricated is its reproducibility by other groups, as I mentioned at the beginning. It is well shown in the literature that our results [2] are being increasingly reproduced, and I am happy to see that. In our clinic, we have been using interferon in Behcet's disease since early 1990s and we are among the first groups to use it in this disease. We published our preliminary results previously.[11-12] The main problem in Behcet's disease is to prevent serious complications such as vascular thrombotic attacks, ocular involvement and their recurrences.[13] Conventional drugs and corticosteroids have very little if any effect on the course of such complications. The first two years of the disease is the most critical period and the disease generally runs a more severe course in patients in whom the disease is diagnosed at an age less than 30.[14-16] I believe that as interferon usage is increased, ocular complications of Behcet's disease will be minimised as well as extraocular manifestations. I suggest that the earlier we begin interferon, the better it is.
References
(1) Kotter I, Zierhut M, Eckstein, et al. Human recombinant interferon alfa-2a for the treatment of Behcet's disease with sight threatening posterior or panuveitis. Br J Ophthalmol 2003;87:423-31.
(2) Demiroglu H, Ozcebe OI, Barista I, et al. Interferon alfa-2b, colchicine, and benzathine penicillin versus colchicine and benzathine penicillin in Behcet's disease: a randomised trial. Lancet 2000;355:605-9.
(3) Horton R. Retraction: Interferon alfa-2b ... in Behcet's disease. Lancet 2000;356:1292.
(4) Sayek I. Behcet's disease: flaws in research integrity of randomised trial. Lancet 2000;356:1351.
(5) Turkish Republic, Ankara 3rd Court of General Criminal Jurisdiction; file no: 2003/256, decision no: 2003/335.
(7) Turkish Republic, Ankara 3rd Administrative Court; file no: 2000/1121.
(8) Turkish Republic, Ankara 2nd Civil Court of First Instance; file no: 2002/66 different work..
(9) 12th Chamber of The State Council of Turkey; file no: 2002/883.
(10) Plenary session, The State Council of Turkey, no: 2002/340.
(11) Caliskan S, Eldem B, Demiroglu H, et al. Interferon alpha-2b in the treatment of ocular Behcet's disease. Middle East J Ophthalmol 1995;3:94-9.
(12) Dundar S, Demiroglu H, Ozcebe O, et al. Alpha interferon in Behcet's disease. Hematol Rev 1996;9:285-90.
(13) Demiroglu H, Yalcin S, Buyukasik Y, et al. Vascular thrombotic problems in Behcet's disease. Acta Haematol 1997;98:172.
(14) Demiroglu H, Barista I, Dundar S. Assessing the risk of deep vein thrombosis in Behcet's disease. Thromb Res 1996;84:297-8.
(15) Demiroglu H, Barista I, Dundar S. Risk factor assessment and prognosis of eye involvement in Behcet's disease in Turkey. Ophthalmology 1997;104:701-5.
(16) Bardak Y. Effects of age and sex on Behcet's disease. J Rheumatol 1999;26:1008-9.
Editor,
I am a 76-year-old suffering from myopic degeneration (is this ARMD?).I have been operated for cataract on my left eye with no significant improvement. I am strongly convinced that the usual measurement of visual acuity is almost
meaningless. The major problem I find in practical life is the lack of adequate sensitivity to contrast. For example, in my bank they print their copy report with a gray ink...
Editor,
I am a 76-year-old suffering from myopic degeneration (is this ARMD?).I have been operated for cataract on my left eye with no significant improvement. I am strongly convinced that the usual measurement of visual acuity is almost
meaningless. The major problem I find in practical life is the lack of adequate sensitivity to contrast. For example, in my bank they print their copy report with a gray ink (for reasons of elegance, I suppose). These are not readable to me, but if I use a scanner copy they become immediately
readable. In the seventy years that I have undergone eye tests I do not remember one single time that somebody would care about contrast sensitivity. Is there at least a standard procedure to measure contrast sensitivity about which I could inquire and possibly use to check my progress?
Thank you.
We read with interest for the article by Raiskup et al. on the long
term evaluation on mitomycin C (MMC) for pterygium.[1] It seems that the
usage MMC in pterygium surgery is relatively safe in the long term.
Overdosge of MMC eyedrops may be associated with potential serous
side effects such as corneal perforation.[2] In this regards, we would like
to point out a major typo in the Abstr...
We read with interest for the article by Raiskup et al. on the long
term evaluation on mitomycin C (MMC) for pterygium.[1] It seems that the
usage MMC in pterygium surgery is relatively safe in the long term.
Overdosge of MMC eyedrops may be associated with potential serous
side effects such as corneal perforation.[2] In this regards, we would like
to point out a major typo in the Abstract. The dosage of the MMC
eyedrops should be 0.01% or 0.02% instead of 1% or 2%. Besides, we would
be appreciative if the authors could clarify the duration of MMC eyedrops
that was given postoperatively, whether it is a 2-week course as described
in the Abstract or a 5-day course as described in the Patients and
Methods.
Since a single intraoperative application of MMC and post operative
MMC eyedrops are equally effective, it seems that the former is the
treatment of choice as it is easier to administer and there is no
compliance issue.
Finally, the authors also suggested that at present, they advise the
use of MMC at a concentration of 0.02% intraoperatively for 3 minutes.
This, however, according to our experience, is associated with a higher
recurrence rate as compared with 0.02 % for 5 minutes (42.9% vs 8.3%).[2]
References
1. Raiskup F, Solomon A, Landau D, Ilsar M, Frucht-Pery J. Mitomycin
C for pterygium: long term evaluation. Br J Ophthalmol. 2004;88:1425-8.
2. Lam DS, Wong AK, Fan DS, Chew S, Kwok PS, Tso MO. Intraoperative
mitomycin C to prevent recurrence of pterygium after excision: a 30-month
follow-up study. Ophthalmology. 1998;105:901-4
We read the article on intravitreal triamcinolone injections for
exudative age-related macular degeneration with interest.[1] The paper
stated that visual acuity increased significantly (p...
We read the article on intravitreal triamcinolone injections for
exudative age-related macular degeneration with interest.[1] The paper
stated that visual acuity increased significantly (p<_0.001 from="from" _0.16="_0.16" _0.11="_0.11" to="to" a="a" mean="mean" maximum="maximum" of="of" _0.23="_0.23" _0.17.="_0.17." the="the" authors="authors" therefore="therefore" picked="picked" best="best" one="one" up="up" _10="_10" postoperative="postoperative" visual="visual" acuity="acuity" measurements="measurements" and="and" compared="compared" it="it" with="with" single="single" preoperative="preoperative" measurement.="measurement." this="this" is="is" misleading="misleading" reader="reader" regarding="regarding" true="true" effectiveness="effectiveness" treatment.="treatment." p="p"/> The Macular Photocoagulation Study Group found that the differences
in between two repeated tests was one line or more in 13% of cases and the
differences were greatest in patients with visual acuity of 20/100 or
worse.[2] By taking up to 10 postoperative measurements, Jonas et al.
greatly increased the chances of a positive result. The difference between
mean pre-injection 0.16 (20/125 or 6/36) and best mean postoperative 0.23
(20/87 or 6/26) was less than one line on the Snellen chart.
Table 1 gave the mean visual acuity pre-injection and at various time
intervals post-injection. At 1 and 2 months, the p values were 0.04. It
was unclear whether the p values were one or two tailed but both were
described as not significant (NS) in table 1. Multiple significance
testing at each of a number of time points is generally not recommended -
if it is done, some kind of adjustment to the p values is needed.[3,4]
Looking at the results presented table 1, the readers might conclude that
triamcinolone had a transient and doubtful beneficial effect on the visual
acuity.
The authors go on to further analyse the results into improvements of
3 and 6 or more lines. The vision was tested on a Snellen chart which has
irregular steps. Three or 6 lines do not therefore represent a constant
change in visual angle (as in a logMAR chart) and therefore the analysis
was confusing.
Variations in intraocular pressure of 5 or 6 mmHg occur diurnally in
normal individuals as well as glaucomatous patients.[5-7] Whilst there
is little doubt that triamcinolone may affect the intraocular pressure,
the comparison of the baseline with the highest (p<_0.001 was="was" misleading="misleading" as="as" the="the" comparison="comparison" of="of" highest="highest" with="with" that="that" at="at" _7="_7" months="months" p0.001.="p0.001." more="more" interest="interest" might="might" be="be" number="number" patients="patients" who="who" had="had" very="very" high="high" levels="levels" range="range" extended="extended" to="to" _64="_64" mmhg="mmhg" and="and" whether="whether" these="these" intraocular="intraocular" pressures="pressures" responded="responded" treatment.="treatment." p="p"/> The authors’ experience in using triamcinolone is well recognised.
We congratulate them on an otherwise excellent piece of work.
References
(1) Jonas JB, Kreissig I, Degenring R. Intraocular pressure after
intravitreal injection of triamcinolone acetonide. Br J Ophthalmol 2003;87(1):24-7.
(2) Blackhurst DW, Maguire MG. Reproducibility of refraction and visual
acuity measurement under a standard protocol. The Macular Photocoagulation
Study Group. Retina 1989;9(3):163-9.
(3) Altman DG. Practical Statistics for Medical Research. London: Chapman
and Hall, 1991.
(4) Matthews R. The numbers don't add up. New Scientist 2003;177(2385):28.
(5) Pointer JS. The diurnal variation of intraocular pressure in non-
glaucomatous subjects: relevance in a clinical context. Ophthalmic Physiol
Opt 1997;17(6):456-65.
(6) De_Vivero C, O_Brien C, Lanigan L, Hitchings R. Diurnal intraocular
pressure variation in low-tension glaucoma. Eye 1994;8(Pt5):521-3.
(7) Smith J. Diurnal intraocular pressure. Correlation to automated
perimetry. Ophthalmology 1985;92(7):858-61.
Editor,
We read with interest the article by Ishioka and coworkers, in which the authors studied the effect of trabeculectomy with and without mitomycin C in post-keratoplasty glaucoma. The authors conclude that trabeculectomy with mitomycin C showed better results for glaucoma following penetrating keratoplasty. We congratulate the authors for an excellent study. We have published similar observations on...
Editor,
We read with interest the article by Ishioka and coworkers, in which the authors studied the effect of trabeculectomy with and without mitomycin C in post-keratoplasty glaucoma. The authors conclude that trabeculectomy with mitomycin C showed better results for glaucoma following penetrating keratoplasty. We congratulate the authors for an excellent study. We have published similar observations on trabeculectomy with mitomycin C for post-
keratoplasty in 1997.[1] The salient features of this
study are worth mentioning as literature on mitomycin C augmented trabeculectomy in post-keratoplasty glaucoma is limited.
In the study by Sharma and coworkers trabeculectomy with mitomycin C (0.2 mg/ml for 2.5 minutes) was performed in 16 eyes of 16 patients for medically uncontrolled glaucoma following penetrating keratoplasty. The mean pre-trabeculectomy IOP with maximal medical therapy was 34.6 mm Hg (range 24 to 45 mm Hg). The mean IOP following trabeculectomy with mitomycin C was 14.2 mm Hg (range 8 to 36 mm Hg) by the end of follow-up of 14.2 months (range 8 to 32 months). Fourteen eyes (87.5%) had complete success, one eye (6.25%) had qualified success and one eye (6.25%) had
failure. All the patients had either better than or maintained pre-operative visual acuity. None of the patients developed postoperative complications such as shallow anterior chamber, epithelial defect of
hypotony. Earlier Khatana et al[2] presented in ARVO showed reduction of IOP following trabeculectomy with mitomycin C in most of their patients. In addition to the efficacy, safety of trabeculectomy with mitomycin C for
post-keratoplasty glaucoma reported is a major concern. Mitomycin C as an adjunct to trabeculectomy has been safe for corneal endothelium.[3] In an experimental study on rabbit eyes, the peak aqueous level of mitomycin C
after topical application (0.4 mg/ml) was 0.03 ± 0.02 mg/ml.[4] This aqueous concentration was considered above the therapeutic level for inhibition of subconjunctival fibroblast proliferation but below the level known to cause endothelial toxicity.[4] In studies by Sharma et al[1] and
Khatana et al,[2] mitomycin augmented trabeculectomy caused no damage to the clear penetrating grafts.
Our observations were in accordance with those by Ishioka, et al that in medically uncontrolled glaucoma following penetrating keratoplasty, trabeculectomy with mitomycin C may be considered unless there is a
contraindication to the use of adjuvant. However, the authors may have inadvertently missed our earlier report.
References
1. Sharma A, Kumar S, Ram J, et al. Trabeculectomy with mitomycin C for post-keratoplasty glaucoma: A preliminary study. Ophthal Surg Lasers 1997;28:891-5.
2. Khatana AK, Olivier M, Shin DH, et al. Safety and efficacy of adjunctive mitomycin-C in filtration surgery in eyes with corneal grafts. Invest Ophthalmol Vis Sci 1993;34(Suppl):1099.
3. Anglade E and Dreyer E. The effect of mitomycin-C and 5-fluorouracil on corneal endothelium in trabeculectomy surgery. Invest Ophthalmol Vis Sci 1993;34(Suppl):730A.
4. Eezuduemboi RD, Sarraf D, Wilson MR, et al. Aqueous and vitreous concentration of mitomycin following topical administration. Invest Ophthalmol Vis Sci 1993;34(Suppl):726.
Dear Editor,
We were highly interested by Sharma et al's paper on inferior-tear
retinal
detachment (RD) and we would like to make a few remarks.
Is there any significant difference between phakic and pseudophakic
patients ? When comparing the two techniques, it is worth reminding that
vitrectomy will systematically induce cataract within a few years, which
will imply secondary surgery. This will considerably increa...
Dear Editor,
We were highly interested by Sharma et al's paper on inferior-tear
retinal
detachment (RD) and we would like to make a few remarks.
Is there any significant difference between phakic and pseudophakic
patients ? When comparing the two techniques, it is worth reminding that
vitrectomy will systematically induce cataract within a few years, which
will imply secondary surgery. This will considerably increase management
costs.
We do not fully agree with the definition proposed for this particular
RD
group. According to Sharma et al, inferior-tear RD is characterised by
at
least one tear being localised between the 4- and 8-hour meridians.
Figure
2 is a good illustration of that, where all three sketches show tears
beyond the 3h-9h meridians. It is our view that inferior-tear RD can
only
be evoked when all tears are between 4 and 8-h meridians. Otherwise, it
is
not inferior-tear RD but rather superior-tear RD complicated by an
inferior tear. Consistently with this definition, inferior-tear RDs
appear
to induce a high risk of recurrence. Indeed, we found a significantly
increased risk of recurrence in such specific RD cases2.
We agree with Sharma et al when they underline the importance of
postoperative positioning following inferior-tear RD surgery. Several
processes have been used. We setup a prospective study in patients
operated on for inferior-tear RD by indentation, subretinal fluid
drainage
and gas injection. We systematically positioned a wire under the right
inferior so as to leave the eye under traction for a few days (photos).
Bed foot legs were also propped up to give the patient a feet-up
posture.
Our first results in 10 patients revealed 100% anatomical success with
subretinal fluid persistence for 3 months in one patient and we had to
reinject gas in another.
Management of inferior tear RD is specific and requires more studies
like
that of Sharma et al, to try and establish a consensus.
References
1. Sharma A, Grigoropoulos V, Wiliamson TH. Management of primary
rhegmatogenous retinal detachment with inferior breaks. Br J Ophthalmol
2004;88:1376-1379
2. Quintyn JC, Ponchel C, Fillaux J et al. A. Retinal detachment by
inferior tear, bad pronostic ? J Fr Ophtalmol to be published
Competing Interest Statement No authors have any competing financial interests.
Schueler and associates describe their experience with thermochemotherapy (TCT) in bilateral retinoblastoma.[1] The reported results of transpupillary thermotherapy used in combination with chemotherapy are encouraging, with 86-96% tumor control.[2,3] In the current series, however, local recurrence occurred in 38%.
The dosage of carboplatin used in the current series was 10 mg/Kg BW, which is lower...
Schueler and associates describe their experience with thermochemotherapy (TCT) in bilateral retinoblastoma.[1] The reported results of transpupillary thermotherapy used in combination with chemotherapy are encouraging, with 86-96% tumor control.[2,3] In the current series, however, local recurrence occurred in 38%.
The dosage of carboplatin used in the current series was 10 mg/Kg BW, which is lower than the standard dosage of 18.6-mg/Kg BW.[4] Lower dose of carboplatin, the key drug in the chemotherapy regimen for retinoblastoma, could have influenced the higher recurrence rate.
The authors mention that they treated submacular tumors with TCT. However, in our experience, tumors located in the macular area are better treated initially with chemotherapy for 3-6 cycles in order to achieve maximum possible reduction in tumor size before considering thermotherapy. Chemo reduced macular tumors tend to shrink away from the fovea towards one of the major arcades or the optic nerve, thus exposing the foveal region. Residual tumor beyond 3-6 cycles of chemotherapy could be treated with thermotherapy. A smaller scar thus produced may optimize residual central vision.
The high mean total duration of thermotherapy in the current series is probably because of a smaller spot size of 0.4 mm. The diode laser (Iris Medical Inc, Mountain View, Ca, USA) with an operating microscope adapter allows for a spot size of 0.8,1.2,and 2.0 mm.[3] The relatively newer large spot indirect ophthalmoscope delivery system provides a 1.2mm spot size.[3] A larger spot size will indeed reduce the duration of thermotherapy and allow for a more uniform coverage. Corneal, iris and lens complications are minimized with better convergent beam optical systems currently available.
We believe that with higher dose of carboplatin, staggered thermotherapy for submacular tumors, use of better optical systems for delivery and a larger spot size for thermotherapy, and judicious selection of cases, the tumor regression and vision salvage with TCT could be further optimized.
References
(1) Schueler AO, Jurklies C, Heimann H et al. Thermochemotherapy in hereditary retinoblastoma. Br J Ophthalmol 2003; 87:90-95.
(2) Lumbraso L, Doz F, Urbeita M et al. Chemothermotherapy in the management of retinoblastoma. Ophthalmology 2002; 109:1130-1136
(3) Shields CL, Santos CM, Diniz W et al. Thermotherapy for retinoblastoma. Arch Ophthalmol 1999; 117:885-893.
(4) Shields CL, Honavar SG, Shields JA et al. Factors predictive of recurrence of retinal tumors, vitreous seeds, and subretinal seeds following chemoreduction for retinoblastoma. Arch Ophthalmol 2002; 120:460-464.
Dear Editor
We thank Dr Perera [1] for his interest in our article.[2] We do agree with him that the results of partial flaps without ablation and good flaps with ablation are not comparable, which in fact was not the aim of the study.
The primary aim of the study was to evaluate the changes in the posterior corneal elevation after the partial flaps. We, in this article, attempted to evaluate the changes i...
Editor,
Could you please provide a reference for Bell's phenomenon and the occurrence of optical zone intrusion as well as the ability to control spontaneous eye movements during the procedure?
Dear Editor
We read with interest the article by Muhtaseb et al. on the development of a system for preoperative stratification of cataract patients according to their risk of intraoperative complications. [1] In their article the authors have analyzed 1441 cataract surgeries in order to determine factors that would increase the risk of surgical complications.
We have previously described a si...
Dear Editor
Kotter et al. refer to some problems, such as fabrication of authorship, data and ethical transgressions,[1] in our article published in The Lancet[2] on February 19, 2000. However, they do so without knowing the current facts about an ongoing process. They cite accusations that rely on an unfinalised investigation from the year 2000. As we are now in 2003, I do feel that I have to present updated cor...
Editor,
I am a 76-year-old suffering from myopic degeneration (is this ARMD?).I have been operated for cataract on my left eye with no significant improvement. I am strongly convinced that the usual measurement of visual acuity is almost meaningless. The major problem I find in practical life is the lack of adequate sensitivity to contrast. For example, in my bank they print their copy report with a gray ink...
Dear Editor
We read with interest for the article by Raiskup et al. on the long term evaluation on mitomycin C (MMC) for pterygium.[1] It seems that the usage MMC in pterygium surgery is relatively safe in the long term.
Overdosge of MMC eyedrops may be associated with potential serous side effects such as corneal perforation.[2] In this regards, we would like to point out a major typo in the Abstr...
Dear Editor
We read the article on intravitreal triamcinolone injections for exudative age-related macular degeneration with interest.[1] The paper stated that visual acuity increased significantly (p...
Editor,
We read with interest the article by Ishioka and coworkers, in which the authors studied the effect of trabeculectomy with and without mitomycin C in post-keratoplasty glaucoma. The authors conclude that trabeculectomy with mitomycin C showed better results for glaucoma following penetrating keratoplasty. We congratulate the authors for an excellent study. We have published similar observations on...
Dear Editor, We were highly interested by Sharma et al's paper on inferior-tear retinal detachment (RD) and we would like to make a few remarks. Is there any significant difference between phakic and pseudophakic patients ? When comparing the two techniques, it is worth reminding that vitrectomy will systematically induce cataract within a few years, which will imply secondary surgery. This will considerably increa...
Dear Editor
Schueler and associates describe their experience with thermochemotherapy (TCT) in bilateral retinoblastoma.[1] The reported results of transpupillary thermotherapy used in combination with chemotherapy are encouraging, with 86-96% tumor control.[2,3] In the current series, however, local recurrence occurred in 38%.
The dosage of carboplatin used in the current series was 10 mg/Kg BW, which is lower...
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