Cataract surgery on post radial keratotomy patients

This study aims to evaluate and to compare three different approaches of cataract surgery to patients with previous radial keratotomy（RK）, and to analyze the mechanical properties of the cornea after cataract surgery. Three groups of patients, each one including 8 eyes of patients with 16 RK incisions. The first group includes eyes with the first cataract incision superiorly, the second group in the temporal area, the third group in temporal area and a precautionary stabilizing suture across the RK incision adjacent to the main tunnel. In the first group intraoperative dehiscence occurred in three eyes（37.5%）： it required immediate application of a suture. In the second group dehiscence occurred intraoperatively in two radial scars（20%）： it required immediate application of a suture. In the third group, no intraoperative dehiscences were observed. The stabilizing suture of the RK incision works safer, with a lower risk of dehiscences and less postoperative astigmatism.

In vivo confocal microscopy: qualitative investigation of the conjunctival and corneal surface in open angle glaucomatous patients undergoing the XEN-Gel implant, trabeculectomy or medical therapy

Purpose:Assessing the quality of the ocular surface by in vivo scanning laser confocal microscopy(IVCM)in primary open angle glaucoma(POAG)patients treated by Xen 45 Gel Stent,medical therapy and trabeculectomy.Methods:Retrospective,single-center,single-masked,comparative study including 60 eyes of 30 patients(mean age 61.16±10 years)affected by POAG.Eyes were divided into 3 groups:Group 1 eyes underwent the Xen 45 Gel Stent procedure,Group 2 eyes were under medical therapy,Group 3 eyes were surgically treated by trabeculectomy.All patients underwent HRT II IVCM analysis of cornea,limbus,conjunctiva,sub-tenionian space and sclera.Results:The Xen 45 Gel stent,if properly positioned in the sub-conjunctival space preserves goblet cells and limits ocular surface inflammation.Regular corneal epithelial cells with micro-cysts,and normo-reflective sub-epithelial nerve plexus are documented by IVCM.In sub Tenon’s implants an alternative lamellar intra-scleral filtration is detectable.Combined surgical procedures show a noticeable number of inflammatory cells with rare micro-cysts.Post-trabeculectomy inflammatory reaction is more evident than Xen 45 Gel Stent associated surgical procedures,but less than medical therapy where a conspicuous presence of Langerhans cells,peri-neural infiltrates,marked loss of goblet cells and fibrosis is visible.Conclusion:Ocular surface inflammation was more notable in topical therapy than after trabeculectomy,which itself causes more inflammation than XEN Gel stents.

In vivo confocal microscopy:qualitative investigation of the conjunctival and corneal surface in open-angle glaucomatous patients undergoing the XEN-Gel implant,trabeculectomy or medical therapy

Purpose:Assessing the quality of the ocular surface by in vivo scanning laser confocal microscopy(IVCM)in primary open-angle glaucoma(POAG)patients treated by XEN 45 Gel Stent,medical therapy and trabeculectomy.Methods:Retrospective,single-center,single-masked,comparative study including 60 eyes of 30 patients(mean age 61.16±10 years)affected by POAG.Eyes were divided into 3 groups:Group 1 eyes underwent the XEN 45 Gel Stent procedure,Group 2 eyes^were under medical therapy,Group 3 eyes were surgically treated by trabeculectomy.All patients underwent HRTII IVCM analysis of cornea,limbus,conjunctiva,sub-tenionian space and sclera.Results:The XEN 45 Gel Stent,if properly positioned in the sub-conjunctival space preserves goblet cells and limits ocular surface inflammation.Regular corneal epithelial cells with microcysts,and normo-reflective sub-epithelial nerve plexus are documented by IVCM.In sub Tenon's implants an alternative lamellar intra-scleral filtration is detectable.Combined surgical procedures show a noticeable number of inflammatory cells with rare microcysts.Post-trabeculectomy inflammatory reaction is more evident than XEN 45 Gel Stent associated surgical procedures,but less than medical therapy where a conspicuous presence of Langerhans cells,peri-neural infiltrates,marked loss of goblet cells and fibrosis is visible.Conclusion:Ocular surface inflammation was more notable in topical therapy than after trabeculectomy,which itself causes more inflammation than XEN Gel Stents.