RESUMEN
PURPOSE: To assess the correlation between lens thickness (LT) measured by ultrasonography and duration of surgery as well as complications. SETTING: The study was conducted in a hospital in the Parisian suburb of Bobigny, France. DESIGN: A prospective and monocentric study was conducted. All patients undergoing surgery for hypermature cataract between January 2013 and March 2014 were included. METHODS: Morphological features, including LT, axial length, anterior chamber depth and vitreous length were assessed using A-scan ultrasonography. The other parameters assessed were the duration of surgery, occurrence of complications during surgery, visual acuity (VA) and corneal edema score one week after surgery. RESULTS: Thirty eyes of 29 patients were included. Mean LT was 4.11±0.64mm (median: 3.89mm). Mean surgery duration was 24.2±8.7min. Three patients experienced complications during surgery: 2 capsular breaks and 1 posterior lens dislocation. At one week, the mean decimal VA was 0.49±0.34 and the mean corneal edema score was 0.76±1.09. The Pearson correlation coefficient was r=0.27 (P>0.05) between LT and surgery duration while it was r=-0.53 (P=0.01) between VA and LT. No correlation was found for the other parameters studied. DISCUSSION: In this study, the linear correlation between LT and the surgery duration was low. The visual recovery at day 7 appeared inversely correlated with the LT. CONCLUSIONS: LT did not seem to be a marker for longer surgery duration but appeared related to the visual recovery at one week.
Asunto(s)
Extracción de Catarata/efectos adversos , Catarata/patología , Cristalino/patología , Complicaciones Posoperatorias/etiología , Anciano , Anciano de 80 o más Años , Edema Corneal/etiología , Femenino , Humanos , Subluxación del Cristalino/etiología , Cristalino/diagnóstico por imagen , Cristalino/cirugía , Masculino , Persona de Mediana Edad , Tempo Operativo , Tamaño de los Órganos , Facoemulsificación , Índice de Severidad de la Enfermedad , UltrasonografíaRESUMEN
INTRODUCTION: DME is the main cause of loss of vision over the course of diabetes. DME incidence is correlated with diabetes duration, high glycemic levels, high blood pressure, and the severity of diabetic retinopathy. To prevent DME, patients need to have access to medical care. In this study, we sought to know whether DME was more severe in Seine-Saint-Denis, a French area, where the poverty is higher than in other french places, and where the number of physicians is lower. PATIENTS AND METHODS: We enrolled patients suffering from DME and treated by ranibizumab intravitreal injections between November 2012 and April 2013. In order to evaluate the severity of DME and the medical management of diabetes of these patients, we collected the following parameters: central macular thickness measured by SD-OCT, best corrected visual acuity, diabetic retinopathy severity, HbA1c, diabetes duration, type of diabetes, insulinotherapy, previous DME treatment and associated diseases. RESULTS: We included 25 type 2 diabetic patients (8 women and 17 men), the mean age was 64±8.1 years. Mean central macular thickness was 523±145µm. The best corrected visual acuity was 45 letters at baseline (counting fingers-70 letters). Twenty-two patients (88%) had a severe non-proliferative diabetic retinopathy or a proliferative diabetic retinopathy. Mean HbA1c was 7.8% (±2.3%). For 23 cases (92%), diabetes was associated with high blood pressure. Sixty-four percent were treated by insulin. Diabetes lasted for 13.1 years at baseline. DISCUSSION AND CONCLUSION: Diabetic patients, in this case series, had a more severe DME regarding macular thickness and visual acuity than patients from large randomized studies found in the literature. This severity could be due to a sub-optimal management of their diabetes. DME may become a tool to identify patients with a limited access to good medical cares.