RESUMEN
BACKGROUND: Although cataract surgery is a well-established and standardised procedure, it can be demanding and associated with higher complication rates in high hyperopia. We present clinical data for highly hyperopic patients who underwent cataract surgery over a 12-year period (2005â-â2016) and at a single centre. PATIENTS AND METHODS: Out of a total of 11â434 cataract operations, 41 highly hyperopic eyes (SN60AT ≥ 31 dpt) were included for analysis. We compared the target spherical equivalent to the final postoperative spherical equivalent for five different formulas. We also reviewed the best corrected distance visual acuity (BCDVA) before and after surgery and any complications. RESULTS: LogMAR BCDVA increased significantly from a mean of 0.5 before to 0.37 after surgery (p = 0.02). The main reasons for the reduced final BCDVA were glaucoma, Fuchs corneal endothelial dystrophy, and age-related macular degeneration. One eye suffered a radial capsule tear and received a sulcus implanted intraocular lens (IOL). There was no statistically significant difference between formulas with respect to aberration of the final spherical equivalent. CONCLUSIONS: Patients with high hyperopia often have ocular comorbidities. Such eyes may be surgically challenging, resulting in reduced benefits from cataract surgery compared to normal eyes.
Asunto(s)
Extracción de Catarata/métodos , Hiperopía/cirugía , Complicaciones Posoperatorias/etiología , Anciano , Oftalmopatías/complicaciones , Femenino , Distrofia Endotelial de Fuchs/complicaciones , Glaucoma/complicaciones , Humanos , Degeneración Macular/complicaciones , Masculino , Persona de Mediana Edad , Factores de Riesgo , Agudeza VisualRESUMEN
The effects of TGase in dough after 15, 30, 45, and 60 min of resting time after mixing were studied with a Kieffer test. The resistance to stretching of control dough did not change greatly during the 60 min time period after mixing. In dough, TGase decreased extensibility and increased resistance to stretching and this change was already observed after the first 15 min (first measurement). The higher the enzyme dosage was, the higher the magnitude of the rheological change was. All of the doughs that contained TGase 3.8 or 5.7 nkat/g flour had a higher resistance to stretching and lower extensibility than control dough 15 min after mixing. Resistance to stretching clearly increased at a dosage of 5.7 nkat/g flour during the 15-60 min period after mixing. Extensibility increased in the control dough and in the doughs with a low enzyme dosage almost at the same rate. The evolution of air bubbles during proofing was determined with bright field microscopy and image analysis. In the presence of 5.7 nkat/g TGase, the fermented dough contained more of the smallest and less large air bubbles in comparison to the control dough. The effect of TGase and water content on the specific volume of the conventional and organic wheat bread was studied. Water did not have a significant effect on the specific volume of bread. TGase increased the specific volume of breads baked from organic flour only, when additional water (+10% of farinogram absorption) and a small enzyme dosage were used. Microstructural characterization showed that bread baked without TGase from conventional flour had a stronger protein network than that baked from organic flour. TGase improved the formation of protein network in breads baked from either normal or organic flour but at higher dosage caused uneven distribution.