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There is a constant controversy between performing cataract surgery for one eye or for both eyes in the same surgical session. The objective of this study is to review the scientific evidence on the efficacy and safety, determine the reduction of costs of sequential bilateral cataract surgery on the same day compared to unilateral cataract surgery, as well as to compare the rate of associated complications.A comprehensive search of the PubMed and Web of Science databases has been conducted to identify relevant articles on sequential bilateral cataract surgery from 2000 to 31 of December of 2020.Literature shows that there is strong evidence demonstrating the efficacy and safety of same-day sequential bilateral cataract surgery. Studies have not found a higher rate of postoperative complications compared to unilateral cataract surgery.Same-day sequential bilateral cataract surgery is a good surgical option for the resolution of the cataract, provides rapid visual rehabilitation and without greater risks than unilateral surgery. It also provides a reduction in sanitary costs. There is a psychological fear of performing bilateral surgery due to the potential risk of complications that would affect both operated eyes. In this article we discuss the efficacy, safety, complications rate and associated costs in sequential bilateral cataract surgery in the same surgical act.

Cataract surgery is the most common operation performed worldwide. A fixed topical corticosteroid-antibiotic combination is usually prescribed in clinical practice for 2 or more weeks to treat post surgical inflammation and prevent infection. However, this protracted schedule may increase the incidence of corticosteroid-related adverse events and notably promote antibiotic resistance.This International, multicentre, randomized, blinded-assessor, parallel-group clinical study evaluated the non-inferiority of 1-week levofloxacin/dexamethasone eye drops, followed by 1-week dexamethasone alone, vs. 2-week gold-standard tobramycin/dexamethasone (one drop QID for all schedules) to prevent and treat ocular inflammation and prevent infection after uncomplicated cataract surgery. Non-inferiority was defined as the lower limit of the 95% confidence interval (CI) around a treatment difference-10%. The study randomized 808 patients enrolled in 53 centres (Italy, Germany, Spain and Russia). The primary endpoint was the proportion of patients without anterior chamber inflammation on day 15 defined as the end of treatment. Endophthalmitis was the key secondary endpoint. This study is registered with EudraCT code: 2018-000286-36.After the end of treatment, 95.2% of the patients in the test arm vs. 94.9% of the control arm had no signs of inflammation in the anterior chamber (difference between proportions of patients = 0.028; 95% CI: -0.0275/0.0331). No case of endophthalmitis was reported. No statistically significant difference was evident in any of the other secondary endpoints. Both treatments were well tolerated.Non-inferiority of the new short pharmacological strategy was proven. One week of levofloxacin/dexamethasone prevents infection, ensures complete control of inflammation in almost all patients and may contain antibiotic resistance.

Lipid peroxides are thought to be formed by free radicals and have been implicated in the pathogenesis of diabetes complications. A convenient and sensitive method for estimation of lipid peroxide concentration is the quantitative estimation of their metabolic end-product malondialdehyde (MDA) expressed in mmol/L using the thiobarbituric acid test (TBA-test). We have measured the serum concentrations of MDA in 60 well controlled type I diabetic patients (28 without retinopathy and 32 with retinopathy) and 13 age-matched healthy subjects. Patients with retinopathy showed significantly increased MDA level (2.65+/-1.00) compared to diabetics without retinopathy (1.80+/-0.81) and healthy controls (1.47+/-0.45). The serum levels of MDA correlated best with glycosylated haemoglobin (r=0.28), serum triglyceride concentration (r=0.29) and serum cholesterol concentration. (r=0.47). Increased lipid peroxides suggesting increased free radical activity is associated with retinopathy and this may have pathogenetic implications.

To study the predisposing factors for late in-the-bag intraocular lens (IOL) dislocation and to analyze the outcomes after explantation surgery. In this retrospective multicentre study, 61 eyes were enrolled. The main inclusion criterion was in-the-bag spontaneous IOL dislocation after uneventful phacoemulsification cataract extraction. Only eyes with serious dislocation that required IOL explantation were eligible. Follow-up after explantation surgery of at least 3 months was required. Exclusion criteria were complicated cataract surgery, out-of-the-bag IOL dislocation, and dislocations that occurred in the first year after the cataract surgery. The main outcome measures were predisposing factors for dislocation, interval between cataract surgery and dislocation, surgical treatment at the time of explantation, preoperative and postoperative corrected distance visual acuity (CDVA), and postoperative complications. High myopia was detected in 12 cases (19.7%) and it was the main predisposing factor. Mean time interval from cataract surgery to dislocation was 7.5 (SD 5.2) years. The dislocated in-the-bag IOL was replaced with a scleral fixated IOL (36.1%), angle-supported anterior chamber IOL (31.1%), sulcus repositioning (18%), or posterior chamber iris sutured IOL (4.9%). Finally, 9.8% of the patients were left aphakic. Mean CDVA improved significantly after surgery (P=0.005). Final CDVA of 20/40 or better was achieved in 29 cases (47.5%). High myopia was the main risk factor for late in-the-bag IOL dislocation. Surgical treatment significantly improved the CDVA in our sample and was associated with a low complication rate.

To determine the effect of posterior capsulotomy on macular thickness, intraocular pressure and endothelial cell loss in pseudophakic patients with posterior capsule opacification using the other eye of every patient as a control.An observational prospective study was conducted on 31 pseudophakic patients with posterior capsular opacification in one eye, using the other eye as a control. Patients did not suffer any other ocular pathology. All patients were treated by posterior capsular opacification with Nd:YAG capsulotomy, and followed up for a three-month period. The ocular examination included, best corrected visual acuity (BCVA), intraocular pressure (IOP), macular optical coherence tomography (OCT), and endothelial cell assessment (including densitometry, cell size and coefficient of variation, hexagonal cell percentage and pachymetry), which were determined in both eyes before treatment, and one week, one month and 3 months after capsulotomy.Generalized estimating equations (GEE) were used to assess the capsulotomy effect adjusted by corresponding baseline measurements and time. No association was found between capsulotomy and IOP (P=.597), macular thickness (P=.085) or ECA (densitometry (P=.422), average size of cells (P=.299), variation coefficient (P=.495), hexagonal cell percent (P=.093) and corneal pachymetry (P=.423). A significant increase of 0.15 Snellen units in BCVA was found during the 3-month follow-up period (P.001).This study shows that after Nd:YAG capsulotomy, BCVA improves significantly without any IOP, OCT or ECA changes during the three-month follow-up. Nd:YAG capsulotomy is a safe procedure in pseudophakic patients without any other ocular pathology.

We present the case of a patient with neurotrophic queratitis in the left eye treated with a Tutopatch® cover and platelet-rich plasma (PRP). Solid autologous PRP was placed in the bed of the ulcer and Tutopatch® was sutured to the conjunctiva.We found this form of treatment very effective for progressive ulcers. Tutopatch® may constitute an alternative to amniotic membrane transplantation.

To evaluate the efficacy and biotolerance of the Adal-1 adhesive for muscle sealing in strabismus surgery.27 eyes were included in the study: 17 in the control group and 10 in the study group. Surgery was performed on the recession of the horizontal rectus muscles. In the control group the muscle was joined to the sclera by a Vicryl 7/0 suture. In the study group, the Adal-1 adhesive was used instead. The efficacy of the sealing of the muscle to the sclera and the biotolerance of the surrounding tissues were evaluated.The muscular recession in the control group was 8.17 (SD 2.38) with displacement of the sealing point of 0.02 (1.7) mm. In the group sealed with adhesive, the muscular recession was 9.09 (3.08) and the displacement was 0.15 (1.56) mm, with no significant differences between the techniques (p0.05). The inflammation of the surrounding tissues in the immediate postoperative period was greater with the suture technique (p0.05), but there were no differences in the other postoperative periods (Mann-Whitney U test).Adal-1 was an effective and safe alternative to sutures in muscle recession for strabismus surgery in this study.

We made a study of the effect on the corneal endothelium of rabbits of the introduction of 5-Fluorouracile into the anterior chamber. An EECC was performed on 24 rabbits, using BSS-Plus for right eye and 5-Fluorouracile dissolved in BSS-Plus for the left eye as irrigation solutions. We calculated the individual endothelial cell surface and form factor, finding no statistically significant differences between the two groups.

We report on the results obtained in the treatment of inflammation of the cornea by means of the saturation of free radicals, using chemiluminescence. The experiment was conducted on the Alloxan model of corneal inflammation caused by the freeing of free radicals in the stroma. We compared the action of steroidal and non-steroidal antiinflammatory substances, and also specific saturators of free radicals.