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Purpose: To assess the outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) via a sclerocorneal frown incision. Study design: Retrospective comparative study. Methods: The outcomes of Descement stripping endothelial keratoplasty (DSAEK) were retrospectively compared between 36 patients (36 eyes) who underwent surgery via a 3.8-mm frown incision (frown incision group) and 20 patients (20 eyes) who underwent surgery via a 4.6-mm straight incision (straight incision group). In all patients, an NS Endo-Inserter was used as the graft inserter and the incision for a frown incision was via the superior sclerocorneal site and for the straight incision via the temporal cornea. DSAEK was performed by the standard technique, except for the incision. At 1 year after surgery, the two groups were compared with respect to the visual acuity, decrease of corneal endothelial cell density, the severity of corneal astigmatism (diopters), the number of sutures for wound closure, and intraoperative/postoperative complications. Results: There was no significant difference between the two groups in terms of postoperative visual acuity, corneal astigmatism, and intraoperative/postoperative complications one year after surgery. On the other hand, the number of sutures required for wound closure was 1.13 ± 0.42 in the frown incision group, whereas in the straight incision group, it was 3.20 ± 0.40, showing a significant difference (P<0.001). In addition, there was no decreased corneal endothelial cell density associated with the reduction in incision width. Conclusions: A sclerocorneal frown incision is useful for performing DSAEK with an NS Endo-Inserter as it does not affect endothelial cell loss despite its short incision width. [ABSTRACT FROM AUTHOR]

Background: Cataract surgery is considered refractive surgery. Apart from implanting the right dioptric power of Intra ocular lens (IOL), minimizing postoperative astigmatism plays an important role in good visual rehabilitation. Hence, surgical incision is of major importance in minimizing postoperative astigmatism and reducing or abolishing preexisting astigmatism. Objectives: The objective of this study is to compare surgically induced astigmatism (SIA) following straight and frown scleral incisions in manual small-incision cataract surgery (MSICS). Materials and Methods: This is a prospective randomized comparative study conducted among two groups of patients undergoing MSICS, where the straight scleral incision was performed in one group with 29 cases and the frown incision was performed in the other group with 29 cases. Postoperatively, patients were followed up on postoperative day 1, week 1, and week 6. Uncorrected visual acuity, Kv and Kh readings, and SIA were noted at each postoperative visit. Results: SIA on the postoperative day 1 in the straight incision group (SIG) was 1.4914D ± 1.251 and in the frown incision group (FIG) was 0.629D ± 0.288. On the postoperative week 1 in SIG, it was 0.9655D ± 0.699, and in FIG, it was 0.474D ± 0.397. On the postoperative week 6 in SIG, it was 0.8793D ± 0.599, and in FIG, it was 0.414D ± 0.286. SIA was significantly less in FIG compared to SIG (P = 0.011). Postoperative uncorrected visual acuity was better in FIG compared with SIG. More amount the rule astigmatism was noted in FIG on the postoperative 6th-week follow-up, which is favorable to the patient, while SIG witnessed more amount against the rule astigmatism. Conclusion: Frown incision is a better incision than the straight incision in MSICS to create a sclerocorneal tunnel.

Purpose: To calculate the surgically induced astigmatism (SIA) in MSICS through a superiorly placed straight scleral incision closed with a single, central, perpendicular 10-0 polyamide suture and to document any suture-related complaints and complications.Methods: A retrospective, hospital-based study was carried out in 50 cases of uncomplicated senile cataract (>50 year) with nuclear sclerosis ≥ grade 4, "with the rule" astigmatism who underwent MSICS through a superior, straight incision with a single, central, perpendicular 10-0 nylon suture. Patients with "against the rule" astigmatism, keratoconus, pre-existing corneal opacity, astigmatism >2D, distorted or oblique mires, and previous ocular surgeries and unwilling to participate were excluded.Results: The mean age of the patients was 64.81 + 2.824 years, with a male: female ratio of 1.38:1. The mean SIA at day 7, week 6, and 12 weeks was 0.539 + 0.118, 0.529 + 0.134, and 0.524 + 0.129, respectively. Only 6 patients (12%) complained of foreign body sensation. No patient developed any suture-related complications.Conclusion: SIA is significantly reduced in straight incision by applying a single, central, and perpendicular 10-0 polyamide suture, as compared to a straight incision without a suture. [ABSTRACT FROM AUTHOR]

Purpose: To calculate the surgically induced astigmatism (SIA) in MSICS through a superiorly placed straight scleral incision closed with a single, central, perpendicular 10-0 polyamide suture and to document any suture-related complaints and complications. Methods: A retrospective, hospital-based study was carried out in 50 cases of uncomplicated senile cataract (>50 year) with nuclear sclerosis ≥ grade 4, “with the rule” astigmatism who underwent MSICS through a superior, straight incision with a single, central, perpendicular 10-0 nylon suture. Patients with “against the rule” astigmatism, keratoconus, pre-existing corneal opacity, astigmatism >2D, distorted or oblique mires, and previous ocular surgeries and unwilling to participate were excluded. Results: The mean age of the patients was 64.81 + 2.824 years, with a male: female ratio of 1.38:1. The mean SIA at day 7, week 6, and 12 weeks was 0.539 + 0.118, 0.529 + 0.134, and 0.524 + 0.129, respectively. Only 6 patients (12%) complained of foreign body sensation. No patient developed any suture-related complications. Conclusion: SIA is significantly reduced in straight incision by applying a single, central, and perpendicular 10-0 polyamide suture, as compared to a straight incision without a suture.

Ryo Yomoda, Hiroki Sasaki, Jiro Kogo, Akira Shiono, Tatsuya Jujo, Reio Sekine, Naoto Tokuda, Yasushi Kitaoka, Hitoshi Takagi Department of Ophthalmology, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan Purpose: The purpose of this study was to compare straight and angled incisions in 27-gauge microincision vitrectomy in patients with epiretinal membrane (ERM).Methods: Seventy-three eyes of 68 patients with ERM who underwent straight (35 eyes) or angled incision (38 eyes) for 27-gauge microincision vitrectomy were retrospectively evaluated.Results: No statistically significant difference was found between the two groups in postoperative logarithm of minimal angle of resolution best-corrected visual acuity. The intraocular pressure and rate of hypotony 1 day postoperatively did not differ between the straight- and angled-incision groups (intraocular pressure: 11.5 vs 13.4 mmHg, respectively; rate of hypotony: 20% vs 8%, respectively). Surgical wound closing occurred by postoperative day 10 in both groups.Conclusion: A straight incision is as safe and useful in ERM vitrectomy as an angled one. Keywords: 27-gauge vitrectomy, MIVS, epiretinal membrane, straight incision, angled incision, anterior segment OCT

Objective: To compare the effects of straight and transverse S incision on the postoperative scar formation and joint function of patients with patellar fracture. Methods: The clinical data of 85 cases of patients with patellar fracture from March 2014 to September 2016 were retrospectively analyzed, 40 cases were treated with surgical straight incision and 45 cases were treated with S transverse incision. The incision length, operation time, incidence of postoperative complications, the ratio of scar formation and Bostman joint function score were compared between the two groups. Results: There was no significant difference in the operation time, incision infection and incision skin necrosis between two groups (P>0.05). However, the incision length of transverse S incision group (127.79± 5.55) was significantly longer than that of the straight incision group (72.64± 6.75, P<0.05), and the incidence of postoperative numbness in transverse S incision group (24.4%) was significantly higher than that in the straight incision group (7.5%, P < 0.05). After follow-up for 12 weeks, the Bostman score of transverse S incision group (20.63± 5.73) was significantly lower than that of the straight incision group (26.83 ± 4.76, P < 0.05), and after follow-up for 24 weeks, the Bostman scores between the two groups showed no significantly difference(P>0.05). The incidence of scar formation in transverse S incision group (33.3%) was significantly higher than that of the straight incision group (17.5%, P<0.05). Conclusions: The trauma of straight incision was significantly smaller than that of the transverse S shaped incision, so the scar formation was less and the joint function recovered faster. However, the transverse S shape incision was better, and in clinical practiceshould according to the specific situation of the patients with patellar fracture to choose the surgical incision. [ABSTRACT FROM AUTHOR]

Background: This study compared the postoperative outcomes of 27-gauge (G) and 25-G vitrectomy performed for the treatment of idiopathic epiretinal membrane (ERM).Methods: The study design was single center, retrospective, interventional case series. Two hundred consecutive eyes that underwent primary vitrectomy for ERM (27-G vitrectomy in 100 eyes and 25-G vitrectomy in 100 eyes) were studied for 6 months. In all eyes, scleral tunnels were made using angle incisions, and air or gas exchange was performed.Results: There were no significant differences in age, spherical diopter power, as well as preoperative Early Treatment Diabetic Retinopathy Study (ETDRS) score, central retinal thickness (CRT), and intraocular pressure between the 27-G and 25-G groups. The proportions of simultaneous cataract surgery (27-G vs. 25-G: 82% vs. 90%), air-filled eyes (99% vs. 98%), and scleral wound suture at the end of surgery (0% vs. 0%) were not significantly different between two groups. The mean operation time for vitrectomy was significantly (P = 0.0322) longer by 4 min for 27-G (37 min) compared to 25-G (33 min) vitrectomy. Gain in ETDRS score was significantly (P = 0.0421) better in 27-G group (4.7 ± 8.1 letters) compared to 25-G group (1.1 ± 13.6 letters) at 1 month post-vitrectomy, but not significantly different at 3 and 6 months (P = 0.0835 and 0.0569, respectively). Decrease in CRT was significantly (P = 0.0354) greater in 27-G group (-24.2 ± 50.0 μm) compared to 25-G group (-8.0 ± 48.6 μm) at 1 month post-vitrectomy, but not significantly different at 3 and 6 months (P = 0.6059 and 0.1725, respectively). On postoperative day 1, hypotony (≤ 6 mmHg) was observed in 2 eyes in 27-G group and 6 eyes in 25-G group, while ocular hypertension (≥ 25 mmHg) was found in 4 eyes in 27-G group and 11 eyes in 25-G group, with no significant differences between two groups. Postoperative complications requiring treatment occurred in one eye (vitreous hemorrhage) in 27-G group, and in two eyes (vitreous hemorrhage and retinal detachment in one eye each) in 25-G group.Conclusions: Although 27-G vitrectomy requires operation time of 4 min longer compared to 25-G vitrectomy for ERM surgery, using the 27-G system results in earlier recovery of visual acuity, CRT improvement and stabilized ocular pressure. [ABSTRACT FROM AUTHOR]

Background: This study compared the postoperative outcomes of 27-gauge (G) and 25-G vitrectomy performed for the treatment of idiopathic epiretinal membrane (ERM)., Methods: The study design was single center, retrospective, interventional case series. Two hundred consecutive eyes that underwent primary vitrectomy for ERM (27-G vitrectomy in 100 eyes and 25-G vitrectomy in 100 eyes) were studied for 6 months. In all eyes, scleral tunnels were made using angle incisions, and air or gas exchange was performed., Results: There were no significant differences in age, spherical diopter power, as well as preoperative Early Treatment Diabetic Retinopathy Study (ETDRS) score, central retinal thickness (CRT), and intraocular pressure between the 27-G and 25-G groups. The proportions of simultaneous cataract surgery (27-G vs. 25-G: 82% vs. 90%), air-filled eyes (99% vs. 98%), and scleral wound suture at the end of surgery (0% vs. 0%) were not significantly different between two groups. The mean operation time for vitrectomy was significantly (P = 0.0322) longer by 4 min for 27-G (37 min) compared to 25-G (33 min) vitrectomy. Gain in ETDRS score was significantly (P = 0.0421) better in 27-G group (4.7 ± 8.1 letters) compared to 25-G group (1.1 ± 13.6 letters) at 1 month post-vitrectomy, but not significantly different at 3 and 6 months (P = 0.0835 and 0.0569, respectively). Decrease in CRT was significantly (P = 0.0354) greater in 27-G group (-24.2 ± 50.0 μm) compared to 25-G group (-8.0 ± 48.6 μm) at 1 month post-vitrectomy, but not significantly different at 3 and 6 months (P = 0.6059 and 0.1725, respectively). On postoperative day 1, hypotony (≤ 6 mmHg) was observed in 2 eyes in 27-G group and 6 eyes in 25-G group, while ocular hypertension (≥ 25 mmHg) was found in 4 eyes in 27-G group and 11 eyes in 25-G group, with no significant differences between two groups. Postoperative complications requiring treatment occurred in one eye (vitreous hemorrhage) in 27-G group, and in two eyes (vitreous hemorrhage and retinal detachment in one eye each) in 25-G group., Conclusions: Although 27-G vitrectomy requires operation time of 4 min longer compared to 25-G vitrectomy for ERM surgery, using the 27-G system results in earlier recovery of visual acuity, CRT improvement and stabilized ocular pressure.