At Press Time

Research Digest

New & Noteworthy Journal Article

Compiled by Andrew E. Mathis, PhD, Medical Editor

► DALK vs. PK. A team of ophthalmologists in South Korea have conducted a retrospective cohort study to compare endothelial cell loss, visual outcomes, refractive status and complications following deep anterior lamellar keratoplasty vs. penetrating keratoplasty.

Sixteen eyes of eight patients were enrolled. In each patient, one eye received DALK, while the fellow eye received PK. After two years of follow-up, endothelial cell density was significantly greater after DALK. At the same time, visual outcomes and refractive status were comparable between the two surgical methods.

While two rejection episodes were reported in two eyes receiving PK, no graft rejections occurred. The authors concluded that DALK is an appropriate and effective alternative procedure for corneal stromal pathologies, particularly due to the increased endothelial cell density seen following this method.

Kim MH, Chung TY, Chung ES. A retrospective contralateral study comparing deep anterior lamellar keratoplasty with penetrating keratoplasty. Cornea. 2013;32:385-389.

► PRP and QOL in PDR. Retinal physicians in Greece recently investigated the effect on the quality of life (QOL) of patients with proliferative diabetic retinopathy (PDR) who underwent panretinal photocoagulation (PRP).

In a prospective study, 20 patients with bilateral disease were treated with PRP, the protocol of which was 2,140 laser spots per eye. To assess QOL, the study authors administered the NEI’s Visual Function Questionnaire, both at the beginning of the study and at least one month after PRP.

Upon comparing pre- and post-treatment scores, the authors found no significant differences in questionnaire scores. The domains with the higher number of respondents reported either no changes or improvements in peripheral vision, color vision and limitations in social functioning.

The authors concluded that, regarding the protocol they used, PRP was well tolerated, despite its inherently destructive nature.

Tsilimbaris MK, Kontadakis GA, Tsika C, Papageorgiou D, Charoniti M. Effect of panretinal photocoagulation treatment on vision-related quality of life of patients with proliferative diabetic retinopathy. Retina. 2013;33:756-756

► SLO in dry AMD. Doctors at the University of Southern California’s Doheny Eye Institute compared several methods for detecting drusen in eyes with dry AMD.

Eleven eyes of patients with AMD were submitted to confocal slit-lamp ophthalmoscopy using multiple apertures, including central and ring, right and left side and with and without differential contrast. Fundus photos were also obtained. The study graded the images manually and calculated intergrader reliability.

The study detected more drusen, including subclinical drusen, with the aperture on the left or right side, as scattered light was captured better. They suggested lateral confocal apertures may be useful in tracking progression of the disease.

Diniz B, Ribeiro RM, Rodger DC, Maia M, Sadda S. Drusen detection by confocal aperture-modulated infrared scanning laser ophthalmoscopy. Br J Ophthalmol. 2013;97:285-290.

► PROSE for corneal epithelial defects. To review the effectiveness of extended daily wear of the Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) to treat corneal epithelial defects, ophthalmologists at Baylor College of Medicine in Houston undertook a retrospective case series of nine patients treated with the PROSE.

These patients, whose etiologies varied, were all refractory to conventional therapy. All their cases improved with the PROSE. Further, eight experienced worsening conditions when the PROSE was discontinued, but they improved when it was resumed.

Although they conceded the small size of their study as a limitation and urge larger, controlled studies, the authors concluded the PROSE could be useful in treating patients with refractory or recurring corneal epithelial defects.

Ling JD, Gire A, Pflugfelder SC. PROSE therapy used to minimize corneal trauma in patients with corneal epithelial defects. Am J Ophthalmol. 2013;155:615-619.

► Driving with glaucoma. Doctors at Wilmer Eye Institute of Johns Hopkins University, Baltimore, recently undertook a cross-sectional study of driving patterns in older adults with glaucoma. They examined whether the disease and its effects on VF loss were associated with driving cessation, limitation and preference for having other people drive.

Eighty-one patients with glaucoma and 58 controls suspected of having glaucoma were enrolled and interviewed. Almost a quarter of the patients vs. 6.9% of the control group had stopped driving entirely. The patients were also more likely to report driving limitations. However, neither glaucoma nor VF loss were associated with the likelihood of deferring to other drivers.

Not surprisingly, the authors concluded glaucoma has a serious impact on driving cessation and limitations. They recommended further study to determine when and why these changes occur, and whether self-regulation results in greater driver safety. OM

van Landingham SW, Hochberg C, Massof RW, Chan E, Friedman DS, Ramulu PY. Driving patterns in older adults with glaucoma. BMC Ophthalmol. 2013;13:4