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  • Ylinen, Petteri; Laine, Ilkka; Lindholm, Juha-Matti; Tuuminen, Raimo (2017)
    Purpose: To specify the risk factors for pseudophakic cystoid macular edema (CME) in patients with diabetes. Setting: Kymenlaakso Central Hospital, Unit of Ophthalmology, Kotka, Finland. Design: Prospective case series. Methods: Patients with type 1 or type 2 diabetes having routine cataract surgery were evaluated. Spectral-domain optical coherence tomography imaging was performed before surgery and 1 month postoperatively. Results: The study comprised 93 patients (95 eyes). The central retinal thickness increase was 9.7 mu m 1.7 (SEM) in diabetic patients with no retinopathy, 22.7 +/- 8.6 mu m in those who had nonproliferative retinopathy, and 73.8 +/- 37.4 mu m in those who had proliferative retinopathy (P Conclusions: Young patient age and poor glycemic control were risk factors for postoperative central retinal thickness increase. This study showed it is necessary to identify, effectively treat, and followup with patients with diabetes who are at a greater risk for pseudophakic CME. (C) 2017 ASCRS and ESCRS
  • Loukovaara, Sirpa; Haukka, Jari (2018)
    Background: Pars plana vitrectomy (PPV) combined with phacoemulsification and primary intraocular lens implantation can be performed for the repair of primary rhegmatogenous retinal detachment (RRD; PHACOVIT group). The safety and efficacy of this combined ophthalmic procedure on RRD surgery outcomes remain unclear compared with more conventional PPV technique alone (VITRET group). We explored the need for reoperation after primary surgical procedure in these two groups. Methods: Retrospective, longitudinal, register-based cohort of RRD patients was operated in University Eye Clinic, Helsinki, Finland, during 2008-2014. The main outcome measure was reoperation rate during a postoperative follow-up period of 1 year due to retinal re-detachment, vitreous rehemorrhage, postoperative endophthalmitis, secondary pucker, macular hole or other reasons. Results: We analyzed 1,690 consecutive RRD cases, out of which 1,564 patients were treated in the PPV VITRET group and 126 patients in the PHACOVIT-operated group. Risk for reoperation was 2.67 times higher in the PHACOVIT group compared to the PPV VITRET group (95% CI 1.85-3.85). Conclusion: The reoperation rate was higher in RRD eyes operated with combined cataract surgery plus PPV, suggesting that RRD eyes should not primarily undergo combined PHACOVIT surgery.