Macular Degeneration: Schwartz SG

Gregori NZ, Gaitan J, Rosenfeld PJ, Puliafito CA, Feuer W, Flynn HW, Berrocal AM, Al-Attar L, Dubovy S, Smiddy WE, Schwartz SG, Lee WH, Murray TG. · Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th St., Miami, FL 33136, USA. · Retina. · Pubmed #19430392 No free full text.

Abstract: PURPOSE: To evaluate the long-term safety and efficacy of intravitreal bevacizumab injections (Avastin, Genentech Inc., San Francisco, CA) for the treatment of macular edema secondary to central retinal vein occlusions. METHODS: A retrospective review was performed of eyes treated from May 2005 to August 2006 with follow-up through February 2007. The dose of bevacizumab was 1.25 mg (0.05 mL). Retreatment was performed at monthly or longer intervals at the discretion of the treating physician. RESULTS: Fifty-seven eyes received intravitreal bevacizumab at baseline. Visual acuity improved by a mean of 14 letters (N = 53; P < 0.001) at 1 month, 13 letters at 3 months (N = 53; P < 0.001), 9 letters at 6 months (N = 30; P = 0.001), 9 letters at 12 months (N = 17; P = 0.004). The mean optical coherence tomography thickness decreased by 299 microm at 1 month (N = 53; P < 0.001), 144 microm at 3 months, (N = 53; P < 0.001), 127 microm at 6 months (N = 30; P = 0.011), and 276 microm at 12 months (N = 17; P < 0.001). No ocular or systemic adverse events were observed. CONCLUSION: Improvements in visual acuity and optical coherence tomography were observed during the first year following intravitreal bevacizumab for macular edema secondary to central retinal vein occlusions. These retrospective results provide additional evidence to support the perceived safety and efficacy of intravitreal bevacizumab in this disorder.

Schwartz SG, Holz ER, Mieler WF, Kuhl DP. · Department of Ophthalmology, Medical College, Virginia Campus of Virginia Commonwealth University, Richmond, USA. · CLAO J. · Pubmed #11838989 No free full text.

Abstract: PURPOSE: To investigate the incidence, management, and outcome of retained lens fragments following resident-performed cataract extraction. METHODS: A retrospective review of all eyes undergoing cataract extraction by the residents of Baylor College of Medicine over a 4-year time frame (July/95-June/99). RESULTS: A total of 3389 eyes underwent cataract extraction, and 26 patients (0.8%) required pars plana vitrectomy (PPV) for retained lens fragments. One or more vision threatening complications occurred in 19 (73%) of these patients. The most common complications were cystoid macular edema (CME) (8 eyes, 31%) and rhegmatogenous retinal detachment (RRD) formation (6 eyes, 23%). Additional surgical procedures were required for 9 (35%) eyes; the most common were repeat PPV, and placement of focal photocoagulation for diabetic macular edema (4 eyes per each procedure, 15%). Six-month follow-up was available for 16 eyes; of these, best-corrected visual acuity was 20/40 or better in 5 (31%) and 20/200 or worse in 7 (44%). The most common reasons for limited visual acuity were RRD (3 eyes, 19%) and CME (3 eyes, 19%). CONCLUSION: In this retrospective series, the incidence of retained lens fragments following resident-performed cataract extraction was less than 1%. Significant complications, resulting in the need for additional surgical procedures, occurred in most of these eyes, and this was associated with limited visual function at final follow-up. Retention of lens fragments following resident-performed cataract extraction remains an infrequent yet serious complication associated with a guarded visual prognosis.