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Management of cataract in keratoconus: early visual outcomes of different treatment modalities

International Journal of Ophthalmology(English edition) 2019年第10期12卷 1654-1658页

作者： Nicolas Arej Wassef Chanbour Karen Zaarour Mazen Amro Hala El-Rami fadi harb Elias Jarade Department of Ophthalmology Faculty of MedicineSaint-Joseph University of BeirutBeirut11-5208Lebanon Beirut Eye&ENT Specialist Hospital Beirut116-5311Lebanon Department of Ophthalmology Faculty of MedicineLebanese UniversityBeirut14-6573Lebanon Mediclinic Dubai Mall Dubai282890United Arab Emirates

A review of 31 eyes with keratoconus who developed cataract and underwent phacoemulsification. Visual acuities were measured 1 mo postoperatively. Six eyes with a history of good corrected distance visual acuity(CDVA) and a similar refractive and topographic astigmatic axis were implanted with toric intraocular lenses(IOLs). The mean postoperative uncorrected distance visual acuity(UDVA) was 0.2 logMAR with a spherical equivalent(SE): 0.75 D. Eleven eyes with a history of good CDVA and different refractive and topographic axis were implanted with monofocal IOL+/-Toric implantable collamer lenses to treat anisometropia and ametropia;mean UDVA was 0.25 logMAR with a mean SE:-0.51 D postoperatively. Six eyes with poor CDVA were first treated with intra-corneal ring segments, followed by phacoemulsification, the mean postoperative UDVA was 0.82 logMAR with an SE: 0.22 D. Eight eyes had advanced ectesia and received combined phacoemulsification and penetrating keratoplasty. Our approach is efficient in addressing ametropia after cataract surgery in keratoconic eyes.

关键词： keratoconus cataract surgery residual ametropia algorithm

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Split-dose menthol-enhanced PEG vs PEG-ascorbic acid for colonoscopy preparation

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World Journal of Gastroenterology 2015年第6期21卷 1938-1944页

作者： Ala I Sharara Ali H harb Fayez S Sarkis Jean M Chalhoub Rami Badreddine fadi H Mourad Mahmoud Othman Omar Masri Division of Gastroenterology Department of Internal Medi-cine American University of Beirut Medical Center

AIM:To compare the efficacy and palatability of 4L polyethylene glycol electrolyte(PEG)plus sugar-free menthol candy(PEG+M)vs reduced-volume 2 L ascorbic acid-supplemented PEG(Asc PEG).METHODS:In a randomized controlled trial setting,ambulatory patients scheduled for elective colonoscopy were prospectively enrolled.Patients were randomized to receive either PEG+M or Asc PEG,both splitdosed with minimal dietary restriction.Palatability was assessed on a linear scale of 1 to 5(1=disgusting;5=tasty).Quality of preparation was scored by assignment-blinded endoscopists using the modified Aronchick and Ottawa scales.The main outcomes were the palatability and efficacy of the preparation.Secondary outcomes included patient willingness to retake the same preparation again in the future and completion of the prescribed preparation.RESULTS:Overall,200 patients were enrolled(100patients per arm).PEG+M was more palatable than Asc PEG(76%vs 62%,P=0.03).Completing the preparation was not different between study groups(91%PEG+M vs 86%Asc PEG,P=0.38)but more patients were willing to retake PEG+M(54%vs 40%respectively,P=0.047).There was no significant difference between PEG+M vs Asc PEG in adequate cleansing on both the modified Aronchick(82%vs77%,P=0.31)and the Ottawa scale(85%vs 74%,P=0.054).However,PEG+M was superior in the left colon on the Ottawa subsegmental score(score0-2:94%for PEG+M vs 81%for Asc PEG,P=0.005)and received significantly more excellent ratings than Asc PEG on the modified Aronchick scale(61%vs 43%,P=0.009).Both preparations performed less well in afternoon vs morning examinations(inadequate:29%vs 15.2%,P=0.02).CONCLUSION:4 L PEG plus menthol has better palatability and acceptability than 2 L ascorbic acidPEG and is associated with a higher rate of excellentpreparations;Clinicaltrial.gov identifier:NCT01788709.

关键词： Colonoscopy Bowel preparation Efficacy Tolerabilit

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