Comparison of ACIOL Exchange and Descemet Membrane Endothelial Keratoplasty with ACIOL Retention and Descemet Stripping Automated Endothelial Keratoplasty in the Setting of Pseudophakic Bullous Keratopathy

Objective: To compare the clinical outcomes and complications of anterior chamber intraocular lens (ACIOL) exchange and Descemet membrane endothelial keratoplasty (DMEK) with ACIOL retention and Descemet stripping automated endothelial keratoplasty (DSAEK) in patients with PBK.Methods: A multicenter retrospective cohort study. Patients with ACIOL who underwent endothelial keratoplasty procedure due to PBK between 2012-2018 in two tertiary medical centers, were identified. Clinical and demographical data including preoperative and postoperative characteristics were collected.Results: Thirteen eyes in the “DMEK and ACIOL exchange” group and 15 in the “DSAEK and ACIOL retention” group were included in the analysis. Mean BCVA six months postoperatively was 0.51±0.20 LogMAR (Snellen 20/64) and 0.57±0.22 LogMAR (Snellen 20/83) in the “DMEK and ACIOL exchange” group and “DSAEK and ACIOL retention” group, respectively (P=0.38). Graft failure occurred in 6 eyes (40%) in the “DSAEK and ACIOL retention” group; four of them were secondary failures occurring at an average follow-up time of 15±11.9 months. In the “DMEK and ACIOL exchange” group, graft failure occurred in one eye and was a primary failure (P=0.046). In the “DMEK and ACIOL exchange” group, postoperative complications were seen in 4 eyes (30.7%). No postoperative complications were recorded in the “DSAEK and ACIOL retention” group (P=0.035).Conclusion: Despite the lower complication rate, the higher incidence of graft failure and the need for second keratoplasty in the DSAEK group along with the similar visual outcomes, might suggest that in the indication of PBK, ACIOL exchange with DMEK offers a good alternative to ACIOL retention with DSAEK.

Surgical Outcome of Refixation versus Exchange of Dislocated Intraocular Lens: A Retrospective Cohort Study

We compared the surgical outcomes and complications of refixation vs. exchange of dislocated intraocular lenses (IOLs) in patients who underwent transscleral suture fixation combined with pars plana vitrectomy for the treatment of IOL dislocation. A total of 83 eyes (n = 83 patients) with postoperative follow-up of ≥6 months were evaluated: 40 received refixation of dislocated IOL (refixation group) while 43 received IOL exchange (exchange group) treatment. Treatment outcomes, including best-corrected visual acuity (BCVA), spherical equivalent, corneal cylinder, intraocular pressure (IOP), central macular thickness (CMT), and corneal endothelial cell density (ECD), and postoperative complications were retrospectively reviewed. BCVA improvement at 6 months after surgery was comparable between the groups. Postoperative decrease in corneal ECD was significantly greater in the exchange group than in the refixation group, but no significant differences were found in spherical equivalent, corneal cylinder, IOP, or CMT changes. The exchange group experienced significantly more frequent postoperative vitreoretinal complications, such as retinal detachment, choroidal effusion, cystoid macular edema, and secondary epiretinal membrane, than the refixation group. Without any reason to extract the dislocated IOL, reuse of the dislocated IOL would be a better surgical option for transscleral suture fixation to protect corneal endothelial cells and prevent postoperative vitreoretinal complications.

The ability of cash flows to predict the earning

This study aims to test is ability of cash flows to predict the earning, his research is expected to give contribution in providing evidence on whether (1) operating cash flow useful to predicting earning. (2) Investing cash flow useful to predicting earning. (3) Financing cash flow useful to predicting earning. In the present research, Statistical population consists of firms listed on London Stock Exchange Group (LSEG) during 2015-2018. Earning (dependent variable) was measured by net income, operating income and independent variable, namely cash flows through operating, investing and financing operations. The results generally indicates the models' ability to interpret hypothesis and confirm the ability of cash flows to predict earnings

DIPLOMASI PERTAHANAN LITTORAL STATES DI SELAT MALAKA MELALUI KERANGKA PATROLI SELAT MALAKA

<p>Selat Malaka sebagai salah satu selat yang memiliki nilai strategis dalam perdagangan dunia kerap menghadapi berbagai ancaman keamanan non-tradisional. Sesuai dengan UNCLOS, littoral states seperti Indonesia, Singapura, dan Malaysia berkewajiban untuk menjaga keamanan di wilayah perairan Selat Malaka agar perdagangan dan ekonomi dunia tidak terganggu. Penelitian ini menganalisis bagaimana kerangka kerjasama Malacca Straits Patrol (MSP) dibentuk sebagai sebuah kerjasama yang dibentuk oleh littoral states dalam rangka menjaga stabilitas keamanan di wilayah perairan Selat Malaka. Peneliti menggunakan metode penelitian kualitatif melalui studi pustaka. Data yang diperoleh dianalisis menggunakan konsep kerja sama pertahanan dan diplomasi pertahanan. Hasil penelitian menjelaskan bahwa MSP yang terdiri atas Malacca Straits Sea Patrol (MSSP), “Eyes-in-the-Sky” Combined Maritime Air Patrols (EiS), dan MSP Intelligence Exchange Group (IEG) merupakan salah satu bentuk aktivitas diplomasi pertahanan berupa multilateral contacts between military officials dan multilateral military exercise yang bertujuan untuk meningkatkan rasa percaya dan kapabilitas pertahanan masing-masing negara.</p><p><strong>Kata Kunci :</strong> selat malaka, the malacca straits patrol framework, ancaman, kerjasama pertahanan, diplomasi pertahanan</p>

Outcome of single-stage versus two-stage exchange for revision knee arthroplasty for chronic periprosthetic infection

The gold standard for treating chronic periprosthetic joint infection is still considered to be double-stage exchange revision. The purpose of this review is to analyse the difference in terms of eradication rates and functional outcome after single- and double-stage prosthetic exchange for chronic periprosthetic joint infection around the knee. We reviewed full text articles written in English from 1992 to 2018 reporting the success rates and functional outcomes of either single-stage exchange or double-stage exchange for knee arthroplasty revision performed for chronic infection. In the case of double-stage exchange, particular attention was paid to the type of spacer: articulating or static. In all, 32 articles were analysed: 14 articles for single-stage including 687 patients and 18 articles for double-stage including 1086 patients. The average eradication rate was 87.1% for the one-stage procedure and 84.8% for the two-stage procedure. The functional outcomes were similar in both groups: the average Knee Society Knee Score was 80.0 in the single-stage exchange group and 77.8 in the double-stage exchange. The average range of motion was 91.4° in the single-stage exchange group and 97.8° in the double-stage exchange group. Single-stage exchange appears to be a viable alternative to two -stage exchange in cases of chronic periprosthetic joint infection around the knee, provided there are no contra-indications, producing similar results in terms of eradication rates and functional outcomes, and offering the advantage of a unique surgical procedure, lower morbidity and reduced costs. Cite this article: EFORT Open Rev 2019;4:495-502. DOI: 10.1302/2058-5241.4.190003