CLINICAL SCENARIO A 30-year-old overseas contract worker consulted the outpatient department for a noninflamed, large, slightly vascularized, fleshy mass that encroached on the limbus of the right eye and reached the paracentral area of the cornea. The mass gradually increased in size over the past 3 years, associated with occasional redness that spontaneously resolved without any medication. The vision in the right eye degenerated over the last year. There were no other ocular or systemic signs and symptoms, and no surgery was ever done in that eye. Visual acuity was 20/40 (correctable to 20/20) in the right eye (OD) and 20/20 uncorrected in the left eye (OS). Manifest refraction revealed an against the-rule astigmatism of -2.0 diopters OD and plano OS. The rest of the ophthalmic examination was normal. His agency instructed him to have the mass removed prior to departure for Dubai in about 4 months. Since the mass was already causing astigmatism and reduced uncorrected visual acuity, surgery was contemplated. The ophthalmologist on duty wants to know whether the traditional bare-sclera technique is still the best method to use in treating this disease and preventing recurrence CLINICAL QUESTION: Pertinent data presented include a noninflamed, fleshy mass that over a period of 3 years gradually crossed the limbal border into the paracentral area of the cornea causing a two-diopter against-the-rule astigmatism. In the absence of any previous eye surgery, this picture is compatible with a primary pterygium After identifying the ocular condition in the clinical scenario, a clinical question can now be formulated as follows: Among patients with primary pterygia, how effective is bare-sclera technique compared to adjuvant treatment with mitomycin C (MMC) or conjunctival autografting (CA) in minimizing pterygium recurrence? (Author)
MITOMYCIN

OBJECTIVE: To determine if there is an agreement between keratometry readings and intraocular lens (IOL) power calculation using Haigis and Sanders, Retzlaff and Kraff theoretical (SRK/T) formulas obtained by iTrace® and IOLMaster®.

METHODS: A retrospective chart review of patients who underwent preoperative biometry using both IOLMaster® and iTrace® from January 2015 to July 2015 and satisfied the inclusion/exclusion criteria were included in the study. The average keratometry, cylinder power and predicted IOL power were computed accordingly. Agreement between devices was analyzed using Bland Altman.

RESULTS: A total of 70 eyes from 35 study participants were included in the analysis. The means of average keratometry values obtained from IOLMaster® and iTrace® were 43.9 ± 1.3 D and 43.6 ± 1.3 D respectively. The paired mean differences in the average keratometry and cylinder power between instruments were -0.3 ± 0.3 and 0.1 ± 0.4 respectively. There was a statistically significant difference in the proportion between the number of times there will be a need to change IOL power and the number of times IOL power will remain the same using the Haigis formula with a p value of <0.0005.

CONCLUSION: Average keratometry values, cylinder power and IOL calculation using the Haigis formula obtained by the two devices tested did not show agreement. There is agreement using the SRK/T formula. 

Human ; Male ; Female ; Adult ; Retrospective Studies ; Lenses, Intraocular ; Biometry ; Cornea