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Purpose: Our purpose was to evaluate the long-term visual outcomes after bilateral implantation of Crystalens® HD (Bausch and Lomb, Inc.) accommodative intraocular lenses. Methods: In this study, 25 patients (50 eyes) who underwent cataract surgery and bilateral Crystalens HD accommodative intraocular lens implantation were included. The Crystalens HD lens was implanted in the bag in both eyes, without any intra- or postoperative complications. The visual parameters measured before and after surgery were: uncorrected distance visual acuity, corrected distance visual acuity (CDVA) (using the Early Diabetic Retinopathy Study [EDTRS] logMAR charts), uncorrected intermediate visual acuity, and uncorrected near visual acuity using a Birkhäuser reading chart, at a distance of 66 cm and 33 cm for intermediate and near vision, respectively, directly illuminated by a lamp of 60 watts. After surgery, the patients were evaluated at 1, 3, 6, 12, 24, and 36 months. Results: The mean age was 68.70±7.1 (range: 54 to 83) years. The mean follow-up was 42.72±0.49 (range: 42.33 to 43.27) months. The uncorrected distance visual acuity improved from 0.56±0.41 (range: 0 to 2) preoperatively to 0.19±0.13 (range: 0 to 0.38) (logMAR scale) at the last follow-up visit, and the CDVA improved from 0.17±0.18 (range: 0 to 0.7) preoperatively to 0.05±0.05 (range: -0.02 to 0.22) at the last follow-up visit. No eyes lost lines of CDVA during the follow-up period, while 54% of patients gained one or more lines of CDVA. The uncorrected intermediate and near visual acuity was J2 or better in 71% and 69% of our patients, respectively. Conclusion: Crystalens HD implantation seems to provide an improvement in visual acuity for far, intermediate, and near distances. [ABSTRACT FROM AUTHOR]

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Purpose: Previous studies have evaluated macular retinal thickness (RT) and nerve fiber layer thickness (RNFLT) changes in early glaucoma using elaborate optical coherence tomography (OCT) scanning protocols. Materials and Methods: This study examines RT and RNFLT using standard scanning protocols in early glaucoma. In this prospective, nonrandomized case series, 95 eyes of 95 patients were evaluated, including 29 nonglaucomatous subjects (control group), 34 glaucoma suspects, and 32 early manifest glaucoma patients. RT and RNFLT were measured using scanning fast macular thickness map and Fast RNFLT (3.4) protocols on a 1.70 mm radius around the macular center (respectively) in all four quadrants. The fast RNFLT (3.4) protocol was transposed on the macula from the peri-papillary area. Data were statistically analyzed for differences between groups, and for correlations between parameters. P<0.5 was statistically significant. Results: Both early manifest glaucoma patients and glaucoma suspects had significantly lower RT than controls in all quadrants. RNFLT differences in all quadrants were not statistically significant (P>0.05). RT was significantly inversely correlated with axial length in early manifest glaucoma patients and glaucoma suspects but not in controls. Conclusions: The finding that RT was significantly lower in early manifest glaucoma patients and glaucoma suspects indicates that the transposition of the OCT fast RNFL thickness (3.4) protocol from the peri-papillary area to the peri-macular area can be used for early glaucoma diagnosis. Intraretinal changes in early glaucoma, likely precede nerve fiber changes. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the long-term results of phakic refractive lens (PRL; Carl Zeiss Meditec) implantation in eyes with high myopia. Methods: In this retrospective, noncomparative, interventional case series, 143 myopic eyes of 82 patients were treated for high myopia with the implantation of the silicone PRL in the posterior chamber. Results: Mean follow-up was 3.8±1.7 years (range: 1 to 6 years). Six years postoperatively (n=34), a statistically significant reduction was noted in the cycloplegic spherical equivalent from −14.08±4.00 diopters (D) (range: −24.88 to −4.75 D) before PRL implantation to −0.45±0.62 D (range: −1.00 to 1.00 D) (P<.001). At 6 years, 67.6% (23 eyes) and 91.2% (31 eyes) were within ±0.50 and ±1.00 D of target refraction, respectively. Mean logMAR uncorrected and corrected distance visual acuity improved significantly (P<.001) (counting fingers preoperatively in all eyes to 0.17±0.15 [range: 0.54 to −0.06] and 0.19±0.19 [1.00 to −0.08] to 0.07±0.10 [range: 0.30 to −0.10], respectively). Complications included anterior capsule damage (3 eyes), temporary intraocular pressure increase (14 eyes), pigment dispersion (1 eye), and PRL decentration (1 eye). No eyes presented any signs of cataract up to 6 years postoperatively. Conclusions: Long-term results show that PRL implantation is an effective and safe method for treating high myopia. [ABSTRACT FROM AUTHOR]

Purpose: To report complications after the implantation of intrastromal corneal ring segments (Keraring; Mediphacos, Belo Horizonte, Brazil) in keratoconic eyes using a femtosecond laser (IntraLase; Advanced Medical Optics, Santa Ana, California, USA) for channel creation. Methods: Retrospective chart review of 531 patients (850 eyes) who underwent Keraring insertion using a femtosecond laser for channel creation. Intraoperative and postoperative complications were recorded. Results: Intraoperatively, there were 22 (2.7%) cases of incomplete channel formation. The rest of the intraoperative complications were galvo lag error (system malfunction) [five eyes (0.6%)], endothelial perforation [five eyes (0.6%)] and incorrect entry of the channel [two eyes (0.2%)]. Postoperatively, there were 11 (1.3%) cases of segment migration, two (0.2%) cases of corneal melting and one (0.1%) case of mild infection. The overall complication rate was 5.7% (49 cases out of 850 eyes). Conclusion: In this study, intracorneal ring segment implantation using a femtosecond laser for channel creation was related to a number of complications. The most common complications were incomplete channel creation (intraoperatively) and segment migration (postoperatively). [ABSTRACT FROM AUTHOR]