Search

Objective: To identify the incidence and refractive outcome of intraoperative laser in situ keratomileusis (LASIK) complications using one type of microkeratome. Design: Retrospective noncomparative case series. Participants: Three hundred thirty-four consecutive myopic LASIK patients (September 1997 to November 1998) operated on by one surgeon. Intervention: Myopic LASIK surgeries were performed with the Mediate Mel 60 Aesculap Meditec Laser system. Main Outcome Measures: Preoperative and 1 -year postoperative spherical equivalent, best spectacle-corrected visual acuity (BSVA), and corneal anatomic features (as obtained from videokeratography) were recorded, as was the incidence of intraoperative complications. Results: Forty-eight (14%) eyes had keratome-related complications. Thirty-seven (77%) eyes were immediately treated; the remaining eyes were treated on a later date. One year after treatment, 13% of the immediately treated complicated eyes maintained the preoperative BSVA; 24% had a 1-line loss; 2.7% had a greater loss of BSVA. Conclusions: Microkeratome-related complications may result in loss of BSVA. The complication of an irregular flap had the poorest refractive outcome in this series of eyes. We did not find any statistically significant relationship between corneal anatomic factors and keratome-related complications in this series. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the epidemiological correlation between age-related macular degeneration and pseudoexfoliation syndrome in the inhabitants of the island of Crete (Greece). Subjects and Methods: A total of 777 persons (315 men and 462 women, aged 40-99 years), representing a randomized sample (1.43%) of the Cretan population, underwent slitlamp and fundus examinations according to protocol. The results were statistically analyzed. Results: The prevalence of pseudoexfoliation was 16.1% (21.3% in men and 12.6% in women) and that of maculopathy, 7.9% (11.7% in men and 5.2% in women). The conditions were significantly correlated with each other (P = .002). Also, both displayed a significant direct correlation with age and altitude (for pseudoexfoliation, P < .001 and P = .002 for age and altitude, respectively; for age-related macular degeneration, P<.001 for age and for altitude) and an increase in bilateral incidence with progressing age. Conclusions: The observed prevalences of pseudoexfoliation and maculopathy were lower than those reported in the mainland of Greece and other Mediterranean regions. The correlation between age-related macular degeneration and pseudoexfoliation syndrome may be explained by the relationship of each disease with age and altitude. [ABSTRACT FROM AUTHOR]

Aims/purpose: To report the preoperative use of anterior segment optical coherence tomography (AS-OCT) for the determination of pre-existing posterior capsule defect in patients with posterior polar cataract. Methods: Three patients presented with posterior polar cataract and were evaluated preoperatively using AS-OCT, revealing in one patient intact posterior capsule and in the other two a pre-existing posterior capsule defect not detectable by slit-lamp evaluation. All patients underwent phacoemulsification and intraocular lens implantation. Results: Intraoperatively, AS-OCT findings were confirmed after cataract surgery in all patients. No intra- or late postoperative complications were noted. Conclusion: AS-OCT could be an additional useful imaging modality in these patients, essential for surgical planning and patient consultation. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Optometry is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To describe the technique of femtosecond laser–assisted intracorneal pocket creation, using a mask for the implantation of a corneal inlay in the non-dominant eye of a 56-year-old, emmetropic, presbyopic woman for the correction of presbyopia. Methods: Using the iFlap treatment-type software of the femtosecond laser (IntraLase 150, Abbott Medical Optics), a full lamellar cut was created at 280-μm depth. A keyhole-shaped mask was placed at the internal part of the glass of the applanation cone. A separator was used to separate the stroma, and an inserter was used to implant the inlay at the center of the line of sight. To determine the line of sight, the microscope and centration system of the excimer laser (Allegretto Wave 400 Hz, WaveLight Laser Technologie AG) were used. The Flexivue Microlens inlay (Presbia) was implanted. Results: No intra- or postoperative complications occurred during follow-up. Uncorrected near visual acuity improved from 20/50 to 20/20 at the first postoperative week. Conclusions: Femtosecond-assisted intracorneal pocket creation using a mask is a simple, safe, and efficient approach for the implantation of corneal inlays. [ABSTRACT FROM AUTHOR]

Purpose. To present a case of a keratoconic patient who underwent epithelial removal with transepithelial phototherapeutic keratectomy (t-PTK) using a 213-nm solid-state laser system followed by corneal collagen cross-linking (CXL) with riboflavin and ultraviolet-A (UVA) irradiation. Methods. Case report. Results. A twenty-four-year-old male with keratoconus underwent CXL treatment after epithelial removal with t-PTK using a solid-state laser system. No intra- or early postoperative complications were found. One month postoperatively, uncorrected visual acuity (UCVA) improved from 20/63 to 20/32 while best spectacle-corrected visual acuity (BSCVA) improved from 20/40 to 20/25. Corneal topography revealed a significant improvement which remained stable during the six-month followup period. Conclusions. Epithelial removal with t-PTK before CXL could improve patient's visual outcome. [ABSTRACT FROM AUTHOR]

PURPOSE: To report a case of laser in situ keratomileusis (LASIK) in a patient with previous conductive keratoplasty. METHODS: A 48-year-old man underwent conductive keratoplasty for low hyperopic astigmatism (manifest refraction OD: +2.25 -0.50 x 77°; OS: +2.50 -0.50 x 105°). Three months postoperatively, UCVA was 20/25 and BSCVA was 20/20 in both eyes; manifest refraction OD: -0.25 -0.75 x 110°; OS: +0.75 -0.75 x 50°. Sixteen months after the operation, regression of refractive outcome was (manifest) OD: +1.75 -1.25 x 90°; OS: +2.50 -0.50 x 85°; UCVA was 20/40 in the right eye and 20/63 in the left eye and BSCVA was 20/20 in both eyes. LASIK was performed for hyperopic regression in the left eye using an automated microkeratome (Alcon SKBM, 130-µm plate; Aesculap-Meditec MEL 70 excimer laser). RESULTS: LASIK was uneventful and no intraoperative or postoperative complications related to the previous conductive keratoplasty procedure or LASIK were observed. Three months after LASIK and 19 months after the initial conductive keratoplasty, the patient's left eye was emmetropic; UCVA was 20/20-2, BSCVA was 20/20 and manifest refraction was +0.25 -0.25 x 35°. There was a uniform increase in topographical steepening. Visual acuity, refraction and topographic findings remained unchanged at 6 months. CONCLUSIONS: Even though our experience is limited, treatment of hyperopia with LASIK in an eye with refractive regression following previous conductive keratoplasty resulted in a predicted refractive outcome, with no complications, and improvement in visual acuity at 6 months followup. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to two articles including "The Final Frontier: Pediatric Intraocular Lens Power," by K.J. Hoffer et al and "Accuracy of Intraocular Lens Power Calculation Formulae in Children Less than Two Years," by R. Kekunnaya et al both in a 2012 issue.

Use of Descemet stripping automated endothelial keratoplasty (DSAEK) has been reported in children for the treatment of postoperative endothelial decompensation and Descemet membrane break after forceps delivery. Rapid visual recovery and minimally induced postoperative astigmatism make DSAEK preferable to penetrating keratoplasty for the management of isolated endothelial disorders in this age group. We present a case of DSAEK in a 4-year-old boy for the management of irreversible endothelial rejection after penetrating keratoplasty. Three months after the procedure, the cornea remained clear with the donor button in place. [Copyright &y& Elsevier]

Purpose. To report a case of Parinaud's oculoglandular syndrome (POS) in which, despite the initially negative, a late onset of serologic positive titers was observed. Methods. Case report. Results. A 65-year-old man was examined for a foreign body in the left eye associated with granulomatous nodule on the palpebral conjuctiva, chemosis and a swollen preauricular lymph node. Despite the initially negative serologic titers to Bartonella henselae , a clinical diagnosis of POS was made and treatment was instituted initially with oral ciprofloxacin (500 mg twice a day). Three weeks later, serologic positive titers were found which confirmed the diagnosis of POS. Conclusion. Even though the improvements in diagnostic testing such as indirect immunofluorescence antibody, negative titles could be initially observed, confusing the diagnostic process. Other techniques (such as polymerase chain reaction (PCR) testing) should be also taken into consideration in cases with increased clinical suspicious of B. henselae indections. [ABSTRACT FROM AUTHOR]

Purpose: To compare the ocular rigidity in vivo measurements of patients with age-related macular degeneration (AMD) and control subjects. Design: Prospective comparative clinical study. Methods: The pressure-volume relation and the ocular rigidity coefficient were compared among 32 patients with AMD (AMD group: 16 with neovascular and 16 with nonneovascular AMD) and 44 age-matched control patients (control group) who underwent operation for cataract. This was achieved by an injection of 200 μl of a balanced salt solution (in steps of 4.5 μl) through the limbus in the anterior chamber, while the intraocular pressure was monitored continually with a transducer, up to the limit of 30 mm Hg. Results: The mean age (AMD group: 69.89 ± 15.92 years vs control group: 65.28 ± 12.34 years; P = .195), gender (AMD group: 13 female vs control group: 17 female; P = .513), eye’s axial length (AMD group: 23.14 ± 0.75 mm vs control group: 23.04 ± 1.16 mm; P = .725) of patients with AMD and the healthy control subjects were comparable. No statistically significant difference in ocular rigidity measurements between patients with AMD and control subjects (AMD group: 0.0142 ± 0.0077 μl−1 vs control group: 0.0125 ± 0.0049 μl−1; P = .255) was found. When we examined separately the two subgroups of patients with AMD (neovascular and nonneovascular AMD), the average ocular rigidity measurements were higher in patients with neovascular AMD vs both control subjects and patients with nonneovascular AMD (neovascular AMD group: 0.0186 ± 0.0078 μl−1 vs control group: 0.0125 ± 0.0048 μl−1 [P = .014] vs nonneovascular AMD group: 0.0104 ± 0.0053 μl−1 [P = .004]). Conclusions: Despite the limitations placed by the small sample of the examined cases, patients with neovascular AMD who are treated (with photodynamic therapy) have increased ocular rigidity measurements compared with patients with nonneovascular AMD and control patients. [Copyright &y& Elsevier]

We present the case of a patient who had refractive corneal inlay implantation for near vision improvement after bilateral cataract surgery. The patient had a history of bilateral cataract, and a 2-step procedure was suggested to improve her near and distance visual acuities. The first step was bilateral cataract extraction with a power target of plano intraocular lens implantation. Six months later, a refractive corneal inlay, Presbia Microlens, was implanted in the nondominant eye in the intracorneal pocket made with the femtosecond laser. No intraoperative or postoperative complications occurred. The bilateral uncorrected near visual acuity improved from less than Jaeger (J)6 to J1 and remained stable during the 2-year follow-up. The refractive corneal inlay is a safe, simple, and efficient method for improving near visual acuity in patients after cataract surgery. Financial Disclosure: Dr. Pallikaris is the chair of the medical advisory board of Presbia Coöperatief U.A. No other author has a financial or proprietary interest in any material or method mentioned. [ABSTRACT FROM AUTHOR]

Purpose: To report the 2-year follow-up of the initial clinical evaluation of Infinite Vision Optics multicomponent intraocular lens (IOL) implantation. Setting: Institute of Vision and Optics, University of Crete, Crete, Greece. Design: Case series. Methods: All patients had routine cataract surgery and multicomponent IOL implantation. The primary objectives of the study were to evaluate the manufacturing feasibility of the IOL, the evaluation of the surgical implantation technique, and the incidence of interlenticular fibrosis. Results: This initial clinical evaluation comprised 6 patients with a mean age of 63.3 years ± 12.7 (SD) (range 49 to 82 years). Implantations were uneventful in all cases. There were no intraoperative or postoperative complications. There was no interlenticular fibrosis. There was no statistically significant difference in the endothelial cell density, anterior chamber depth, or pachymetry readings between preoperatively and 2 years postoperatively. No patient lost lines of corrected distance visual acuity. Conclusions: Multicomponent IOL implantation was easy and safe and resulted in excellent visual recovery. No cases of interlenticular fibrosis developed. Financial Disclosure: Dr. Portaliou has received travel grant and meeting expenses from Infinite Vision Optic. Neither of the other 2 authors has a financial or proprietary interest in any material or method mentioned. [Copyright &y& Elsevier]

Purpose It is widely accepted that monocular deprivation results in improved visual performance in the non-pathological eye. The current study investigates the effect of deprivation due to severe impairment in one eye during late childhood or adulthood, on the spatial performance of the fellow 'good' eye. Methods Twenty patients (age: 29 ± 9 years) with severe visual impairment in one eye (visual acuity equal or worse than count fingers at 1 m), for a period longer than 2 years, participated in the study. Only patients with an age less than 50 years and monocular deprivation onset greater than 9 years were included. On the basis of the time of deprivation the patients were categorised into two subgroups: (i) long-past deprivation (N = 8, age 28 ± 8 years, 9-20 years of deprivation) and recent deprivation (N = 12, age 30 ± 11 years, 2-4 years of deprivation). Eighteen more participants (age: 28 ± 5 years) with normal binocular vision served as the control group. Best-corrected contrast sensitivity was evaluated using reversing (2 Hz) vertical sinusoidal gratings. Seven spatial frequencies (1, 2, 4, 8, 12, 16 and 24 c/deg) were tested. Performance of the control group was tested both monocularly (dominant eye) and binocularly. Results In normal subjects, binocular viewing improved contrast sensitivity on average by 4.2 dB (corresponding to a 70% improvement in contrast threshold) compared to monocular recordings. Average contrast sensitivity in subjects with impaired vision in one eye was found to be higher by 5.0 dB (corresponding to an 83% improvement in contrast threshold) compared with the dominant eye of the control group. The increase in sensitivity was independent of spatial frequency. No differences were observed between the two subgroups with recent and long-past deprivation. Conclusions Notable improvement in contrast sensitivity was found in the non-pathological eye of patients with severe impairment in the other eye at an age after the 'critical' period of visual development. These findings are consistent with growing evidence supporting functional changes as a result of altered experience or injury in the adult vision system. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate differences between Goldmann Applanation Tonometry (GAT) and Dynamic Controur Tonometry (DCT) in eyes with pseudoexfoliation syndrome (PEX). Methods: Thirty-eight patients (38 eyes) with PEX in both eyes (pseudoexfoliative group, PG) as well as 19 patients (19 eyes) without PEX in either eye (control group, CG), were included. All eyes were phakic. GAT, DCT, the central corneal thickness (CCT) and the axial length of the eyeball (AL) were measured and the difference between GAT and DCT (dIOP) was calculated. Differences in dIOP between CG and PG and correlations of dIOP with CCT and AL were examined. Results: dIOP was significantly ( P = 0.02) higher in PG (mean value 3.69 mmHg), compared with CG (mean value 2.15 mmHg). In PG (but not in CG), dIOP was also significantly correlated with AL but not with CCT. Conclusion: The fact that dIOP was significantly higher in PG than in CG implies that PEX may affect ocular biomechanical properties. The significant association of dIOP with AL but not with CCT is in agreement with previous reports and complies with the fact that pseudoexfoliative material is not deposited in corneal stroma. [ABSTRACT FROM AUTHOR]

Background. To evaluate differences between Goldmann Applanation Tonometry (GAT) and Dynamic Controur Tonometry (DCT) following trabeculectomy. Methods. Thirty eight glaucomatous eyes with a history of trabeculectomy (Trabeculectomy group, TG), 20 eyes without a history of trabeculectomy but with a history of latanoprost use (Latanoprost group, LG), and 19 nonglaucomatous eyes (Control group, CG) were included. GAT-IOP, DCT-IOP, the difference between them (dIOP), the central corneal thickness (CCT), the axial length (AL), and the depth of the anterior chamber (ACD) were measured. Results. dIOP was significantly higher in TG (5.19 mmHg) than in LG (4.01 mmHg) and CG (1.98 mmHg). Correlations between AL and dIOP were statistically significant in both TG and LG but not in CG whereas correlations between dIOP and other clinical parameters examined were statistically not significant in all groups. Conclusions. The significantly higher dIOP in TG implies that the biomechanical properties of the ocular walls are altered following trabeculectomy. [ABSTRACT FROM AUTHOR]

A 36-year-old male underwent uneventful small incision lenticule extraction (SMILE) for the correction of his high residual refractive error 12 years after photorefractive keratectomy (PRK). Preoperatively, uncorrected distance visual acuity (UDVA) was counting fingers in both eyes. Corrected distance visual acuity was 20/20 in the right and 20/30 in the left eye due to amblyopia. One month after SMILE, UDVA was 20/20 and 20/30 in the right and left eye, respectively; post-PRK corneal haze had reduced. During the 4-year follow-up, UDVA remained stable and there were no complications. SMILE could be a good alternative approach for retreatment in post-PRK patient. [ABSTRACT FROM AUTHOR]

Purpose To evaluate the visual, refractive, and topographic outcomes after combined transepithelial phototherapeutic keratectomy (PTK) and conventional photorefractive keratectomy (PRK) followed simultaneously by corneal crosslinking (CXL) for keratoconus. Setting Vardinoyiannion Eye Institute of Crete, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece. Design Prospective case series. Methods Patients with progressive keratoconus had simultaneous conventional PRK followed by CXL; the corneal epithelium was removed using transepithelial PTK (Cretan protocol plus). The visual, refractive, and topographic outcomes and the endothelial cell density (ECD) were evaluated preoperatively and 1, 3, 6, and 12 months postoperatively. Results Forty-three patients (55 eyes) were enrolled. The mean uncorrected and corrected distance visual acuities improved significantly from 0.98 ± 0.63 (SD) logarithm of minimum angle of resolution (logMAR) and 0.20 ± 0.23 logMAR preoperatively to 0.39 ± 0.35 logMAR ( P  < .001) and 0.08 ± 0.16 logMAR ( P  < .001) 12 months postoperatively, respectively. The mean spherical equivalent improved significantly from −4.67 ± 4.00 diopters (D) preoperatively to −2.24 ± 2.81 D ( P  < .001) at 12 months. The mean steep keratometry (K) and flat keratometry readings decreased significantly from 50.30 ± 5.00 D and 45.62 ± 3.10 D preoperatively to 46.27 ± 3.90 D ( P  < .001) and 43.46 ± 3.00 D ( P  < .001) 12 months postoperatively, respectively. No ECD alterations were observed throughout the follow-up ( P  > .05). Conclusion Combined transepithelial PTK and conventional PRK followed simultaneously by CXL was effective in corneal stabilization and vision improvement in keratoconic patients. [ABSTRACT FROM AUTHOR]

Purpose: To compare Plusoptix (Gmbh, Nuremberg, Germany), 2WIN (Adaptica, Padua, Italy), the benchtop refractometer (Auto-Kerato-Refractometer KR-8900; Topcon Co, Tokyo, Japan), and retinoscopy with regard to the consistencies.Materials and Methods: In our prospective study, 200 eyes of 100 patients were included. We analyzed the demographics and characteristics of the patients, the percentage of patients from whom measurements could not be obtained, the measurements from both patients' eyes of pupil diameter, spherical, cylindrical, axis, and spherical equivalence.Results: The mean age ± SD was 7.8±4.5 years (range, 1-18 years). Pupil diameter measurements were found to be consistent (Cronbach's alpha value >0.8). The sphere and spherical equivalence measurements for both eyes were found to be consistent with each other in all apparatus (Cronbach's alpha value >0.8). However, consistency was found to be lower in cylindrical values and the Jackson cross-cylinder measurements at 0° and 45° axis were found to be inconsistent with each other (Cronbach's alpha value <0.8).Conclusions: While consistency was observed in all methods in terms of sphere and spherical equivalence, consistency dropped in cylindrical values and no consistency was observed in axis values. It is important to take this point into consideration, especially in axis measurements. [ABSTRACT FROM AUTHOR]