Search

Purpose: Regression of the refractive outcome is a major concern of LASIK procedures mainly in presbyopic patients. The purpose of this study was to evaluate the long-term efficacy of the pharmacological treatment of presbyopia performed with Benozzi's method, in combination with hyperopic LASIK surgery in presbyopic population. Methods: A nonrandomized case series was developed, including presbyopic patients who underwent bilateral "Hyperopic LASIK surgery" and were pharmacologically treated with Benozzi's Method from January 2011 to August 2018, with at least 2 years of follow-up, at two private ophthalmological clinics of Argentina. Main outcomes were spherical equivalent (SE), uncorrected distance visual acuity (UDVA), and uncorrected near visual acuity (UNVA). Measurements were evaluated at baseline and postoperative at 1 month (without Benozzi's treatment), 2 months (starting with Benozzi's treatment), and 2 years. The SE stability across the time was statistically compared. Results: A total of 84 eyes of 42 patients, with a mean age at the time of the surgery of 51.07 ± 4.5 (42-59), were found following 2 years of follow-up. Patients have improved and maintained UDVA, achieving Jaeger 1 in the second postoperative month, which was maintained up to the last year of follow-up. Refractive stability across the time is observed comparing first month after surgery with the last year of follow-up, without statistical significant difference (p: 0.11). Conclusion: Hyperopic presbyopic patients that underwent LASIK surgery and 1 month after surgery started with the pharmacological treatment of presbyopia (Benozzi's method) results in excellent UNVA and UDVA that is stable over time without refractive regression. [ABSTRACT FROM AUTHOR]

It is generally accepted that myopic defocus is a more potent signal to the emmetropization system than hyperopic defocus: one hour per day of myopic defocus cancels out 11 h of hyperopic defocus. However, we have recently shown that the potency of brief episodes of myopic defocus at inhibiting eye growth depends on the time of day of exposure. We here ask if this will also be true of the responses to brief periods of hyperopic defocus: may integration of the signal depend on time of day? If so, are the rhythms in axial length and choroidal thickness altered? Hyperopic defocus : Birds had one eye exposed to hyperopic defocus by the wearing of −10D lenses for 2 or 6 h at one of 3 times of day for 5 days: Morning (7 am – 9 am: n = 13; 7 am – 1 pm: n = 6), Mid-day (12 pm – 2 pm: n = 20; 10 am – 4 pm: n = 8), or Evening (7 pm – 9 pm: n = 12; 2 pm – 8 pm: n = 11). A separate group wore monocular lenses continually as a control (n = 12). Form deprivation : Birds wore a diffuser over one eye for 2 h at one of 3 times of day for 5 days: Morning (n = 12); Mid-day (n = 19) or Evening (n = 6). For all groups, ocular dimensions were measured using high-frequency A-scan ultrasonography at noon on the first day, under inhalation anesthesia. On day 5, eye dimensions were re-measured at 12 pm, and refractive errors were measured using a Hartinger's refractometer. A subset of birds in the 2-h lens group (morning, n = 8; mid-day, n = 8; evening, n = 6), and the deprivation group (n = 6 per time point), were also measured at 6 pm, 12 am, 6 am and 12 pm on the last day of exposure, to obtain the parameters of the diurnal rhythms in axial length and choroidal thickness. The effects of 2 h of defocus depended on time of day of exposure: it stimulated eye growth when exposure was in the morning and inhibited it when it was at mid-day (change in vitreous chamber, X-C; ANOVA p < 0.0005; 120 μm vs −77 μm/5d, respectively; t-tests: p = 0.001; p = 0.01; post-hoc tests: p = 0.002). For mid-day, experimental eyes were more hyperopic (1.4 D; p < 0.0001). Similar to 2 h defocus, 6 h exposures at mid-day inhibited growth and produced hyperopia (X-C: −167 μm; t -test p = 0.005; RE: 1.8 D; p = 0.03). The effects of 2 h of FD were similar to those of hyperopic defocus in inhibiting growth for mid-day exposures, but FD inhibited growth for the morning exposures as well (Axial length: X-C: Morning: −122 μm; mid-day: −92 μm; ttests p = 0.006 and p = 0.016 respectively). Experimental eyes were more hyperopic (1.8 D; 1.0 D; p < 0.05). The rhythms in axial length were altered for the morning exposures in both conditions. Form deprivation in the morning, which caused inhibition, caused the phases of the two rhythms to shift toward one another (peaks at 6:00 am and 10:45 am for choroid and axial length respectively). Our findings imply that the retinal “integrator”, and/or scleral growth regulator exhibit diurnal rhythms. Furthermore, they suggest that reading activities early in the day may be contraindicated in school children at risk of becoming myopic. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the differences in induced multifocality after LASIK surgery in myopic and hyperopic patients using conventional and aberration-free profiles. Setting: Augenlaserzentrum, Recklinghausen, Germany. Methods: We retrospectively evaluated four consecutive groups of 280 eyes treated by the ESIRIS laser platform: Group A myopic with conventional treatment (70 eyes), group B myopic with aspheric treatment (70 eyes), group C hyperopic eyes treated with conventional LASIK (70 eyes) and group D hyperopic eyes treated with aspheric profile (70 eyes). We used in all the cases the ESIRIS SCHWIND Laser Platform and the Carriazo Pendular Microkeratome. The Optikon Keratron Topographer obtained the measurement of change in corneal refractive power of the anterior surface at 3, 5, and 7 mm meridionally and in the form of corneal wavefront analysis. Results: We compared the preoperative multifocality with the created multifocality measured in diopters (D) per achieved diopter of defocus correction after LASIK treatment. The created multifocality was in the myopic group A +0.12 D per achieved diopter of defocus correction, in group B +0.08 D per achieved diopter of defocus correction, in the hyperopic group C −0.51 D per achieved diopter of defocus correction and in group D −0.14 D per achieved diopter of defocus correction. Conclusions: Analyzing the slope of the anterior corneal surface and the corneal wavefront the local refractive changes after LASIK can be characterized in the form of positive (relative central myopization) and negative multifocality (relative peripheral myopization). Less multifocality is created with the aberration-free pattern than with the classic pattern.

Purpose: To evaluate the corneal Functional Optical Zone (FOZ) and the Effective Optical Zone (EOZ) of the ablation, among eyes that underwent LASEK/Epi-LASEK treatments for hyperopic astigmatism. Methods: Twenty LASEK/Epi-LASEK treatments with mean defocus +2.21 ± 1.28 D performed using the SCHWIND AMARIS were retrospectively evaluated at 6-month follow-up. In all cases pre-/post-operative Corneal-Wavefront analyses using the Keratron-Scout (OPTIKON2000) were performed. FOZ-values were evaluated from the Root-Mean-Square of High-Order Wave-Aberration (RMSho), whereas EOZ-values were evaluated from the changes of Root-Mean-Square of High-Order Wave-Aberration (ΔRMSho) and Root-Mean-Square of the change of High-Order Wave-Aberration (RMS(ΔHOAb)). Correlations of FOZ and EOZ with Planned Optical Zone (POZ) and Defocus correction (SEq) were analyzed using a bilinear function. Results: At six-month, defocus was −0.04 ± 0.44 D, ninety percent eyes were within ± 0.50 D from emmetropia. Mean RMSho increased 0.18 ± 0.22 μm, SphAb −0.30 ± 0.18 μm, and Coma 0.07 ± 0.18 μm 6-month after treatment (6-mm diameter). Mean FOZPre was 7.40 ± 1.48 mm, mean POZ was 6.76 ± 0.22 mm, whereas mean FOZPost was 5.53 ± 1.18 mm (significantly smaller, p

Background: To compare wavefront (WF)-guided and WF-optimized laser in situ keratomileusis (LASIK) in hyperopes with respect to the parameters of safety, efficacy, predictability, refractive error, uncorrected distance visual acuity, corrected distance visual acuity, contrast sensitivity, and higher order aberrations. Methods: Twenty-two eyes of eleven participants with hyperopia with or without astigmatism were prospectively randomized to receive WF-guided LASIK with the VISX CustomVue S4 IR or WF-optimized LASIK with the WaveLight Allegretto Eye-Q 400 Hz. LASIK flaps were created using the 150-kHz IntraLase iFS. Evaluations included measurement of uncorrected distance visual acuity, corrected distance visual acuity, <5% and <25% contrast sensitivity, and WF aberrometry. Patients also completed a questionnaire detailing symptoms on a quantitative grading scale. Results: There were no statistically significant differences between the groups for any of the variables studied after 12 months of follow-up (all P<0.05). Conclusion: This comparative case series of 11 subjects with hyperopia showed that WF-guided and WF-optimized LASIK had similar clinical outcomes at 12 months. [ABSTRACT FROM AUTHOR]

We aimed to determine the timing of neodymium:yttrium–aluminum–garnet (Nd:YAG) laser capsulotomy on corrected-distance visual acuity (CDVA), intraocular pressure (IOP), and spherical equivalent (SE) in patients with posterior capsular opacification (PCO). There were 59 patients with unilateral PCO and a history of Nd:YAG laser capsulotomy enrolled and further divided into the early Nd:YAG group (timing < 12 months, n = 25) and late Nd:YAG group (timing > 12 months, n = 34) depending on the elapsed months from phacoemulsification to Nd:YAG laser capsulotomy. The primary outcomes were CDVA, IOP, and SE before (immediately before Nd:YAG laser capsulotomy) and after (weeks one and four after the laser treatment). The independent t test was applied to analyze the difference in CDVA, IOP, and SE between the two groups, while the generalized estimating equation with Bonferroni adjustment was conducted to evaluate the effect of all the parameters on the change in SE with adjusted odds ratio (aOR) and 95% confidence interval (CI). The CDVA showed significant improvement in both the early Nd:YAG group (p = 0.005) and the late Nd:YAG group (p = 0.001), and hyperopic change occurred in both the early Nd:YAG group (p = 0.003) and the late Nd:YAG group (p = 0.017). The early Nd:YAG group revealed more significant hyperopic change compared with the late Nd:YAG group four weeks after Nd:YAG treatment (p < 0.001), which was still significant after multivariable analysis (aOR: 0.899, 95% CI: 0.868–0.930, p = 0.011). In addition, a deeper ACD (aOR: 0.764, 95% CI: 0.671–0.869, p = 0.019) was significantly correlated with hyperopic change. In conclusion, Nd:YAG laser capsulotomy performed within one year after cataract surgery may lead to significant hyperopic change, in which the ACD alteration affects the hyperopic shift significantly. [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.)

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.)

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU 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.)

Abstract: Adaptive designs are effective mechanisms for flexibly allocating experimental resources. In clinical trials particularly, such designs allow researchers to balance short- and long-term goals. Unfortunately, fully sequential strategies require outcomes from all previous allocations prior to the next allocation. This can prolong an experiment unduly. As a result, we seek designs for models that specifically incorporate delays. We utilize a delay model in which patients arrive according to a Poisson process and their response times are exponential. We examine three designs with an eye towards minimizing patient losses: a delayed two-armed bandit rule which is optimal for the model and objective of interest; a newly proposed hyperopic rule; and a randomized play-the-winner rule. The results show that, except when the delay rate is several orders of magnitude different than the patient arrival rate, the delayed response bandit is nearly as efficient as the immediate response bandit. The delayed hyperopic design also performs extremely well throughout the range of delays, despite the fact that the rate of delay is not one of its design parameters. The delayed randomized play-the-winner rule is far less efficient than either of the other methods. [Copyright &y& Elsevier]

Aims: To evaluate the age-related variations of ocular parameters in Korean subjects., Methods: We recruited 314 normal subjects who visited the department of Ophthalmology between January 2007 and October 2007. Refraction, axial length, corneal curvature, white-to-white distance, anterior chamber depth, corneal endothelial cell density, and retinal nerve fiber layer (RNFL) thickness were measured using auto-refractive keratometer, intraocular lens master, noncontact specular microscope, and optical coherence tomography., Result: In correlation analysis, from 19 to 82 years, hyperopic shift showed a strong positive statistical correlation with age (r = 0.553, P < 0.001). Corneal curvatures increased (r = 0.221, P < 0.001), while axial length (r = -0.506, P < 0.001), anterior chamber depth (r = -0.491, P < 0.001) and white-to-white distance (r = -0.205, P < 0.001) decreased with age. Also, corneal endothelial cell density was lower in older patients than in younger patients (r = -0.409, P < 0.001). Compared to younger patients, RNFL thickness was lower in the older patients as well, in all quadrants (superior, r = -0.283, P < 0.001; inferior, r = -0.230, P < 0.001; nasal, r = 0.025, P = 0.676; and temporal, r = -0.393, P < 0.001). According to multiple regression analysis, out of the six parameters measured, only hyperopic shift, anterior chamber depth and corneal endothelial cell density (P < 0.05) had statistically significant correlation with age., Conclusion: Some of the ocular parameters changed with aging. Hyperopic shift, shallowing anterior chamber depth, and reduction of corneal endothelial cell density were only definitely related to age.