scholarly journals Quality of Vision Following LASIK and PRK-MMC for Treatment of Myopia

2021 ◽  
Author(s):  
Hong Gao ◽  
Tyler P Miles ◽  
Ray Troche ◽  
Donna M Murdoch ◽  
Vilhelm F Koefoed ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Repeated Measures ◽  
Military Service ◽  
High Order ◽  
Mean Difference ◽  
Analysis Of Covariance ◽  
Prospective Clinical Study ◽  
Quality Of Vision ◽  
High Order Aberrations

ABSTRACT Introduction Femtosecond-assisted thin flap, laser-assisted in situ keratomileusis (LASIK) and photorefractive keratectomy with mitomycin-C (PRK-MMC) are the two most common refractive surgical procedures used to enhance visual capability in the U.S military. The purposes of the study were to examine effects on quality of vision following LASIK and PRK-MMC using a novel computer-based quick contrast sensitivity function (qCSF) test. Materials and Methods This prospective clinical study included 58 active duty U.S. military service members who elected LASIK (n = 29) or PRK-MMC (n = 29) refractive surgery for myopia (nearsightedness) treatment. Monocular photopic and mesopic quality of vision of the right eyes in spectacle correction preoperatively and unaided right eyes at four postoperative follow-up visits (1 week, 2 weeks, 1 month, and 3 months) were examined using the qCSF device. Two qCSF parameters, area under a log CSF (AULCSF) between 1.5 and 18 cycles per degree, and CSF cutoff acuity (CSF Acuity), were collected using a 50-trial setting at a 4-m testing distance. General linear model (GLM) Repeated-measures Analysis of Covariance was used to examine effects on quality of vision following LASIK and PRK-MMC. Post hoc testing with Bonferroni correction was used for pairwise comparisons, and preoperative cylinder refraction was used as a covariate. Two-tailed independent t-test was used to compare preoperative and postoperative parameters between LASIK and PRK-MMC. Pearson’s correlation, Bland–Altman plots, and multiple linear regression were used to examine the relationship among the qCSF and other vision tests. Results Quality of vision, AULCSF, and CSF Acuity returned to the preoperative baseline at postoperative 2 weeks under mesopic condition and at postoperative 1 month under photopic condition after PRK-MMC. In comparison, photopic and mesopic quality of vision were not significantly different from the baseline at any of the four postoperative visits following LASIK. Changes of CSF Acuity from the baseline after LASIK were significantly better under photopic than mesopic condition by 0.067 ± 0.014 logarithm of the minimum angle of resolution (logMAR); P < .001). Quality of vision was not significantly different between the LASIK and PRK-MMC groups at postoperative 1 and 3 months. When predicting photopic AULCSF (overall model fit R2 = 0.47), 5% contrast acuity (beta = −0.43), visual acuity in 100% contrast (beta = −0.18), and residual refraction in spherical equivalent (beta = 0.20) were significant predictors (P ≤ .001), while high-order aberrations (beta = −0.07, P = .22) were not significant predictors. Visual acuity (beta = −0.12, P = .07) and high-order aberrations (beta = −0.04, P = .58) were not significant predictors of mesopic AULCSF. Bland–Altman plots show that photopic CSF Acuity and visual acuity had a mean difference of 0.19 ± 0.01 logMAR with limits of agreement (LOAs) at −0.01 and 0.39 logMAR. Photopic CSF Acuity and 5% contrast acuity had a mean difference of −0.06 ± 0.01 logMAR with LOAs at −0.33 and 0.21 logMAR. Conclusion Quality of vision recovers at postoperative 1 week after LASIK and at postoperative 1 month after PRK-MMC. The standard black-on-white high-contrast, chart-based visual acuity test is weak in predicting quality of vision. The qCSF detects mild-to-moderate visual changes and is suitable for quality of vision assessment following refractive eye surgery.

scholarly journals Objective and subjective evaluation of trifocal diffractive intraocular Lens after cataract extraction with phacoemulsification: a prospective clinical study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ahmed A. Zein El-Dein ◽  
Ahmed Elmassry ◽  
Hazem M. El-Hennawi ◽  
Ehab F. Mossallam
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Intraocular Lens ◽  
Subjective Evaluation ◽  
Cataract Extraction ◽  
Prospective Clinical Study ◽  
Gradual Change ◽  
Quality Of Vision ◽  
Defocus Curve

Abstract Background This study aimed to assess visual outcomes, quality of vision and patients’ satisfaction of a trifocal diffractive intraocular lens after cataract surgery with phacoemulsification. Results The study included 36 eyes that underwent implantation of trifocal diffractive intraocular lens (IOL). The residual mean postoperative spherical equivalent was − 0.40 ± 0.29 diopters. Mean Uncorrected distance visual acuity was 0.80 ± 0.16 decimal (snellen equivalent 25 ft) while mean Uncorrected intermediate visual acuity was 0.82 ± 0.31 decimal (snellen equivalent 25 ft) and mean Uncorrected near visual acuity (UCNVA) was 0.87 ± 0.20 decimal (snellen equivalent 23 ft). In defocus curve, there was infinitesimal gradual change between the three foci. Contrast sensitivity was just below the inferior limit of normal. Conclusion Trifocal diffractive IOL created a true intermediate focus proved by VA and defocus curve and better quality of vision assessed by contrast sensitivity and high order aberration. Moreover, it was safe and effective for correcting distance and near vision in these patients. Most of the patients were very satisfied and achieved spectacle independence. Trial registration Registration number and date: NCT04465279 on July 10, 2020.

scholarly journals Intacs Intracorneal Ring Segments Complications in Patients Suffering from Keratoconus

2013 ◽  
Vol 2 (3) ◽  
pp. 121-128 ◽  
Author(s):  
Ramez Barbara ◽  
Adel Barbara
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Postoperative Complications ◽  
Retrospective Studies ◽  
Contact Lenses ◽  
Case Reports ◽  
High Order ◽  
Positive Results ◽  
High Order Aberrations

ABSTRACT Intacs, intrastromal corneal rings are widely used to reduce myopia, astigmatism, keratometry readings and high order aberrations in patients suffering from keratoconus, almost 15 years have passed from the first procedure which was performed in the eye of a patient with unsatisfactory visual acuity and contact lenses intolerance. Many publications including book chapters, retrospective studies, case reports and literatures reviews have been published on this issue. In this review, we are reporting on the complications of Intacs implanted in keratoconic eyes, we are reporting on intraoperative and postoperative complications. The review although focusing on complications of the does not contradict the positive results of the procedure on the quality of life of the patients suffering from keratoconus and the its safety. How to cite this article Barbara A, Barbara R. Intacs Intracorneal Ring Segments Complications in Patients Suffering from Keratoconus. J Kerat Ect Cor Dis 2013;2(3):121-128.

Objective and Subjective Evaluation of Trifocal Diffractive Intraocular Lens after Cataract Extraction with Phacoemulsification: A Prospective Clinical Study

2021 ◽  
Author(s):  
Ahmed A. Zein El-Dein ◽  
Ahmed Elmassry ◽  
Hazem M. El Hennawi ◽  
Ehab F. Mossallam
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Intraocular Lens ◽  
Subjective Evaluation ◽  
Cataract Extraction ◽  
Prospective Clinical Study ◽  
Gradual Change ◽  
Quality Of Vision ◽  
Defocus Curve

Abstract Background: This study aimed to assess visual outcomes, quality of vision and patients’ satisfaction of a trifocal diffractive intraocular lens after cataract surgery with phacoemulsification.Results: The study included 36 eyes that underwent implantation of trifocal diffractive intraocular lens (IOL). The residual mean postoperative spherical equivalent was –0.40 ± 0.29 diopters. Mean Uncorrected distance visual acuity was 0.80 ± 0.16 decimal (snellen equivalent 25 feet) while mean Uncorrected intermediate visual acuity was 0.82 ± 0.31 decimal (snellen equivalent 25 feet) and mean Uncorrected near visual acuity (UCNVA)was 0.87 ± 0.20 decimal (snellen equivalent 23 feet). In defocus curve, there was infinitesimal gradual change between the three foci. Contrast sensitivity was just below the inferior limit of normal. Conclusion: Trifocal diffractive IOL created a true intermediate focus proved by VA and defocus curve and better quality of vision assessed by contrast sensitivity and high order aberration. Moreover, it was safe and effective for correcting distance and near vision in these patients. Most of the patients were very satisfied and achieved spectacle independence.

scholarly journals Quality of Life and Hemodynamic Effects of Switching From Hemodialysis to Hemodiafiltration: A Canadian Controlled Cohort Study

2021 ◽  
Vol 8 ◽  
pp. 205435812110577
Author(s):  
Isabelle Ethier ◽  
Immaculate Nevis ◽  
Rita S. Suri
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
Repeated Measures ◽  
Recovery Time ◽  
Randomized Clinical Trials ◽  
Analysis Of Covariance ◽  
Intradialytic Hypotension ◽  
Laboratory Values

Background: Recent randomized clinical trials have demonstrated beneficial effects of hemodiafiltration (HDF) compared with hemodialysis (HD) on mortality and hemodynamic stability. Data on quality of life in HDF compared with HD is limited. Objective: This study aimed to determine whether patients receiving HD experience improvements in quality of life, hemodynamic and laboratory parameters after switching to HDF. Design: Observational controlled cohort study. Setting & Patients: Adult patients receiving maintenance dialysis were followed for 3 months both before and after transfer to a new unit, where they received HDF. Prior to transfer, control patients were already treated by HDF. Methods: Quality of life at baseline and follow-up was measured using the validated minutes to recovery (MR) question. Dialysis data were collected for 3 consecutive sessions monthly; laboratory values were collected monthly. Wilcoxon signed rank test and repeated measures analysis of covariance were used to evaluate pre/post transfer changes and quantile regression to identify predictors of change in recovery time. Results: Of 227 patients, 82 died, were transplanted, were hospitalized or did not transfer, leaving 123 subjects and 22 controls for analysis. MR did not improve with switching to HDF, although patients with MR > 60 min before transfer experienced a significant decrease in their MR, compared with controls. There was no improvement in intradialytic hypotension with HDF. There were no differences in laboratory values before vs after switch. Limitations: Nonrandomized single-center study, including only small numbers of patients and covering a short follow-up period; hemodynamic values only evaluated over 1 week per month; residual kidney function not recorded. Conclusions: In this Canadian experience of HDF, patients remained stable with respect to several laboratory and dialysis related parameters. Switch to HDF was associated with substantially reduced recovery time in patients with MR > 60 minutes at baseline.

scholarly journals Impact of Aquatic Exercise on Respiratory Outcomes and Functional Activities in Children with Neuromuscular Disorders: Findings from an Open-Label and Prospective Preliminary Pilot Study

2020 ◽  
Vol 10 (7) ◽  
pp. 458
Author(s):  
Marta Huguet-Rodríguez ◽  
José Luis Arias-Buría ◽  
Belén Huguet-Rodríguez ◽  
Rocío Blanco-Barrero ◽  
Daniel Braña-Sirgo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Repeated Measures ◽  
Neuromuscular Disorders ◽  
Analysis Of Covariance ◽  
Aquatic Exercise ◽  
Functional Skills ◽  
Functional Activities ◽  
Significant Difference ◽  
Respiratory Outcomes

Neuromuscular disorders (NMD) lead to the progressive loss of motor and respiratory functions and a decline in daily activities and participation. We aimed to evaluate respiratory changes and functional outcomes in children attending an aquatic therapy program. Eleven patients diagnosed with NMD (4–18 years, Vignos scale 1–9) were involved in a 10-week aquatic exercise program. The ventilation variables were: peak cough flow, volumes (forced expiratory volume in one second-FEV1 and inspiratory volume) and respiratory pressures to evaluate strength and oxygen saturation (O2 sat). Functional skills were measured in the aquatic environment (Water Orientation Test Alyn 1) and on dry land, (Pediatric Evaluation of Disability Inventory), together with quality of life (Pediatric Quality of Life Inventory). Our evaluation included several 2 × 6 mixed-model repeated measures analysis of covariance (ANCOVA) with time (baseline, post 1 session, pre-post at five weeks and pre-post at 10 weeks). Important improvements in functional skills were observed in and out of the water and children under the age of 11 displayed a significant difference for inspirational volume (p = 0.002) and O2 sat (p = 0.029). Clinical, statistically insignificant changes were found for peak cough flow and expiratory pressures values after aquatic exercise. These results may support a relationship between aquatic exercise in NMD, respiratory outcomes and functional activities in water and on land.

Keratoconic Bi-aspheric Contact Lenses

2016 ◽  
Vol 5 (3) ◽  
pp. 132-138
Author(s):  
Ariela Gordon-Shaag ◽  
Philip Fine ◽  
Liat Gantz ◽  
Arige Gideon-Abousaid ◽  
Gad Serero
Keyword(s):  
Visual Acuity ◽  
Contact Lenses ◽  
Case Series ◽  
Visual Stability ◽  
Wavefront Aberrations ◽  
Body Sensation ◽  
Quality Of Vision ◽  
Base Curve ◽  
Aspheric Lenses

ABSTRACT Aim This observational clinical case series examined patients with keratoconus (KC) fit with keratoconic bi-aspheric (KBA) lenses to assess visual acuity (VA), wavefront aberrations, physiological fitting, subjective comfort, and manufacturer's fitting guidelines. Materials and methods Seven adult patients (11 eyes, four females, mean age: 34.15 ± 14.12) with nipple cones from the Hadassah Academic College contact lens clinic (Jerusalem, Israel) were fit with KBA lenses by modifying the initial base curve (BC) to obtain an acceptable physiological fit. The uncorrected and corrected distance (D) and near (N) Snellen VA and the ocular wavefront measurements, and responses to a self-administered five-point scale questionnaire were compared after 2 weeks of wear using paired two-tailed t-test or Mann-Whitney U test, as appropriate. Results Visual acuity and total root mean square (RMS) improved significantly with the lenses (DVAuncorrected = 0.04 ± 0.02, DVAcorrected = 0.66 ± 0. 22, NVAuncorrected = 0.34 ± 0.30, NVAcorrected = 0.95 ± 0.12). Subjects reported an average of 7.0 ± 2.7 hours of wear daily, with good scores in visual stability, satisfaction with VA and quality of vision, improvement of mood and quality of life, and low scores in foreign body sensation, pain, red eye, and itching during wear, and difficulty with lens removal. An average of two BC modifications from the diagnostic lens were necessary (0.16 mm steeper in nine eyes, 0.27 mm flatter in two eyes). Conclusion Keratoconic bi-aspheric lenses can provide 7 hours of comfortable wear, significantly improved VA and total RMS aberrations, alongside subjective satisfaction. Base curve modifications can be reduced by fitting a diagnostic lens 0.75 mm steeper than the flattest keratometry reading. How to cite this article Gantz L, Gordon-Shaag A, Gideon-Abousaid A, Serero G, Fine P. Keratoconic Bi-aspheric Contact Lenses. Int J Kerat Ect Cor Dis 2016;5(3):132-138.

High-order Aberrations in Keratoconus

2016 ◽  
Vol 5 (3) ◽  
pp. 128-131 ◽  
Author(s):  
Hagar Hefner-Shahar ◽  
Nir Erdinest
Keyword(s):  
Refractive Surgery ◽  
Early Stage ◽  
Visual Quality ◽  
High Order ◽  
Wavefront Analysis ◽  
Technological Advances ◽  
High Order Aberrations

ABSTRACT With all the technological advances today and the increasing number of people undergoing refractive surgery, the importance of detecting keratoconus (KC) prior to surgery has become evident. Although by using a topographer we can detect early stage KC, however, by using wavefront analysis technology, we are able to detect KC at an even earlier stage. Every eye possesses a number of aberrations. However, in a KC patient's eye, there are approximately five to six times the numbers of high-order aberrations (HOAs) than in a healthy eye. Using this technology to detect and assess the HOAs, it was found that in a KC cornea, it is possible to detect at a very early stage a much higher value of vertical coma aberrations compared with a normal eye. By using this technology, it is possible to study and understand the characteristics of the quality of the image on the retina, thereby understanding its impact on the patient's visual quality. How to cite this article Hefner-Shahar H, Erdinest N. Highorder Aberrations in Keratoconus. Int J Kerat Ect Cor Dis 2016;5(3):128-131.

scholarly journals Sleep Deprivation Has No Effect on Dynamic Visual Acuity in Military Service Members Who Are Healthy

2013 ◽  
Vol 93 (9) ◽  
pp. 1185-1196 ◽  
Author(s):  
Matthew R. Scherer ◽  
Pedro J. Claro ◽  
Kristin J. Heaton
Keyword(s):  
Visual Acuity ◽  
Sleep Deprivation ◽  
Repeated Measures ◽  
Military Service ◽  
Intraclass Correlation ◽  
Vestibular Function ◽  
Service Members ◽  
Behavioral Measure ◽  
Dynamic Visual Acuity ◽  
Repeated Measures Design

Background The risk of traumatic brain injury (TBI) and comorbid posttraumatic dizziness is elevated in military operational environments. Sleep deprivation is known to affect a service member's performance while deployed, although little is known about its effects on vestibular function. Recent findings suggest that moderate acceleration step rotational stimuli may elicit a heightened angular vestibulo-ocular reflex (aVOR) response relative to low-frequency sinusoidal stimuli after 26 hours of sleep deprivation. There is concern that a sleep deprivation–mediated elevation in aVOR function could confound detection of comorbid vestibular pathology in service members with TBI. The term “dynamic visual acuity” (DVA) refers to an individual's ability to see clearly during head movement and is a behavioral measure of aVOR function. The Dynamic Visual Acuity Test (DVAT) assesses gaze instability by measuring the difference between head-stationary and head-moving visual acuity. Objective The purpose of this study was to investigate the effects of 26 hours of sleep deprivation on DVA as a surrogate for aVOR function. Design This observational study utilized a repeated-measures design. Methods Twenty soldiers with no history of vestibular insult or head trauma were assessed by means of the DVAT at angular head velocities of 120 to 180°/s. Active and passive yaw and pitch impulses were obtained before and after sleep deprivation. Results Yaw DVA remained unchanged as the result of sleep deprivation. Active pitch DVA diminished by −0.005 LogMAR (down) and −0.055 LogMAR (up); passive pitch DVA was degraded by −0.06 LogMAR (down) and −0.045 LogMAR (up). Limitations Sample homogeneity largely confounded accurate assessment of test-retest reliability in this study, resulting in intraclass correlation coefficients lower than those previously reported. Conclusions Dynamic visual acuity testing in soldiers who are healthy revealed no change in gaze stability after rapid yaw impulses and subclinical changes in pitch DVA after sleep deprivation. Findings suggest that DVA is not affected by short-term sleep deprivation under clinical conditions.

scholarly journals Comparison of efficacy and visual quality after CWFG-FS-LASIK, AF-FS-LASIK and SMILE for correcting myopia with asymmetry mid-to-high astigmatism

2020 ◽  
Author(s):  
zhongxiu zhao ◽  
Miaomiao Zhu ◽  
Qian Jian ◽  
Xialu Liu ◽  
Pingting Ma ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Visual Quality ◽  
Modulation Transfer ◽  
Surgical Methods ◽  
Uncorrected Visual Acuity ◽  
Better Than ◽  
High Order Aberrations

Abstract Background: Individualized ablation is not only able to correct corneal low-order aberrations but also to improve corneal high-order aberrations in patients with corneal asymmetry. In this study, we compared the effects of three different surgical methods, namely, corneal wavefront-guided femtosecond laser assisted in-situ keratomileusis (CWFG-FS-LASIK), aberration-free femtosecond laser assisted in-situ keratomileusis (AF-FS-LASIK) and small incision lenticule (SMILE), in patients with mid-to-high astigmatism asymmetric corneas (1-4D).Methods: One hundred-fourteen eyes from 58 patients were enrolled in this retrospective study. We measured and compared the best corrected visual acuity (BCVA), uncorrected visual acuity (UCVA), residual astigmatism, total coma, vertical coma (Z3-1), horizontal coma (Z31), modulation transfer function (MTF) and point spread function (PSF) preoperatively and three months postoperatively. Results: The visual acuity of patients in the three groups was increased after surgery, but the improvements in visual acuity and residual astigmatism among them were not significantly different. However, the improvements in 4-mm and 6-mm total coma, Z3-1 and Z31 in patients who underwent CWFG-FS-LASIK were better than those in patients who underwent AF-FS-LASIK and SMILE. Consistent with these results, the improvements in MTF and PSF (3 mm and 5 mm) in the CWFG-FS-LASIK group were better than those in the AF-FS-LASIK and SMILE groups.Conclusions: Among surgeries for treating patients with mid-to-high astigmatism in asymmetric corneas, the selective coma-guided modality was able to decrease the coma of original cornea, improve visual acuity and optimize the visual quality of patients.

scholarly journals Relationship between electronically measured medication adherence and vision-related quality of life in a cohort of patients with open-angle glaucoma

2018 ◽  
Vol 3 (1) ◽  
pp. e000114 ◽  
Author(s):  
Atalie C Thompson ◽  
Sandra Woolson ◽  
Maren K Olsen ◽  
Susanne Danus ◽  
Hayden B Bosworth ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Medication Adherence ◽  
Open Angle Glaucoma ◽  
Mean Difference ◽  
Eye Drops ◽  
Open Angle ◽  
Related Quality ◽  
Adjusted Model

ObjectiveTo investigate whether electronically measured medication adherence is associated with vision-related quality of life (VRQoL) in patients with open-angle glaucoma.Methods and analysisThis is a 3-year prospective cohort study of 79 subjects with open-angle glaucoma at a Veterans Affairs medical centre. Participants returned a medication event monitoring system (MEMS) for their glaucoma eye-drops and had at least two visits with glaucoma during the study period. Those taking less than 80% of prescribed glaucoma medication doses were considered to be non-adherent. Subjects were interviewed using the National Eye Institute’s Visual Function Questionnaire-25 (VFQ-25) at baseline and after 3 years.ResultsThirty per cent (n=24/79) of participants took less than 80% of prescribed doses of their glaucoma medications at baseline. Patients who did not adhere to their medications at baseline had lower mean composite VFQ-25 scores at baseline (70.66±20.50 vs 75.91±19.12, standardised mean difference=0.27) and after 3 years (71.68±21.93 vs 76.25±21.67, standardised mean difference=0.21). Visual acuity (P=0.03), but not visual field severity (P=0.13) or medication adherence (P=0.30), was significantly associated with composite VFQ-25 score in an adjusted model.ConclusionsSubjects who were non-adherent to their glaucoma medications at baseline as assessed by a MEMS device reported lower VRQoL than adherent subjects at baseline and after 3 years. However, visual acuity was significantly associated with VRQoL. Future studies should assess whether improved adherence to eye-drops impacts VRQoL in patients with glaucoma.

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