The Effect of Pterygium Surgery on Corneal Topography

Abstract Objective To evaluate the effect of pterygium surgery on corneal topography by comparing wave front analysis before and one month after the surgical treatment. Methodology Fifty eyes of forty-one patients were included in this study. Twenty five male and sixteen female patients seeking pterygium surgery were recruited from the Ophthalmology Department Outpatient Clinic in Sohag Teaching Hospital during the period from July 2017 to May 2018. All eyes underwent pterygium excision with conjunctival autograft. Results In this study we found a highly statistically significant improvement in the mean uncorrected visual acuity from 0.44±0.21SD preoperatively to 0.62±0.18SD postoperatively (p < 0.001) and a highly statistically significant difference in the mean logMAR visual acuity as it was decreased from 0.43±0.28 SD preoperatively to 0.34±0.23 SD postoperatively (p < 0.001). Also, there was a highly statistically significant improvement in mean of manifest refractive astigmatism from -4.08±3.28 SD preoperatively to -1.46±1.40 SD postoperatively (p < 0.001). We also found a highly statistically significant improvement in the mean cycloplegic astigmatism from -4.00±3.01 SD preoperatively to -1.39±1.33 SD postoperatively (p < 0.001) and also there was a highly statistically significant improvement in the mean topographic astigmatism from -5.17±4.08 SD preoperatively to -2.20±2.31 SD postoperatively (p < 0.001). We also found a highly statistically significant improvement in the mean of ISV (Index of Surface Variance) from 76.22±36.86 SD preoperatively to 33.56±15.02 SD post operatively (p < 0.001) and also there was a highly statistically significant improvement in the mean IHD (Index of Height Decentration) from 0.042±0.027SD pre-operatively to 0.023±0.036 SD post operatively. Conclusion There was a highly statistically significant difference in the mean logMAR visual acuity and a highly statistically significant improvement in the mean uncorrected visual acuity. A highly statistically significant improvement in both refractive and topographic astigmatism after one month of the surgery was noted also. Here were also a highly statistically significant improvement in ISV and IHD that indicate improvement after pterygium removal. Recommendations Patient with pterygium that inducing astigmatism will benefit from surgical removal of the pterygium.

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Two-Year Accelerated Corneal Cross-Linking Outcome in Patients with Progressive Keratoconus

BioMed Research International ◽

10.1155/2015/325157 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9 ◽

Cited By ~ 24

Author(s):

Arleta Waszczykowska ◽

Piotr Jurowski

Keyword(s):

Visual Acuity ◽

Corneal Thickness ◽

Long Term Results ◽

Cross Linking ◽

Mean Values ◽

Significant Difference ◽

Uncorrected Visual Acuity ◽

The Mean

Purpose. To evaluate the long-term results of accelerated corneal cross-linking (CXL) in patients with progressive keratoconus.Methods. Sixteen patients underwent accelerated CXL at 6 mW/cm2for 15 minutes in one eye. The follow-up visits were scheduled on 7 days, 14 days, and 3, 12, and 24 months after the treatment.Results. There were no significant differences (P>0.05) between preoperative and 2-year postoperative mean values, respectively, in terms of uncorrected visual acuity, best spectacle-corrected visual acuity, maximum keratometryKmax⁡, minimum keratometryKmin⁡, corneal astigmatism, and corneal eccentricity index. We noted a significant flattening of the cornea in 18.7% of patients with a higher preoperativeKmax⁡value (>50 D) and its steepening in patients with a lowerKmax⁡value (<50 D) (6.25%). There was no significant difference in the central corneal thickness and the apical corneal thickness preoperatively and 2 years postoperatively. The mean demarcation line depth was282±11 μm. Persistent corneal haze was noted in 25% of patients.Conclusions. Accelerated CXL appears to be a relatively effective procedure for the treatment of keratoconus in 2-year follow-up.

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To evaluate the Role and Efficacy of Collagen Cross-linkage with Ultraviolet Therapy following Riboflavin Drops with Orbscan in Cases of Progressive Keratoconus

International Journal of Keratoconus and Ectatic Corneal Diseases ◽

10.5005/jp-journals-10025-1145 ◽

2017 ◽

Vol 6 (2) ◽

pp. 67-72

Author(s):

Parmod Guleria ◽

Vikas Sharma

Keyword(s):

Visual Acuity ◽

Mean Value ◽

Corrected Visual Acuity ◽

Significant Difference ◽

Uncorrected Visual Acuity ◽

Cross Linkage ◽

The Mean ◽

Best Fit ◽

Best Fit Sphere

ABSTRACT Aim To evaluate the role and efficacy of collagen cross-linkage with riboflavin (C3R) in cases of progressive keratoconus. Study design Prospective, nonrandomized, single-center clinical study. Materials and methods The C3R was done in 32 eyes of 21 patients with at least 6 months of documented progression. Outcome of the procedure was measured by means of uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), corneal topography with Orbscan changes in posterior best fit sphere (PBFS), ratio of anterior and posterior best fit sphere (ABFS/PBFS), astigmatic changes in central 3- and 5-mm zone, central endothelial count postcorneal C3R. Results Thirty-two eyes with a follow-up of 6 months were analyzed. The mean age was 19.8 years. The preoperative values on the day of treatment were compared with postoperative values after the 6-month examination. The improvement in UCVA and BSCVA was statistically significant (p = 0.02 and 0.01 respectively). The change in power for PBFS was not statistically significant (p = —0.08). There was no significant difference in corneal endothelial counts pre- and post-C3R (p = 0.058). Mean value pre-C3R for ratio of ABFS/PBFS was 1.25 ± 3.7 and post-C3R was 1.22 ± 1.8 (p = 0.00). Mean value of astigmatism in 3-mm zone pre- and post-C3R was —4.3 ± 0.98 and —3.9 ± 0.66(p = 0.046) respectively. Mean value pre-C3R for astigmatism in 5-mm zone was —4.9 ± 1.91 and post-C3R was —4.0 ± 0.82 (p = 0.02). Conclusion The results show a stabilization and improvement in keratoconus after C3R in Indian eyes. How to cite this article Guleria P, Sharma V. To evaluate the Role and Efficacy of Collagen Cross-linkage with Ultraviolet Therapy following Riboflavin Drops with Orbscan in Cases of Progressive Keratoconus. Int J Kerat Ect Cor Dis 2017;6(2):67-72.

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Effect of Ranibizumab Treatment in Cases of Choroidal Neovascular Membranes Secondary to Pathological Myopia versus Age-Related Macular Degeneration

QJM ◽

10.1093/qjmed/hcaa058.011 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

M S Abdaltawab ◽

Z F Ismail ◽

W M A Ebeid ◽

S M Fawzy

Keyword(s):

Visual Acuity ◽

Macular Degeneration ◽

Age Related Macular Degeneration ◽

Intravitreal Injections ◽

P Value ◽

Newly Diagnosed ◽

Pathological Myopia ◽

Age Related ◽

Significant Difference ◽

The Mean

Abstract Aim of the Work The aim of this work is to compare the response of treatment with ranibizumab in terms of visual acuity in cases of CNV secondary to pathological myopia versus CNV secondary to age-related macular degeneration. Methods This prospective, comparative study included ten eyes newly diagnosed as having CNV secondary to pathological myopia, and 10 eyes newly diagnosed as having subfoveal active CNV secondary to AMD. All patients had 3 monthly intravitreal Injections of 0.50 mg (in 0.05 ml of solution) ranibizumab with monthly evaluation of best corrected visual acuity (BCVA) by Landolt C chart, and also calculated in Logarithm of Minimum Angle of Resolution (Log MAR). Results pretreatment there was no significant difference between the two groups as the mean VA (Log Mar) was 1.31 ± 0.2 in AMD group and 1.17 ± 0.3 in MCNV group of P value = 0.431 and also post three IVI of ranibizumab showed no significant difference between the two groups as the mean VA (Log Mar) was 1.22 ± 0.2 for AMD and 1.22 ± 0.5 for MCNV of P value = 0.635. Conclusion there was no significant difference in BCVA between AMD and MCNV groups after three intravitreal injections of ranibizumab.

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Anatomical and Visual Effects of Implantable Phakic Contact Lens on Correction of Myopia

10.21203/rs.3.rs-1245764/v1 ◽

2022 ◽

Author(s):

Mahmoud Ekram ◽

Ahmed Mohamed Kamal Elshafei ◽

Asmaa Anwar Mohamed ◽

Mohamed Farouk Sayed Othman Abdelkader

Keyword(s):

Visual Acuity ◽

Anterior Chamber ◽

Contact Lens ◽

Anterior Segment ◽

Anterior Chamber Depth ◽

Case Series ◽

Care Group ◽

Case Series Study ◽

Significant Difference ◽

The Mean

Abstract Purpose: To evaluate the anatomical effects of implantable phakic contact lens (IPCL) (Care Group, India) on anterior segment and its visual outcomes .Patients and methods: In a prospective interventional case series study, 60 highly myopic eyes of 32 patients were subjected to IPCL implantation in the Ophthalmology Department of Minia University Hospital, Egypt from January 2019 to June 2021. All patients had complete ophthalmic examination and were followed up for 1 year. Pentacam was used for preoperative and postoperative estimation of anterior chamber depth (ACD), anterior chamber angle (ACA), anterior chamber volume (ACV) and IPCL vault in the 1st, 3rd, and 12th months. Assessment of corneal endothelium was done using specular microscope preoperatively and after 12 months. Preoperative and postoperative refraction and visual acuity were measured. Results: There was a statistically significant decrease in ACD, ACA, and ACV. There was no significant difference between preoperative and postoperative mean intraocular pressure (IOP) by the 12th month (P=0.163). The mean preoperative endothelial cell count (ECD) was significantly reduced from 2929.3±248 cells/mm2 to 2737.9±303 cells/mm2 at the 12th month (P<0.001). with a statistically highly significant improvement of mean Log Mar uncorrected visual acuity (UCVA) from 1.48±0.19 preoperatively to 0.46±0.11 by the end of follow up (P<0.001) with insignificant difference between preoperative best corrected visual acuity (BCVA) and postoperative UCVA (P=0.209). In the 12th month, the mean vault was 240±540 μm. No sight threatening complications occurred.Conclusion: Although IPCL induced anatomical changes, it was safe and effective for correction of high myopia.

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Preservation of the Tenon’s capsule and Sub-Tenon’s space after the autologous limbal-conjunctival transplantation in pterygium surgery

10.21203/rs.3.rs-240755/v1 ◽

2021 ◽

Author(s):

FERNANDA Santos VIDAL ◽

Sebastião Cronemberger ◽

José Aloísio Massote

Keyword(s):

Anterior Segment ◽

Preoperative Period ◽

Secondary Intention ◽

Tenon’S Capsule ◽

Postoperative Control ◽

Significant Difference ◽

Donor Area ◽

Tenon's Capsule ◽

Pterygium Surgery ◽

The Mean

Abstract Background No previous studies have evaluated the scarring of the conjunctiva and Tenon’s capsule (TC) separately when only the conjunctiva is removed, and TC is preserved in the upper part of the bulb: the site designated for trabeculectomy. Thus, this cohort interventional study aims to investigate the scarring of the donor area after autologous limbal-conjunctival transplantation (ALCT) using anterior segment optical coherence tomography (AS-OCT). Methods Twenty-three eyes with pterygium were submitted to resection and local reconstruction with ALCT. AS-OCT images obtained from each eye preoperatively served as postoperative control. ALCT was removed superiorly with preservation of TC. The cure of this donor area occurred by secondary intention. AS-OCT was performed preoperatively and 30 and 180 days postoperatively in the donor area, measuring the thickness of the conjunctiva (epithelium and stroma) and TC. The sub-Tenon’s space (STS) was clinically assessed. Results The mean thickness of the conjunctival epithelium was 48.04 ± 11.37µm in the preoperative period and 51.87±15.04µm 180 days after surgery, without statistically significant difference (P=0.282). A statistically significant increase (P=0.005) in the mean thickness of the conjunctival stroma, from 85.35±23.10µm in the preoperative period to 101.61±20.19µm 180 days after surgery was found. TC had no significant changes, slightly increasing from 117.13±24.26µm preoperatively to 118.09±19.24µm (P=0.808) 180 days after surgery. STS was found in 19 (82%) eyes 180 days after surgery. Conclusions Following ALCT with TC preservation, scarring took place in the conjunctiva, epithelium, and stroma. The TC and the STS were preserved not showing any significant changes.

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Superior versus Inferior Conjunctival Limbal Autograft with Sutures in the Management of Primary Pterygium in a Tertiary Care Hospital in Dakshina Kannada - A Cross Sectional Study

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/118 ◽

2021 ◽

Vol 8 (11) ◽

pp. 603-607

Author(s):

Madhuri Upadhyaya ◽

Sheetal Savur

Keyword(s):

Cross Sectional Study ◽

Bulbar Conjunctiva ◽

Care Hospital ◽

Sectional Study ◽

Surgical Time ◽

Cross Sectional ◽

Significant Difference ◽

The Mean ◽

Pterygium Excision ◽

Primary Pterygium

BACKGROUND Pterygium excision with conjunctival limbal autograft (CAU) is one of the most frequently used modalities in the treatment of pterygium. The graft has traditionally been harvested from the superior bulbar conjunctiva, but this may not be possible in all patients. The purpose of this study was to compare the intraoperative difficulties and early postoperative outcomes between superior and inferior CAU in the management of primary pterygium. METHODS This hospital based cross sectional study evaluated 58 eyes of 50 patients with primary pterygium who underwent pterygium excision with conjunctival limbal autograft secured with the help of sutures over a period of 2 years from March 2018 to March 2020. In 28 eyes, the superior bulbar conjunctiva was used for grafting whereas in 30 eyes, the inferior conjunctiva was used for the same. The outcome measured was in terms of the mean surgical time, clinical symptoms and signs in the early postoperative period and recurrence rate. RESULTS The mean age of the patients was 44.14 ± 12.71 years in the superior CAU group and 45.76 ± 14.51 years in the inferior CAU group. There was no statistically significant difference between the two groups in terms of the mean surgical time (68.39 ± 31.51 in superior group, 2.60 ± 0.79 in inferior group; P value 0.712). The duration of follow-up after surgery was significantly more (P = 0.048) in the inferior CAU group (42.60 ± 11.71 days) as compared to the superior CAU group (37.39 ± 7.52 days). Postoperative symptoms were comparable, and no recurrence was observed in either of the two groups. CONCLUSIONS Pterygium excision with inferior conjunctival limbal autograft is safe and effective in the management of primary pterygia and may be considered as an alternative to superior graft in cases where harvesting the superior conjunctiva is not possible or not advisable. KEYWORDS Primary Pterygium, Conjunctival Limbal Autograft, Inferior Graft

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Effects of spectacles and telescopes on visual function in students with oculocutaneous albinism

African Health Sciences ◽

10.4314/ahs.v20i2.28 ◽

2020 ◽

Vol 20 (2) ◽

pp. 758-767

Author(s):

Siddeeqa Jhetam ◽

Khathutshelo P Mashige

Keyword(s):

Visual Acuity ◽

Contrast Sensitivity ◽

Reading Rate ◽

Oculocutaneous Albinism ◽

Eye Care ◽

Significant Difference ◽

Observational Study Design ◽

The Mean ◽

Better Than ◽

Spectacle Correction

Purpose: To investigate the effects of spectacle and telescope corrections on visual acuity (VA), contrast sensitivity (CS) and reading rates (RR) in students with oculocutaneous albinism (OCA). Methods: An observational study design was conducted on 81 students with OCA. Distance and near VA, CS and RR were measured without correction, with spectacle correction and with a combination of spectacle correction and telescopes. Results: The mean distance and near VA values with a combination of spectacle correction and telescopes were significantly better than those without correction and with spectacle correction alone (p = 0.01). Mean CS values achieved with spectacles alone were significantly better than those obtained with a combination of spectacles and telescopes (p = 0.01). There was no significant difference between logCS values obtained without correction compared to those obtained with a combination of spectacle correction and telescopes. There were no significant differences between RR values obtained with a combination of spectacles and telescopes and those without and with spectacle correction alone (all p > 0.05). Conclusion: This article provides valuable information to eye care practitioners on the effects of spectacles and telescopes on visual acuity, contrast sensitivity and reading rate in students with OCA. Keywords: Oculocutaneous albinism; visual acuity; telescope; contrast sensitivity; reading rate.

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A PROSPECTIVE ANALYSIS OF VISUAL ACUITY AND ASTIGMATIC CHANGES AFTER PTERYGIUM EXCISION WITH LIMBAL STEM CELL GRAFTING

10.36106/ijsr/5939358 ◽

2021 ◽

pp. 21-23

Author(s):

Kumari Preeti ◽

Nitu Kumari ◽

[Prof.] Alka Jha ◽

Debarshi Jana

Keyword(s):

Visual Acuity ◽

Stem Cell ◽

Corneal Astigmatism ◽

Surgical Removal ◽

Prospective Analysis ◽

Cell Grafting ◽

Induced Astigmatism ◽

Pterygium Excision ◽

Limbal Stem Cell ◽

Primary Pterygium

Objectives: The aim of this study was to assess if there is any signicant reduction in astigmatism and thus improvement in visual acuity after pterygium excision with limbal stem cell grafting. Methods: In this prospective study, patients with primary pterygium were included. Preoperative and postoperative corneal astigmatism, refractive astigmatism and visual acuity were analyzed. All patients underwent pterygium excision with limbal stem cell grafting. Results: Mean improvement in visual acuity of 0.09 log MAR units was observed (p <0.0001, statistically signicant).Mean corneal astigmatism for grade I, II and III was found to be 1.03 ± 0.68D, 1.69 ± 0.80D and 2.90 ± 1.06D respectively. Mean corneal astigmatism decreased by 1.29 D (p <0.0001, statistically signicant).A decrease of 0.77D in cylindrical power required was found after surgery (p <0.0001, statistically signicant). Conclusions: there is a signicant reduction in pterygium induced astigmatism and improvement in visual acuity on surgical removal of the pterygium.

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A profile and treatment outcome of seasonal hyper-acute panuveitis

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v2i1.3702 ◽

1970 ◽

Vol 2 (1) ◽

pp. 35-38 ◽

Cited By ~ 4

Author(s):

E Shrestha

Keyword(s):

Visual Acuity ◽

Medical Treatment ◽

Visual Outcome ◽

P Value ◽

Fisher Exact Test ◽

Mean Values ◽

Exact Test ◽

Pediatric Age Group ◽

Significant Difference ◽

The Mean

Introduction: Seasonal hyper-acute panuveitis (SHAPU) is a sight-threatening disease and its management is challenging. Objective: To study the profile and evaluate the visual outcome of the patients of clinicallydiagnosed cases of SHAPU after treatment. Subjects and methods: A retrospective interventional hospital-based study was carried out involving 21 subjects with clinically-diagnosed SHAPU. The data were retrieved from the record section of the hospital and analyzed. The variables studied were demographic pattern, clinical condition, duration of presentation and visual acuity before and after the treatment. Statistics: The data were analyzed using Epi Info version 2000. Percentage prevalence, mean values with standard deviation, relative risk, 95% CI and p value were calculated. P value of < 0.05 was considered to be significant. Results: Among the 21 cases, the numbers of male and female were 11 (52.4 %) and 10 (46.7 %) respectively. A comparative analysis of gender in children and adults did not show any significant difference (RR=0.47, 95% CI = 0.22 - 1.01, Fisher exact test: p = 0.14). The mean for all ages was 7 ± 12.68 years, while the mean age in pediatric cases was 4.5 ± 3.91 years. Thirteen (61.9%) cases occurred in children below fifteen years. Fifteen (71.4 %) cases reported during September and October. Presenting visual acuity of all cases was less than 3/60. All of them received medical treatment. By the end of the 4th week, seven (33.3 %) patients regained vision to 6/18. Conclusion: SHAPU is more prevalent in pediatric age group. It is equally prevalent among males and females. The visual acuity can improve with early medical treatment. Keywords: SHAPU; panuveitis; steroid; phthisis bulbi DOI: 10.3126/nepjoph.v2i1.3702 Nep J Oph 2010;2(1) 35-38

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Topographically Guided Two-Step LASIK and Standard LASIK in the Correction of Refractive Errors after Penetrating Keratoplasty

European Journal of Ophthalmology ◽

10.1177/112067210901900404 ◽

2009 ◽

Vol 19 (4) ◽

pp. 535-543 ◽

Cited By ~ 4

Author(s):

Leopoldo Spadea ◽

Massimo Saviano ◽

Angela Di Gregorio ◽

Domenico Di Lodovico ◽

Fabio De Sanctis

Keyword(s):

Visual Acuity ◽

Penetrating Keratoplasty ◽

Laser In Situ Keratomileusis ◽

Refractive Errors ◽

Manifest Refraction ◽

Uncorrected Visual Acuity ◽

The Mean ◽

Group 2 ◽

Group 1

Purpose To evaluate in a long-term period the effectiveness and safety of topographically guided two-step laser in situ keratomileusis (LASIK) and standard LASIK technique in the correction of refractive errors after successful penetrating keratoplasty (PKP) for keratoconus. Methods At least 2 years after PKP and 6 months after removal of all sutures, 15 eyes of 15 patients (Group 1; mean manifest refraction spherical equivalent (MRSE) −7.23 D ± 3.42 SD) were submitted to standard LASIK and 15 eyes of 15 patients (Group 2; mean MRSE −4.37 D ± 1.97 SD) to a topographically guided two-step LASIK procedure (first the flap and at least 2 weeks later the laser ablation). In all cases, a superior hinged corneal flap (160 μm/9.5 mm) was created. Results After a follow-up of 36 months, in Group 1 the mean uncorrected visual acuity (UCVA) was 0.51 logarithm of the minimum angle of resolution (logMAR) ± 0.41 SD and the mean best-corrected visual acuity (BCVA) was 0.03 logMAR ± 0.05 SD, with a mean MRSE of −1.57 D ± 2.65 SD. In Group 2, the mean UCVA was 0.28 logMAR ± 0.24 SD and the mean BCVA was 0.01 logMAR ± 0.03 SD, with a mean MRSE of −0.07 D ± 1.00 SD. In both groups, no complications were observed. Conclusions After a long follow-up period, both topographically guided two-step LASIK and standard LASIK could be considered effective and safe tools in the correction of refractive errors after successful PKP for keratoconus.

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