Hyperopia Correction Using an Erodible Mask Excimer Laser Delivery System Coupled to an Axicon: Preliminary Results

Purpose. This paper presents the results of the first human trial on the correction of hyperopia using an erodible mask excimer laser delivery system coupled to an axicon. Methods. We treated 17 eyes of 17 patients (age range 34–62 years) for the correction of +3.21 ± 1.04 D (range +1.00 to +4.00 D). The hyperopic correction was made using an erodible mask inserted on the laser optical pathway, to produce a circular ablation measuring 6.5 mm in diameter. An axicon was then used to create a blend transition zone from 6.5 mm up to 9.4 mm in diameter. Eyes were evaluated at one, three and six months after surgery. Results. Reepithelization was always observed by the fifth postoperative day, despite the large area of deepithelization (diameter 9.5 mm). Mean refractive error one month after treatment was −2.44 ± 1.59 D (range 0.00 to −6.50 D). Five eyes (29.4%) had a best corrected visual acuity loss more than two to three lines; all eyes showed mild annular haze not involving the central part of the cornea. Six months after treatment, mean refractive error was −0.88 ± 0.99 D (range +0.50 to −3.00 D). Compared to preoperative status, 13 eyes (76.5%) showed an improvement in uncorrected distance visual acuity (1–8 lines), and 14 eyes (82.4%) showed an improvement in uncorrected vision at reading distance (3–7 lines). Two eyes (11.7%) showed a best corrected visual acuity loss of two of three lines. Conclusions. These preliminary results indicate this approach is effective in reducing hyperopia, while its predictability has still to be proved in a larger treatment group with longer follow-up. A cautious approach to this technique is still advisable, especially for higher hyperopic corrections, in view of the large best corrected visual acuity loss seen in two eyes at six months.

Download Full-text

Treatment of the Pterygium: Autologous Conjunctival Implant Associated with Phototherapeutic Keratectomy (PTK), Second Experience

10.37191/mapsci-joo-1-001 ◽

2019 ◽

Author(s):

Meduri A

Keyword(s):

Visual Acuity ◽

Refractive Error ◽

Randomized Study ◽

Phototherapeutic Keratectomy ◽

Corrected Visual Acuity ◽

Recurrent Pterygium ◽

Topographic Astigmatism ◽

Best Corrected Visual Acuity

Aim: To evaluate for the second time the efficacy of new PTK formula for the treatment of the pterygium. Methods: The study was conducted on 10 eyes of 10 patients (5 eyes primary and 5 eyes with recurrent pterygium). It is a prospective non randomized study. We evaluated BCVA (Best Corrected Visual Acuity), mean refractive error (ME) and topographic astigmatism and recurrence of pterygium. Results: Mean post-operative BCVA increase significantly after the treatment. Recurrence of pterygium in the patients that underwent the surgery was 0%. Conclusion: This technique seems to be effective in the treatment of the pterygium. After the treatment, none of the patients presented a recurrence.

Download Full-text

The effectiveness and safety of modified posterior scleral reinforcement in Chinese children with high myopia

10.21203/rs.3.rs-255754/v1 ◽

2021 ◽

Author(s):

Qianru Ouyang ◽

Zequn Miao ◽

Xin Xu ◽

Lili Guo ◽

Qingyu Meng ◽

...

Keyword(s):

Visual Acuity ◽

Refractive Error ◽

Axial Length ◽

High Myopia ◽

Upward Trend ◽

Short Term ◽

Reference Information ◽

Corrected Visual Acuity ◽

Posterior Scleral Reinforcement ◽

Best Corrected Visual Acuity

Abstract Background To evaluate the effectiveness and safety of modified posterior scleral reinforcement in controlling the progression of myopia in patients with high myopia and provide reference information on surgical treatment for these patients.Methods The study included 32 patients (55 eyes) with high myopia who were treated with modified posterior scleral reinforcement and were followed up at 3 months, 6 months, 1 year and 2 years after the operation.The axial length, refractive error, best corrected visual acuity (BCVA) and fundus colour photographs after the operation were compared with those before the operation, and whether there were any complications was recorded.Results The axial length of the eye increased by 0.07 mm, 0.12 mm, 0.31 mm and 0.19 mm at 3 months, 6 months, 1 year and 2 years after the operation, respectively. The refractive error increased by 0.05 D, 0.28 D, 0.53 D and 0.50 D at 3 months, 6 months, 1 year and 2 years after the operation, respectively, and the differences were not significant (P > 0.05). There were no statistically significant changes in BCVA, but there was an upward trend. No severe complications occurred.Conclusion Modified posterior scleral reinforcement can effectively delay the worsening of the ocular axis and refractive error, without severe complications in the short term.

Download Full-text

Association of low birth weight with myopic refractive error and lower visual acuity in adulthood: results from the population-based Gutenberg Health Study (GHS)

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2017-311774 ◽

2018 ◽

Vol 103 (1) ◽

pp. 99-105 ◽

Cited By ~ 10

Author(s):

Achim Fieß ◽

Alexander Karl-Georg Schuster ◽

Stefan Nickels ◽

Heike M Elflein ◽

Andreas Schulz ◽

...

Keyword(s):

Visual Acuity ◽

Birth Weight ◽

Refractive Error ◽

Population Based ◽

Health Study ◽

Spherical Equivalent ◽

Gutenberg Health Study ◽

Corrected Visual Acuity ◽

Best Corrected Visual Acuity

PurposeLow birth weight (BW) is linked to impaired organ development in childhood, including altered ocular morphological and functional development. The aim of this study was to evaluate whether low BW has long-term effects on visual acuity and refraction in adulthood.MethodsThe Gutenberg Health Study is a population-based, observational cohort study in Germany, including 15 010 participants aged between 35 and 74 years. These participants were divided into three different BW groups (low: <2500 g; normal: between 2500 and 4000 g; and high: >4000 g). Best-corrected visual acuity and objective refraction were examined. We used multivariable linear regression models with adjustment for age, sex, socioeconomic status and self-reported glaucoma, age-related macular degeneration, corneal disease and cataract to assess associations between BW and the main outcome measures, best-corrected visual acuity, spherical equivalent and astigmatism.ResultsOverall, 8369 participants reported their BW. In a multivariable analysis, an association for low BW with spherical equivalent (B=−0.28 per dioptre, P=0.005) and best-corrected visual acuity (B=0.02 logarithm of the minimum angle of resolution, P=0.006) compared with normal BW was observed. For participants with high BW, an association was observed with spherical equivalent (B=0.29 per dioptre, P<0.001), while none with visual acuity.ConclusionsOur data demonstrated that low BW is linked to visual acuity and refractive long-term outcomes long after childhood. Individuals with low BW are more likely to have lower visual acuity and a higher myopic refractive error in adulthood. Adults with high BW are more likely to have a more hyperopic refractive error.

Download Full-text

Posterior Scleral Reinforcement for The Treatment of Myopic Foveoschisis

10.21203/rs.3.rs-966882/v1 ◽

2021 ◽

Author(s):

Qing He ◽

Xiu Wang ◽

Caiyuan Xie ◽

Anquan Xue ◽

Ruihua Wei

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Refractive Error ◽

Axial Length ◽

Spherical Equivalent ◽

Myopic Foveoschisis ◽

Corrected Visual Acuity ◽

Posterior Scleral Reinforcement ◽

Best Corrected Visual Acuity

Abstract Background: This study aimed to investigate the clinical effectiveness of posterior scleral reinforcement for the treatment of myopic foveoschisis.Methods: This was a prospective study of 32 eyes from 20 patients with myopic foveoschisis treated with posterior scleral reinforcement using genipin-cross-linked donor sclerae . The length of the scleral strip used for the surgery was designed to be 1.5-times the axial length of the eye, whereas its width was 0.4-times the axial length of the eye. The optical coherence tomography images, spherical equivalent of refractive error, axial length, best corrected visual acuity, electroretinogram findings, and intraocular pressure of the patients were assessed postoperatively. Results: The mean duration of follow-up was 17.80 ± 8.74 months. The differences between the spherical equivalent of refractive error, best corrected visual acuity, axial length, and electroretinogram findings recorded preoperatively and those measured postoperatively were statistically significant (p＜0.05). The final reduction in axial length was 1.64 ± 0.85 mm. At the end of the follow-up, optical coherence tomography showed essential foveal reattachment in 30 eyes (93.75%), partial reattachment in two eyes (6.25%), and closure of macular holes in seven eyes (77.78%). No retinal detachment, vitreous haemorrhage, or other serious complications occurred following the surgery. Conclusions: Posterior scleral reinforcement with genipin-cross-linked sclera showed safe and effective outcomes for the treatment of myopic foveoschisis during a follow-up period of at least one yearTrial registration:ChiCTR1800020012

Download Full-text

Comparison of the Effectiveness of Intravitreal Ranibizumab for Diabetic Macular Edema in Vitrectomized and Nonvitrectomized Eyes

Ophthalmologica ◽

10.1159/000446992 ◽

2016 ◽

Vol 236 (2) ◽

pp. 67-73 ◽

Cited By ~ 5

Author(s):

Yoshito Koyanagi ◽

Shigeo Yoshida ◽

Yoshiyuki Kobayashi ◽

Yuki Kubo ◽

Muneo Yamaguchi ◽

...

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Treatment Option ◽

Central Macular Thickness ◽

Intravitreal Ranibizumab ◽

Corrected Visual Acuity ◽

The Mean ◽

The Difference ◽

Best Corrected Visual Acuity

Purpose: To compare the effectiveness of intravitreal ranibizumab (IVR) for diabetic macular edema (DME) between eyes with and without previous vitrectomy. Procedures: We prospectively assessed the best-corrected visual acuity (BCVA) and central macular thickness (CMT) after IVR for 6 months. Results: There were no significant differences in the baseline BCVA and CMT between both groups. In the nonvitrectomized group (n = 15), the mean changes of BCVA and CMT from baseline to month 6 were significant (p < 0.01). In the vitrectomized group (n = 10), the improvement appeared to be slower, and the mean BCVA improvement was not significant (p = 0.5), although the mean CMT decrease was significant (p < 0.05). There were no significant differences in the mean changes of BCVA and CMT between both groups at 6 months. Conclusions: The difference in the effectiveness of IVR between both groups was not significant. IVR can be a treatment option even for vitrectomized DME eyes.

Download Full-text

Rebubbling rate in preloaded versus surgeon prepared DSAEK

European Journal of Ophthalmology ◽

10.1177/11206721211014380 ◽

2021 ◽

pp. 112067212110143

Author(s):

Luca Pagano ◽

Kunal A Gadhvi ◽

Giulia Coco ◽

Matthew Fenech ◽

Mitchell Titley ◽

...

Keyword(s):

Visual Acuity ◽

Statistical Difference ◽

Preparation Method ◽

Eye Bank ◽

Eye Banks ◽

Corrected Visual Acuity ◽

Detachment Rate ◽

Pull Through ◽

Graft Diameter ◽

Best Corrected Visual Acuity

Purpose: To compare the clinical outcomes of eye bank preloaded Descemet stripping automated endothelial keratoplasty (DSAEK) grafts and surgeon prepared. Methods: In this retrospective study, the data were obtained from two groups (a) surgeon cut DSAEK where tissue was prepared by the surgeon immediately before surgery, and (b) preloaded DSAEK tissue shipped to the surgeon after preparation by the eye bank. Standard DSAEK preparations using Moria microkeratome with single pass method were performed. For the tissues prepared by the eye banks, they were preloaded in an iGlide device and shipped in transport media. Standard DSAEK surgery using bimanual pull-through technique was performed for all the grafts. Air was used as a tamponade. Main outcome measures included best corrected visual acuity (BCVA) and rebubbling rate. Result: Out of 107 eyes of 101 patients that underwent DSAEK surgery, 33 tissues were prepared by the surgeon (sc-DSAEK), while 74 were prepared by the eye bank (pl-DSAEK). sc-DSAEK showed a rebubbling rate of 9.1%, compared to the 16.2% for the preloaded DSAEK ( p = 0.11). There was no statistical difference in postoperative BCVA between the two groups. Logistic regression analysis showed no association between detachment rate and cataract surgery, graft preparation method, graft diameter and reason for graft. Conclusion: Preloaded grafts have similar rebubbling rate and visual acuity achieved compared with surgeon prepared grafts.

Download Full-text

Intraoperative choroidal detachment during small-gauge vitrectomy: analysis of causes, anatomic, and visual outcomes

Eye ◽

10.1038/s41433-021-01605-y ◽

2021 ◽

Author(s):

Ting Zhang ◽

Yantao Wei ◽

Zhaotian Zhang ◽

Wei Chi ◽

Lujia Feng ◽

...

Keyword(s):

Visual Acuity ◽

Medical Records ◽

Demographic Characteristics ◽

Choroidal Detachment ◽

Fluid Exchange ◽

Visual Outcomes ◽

Corrected Visual Acuity ◽

Ocular Hypotony ◽

Small Gauge ◽

Best Corrected Visual Acuity

Abstract Introduction To investigate the incidence and causes of intraoperative choroidal detachment (CD) during small-gauge vitrectomy, as well as the anatomic and visual outcomes. Methods We retrospectively reviewed the medical records of 1026 consecutive patients who underwent small-gauge vitrectomy from June 2017 to December 2018 at Zhongshan Ophthalmic Centre, Guangzhou, China. Data on the presence, location, and extent of intraoperative CD and its relationship to the infusion cannula were collected. Patient demographic characteristics and postoperative anatomic and visual outcomes were also assessed. Results A total of six cases were found to have intraoperative CD, including two with serous CD, three with limited haemorrhagic CD, and one with CD caused by inadvertent perfusion of gas during air/fluid exchange. Retraction of the infusion cannula and acute ocular hypotony were found to be the main causes of intraoperative CD in five out of the six cases. The best-corrected visual acuity of all cases significantly improved after the surgery. Conclusion The incidence of intraoperative CD during small-gauge vitrectomy is low; the predominant causes are retraction of the infusion cannula and acute ocular hypotony. Immediate awareness and timely closure of the incision may contribute to a better surgical prognosis.

Download Full-text

Pseudoamblyopia in Congenital Cyclotropia

Journal of Ophthalmology ◽

10.1155/2017/1870290 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5

Author(s):

Antonio Frattolillo ◽

Filippo Tassi ◽

Valentina Di Croce ◽

Costantino Schiavi

Keyword(s):

Visual Acuity ◽

Surgical Correction ◽

Visual Performance ◽

Time Study ◽

Superior Oblique Palsy ◽

Fixation Pattern ◽

Corrected Visual Acuity ◽

Best Corrected Visual Acuity ◽

Superior Oblique

Purpose. To study the effect of surgery on amblyopia and suppression associated with congenital cyclovertical strabismus. Methods. The fixation pattern was investigated with microperimetry before and soon after surgery in ten consecutive children operated for congenital superior oblique palsy at the S. Martino Hospital, Belluno, Italy, between September 2014 and December 2015. Changes in visual performance in terms of best-corrected visual acuity (BCVA) and stereopsis between the day before and one week after surgery were also evaluated. No other amblyopia treatment has been administered during the time study. Results. Surgical correction of the excyclodeviation in congenital SO palsy determined monocular and binocular sensory consequences: monocularly, in the cyclodeviated amblyopic eye, BCVA (0.46–0.03 LogMAR; p<0.0001) and the fixation pattern improved, as demonstrated by microperimetry examination. Binocularly, stereopsis improved or emerged while suppression at the Worth four-dot test disappeared. Conclusions. In the absence of further amblyopic factors such as coexisting constant vertical and/or horizontal deviation and anisometropia, the amblyopia encountered in congenital SO palsy may resolve soon after the surgical alignment. Therefore, it may be considered and defined “pseudoamblyopia.”

Download Full-text

Foveal Exudative Macroaneurysm Treated with Intravitreal Ranibizumab

Case Reports in Ophthalmology ◽

10.1159/000431353 ◽

2015 ◽

Vol 6 (2) ◽

pp. 170-175 ◽

Cited By ~ 6

Author(s):

Carlos Menezes ◽

Rui Carvalho ◽

Carla Teixeira ◽

José Alberto Lemos ◽

Rita Gonçalves ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Macular Edema ◽

Morphological Data ◽

Foveal Avascular Zone ◽

Optical Coherence ◽

Intravitreal Ranibizumab ◽

Corrected Visual Acuity ◽

Retinal Macroaneurysm ◽

Best Corrected Visual Acuity

Purpose: We report a case of a foveal macroaneurysm with long-standing macular edema in a rare location, successfully treated with intravitreal ranibizumab. Methods: We report the case of a 52-year-old man with left eye long-term visual loss due to macular edema caused by a retinal macroaneurysm, localized about 400 μm from the center of the fovea, and its response to 6 monthly ranibizumab intravitreal injections. His best-corrected visual acuity and morphological data evaluated by optical coherence tomography and fluorescein angiography are presented. Results: His best-corrected visual acuity improved from 1/10 to 3/10 after the 3rd injection, and from 1/10 to 4/10 after the 6th one. The central retinal thickness was evaluated by optical coherence tomography and improved from 310 to 233 μm, with the resolution of both the associated serous detachments and the cystoid macular edema; an almost complete reabsorption of the hard exudates at the end of the treatment was also observed. The macroaneurysm lumen almost obliterated after the 3rd injection and completely collapsed at the end of treatment. Conclusions: Intravitreal ranibizumab may be effective in the treatment of long-standing macular edema associated with foveal macroaneurysms. To the best of our knowledge, this is the first report of a retinal macroaneurysm located so close to the foveal avascular zone.

Download Full-text

Detecting subclinical keratoconus by biomechanical analysis in tomographically regular keratoconus fellow eyes

European Journal of Ophthalmology ◽

10.1177/11206721211063740 ◽

2021 ◽

pp. 112067212110637

Author(s):

Victor A Augustin ◽

Hyeck-Soo Son ◽

Isabella Baur ◽

Ling Zhao ◽

Gerd U Auffarth ◽

...

Keyword(s):

Visual Acuity ◽

Central Corneal Thickness ◽

Corneal Thickness ◽

Case Series ◽

Biomechanical Analysis ◽

Corvis St ◽

Corrected Visual Acuity ◽

The Mean ◽

Best Corrected Visual Acuity ◽

Fellow Eyes

Purpose To analyze the tomographically non-affected second eyes of keratoconus patients using the Corvis ST to detect any biomechanical abnormalities or subclinical keratoconus. Methods In this retrospective, single-center, consecutive case series 244 eyes of 122 keratoconus patients were analyzed between November 2020 and February 2021. Fourteen fellow eyes fulfilled the inclusion criteria and showed no clinical or tomographic signs of keratoconus. Main outcome measures included best-corrected visual acuity, tomographic and biomechanical analyses using Scheimpflug imaging: Pentacam and Corvis ST (Oculus, Wetzlar, Germany). Tomographic analyses included anterior and posterior simulated keratometry, K-Max, central corneal thickness, thinnest corneal thickness, Belin/Ambrosio Ectasia Display, and the ABCD grading system. For biomechanical analyses, the corneal biomechanical index (CBI) and tomographic biomechanical index were used. Results The mean best-corrected visual acuity was 0.01 ± 0.10 logMAR. Mean K-Max was 43.79 ± 1.12 D, mean central corneal thickness 529 ± 25 µm, mean thinnest corneal thickness 524 ± 23 µm, and mean Belin/Ambrosio Ectasia Display 1.0 ± 0.32. The mean CBI was 0.30 ± 0.21. Regular CBI values were found in six of 14 patients. The mean tomographic biomechanical index was 0.47 ± 0.22 with regular values observed in only two of 14 patients. No signs of tomographic or biomechanical abnormalities were shown in only one of 14 keratoconus fellow eyes, with regular ABCD, Belin/Ambrosio Ectasia Display, CBI and tomographic biomechanical index values. Conclusions Tomographically normal fellow eyes of keratoconus patients are rare. In these cases, a biomechanical analysis of the cornea may help detect a subclinical keratoconus. The tomographic biomechanical index was the most sensitive index to verify a mild ectasia.

Download Full-text