Visual outcomes of a new implantable phakic contact lens in patients with stable keratoconus

AIM: To assess the efficacy, safety, stability and predictability of an implantable Phakic contact lens in patients with stable keratoconus. METHODS: The uncorrected and the best corrected visual acuity, defocus curve, contrast sensitivity, refraction and possible side effects were measured in 14 patients after utilizing implantable phakic contact lens (IPCL) to correct refractive errors. The result was assessed for more than 6mo. RESULTS: The mean preoperative spherical equivalent (SE) and astigmatism got changed from -6.94±2.79 DS and -4.24±1.42 DC to -0.23±0.43 DS and -1.05±0.49 DC, respectively at the last examination after 6mo. Before the preoperative the mean Snellen visual acuity was 0.18±0.10 logMAR. The mean uncorrected and the best corrected visual acuity got changed to 0.13±0.10 logMAR and 0.05±0.15 logMAR, respectively in 6mo. The mean safety indices were 1.11. There was no loss of visual acuity in any of the eyes and 22 eyes (78.5%) gained one or more lines. Twenty eyes (71.4%) were within 0.50 ?D and 27 (96.42%) were within ±1.00?D of the desired SE refraction. There was a change in manifest refraction of -0.23±0.43 (range from -1.00 to +0.75) from the first week of surgery to 6mo. Contrast sensitivity got improvement value at 3 per degree (P<0.005) after Toric IPCL implantation. The total 6mo corneal endothelial cell loss (ECL) was <5%. Intraocular pressure (IOP) was 11.32±2.28 mm Hg after 6mo. CONCLUSION: The clinical consequences of the present study exhibit the efficacy, safety, and predictability of Toric implantable Phakic contact lens in the correction of myopia and myopic astigmatism related with stable keratoconus.

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Pancorneal Contact Lens with a Toric Edge: A New Concept in Keratoconus

European Journal of Ophthalmology ◽

10.5301/ejo.2011.6505 ◽

2011 ◽

Vol 21 (6) ◽

pp. 685-690 ◽

Cited By ~ 6

Author(s):

Sizar Kamar ◽

Charles Vervaet ◽

Gregohus P.M. Luyten ◽

Martine J. Jager

Keyword(s):

Visual Acuity ◽

Contact Lens ◽

Marked Improvement ◽

Corneal Topography ◽

Corrected Visual Acuity ◽

The Mean ◽

Best Corrected Visual Acuity

Purpose. To investigate whether fitting a patient with keratoconus to a pancorneal toric rigid gas-permeable (RGP) contact lens leads to a change in corneal compression and improves the best-corrected visual acuity (BCVA) and keratometry values. Methods. Thirty eyes with keratoconus were fitted with a newly designed pancorneal toric RGP contact lens. Each patient was examined at the time of enrollment and after having used the new contact lens for at least 2 months. Corneal topography was performed both times. Results. A change in corneal compression was noticed in 23 eyes (77%). Following the use of the pancorneal toric RGP contact lens, the average BCVA improved significantly (p=0.007), with a mean BCVA of 0.63 (SD 0.15) before and 0.70 (SD 0.18) after using the toric contact lens. No significant changes were seen in the mean vertical and horizontal K-values or the mean E-values. Conclusions. While no significant measurable differences in K- and E-values were observed, fitting of a pancorneal toric RGP contact lens in keratoconus led to a marked improvement in visual acuity and a visible change in corneal compression.

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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.

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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.

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Effect of phacoemulsification with intraocular lens implantation in eyes with cataract and functioning filtering blebs

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v13i2.44 ◽

2013 ◽

Vol 13 (2) ◽

pp. 33-41

Author(s):

Devendra Maheshwari ◽

Rengappa Ramakrishanan ◽

Mohideen Abdul Kader ◽

Neelam Pawar ◽

Ankit Gupta

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Intraocular Lens ◽

Intraocular Lens Implantation ◽

Corrected Visual Acuity ◽

Lens Implantation ◽

The Mean ◽

One Year ◽

Best Corrected Visual Acuity

Aim: To evaluate the effect of phacoemulsification with intraocular lens implantation in eyes with pre-existing trabeculectomy.Methods: This prospective single-center clinical study evaluated intraocular pressure in 60 eyes of 60 patients who underwent phacoemulsification and implantation of a foldable intraocular lens after a previous successful trabeculectomy. Patients who had a trabeculectomy more than one year prior to the study were included. Intraocular pressure, number of antiglaucoma medications, bleb appearance, and visual acuity were recorded preoperatively, and at each follow-up examination and 12 months after phacoemulsification.Results: The mean intraocular pressure before phacoemulsification was 12.42 mmHg (SD, 4.60 mmHg), which increased to 14.98 mmHg (SD, 4.18 mmHg), 14.47 mmHg (SD, 3.58 mmHg), 15.44 mmHg (SD, 3.60 mmHg), and 15.71 mmHg (SD, 3.47 mmHg) after one, three, six, and 12 months, respectively. At each follow-up visit, the mean IOP was significantly higher than the preoperative value (p < 0.001, p = 0.015, p ≤ 0.001, and p = 0.001 at month one, three, six, and 12, respectively). The mean preoperative best-corrected visual acuity was 0.98 logMAR (SD, 0.44 logMAR) and the mean postoperative best-corrected visual acuity at 12 months was 0.20 logMAR (SD, 0.21 logMAR) [p = 0.0001]. The mean preoperative number of antiglaucoma medications used was 0.57 (SD, 0.63), which increased to 0.65 (SD, 0.63 ), 0.70 (SD, 0.72 ) 0.68, (SD, 0.70), and 0.67 (SD, 0.77 ) at one, three, six, and 12 months, respectively, but there were no statistically significant differences. Bleb size decreased clinically after phacoemulsification. Nineteen of 60 eyes (32%) developed fibrosis of bleb with decreased bleb size.Conclusion: Phacoemulsification with intraocular lens implantation significantly increased intraocular pressure and increased the number of antiglaucoma medications in eyes with pre-existing functioning filtering blebs.

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The effect of amblyopia on clinical outcomes of children with astigmatism

Therapeutic Advances in Ophthalmology ◽

10.1177/25158414211040898 ◽

2021 ◽

Vol 13 ◽

pp. 251584142110408

Author(s):

Burçin Çakır ◽

Nilgün Özkan Aksoy ◽

Sedat Özmen ◽

Özlem Bursalı

Keyword(s):

Visual Acuity ◽

Clinical Outcomes ◽

Medical Records ◽

Convergence Insufficiency ◽

Corrected Visual Acuity ◽

Ocular Deviation ◽

The Mean ◽

The Difference ◽

Best Corrected Visual Acuity

Background: Amblyopia is more common in children with high astigmatism, but factors contributing to development of amblyopia and visual outcomes are not fully understood. Objective: To evaluate the effect of amblyopia on the clinical outcomes in children with ⩾1.75 diopter (D) astigmatism. Methods: We reviewed the medical records of children with ⩾1.75 D astigmatism with and without amblyopia (amblyopes group and non-amblyopes group). The mean age, gender, amount and type of ocular deviation, presence of convergence insufficiency (CI), stereopsis, time of initial spectacle use and follow-up time, differences in best-corrected visual acuity (VoD) and spherical equivalent (SE) between eyes were assessed and compared between the groups. Best-corrected visual acuity (BCVA), mean SE, astigmatism measurements were assessed and compared between amblyopic, fellow, and non-amblyopic eyes. Results: The records included 68 eyes of 34 children with amblyopia and 56 eyes of 28 children without amblyopia. The mean age, gender, amount and type of ocular deviation, presence of CI, stereopsis, time of initial spectacle use, follow-up time, and the difference in SE did not differ between groups. In amblyopes, exodeviation was more common and statistically greater in near (33 cm) than at distance (6 m) (p = 0.005). The mean BCVA and astigmatism values were statistically different between amblyopic, fellow, and non-amblyopic eyes. Conclusion: A greater near than distance exodeviation and higher mean astigmatism value were found in amblyopic children with astigmatism.

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Real-world outcomes of two-year Conbercept therapy for diabetic macular edema

International Journal of Ophthalmology ◽

10.18240/ijo.2021.03.14 ◽

2021 ◽

Vol 14 (3) ◽

pp. 416-422

Author(s):

Yong Cheng ◽

◽

Ming-Wei Zhao ◽

Tong Qian ◽

◽

...

Keyword(s):

Visual Acuity ◽

Adverse Events ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Vision Loss ◽

Retinal Thickness ◽

Corrected Visual Acuity ◽

The Mean ◽

Number Of Injections ◽

Best Corrected Visual Acuity

AIM: To evaluate the two-year outcomes of patients treated for diabetic macular edema (DME) with intravitreal Conbercept (IVC). METHODS: The clinical data of 30 DME patients (36 eyes) were retrospectively reviewed. The patients were treated with IVC for 3mo. Additional IVC was given at subsequent monthly visits, if needed (3+PRN). The patients were followed up for 24mo. RESULTS: The best-corrected visual acuity (BCVA) at 24mo significantly increased (66.7±15.3 letters) in comparison with the baseline (54.4±15.4 letters, P<0.0001). The mean improvement in BCVA was 11.0±2.9 letters. At 24mo, 44.1% of the eyes surveyed gained ≥15 letters, 52.9% of the eyes gained ≥10 letters, and 70.6% of the eyes gained ≥5 letters. No vision loss was noted in 96.8% of the eyes, and 5.9% of the eyes lost ≥5 letters, but ≤10 letters. The central retinal thickness (CRT) at 24mo was significantly reduced (277.1±122.9 μm) in comparison with the baseline (510.9±186.1 μm, P<0.0001). At 24mo, 43.3% of the patients had a CRT ≤250 μm. The mean number of injections over 24mo was 10.6±2.0. No severe eye or systemic adverse events related to either the drug or injection were noted. CONCLUSION: IVC is safe and effective for the treatment of DME.

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Association of foveal avascular zone with the metamorphopsia in epiretinal membrane

Scientific Reports ◽

10.1038/s41598-020-74190-x ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Hideki Shiihara ◽

Hiroto Terasaki ◽

Shozo Sonoda ◽

Naoko Kakiuchi ◽

Hidetaka Yamaji ◽

...

Keyword(s):

Visual Acuity ◽

Superficial Layer ◽

University Hospital ◽

Foveal Avascular Zone ◽

Service Unit ◽

Corrected Visual Acuity ◽

Avascular Zone ◽

The Mean ◽

The Relationship ◽

Best Corrected Visual Acuity

Abstract This study was to investigate the relationship between the metamorphopsia and foveal avascular zone (FAZ) parameter in eyes with epiratinal membrane (ERM). We studied patients with an ERM visited retinal service unit at the Kagoshima University Hospital or Shirai Hospital. The best-corrected visual acuity (BCVA), and the degree of metamorphopsia by M -CHARTS™ were evaluated. The 3 × 3 mm optical coherence tomography angiography (OCTA) images of the superficial layer were obtained. Area (mm2), the circularity, eigen value were calculated using ImageJ software. The relationship between visual function, such as best corrected visual acuity (BCVA) and metamorphopsia, and FAZ parameters were studied by Pearson’s correlational coefficient. Fifty-four eyes of 51 patients (24 men and 27 women) with an ERM were studied. The mean age of the patients was 69.6 ± 8.20 years. The mean BCVA and metamorphopsia score was 0.31 ± 0.29 logMAR units and 0.49 ± 0.42. There was no significant relationship between BCVA and FAZ parameters. While, metamorphopsia score was significantly and negatively correlated with all of FAZ parameters (area R = − 0.491, P < 0.001; circularity R = − 0.385, P = 0.004; eigenvalue ratio R = − 0.341; P = 0.012). Multiple regression analysis showed the FAZ area was solely and significantly correlated with metamorphopsia score (β − 0.479, P < 0.001). The size but not the shape of the FAZ was significantly correlated with the degree of metamorphopsia suggesting that it could be an objective parameter of metamorphopsia in ERM patients.

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Single-pass four-throw pupilloplasty for Urrets-Zavalia syndrome

European Journal of Ophthalmology ◽

10.1177/1120672117747038 ◽

2018 ◽

Vol 28 (5) ◽

pp. 552-558 ◽

Cited By ~ 1

Author(s):

Priya Narang ◽

Amar Agarwal ◽

Dhivya Ashok Kumar

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Intraocular Pressure ◽

Anterior Segment ◽

Anterior Chamber Angle ◽

Single Pass ◽

Corrected Visual Acuity ◽

The Mean ◽

Chamber Angle ◽

Best Corrected Visual Acuity

Purpose: To demonstrate the efficacy and initial results of single-pass four-throw pupilloplasty in cases of Urrets-Zavalia syndrome. Methods: In this prospective interventional study, single-pass four-throw was performed to reconstruct the pupil in all symptomatic cases with Urrets-Zavalia syndrome. Applanation tonometry, indentation gonioscopy, and anterior segment optical coherence tomography for anterior chamber angle assessment were performed in all the cases. Results: Out of 10 cases that were identified with Urrets-Zavalia syndrome, the procedure was performed in 7 cases, whereas 3 cases were left untreated, as they did not have any visual complaints. Five out of seven eyes had preoperative raised intraocular pressure with appositional closure of the angle. Postoperatively, intraocular pressure was controlled in all the eyes, whereas one eye required antiglaucoma medications to control the intraocular pressure. The mean preoperative and postoperative best-corrected visual acuity was 1.1 ± 1.2 and 0.4 ± 0.4 LogMar, respectively. There was a significant improvement in the best-corrected visual acuity (p = 0.0169) in the postoperative period. The mean preoperative and postoperative intraocular pressure was 26.6 ± 11.23 and 16.3 ± 2.98 mm Hg, respectively (p = 0.0168). All the patients had a minimum of 6-month follow-up period (range = 6–8 months). Conclusion: Single-pass four-throw can be employed for cases with Urrets-Zavalia syndrome, and single-pass four-throw helps to prevent the postoperative glare and narrows down the pupil size effectively. Single-pass four-throw helps to alleviate the anterior chamber angle apposition in patients with Urrets-Zavalia syndrome by mechanically pulling the peripheral iris centrally as demonstrated on anterior segment optical coherence tomography. The study also reports the occurrence of Urrets-Zavalia syndrome after glued intraocular lens surgery.

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Contrast Sensitivity and Visual-Field Thresholds in Patients with Thyroid Optic Neuropathy

Perception ◽

10.1068/v970237 ◽

1997 ◽

Vol 26 (1_suppl) ◽

pp. 194-194

Author(s):

J Jankauskiene ◽

R Lukauskiene ◽

B Mickiene

Keyword(s):

Visual Acuity ◽

Visual Field ◽

Contrast Sensitivity ◽

Optic Neuropathy ◽

Control Group ◽

Ophthalmological Examination ◽

Threshold Test ◽

Spatial Frequencies ◽

Snellen Visual Acuity ◽

The Mean

Thyroid optic neuropathy is one of the most troubling complications of endocrine ophthalmopathies. It is related to the degree of extraocular muscle swelling in the apex of the orbit. The purpose of this study was to investigate contrast sensitivity and visual-field thresholds in patients with thyroid optic neuropathy. We examined twenty-two patients aged 29 – 63 years (mean 45.3 years). The control group consisted of fifteen healthy persons of similar age. Contrast sensitivity was measured by means of Volkov's charts (sinusoidal gratings) at eight spatial frequencies from 17.5 to 0.46 cycles deg−1. The visual field was investigated with a static automatic perimeter (Allgan Humphrey Field Analyzer) by means of the central 30-2 threshold test. All patients underwent a complete ophthalmological examination including best corrected Snellen visual acuity, fundus copy, and proptosis measurement with the Hertel exophthalmometer. The mean proptosis of patients was 19.4 mm. Fifteen of the patients had decreased visual acuity. Contrast sensitivity at low spatial frequencies was significantly reduced in the patients. It was established that a reduction of visual-field threshold accompanies the decrease of visual acuity. Our results show that contrast sensitivity and visual-field threshold testing are very sensitive at detecting early optic neuropathy and may be a useful means of following patients after treatment.

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A 12-month, multicenter, parallel group comparison of dexamethasone intravitreal implant versus ranibizumab in branch retinal vein occlusion

European Journal of Ophthalmology ◽

10.1177/1120672117750058 ◽

2018 ◽

Vol 28 (6) ◽

pp. 697-705 ◽

Cited By ~ 13

Author(s):

Francesco Bandello ◽

Albert Augustin ◽

Adnan Tufail ◽

Richard Leaback

Keyword(s):

Visual Acuity ◽

Retinal Vein Occlusion ◽

Branch Retinal Vein Occlusion ◽

Dexamethasone Intravitreal Implant ◽

Vein Occlusion ◽

Corrected Visual Acuity ◽

Increased Risk ◽

Intravitreal Implant ◽

The Mean ◽

Best Corrected Visual Acuity

Purpose: Dexamethasone intravitreal implant and intravitreal ranibizumab are indicated for the treatment of macular edema secondary to retinal vein occlusion. This non-inferiority study compared dexamethasone with ranibizumab in patients with branch retinal vein occlusion. Methods: In this randomized, 12-month head-to-head comparison, subjects with branch retinal vein occlusion were assigned to dexamethasone 0.7 mg at day 1 and month 5 with the option of retreatment at month 10 or 11, or ranibizumab 0.5 mg at day 1 and monthly through month 5 with subsequent as-needed injections at month 6–month 11. The primary efficacy outcome was the mean change from baseline in best-corrected visual acuity at month 12; secondary outcomes included average change in best-corrected visual acuity, proportion of eyes with ≥10- and ≥15-letter gain/loss, change in central retinal thickness, and change in Vision Functioning Questionnaire-25 score. Results: In all, 307 of a planned 400 patients were enrolled in the study and received (mean) 2.5 dexamethasone injections (n = 154) and 8.0 ranibizumab injections (n = 153) over 12 months. The mean change from baseline in best-corrected visual acuity at month 12 was 7.4 letters for dexamethasone versus 17.4 letters for ranibizumab (least-squares mean difference (dexamethasone minus ranibizumab), −10.1 letters; 95% confidence interval, −12.9, −7.2; p = 0.0006). Conclusion: Dexamethasone and ranibizumab improved best-corrected visual acuity and anatomical outcomes; however, dexamethasone did not show non-inferiority to ranibizumab in this under-powered study. Dexamethasone was associated with an increased risk of intraocular pressure elevation and cataract progression, but a lower injection burden, compared to ranibizumab.

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