Early results of circularity and centration of capsulotomy prepared by three different methods

AIM: To compare the difference of capsulotomy produced by precision pulse capsulotomy (PPC), manual (M-CCC), and femtosecond laser assisted capsulotomy (FLAC) in relation to intraocular lens (IOL) centration, circularity and its effect on visual outcomes. METHODS: Prospective, non-randomized comparative study conducted at LV Prasad Eye Institute, Hyderabad, India. Sixty eyes of 52 patients were grouped into 3 (FLAC, PPC and M-CCC) based on capsulotomy techniques used. Twenty consecutive eyes with uneventful phacoemulsification and with no comorbidities affecting the capsulotomy or visual outcome were included in each group. The main outcome measure was IOL centration in relation to capsulotomy and pupil. Secondary outcome measures were post-operative visual acuity, manifest refraction and aberration profile between groups. RESULTS: At 5wk the visual, refractive outcomes and endothelial cell density were comparable between the 3 groups. The median circularity index of FLAC was statistically significantly different to M-CCC or PPC (1-10) groups (P<0.01) but PPC (11-20) was comparable to FLAC. Decentration of IOL center in relation to capsulotomy was seen only between the PPC (1-10) group and FLAC group (P=0.02). The IOL was well centered in relation to the pupil in all the groups (P=0.46). The quality of vision parameters like the higher order aberrations, spherical aberration, coma, trefoil, modular transfer function, and Strehl ratio were comparable between the groups. CONCLUSION: Our study shows that despite differences in the morphology of capsulotomy produced by PPC, M-CCC, FLAC a well-centered IOL can be achieved. The measured capsular morphology parameters do not affect visual outcomes.

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Comparison of 6.0 mm versus 6.5 mm Optical Zone on Visual Outcomes after LASIK

Journal of Clinical Medicine ◽

10.3390/jcm10173776 ◽

2021 ◽

Vol 10 (17) ◽

pp. 3776

Author(s):

Majid Moshirfar ◽

Rachel Huynh ◽

Nour Bundogji ◽

Alyson N. Tukan ◽

Thomas M. Sant ◽

...

Keyword(s):

Visual Acuity ◽

Laser System ◽

Spherical Equivalent ◽

Distance Visual Acuity ◽

Visual Outcomes ◽

Refractive Outcomes ◽

Uncorrected Distance Visual Acuity ◽

Corrected Distance Visual Acuity ◽

Optical Zone ◽

The Difference

Previous studies have demonstrated safety and efficacy using 6.0 and 6.5 mm optical zones in the WaveLight EX500 Excimer Laser System but have not evaluated if differing optical zone sizes influence refractive outcomes. This study examines visual outcomes between two study populations undergoing LASIK with either a 6.0 mm (1332 patients) or 6.5 mm (1332 patients) optical zone. Outcomes were further stratified by severity of myopia (low, moderate, and high) and astigmatism (low and high). Patients were matched by age and preoperative manifest sphere and cylinder. Postoperative measurements were then compared. The 6.5 mm group demonstrated better postoperative manifest refractive spherical equivalent (MRSE), manifest sphere, and absolute value of the difference in actual and target spherical equivalent refraction (|∆ SEQ|), within the total population, moderate myopia, and low astigmatism groups, but this did not lead to improved postoperative uncorrected distance visual acuity (UDVA) or best corrected distance visual acuity (CDVA). Though astigmatic correction and postoperative angle of error were similar between optical zone sizes, they were significantly worse with high myopia. Overall, this study demonstrates differences in visual outcomes between the 6.0 and 6.5 mm optical zone sizes that may warrant consideration; however, essentially, the results are comparable between them.

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Early results of micropulse transscleral cyclophotocoagulation for the treatment of glaucoma

European Journal of Ophthalmology ◽

10.1177/1120672119839303 ◽

2019 ◽

Vol 30 (4) ◽

pp. 700-705 ◽

Cited By ~ 6

Author(s):

Alexander T Nguyen ◽

Jessica Maslin ◽

Robert J Noecker

Keyword(s):

Intraocular Pressure ◽

Continuous Wave ◽

Open Angle Glaucoma ◽

Case Series ◽

Angle Closure ◽

Secondary Outcome ◽

Early Results ◽

Pressure Lowering ◽

Transscleral Cyclophotocoagulation ◽

The Mean

Purpose: To describe our clinical experience with the efficacy and safety of micropulse transscleral cyclophotocoagulation as a treatment for glaucoma. Methods: In this retrospective case series, we reviewed the charts of 95 consecutive patients with various glaucoma subtypes who underwent micropulse transscleral cyclophotocoagulation. Patients were offered micropulse transscleral cyclophotocoagulation if they had perimetric glaucoma refractory to intraocular pressure–lowering topical medications and who were poor candidates for traditional filtering surgery. Eligible patients were treated with the Micropulse P3 device (IQ 810 Laser Systems; Iridex, Mountain View, CA, USA) at 2.0–2.5 W for a duration of 90 s per hemisphere at a 31.3% duty cycle. If a retreatment was needed, the power was increased to up to 3.0 W with other parameters remaining the same. Patients were considered successfully treated if their intraocular pressure was lowered by at least 20% compared to their baseline. The main outcome measure was post-operative intraocular pressure; secondary outcome measures included the number of adverse events and complications that occurred with treatment. Results: The glaucoma subtypes treated included primary open-angle glaucoma (n = 51), exfoliation glaucoma (n = 24), chronic angle-closure glaucoma (n = 15), and congenital/juvenile glaucoma (n = 5). The mean pre-operative intraocular pressure was 25.1 ± 5.3 mm Hg and the mean post-operative intraocular pressure at 12 months was 17.5 ± 5.1 mm Hg (p = 0.004). The mean number of intraocular pressure–lowering medications used preoperatively was 3.0 ± 1.1; the mean number of medications used at the 12-month post-operative visit was 1.4 ± 1.0 (p = 0.03). Success with one treatment was achieved in 73 (76.8%) of patients. With multiple treatments, all patients had significant intraocular pressure–lowering compared to baseline. The maximum number of treatments received by any single patient was 5. There were no instances of prolonged intraocular inflammation or long-term hypotony. Conclusion: Micropulse transscleral cyclophotocoagulation appears to be a safe and efficacious treatment for glaucoma. Given its improved safety profile compared to continuous-wave transscleral cyclophotocoagulation, it deserves consideration as a primary procedure.

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Prechoroidal Cleft in Type 3 Neovascularization: Incidence, Timing, and Its Association with Visual Outcome

Journal of Ophthalmology ◽

10.1155/2018/2578349 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Jae Hui Kim ◽

Young Suk Chang ◽

Jong Woo Kim ◽

Chul Gu Kim ◽

Dong Won Lee

Keyword(s):

Pigment Epithelium ◽

Retinal Pigment ◽

Visual Outcome ◽

Subretinal Hemorrhage ◽

Type 3 Neovascularization ◽

The Difference ◽

Type 3 ◽

Endothelial Growth Factor ◽

Rpe Tear

Purpose. To investigate the incidence and timing of prechoroidal cleft development and its association with visual prognosis in type 3 neovascularization. Methods. This retrospective study included 166 eyes that were diagnosed with type 3 neovascularization. All eyes were treated with antivascular endothelial growth factor therapy. The incidence and timing of prechoroidal cleft development were evaluated. Best-corrected visual acuity (BCVA) at diagnosis and at final follow-up was compared between eyes with (cleft group) and without (no-cleft group) prechoroidal cleft. The incidence of retinal pigment epithelium (RPE) tear and subretinal hemorrhage was also compared between the two groups. Results. During the mean 39.7 ± 18.5 months of follow-up, prechoroidal cleft developed in 37 eyes (22.3%) at an average of 14.6 ± 10.4 months. The BCVA at final follow-up was significantly worse in the cleft group than in the no-cleft group (P=0.024), whereas the difference was not significant at diagnosis (P=0.969). The incidence of RPE tear (P=0.002) and subretinal hemorrhage (P<0.001) was significantly higher in the cleft group. Conclusions. Prechoroidal cleft is a frequently observed finding during the treatment course of type 3 neovascularization. Eyes with prechoroidal cleft are at high risk of RPE tear or subretinal hemorrhage and subsequently associated with poor prognosis.

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Comparison of anterior retraction and anchorage control between en masse retraction and two-step retraction: A randomized prospective clinical trial

The Angle Orthodontist ◽

10.2319/051518-363.1 ◽

2018 ◽

Vol 89 (2) ◽

pp. 190-199 ◽

Cited By ~ 3

Author(s):

Patricia Pigato Schneider ◽

Luiz Gonzaga Gandini Júnior ◽

André da Costa Monini ◽

Ary dos Santos Pinto ◽

Ki Beom Kim

Keyword(s):

Clinical Trial ◽

Treatment Group ◽

Secondary Outcome ◽

Space Closure ◽

The Difference ◽

Maxilla And Mandible ◽

Anchorage Loss ◽

Bimaxillary Protrusion ◽

Best Fit ◽

En Masse Retraction

ABSTRACT Objectives: The purpose of this two-arm parallel trial was to compare en masse (ER) and two-step retraction (TSR) during space closure. Materials and Methods: Forty-eight adult patients with bimaxillary protrusion who were planned for treatment with extraction of four first premolars were enrolled. All patients were randomly allocated in a 1:1 ratio to either the ER (n = 24) group or the TSR (n = 24) group. The main outcome was the amount of posterior anchorage loss in the molars and the retraction of the incisors between ER and TSR; the difference in incisor and molar inclination was a secondary outcome. Lateral cephalometric radiographs and oblique cephalometric radiographs at 45° were taken before retraction (T1) and after space closure (T2). Cephalograms were digitized and superimposed on the anatomic best fit of the maxilla and mandible by one operator who was blinded to the treatment group. Results: Neither incisor nor molar crown movements showed any significant differences between the ER and TSR. There were no significant differences in the tipping of incisors and molars between the two groups. Conclusions: No significant differences existed in the amount of retraction of incisors and anchorage loss of molars between ER and TSR. Changes in incisor and molar tipping were similar, with the crowns showing more movement than the apex.

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Cost-Consequence Analysis of Single-Dose Dalbavancin Versus Standard of Care for the Treatment of Acute Bacterial Skin and Skin Structure Infections in a Multisite Healthcare System

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1732 ◽

2020 ◽

Cited By ~ 1

Author(s):

Julia Gonzalez ◽

Diana Carolina Andrade ◽

JianLi Niu

Keyword(s):

Healthcare System ◽

Treatment Success ◽

Standard Of Care ◽

Cost Of Care ◽

Secondary Outcome ◽

Total Cost ◽

Skin Structure ◽

Cost Consequence ◽

The Difference ◽

The Cost

Abstract Background Acute bacterial skin and skin structure infections (ABSSSIs) are common infectious diseases that cause a significant economic burden on the healthcare system. This study aimed to compare the cost-effectiveness of dalbavancin vs standard of care (SoC) in the treatment of ABSSSI in a community-based healthcare system. Methods This was a retrospective study of adult patients with ABSSSI treated with dalbavancin or SoC during a 27-month period. Patients were matched based on age and body mass index. The primary outcome was average net cost of care to the healthcare system per patient, calculated as the difference between reimbursement payments and the total cost to provide care to the patient. The secondary outcome was proportion of cases successfully treated, defined as no ABSSSI-related readmission within 30 days after the initiation of treatment. Results Of the 418 matched patients, 209 received SoC and 209 received dalbavancin. The average total cost of care per patient was greater with dalbavancin vs SoC ($4770 vs $2709, P < .0001). The average reimbursement per patient was $3084 with dalbavancin vs $2633 SoC (P = .527). The net cost, calculated as revenue minus total cost, was $1685 with dalbavancin vs $75 with SoC (P = .013). The overall treatment success rate was 74% with dalbavancin vs 85% with SoC (P = .004). Conclusions Dalbavancin was more costly than SoC for the treatment of ABSSSI, with a higher 30-day readmission rate. Dalbavancin does not offer an economic or efficacy advantage.

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Early Results with a New Posterior Chamber Phakic Intraocular Lens in Patients with High Myopia

Journal of Ophthalmology ◽

10.1155/2018/1329874 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 6

Author(s):

Dilek Yaşa ◽

Ufuk Ürdem ◽

Alper Ağca ◽

Yusuf Yildirim ◽

Burçin Kepez Yildiz ◽

...

Keyword(s):

Visual Acuity ◽

Endothelial Cell ◽

Intraocular Lens ◽

High Myopia ◽

Posterior Chamber ◽

Phakic Intraocular Lens ◽

Phakic Iol ◽

Distance Visual Acuity ◽

Early Results ◽

Manifest Refraction

Purpose. To report clinical results of a foldable, hydrophilic acrylic, single-piece, injectable, posterior chamber phakic intraocular lens (pIOL).Material and Methods. Medical records of patients who underwent posterior chamber phakic IOL (Eyecryl Phakic IOL, Biotech Vision Care, Ahmedabad, India) implantation for surgical correction of myopia were retrospectively reviewed. Only patients with at least a one-year follow-up were included. Manifest refraction, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), endothelial cell density (ECD), and pIOL vault were analyzed at 1, 3, 6, and 12 months after surgery. Complications observed during and after surgery were also recorded.Results. The study included 58 eyes of 29 patients. Mean patient age was 32 ± 7 years. Spherical equivalent of manifest refraction was −13.41 ± 3.23 D preoperatively and −0.44 ± 0.55 D postoperatively. Preoperative CDVA was 0.29 ± 0.71 logMAR. Postoperative UDVA and CDVA were 0.21 ± 0.66 and 0.15 ± 0.69 logMAR, respectively, at the 12-month visit. At the 12-month visit, the efficacy index was 1.20 and the safety index was 1.39. Mean ECD was 2713 ± 339 cells/mm2at the preoperative visit and 2608 ± 362 cells/mm2at the 12-month visit (3.9% loss,p<0.001). ECD loss from 3 months to 12 months was not statistically significant. No significant cataract formation, significant endothelial cell loss, glaucoma, uveitis, or any other vision-threatening complication was observed.Conclusion. Based on postoperative experience, we have found that Eyecryl Phakic IOL is safe and effective for treating high myopia.

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Femtosecond laser-assisted anterior lamellar keratoplasty (FSALK) versus microkeratome-assisted anterior lamellar keratoplasty (MALK) for the treatment of anterior corneal dystrophy.

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v15i2.178 ◽

2016 ◽

Vol 15 (2) ◽

Author(s):

Radwan Almousa ◽

Sheraz M Daya

Keyword(s):

Visual Acuity ◽

Femtosecond Laser ◽

Visual Outcome ◽

Corneal Dystrophy ◽

Lamellar Keratoplasty ◽

Secondary Outcome ◽

Clinical Recurrence ◽

Corneal Scarring ◽

Anterior Lamellar Keratoplasty

Purpose: To compare the visual outcome of femtosecond laser-assisted anterior keratoplasty (FSALK) and microkeratome-assisted anterior lamellar keratoplasty (MALK) in anterior corneal dystrophy. Methods: retrospective comparative chart review of 7 eyes that underwent FSALK and 7 eyes that underwent MALK. The primary outcome was the visual outcome of both procedures. The secondary outcome was the recurrence of the corneal dystrophies.Results: Mean follow-up time was 30±14(7-51) months for the FSALK group and 127±28(80-127) months for the MALK group. In the FSALK group the preoperative best spectacle-corrected visual acuity (BSCVA) improved from 20/63 to 20/25 at 36 months. In the MALK group there was 1 eye with documented BSCVA over 36 months follow-up; it improved from 20/160 preoperatively to 20/32 at 36 months. Uncorrected visual acuity (UCVA) at 36 months improved from 20/100 preoperatively to 20/63 in the FSALK group and from 20/200 preoperatively to 20/63 in the MALK group. Five eyes with Reis-Bucklers showed a clinical recurrence at a mean of 142±13(125-152) months. Two eyes with granular dystrophy showed a clinical recurrence at 23 and 80 months of follow-up. One eye in the MALK group had epithelial ingrowth. One eye in the FSALK group with compromised ocular surface due to 2 previous penetrating keratoplasty, suffered bacterial keratitis that ended up with corneal scarring. Conclusion: Both procedures improve visual outcome for anterior corneal dystrophy. FSALK has theoretical advantages over MALK; however, larger prospective studies are needed to prove this.

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Prophylactic corneal cross-linking in LASIK surgery: effects on visual outcome and recovery time

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v17i1.451 ◽

2020 ◽

Vol 17 (1) ◽

pp. 61-68

Author(s):

Dominique Clare Oh ◽

Yiong Huak Chan ◽

Sao Bing Lee ◽

Jovina Li Shuen See

Keyword(s):

Visual Acuity ◽

Side Effects ◽

Recovery Time ◽

Visual Outcome ◽

Cross Linking ◽

Safe Procedure ◽

Distance Visual Acuity ◽

Visual Outcomes ◽

Group A ◽

Group B

Introduction: Collagen cross-linking is a useful adjunct in preventing corneal ectasia after laser-assisted in situ keratomileusis (LASIK). This study aimed to evaluate whether prophylactic cross-linking in IntraLase LASIK affects optimum visual outcome and recovery time in the immediate post-surgery period and is associated with any side effects. Methods: This was a retrospective case study on the right eyes of 100 Chinese subjects aged 18 to 40 years who underwent IntraLase LASIK. Fifty subjects who underwentcross-linking after completing LASIK (Group A) were compared with 50 subjects who did not undergo LASIK (Group B). Cases were evaluated for pre- and post-operative spherical equivalent, uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), recovery time and presence of side effects. Results: At 1 week post-LASIK, mean (SD) UDVA of Group A subjects was poorer than Group B, at 1.05 (0.19) vs 1.17 (0.19) (p = 0.036); however, there was no significant difference in CDVA (p = 0.095). By 1 month post-LASIK, differences in both UDVA and CDVA were insignificant (p = 0.055, 0.106, respectively). Mean recovery time was 2.72 (95% confidence interval [CI] = 0.64-4.7) days longer in Group A (p = 0.010), although by 1 month post-LASIK, both groups were able to achieve CDVA equal to or better than that achieved pre-LASIK. Incidence of mild inflammation and dry eyes post-LASIK was similar in both groups (p = 1.00, 0.749, respectively); no other complications were observed. Conclusion: No differences in visual outcomes at and occurrence of side effects at 1 month post-LASIK were observed between subjects who underwent cross-linking prior to refractive surgery and those who did not. However, the group that underwent cross-linking had a slightly longer mean recovery time. Our study supports prophylactic cross-linking as a safe procedure that does not affect immediate visual outcomes among the Chinese population when used in adjunct with LASIK surgery.

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Small-gauge vitrectomy for advanced diabetic eye disease: outcomes and predictive factors for poor postoperative vision

Malaysian Journal of Ophthalmology ◽

10.35119/myjo.v2i3.114 ◽

2020 ◽

Vol 2 (3) ◽

pp. 177-189

Author(s):

Mushawiahti Mustapha ◽

Tan Chim Yoong ◽

Tevanthiran A/L Gobal ◽

Win Inn Chong ◽

Tengku Nadhirah Tengku Zulkeplee ◽

...

Keyword(s):

Predictive Factors ◽

Demographic Data ◽

Visual Outcome ◽

Visual Outcomes ◽

Poor Visual Outcome ◽

Post Surgery ◽

Diabetic Eye Disease ◽

Small Gauge ◽

Anatomical Outcomes

Objective: To evaluate the anatomical and visual outcomes of small-gauge vitrectomy in patients with advance diabetic eye diseases (ADED) and the predictive factors for poor visual outcome. Materials and methods: A retrospective study was conducted from 2009 to 2014. Data at baseline, 6 months, and 12 months post-surgery were collected along with baseline demographic data, indications of surgery, systemic associations, visual and anatomical outcome, and postoperative complications. Poor visual outcomewas defined as visual acuity worse than 6/36. Results: A total of 158 eyes from 133 patients were recruited. Mean age was 54.01 ± 11.57 years and mean follow-up was 9.9 ± 3.7 months. Indications for vitrectomy were vitreous haemorrhage (VH, 77 eyes [48.7%]), tractional retinal detachment (TRD) with macular involvement (75 eyes [47.5%]), and other causes in 6 eyes (3.8%). There was visual improvement in 59.3% of patients, 23.6% worsened, and 17.1% stabilized at 12 months post-surgery. Patients with VH (75.4%) showed significant improvement compared to patients with TRD (48.3%). Successful anatomical outcomes were achieved in VH (98.2%) and TRD (96.7%). However, patients with TRD were found to have a 2.4-fold higher risk of having poor visual outcomes. Conclusion: Small-gauge vitrectomy for ADED resulted in excellent visual and anatomical outcomes. Eyes with TRD were at a higher risk of developing poor visual outcomes.

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Visual Outcome of Tuberculum Sellae Meningiomas after Extradural Optic Nerve Decompression

Neurosurgery ◽

10.1227/01.neu.0000228683.79123.f9 ◽

2006 ◽

Vol 59 (3) ◽

pp. 570-576 ◽

Cited By ~ 90

Author(s):

Tiit Mathiesen ◽

Lars Kihlström

Keyword(s):

Cerebrospinal Fluid ◽

Optic Nerve ◽

Diabetes Insipidus ◽

Visual Outcome ◽

Optic Canal ◽

Visual Deterioration ◽

Nerve Decompression ◽

Visual Outcomes ◽

Tuberculum Sellae

Abstract OBJECTIVE: Meningiomas of the tuberculum sellae have a close relationship with the optic apparatus. Even modern series show a 10 to 20% risk of visual deterioration after surgery. We have attempted to improve visual outcome by extradural decompression of the optic canal and anterior clinoid process, followed by intradural release of the optic nerve; this study provides an analysis of visual outcomes with this approach. METHODS: Treatment, histopathology, and follow-up data of 29 consecutive patients undergoing surgery for tuberculum sellae meningiomas with initial release of the optic nerve were prospectively collected. RESULTS: Radical tumor removal was possible in all 23 patients with primary tumors and in three out of six patients with recurrent tumors. All patients but two of the worst affected with preoperative visual compromise improved from surgery; there were no instances of visual deterioration. Five patients with normal preoperative vision remained intact and visual improvement was 22 (91%) out of 24 patients in the remaining patients. In total, 13 patients (42%) had completely normal vision at follow-up. Mainly patients younger than 60 years experienced complete normalization after surgery. Two patients underwent transsphenoidal surgery for cerebrospinal fluid leaks. Postoperative endocrinological symptoms were temporary diabetes insipidus in one patient and permanent diabetes insipidus in another patient undergoing elective sectioning of the pituitary stalk because of a recurrent tumor with invasive growth into the stalk. CONCLUSION: Adding early optic nerve decompression by extradural clinoidectomy and optic canal unroofing to a frontopterional approach seemed to improve visual outcomes because there were no instances of visual deterioration. Simpson Grade 1 to 2 removal was possible in all patients with primary surgery, whereas recurrent cases could only be treated with lower grades of radicality. Radical removal, however, required readiness to reoperate for cerebrospinal fluid leakage at the site of the drilled tumor origin in bone.

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