scholarly journals Effect of 1.8-mm steep-axis clear corneal incision on the posterior corneal astigmatism in candidates for toric IOL implantation

2020 ◽  
Author(s):  
Xi Li ◽  
Xiang Chen ◽  
Suhong He ◽  
Wen Xu

Abstract PURPOSE In the present study, we aimed to analyze the effects of cataract surgery using a 1.8-mm steep-axis clear corneal incision (CCI) on the posterior corneal surfaces based on the keratometry from the rotating Scheimpflug imaging device (Pentacam HR) in candidates for toric intraocular lens (IOL) implantation. METHODS Preoperative and at least 1-month postoperative data measured by Pentacam HR were collected in patients for toric IOL implantation. Surgically induced astigmatism on the posterior cornea (P-SIA) was calculated based on the preoperative and postoperative keratometric data, and the related factors of P-SIA were analyzed. RESULTS A total of 60 eyes from 56 patients were enrolled. The preoperative anterior and posterior corneal astigmatism was 1.58±0.61 D and 0.28±0.22 D, respectively. The postoperative anterior and posterior corneal astigmatism was 1.26±0.68 D and 0.41±0.26 D, respectively. The astigmatism was significantly decreased on anterior surface (P<0.001, paired t-test) and increased on posterior surface (P<0.001, paired t-test). The mean of P-SIA calculated by Holladay–Cravy–Koch method was 0.34±0.20 D, with 0.5 D or greater accounting for 26.7%. P-SIA showed no significant difference among with-the-rule (WTR) astigmatism, against-the-rule (ATR) astigmatism and oblique astigmatism (F=1.85, P=0.167). A statistically significant correlation was observed between the P-SIA and preoperative anterior corneal astigmatism (r = 0.29, P=0.024), as well as preoperative posterior corneal astigmatism (r=0.27, P=0.038). CONCLUSIONS In candidates for toric IOL implantation with a 1.8-mm steep-axis CCI, the incision caused a significant reduction of the anterior corneal astigmatism but an increase of the corneal posterior astigmatism. P-SIA could not be ignored, and it played a significant role in SIA, especially in cases with higher preoperative anterior or posterior corneal astigmatism.

2020 ◽  
Author(s):  
Xi Li ◽  
Xiang Chen ◽  
Suhong He ◽  
Wen Xu

Abstract Background: In the present study, we aimed to analyze the effects of cataract surgery using a 1.8-mm steep-axis clear corneal incision (CCI) on the posterior corneal surfaces based on the keratometry from the rotating Scheimpflug imaging device (Pentacam HR) in candidates for toric intraocular lens (IOL) implantation. Methods: Preoperative and at least 1-month postoperative data measured by Pentacam HR were collected in patients for toric IOL implantation. Surgically induced astigmatism on the posterior cornea (P-SIA) was calculated based on the preoperative and postoperative keratometric data, and the related factors of P-SIA were analyzed. Results: A total of 60 eyes from 56 patients were enrolled. The preoperative anterior, posterior and total corneal astigmatism was 1.58±0.61 D ,0.28±0.22 D and 1.70 ± 0.52 D respectively. The postoperative anterior, posterior and total corneal astigmatism was 1.26±0.68 D, 0.41±0.26 D and 1.30 ± 0.51 D respectively. The astigmatism was significantly decreased on anterior surface (P<0.001, paired t-test) and increased on posterior surface (P<0.001, paired t-test). The mean of P-SIA calculated by Holladay–Cravy–Koch method was 0.34±0.20 D, with 0.5 D or greater accounting for 26.7%. A statistically significant correlation was observed between the P-SIA and preoperative anterior corneal astigmatism (r = 0.29, P=0.024), as well as preoperative posterior corneal astigmatism (r=0.27, P=0.038). Multivariate regression analysis showed the preoperative anterior and posterior corneal astigmatism had a significant effect on P-SIA (F=7.344, P=0.001). Conclusions: In candidates for toric IOL implantation with a 1.8-mm steep-axis CCI, the incision caused a significant reduction of the anterior corneal astigmatism but an increase of the posterior corneal astigmatism. P-SIA could not be ignored, and it played a significant role in SIA, especially in cases with higher preoperative anterior or posterior corneal astigmatism.


2020 ◽  
Author(s):  
Hye Ji Kwon ◽  
Hun Lee ◽  
Jin Ah Lee ◽  
Jae Yong Kim ◽  
Hungwon Tchah

Abstract Objectives To compare the efficacy of astigmatic correction between simultaneous femtosecond laser-assisted intrastromal arcuate keratotomy (AK) combined with femtosecond laser-assisted cataract surgery (FLACS) and toric intraocular lens (IOL) implantation during cataract surgery in moderate astigmatism. Design: Retrospective observational study, tertiary care medical center Methods We retrospectively reviewed medical records of patients who underwent astigmatic correction via femtosecond laser-assisted intrastromal AK (AK group; 27 eyes of 27 patients) with FLACS or toric IOL implantation (toric IOL group; 21 eyes of 21 patients). All patients had senile cataracts with corneal astigmatism ranging from + 1.00 to + 2.00 diopters (D) before cataract surgery. We measured visual acuity, intraocular pressure, automated keratometry, manifest refraction and topography preoperatively and at 1-day, 1-month, 3-month, and 6-month postoperatively. Results Refractive astigmatism was significantly decreased in both groups. The mean preoperative and 6-month postoperative refractive astigmatism were 1.85 ± 1.07 and 0.99 ± 0.51 D, respectively, in the AK group (P = 0.028), and 1.84 ± 0.81 and 0.68 ± 0.21 D, respectively, in the toric IOL group (P < 0.001). There was no significant difference in refractive astigmatism between the two groups at 6-month postoperatively (0.99 ± 0.51 vs 0.68 ± 0.21 D, P = 0.057). At 6-month postoperatively, parameters for vector analysis of refractive astigmatism showed no statistical difference between the two groups. Corneal astigmatism was significantly decreased in the AK group. There was significant difference in corneal astigmatism from topography and automated keratometer between the two groups at 6-month postoperatively (0.94 ± 0.40 vs 1.53 ± 0.46 D, P = 0.018 for topography and 0.98 ± 0.69 vs 1.37 ± 0.41 D, P = 0.032 for automated keratometer). Conclusions Femtosecond laser-assisted intrastromal AK in FLACS could be an effective procedure for reducing astigmatism as well as toric IOL implantation in cataract surgery.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hye Ji Kwon ◽  
Hun Lee ◽  
Jin Ah. Lee ◽  
Jae Yong Kim ◽  
Hungwon Tchah

Abstract Background To compare the efficacies in astigmatic correction of simultaneous femtosecond laser-assisted cataract surgery (FLACS) with intrastromal arcuate keratotomy (ISAK) versus toric intraocular lens (IOL) implantation with conventional phacoemulsification in moderate astigmatism. Methods A retrospective chart review was conducted for patients who had undergone cataract surgery by one surgeon. We identified patients with preoperative corneal astigmatism from + 0.75 to + 2.00 diopters (D) who had undergone astigmatic correction with FLACS with ISAK or toric IOL implantation with conventional phacoemulsification. We measured the visual acuity, intraocular pressure, automated keratometer, manifest refraction, and topography preoperatively and 1-day, 1-month, 3-month, and 6-month postoperatively. The vector analysis of refractive astigmatism was performed. Results Of a total of 48 eyes of 48 patients, 27 eyes of 27 patients had FLACS with ISAK (AK group), and 21 eyes of 21 patients had conventional cataract surgery with toric IOL implantation (toric IOL group). Refractive astigmatism was significantly decreased in both groups. The mean preoperative and 6-month postoperative refractive astigmatism were 1.85 ± 1.07 and 0.99 ± 0.51 D, respectively, in the AK group (P = 0.028), and 1.84 ± 0.81 and 0.68 ± 0.21 D, respectively, in the toric IOL group (P < 0.001). There was no significant difference in refractive astigmatism between the two groups at 6-month postoperatively (0.99 ± 0.51 vs 0.68 ± 0.21 D, P = 0.057). At 6-month postoperatively, parameters for vector analysis of refractive astigmatism showed no statistical difference between the two groups. Corneal astigmatism was significantly decreased in the AK group. Corneal astigmatism from topography and the automated keratometer were significantly lower in the AK group 6-month postoperatively compared to toric IOL group (0.94 ± 0.40 vs. 1.53 ± 0.46 D, P = 0.018 for topography; and 0.98 ± 0.69 vs. 1.37 ± 0.41 D, P = 0.032 for the automated keratometer). Conclusions FLACS with ISAK could be an effective procedure for reducing astigmatism as well as toric IOL implantation in cataract surgery.


2019 ◽  
Author(s):  
jie luo ◽  
Yang Liu ◽  
Feng Wang ◽  
Ying Su ◽  
Xuebing Xiao

Abstract Background We aimed to evaluate the long-term clinical outcomes of Toric intraocular lens (Toric IOL)and Acrysof IQ Restor Toric +3.0D intraocular lens (ART +3.0D IOL)in patients with cataract and corneal astigmatism.Methods Fifty-eight eyes (46 participants) that had Toric IOL implantation, forty-three eyes (31 participants) that had ART +3.0D IOL implantation, were included in the study. All participants were assessed preoperatively, 3, 6, 12 and 24 months postoperatively. Primary outcomes measure: uncorrected distance visual activity (UCDVA), uncorrected near visual acuity (UCNVA), astigmatism and IOL axis alignment, defocus curve, contrast sensitivity and ocular aberration.Results UCDVA was better than 0.3 LogMAR at 3, 6, 12 and 24 months after surgery in both groups, and UCDVA was significantly improved after surgery than before ( P <0.05). All patients with ART +3.0D IOL implanted after surgery achieved or exceeded the near-vision of Jr3, which could meet the needs for removal of lens. At 3, 6, 12 and 24 months after surgery, the residual astigmatic was (0.28±0.20) diopters(D), (0.32±0.25) D, (0.31±0.16) D, (0.32±0.22) D in Toric group, and (0.27±0.17) D, (0.31±0.21) D, (0.30±0.19) D, (0.33±0.20) D respectively in the ATR group. Compared with preoperative corneal astigmatism, the difference was statistically significant ( P <0.05). The IOL axial mobility of all the patients was less than 5°in the two groups within 2 years after the operation. There was no difference in aberrations between the ART group and the Toric group under 3mm pupil, and there was statistically significant difference between the ART group and the Toric group under 5mm pupil ( P <0.05).Conclusions Toric IOL and ART + 3.0D IOL implantation were safe and effective in the treatment of cataract with corneal astigmatism,and ART + 3.0D IOL provided adequate near vision. The effect had long-term stability.


Author(s):  
Adeleh Sadeghloo ◽  
Parna Shamsaee ◽  
Elham Hesari ◽  
Golbanhar Akhondzadeh ◽  
Hamid Hojjati

Abstract Introduction Thalassemia, as the most common chronic hereditary blood disorder in humans, can impose many adverse effects on parents and their affected children. On the other hand, positive thinking is the method or the result of a positive focus on a constructive issue, so by teaching positive thinking, we can improve physical and social function, and promote emotional health and overall quality of life. The aim of this study was to determine the effect of positive thinking training on the quality of life of parents of adolescents with thalassemia. Methods This quasi-experimental study was performed on 52 parents of adolescents with thalassemia who attended Taleghani Hospital in Golestan province, Iran in 2017. Samples were randomly assigned into two groups of intervention and control. The positive thinking training (based on the theory of Martin Seligman) was carried out in the intervention group in 10 (45–60 min) sessions over a 5-week period. Data collection tools in this study were the World Health Organization (WHO) quality of life questionnaire (WHOQOL-BREF) and a demographic information questionnaire. Data were analyzed by SPSS-16 software using independent t-test, the paired t-test and a covariance test. Results The results of paired t-test showed a significant difference in the score of quality of life in intervention group before and after the intervention (p < 0.001). However, this test did not show any significant difference in the control group (p = 0.11). The covariance test, after removing the pre-test score, showed a significant difference between the intervention and control groups in terms of the score of quality of life, so that 13% of the changes after the intervention were due to the intervention (p = 0.009, η = 0.13). Conclusion The positive thinking training increased the quality of life of parents of adolescents with thalassemia. Therefore, using this program can be an effective way of improving the quality of life of parents. Thus, positive thinking training is suggested to be used as an effective strategy for increasing the quality of life of parents with ill children.


2021 ◽  
Vol 13 ◽  
pp. 251584142110304
Author(s):  
Emine Doğan ◽  
Burçin Çakır ◽  
Nilgün Aksoy ◽  
Elif Köse ◽  
Gürsoy Alagöz

Purpose: The purpose of this study was to evaluate the correlation between corneal astigmatism and the morphology of pterygium with anterior segment optic coherence tomography (AS-OCT). Material and Methods: The size of pterygium (horizontal length, vertical width) was measured manually; pterygium area and percentage extension of the pterygium onto the cornea were calculated. Anterior and posterior corneal astigmatism, Sim K, K1, K2 were measured using a dual Scheimpflug analyzer. Morphological patterns of the pterygium analyzed with AS-OCT were determined according to the extension of the pterygium apex below the corneal epithelium. Two tomographic patterns were identified: continuous and nodular. Correlation between anterior corneal astigmatism and pterygium size, percentage extension of the pterygium, and morphological pattern of the pterygium was analyzed. Results: The mean ages of the 47 patients were 49.4 ± 16.6 (22–80) years. Mean horizontal pterygium length, vertical width, pterygium area, and percentage extension of the pterygium were 2.8 ± 1.2 mm, 4.8 ± 1.6 mm, 7.42 ± 5.6 mm2 and 24.5 ± 10.4%, respectively. Mean anterior corneal astigmatism was 2.3 ± 2.3 D and simulated keratometry was 43.4 ± 2.02 D. In terms of the morphological pattern of the pterygium, 24 eyes had continuous, 23 eyes had a nodular pattern and the median (interquartile range) anterior corneal astigmatism was 1.87 (1.01–3.80) and 1.22 D (0.58–2.35), respectively ( p = 0.102). Other topographic and pterygium size parameters were similar between groups. Analyzing the correlations in groups separately, a positive moderate statistically significant correlation was present between vertical width, percentage extension, pterygium area, and anterior corneal astigmatism in both continuous and nodular groups. Conclusions: Although not statistically significant, anterior corneal astigmatism was higher in continuous group. Using AS-OCT to standardize the morphology of pterygium could provide additional clinical information.


Author(s):  
Pooja A Mulchandani ◽  
Trupti Warude ◽  
Amrutkuvar Pawar

Objectives: To compare the effect of gluteal muscle strengthening along with conventional exercises versus conventional exercises alone on flat foot.Method: An experimental study conducted at Physiotherapy Department of Krishna Institute of Medical Sciences, Karad. A total of 52 subjects were equally divided into two groups using convenient sampling with random allocation (Groups A and B). Baseline treatment was given to both groups (intrinsic muscle strengthening). Group A was given intrinsic muscle strengthening alone while Group B was given gluteal muscle strengthening along with intrinsic muscle strengthening.Result: Statistical analysis was performed using paired t-test and unpaired t-test. In pre-intervention there was no statistically significant difference seen with p values for the navicular drop was 0.3563 and for Ink test was 0.7342. While on comparing the post-interventional values, the results between the two groups using paired t-test revealed that there was extremely significant difference seen with p-value for the navicular drop was <0.0001 and for Ink test was <0.0001.Conclusion: From the study, it can be concluded that there was a significant effect of gluteal muscle strengthening on the flat foot.


2017 ◽  
Vol 24 (8) ◽  
pp. 1126-1130 ◽  
Author(s):  
Neda Sattarnezhad ◽  
Samantha Farrow ◽  
Dorlan Kimbrough ◽  
Bonnie Glanz ◽  
Brian Healy ◽  
...  

Background: Visual symptoms are common in multiple sclerosis (MS). Low-contrast visual acuity (LCVA) testing using Sloan charts has demonstrated increased sensitivity for visual deficits compared to high-contrast acuity testing. Computerized testing of visual acuity may facilitate use in the clinic setting. Objectives: To evaluate the agreement between an iPad-based and Sloan testing of LCVA in a cohort of MS patients. Methods: A total of 38 patients with relapsing-remitting MS were enrolled after providing informed written consent at Partners MS Center, Brigham and Women’s hospital. Monocular LCVA was measured using retroilluminated Sloan chart and iPad-based LogMAR chart. Number of correct letters and agreement between two measurements were assessed for each eye using Bland–Altman analysis and paired t-test. Results: For both eyes, there was no significant difference in number correct between the two measurements using a paired t-test, and there was high correlation between two measurements (oculus dextrus (OD) r = 0.89, p < 0.001; oculus sinister (OS) r = 0.78, p < 0.001). The limits of agreement were −7.9 to +8.5 letters for the right eye and −10.9 to +11.2 letters for the left eye. Conclusion: An iPad-based LCVA test shows good agreement with Sloan testing in MS patients.


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