scholarly journals Prospective Interventional Non-Comparative Non-Randomized Clinical Study of A Topical Synergic Compound to Mitigate Presbyopia Effects

Author(s):  
Cesar A Sanchez Galeana

Abstract Purpose To assess the safety and efficacy of a novel compound with low -dose pilocarpine, brimonidine and oxymetazoline (PBO) in the near vision of a group of healthy presbyopic individuals. Design Prospective, consecutive, noncomparative, nonrandomized interventional study. Subjects Twenty-six healthy presbyopic patients presented from August to September 2021 to our clinic and were willing to participate in the study. Methods PBO compound was instilled in both eyes to assess its effect in near vision one hour after instillation.Main Outcome Measures Under corrected near visual acuity using the Jaeger notation, under corrected and corrected distance visual acuity, photopic and scotopic pupil diameter was registered before and one hour after instillation of the compound. Results Baseline binocular Jaeger notation was 5.86 +/-1.39 SD range (3-9). One hour after drop instillation, binocular Jaeger was 2.53 +/ 1.71 SD range (1 – 6) (p ≤ 0.0001) Lines gained 3.30 +/-1.40 SD range (0 – 6). Mean photopic pupilar diameter was 3.69 mm +/- 0.67 SD range (2.5 – 5 mm). Mean scotopic pupilar diameter was 4.61 mm +/- 0.78 SD range (3 – 6 mm). The mean photopic pupilar diameter was 2.27 mm +/-052 SD (1.5 – 3) (p ≤ 0.000). Scotopic pupilar diameter was 2.63 mm +/-0.53 SD range (2 – 3) (p ≤ 0.000). One patient reported no improvement in near vision. (3.8%). One patient reported dim vision rated 5 in a VAS (1 –10) (3.8%). Conclusion Low-dose pilocarpine, brimonidine, and oxymetazoline showed efficacy, improving near-distance vision one hour after instillation in a group of presbyopic patients, and safety showed few and transient secondary effects.

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Michael Moore ◽  
Antonio Leccisotti ◽  
Claire Grills ◽  
Tara C. B. Moore

Purpose. To assess near visual acuity in a presbyopic age group following hyperopic photorefractive keratectomy (PRK). Setting. Private practice in Siena, Italy. Methods. In this retrospective single-surgeon comparative study, PRK with mitomycin C was performed to correct hyperopia using Bausch & Lomb 217z laser for 120 eyes of 60 patients in the presbyopic age group (mean spherical equivalent SE +2.38 D ± 0.71 D and mean age ). 120 eyes of 60 age-matched controls (mean age ) had their unaided near vision measured. Results. At 12 months mean SE was −0.10 D ± 0.27 D in the PRK group. Mean best corrected visual acuity (BSCVA) was log MAR; 2 eyes lost ≥0.1 log MAR. Mean uncorrected visual acuity was log MAR. Mean distance corrected near visual acuity (DCNVA) in the PRK group was . This was statistically better () than the mean unaided near visual acuity in the control group . Conclusion. PRK was found to be safe, predictable, and an effective way of correcting hyperopia in this age group. It was also found to give better than expected near vision.


2017 ◽  
Vol 28 (3) ◽  
pp. 282-286 ◽  
Author(s):  
Javier García-Bella ◽  
Néstor Ventura-Abreu ◽  
Laura Morales-Fernández ◽  
Paula Talavero-González ◽  
Jesús Carballo-Álvarez ◽  
...  

Purpose: To assess photopic and mesopic vision in patients implanted with the Bi-Flex® M 677 MY bifocal intraocular lens (IOL). Methods: In this prospective clinical study, 25 patients with cataract in both eyes were subjected to cataract surgery and bilateral implantation of the Bi-Flex® M 677MY (Medicontur, Hungary) IOL. Three months after surgery, high-contrast photopic uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were determined. Intermediate at 65 cm (DCIVA) and near at 40 cm (DCNVA) visual acuity were also measured, both with best distance correction. The CSV-1000 test chart was used to assess contrast sensitivity (CS). Defocus curves were constructed under photopic and mesopic conditions, determining binocular best-corrected visual acuity over the range +1.50 D to -4.00 D in 0.50-D steps. A KR-1W Wavefront Analyzer was used to measure pupil size and aberrometric outcomes. Presence and type of dysphotopsia were evaluated with the Likert scale. Results: Mesopic mean pupil diameter was 4.58 ± 0.73 mm. The mean values at 3 months were UDVA 0.03 ± 0.09, CDVA -0.05 ± 0.06, DCIVA 0.20 ± 0.07, and DCNVA 0.11 ± 0.08. Mean CS for the 4 frequencies examined were 1.66 ± 0.16, 1.75 ± 0.14, 1.39 ± 0.22, and 0.96 ± 0.19. Significant differences were observed in defocus curves for photopic and mesopic conditions. A significant correlation between pupil diameter and the dysphotopic photopic was found (r = 0.62; p = 0.02). Conclusions: The evaluated progressive apodized diffractive design IOL provides effective restoration of visual function in far and near vision distance with an adequate intermediate visual quality between -1.00 and -1.50 focus.


2017 ◽  
Vol 27 (4) ◽  
pp. 454-459 ◽  
Author(s):  
Behrad Samadi ◽  
Mats Lundström ◽  
Maria Kugelberg

Purpose To identify and evaluate possible causes of poor patient-reported visual function after cataract surgery. Methods We obtained retrospective data from the Swedish National Cataract Register on patient self-assessed visual function before and after cataract surgery based on the Catquest-9SF questionnaire. We identified patients who self-reported similar or more difficulties postoperatively than preoperatively, and looked at possible causative variables such as sex, age, preoperative and postoperative corrected distance visual acuity (CDVA) and refractive errors, and ocular comorbidity. Results Nearly 75% of the 119 patients identified had a better postoperative CDVA; the mean CDVA increased by over 0.2 logarithm of the minimum angle of resolution visual acuity. Patients with low or high preoperative CDVA had poor self-assessed outcomes postoperatively. Younger patients (52-68 years) had a lower self-assessed outcome than more elderly patients. Surgical complications and poor near vision yielded lower outcomes. Anisometropia, ocular comorbidity, and sex did not significantly affect the outcome in this specific group. Conclusions Patients content with their visual function despite the presence of a cataract should defer surgery. This may also include patients younger than 68 years with good visual function. Detailed information given to the patients about their ophthalmic condition, the surgical procedure and risks, and the eventual need for reading glasses postoperatively may result in higher self-assessed visual function outcomes among patients.


2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Ugur Unsal ◽  
Gonen Baser

Purpose.To compare near, intermediate, and distance vision and quality of vision, when refractive rotational multifocal intraocular lenses with 3.0 diopters or diffractive multifocal intraocular lenses with 2.5 diopters near addition are implanted.Methods.41 eyes of 41 patients in whom rotational +3.0 diopters near addition IOLs were implanted and 30 eyes of 30 patients in whom diffractive +2.5 diopters near addition IOLs were implanted after cataract surgery were reviewed. Uncorrected and corrected distance visual acuity, intermediate visual acuity, near visual acuity, and patient satisfaction were evaluated 6 months later.Results. The corrected and uncorrected distance visual acuity were the same between both groups (p=0.50andp=0.509, resp.). The uncorrected intermediate and corrected intermediate and near vision acuities were better in the +2.5 near vision added intraocular lens implanted group (p=0.049,p=0.005, andp=0.001, resp.) and the uncorrected near vision acuity was better in the +3.0 near vision added intraocular lens implanted group (p=0.001). The patient satisfactions of both groups were similar.Conclusion. The +2.5 diopters near addition could be a better choice in younger patients with more distance and intermediate visual requirements (driving, outdoor activities), whereas the + 3.0 diopters should be considered for patients with more near vision correction (reading).


2018 ◽  
Vol 30 (1) ◽  
pp. 139-146 ◽  
Author(s):  
Guilherme Andrade do Nascimento Rocha ◽  
Paulo Ferrara de Almeida Cunha ◽  
Leonardo Torquetti Costa ◽  
Luciene Barbosa de Sousa

Importance: This study shows that a newer long-arc length intrastromal corneal ring segment is efficient and safe for keratoconus treatment. Background: To evaluate visual, tomographic results and complications of a 320-degree intrastromal corneal ring segment implantation with the femtosecond laser for keratoconus treatment. Design: A prospective, nonrandomized, and interventional study. Participants: A total of 34 eyes of 31 patients diagnosed with keratoconus were enrolled. Methods: Patients were divided into two groups based on the strategy used for 320-degree intrastromal corneal ring segment thickness selection. In one group, this selection was based on spherical equivalent (SE group) and in the other on the mean asphericity (Q group). The uncorrected and corrected distance visual acuities, spherical equivalent, K1, K2, Km, Kmax, and mean asphericity ( Q) on corneal tomography were evaluated preoperatively and at 3 and 6 months postoperatively. For astigmatism improvement, we analyzed the corneal tomographic vectorial astigmatism change preoperatively and at 6 months postoperatively. The mean follow-up period was 6.63 ± 0.96 months. Results: The mean uncorrected distance visual acuity and corrected distance visual acuity improved with a significant spherical equivalent improvement ( p < 0.05), with no differences between the 320-degree intrastromal corneal ring segment groups. All corneal tomographic parameters improved significantly ( p < 0.05) between the preoperative and postoperative intervals, with a significant better performance when we used spherical equivalent for the 320-degree intrastromal corneal ring segment thickness selection. Finally, the mean vectorial corneal tomographic astigmatism significantly improved after 6 months, again with no differences between groups. Conclusion: This study suggests that implanting a 320-degree intrastromal corneal ring segment is a safe and effective procedure for treating patients with keratoconus. It also suggests that for thickness selection spherical equivalent is the better strategy.


2018 ◽  
Vol 28 (4) ◽  
pp. 419-424 ◽  
Author(s):  
Jorge L Alió ◽  
Ana B Plaza-Puche ◽  
Jorge L Alió del Barrio ◽  
Pedro Amat-Peral ◽  
Vicente Ortuño ◽  
...  

Purpose: To evaluate clinical and visual outcomes, quality of near vision, and intraocular optical quality of patients bilaterally implanted with a trifocal PanOptix intraocular lens. Methods: In this prospective consecutive case-series study, 52 eyes of 26 bilateral patients (mean age, 60.2 ± 7.4 years) were implanted with the AcrySof IQ Panoptix intraocular lens. Visual acuity, defocus curve, contrast sensitivity (Pelli-Robson test), near activity visual questionnaire, and internal aberrations with Osiris were evaluated. A prototype light-distortion analyzer was used to quantify the postoperative light-distortion indices. The follow-up was 6 months after surgery. Results: Uncorrected, corrected distance, and uncorrected near visual acuities improved with the surgery (p ≤ 0.02). Distance corrected near visual acuity was 0.13 ± 0.10, 0.13 ± 0.13, and 0.13 ± 0.08 at 1, 3, and 6 months after surgery, respectively (p = 0.82). Distance corrected intermediate visual acuities were 0.09 ± 0.13, 0.13 ± 0.15, and 0.12 ± 0.12 at 1, 3, and 6 months, postoperatively. Binocular contrast sensitivity was 1.86 ± 0.15 Log Units. Defocus curve provided a visual acuity equal or better to 0.30 LogMAR between defocus levels of +0.50 to −3.00 D. The near activity visual questionnaire scores improved significantly with the surgery (p < 0.01). Conclusion: The AcrySof IQ Panoptix intraocular lens is able to restore visual function with an acceptable intermediate and near vision after cataract surgery with good contrast sensitivity and an improvement in the near activity visual questionnaire.


2020 ◽  
Author(s):  
Joao Beato ◽  
Sonia Torres-Costa ◽  
Joao Esteves-Leandro ◽  
Manuel Falcão ◽  
Vitor Rosas ◽  
...  

Abstract BackgroundDiabetic retinopathy (DR) and cataract are major complications that lead to significant visual impairment of diabetic patients. This study aims to compare the changes in visual acuity, quality of life and satisfaction after phacoemulsification between type 2 diabetic and nondiabetic patients.MethodsFifty-seven diabetic patients (37 with no diabetic retinopathy [DR], 11 with mild/moderate nonproliferative DR and 9 with severe nonproliferative/proliferative DR) and 45 controls were submitted to first-eye cataract surgery by phacoemulsification alone or with co-adjuvant intravitreal injection of bevacizumab or triamcinolone. National Eye Institute Visual Function Questionnaire (NEI VFQ-25) was recorded preoperatively and 6 months after surgery; and satisfaction evaluated at 1-month. ResultsCorrected distance visual acuity (CDVA) of the operated eye at 1 and 6-months (p<0.001) was significantly higher than preoperative value in the controls and all diabetic subgroups. The final CDVA in the severe nonproliferative/proliferative DR subgroup was significantly lower compared to the controls and the remaining diabetic subgroups (p<0.05). The mean NEI VFQ-25 composite score significantly improved in both control (15.413.2 points) and diabetic (15.413.0 points) groups, without differences among the diabetic subgroups (p>0.05). Overall patient satisfaction was 93% in both control and diabetic groups. ConclusionThis study provides vision-related patient-reported outcomes that support the benefit from phacoemulsification in all stages of DR, as long as there is adequate monitoring and treatment of retinopathy.


2021 ◽  
Author(s):  
Nesrin Tutas Gunaydın ◽  
Ayse Aydın Oral

Abstract Background: To evaluate the factors influencing final visual acuity in pediatric traumatic cataracts. Methods: Data of patients who presented with traumatic cataracts were reviewed retrospectively. We evaluated sex; age at trauma; trauma type, cause, and zone; duration between the time of trauma and cataract surgery; surgical method used; time, location, and type of intraocular lens (IOL) implantation; initial and final corrected distance visual acuity (CDVA); amblyopia rate and complications. Results: In all, 61 eyes of 59 patients with cataracts after trauma, under 16 years of age, were included. The mean age of the children was 7.2 ± 3.9 years. Primary IOL implantation was performed in 70.9% of eyes. The CDVA was 0.7 LogMAR or better in 16.3% of the 49 eyes where the visual acuity could be measured at the time of trauma and in 69.1% of 55 eyes in which it could be measured after treatment. The evaluation of factors potentially influencing the final visual acuity revealed that eyes that had undergone posterior capsulotomy (PC) and anterior vitrectomy (AV) during cataract surgery had significantly better final vision compared to eyes that did not undergo these procedures. Conclusion: Good visual results can be obtained in children with traumatic cataracts using PC and AV together with lens aspiration and IOL implantation, followed by effective amblyopia treatment and close monitoring.


2021 ◽  
Author(s):  
Takushi Kawamorita ◽  
Hiroshi Uozato ◽  
Tetsuro Oshika ◽  
Kazuno Negishi ◽  
Takashi Fujikado ◽  
...  

Abstract This prospective observational study aimed to evaluate the eye shape and visual function of Japanese people through a multicenter approach and to create a Japanese model eye. Uncorrected and corrected distance visual acuity (UDVA and CDVA, respectively) in the log minimum angle of resolution (logMAR), subjective and objective spherical equivalent values (SE) of ocular refraction, anterior and posterior corneal curvature (ACC and PCC, respectively), anterior and posterior corneal asphericity (ACA and PCA, respectively), central corneal thickness (CCT), anterior chamber depth (ACD), and ocular axial length (AL) were measured in the eyes of 250 participants (mean age = 46.5 ± 18.0 years, range: 20–90 years) across five institutions in Japan. The mean UDVA, CDVA, subjective SE, objective SE, ACC, PCC, ACA, PCA, CCT, ACD, and AL were 0.68, -0.08, -2.42 D, -2.66 D, 7.77 mm, 6.33 mm, -0.31, -0.39, 0.55 mm, 2.92 mm, and 24.78 mm, respectively. Age-related changes and sex-based differences were observed in the visual acuity, refraction, corneal shape, ACD, and AL. Although the sample size needs to be increased, the results of this study can be applied to the development of refractive correction methods and various vision-related fields.


2021 ◽  
pp. 112067212110528
Author(s):  
Abdelrahman Salman ◽  
Ali Ali ◽  
Shaaban Rafea ◽  
Rana Omran ◽  
Buraa Kubaisi ◽  
...  

Aim To evaluate the long-term outcomes of corneal cross-linking (CXL) in patients with progressive keratoconus. Method In this retrospective non-comparative study, forty-five eyes of 31 patients with progressive keratoconus were treated with 30 min “epi-off” corneal cross-linking. The visual, refractive, topographic and tomographic outcomes were evaluated preoperatively and at least 10 years after cross-linking. Results Ten years post-corneal cross-linking, the mean anterior maximum keratometry decreased (−2.10 ± 3.25 D, P = 0.0001). Conversely, the posterior maximum keratometry increased (6.38 ± 9.79 D, P = 0.065). Both uncorrected and corrected distance visual acuity improved (LogMAR −0.08 ± 0.30) and (LogMAR −0.05 ± 0.21), respectively (P > 0.05, both). A statistically significant hyperopic shift was observed postoperatively (0.70 ± 1.31 D, P = 0.0009). The anterior topographic cylinder values revealed no change (−0.17 ± 1.31 D, P = 0.3), whereas the mean posterior cylinder values decreased (absolute value increased) significantly compared to baseline from −1.31 ± 0.97 D to −1.82 ± 1.78 D, (P < 0.05). The minimum corneal thickness values decreased significantly (−35.11 ± 48.63 µm, P = 0.0001). Four eyes (8.8%) showed more than 1 D increase in the anterior maximum keratometry. Conclusion This protocol and duration of Epi-off corneal cross-linking was found to be effective in halting keratoconus progression over the follow up period (10 years). Anterior corneal flattening and a hyperopic shift were observed. A statistically significant increase in the posterior corneal cylinder was observed. Although, not reaching statistical significance, the logMAR uncorrected and corrected visual acuity were improved.


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