scholarly journals Modern possibilities of optical reconstructive surgery in patients after removal of tumor of iridociliary zone

2021 ◽  
pp. 48-51
Author(s):  
N.S. Khodzhaev ◽  
◽  
N.P. Sobolev ◽  
Y.V. Shkandina ◽  
M.A. Soboleva ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Reconstructive Surgery ◽  
Functional Results ◽  
Intraocular Tumors ◽  
Corrected Visual Acuity ◽  
Iris Defect ◽  
Optical Effects ◽  
Uncorrected Visual Acuity ◽  
Tumor Material

Choroid tumors constitute 2/3 of all intraocular tumors, out of which 23% are tumors of the iris and the ciliary body, and the rest are tumors of the choroid. After removing the tumor of the iridociliary zone (ICZ) it is necessary to perform optical reconstructive surgery to reduce light aberrations and increase visual functions. Purpose. To identify key features of the complex rehabilitation of patients after removal of the ICZ tumor. Material and methods. The clinical and functional results of the complex rehabilitation of 12 patients (12 eyes) aged from 35 to 84 years (average 66 years) were studied at least 1 year after removal of the ICZ tumor. The area of the iris defect before the reconstructive surgery ranged from 15% to 55%. Preoperative uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) were 0.26 ± 0.19 (from 0.01 to 0.6) and 0.46 ± 0.22 (from 0.1 to 0.8) respectively. All patients were underwent phacoemulsification of cataract and implantation of the iris-lens diaphragm. Results. After the reconstructive surgery, UCVA and BCVA increased:0.5 ± 0.17 (from 0.2 to 0.7) and 0.61 ± 0.27 (from 0.3 to 0.9) respectively. Undesirable optical effects were decreased, and patients were satisfied with the cosmetic result. Conclusion. The presented algorithm of optical reconstructive surgery after removal of the ICZ tumor creates necessary conditions for increasing postoperative functional results and improving the quality of life of these patients. Key words: tumor of the iridociliary zone, iris-lens diaphragm, optical reconstructive surgery, phacoemulsification of cataract.

Why does an ophthalmologist wear glasses?

2021 ◽  
pp. 121-123
Author(s):  
L.S. Voskanyan ◽  
◽  
I.V. Zverova ◽  
M.E. Mirgorodskaya ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Online Survey ◽  
Surgical Interventions ◽  
Work Related ◽  
Corrected Visual Acuity ◽  
Quality Of Vision ◽  
Uncorrected Visual Acuity ◽  
Subsequent Choice ◽  
Personal Use ◽  
Visual Organ

The aim of the study was to identify the reasons for the personal use of vision correction tools by ophthalmologists and the importance of vision for the specialty. Materials and methods. An anonymous online survey was conducted, which was attended by 122 respondents, including 111 ophthalmologists. Results. The visual acuity of two eyes without correction among the respondents was 1.0 and higher in 51 people. The maximum corrected visual acuity with two eyes was: 1.0 and higher in 79 respondents; less than 1.0 to 0.7 inclusive in 12 (those who refrained from answering the question had uncorrected visual acuity of 1.0 and higher). More than half of the respondents (56) suffer from myopia. Among the respondents, 53 use point correction. Of the spectacle lenses, ophthalmologists prefer plastic ones more. 36 respondents use contact correction. Surgical interventions on the organ of vision were performed in 12 patients. All respondents noted that they do not have cataracts, glaucoma, diseases of the optic nerve and color perception disorders. The choice of specialty did not depend on the existing diseases of the visual organ in 101 doctors, 9 people noted the connection between the previous pathologies of the visual organ with the subsequent choice of profession. Conclusions. According to the results of the study, it is possible to note the high maximum corrected visual acuity of ophthalmologists. Despite this, some respondents experience inconveniences at work related to visual impairments. For themselves, ophthalmologists often choose eyeglass correction instead of contact. And of the spectacle lenses, they prefer plastic ones more. The reasons for the use of glasses or contact correction among doctors of this specialty are increased requirements for the quality of vision. Key words: ophthalmologist, myopia, vision, glasses.

Μελέτη της ασφάλειας και αποτελεσματικότητας του ενδοκερατοειδικού διαθλαστικού ενθέματος Flexivue TM Micro-Lens (Presbia, CA Cooperatief U. A, Netherlands) για τη διόρθωση της πρεσβυωπίας

2014 ◽  
Author(s):  
Αλίκη Λιμνοπούλου
Keyword(s):  
Visual Acuity ◽  
Corrected Visual Acuity ◽  
Uncorrected Visual Acuity ◽  
Micro Lens

Η πρεσβυωπία (φυσιολογική γήρανση του μηχανισμού της προσαρμογής) αποτελεί ένα κοινό πρόβλημα για τα άτομα ηλικίας άνω των 40 με 45 ετών. Αρκετές πιθανές θεωρίες έχουν προταθεί σχετικά με την παθολογική φυσιολογία για την ανάπτυξη της πρεσβυωπίας. Η πιο αποδεκτή είναι η σχετιζόμενη με την ηλικία μείωση της ικανότητας του κρυσταλλοειδούς φακού να προσαρμόσει, η οποία επιδεινώνεται προοδευτικά με την αύξηση της ηλικίας 1. Το γεγονός αυτό θα μπορούσε να προκληθεί είτε από την ηλικιακή σκλήρυνση του κρυσταλλοειδούς φακού, είτε από μεταβολές στον περιφακικό σάκο και το ακτινωτό σώμα σχετιζόμενες με ηλικιακές εκφυλίσεις των ιστών. Ανεξάρτητα τον μηχανισμό, η πρεσβυωπία μειώνει την κοντινή όραση. Όταν δε διορθωθεί μπορεί να επηρεάσει την ικανότητα του ατόμου για διάβασμα, τη συμμετοχή του σε διάφορες δραστηριότητες και τελικά την παραγωγικότητα του στην καθημερινή του ζωή 2.Είναι σημαντικό να τονισθεί η σημασία του φαινόμενου της πρεσβυωπίας και το πόσο αυτή επιδρά στην καθημερινή μας ζωή. Σε μελέτες που έγιναν στην Αμερική βρέθηκε ότι το 1998, περίπου 113 εκατομμύρια Αμερικανοί πολίτες ήταν σε ηλικία άνω των 45 ετών, ηλικία που αρχίζει να εμφανίζεται η πρεσβυωπία. Η θεραπεία της πρεσβυωπίας, παρόλο που είναι αποτελεσματική με την χρήση των θετικών διορθωτικών φακών για κοντινή όραση, έχει προκαλέσει το ενδιαφέρον των ερευνητών που έχουν προτείνει μια σειρά από χειρουργικές θεραπευτικές παρεμβάσεις. Η τοποθέτηση σκληρικών ενθεμάτων επέκτασης συνιστά μία χειρουργική τεχνική επιδίωξης αναστροφής της πρεσβυωπίας μέσω αύξησης της απόστασης της ακτινωτής απόφυσης από το σκληρό χιτώνα, με επακόλουθο την ανάκτηση μέρους της ελαστικότητας των ινών της ζιννείου ζώνης 3. Εναλλακτικά, αξιοποιείται η τεχνική της ‘μονο-όρασης’ (monovision), κατά την οποία ο κυρίαρχος οφθαλμός διορθώνεται με laser ή με τοποθέτηση μονοεστιακού ενδοφακού για την εξυπηρέτηση της μακρινής όρασης, ενώ ο έτερος για εκείνη της κοντινής. Ωστόσο, ο ασθενής συχνά αντιμετωπίζει σημαντικά προβλήματα στη διόφθαλμη όραση (όπως η μείωση του βάθους πεδίου και η απώλεια στερέοψης) 4-7. Ένας άλλος τρόπος διόρθωσης αυτού του περιοριστικού παράγοντα είναι με τη χρήση προσαρμοστικών ενδοφακών οι οποίοι ακολουθούν τις κινήσεις της προσαρμογής που υπόκειται ο σάκος του περιφακίου (στον οποίο είναι τοποθετημένοι) από το ακτινωτό σώμα. Αυτοί οι φακοί μπορούν να παρέχουν 0,5-1 διοπτρίες ‘ψευδο-προσαρμογής’8. Συγκριτικές μελέτες απέδειξαν ότι οι προσαρμοστικοί ενδοφακοί παρέχουν την ίδια, άνευ διόρθωσης, μακρινή οπτική οξύτητα, όμως χάνεται η δυνατότητα για κοντινή όραση μετά τους πρώτους έξι μήνες, εξαιτίας μείωσης της ελαστικότητας του περιφακίου (ανάπτυξη μετεγχειρητικών συμφύσεων) 9.Η χρήση πολυεστιακών ενδοφακών τελευταία έχει γνωρίσει ιδιαίτερη αποδοχή τόσο από τους ασθενείς όσο και από τους οφθαλμιάτρους. Ωστόσο και με αυτή τη μέθοδο παρατηρήθηκε μία σχετική μείωση των ποιοτικών χαρακτηριστικών της μακρινής και κοντινής οπτικής οξύτητας με (best spectacles corrected visual acuity-BSCVA)/χωρίς (uncorrected visual acuity-UCVA) διόρθωση καθώς και της ευαισθησίας στην φωτεινή αντίθεση 10, 11.Οι χειρουργικές τεχνικές με τη χρήση laser στο επίπεδο του κερατοειδούς είναι μη αναστρέψιμες, καθώς μεταβάλλουν τη δομή του ιστού μέσω φωτοδιάσπασης, ενώ ο ασθενής ενδεχομένως να υποστεί μελλοντικά επιπλέον επέμβαση στους οφθαλμούς του για την αποκατάσταση του καταρράκτη. Οι χειρουργικές τεχνικές που αφορούν το σκληρό και τον κρυσταλλοειδή φακό, είναι πιο επεμβατικές και ακρωτηριαστικές για τους νέους πρεσβύωπες μέχρι 50 ετών στους οποίους ο φακός διατηρεί κάποιες εφεδρείες προσαρμογής. Έτσι, η επιστημονική κοινότητα αναζητά μία ελάχιστα επεμβατική και δυνητικά αναστρέψιμη χειρουργική τεχνική για τη διόρθωση της πρεσβυωπίας σε ασθενείς 45-55 ετών. Με βάση τα παραπάνω, η έρευνα για την διόρθωση της πρεσβυωπίας έστρεψε το ενδιαφέρον της εκ νέου στο επίπεδο του κερατοειδούς. Το τελευταίο, πολλά υποσχόμενο, επίτευγμα της επιστημονικής αυτής αναζήτησης είναι η κατασκευή ενδοκερατοειδικών διαθλαστικών ενθεμάτων 12. Το "FlexivueTM system " είναι μία τεχνική σχεδιασμένη να εισάγει ένα μικρού μεγέθους οπτικό φακό με θετική διαθλαστική δύναμη στο στρώμα του κερατοειδούς σε ένα σημείο ακριβώς απέναντι από το κέντρο της κόρης. Πρόκειται στην πραγματικότητα για ένα διπλοεστιακό φακό πάχους 15 μm και διαμέτρου 3 mm που τοποθετείται στον μη-επικρατούντα οφθαλμό. Λόγω της διπλοεστιακότητας του φακού η μακρινή όραση στο χειρουργημένο οφθαλμό επηρεάζεται πολύ λιγότερο από ότι με ένα κλασικό monovision.Με το φακό FlexivueTM τοποθετημένο, ο κερατοειδής γίνεται διπλοεστιακός. Το κεντρικό αναλλοίωτο τμήμα του κερατοειδούς οπού ο φακός είναι τοποθετημένος, προσφέρει ευκρινή μακρινή όραση και το περιφερικό τμήμα παρέχει ευκρινή κοντινή όραση.Κατά τη μακρινή όραση, οι φωτεινές ακτίνες του αντικειμένου που διέρχονται από την κεντρική plano ζώνη του ενθέματος και εκείνες που διέρχονται από την περιοχή του κερατοειδούς εξωτερικά του ενθέματος θα εστιαστούν στον αμφιβληστροειδή, ενώ οι ακτίνες του μακρινού αντικειμένου που διέρχονται από την περιφερική ζώνη του ενθέματος με τη διαθλαστική δύναμη θα εστιαστούν μπροστά από τον αμφιβληστροειδή και η θολή εικόνα που δημιουργούν θα απορριφθεί από το οπτικό σύστημα. Εστιάζοντας σε ένα κοντινό αντικείμενο, η κόρη φυσιολογικά συστέλλεται, οπότε διέρχονται μόνο οι κεντρικές φωτεινές ακτινοβολίες, αφού όμως διαπεράσουν πρώτα το ένθεμα. Οι φωτεινές ακτίνες του κοντινού αντικειμένου που διέρχονται από την κεντρική ζώνη του ενθέματος θα εστιάζονται πίσω από τον αμφιβληστροειδή και η θολή εικόνα που δημιουργούν απορρίπτεται από το οπτικό σύστημα. Οι φωτεινές ακτίνες του κοντινού αντικειμένου που διέρχονται από την περιφερική ζώνη του ενδοκερατοειδικού ενθέματος θα εστιάζονται στον αμφιβληστροειδή. Σαν αποτέλεσμα, μόνο η περιφερική ζώνη του ενθέματος παρέχει κοντινή διόρθωση και επηρεάζει τη μακρινή όραση, ενώ το κεντρικό τμήμα του ενδοκερατοειδικού φακού και η εκτός του ενθέματος ζώνη του κερατοειδούς δεν επηρεάζουν τη μακρινή όραση του ασθενούς.

scholarly journals Clinical Performance of Toris K Contact Lens in Patients with Moderate to Advanced Keratoconus: A Real Life Retrospective Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Ihsan Yilmaz ◽  
Ferah Ozcelik ◽  
Berna Basarir ◽  
Gokhan Demir ◽  
Gonul Durusoy ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Contact Lens ◽  
Contact Lenses ◽  
Clinical Performance ◽  
Real Life ◽  
Soft Contact Lenses ◽  
Corrected Visual Acuity ◽  
Uncorrected Visual Acuity ◽  
Central Cone ◽  
The Mean

Objectives.To evaluate the visual performance of Toris K soft contact lenses in patients with moderate-to-advanced keratoconus and also to compare the results according to cone types, cone location, and severity of keratoconus.Materials and Methods.Sixty eyes of 40 participants were included in this retrospective study. Uncorrected visual acuity (UCVA), best-spectacle corrected visual acuity (BCVA), best-contact lens corrected visual acuity (BCLCVA), and comfort rating via visual analogue scales (VAS) were measured.Results.The mean age was 27.3 ± 8.6 years (range: 18 to 54). The mean logMAR UCVA, BCVA, and BCLCVA were 0.85 ± 0.38 (range: 0.30–1.30), 0.47 ± 0.27 (range: 0.10–1.30), and 0.16 ± 0.20 (range: 0–1.00). There were significant increases in visual acuities with contact lenses (p<.05). BCLCVA was significantly better in oval type than globus type (p=.022). UCVA and BCLCVA were significantly better in moderate keratoconus group (p=.015,p=.018). The mean line gain in Snellen was 3.6 ± 1.8 lines (range: 0–7 lines). The mean line gain was higher in central cone group than paracentral cone group and oval group than globus group (p=.014,p=.045). The mean VAS score was 8.14 ± 1.88 (range: 6–10).Conclusions.Toris K can improve visual acuity of patients with keratoconus. Toris K is successful even in the moderate and advanced form of the disease.

scholarly journals Considerations of Visual Quality in Ocular Surgery as Presented at Dry Eye University

2020 ◽  
Vol 3 ((SP1)) ◽  
pp. e28-e29
Author(s):  
Frank Bowden
Keyword(s):  
Visual Acuity ◽  
Visual Experience ◽  
Visual Quality ◽  
Ocular Surgery ◽  
Optical Efficiency ◽  
Corrected Visual Acuity ◽  
Uncorrected Visual Acuity ◽  
Visual Phenomena ◽  
Visual Disturbances ◽  
Best Corrected Visual Acuity

Visual quality may be described as the visual experience which reflects the optimal optical efficiency of the eye. Patients undergoing ocular surgery expect improvement in visual acuity. Ocular surgeons typically aim to improve best-corrected visual acuity. Refractive surgeons, on the other hand, strive to improve uncorrected visual acuity. It is not uncommon that patients with excellent corrected visual acuity following surgery may be dissatisfied with visual quality which is less than anticipated due to unexpected visual disturbances. These visual phenomena may include ghosting, glare, halos, reduced contrast sensitivity, and visual fluctuation.

scholarly journals Long-Term Evaluation of Visual Outcomes and Patient Satisfaction after Binocular Implantation of a Bioanalogic Lens

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Sylwia Wagner ◽  
Grzegorz Wagner ◽  
Ewa Mrukwa-Kominek
Keyword(s):  
Visual Acuity ◽  
Patient Satisfaction ◽  
Contrast Sensitivity ◽  
Case Series ◽  
Spatial Frequencies ◽  
Uncorrected Visual Acuity ◽  
Term Evaluation ◽  
The Mean

Purpose. Long-term evaluation of the visual refractive outcomes and the quality of life after implantation of the WIOL-CF (Medicem, Czech Republic) in both eyes. Design. retrospective, nonrandomized noncomparative case series. Methods. 50 eyes of 25 patients, including 11 women (44%) and 14 men (56%). The age range of the patients was 38 to 77 years (mean age 55.48 ± 10.97 years). All patients underwent bilateral implantation of the WIOL-CF. Exclusion criteria were previous ocular surgeries except for cataract surgery and refractive lens exchange, irregular corneal astigmatism of >1.0 diopter, and ocular pathologies or corneal abnormalities. Postoperative examinations were performed at 14 days and 3, 6, 12 months of surgery; the last follow-up was between 24 and 36 months after the procedure. All exams included manifest refraction, monocular uncorrected visual acuity (UCVA) and distance-corrected visual acuity (DCVA) in 5 m (Snellen), monocular uncorrected visual acuity in 70 cm and 40 cm (Jeager) and binocular UCVA, DCVA in 5 m, 70 cm, and 40 cm, binocular contrast sensitivity (CS) under photopic conditions, binocular defocus curves, high-order aberrations, quality-of-vision VF-14 questionnaire, and spectacle independence. Results. Significant improvement in monocular visual acuity at all distances was demonstrated; the mean postoperative spherical equivalent was 0.32 ± 0.45D. The postoperative means of binocular distance UCVA and BCVA were also improved ( p  < .001) and so were the mean uncorrected intermediate VA (2.053 ± 1.268) and near uncorrected VA (2.737 ± 1.447). There was a significant improvement in contrast sensitivity at all spatial frequencies and higher-order aberration, compared to preoperative results. Conclusions. The evaluation of a WIOL-CF showed good distance, intermediate, and near visual acuity. Contrast sensitivity increased after surgery in all spatial frequencies. Patient satisfaction was high despite some optical phenomena. The rate of postoperative spectacle independence also turned out high. Financial Disclosure. No author has a financial or proprietary interest in any material or method mentioned.

scholarly journals Corneal Cross-Linking for Progressive Keratoconus in Children: Our Experience

2012 ◽  
Vol 1 (1) ◽  
pp. 53-56 ◽  
Author(s):  
Erez Bakshi ◽  
Yaniv Barkana ◽  
Yakov Goldich ◽  
Isaac Avni ◽  
David Zadok
Keyword(s):  
Visual Acuity ◽  
Medical Center ◽  
Statistical Significance ◽  
Cross Linking ◽  
Long Term Stability ◽  
Corrected Visual Acuity ◽  
Department Of Ophthalmology ◽  
Manifest Refraction ◽  
Uncorrected Visual Acuity

ABSTRACT Purpose To assess the effect of corneal cross-linking on progressive keratoconus in children. Method In this retrospective study we enrolled nine eyes of nine consecutive children aged 11 to 17 years old who underwent corneal riboflavin-UVA induced cross-linking for progressive keratoconus at the Department of Ophthalmology at Assaf Harofeh Medical Center. They were followed for 6 to 24 months (average 16 ± 8.1 months). Evaluated parameters were uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, pachymetry, slit lamp examination and corneal topography. Results Cross-linking resulted in stability of visual acuity in seven of the nine (77.8%) treated eyes. We found a nonsignificant improvement in UCVA and BSCVA with a small reduction of manifest cylinder. Furthermore, there was an improvement in spherical equivalent that was close to statistical significance (p = 0.07). There was 0.86 D reduction of average Kmax value postoperatively (p = 0.36). Most patients (7 of 9, 77.8%) showed a long-term stability or reduction in Kmax. Conclusion In this study, we demonstrated the efficacy of corneal cross-linking in arresting the progression of keratoconus in children. We believe that larger scale studies in this age group should be performed to further establish the relevance of this technique in children. How to cite this article Bakshi E, Barkana Y, Goldich Y, Avni I, Zadok D. Corneal Cross-Linking for Progressive Keratoconus in Children Our Experience. Int J Keratoco Ectatic Corneal Dis 2012;1(1):53-56.

scholarly journals Comparison of efficacy and visual quality after CWFG-FS-LASIK, AF-FS-LASIK and SMILE for correcting myopia with asymmetry mid-to-high astigmatism

2020 ◽  
Author(s):  
zhongxiu zhao ◽  
Miaomiao Zhu ◽  
Qian Jian ◽  
Xialu Liu ◽  
Pingting Ma ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Visual Quality ◽  
Modulation Transfer ◽  
Surgical Methods ◽  
Uncorrected Visual Acuity ◽  
Better Than ◽  
High Order Aberrations

Abstract Background: Individualized ablation is not only able to correct corneal low-order aberrations but also to improve corneal high-order aberrations in patients with corneal asymmetry. In this study, we compared the effects of three different surgical methods, namely, corneal wavefront-guided femtosecond laser assisted in-situ keratomileusis (CWFG-FS-LASIK), aberration-free femtosecond laser assisted in-situ keratomileusis (AF-FS-LASIK) and small incision lenticule (SMILE), in patients with mid-to-high astigmatism asymmetric corneas (1-4D).Methods: One hundred-fourteen eyes from 58 patients were enrolled in this retrospective study. We measured and compared the best corrected visual acuity (BCVA), uncorrected visual acuity (UCVA), residual astigmatism, total coma, vertical coma (Z3-1), horizontal coma (Z31), modulation transfer function (MTF) and point spread function (PSF) preoperatively and three months postoperatively. Results: The visual acuity of patients in the three groups was increased after surgery, but the improvements in visual acuity and residual astigmatism among them were not significantly different. However, the improvements in 4-mm and 6-mm total coma, Z3-1 and Z31 in patients who underwent CWFG-FS-LASIK were better than those in patients who underwent AF-FS-LASIK and SMILE. Consistent with these results, the improvements in MTF and PSF (3 mm and 5 mm) in the CWFG-FS-LASIK group were better than those in the AF-FS-LASIK and SMILE groups.Conclusions: Among surgeries for treating patients with mid-to-high astigmatism in asymmetric corneas, the selective coma-guided modality was able to decrease the coma of original cornea, improve visual acuity and optimize the visual quality of patients.

scholarly journals Evaluation of vision-related quality of life with autologous internal limiting membrane transplantation for refractory macular hole.

2019 ◽  
Author(s):  
dongqing yuan ◽  
Weiwei Zhang ◽  
Songtao Yuan ◽  
Ping Xie ◽  
Qinghuai Liu
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Macular Hole ◽  
Internal Limiting Membrane ◽  
Ilm Peeling ◽  
Corrected Visual Acuity ◽  
Hole Index ◽  
Related Quality ◽  
Best Corrected Visual Acuity

Abstract Background: To evaluate the vision-related quality of life of vitrectomy combined with autologous internal limiting membrane(ILM) transplantation for refractory macular hole． Methods: A prospective and nonrandomized clinical study was carried out. There were fourty eyes with refractory macular hole included and all eyes received 23G vitrectomy and ILM peeling with autologous ILM transplantation. Preoperative and postoperative basic conditions were recorded, including best corrected visual acuity (BCVA), intraocular pressure, central retinal thickness (CRT) measurement by Optical coherence tomography (OCT) examination, macular hole index (MHI) and operative complications. The Chinese version of visual-related quality of life scale -25 (CVRQoL-25) was used to evaluate the visual related quality of life of patients after operation. The correlation between the quality of life and the postoperative visual acuity and the size of the macular hole before operation was tested by Spearman rank correlation test. Results: All patients were followed up for three months after surgery, and 38 patients achieved anatomical closure. The mean postoperative logMAR BCVA was 1.09±0.33, which has significantly improved than that before operation (P=0.000). The vision-related quality of life of patients after surgery was closely related to the macular hole index (r=0.375, P=0.017), but was negatively correlated with the best corrected visual acuity before and after surgery (r=-0.495, P=0.001; r=-0.760，P=0.000). It was also found that the vision-related quality of life of patients positively correlated with the postoperative CRT ( r=0.414，P=0.008). Conclusions: The anatomical structure of refractory macular hole patients with ILM peeling combined with autologous ILM transplantation was largely reduced, and the visual acuity of the patients improved significantly. Meanwhile, the vision-related quality of life was significantly improved after surgery. Trial Registration: ChiCTR-INR-16008660, date of registration: 2016/06/17

scholarly journals Correction of postkeratoplastic astigmatism by intrastromal corneal segments implantation using a femtosecond laser

2021 ◽  
Vol 6 (6-1) ◽  
pp. 48-55
Author(s):  
N. A. Pozdeyeva ◽  
M. V. Sinitsyn ◽  
A. E. Terentieva ◽  
O. V. Shlenskaya
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Penetrating Keratoplasty ◽  
Biomechanical Properties ◽  
Corneal Graft ◽  
Corneal Resistance Factor ◽  
Astigmatism Correction ◽  
Corrected Visual Acuity ◽  
Uncorrected Visual Acuity ◽  
Best Corrected Visual Acuity

Background. After penetrating keratoplasty, mild to high induced corneal astigmatism was observed in each case. The existing choice of correction of postkeratoplastic astigmatism is aimed at fi nding an individual approach in order to compensate for it and not weaken the biomechanical properties of the corneal graft.The aim: to analyze the clinical, functional, and morphological results of postkeratoplastic astigmatism correction by implantation of intrastromal corneal segments using a femtosecond laser.Methods. 22 patients were examined before and 1 year after surgery. The operation was performed under local anesthesia: stage I – an intrastromal tunnel was formed using a femtosecond laser “Femto Visum” 1 MHz (Optosystems, Russia); stage II – the intrastromal corneal segments were implanted. The results were assessed using standard and special research methods using optical coherence tomography Visante OCT (Zeiss, Germany), keratotopography (Tomey-5, Japan), optical corneal analyzer ORA (Reichert, USA), laser tindalemetry FC-2000 (Kowa, Japan) and confocal microscope Confoscan-4 (Nidek, Japan).Results. Before the operation, uncorrected visual acuity averaged 0.09 ± 0.05, after a year – 0.50 ± 0.16; best corrected visual acuity – 0.30 ± 0.12 and 0.60 ± 0.05 respectively; cylindrical component of refraction – –10.29 ± 3.12 and –2.20 ± 0.64 D respectively; mean keratometry value – 43.59 ± 2.14 and 38.56 ± 1.75 D respectively; corneal hysteresis – 7.92 ± 1.22 and 8.95 ± 1.05 mm Hg respectively; corneal resistance factor – 7.01 ± 1.81 and 8.44 ± 1.44 mm Hg respectively; protein fl ux in the moisture of the anterior chamber – 2.97 ± 0.28 and 3.04 ± 0.24 f/ms respectively; endothelial cell density – 1521 ± 327 and 1475 ± 419 cells/mm2 respectively.Conclusion. Intrastromal corneal segments implantation into a corneal graft using a femtosecond laser has efficiency and safety method in correcting postkeratoplastic astigmatism.

Use of new-generation hybrid contact lenses for managing challenging corneas

2020 ◽  
pp. 112067212094275
Author(s):  
Ibrahim Inan Harbiyeli ◽  
Elif Erdem ◽  
Puren Isik ◽  
Meltem Yagmur ◽  
Reha Ersoz
Keyword(s):  
Visual Acuity ◽  
Medical Records ◽  
Contact Lenses ◽  
Corrected Visual Acuity ◽  
Manifest Refraction ◽  
Uncorrected Visual Acuity ◽  
The Mean ◽  
New Generation ◽  
Generation Hybrid ◽  
Irregular Astigmatism

Introduction: To evaluate the safety and efficacy of new-generation hybrid contact lenses (HCL) among patients with irregular astigmatism. Methods: Medical records of 25 patients fit with new-generation HCL (Eyebrid® and AirFlex®) were retrospectively reviewed. The data collected included etiology of irregular astigmatism, uncorrected visual acuity, manifest refraction, spectacle-corrected visual acuity (S-CDVA), steep / flat keratometric values, corneal astigmatism, records of rigid / soft CL fitted before HCL, all parameters of the trial lenses, and the final prescribed HCL parameters and HCL-CDVA. Results: The study included 34 eyes from 25 patients (nine females and 16 males) with an average age of 29 ± 13 (ranging from 8–56) years. In total, 25 eyes with keratoconus, four with post - keratoplasty astigmatism, three with irregular astigmatism due to corneal trauma and two with residual astigmatism after radial keratotomy were fit with HCL. The mean S-CDVA (logMAR) improved significantly from 0.76 ± 0.41 to 0.14 ± 0.15 with HCL ( p < 0.01). The most common indication for HCL was inability to fit with rigid gas permeable (RGP) lenses (22 eyes). The average number of lenses to successful fit was 1.4 (mode, 1; median, 1) and ideal fit was achieved with the first trial lens in 25 eyes (73%). Seven patients (nine eyes, 36%) discontinued lens use within the first 6 months because of discomfort (six eyes, 24%), ocular allergy (two eyes, 8%) and tearing of contact lens (one eye, 4%). Discussion: New-generation HCL may be a suitable option for fitting challenging corneas with irregular astigmatism that cannot be rehabilitated efficiently with rigid lenses.

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