scholarly journals Possibilities of prismatic correction in the treatment of congenital horizontal nystagmus

2021 ◽  
pp. 71-76
Author(s):  
G.V. Gladysheva ◽  
◽  
I.L. Plisov ◽  
N.G. Antsiferova ◽  
V.B. Pushchina ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Dynamic Control ◽  
Compensatory Mechanisms ◽  
Primary Position ◽  
Head Posture ◽  
Uncorrected Visual Acuity ◽  
Pendular Nystagmus ◽  
Abnormal Head ◽  
Horizontal Nystagmus

Purpose. Analysis the effectiveness of prismatic correction in the treatment of congenital horizontal nystagmus. Material and methods. The study included 20 patients with congenital horizontal nystagmus. Depending on the type of nystagmus and compensatory mechanisms to reduce its amplitude, two groups were identified: 10 patients with pendular nystagmus and nystagmus blockage syndrome (mean age, M±sd, 5.8±1.9 years) and 10 patients with jerky nystagmus and abnormal head posture and a null zone (5.7±2.1 years). Fresnel prisms were used to select and prescribe prismatic correction. Patients were under dynamic control from 6 months to 2 years with an assessment of the results every 3 months. Results. During treatment (using prism correction), uncorrected visual acuity had a statistically significant increase of 1.8 and 1.5 times both in the first (p=0.004) and the second (p=0.001) group, respectively. A similar, and even more pronounced, change in visual acuity was observed for corrected visual acuity – in the first group it increased 3 times (p=0.001) and in the second group 2.2 times (p=0.001). Conclusion. Prismatic correction in pendular nystagmus and esotropia allows to simulate (eliminate) nystagmus blockage syndrome and, thereby, to improve the quality of vision of the patient. In its turn, prismatic correction in jerky nystagmus with abnormal head posture allows to move null zone into the primary position of gaze, increase visual acuity due to the optimal optical correction and improve the patient's quality of life. Key words: nystagmus blockage syndrome, convergence fusion, abnormal head posture, null zone, Fresnel prisms

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 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 The Diagnosis and Treatment of Infantile Nystagmus Syndrome (INS)

2006 ◽  
Vol 6 ◽  
pp. 1385-1397 ◽  
Author(s):  
Sangeeta Khanna ◽  
Louis F. Dell'Osso
Keyword(s):  
Visual Acuity ◽  
Standard Of Care ◽  
Ocular Motility ◽  
Primary Position ◽  
Infantile Nystagmus Syndrome ◽  
Infantile Nystagmus ◽  
Visual Acuity Loss ◽  
Post Therapy

The successful treatment of infantile nystagmus syndrome (INS) depends primarily on accurate and repeatable diagnosis of the type(s) of nystagmus present as well as their variation with gaze and convergence angles or fixating eye. Research over the past 40 years has demonstrated that the only way to achieve both is by making and analyzing ocular motility recordings. Determination of the direct effects of peripheral and central INS therapies can only be made by pre- and post-therapy comparisons of the nystagmus characteristics, specifically of the quality of the foveation periods within each cycle. If one is only interested in cosmetic improvements, diminution of the nystagmus amplitude is all that need be measured. However, if improvement of visual function is the primary goal of therapy, then measurement of the pre- and post-therapy foveation quality must be made, both in primary position and over a broad range of gaze angles. The use of the eXpanded Nystagmus Acuity Function (NAFX) on nystagmus data yields both an accurate measure of foveation quality and a prediction of maximum potential acuity for the patient's waveform. When used with the patient's measured, pre-therapy visual acuity, the NAFX demonstrates the amount of visual acuity loss that is due to sensory abnormalities, demonstrates the amount due to the nystagmus waveform, and estimates the measured post-therapy acuity for all values of improved NAFX and gaze angles measured. The ability to predict visual acuity improvement was not possible before the use of the NAFX. The failure to incorporate accurate measures of nystagmus waveform and foveation quality into their diagnostic evaluation continues to deprive patients of the best possible standard of care and results in mistaken diagnoses as well as inappropriate and, in some cases, unneeded multiple surgeries.

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.

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 ◽  
Laser In Situ Keratomileusis ◽  
Modulation Transfer ◽  
Guided Mode ◽  
Surgical Methods ◽  
Uncorrected Visual Acuity

Abstract Background The individualized ablation is not only able to correct corneal low-order aberrations but also improve the corneal high-order aberrations in corneal asymmetry patients. In this study, we compared the effect of patients with mid-to-high astigmatism asymmetric corneas (1-4D) after three different surgical methods: Selective coma guidance femtosecond Laser in-situ keratomileusis (CWFG-FS-LASIK),Aberration-Free femtosecond Laser in-situ keratomileusis (AF-FS-LASIK) and Small incision lenticule (SMILE).Methods One hundred and fourteen eyes from 58 patients were enrolled in the 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) at preoperation and postoperation after three months.Results Visual acuity of patients in three groups was increased after surgeries, but the improvements of visual acuity and residual astigmatism among them were no significant differences. However, the improvements of 4mm and 6mm total coma, Z3-1 and Z31 in CWFG-FS-LASIK were superior than in AF-FS-LASIK and SMILE. Consistent with this, the improvements of MTF and PSF (3mm and 5mm) in CWFG-FS-LASIK were better than in AF-FS-LASIK and SMILE.Conclusions In surgeries for treating patients with mid-to-high astigmatism in asymmetric corneas, the selective coma-guided mode was able to decrease the coma of original cornea, improve visual acuity and optimize the visual quality of patients.

Outcomes of symmetric bilateral medial rectus recession in large-angle esotropic Duane syndrome

2020 ◽  
pp. 112067212096873
Author(s):  
Reza Nabie ◽  
Vahideh Manouchehri ◽  
Beheshteh Azad
Keyword(s):  
Large Angle ◽  
Medial Rectus ◽  
Successful Outcome ◽  
Primary Position ◽  
Head Posture ◽  
Duane Syndrome ◽  
Abnormal Head ◽  
Medical Reports ◽  
The Mean

Purpose: To evaluate the efficacy of symmetric bilateral medial rectus recession in large-angle esotropic Duane retraction syndrome (DRS) with moderate to severe globe retraction. Methods: In a retrospective study, medical reports of 30 patients with esotropia of equal or more than 20 prism diopters (pd) and moderate to serve globe retraction due to unilateral DRS who underwent symmetric bilateral medial rectus recession were reviewed. Age, gender, laterality, amblyopia, length of follow-up, pre- and postoperative measurements of primary position deviation, ocular ductions and severity of globe retraction and abnormal head posture were evaluated. A successful result was defined as decreasing esotropia to equal or less than 8 pd or equal or less than 8 pd of consecutive exotropia. Results: The mean age of patients at surgery was 13.7 ± 8.5 years old (range: 3–38). The mean preoperative esotropia measured 28.9 ± 9.1 pd in distance and 25.7 ± 7.2 pd in near, which decreased to 4.9 ± 6.1 pd in distance and 3.9 ± 8.8 pd in near postoperatively. The mean bilateral medial rectus recession was 4.9 ± 0.9 mm (range: 3–6 mm). The mean abnormal head posture improved from 19.1 ± 6.9 degrees (range: 10–30 degrees) to 3.3 ± 4.7 degrees (range: 0-15 degrees) postoperatively. At the last follow-up visit, 23 patients (76.7%) had a successful outcome. Conclusions: In the large-angle esotropic DRS patients with moderate to severe globe retraction, symmetric bilateral medial rectus recession, can be conducted to successfully resolve primary position deviation and abnormal head posture.

scholarly journals Surgical treatment of a patient with congenital nystagmus with compensatory head posture: A case report

2020 ◽  
Vol 89 (9-10) ◽  
pp. 515-520
Author(s):  
Alma Kurent ◽  
Dragica Kosec
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Rectus Muscle ◽  
Congenital Nystagmus ◽  
Head Turn ◽  
Primary Position ◽  
Head Posture ◽  
Straight Position ◽  
Lateral Rectus Muscle ◽  
The Right

The correction of compensatory head posture in a congenital nystagmus involves surgical treatment that includes recession and resection of extraocular muscles to move the eccentric null zone to a primary position. A 39-year-old patient presented with an impaired visual acuity and nystagmus that was present since childhood. She had a left head turn with permanent neck pain. At the examination, best corrected visual acuity was 0.4 in both eyes with her glasses. Correction in the right eye was -6.50-1.50/180° and in the left eye -5.50-2.50/180°. Measured objective and subjective angles of squint were +4°, fusion from -3° to +29°, with the presence of stereo vision. During the cover test the nystagmus was present and it enhanced while covering the eye. Ocular motility was not limited. Fundus examination revealed myopic changes in both eyes. Prisms were prescribed, which were well tolerated by the patient. Also, no apparent head turn was noticed while wearing the prisms. Nine months later, the patient underwent a Kestenbaum procedure. Retroposition of the lateral rectus muscle with resection of the medial rectus muscle in the right eye and retroposition of the medial rectus muscle with resection of the lateral rectus muscle in the left eye were performed. After the procedure nystagmus dampened the most in the minimal left position, the head was in a straight position. Two years after the procedure nystagmus dampened the most in the primary position, the head was in a straight position. Nine years after surgery and refractive correction with contact lenses, the visual acuity was 0.8-0.9p in both eyes. The presented case showed that adequate functional and surgical treatment led to a good morphological outcome with improved visual acuity in a patient with congenital nystagmus and a compensatory head posture even in adulthood.

scholarly journals Bilateral lateral rectus recession in exotropic Duane syndrome with downshoot

2016 ◽  
Vol 8 (1) ◽  
pp. 74-77 ◽  
Author(s):  
Chandra Maya Gurung ◽  
Suma Ganesh ◽  
Pawan Shrestha
Keyword(s):  
Lateral Rectus ◽  
Palpebral Fissure ◽  
Primary Position ◽  
Head Posture ◽  
Duane Syndrome ◽  
Retraction Syndrome ◽  
Abnormal Head ◽  
Ocular Deviation ◽  
Duane Retraction Syndrome

Objective: To report that maximum weakening of lateral rectus muscles can improve significant exotropia in primary position, abnormal head posture, retraction, narrowing of palpebral fissure and downshoot in exotropic duannes retraction syndrome. Case: A 12-year-old boy with exotropic Duane syndrome presented with downshoot and globe retraction in attempted adduction. Squint surgery was undertaken to correct the alignment and treat the secondary aberrant movements doing maximum weakening of the lateral rectus muscles by hang- back method. At 6 months follow up visit, there was improvement in abnormal head posture, reduction of ocular deviation with downshoot and stereoacuity. Conclusion: Supramaximal recession of lateral rectus muscles can correct exotropia with down shoot in a patient with Duane retraction syndrome. Nepal J Ophthalmol 2016; 8(15): 74-77

scholarly journals Refractive and Quality of Vision Outcomes with Toric IOL Implantation in Low Astigmatism

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Eduardo Scaldini Buscacio ◽  
Lia Florim Patrão ◽  
Haroldo Vieira de Moraes
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Correlation Coefficients ◽  
Life Questionnaire ◽  
Toric Iol ◽  
Iol Implantation ◽  
Quality Of Vision ◽  
Uncorrected Visual Acuity ◽  
Before And After

Purpose. To evaluate the refractive and the quality of vision outcomes of toric IOL implantation in patients with low astigmatism. Design. Prospective study of single-arm. Methods. Patients with corneal astigmatism range from 0,75 D to 1,5 D and cataract that underwent cataract surgery with toric IOL. The measurements were performed preoperatively and 6 weeks after the surgery. Patients were evaluated for visual acuity with and without correction, contrast sensitivity, static and dynamic refraction, and quality of life questionnaire. Pre- and postoperative values were compared and their variations were evaluated for linear correlation. Results. 21 eyes of 21 patients. Postoperative mean uncorrected visual acuity was 0.80±0.19, and the best corrected visual acuity was 0.97±0.15. p<0.001 compared to preoperative values. The average postoperative refractive cylinder was -0.34±0.39. The questionnaire’s total value before and after surgery was, respectively, 43.20±15.76 and 79.70±10.11 (p<0.001). The correlation coefficients between the values of the questionnaire variation and the UCVA, BCVA, and CS variation were, respectively, 0.548 (p=0.005), 0.508 (p=0.009), and 0.409 (p=0.033). Conclusion. Patients with low astigmatism who underwent phacoemulsification with toric IOL implantation experienced significant decrease in refractive astigmatism and improvement in their quality of life.

scholarly journals Long Term Assessment of the Quality of Visual-related Daily Activities after ICL (V4C) Implantation for Myopia and Myopic Astigmatism

2018 ◽  
Author(s):  
Shaorong Linghu ◽  
Taixiang Liu ◽  
Yilu Liao ◽  
Rong Shi ◽  
Le Pan
Keyword(s):  
Visual Acuity ◽  
Daily Activities ◽  
Safety And Efficacy ◽  
Uncorrected Visual Acuity ◽  
Post Operation ◽  
Icl V4c ◽  
Myopic Astigmatism

Abstract Background: The purpose of the study was to evaluate long-term quality of visual related daily activities after Central Hole Collamer Lens implantation to treat myopia and myopic astigmatism. Methods: This retrospective study included 46 eyes (23 patients) receiving an ICL-V4c implantation. The follow up time was at least 24 m. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refraction, eye axis, intraocular pressure, endothelial cell density (ECD), vault, and the patients’ satisfaction related to vision related daily activities were recorded at 6 m and 24 m. Results: The mean spherical equivalents were -0.14 ± 0.21 D and -0.12 ± 0.33 D at 6 m and 24 m after surgery, respectively. UCVA of all eyes were equal to or better than preoperative BCVA. The BCVA at 6 m and 24 m after implantation were -0.03 ± 0.08 LogMAR, and −0.03 ± 0.11 LogMAR, respectively, which was statistically better (P = 0.031) than that of pre-operation value of 0.07 ± 0.12 LogMAR. There was no significant differences (P > 0.05) between the pre operation and post operation ECD.At 24 m post operation, 10% of the patients complained of difficulty driving at night, but most of patient had satisfactory or very satisfactory vision-related daily activity scores. Some patients, 13%, were worried about the long-term safety and efficacy of the V4c-ICL implantation. Conclusions: Patients were very satisfied with their vision related daily activities after V4c-ICL implantation. With time, some patients worried about the permanent safety and efficacy.

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