Trans-PRK: Compromise?

2021 ◽  
pp. 148-151
Author(s):  
A.I. Miagkikh ◽  
Keyword(s):  
Visual Acuity ◽  
Key Words ◽  
High Myopia ◽  
Visual Analyzer ◽  
The Brain

Purpose. A statement of the fact of the presence of abnormally high visual acuity after the first stage of Trans-PRK and a proposal to use this information when planning laser correction of high and ultra-high myopia. Material and methods. Eyes were selected after the first stage of Trans-PRK (581 eyes), in which the postoperative myopic sphere equivalent was at least 2 diopters. Visual acuity was compared with non-operated eyes with a similar myopic sphere equivalent. Results. The revealed effect is that patients with high residual myopic refraction after the first stage of Trans-PRK have significantly higher visual acuity than non-operated people with similar refraction. Postoperative keratotopograms do not give grounds for understanding this effect. Conclusion. The explanation can be the forced work of the visual analyzer of the brain. With this in mind, it is possible to achieve and widely use a compromise between the desired and possible result in the practice of laser correction of myopia. Key words: myopia correction, first-stage, Trans-PRK, residual myopia, sphere equivalent, sight acuity, keratotopogram, visual analyzer of the brain, Ambliocor.

scholarly journals Comparison of the visual performance of iris-fixated phakic lens and implantable collamer lens to correct high myopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiao-ling Jiao ◽  
Jun Li ◽  
Zhe Yu ◽  
Ping-hui Wei ◽  
Hui Song
Keyword(s):  
Visual Acuity ◽  
High Myopia ◽  
Optical Quality ◽  
Visual Performance ◽  
Quality Analysis ◽  
Modulation Transfer ◽  
Implantable Collamer Lens ◽  
Good Visual Acuity ◽  
Significant Difference ◽  
Group 6

Abstract Background To compare visual performance between the iris-fixated phakic intraocular len (pIOL) and implantable collamer len (ICL) to correct high myopia. Methods Twenty-four eyes underwent iris-fixated pIOL implantation and 24 eyes underwent ICL implantation. At the 6-month follow-up, the best-corrected visual acuity (BCVA) and uncorrected distance visual acuity (UDVA) were compared between the iris-fixated pIOL and ICL groups. The objective scatter index (OSI), modulation transfer function (MTF) cutoff, and ocular aberrations were performed to evaluate postoperative visual quality between the two groups. Results No significant difference was found in UDVA, BCVA, and spherical equivalent between the iris-fixated pIOL and ICL groups (P > 0.05). Six months after surgery, the following values were significantly higher in the ICL group than in the iris-fixated pIOL group: MTF cutoff, strehl ratio and optical quality analysis system values at contrasts of 9 %, 20 %, and 100 % (P < 0.01). The OSI in the iris-fixated pIOL group was higher than in the ICL group 6 months after surgery (P < 0.01). All high-order aberrations were slightly more severe in the iris-fixated pIOL group than in the ICL group 6 months after surgery, although only trefoil (P = 0.023) differed significantly in this regard. Conclusions Both iris-fixated lenses and ICLs can provide good visual acuity. ICLs confer better visual performance in MTF-associated parameters and induce less intraocular light scattering than iris-fixated pIOLs.

scholarly journals Incidence, Risk, and Visual Outcomes after Repositioning of Acute Non-Traumatic Flap Dislocations Following Femtosecond-Assisted LASIK

2021 ◽  
Vol 10 (11) ◽  
pp. 2478
Author(s):  
Majid Moshirfar ◽  
David G. West ◽  
Chase M Miller ◽  
William B. West ◽  
Shannon E. McCabe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Visual Acuity ◽  
High Myopia ◽  
Case Series ◽  
Retrospective Case ◽  
Visual Outcomes ◽  
Uncorrected Distance Visual Acuity ◽  
Incidence Risk ◽  
Mechanical Devices

Although the use of femtosecond lasers instead of mechanical devices has decreased the incidence of flap complications following laser-assisted in situ keratomileusis (LASIK), dislocations and striae still occur. Flap repositioning is an effective intervention to improve visual outcomes after acute flap complications in both microkeratome-assisted and femtosecond-assisted LASIK. This retrospective case series included patients undergoing flap repositioning secondary to acute flap dislocation and/or visually significant striae within the first two weeks following femtosecond LASIK (FS-LASIK) from 2015 to 2020 at a single institution. Preoperative, intraoperative, and postoperative de-identified data were analyzed for incidence, risk factors, and visual acuity outcomes. The incidence of flap repositioning was 0.35% in 21,536 eyes (n = 70). Indications for repositioning included acute flap dislocation (35.7%) and visually significant striae (64.3%). High myopia (OR = 3.04, p = 0.001) and patient age over 50 years (OR = 3.69, p = 0.001) were the strongest risk factors for these complications. Prior to flap repositioning, uncorrected distance visual acuity (UDVA) of 20/20 or better and 20/40 or better occurred in 19% and 57% of eyes, respectively. After repositioning, a final UDVA of 20/20 or better and 20/40 or better occurred in 78% and 98% of eyes, respectively. After repositioning, one line of UDVA was lost in two eyes (2.8%) and two lines were lost in one eye (1.4%). Risk factors for acute flap dislocation included high myopia and age over 50 years. Flap repositioning was effective in salvaging visual outcomes.

scholarly journals Matched comparison of corneal higher order aberrations induced by SMILE to femtosecond assisted LASIK and to PRK in correcting moderate and high myopia: 3.00mm vs. 6.00mm

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammad Miraftab ◽  
Hassan Hashemi ◽  
Mohammadreza Aghamirsalim ◽  
Shiva Fayyaz ◽  
Soheila Asgari
Keyword(s):  
Visual Acuity ◽  
High Myopia ◽  
Spherical Aberration ◽  
Corneal Thickness ◽  
Higher Order ◽  
Laser In Situ Keratomileusis ◽  
Higher Order Aberrations ◽  
Surgical Methods ◽  
Matched Comparison ◽  
Surgical Group

Abstract Background The refractive surgeries induce corneal higher order aberrations (C-HOAs). In this study, change of C-HOAs after small-incision lenticule extraction (SMILE) compared to femtosecond assisted laser in situ keratomileusis (femto-LASIK), and to photorefractive keratectomy with mitomycin-C (PRK) under photopic and mesopic conditions. Methods In this prospective study, age, gender, and apical corneal thickness (ACT) matched cases with moderate myopia [spherical equivalent (SE) 3.00 to 6.00D) to high myopia (SE > 6.00D)] were enrolled. In addition to visual acuity and refraction, total C-HOA, coma, spherical aberration (SA), and trefoil in the 3- and 6-mm zones were measured before and 3 and 6 months after surgery. Results Overall, 372 moderate myopia cases (124 eyes of 124 individuals in each surgical group) and 171 high myopia cases (57 eyes of 57 individuals in each surgical group) were enrolled. At baseline, the differences in age, gender, ACT, uncorrected and corrected visual acuity, and SE were not statistically significant between subgroups of surgical methods within each myopia group (all P > 0.05). At 12 months, in the moderate myopia group, there was less increase in 6-mm zone total C-HOA, coma, and SA with SMILE compared to the other groups (all P < 0.05). In the high myopia group, there was greater increase in photopic total C-HOA and trefoil and less increase in mesopic SA with SMILE (all P < 0.05). Conclusions In correction of moderate myopia, SMILE has better results in mesopic condition. In high myopia correction, femto-LASIK and PRK have better results in photopic and SMILE in mesopic condition.

Choroidal metastases: case report and review

2020 ◽  
pp. 1-7
Author(s):  
Victor Duque ◽  
Carolina de la Pinta ◽  
Ciriaco Corral ◽  
Carmen Vallejo ◽  
Margarita Martin ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Side Effects ◽  
External Beam Radiotherapy ◽  
Choroidal Metastasis ◽  
Good Visual Acuity ◽  
Good Local Control ◽  
Radiological Response ◽  
The Right ◽  
The Brain

Abstract Introduction: Choroidal metastases are the most frequent intraocular secondary tumours, with a prevalence of 2–7% according to the literature. Our aim was to review a clinical case of choroidal metastasis. We present a case of a 63-year-old male patient diagnosed in 2018 with lung adenocarcinoma cT4N0M1. The patient had three metastases in the brain, which were successfully treated with radiosurgery (RS). The patient was treated with chemotherapy with pemetrexed–cisplatin schedule. Five months after diagnosis, the patient presented with decreased vision in the right eye. After ophthalmologic evaluation, he was diagnosed with a right choroidal metastasis, which was treated with external beam radiotherapy with 20 Gy in five fractions, resulting in improved visual acuity and a complete clinical and radiological response. The patient took part in a clinical trial that continued with systemic chemotherapy. Twenty-two months after radiotherapy to the eye, the patient has good visual acuity without any side effects. Conclusions: Choroidal metastasis treated with radiotherapy achieves good local control, with limited side effects, allowing an improvement in visual acuity and consequently, an improvement in the patient´s quality of life.

scholarly journals Observational study of clinical characteristics of dome-shaped macula in Chinese Han with high myopia at Zhongshan Ophthalmic Centre

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e021887 ◽  
Author(s):  
Xiujuan Zhao ◽  
Xiaoyan Ding ◽  
Cancan Lyu ◽  
Shiyi Li ◽  
Yu Lian ◽  
...  
Keyword(s):  
Visual Acuity ◽  
High Myopia ◽  
Choroidal Thickness ◽  
Clinical Characteristics ◽  
Serous Retinal Detachment ◽  
Protective Mechanism ◽  
Chinese Han ◽  
Corrected Visual Acuity ◽  
Myopic Maculopathy ◽  
Best Corrected Visual Acuity

PurposeTo evaluate the prevalence of dome-shaped macula (DSM) in highly myopic eyes among Chinese Han and to detect the correlation with myopic maculopathy and macular complications.MethodsA total of 736 Chinese Han patients (1384 eyes) with high myopia (refractive error≤6.0 diopters or axial length ≥26.5 mm) are reviewed based on information entered into a high-myopia database at Zhongshan Ophthalmic Centre. Subfoveal choroidal thickness (SFCT) and parafoveal choroidal thickness (PFCT) are measured. The prevalence of DSM in patients with myopic maculopathy is categorised from C0 to C4. Clinical features, including macular complications, SFCT and PFCT, are compared between myopic eyes with and without DSM.ResultsAmong the 1384 eyes, 149 (10.77%) show DSM. In highly myopic eyes without macular complications, the best corrected visual acuity is significantly worse in patients with DSM (p=0.002), and the ratio between subfoveal and parafoveal choroidal thickness (S/PCT) is significantly elevated in patients with DSM (p=0.021). The proportion of foveal schisis (17.24% vs 62.86%) is much lower in eyes with DSM compared with those without DSM. However, the proportions of extrafoveal schisis (39.66% vs 5.37%), foveal serous retinal detachment (SRD) (5.17% vs 0) and epiretinal membrane (ERM) (24.14% vs 10.74%) are much higher in eyes with DSM. The proportion of DSM was lower in C0 and C1, but higher proportion of DSM was found in C3 and C4.ConclusionsDSM is found in 10.77% of highly myopic eyes among Chinese Han. DSM might be a protective mechanism for foveal schisis and a risk factor for extrafoveal schisis, SRD and ERM.

scholarly journals A New Sutureless Illuminated Macular Buckle Designed for Myopic Macular Hole Retinal Detachment

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Ahmed M. Bedda ◽  
Ahmed M. Abdel Hadi ◽  
Mohamed Lolah ◽  
Muhammad S. Abd Al Shafy
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Macular Hole ◽  
High Myopia ◽  
Terminal Part ◽  
Macular Hole Retinal Detachment ◽  
Myopic Macular Hole ◽  
The Mean ◽  
Visual Results

Purpose. To report the anatomic and visual results of a new sutureless illuminated macular buckle designed for patients with macular hole retinal detachment related to high myopia (MMHRD). Design. Prospective nonrandomized comparative interventional trial. Methods. Twenty myopic eyes of 20 patients (mean age, 51.4 years; range, 35–65 years) presenting with MMHRD with a posterior staphyloma, in whom the new buckle was used, were evaluated. The buckle used was assembled from a 5 mm wide sponge and a 7 mm wide silicone tire; it was fixed utilizing the sterile topical adhesive Histoacryl Blue (B Braun, TS1050044FP) which polymerizes in seconds upon being exposed to water-containing substances. The primary outcomes measured included aided visual acuity (BCVA) and optical coherence tomography (OCT) findings. The mean follow-up period was 6 months. Results. Postoperatively, the MH closure was identified by OCT in 8 (40%) eyes. The mean BCVA increased from 0.11 to 0.21 (p<0.005). The axial length of the eyes included decreased from 30.5 mm preoperatively to 29.8 mm (p=0.002) postoperatively. Conclusion. Preparation of the new sutureless macular buckle is simple and easy. Illumination of the terminal part of the buckle ensures proper placement. Histoacryl Blue is effective in fixing the buckle in its place for at least 6 months with no reported intra- or postoperative complications.

scholarly journals Neuroplasticity in visual impairments

2018 ◽  
Vol 10 (4) ◽  
Author(s):  
Paulo Ramiler Silva ◽  
Tiago Farias ◽  
Fernando Cascio ◽  
Levi Dos Santos ◽  
Vinícius Peixoto ◽  
...  
Keyword(s):  
Systematic Review ◽  
Visual Acuity ◽  
Visual Impairment ◽  
Visual Impairments ◽  
Cortical Reorganization ◽  
Pubmed Database ◽  
Visual Areas ◽  
Visual Acuity Loss ◽  
The Brain

The visual acuity loss enables the brain to access new pathways in the quest to overcome the visual limitation and this is wellknown as neuroplasticity which have mechanisms to cortical reorganization. In this review, we related the evidences about the neuroplasticity as well as cortical anatomical differences and functional repercussions in visual impairments. We performed a systematic review of PUBMED database, without date or status publication restrictions. The findings demonstrate that the visual impairment produce a compensatory sensorial effect, in which non-visual areas are related to both cross (visual congenital) and multimodal (late blind) neuroplasticity.

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

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
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.

scholarly journals Evaluation of changes in choroidal thickness after implantable collamer lens surgery in high myopia patients with Graves’ Ophthalmopathy (inactive phase)

2020 ◽  
Author(s):  
Fanglin He ◽  
Yan Liu ◽  
Renbing Jia ◽  
Jing zhang
Keyword(s):  
Visual Acuity ◽  
High Myopia ◽  
Choroidal Thickness ◽  
Control Group ◽  
Safety Index ◽  
Implantable Collamer Lens ◽  
Graves Ophthalmopathy ◽  
Group A ◽  
Efficacy Index ◽  
Group B

Abstract Background To evaluate the safety and effectiveness of the Visian Implantable Collamer Lens (ICL) implantation in high myopic patients with inactive Graves’ ophthalmopathy (GO) by observing the changes of choroidal thickness (CT). Methods Eight patients (16 eyes) with high myopia accompanied with inactive GO were selected as the experimental group (group A) and 18 high myopic patients (36 eyes) without GO were selected as a control group (group B). The outcomes of uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BCVA), safety index, efficacy index, intraocular pressure (IOP), vault, corneal endothelial count, and choroidal thickness (CT) were observed. The values of CT were measured using swept-source optical coherence tomography (SS-OCT) scans. Results The UCVA and BCVA in all operated eyes were better than that before surgery. The postoperative safety index and efficacy index were 1.23 and 1.19 in the group A, respectively, and 1.26 and 1.21 in the group B, respectively. In both groups, foveal CT increased significantly in high myopic patients at 2 hours and at 3 months after surgery, compared to preoperative values. The same tendencies were observed in the inner nasal and outer nasal regions. Compared with patients without GO, the increase of CT was more obvious in GO patients, 2 hours postoperatively (P = 0.006) and 3 months postoperatively (P = 0.011). Conclusions The ICL implantation is safe and effective in high myopic patients with inactive GO. Subfoveal and nasal CT may be useful parameters for monitoring the activity of GO patients.

scholarly journals Unexpected Genetic Cause in Two Female Siblings with High Myopia and Reduced Visual Acuity

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
M. N. Preising ◽  
C. Friedburg ◽  
W. Bowl ◽  
B. Lorenz
Keyword(s):  
Visual Acuity ◽  
High Myopia ◽  
Autosomal Recessive ◽  
Electrical Coupling ◽  
Splice Site Mutation ◽  
Bipolar Cells ◽  
Night Vision ◽  
Site Mutation ◽  
Frequent Finding ◽  
Biallelic Mutations

In daily life, myopia is a frequent cause of reduced visual acuity (VA) due to missing or incomplete optical correction. While the genetic cause of high myopia itself is not well understood, a significant number of cases are secondary to hereditary malfunctions or degenerations of the retina. The mechanism by which this occurs remains yet unclear. Two female siblings, 4 y and 2 y, respectively, from a consanguineous Pakistani family were referred to our department for reduced VA and strabismus. Both girls were highly myopic and hence were further examined using standard clinical tests and electroretinography (ERG). The latter confirmed confounded electrical coupling of photoreceptors and bipolar cells. Further inquiry and testing confirmed a similar condition for the father including impaired night vision, reduced VA, photophobia, and an equally characteristic ERG. Findings in the mother were unremarkable. Subsequent genetic analysis of autosomal recessive and X-linked genes for congenital stationary night blindness (CSNB) revealed a novel homozygous splice site mutation in CACNA1F in the two girls transmitted from both the father and the mother. While in males the above clinical constellation is a frequent finding, this report, to the authors’ knowledge, is the first demonstrating biallelic mutations at the CACNA1F locus in females.

Sign in / Sign up

Export Citation Format

Share Document