scholarly journals Comparative Analysis of Clinical and Functional Results and Position of Intraocular Lens after Femtolaser-Assisted and Standard Cataract Phacoemulsification

2019 ◽  
Vol 4 (4) ◽  
pp. 139-144
Author(s):  
I. L. Kulikova ◽  
N. S. Timofeyeva
Keyword(s):  
Visual Acuity ◽  
Comparative Analysis ◽  
Intraocular Lens ◽  
Functional Results ◽  
Higher Order ◽  
Significant Difference ◽  
Corrected Distance Visual Acuity ◽  
Capsular Bag ◽  
Observation Period

Modern surgical treatment of cataracts provides effective results. The study of the position of the intraocular lens (IOL) in the capsule bag can be considered as one of the most important factors influencing the final visual and refractive result of the operation.Aim: comparative analysis of clinical and functional results and position of the IOL in the capsular bag, namely decentration and tilt, when performing femtolazer-assisted phacoemulsification (FLACS) and standard phacoemulsification (CPCS). Materials and methods. We surveyed 57 patients (57 eyes). FLACS was performed in 27 patients, CPCS – in 30 patients. Standard methods of research were used, determination of the position of the IOL (decentration and tilt) in the capsular bag on the device OCT-Casia2 (TOMEY, Germany) and study of wave front were conducted.Results. Comparative analysis of the obtained results showed no significant difference between groups in postoperative visual acuity, however, there was the trend towards higher performance corrected distance visual acuity and uncorrected distance in the group FLACS (0.68 ± 0.18 and 0.74 ± 0.2) compared to the group CPCS (0.58 ± 0.28 and 0.65 ± 0.24). Internal higher order aberrations were significantly low in the group with femtolazer accompaniment: in 3 mm zone almost 2 times (p = 0.041), in 5 mm zone 1.3 times (p = 0.047). Vertical decentration in a CPCS group made 0.217 ± 0.26 mm, in FLACS group – 0.118 ± 0.05 mm, the vertical tilt – 0.75 ± 0.37° and 0.54 ± 0.36 respectively. Conclusion. Decentralizations and IOL tilt tended to lower indices in the FLACS during the observation period up to 2 months after the operation, which was accompanied by lower values of higher order internal aberrations.

scholarly journals Corneal wavefront guided versus aberration free transepithelial photorefractive keratectomy in myopic patients with high pre-existing corneal higher order aberrations

2019 ◽  
Author(s):  
Amin Faisal Ellakwa ◽  
Marwa Ali Zaki ◽  
Rana Mohammed Ashour
Keyword(s):  
Visual Acuity ◽  
Higher Order ◽  
Single Step ◽  
Photorefractive Keratectomy ◽  
Higher Order Aberrations ◽  
Distance Visual Acuity ◽  
Randomized Controlled ◽  
Uncorrected Distance Visual Acuity ◽  
Significant Difference ◽  
Corrected Distance Visual Acuity

Abstract Objectives:to compare the efficacy, safety and predictability of corneal wavefront guided (WFG) and aberration free ablation in single-step transepithelial photorefractive keratectomy (TransPRK) in myopic patients with high pre-existing corneal higher order aberrations (HOAs). Background: Corneal WFG and aberration free treatments have been proposed as methods to achieve better visual, refractive, and optical outcomes. Methods:Non-randomized controlled trialwas conducted in El-HekmaEye-LASIK center, Menoufia governorate, Egypt during the period from January 2017 to December 2017. TransPRK was performed to eligible myopic patients with or without astigmatism with corneal HOAs ≥ 0.35 µmat 6 mm diameter utilizing either optimized (aberration free) or corneal WFG patterns (SCHWIND eye-tech-solutions, Kleinostheim, Germany). Uncorrected distance visual acuity (UDVA), manifest and cycloplegic refractions, best spectacle corrected distance visual acuity (CDVA), thorough slit lamp examination and corneal topography were assessed and repeated six months postoperatively. Results: Six months postoperatively, 97.6% and 100% of patients achieved MRSE within ± 1D with 76.2% and 66.67% of patients achieved UDVA of ≥20/20 in aberration free and corneal WFG groups respectively. Both groups showed increase in spherical and total corneal HOAs, with no significant difference in corneal WFG (p=0.08, p=0.28 respectively) while significantly higher postoperatively in aberration free group (p<0.001, p=0.001 respectively). Coma and trefoil aberrations declined after corneal WFG technique, yet increased after aberration free one. Conclusions: both aberration free and corneal WFG TransPRK were safe, effective and predictable in treatment of myopia in patients with high pre-existing corneal HOAs at 6 mm diameter with better aberrometric outcomes in corneal WFG group.

scholarly journals Corneal wavefront guided versus aberration free transepithelial photorefractive keratectomy in myopic patients with high pre-existing corneal higher order aberrations

2019 ◽  
Author(s):  
Amin Faisal Ellakwa ◽  
Marwa Ali Zaki ◽  
Rana Mohammed Ashour
Keyword(s):  
Visual Acuity ◽  
Higher Order ◽  
Single Step ◽  
Photorefractive Keratectomy ◽  
Higher Order Aberrations ◽  
Distance Visual Acuity ◽  
Randomized Controlled ◽  
Uncorrected Distance Visual Acuity ◽  
Significant Difference ◽  
Corrected Distance Visual Acuity

Abstract Objectives to compare the efficacy, safety and predictability of corneal wavefront guided (WFG) and aberration free ablation in single-step transepithelial photorefractive keratectomy (TransPRK) in myopic patients with high pre-existing corneal higher order aberrations (HOAs). Background Corneal WFG and aberration free treatments have been proposed as methods to achieve better visual, refractive, and optical outcomes. Methods Non-randomized controlled trailwas conducted in El-HekmaEye-LASIK center, Menoufia governorate, Egypt during the period from January 2017 to December 2017. TransPRK was performed to eligible myopic patients with or without astigmatism with corneal HOAs ≥ 0.35 µ utilizing either aberration free or corneal WFG patterns provided by ORKCAM software (SCHWIND eye-tech-solutions, Kleinostheim, Germany). Uncorrected distance visual acuity (UDVA), manifest and cycloplegic refractions, best spectacle corrected distance visual acuity (CDVA), thorough slit lamp examination and corneal topography were assessed and repeated six months postoperatively. Results Six months postoperatively, 97.6% and 100% of patients achieved MRSE within ± 1D with 76.2% and 66.67% of patients achieved UDVA of ≥20/20 in aberration free and corneal WFG groups respectively. Both groups showed increase in spherical and total corneal HOAs, with no significant difference in corneal WFG (p=0.08, p=0.28 respectively) while significantly higher postoperatively in aberration free group (p<0.001, p=0.001 respectively). Coma and trefoil aberrations declined after corneal WFG technique, yet increased after aberration free one. Conclusions both aberration free and corneal WFG TransPRK were safe, effective and predictable in treatment of myopia in patients with high pre-existing corneal HOAs with better aberrometric outcomes in corneal WFG group.

scholarly journals Comparative Analysis of the Clinical Efficacy of Intrastromal Keratoplasty using a Digital Marking Device in Patients with Keratoconus

2020 ◽  
Vol 17 (1) ◽  
pp. 42-48
Author(s):  
A. V. Tereshchenko ◽  
I. G. Trifanenkova ◽  
E. N. Vishnyakova ◽  
S. K. Dem’yanchenko ◽  
E. А. Nikolaev
Keyword(s):  
Visual Acuity ◽  
Comparative Analysis ◽  
Clinical Efficacy ◽  
Functional Results ◽  
Main Group ◽  
Vector Analysis ◽  
Control Group ◽  
Postoperative Astigmatism ◽  
Uncorrected Visual Acuity ◽  
Observation Period

Purpose — to perform a comparative analysis of the clinical efficacy of intrastromal keratoplasty (ISKP) in patients with keratoconus during surgery with and without Verion digital marking device.Patients and methods. 37 patients (50 eyes) with corneal astigmatism up to -5.0 diopters were included in the study. These patients were operated with the femtolaser method of ISKP with implantation of corneal segments. The average age of the patients was 27.96 ± 3.40 years. The observation period is from 3 to 12 months. All patients were divided into two groups depending on the surgical technique: Verion-assisted, using a digital marking device and taking into account the angle of cyclotorsia, or standard, without taking into account the angle of cyclotorsia. The first main group included 28 eyes (56 %), the second control group included 22 eyes (44 %) accordingly.Results. The functional results after ISKP in both groups were quite good. Stabilization of functional parameters and keratometric data was noted in the postoperative period, by 3 months. Patients of the main group showed a statistically significant (p < 0.05) increase in average uncorrected visual acuity to 0.50 ± 0.16, and visual acuity with maximum correction to 0.70 ± 0.12 (p < 0.05). The average keratometry of the weak meridian decreased to 44.3 ± 1.4 diopters, the average keratometry of the strong meridian decreased to 50.8 ± 3.2 diopters. Patients in the control group showed a statistically significant (p < 0.05) increase in average uncorrected visual acuity to 0.45 ± 0.12, and visual acuity with maximum correction to 0.60 ± 0.17. The average values of keratometry of the weak meridian decreased to 45.3 ± 1.8 diopters, the average values of keratometry of the strong meridian decreased to 51.8 ± 2.2 diopters. The results of the vector analysis reliably indicate a significantly higher accuracy of the Verion-assisted ISKP. Which is confirmed by the achieved indicators of the “success” index, the calculated astigmatism vector close to the actual postoperative astigmatism vector, the smaller the magnitude of the astigmatism axis difference vector compared to the control.Conclusion. The use of the Verion-assisted intrastromal technique for keratoconus reduces the risk of erroneous positioning of the corneal segments in the tunnel during transferring diagnostic data to the operating room. Taking into account the angle of cyclotorsia during cutting into the intrastromal tunnel increases the effective correction of the cylindrical component of refraction, which is confirmed by the main coefficients of the vector analysis by N. Alpins.

scholarly journals Corneal wavefront guided versus aberration free transepithelial photorefractive keratectomy in myopic patients with high pre-existing corneal higher order aberrations

2019 ◽  
Author(s):  
Amin Faisal Ellakwa ◽  
Marwa Ali Zaki ◽  
Rana Mohammed Ashour
Keyword(s):  
Visual Acuity ◽  
Higher Order ◽  
Single Step ◽  
Photorefractive Keratectomy ◽  
Higher Order Aberrations ◽  
Distance Visual Acuity ◽  
Randomized Controlled ◽  
Uncorrected Distance Visual Acuity ◽  
Significant Difference ◽  
Corrected Distance Visual Acuity

Abstract Objectives to compare the efficacy, safety and predictability of corneal wavefront guided (WFG) and aberration free ablation in single-step transepithelial photorefractive keratectomy (TransPRK) in myopic patients with high pre-existing corneal higher order aberrations (HOAs). Background Corneal WFG and aberration free treatments have been proposed as methods to achieve better visual, refractive, and optical outcomes. Methods Non-randomized controlled trailwas conducted in El-HekmaEye-LASIK center, Menoufia governorate, Egypt during the period from January 2017 to December 2017. TransPRK was performed to eligible myopic patients with or without astigmatism with corneal HOAs ≥ 0.35 µ utilizing either aberration free or corneal WFG patterns provided by ORKCAM software (SCHWIND eye-tech-solutions, Kleinostheim, Germany). Uncorrected distance visual acuity (UDVA), manifest and cycloplegic refractions, best spectacle corrected distance visual acuity (CDVA), thorough slit lamp examination and corneal topography were assessed and repeated six months postoperatively. Results Six months postoperatively, 97.6% and 100% of patients achieved MRSE within ± 1D with 76.2% and 66.67% of patients achieved UDVA of ≥20/20 in aberration free and corneal WFG groups respectively. Both groups showed increase in spherical and total corneal HOAs, with no significant difference in corneal WFG (p=0.08, p=0.28 respectively) while significantly higher postoperatively in aberration free group (p<0.001, p=0.001 respectively). Coma and trefoil aberrations declined after corneal WFG technique, yet increased after aberration free one. Conclusions both aberration free and corneal WFG TransPRK were safe, effective and predictable in treatment of myopia in patients with high pre-existing corneal HOAs with better aberrometric outcomes in corneal WFG group.

scholarly journals Corneal wavefront guided versus aberration free transepithelial photorefractive keratectomy in myopic patients with high pre-existing corneal higher order aberrations

2019 ◽  
Author(s):  
Amin Faisal Ellakwa ◽  
Marwa Ali Zaki ◽  
Rana Mohammed Ashour
Keyword(s):  
Visual Acuity ◽  
Higher Order ◽  
Single Step ◽  
Photorefractive Keratectomy ◽  
Higher Order Aberrations ◽  
Distance Visual Acuity ◽  
Randomized Controlled ◽  
Uncorrected Distance Visual Acuity ◽  
Significant Difference ◽  
Corrected Distance Visual Acuity

Abstract Objectives to compare the efficacy, safety and predictability of corneal wavefront guided (WFG) and aberration free ablation in single-step transepithelial photorefractive keratectomy (TransPRK) in myopic patients with high pre-existing corneal higher order aberrations (HOAs). Background Corneal WFG and aberration free treatments have been proposed as methods to achieve better visual, refractive, and optical outcomes. Methods Non-randomized controlled trailwas conducted in El-HekmaEye-LASIK center, Menoufia governorate, Egypt during the period from January 2017 to December 2017. TransPRK was performed to eligible myopic patients with or without astigmatism with corneal HOAs ≥ 0.35 µ utilizing either aberration free or corneal WFG patterns provided by ORKCAM software (SCHWIND eye-tech-solutions, Kleinostheim, Germany). Uncorrected distance visual acuity (UDVA), manifest and cycloplegic refractions, best spectacle corrected distance visual acuity (CDVA), thorough slit lamp examination and corneal topography were assessed and repeated six months postoperatively. Results Six months postoperatively, 97.6% and 100% of patients achieved MRSE within ± 1D with 76.2% and 66.67% of patients achieved UDVA of ≥20/20 in aberration free and corneal WFG groups respectively. Both groups showed increase in spherical and total corneal HOAs, with no significant difference in corneal WFG (p=0.08, p=0.28 respectively) while significantly higher postoperatively in aberration free group (p<0.001, p=0.001 respectively). Coma and trefoil aberrations declined after corneal WFG technique, yet increased after aberration free one. Conclusions both aberration free and corneal WFG TransPRK were safe, effective and predictable in treatment of myopia in patients with high pre-existing corneal HOAs with better aberrometric outcomes in corneal WFG group.

scholarly journals Comparisons of Visual and Surgical Outcomes after Reuse or Replacement of Dislocated in-the-Bag Intraocular Lens

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Takayuki Baba ◽  
Tomohiro Nizawa ◽  
Toshiyuki Oshitari ◽  
Shuichi Yamamoto
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Intraocular Lens ◽  
Refractive Error ◽  
Surgical Outcomes ◽  
Case Series ◽  
Cell Loss ◽  
Significant Difference ◽  
Group A ◽  
Group B

Purpose. To compare the visual and surgical outcomes after a reuse or a replacement of a dislocated in-the-bag intraocular lens (IOL). Methods. This was a retrospective, nonrandomized case series at a single ophthalmological institution. Cases with an in-the-bag dislocation of an IOL were treated by pars plana vitrectomy and the reuse or the replacement of the IOL. The lens was held by intrascleral fixation of the haptics of the IOL under both conditions. The same dislocated IOL was reused in 6 eyes (group A) or it was replaced with another IOL in the other 9 eyes (group B). The pre- and postoperative parameters analyzed included the visual acuity, refractive error, corneal endothelial cell density, and intraocular pressure (IOP). Results. There was no significant difference between the two groups in the postoperative visual acuity (P=0.388), refractive error (P=0.955), IOP (P=0.529), and endothelial cell loss (P=0.940). A breakage or a tilting of the IOL was observed and required replacement in three eyes in the reuse group (P=0.044). Conclusions. Half of the cases with reused in-the-bag dislocated IOL had a breakage or a tilting of the IOL. The replacement of the in-the-bag dislocated IOL is better than the reuse of the IOL with intrascleral haptics fixation.

scholarly journals Effect of Cap-Lenticule Diameter Difference on the Visual Outcome and Higher-Order Aberrations in SMILE: 0.4 mm versus 1.0 mm

2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
Banu Torun Acar ◽  
Suphi Acar
Keyword(s):  
Visual Acuity ◽  
Visual Outcome ◽  
Higher Order ◽  
Early Postoperative Period ◽  
Higher Order Aberrations ◽  
Corrected Distance Visual Acuity ◽  
Lenticule Extraction ◽  
Group 2 ◽  
Group 1

Purpose. To evaluate the effect of cap-lenticule diameter difference (CLDD) on the visual outcome and higher-order aberrations (HOAs) of small-incision lenticule extraction (SMILE). Methods. A total of 132 patients who had bilateral SMILE for myopia or myopic astigmatism were included. The CLDD was 0.4 mm in 54 patients (group 1) and 1.0 mm in 78 patients (group 2). The refractive parameters, uncorrected (UDVA) and corrected distance visual acuity (CDVA), and HOAs were determined preoperatively and during six months follow-up. Results. Group 1 had better CDVA (in logMAR) compared to group 2 at day 1 (−0.07 ± 0.07 versus 0.04 ± 0.07, resp.; p<0.001) and week 1 (−0.07 ± 0.07 versus –0.04 ± 0.07, resp.; p=0.001). The visual acuity improved more in group 1 than in group 2. The UDVA (in logMAR) was 0.07 ± 0.07 and 0.29 ± 0.09 at day 1 (p<0.001) and −0.08 ± 0.07 and −0.06 ± 0.06 at six months (p=0.038) in group 1 and group 2, respectively. Group 1 was associated with significantly less induction of HOAs (0.24 ± 0.08 μm and 0.32 ± 0.26 μm, resp.; p=0.002). Conclusions. In SMILE, 0.4 mm CLDD is associated with better visual outcome and less induction of HOAs than 1.0 mm. Narrow CLDD should be considered in SMILE to increase the visual acuity particularly in the early postoperative period.

Comparative Analysis of a New Hybrid EDOF-Multifocal Diffractive Intraocular Lens with a Trifocal Diffractive Intraocular Lens

2021 ◽  
pp. 112067212110676
Author(s):  
Cem Ozturkmen ◽  
Cem Kesim ◽  
Pinar Gunel Karadeniz ◽  
Afsun Sahin
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Visual Quality ◽  
Visual Performance ◽  
Significant Difference ◽  
Defocus Curve ◽  
Visual Quality Of Life ◽  
Cataract Patients ◽  
Diffractive Iol

Purpose To compare visual acuity, defocus curve and visual quality of life performances of a new hybrid refractive-diffractive intraocular lens (IOL) and a trifocal diffractive IOL. Methods Patients who underwent cataract surgery with bilateral implantation of ZFR00V or TFNT00 IOLs were enrolled in this study. The main outcomes were defined as uncorrected distant, intermediate and near visual acuities (UDVA, UIVA and UNVA, respectively), defocus curve and VF-14 questionnaire aimed for visual performance. Results Fifty patients, of whom 30 had bilateral ZFR00V implantation, were enrolled in the study. Patients with ZFR00V had significantly better UIVA than patients with TFNT00 (0.05 ± 0.03 vs. 0.07 ± 0.04 logMAR, P = 0.02). Defocus curve showed significantly higher visual acuity in intermediate range for ZFR00V IOL between −1.00 and −1.50 dioptres (all P < 0.05). All patients had good visual performance with mean VF-14 scores above 3 points with no significant difference between two IOL models. Spectacle independence was 100% for both distant and near vision in both group of patients. Conclusion Bilateral implantation of ZFR00V in cataract patients shows better intermediate visual acuity scores and similar daily visual performance when compared with trifocal TFNT00 IOL.

Relationship between Higher Order Aberrations and Astigmatism in Hyperopic Amblyopia

The Eye ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. 27-32
Author(s):  
Sh. A. Mukhanov
Keyword(s):  
Visual Acuity ◽  
Treatment Success ◽  
Higher Order ◽  
The Other ◽  
Complex Treatment ◽  
Higher Order Aberrations ◽  
Significant Difference ◽  
The Relationship ◽  
Decrease In Visual Acuity

Aim. To study the dynamics of changes in the values of higher order aberrations in amblyopia treatment and the correlation between higher-order aberrations and astigmatism in patients with hyperopic amblyopia.Methods. This cohort prospective study included 36 patients (36 eyes) with refractive amblyopia aged 4 to 16 years. All patients had anisometropia: emmetropia in one eye and hyperopic astigmatism combined with refractive amblyopia of varying degrees in the other eye. Patients were divided into two groups depending on the degree of astigmatism. Astigmatism greater than 1.5 D was detected in 20 patients (55.5%) and astigmatism less than 1.5 D was detected in 16 patients (44.5%). All patients underwent a complex treatment, including twenty half-hour sessions of videocomputer autotraining using “Amblyotron” device during 20 days, in addition to constant wearing of glasses. Higher order aberrations were measured using the WaveScan Wavefront System aberrometer at the first visit and at 3-, 6 - and 12-month follow-up. A correlation analysis was performed to assess the relationship between higher order aberrations and astigmatism.Results. There was a statistically significant difference in treatment success between groups with high and low astigmatism. In both groups, higher order aberrations were reduced during the treatment of amblyopia. When comparing the two groups, a significant difference in coma was found at 12-month follow-up (p = 0.043). At 12-month follow-up, coma showed a statistically significant correlation with astigmatism, and a stronger correlation with astigmatism was found in the group of patients with high astigmatism.Conclusions. In patients with refractive amblyopia associated with astigmatism, the decrease in visual acuity is directly dependent on the values of higher-order aberrations, especially on the values of coma, which should be considered as the cause of the development of amblyopia.

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