scholarly journals Prophylactic corneal cross-linking in LASIK surgery: effects on visual outcome and recovery time

2020 ◽  
Vol 17 (1) ◽  
pp. 61-68
Author(s):  
Dominique Clare Oh ◽  
Yiong Huak Chan ◽  
Sao Bing Lee ◽  
Jovina Li Shuen See
Keyword(s):  
Visual Acuity ◽  
Side Effects ◽  
Recovery Time ◽  
Visual Outcome ◽  
Cross Linking ◽  
Safe Procedure ◽  
Distance Visual Acuity ◽  
Visual Outcomes ◽  
Group A ◽  
Group B

Introduction: Collagen cross-linking is a useful adjunct in preventing corneal ectasia after laser-assisted in situ keratomileusis (LASIK). This study aimed to evaluate whether prophylactic cross-linking in IntraLase LASIK affects optimum visual outcome and recovery time in the immediate post-surgery period and is associated with any side effects. Methods: This was a retrospective case study on the right eyes of 100 Chinese subjects aged 18 to 40 years who underwent IntraLase LASIK. Fifty subjects who underwentcross-linking after completing LASIK (Group A) were compared with 50 subjects who did not undergo LASIK (Group B). Cases were evaluated for pre- and post-operative spherical equivalent, uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), recovery time and presence of side effects. Results: At 1 week post-LASIK, mean (SD) UDVA of Group A subjects was poorer than Group B, at 1.05 (0.19) vs 1.17 (0.19) (p = 0.036); however, there was no significant difference in CDVA (p = 0.095). By 1 month post-LASIK, differences in both UDVA and CDVA were insignificant (p = 0.055, 0.106, respectively). Mean recovery time was 2.72 (95% confidence interval [CI] = 0.64-4.7) days longer in Group A (p = 0.010), although by 1 month post-LASIK, both groups were able to achieve CDVA equal to or better than that achieved pre-LASIK. Incidence of mild inflammation and dry eyes post-LASIK was similar in both groups (p = 1.00, 0.749, respectively); no other complications were observed. Conclusion: No differences in visual outcomes at and occurrence of side effects at 1 month post-LASIK were observed between subjects who underwent cross-linking prior to refractive surgery and those who did not. However, the group that underwent cross-linking had a slightly longer mean recovery time. Our study supports prophylactic cross-linking as a safe procedure that does not affect immediate visual outcomes among the Chinese population when used in adjunct with LASIK surgery.

scholarly journals Comparison of Refractive and Visual Outcomes after Transepithelial Photorefractive Keratectomy (TransPRK) in Low versus Moderate Myopia

Photonics ◽  
2021 ◽  
Vol 8 (7) ◽  
pp. 262
Author(s):  
Diego de Ortueta ◽  
Dennis von Rüden ◽  
Samuel Arba-Mosquera
Keyword(s):  
Visual Acuity ◽  
Group Versus ◽  
Photorefractive Keratectomy ◽  
Distance Visual Acuity ◽  
Visual Outcomes ◽  
Uncorrected Distance Visual Acuity ◽  
Epithelium Thickness ◽  
Group A ◽  
Optical Zone ◽  
Group B

Is it possible to obtain good results in myopia of 2 or fewer diopters (D) with transepithelial photorefractive keratectomy (TransPRK) changing the optical zone and epithelium thickness? We retrospectively analyzed two groups of 296 eyes with a minimum follow-up of 4 months. Group A had 2 or less D, treated with an optical zone (OZ) 0.2 mm bigger than recommended, and a central epithelium thickness of 60 microns, and group B had 2 D to 5 D, with the recommended optical zone, and a 55-micron epithelium ablation at the center. The outcomes were not different between the two myopic ranges; the postop uncorrected distance visual acuity was 20/20 ± 4 in both groups (p = 0.2), which was −0.3 ± 0.8 lines worse than the preoperative corrected distance visual acuity in both groups (p = 0.5). The safety of the treatments resulted in a change of 0.0 ± 0.7 lines in the low myopia group, versus a gain of +0.1 ± 0.8 lines in the moderate myopia group (p = 0.1). The deviation from the intended target was −0.04 ± 0.33 D in the low myopia group and +0.07 ± 0.32 D in the moderate myopia group (p < 0.0001); the postoperative spherical equivalent was 0.00 ± 0.33 D in the low myopia group and +0.10 ± 0.31 D in the moderate myopia group (p < 0.0001). The postop refractive astigmatism was 0.32 ± 0.16 D in both groups (p = 0.5). In conclusion, the refractive and visual outcomes after TransPRK are comparable in low myopia changing the optical zone and epithelium thickness versus moderate myopia with standard optical zone and epithelium thickness.

scholarly journals Small Incision Cataract Surgery (SICS) with Clear Corneal Incision and SICS with Scleral Incision – A Comparative Study

2014 ◽  
Vol 2 (1) ◽  
pp. 22-27
Author(s):  
Md Shafiqul Alam ◽  
Khaleda Nazneen Bari
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Visual Outcome ◽  
Small Incision Cataract Surgery ◽  
Corneal Incision ◽  
Clear Corneal Incision ◽  
Age Related ◽  
Postoperative Astigmatism ◽  
Group A ◽  
Group B

Background: Age related cataract is the leading cause of blindness and visual impairment throughout the world. With the advent of microsurgical facilities simple cataract extraction surgery has been replaced by small incision cataract surgery (SICS) with posterior chamber intra ocular lens implant, which can be done either with clear corneal incision or scleral incision. Objective: To compare the post operative visual outcome in these two procedures of cataract surgery. Materials and method: This comparative study was carried out in the department of Ophthalmology, Delta Medical College & Hospital, Dhaka, Bangladesh, during the period of January 2010 to December 2012. Total 60 subjects indicated for age related cataract surgery irrespective of sex with the age range of 40-80 years with predefined inclusion and exclusion criteria were enrolled in the study. Subjects were randomly and equally distributed in 2 groups; Group A for SICS with clear corneal incision and group B for SICS with scleral incision. Post operative visual out come was evaluated by determining visual acuity and astigmatism in different occasions and was compared between groups. Statistical analysis was done by SPSS for windows version12. Results: The highest age incidence (43.3%) was found between 61 to 70 years of age group. Among study subjects 40 were male and 20 were female. Preoperative visual acuity and astigmatism were evenly distributed between groups. Regarding postoperative unaided visual outcome, 6/12 or better visual acuity was found in 19.98% cases in group A and 39.6% cases in group B at 1st week. At 6th week 6/6 vision was found in 36.3% in Group A and 56.1% in Group B and 46.2% in group A and 66% in group B without and with correction respectively. With refractive correction, 6/6 vision was attained in 60% subjects of group A and 86.67% of group B at 8th week. Post operative visual acuity was statistically significant in all occasions. Postoperative astigmatism of >0.50D was in 82.5% subjects of group A and 52.8% subjects of group B at 1st week. At 6th week postoperative astigmatism of less than 1D was in 79.95% subjects of Group A and 83.34% subjects of Group B. About 20% subjects in Group A and only 3.3% in Group B showed astigmatism of more than 1D and these differences on both the occasions were statistically significant. Conclusion: The post operative visual outcome was better in SICS with scleral incision (group B) than in SICS with clear corneal incision (Group-A). DOI: http://dx.doi.org/10.3329/dmcj.v2i1.17793 Delta Med Col J. Jan 2014; 2(1): 22-27

scholarly journals Safety and Visual Outcome of Visian Toric ICL Implantation after Corneal Collagen Cross-Linking in Keratoconus: Up to 2 Years of Follow-Up

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Rafic Antonios ◽  
Ali Dirani ◽  
Ali Fadlallah ◽  
Elias Chelala ◽  
Adib Hamade ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Outcome ◽  
Cross Linking ◽  
Implantable Collamer Lens ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Effective Option ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Purpose. To evaluate the long-term safety and clinical outcome of phakic Visian toric implantable collamer lens (ICL) insertion after corneal collagen cross-linking (CXL) in progressive keratoconus.Methods. This was a retrospective study of 30 eyes (19 patients), with progressive keratoconus, who underwent sequential CXL followed by Visian toric ICL implantation after 6 months.Results. At baseline, 6 eyes had stage I, 14 eyes stage II, and 10 eyes stage III keratoconus graded by Amsler-Krumeich classification. At 6 months after CXL, onlyK(steep) andK(max) decreased significantly from baseline, with no change in visual acuity or refraction. Flattening in keratometric readings was stable thereafter. There was significant improvement in mean uncorrected distance visual acuity (1.57 ± 0.56 to 0.17 ± 0.06 logMAR,P<0.001) and mean corrected distance visual acuity (0.17 ± 0.08 to 0.11 ± 0.05 logMAR,P<0.001) at 12 months after ICL implantation that was maintained at the 2-year follow-up. Mean cylinder power and mean spherical equivalent (SE) also decreased significantly after ICL implantation. A small hyperopic shift in SE (+0.25 D) was observed at 2 years that did not alter visual outcomes.Conclusions. Visian toric ICL implantation following CXL is an effective option for improving visual acuity in patients with keratoconus up to 2 years.

MACULAR CHANGES AFTER CATARACT SURGERY: A PROSPECTIVE STUDY.

2019 ◽  
pp. 1-3
Author(s):  
Ritu Agarwal ◽  
Piyush Gupta*
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Visual Outcome ◽  
Macular Thickness ◽  
Small Incision Cataract Surgery ◽  
Corrected Visual Acuity ◽  
Group A ◽  
Group B ◽  
A Prospective Study ◽  
Final Visual Outcome

AIM: To evaluate and compare macular thickness changes after uneventful Phacoemulsification and Manual Small Incision Cataract Surgery in correlation with visual acuity. METHOD: Study was conducted on 250 cataract patients they were equally divided into Group A and Group B. Group A patients underwent Phacoemulsification and Group B underwent MSICS. In both groups macular thickness using OCTand Best Corrected Visual Acuity (BCVA) was recorded preoperatively and postoperatively at 1 day, 1, 3, 6 weeks, 3 and 6 months. Macular thickness changes were evaluated and compared with visual acuity. RESULTS: Macular thickness continued to increase from 1 week to 6 months postoperatively which was statistically significant. No correlation found between increased macular thickness and BCVA. CONCLUSION: Increase in macular thickness remained subclinical and there was no impact of increased macular thickness on the final visual outcome.

scholarly journals Visual Outcome after Oral versus Intravenous Methylpredisolone Therapy for Bilateral Optic Neuritis in Adults

2020 ◽  
Vol 2 (1) ◽  
pp. 06-10
Author(s):  
Naima Lassie ◽  
Hartono Hartono
Keyword(s):  
Visual Acuity ◽  
Optic Neuritis ◽  
Early Period ◽  
Visual Outcome ◽  
Intravenous Methylprednisolone ◽  
Group A ◽  
Ishihara Test ◽  
Group B ◽  
Age Range ◽  
Pathologic Processes

AbstractIntroduction: Bilateral optic neuritis in adults is rarer then unilateral optic neuritis. The purpose of this study was to know the clinical profile and to know the visual outcome of bilateral optic neuritis in adult patients after oral versus intravenous methylprednisolone therapy.Methods: A retrospective review of patients with bilateral optic neuritis referred to dr.Sardjito General Hospital, Yogyakarta from 2011-2014. The data consisted of bilateral optic neuritis, unassociated with other pathologic processes. There are two groups of patients: Group A taking oral methylprednisolone 1mg/kgBB and Group B received intravenous methylprednisolone (as ONTT guideline). Visual acuity, visual field with Goldmann Perimetry, RAPD (Relative Afferent Puppilary Defect), Ishihara test and direct ophthalmoscopy evaluation were recorded and analysed in both group at baseline, 1 week, 1 month and 3 months follow up. Results: Nineteen women and 9 men, with age range of 18-54 years old, had bilateral optic neuritis. The majority of the patients suffered from retrobulbar neuritis (43%), papilitis (39%) and neuroretinitis (18%). The average visual acuity before treatment in Group A was 0.22 ± 0.29 and in Group B had poorer average visual acuity 0.03±0.04 (p>0.05). But the trend of visual recovery in Group B with visual acuity at baseline worsen, the recovery of visual acuity was faster and better at one week. After one month the visual acuity was comparable in both groups (p>0.05).Conclusions: Visual improvement in early period of adult bilateral optic neuritis was similar after oral and intravenous methylprednisolone therapy.Keywords: Bilateral optic neuritis, methylprednisolone therapy, visual outcome

scholarly journals Optimal timing of vitrectomy for severe mechanical ocular trauma: A retrospective observational study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Honghua Yu ◽  
Jianhua Li ◽  
Ying Yu ◽  
Guodong Li ◽  
Dongli Li ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Ocular Trauma ◽  
Visual Outcome ◽  
Optimal Timing ◽  
Trauma Patients ◽  
Ocular Trauma Score ◽  
Post Operation ◽  
Group A ◽  
Group B ◽  
Trauma Score

AbstractMechanical ocular trauma could lead to disastrous visual outcomes. There has been a controversy regarding the timing of vitrectomy for such cases. This study aimed to find out the optimal timing of vitrectomy for severe mechanical ocular trauma. Patients with severe mechanical ocular trauma who had undergone vitrectomy were enrolled and followed up for at least 6 months. Clinical data were collected including ocular trauma score (OTS), the timing of vitrectomy upon injury, visual acuity, vitrectomy results, post-operation complications and etc. All cases were classified according to the timing of vitrectomy upon injury into 3 groups: group A 1–7 days, group B 8–14 days, group C more than 14 days. A total of 62 cases were enrolled, including 20 eyes in group A, 25 eyes in group B, and 17 eyes in group C. No significant differences were shown of the gender, age or OTS among the 3 groups. Both functional success rate and visual outcome were optimal in group B, then in group A, and worst in group C. These results suggested that the best timing of vitrectomy for severe mechanical ocular trauma is 8–14 days upon injury; second best is 1–7 days; worst is after 14 days.

scholarly journals Comparative evaluation of rotational stability of toric IOLs with four-eyelet vs two-eyelet capsular tension rings in eyes with high myopia

2021 ◽  
Vol 14 (3) ◽  
pp. 378-382
Author(s):  
Hui-Min Jiang ◽  
◽  
Li-Ming Tao ◽  
Keyword(s):  
Visual Acuity ◽  
High Myopia ◽  
Visual Outcome ◽  
Corneal Astigmatism ◽  
Rotational Stability ◽  
Toric Iol ◽  
Toric Iols ◽  
Group A ◽  
The Mean ◽  
Group B

AIM: To compare the rotational stability of Toric intraocular lens (IOLs) implantation combined with four-eyelet or two-eyelet capsular tension rings (CTRs) in eyes with high myopia and cataract. METHODS: This prospective randomized controlled interventional study included 33 eyes which had preoperative corneal astigmatism ≥1.5 D and ocular axial length ≥25.5 mm. These eyes were randomly divided into two groups to undergo phacoemulsification and toric IOL implantation with either four-eyelet CTR implantation (group A, n=16) or two-eyelet CTR implantation (group B, n=17). Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), phoropter examination results, and toric IOL rotation degrees were tested 6mo after the surgery. RESULTS: In both groups, the toric IOL was in the capsular sac 6mo after surgery. The difference between the two groups in terms of visual outcome was not found to be statistically significant (P>0.05) at a follow-up of 6mo. The mean residual astigmatism values were 0.56±0.22 D and 0.92±0.24 D in A and B groups, respectively (P<0.001). The mean rotation degree of IOL was 1.00°±0.73° in group A and 3.53°±1.46° in group B (P<0.001). CONCLUSION: In cataract patients with high myopia and astigmatism, four-eyelet CTR can effectively increase the rotation stability of toric IOLs, achieving the desired goal of correcting corneal astigmatism.

scholarly journals Long-Term Visual, Refractive and Topographic Outcomes of KeraRings Combined with Accelerated Transepithelial Crosslinking for Management of Different Grades of Progressive Keratoconus: A Retrospective Cohort Study

2021 ◽  
Vol 15 (1) ◽  
pp. 54-69
Author(s):  
Mohammed Iqbal ◽  
Amr Mounir ◽  
Khaled Abd-Elaziz ◽  
Omar M. Said
Keyword(s):  
Visual Acuity ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Corrected Distance Visual Acuity ◽  
Group A ◽  
Group B

Purpose: To evaluate long-term visual, refractive, and topographic outcomes of KeraRings intrastromal implantation combined with accelerated transepithelial cross-linking for management of different stages of progressive keratoconus. Materials and Methods: This retrospective cohort study included 70 eyes of 70 patients with Amsler-Krumeich grades 1 to 4 keratoconus. They were divided into two groups: group-A included 37 eyes with grades 1-2 keratoconus, and group-B included 33 eyes with grades 3-4 keratoconus. Both groups underwent combined Keraring implantation with TCXL treatment. The main outcome measures included the preoperative and postoperative visual acuity, refraction, keratometry readings, and pachymetry. Results: At postoperative month 60, group-B exhibited significantly higher values of all mean uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), sphere/cylinder/spherical equivalent/defocus equivalent (DEQ), and K1/K2/Kaverages/Kmax parameters compared to that of group A. However, group-A exhibited better stability of postoperative improvements. Keratoconus progression (KCP) was greater in group-B (45.5%) than group-A (10.8%). Two eyes revealed segments' migration while one eye showed tunnel vascularization and opacification with segments' migration. Conclusion: The diagnostic criteria of preoperative-KCP are not adequate for the diagnosis of postoperative-KCP following ICRS implantation. UDVA and K average posterior seemed to be more sensitive parameters than K max in documenting early postoperative-KCP. We suggest that deterioration of UDVA≥0.10 log MAR and/or K average posterior ≥0.25 D are highly suspicious of post-ring implantation keratoconus progression (PR-KCP). The occurrence of two of the following parameters: Kmax≥0.50 D, Kaverageanterior≥0.50 D, K average posterior ≥0.25 D, or pachymetry≥1.5% thinning, is diagnostic of PR-KCP. The occurrence of two or more of the following parameters: Kmax≥0.50 D, Kaverageanterior≥0.50 D, Kaverageposterior ≥0.25 D, pachymetry≥ 1.5% thinning or UDVA≥0.10 logMAR, is diagnostic of PR-KCP. We also suggest that Kmax≥0.75 D alone is diagnostic of PR-KCP.

Combining cataract surgery with 25-gauge high-speed pars plana vitrectomy: A prospective study

2020 ◽  
pp. 112067212090203
Author(s):  
Alfonso Savastano ◽  
Chiara Lenzetti ◽  
Lucia Finocchio ◽  
Daniela Bacherini ◽  
Fabrizio Giansanti ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Postoperative Complications ◽  
Prospective Study ◽  
Macular Hole ◽  
Epiretinal Membrane ◽  
Pars Plana Vitrectomy ◽  
Visual Outcome ◽  
Group A ◽  
Pars Plana ◽  
Group B

Purpose: To compare visual outcome and postoperative complications of combined 25-gauge pars plana vitrectomy and phacoemulsification with vitrectomy alone surgery in patients with epiretinal membrane and macular hole. Methods: A total of 110 eyes (73 eyes with epiretinal membrane and 37 eyes with macular hole) were enrolled in this prospective study. The eyes were divided into two groups: Group A included 55 eyes which underwent phacovitrectomy at the same time and Group B included 55 eyes which underwent vitrectomy alone. Follow-up visits were at 1, 3, and 6 months. Results: The best-corrected visual acuity correlation by analysis of variance measurement showed statistically non-significant differences between the two groups ( p = 0.32). The post hoc analysis from baseline, 1°, 2°, and 3° follow-ups was not statistically significant ( p > 0.05). The most common postoperative complication was cystoid macular edema that has been detected in 11 patients (10%) (seven eyes in Group A and four eyes in Group B): 2 patients (1.8%) developed a chronic macular edema. Intraocular hypertension occurred in five eyes (4.5%) (three in Group A and two in Group B). Four eyes (3.6%) underwent another surgical procedure for a persistent macular hole (two in Group A and two in Group B). The intraocular lens repositioning was performed one day after surgery in three eyes (2.7%) (Group A). The mean preoperative visual acuity was not different between the two groups ( p = 0.80). Conclusion: No significative differences between combined surgery and vitrectomy alone have been detected, in terms of postoperative complications and visual outcome.

scholarly journals ANATOMICAL AND VISUAL OUTCOME OF COMBINED PHACO-VITRECTOMY VS VITRECTOMY ALONE

2021 ◽  
Vol 31 (04) ◽  
pp. 204-209
Author(s):  
Irfan Muslim ◽  
Asad Aslam Khan ◽  
Nasir Chaudhry
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Visual Outcome ◽  
P Value ◽  
Corrected Visual Acuity ◽  
Group A ◽  
Pars Plana ◽  
Group B ◽  
Anatomical Outcome

Introduction Separation of Neurosensory retina from RPE(Retinal Pigment Epithelium) is described as retinal detachment. Recently Pars plana vitrectomy has emerged as a preferred surgical treatment for management of uncomplicated primary rhegmatogenous retinal detachment. Various studies have evaluated the results of combined phaco-vitrectomy, the combined approach allows faster visual recovery and has cost effectivity for patient. The rationale of this study is to compare the anatomical and visual outcome of combined phacoemulsification and vitrectomy vs vitrectomy alone Materials and methods This prospective randomized controlled trial was performed at Eye Unit II Mayo Hospital Lahore (tertiary care eye hospital in Lahore), Pakistan from August 2019 to February 2020. 36 patients full filling the inclusion criteria were divided into two groups 18 patients each. Group A was of combined Phaco-vitrectomy and Group B was of vitrectomy only. The Mann-whitney test as test of significance was applied and P≤0.05 was considered statistically significant. Results BCVA done Pre-operatively for Group A and B, P-value was > 0.05 which was insignificant. Best corrected visual acuity at first week post operatively was significantly lower in patients in which we used gasses as internal tamponade as compared those in which we used silicon oil as tamponade. The BCVA at 1 month showed improvements in both groups, however the BCVA in group B was significantly lower than group A, P-value being < 0.05. The BCVA at 3 month showed improvements in both groups, however the BCVA in group B was significantly lower than group A, P-value being < 0.05. Anatomical Outcome was seen as weather retina was attached or detached. In Group A detachment was present in all follow-ups in 2/18 patients while in Group B detachment was present in all follow-ups in 3/18 patients. The P-value was >0.05 and thus the difference between two groups was insignificant. Conclusion visual acuity did not differ among the two groups preoperatively and on first follow-up at 1 week. The P value being >0.05 in both. However there was significant difference between the two group at 1 month and 3 months follow up, P value being < 0.05 in each. The visual acuity was significantly better in Group A i.e combined phaco- vitrectomy. For anatomical outcome no difference was seen between the groups. The P value was > 0.05. So the visual outcome of group A was significantly better than group B while the anatomical outcome was the same.   Keywords Phacoemulsification, Three ports pars plana vitrectomy, best corrected visual acuity, retinal detachment.

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