Frequently Experienced Problems in the Early Stages after Prescribing Rigid Gas Permeable Contact Lenses

Prescribing rigid gas-permeable (RGP) lenses involves a series of processes that determine the most appropriate final lens through the trial use of test lenses based on the results of slit lamp microscopy, measuring refraction and corneal curvature, and corneal topography. The final prescription is reached by judging the dynamic lens movement, adequacy of the tear layer around the lens, corrected vision, and quality of vision. Various problems are encountered soon after prescribing lenses, including foreign body sensation, tear hypersecretion, decreased visual acuity, blurring, visual acuity change, redness, dryness, sudden pain, lens centering, and lens fallout. Here, we examine these problems and how to solve them.

One-year post-operative comparison of visual function and patient satisfaction with trifocal and extended depth of focus intraocular lenses

Purpose To evaluate visual performance with trifocal and extended depth of focus IOL at 1 year post-operatively. Setting BMI Southend Hospital. Design Cohort study. Methods An age-matched cohort of forty subjects bilaterally implanted with the AT LISA 839MP trifocal IOL (20 patients, 40 eyes) and the Tecnis Symfony extended depth of focus IOL (20 patients, 40 eyes) were assessed at 3–6 months and 12–18 months post-operatively. Primary outcome measures were distance (6 m), intermediate (70 cm), near visual acuity (40 cm), and analysis of defocus profiles. Secondary outcomes included contrast sensitivity, Radner reading performance, quality of vision and assessment of halos. Results Distance visual acuity (VA) and defocus areas were similar ( p = 0.07). No significant difference in intermediate VA was noted but the intermediate area of focus was greater in the EDoF (0.31 ± 0.12 LogMAR*m−1) compared to the trifocal (0.22 ± 0.08LogMAR*m−1) ( p = 0.02). However, all near metrics were significantly better in the trifocal group. 80% of trifocal subjects were spectacle independent compared to 50% EDoF subjects. Quality of vision questionnaire found no significant differences between groups, however halo scores were greater at 3–6 months in the trifocal group ( p < 0.01) but no differences were noted at 12–18 months. Conclusions Near vision is significantly better for the trifocal, thus greater levels of spectacle independence. The range of intermediate vision was greater for the EDoF but no difference in intermediate VA. In the early period, differences in contrast sensitivity and halo size/intensity were noted, however, by one-year these measures were not significantly different.

Gambaran Kualitas Fungsi Penglihatan Pasien Systemic Lupus Erythematosus Berdasarkan Kuesioner NEI VFQ-25 Di Komunitas Odapus Lampung

ABSTRACT: DESCRIPTION OF THE QUALITY OF VISION FUNCTION IN SYSTEMIC LUPUS ERYTHEMA PATIENTS BASED ON THE NEI VFQ-25 QUESTIONNAIRE IN THE ODAPUS COMMUNITY OF LAMPUNGBackground: Systemic Lupus Erythematosus /Systemic Lupus Erythematosus (SLE) is a multisystem autoimmune disease that has characteristic manifestations or symptoms and varied clinical behavior. Eye involvement can be found in about one-third of cases of SLE, and sometimes occurs early in the disease. To assess and measure the quality of vision function in patients with Systemic Lupus Erythematosus, a measuring instrument that can be used is the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) questionnaire. Objective: To describe the quality of vision function in patients with systemic lupus erythematosus based on the NEI VFQ-25 questionnaire in the ODAPUS community in Lampung 2020. Research Methods: This research is a descriptive survey with an approach cross-sectional using primary data in the form of a questionnaire. The sample of this study was all 40 patients who joined the ODAPUS community in Lampung. Data analysis used univariate analysis using tables and graphs in data presentation. Results: The results of the study were 40 patients who met the criteria for inclusion in the study. Of the 40 patients, the patient characteristics were obtained based on the quality of vision function, namely 26-45 years (65.0%), female (97.5%), tertiary education (65.0 %), IRT (42.5%), quality of vision function is not good (90 , 0%), low-dose corticosteroids (85.0%). Conclusion: Given picture quality visual functions of patients with systemic lupus erythematosus-based questionnaire NEI VFQ-25 in the community of Lampung odapus 2020 is not good. Keywords: Quality Vision Function, SLE INTISARI: GAMBARAN KUALITAS FUNGSI PENGLIHATAN PASIEN SYSTEMIC LUPUS ERYTHEMATOSUS BERDASARKAN KUESIONER NEI VFQ-25 DI KOMUNITAS ODAPUS LAMPUNG Latar Belakang: Lupus Eritematosus Sistemic/Systemic Lupus Erythematosus (SLE) adalah suatu penyakit autoimun multisistem yang memiliki manifestasi atau gejala khas dan perilaku klinis yang sangat bervariasi. Keterlibatan mata dapat ditemukan pada kurang lebih satu per tiga kasus SLE, dan kadang terjadi pada awal penyakit. Untuk menilai dan mengukur kualitas fungsi penglihatan pada pasien Systemic Lupus Erythematosus, alat ukur yang dapat digunakan yaitu dengan kuesioner National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25).Tujuan: Untuk mengetahui gambaran kualitas fungsi penglihatan pasien systemic lupus erythematosus berdasarkan kuesioner NEI VFQ-25 di komunitas ODAPUS Lampung 2020.Metode Penelitian: Jenis penelitian ini adalah survei deskriptif dengan pendekatan Cross- sectional menggunakan data primer berupa kuesioner. Sampel penelitian ini adalah seluruh pasien yang bergabung di komunitas ODAPUS Lampung sebanyak 40 orang. Analisis data menggunakan analisis univariat dengan menggunakan tabel dan grafik dalam penyajian data.Hasil: Hasil penelitian terdapat 40 pasien yang memenuhi kriteria untuk dimasukkan dalam penelitian. Dari 40 pasien tersebut didapatkan karakteristik pasien berdasarkan kualitas fungsi penglihatan yaitu terbanyak pada usia 26-45 tahun (65,0%), jenis kelamin perempuan (97,5%), pendidikan perguruan tinggi (65,0%), pekerjaan IRT (42,5%), kualitas fungsi penglihatan tidak baik (90,0%), dan penggunaan kortikosteroid dosis rendah (85,0%). Kesimpulan: Gambaran kualitas fungsi penglihatan pasien systemic lupus erythematosus berdasarkan kuesioner NEI VFQ-25 di komunitas ODAPUS Lampung 2020 yaitu tidak baik. Kata Kunci : Kualitas Fungsi Penglihatan, SLE

Expectations and Reality in Surgical Rehabilitation of Cataract Patients

The aim. To study the effect of surgical treatment of cataracts on the quality of life of patients and assess satisfaction with the results after implantation of a monofocal or multifocal intraocular lens (IOL), depending on the initial refraction. Materials and methods. We examined 140 patients (280 eyes) who underwent phacoemulsification with IOL (bilateral) according to the standard technique using multimodal anesthesia. The observation groups were divided depending on the initial type of refraction and the type of intraocular correction (mono- or multifocal IOL). The analysis of the results of surgical treatment of cataracts with IOL was assessed taking into account the initial refraction according to objective data, i.e. determination of distance and near visual acuity, and subjective data, i.e. the NEI-VFQ-25 quality of life questionnaire, patient questionnaire survey and assessment of the quality of vision in general, as well as distance, near, and night vision. Results and discussion. Before surgery, the mean values of indicators by all scales of the questionnaire of the quality of life related to the quality of vision ranged from 40 to 60 points and averaged 47 ± 0.5 points. After cataract surgery, the numerical indicator by each of the scales shifted to the range of 85 to 100 points. The difference in values by the scales “activity associated with distance vision” and “driving a car” was obtained. In patients with multifocal IOL, these indicators were lower compared with monofocal implantation. Dissatisfaction with distance vision was observed during the implantation of a multifocal IOL only in patients with hyperopia (12.5%), dissatisfaction with near vision was noted only in patients with myopia (16.7%), and no cases of dissatisfaction were observed in the group of patients with emmetropia. Analysis of night vision in patients with emmetropia also revealed the minimum percentage (2.5%) of cases of dissatisfaction in patients with hyperopia (5.0%) and the maximum in those with myopia (16.7%). Conclusions. IOL implantation is a single cataract treatment option that provides a high level of the patient’s satisfaction with the quality of life and visual functions. However, careful individual approach is required to select the type of implantable IOL, taking into account the patient’s needs and baseline refraction.

Intrastromal keratoplasty with intracorneal ring segments implantation as an independent method of visual rehabilitation in patients with keratoconus

Purpose. To assess the possibility of using intrastromal keratoplasty with intracorneal ring segments implantation as an independent technique to achieve visual rehabilitation in patients with keratoconus of the stages I and II. Material and methods. There were examined and operated 14 eyes (10 patients) with keratoconus of the stages I and II (classification by Izmailova SB, 2014). Patients were divided into two groups depending on the keratoconus stage. All patients underwent intrastromal keratoplasty with intracorneal ring segments implantation using the femtosecond technology. The on average follow-up was 5.7 months. Results. In the first group: the average UCVA value increased with from 0.31±0.21 to 0.81±0.31 (p<0.05); the BCVA increased from 0.89±0.08 to 0.94±0.10 (p>0.05); the spherical component of refraction decreased from 0.96±1.25 to 0.08±0.20 (p<0.05); the cylindrical component of refraction decreased from 4.25±1.73 to 0.50±1.22 (p<0.05). In the second group: UCVA increased from 0.51±0.40 to 0.61±0.28 (p<0.05); the BCVA increased from 0.70±0.17 to 0.81±0.26 (p>0.05); the spherical component of refraction decreased from 4.88±2,61±0.53±0.63 (p<0.05); the cylindrical component of refraction decreased from 2.69±1.65 to 1.41±1.02 (p<0.05). Conclusion. 1. After implantation of intracorneal ring segments, both in patients with I and in patients with the II stage of keratoconus, there was an increase in the UCVA and BCVA, as well as a significant reduction in maximal keratometry and coma, which provides the improving of the quality of vision. 2. In all cases the UCVA and BCVA that were obtained after the treatment reached a sufficiently high level to ensure the possibility of performing their professional functions, without resorting to additional surgical treatment techniques. That characterizes this method as an independent and sufficient to achieve high visual acuity in patients with I and II stages of keratoconus. Key words: keratoconus, corneal intrastromal segments, femtosecond laser, visual rehabilitation.

Validation and Repeatability of Inferior minus Superior Value and its Cut-off Value in Anterior Sagittal Curvature Map Using Pentacam in Early Keratoconus

Background : Keratoconus (KC) is a bilateral asymmetric localised inferior and central corneal thinning and ectasia. Usually, it causes high myopia and irregular astigmatism resulting in a poor quality of vision. One of the most important ways of avoiding iatrogenic ectasia in cornea during refractive surgery is to detect KC in its earliest stage using the Pentacam. An important asymmetry decentration index is the inferior minus superior (IS) value. Purpose : Detection of Inferior minus Superior (IS) value and its Cut-off Value Methods : This is a cross-sectional, case control study that included 92 right eyes of 92 subjects, who presented to the outpatient clinic of “Al Watany Eye Hospitals” seeking refractive surgery or routine medical consultations. Our study focused on the measurement of the IS-value in early KC (TKC grade 1 and FFKC) and normal eyes. The right eye of each candidate was scanned 5 times in the same setting using the Pentacam. The study adhered to the tenets of the Declaration of Helsinki, and an approval was obtained from the ethical committee of Ain Shams University Hospitals. Results : We detected remarkably high statistically significant difference between patients and controls regarding the IS-value (p &lt; 0.001). The mean (±SD) of control and cases group was 0.3 ± 0.2 and 1.4 ± 0.6, respectively. The cut-off point of 0.69 with high area under the receiver operating characteristic (AUROC). Coefficient of variation median (95% CI) for cases and controls were 1.4% (0.9 to 3.1%) and 6.2% (3 to 9.4%), respectively. Conclusion : The IS-value has a high repeatability and AUROC for differentiating early KC from normal corneas. It can be regarded as an accurate parameter for early KC detection.