Comparison of Clinical Outcomes between Different IOL Sizes after Microincisional Cataract Surgery

PURPOSE: To compare clinical outcomes between different IOL sizes after microincisional cataract surgery. METHODS: Retrospective chart review was done in 68 eyes of 68 patients who underwent phacoemulsification and implantation with two different-sized aspheric IOLs (AKREOS MI60 Bausch & Lomb, Inc., Rochester, NY). The patients were divided into 2 groups: group I consisted of 38 eyes between 15.5-22.0 diopter (D) (optic size 6.0 mm, overall size 10.7 mm), and group II consisted of 30 eyes between 22.5-30.0 D (optic size 5.6 mm, overall size 10.5 mm). The best corrected visual acuity (BCVA), refractive error, and anterior chamber depth (ACD) were measured preoperatively and postoperatively and were compared between groups. RESULTS: Postoperative 6 month BCVA was 0.08 +/- 0.10 D in group I and 0.07 +/- 0.11 D in group II. During the same period, the spherical equivalent was -0.32 +/- 0.65 D in group I and -0.16 +/- 0.59 D in group II (p > 0.05). There were no significant differences in ACD or refractive error during the postoperative period (p > 0.05). CONCLUSIONS: Comparison of postoperative visual acuity and spherical equivalent between different sizes of Akreos MI-60(TM) IOLs showed no differences.

Early Postoperative Pain and Visual Outcomes Following Epipolis-Laser In Situ Keratomileusis and Photorefractive Keratectomy

PURPOSE: To compare early postoperative pain and visual outcomes after epipolis-laser in situ keratomileusis (epi-LASIK) and photorefractive keratectomy (PRK) in the treatment of myopia. METHODS: A retrospective chart review was designed and included 49 eyes in 30 patients who underwent epi-LASIK and 54 eyes in 29 patients who underwent PRK. During the early postoperative period (days 1 to 5), pain, uncorrected visual acuity (UCVA), and time to epithelial healing were recorded. Visual outcomes were followed for up to six months. RESULTS: Mean preoperative spherical equivalent refraction for the epi-LASIK group was -3.99+/-1.39 diopters (D) and that of the PRK group was -3.54+/-1.27 D. The pain scores on the fourth postoperative day were significantly higher in the epi-LASIK group than in the PRK group (p=0.017). Duration of pain in the epi-LASIK group was longer than in the PRK group (p=0.010). Mean healing time was significantly longer in the epi-LASIK group than in the PRK group (p<0.000). In addition, UCVA in the epi-LASIK group at postoperative days 1 and 3 were significantly lower than those in the PRK group (p=0.021 and p<0.000, respectively). Uncorrected visual acuity at one week and one month after epi-LASIK were lower than those after PRK (p=0.023 and p=0.004, respectively). CONCLUSIONS: In the epi-LASIK patients, pain relief, corneal healing, and visual recovery seemed to be slower during the early postoperative period compared to those of the PRK patients. With longer duration of follow-up, however, there were no significant differences in visual outcome between the two groups.

Clinical Results of Wavefront-guided LASIK

PURPOSE: To investigate and compare the clinical outcomes of wavefront-guided LASIK performed by 2 different laser platforms. METHODS: A retrospective analysis of consecutive cases of eyes that underwent wavefront-guided LASIK by using the VISX S4 CustomVue system and the Zyoptix Z100 system advanced personalized mode. All procedures were performed by one surgeon. Fifty-six eyes of 36 patients were included. Of the 56 eyes, 30 eyes underwent LASIK by using the VISX S4 CustomVue system (CustomVue group), and other 26 eyes underwent LASIK by using the Zyoptix Z100 system (APT group). Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), manifest refraction, contrast sensitivity, total high order aberration (HOA), spherical aberration (SA) and Q-value were recorded preoperatively and at 1 week, 1 and 3 months postoperatively. RESULTS: There was no statistically significant difference between two groups in terms of preoperative UCVA, BCVA, manifest refraction, high order aberrations, Q-value and contrast sensitivity. Induced amount of SA was significantly lower in CustomVue group than in APT group (p = 0.02). CONCLUSIONS: Wavefront-guided LASIK performed by 2 different laser platforms caused clinically acceptable outcomes including good visual acuity and contrast sensitivity through 3 months. Furthermore, LASIK performed by VISX S4 CustomVue system caused less SA at three months after operation.

Comparison Between Dynamic Contour Tonometry and Goldmann Applanation Tonometry

PURPOSE: To compare the intraocular pressures (IOPs) measured by dynamic contour tonometry (DCT) and Goldmann applanation tonometry (GAT), and to investigate the association of IOPs on eyes of varying central corneal thickness (CCT). METHODS: In this prospective study, 451 eyes of 233 subjects were enrolled. IOPs were measured by GAT and DCT. CCT was measured three times and the average was calculated. Each eye was classified into one of three groups according to CCT: low CCT (group A, CCT550 micrometer, n=142). In each group, we investigated the association of CCT with IOP measurement by GAT and DCT. RESULTS: The IOPs measured by GAT and DCT were significantly associated for all eyes (R=0.853, p<0.001, Pearson correlation). CCT was related with both IOP measurement by GAT and DCT with statistical significance (mixed effect model, p<0.001). However, subgroup analysis showed that CCT affected IOP measured by GAT for groups B and C, whereas it affected IOP measured by DCT only for group C. CONCLUSIONS: IOP measured by DCT was not affected by CCT in eyes with low to normal CCT, whereas this measurement was affected in eyes of high CCT range. CCT may have less effect on IOP measurements using DCT than those obtained by GAT, within a specified range of CCT.