Therapeutic Effect of Intense Pulsed Light of Dry Eye with Meibomian Gland Dysfunction

Purpose@#To evaluate the therapeutic effect of intense pulsed light (IPL) therapy for the treatment of dry eye with meibomian gland dysfunction (MGD). @*Methods@#A retrospective study was conducted for 124 eyes of 62 patients with dry eye with MGD who underwent 3 IPL sessions at 3 week intervals. All patients underwent clinical examination before and during treatment as well as 3 weeks after the last treatment. Measured parameters include Meibomian gland expressibility (MGE), Meibomian gland secretion (MGS) score, tear meniscus height (TMH), noninvasive break-time (NIBUT), corneal staining score (Oxford scale), Ocular Surface Diseases Index (OSDI), and subjective ocular discomfort improvement. @*Results@#Meibomian gland function (MGE, MGS), ocular surface parameters (NIBUT, Oxford scale) and dry eye symptom (OSDI, subjective ocular discomfort improvement) of patients were significantly improved from baseline to after the 1st IPL, and the 3rd IPL weeks (p < 0.05 for all). However, no significant difference in TMH was observed. @*Conclusions@#This study showed that IPL was a useful and effective treatment in patients of dry eye with MGD to stabilizes the tear film and improve meibomian gland function and ocular symptoms.

Therapeutic Effect of Intense Pulsed Light of Dry Eye with Meibomian Gland Dysfunction

Purpose@#To evaluate the therapeutic effect of intense pulsed light (IPL) therapy for the treatment of dry eye with meibomian gland dysfunction (MGD). @*Methods@#A retrospective study was conducted for 124 eyes of 62 patients with dry eye with MGD who underwent 3 IPL sessions at 3 week intervals. All patients underwent clinical examination before and during treatment as well as 3 weeks after the last treatment. Measured parameters include Meibomian gland expressibility (MGE), Meibomian gland secretion (MGS) score, tear meniscus height (TMH), noninvasive break-time (NIBUT), corneal staining score (Oxford scale), Ocular Surface Diseases Index (OSDI), and subjective ocular discomfort improvement. @*Results@#Meibomian gland function (MGE, MGS), ocular surface parameters (NIBUT, Oxford scale) and dry eye symptom (OSDI, subjective ocular discomfort improvement) of patients were significantly improved from baseline to after the 1st IPL, and the 3rd IPL weeks (p < 0.05 for all). However, no significant difference in TMH was observed. @*Conclusions@#This study showed that IPL was a useful and effective treatment in patients of dry eye with MGD to stabilizes the tear film and improve meibomian gland function and ocular symptoms.

Clinical Characteristics and Outcomes of Cataract Surgery in Highly Myopic Koreans

PURPOSE: To evaluate the clinical characteristics and outcomes of cataract surgery in highly myopic Korean subjects. METHODS: We retrospectively reviewed the medical records of 694 eyes of 694 patients who underwent cataract surgery. The case group included 347 eyes of 347 patients whose axial lengths (AXL) were > or =26.00 mm, and the control group included 347 eyes of 347 patients with AXL between 22.00 and 25.99 mm. Cataract density was determined preoperatively using the Pentacam Scheimpflug imaging system. We compared age at operation, cataract type, coexisting disease, visual prognosis, and complications. RESULTS: The mean age at the time of the operation was 59.60 +/- 12.28 years in the case group and 67.47 +/- 11.36 years in the control group. The case group had a larger proportion of nuclear cataracts and posterior subcapsular cataracts (PSC), 40.63% and 26.22%, respectively, versus 25.07% and 11.82%, respectively, in the control group. Postoperative corrected visual acuity showed a negative correlation with AXL (R2 = 0.172), and severe funduscopic findings were related to poor visual prognosis (p = 0.05). The incidence of retinal detachment in the case group after cataract surgery was 1.72%, compared with 0.28% in the control group. CONCLUSIONS: Highly myopic eyes tend to develop cataracts earlier than normal eyes and to have a higher prevalence of coexisting disease and complications, such as retinal detachment. Nuclear cataracts and PSC were more common in the highly myopic group. Poor visual prognosis was associated with longer axial length and retinal myopic degeneration.

The Effect of Manipulation of Corneal Incision on Astigmatism During the Cataract Surgery

PURPOSE: To evaluate the effect of clear corneal incisional size on astigmatism during cataract surgery. METHODS: Randomized prospective study of 78 patients (108 eyes) who had received cataract surgery for a corneal astigmatism over against-the-rule (ATR) 1.0 Diopter (D) was performed. The eyes were checked by corneal topography and autorefractor preoperatively and one week, one month, two months, and six months postoperative. Group 1 included patients who received an inserted foldable intraocular lens (IOL) through a 2.8 mm incision, and Group 2 included patients who underwent IOL implantation through a corneal incision enlarged to 4 mm. RESULTS: Postoperative visual acuity showed a better visual acuity in Group 2 at both one week postoperatively (0.598+/-0.352 vs., 0.713+/-0.345, for Groups 1 and 2, respectively, p=0.046) and one month postoperatively (0.604+/-0.237 vs., 0.791+/-0.242, respectively, p=.043). There were no statistically significant differences between the groups after two and six months (p=.135, .087). Postoperative astigmatism measured by corneal topopgraphy showed 1.62+/-0.44D and, 0.94+/-0.30D for groups 1 and 2 respectively, (P=.045) at 2 months, and 1.73+/-0.45 D and, 0.92+/-0.34 D (P=.042) at six months. These results showed a statistically significant amount of residual astigmatism in Group 2. Autorefractor measurements showed similar results. There were no complications, such as wound leakage, resulting from the increased incision size. CONCLUSIONS: Widening of the incision during cataract surgery can reduce corneal astigmatism without significant complications.

Neovascular Glaucoma Following Stereotactic Radiosurgery for an Optic Nerve Glioma: A Case Report

A 13-year-old girl with a right intraorbital optic nerve glioma (ONG) was referred to our glaucoma clinic because of uncontrolled intraocular pressure (IOP) in her right eye. The IOP reached as high as 80 mmHg. Several months earlier, she had undergone stereotactic image-guided robotic radiosurgery using the CyberKnife for her ONG; the mass had become smaller after treatment. Her visual acuity was no light perception. Slit lamp examination revealed rubeosis iridis, a swollen pale optic disc, and vitreous hemorrhage. After medical treatment, the IOP decreased to 34 mmHg, and no pain was reported. Although the mass effect of an ONG can cause neovascular glaucoma (NVG), this case shows that stereotactic radiosurgery may also cause NVG, even after reducing the mass of the tumor. Patients who undergo radiosurgery targeting the periocular area should be followed carefully for complications.

Changes in Visual Field Index After Cataract Extraction

PURPOSE: To investigate the changes of visual field index (VFI) compared with mean deviation (MD) and pattern standard deviation (PSD) before and after cataract surgery. METHODS: The present study included 77 eyes of 77 patients who were diagnosed with both glaucoma and cataracts and underwent cataract surgery. Preoperative and postoperative VFI, MD, and PSD were examined. Lens opacity type was classified as cortical, nucleosclerosis, or posterior subcapsular opacity (PSCO), and the MD, PSD, and VFI were compared before and after cataract surgery. RESULTS: Preoperative and postoperative MD were -13.64+/-8.97, -11.94+/-9.67(p=0.113), PSD were 6.18+/-3.30, 5.91+/-3.31(p=0.344), and VFI were 67.00+/-33.43, 70.55+/-33.19(p=0.440), respectively. MD showed statistically significant difference in cortical and PSCO type before and after cataract surgery. PSD (p=0.025) and VFI (p=0.020) showed a statistically significant difference in cortical type. CONCLUSIONS: VFI is an effective parameter to monitor the progression of glaucoma in cataract patients with nucleosclerosis and PSCO, but has limitations in cataract patients with cortical opacity.