ABSTRACT
PURPOSE: To compare outcomes of femtosecond laser-enabled deep anterior lamellar keratoplasty (IE-DALK) versus manual trephine using deep anterior lamellar keratoplasty (Manual DALK, M-DALK). METHODS: Seventeen eyes from 17 patients underwent manual deep anterior lamellar keratoplasty, and femtosecond laser-enabled deep anterior lamellar keratoplasty was performed in 13 eyes of 13 patients. Postoperative clinical outcomes such as best corrected visual acuity, refractive astigmatism, keratometric astigmatism, endothelial cell density were compared between the two groups. RESULTS: The mean log MAR best spectacle-corrected visual acuity (BSCVA) was 0.31 +/- 0.17, 0.23 +/- 0.15, 0.18 +/- 0.14 in the IE-DALK group, and 0.55 +/- 0.41, 0.45 +/- 0.28, 0.35 +/- 0.22 (p = 0.056, p = 0.025, p = 0.313) in the M-DALK group at postoperative 2, 4, and 6 months respectively. The mean keratometric cylinder was 5.35 +/- 1.57, 4.24 +/- 1.97, 3.65 +/- 1.31 in the IE-DALK, 8.32 +/- 2.75, 6.80 +/- 2.50, 4.54 +/- 1.25 (p = 0.031, p = 0.041, p = 0.370) in the M-DALK group at postoperative 2, 4, and 6 months respectively. Endothelial cell counts in the two groups did not differ significantly at postoperative 6 months. CONCLUSIONS: The IE-DALK showed better results in BSCVA and keratometric astigmatism in the early postoperative period, in comparison with the M-DALK, and can be considered as a valuable method in deep anterior lamellar keratoplasty.
Subject(s)
Humans , Astigmatism , Corneal Transplantation , Endothelial Cells , Methods , Postoperative Period , Visual AcuityABSTRACT
PURPOSE: To compare the size, circularity and repeatability between the conventional manual technique and the open-ring guided continuous curvilinear capsulorrhexis (CCC) technique in cataract surgery. METHODS: The present study comprised 120 eyes divided into two equal groups. In the first group (group A), CCC was performed using a 5.3-mm open ring-shaped caliper and in the second group (group B), CCC was performed using the conventional manual technique. Photographs were taken after each surgical step (CCC, phacoemulsification, Intraocular lens insertion and corneal stromal hydration). The diameter, area and circularity of the anterior capsule were compared between the two groups. RESULTS: The anterior capsule diameter was 5.32 +/- 0.26 mm for group A (coefficient of variation 0.049) and 5.14 +/- 0.64 mm for group B (coefficient of variation 0.125); the area was 22.9 +/- 0.71 mm2 for group A (coefficient of variation 0.031) and 21.40 +/- 1.37 mm2 for group B (coefficient of variation 0.064). Circularity was 0.93 +/- 0.24 for group A (coefficient of variation 0.258) and 0.86 +/- 0.78 for group B (coefficient of variation 0.907). CONCLUSIONS: The open ring-guided CCC technique resulted in an increase of diameter and capsulorrhexis area. This method showed superior circularity and repeatability compared to conventional manual technique and can be useful in cataract surgery.
Subject(s)
Capsulorhexis , Cataract , Chlormequat , Eye , Lenses, Intraocular , PhacoemulsificationABSTRACT
PURPOSE: To evaluate objectively the improvement level of a patient's visual function using the NEI-VFQ-25 questionnaire pre- and post-operatively and the OQAS results from the patient group who had the same corrected visual acuity pre- and post-operatively. METHODS: We examined and compared the NEI-VFQ-25 test, OSI, MTF cut-off, strehl ratio, OQAS, and width at 50% and 10% in 24 eyes of 24 patients who had cataract surgery between December 2011 and February 2012. The patients' corrected visual acuity in both eyes had no change (0.8 and 0.8) pre-operatively and 2 months post-operatively (1.0 and 1.0). RESULTS: The satisfaction level regarding the patients' visual function increased. The NEI-VFQ-25 test was 71.54 +/- 14.88 points pre-operatively and 85.70 +/- 6.17 points post-operatively. OSI decreased to 3.13 +/- 1.66 (OSI value) and 1.53 +/- 0.58 (OSI value), and MTF cut off value improved from 14.51 +/- 6.97 (C/deg) to 27.63 +/- 8.98 (C/deg). Strehl ratio was improved to 0.09 +/- 0.03 and 0.14 +/- 0.03, width at 50% improved to 8.44 +/- 3.73 and 4.52 +/- 1.90 and width at 10% improved to 35.30 +/- 15.22 and 18.04 +/- 8.87 pre- and post-operatively, respectively. CONCLUSIONS: The NEI-VFQ-25 test reflected the vision improvement in patients where after cataract surgery, determination of the visual function improvement only through vision would not be possible. In addition, the OQAS showed the quality of vision improved through quantified values.
Subject(s)
Humans , Cataract , Eye , Phacoemulsification , Surveys and Questionnaires , Vision, Ocular , Visual AcuityABSTRACT
PURPOSE: To assess the efficacy of levator recession under local anesthesia to treat upper eyelid retraction. METHODS: Records of 12 patients (12 lids) were reviewed retrospectively. Postoperative cosmetic results were assessed as good, fair, or poor based on the upper lid height and symmetry. Preoperative and postoperative marginal reflex distance (MRD1, mm), upper eyelid asymmetry, lid lag, lagophthalmos, and ocular exposure symptoms were compared. The reoperation rate was also evaluated. RESULTS: Causes accounting for upper lid retraction were Graves ophthalmopathy (9 lids, 75.0%), orbital pseudotumor (2 lids, 16.7%), and hypercorrection from previous ptosis operation (1 lid, 8.3%). At a mean +/- standard deviation of 27.7 +/- 24.0 months follow-up (range, 5-60 months), 11 patients (91.7%) showed significantly better cosmetic results. MRD1 decreased an average of 3.1 +/- 1.3 mm from 6.3 +/- 1.5 mm preoperatively to 3.2 +/- 0.9 mm postoperatively (p < 0.001). Upper lid asymmetry, lagophthalmos, and lid lag were also reduced significantly (p < 0.001). Overcorrection occurred in 3 lids (25%) and required levator advancement. Eleven patients (91.7%) experienced complete resolution of dry eye symptoms following levator recession. CONCLUSIONS: Levator recession showed good cosmetic results up to 2 years after surgery for upper eyelid retraction.