Rotational Stability after Toric Implantable Collamer Lens Implantation

PURPOSE: To evaluate rotational stability of Toric Implantable Collamer Lens (ICL) implantation to correct myopic astigmatism. METHODS: We estimated the degree of Toric ICL rotation together with change in visual acuity and astigmatism in 118 eyes of 66 patients who underwent Toric ICL implantation and had a long-term mean follow-up period of 37 months. RESULTS: After Toric ICL implantation, 107 (91%) out of 118 eyes showed uncorrected visual acuity of 0.8 or better. The mean postoperative astigmatism decreased to -0.64 +/- 0.61 D from a mean preoperative astigmatism of -2.96 +/- 1.13 D. The mean axis change of Toric ICL was 2.4 +/- 3.8 degrees during follow-up period. Two (1.7%) out of 118 eyes showed the axis change of more than 10 degrees. These two eyes had a decrease in visual acuity, rotational axis change of 18 degrees and 30 degrees, respectively, and increases in astigmatism of 1.50 D and 1.00 D, respectively. The remaining 116 eyes (98.3%) showed excellent rotational stability without visual acuity decreasing Toric ICL rotation during the follow-up period. CONCLUSIONS: Toric ICL implantation to correct high myopia with astigmatism rarely has axis rotation and maintains excellent rotational stability for long-term follow-up.

Pseudohypopyon after Management of Posterior Capsule Rupture Using Intracameral Triamcinolone Injection in Cataract Surgery

No abstract available.

Comparison of LASIK Mode Ablation and PRK Mode Ablation in LASEK Using MEL-80 Excimer Laser

PURPOSE: We compared laser assisted in situ keratomileusis (LASIK) mode and photorefractive keratectomy (PRK) mode ablation methods in laser subepithelial keratomileusis (LASEK) surgery using the MEL-80 excimer laser. METHODS: All patients were followed up for a minimum of 1 year. The PRK mode group consisted of 46 eyes of 23 patients and the LASIK mode group consisted of 97 eyes of 56 patients. The central corneal thickness (CCT), ablation thickness, manifest refractive error and uncorrected visual acuity were compared preoperatively, 1 month and 1 year postoperatively. Spherical equivalent (SE) of cycloplegic refraction at postoperative 1 month and the uncorrected visual acuity (UCVA) ratios of 1.0 or better at postoperative 1 year were compared between the two groups to evaluate clinical efficacy. RESULTS: The SE of refractive error, CCT and target corneal ablation thickness of the two groups were not significantly different preoperatively. The PRK mode group obtained an actual ablation mean thickness of 82.8% of the target and the LASIK mode group obtained an actual ablation mean thickness of 94.1% of the target at postoperative 1 month. In each group, a statistically significant difference was observed between the actual corneal ablation thickness and target corneal ablation thickness. In the PRK mode group, the mean SE of postoperative 1 month cycloplegic refraction was +0.24 +/- 0.47 D and in the LASIK mode group, +0.87 +/- 0.54 D, indicating a statistically significant difference between the two groups. One year postoperatively, the UCVA ratios of 1.0 or better were 83% in the PRK mode group and 96% in the LASIK mode group, showing a statistically significant difference between the two groups. However, SE of manifest refractive error and CCT in the two groups were not statistically different at postoperative 1 year. CONCLUSIONS: The LASIK mode ablation method showed better results than the PRK mode ablation method in postoperative UCVA prognosis after LASEK surgery using the MEL-80 excimer laser.

Axial Length Change after Implantable Collamer Lens Implantation

PURPOSE: The axial length measurement is an important variable in calculating the intraocular lens (IOL) power in cataract surgery. In this study, the effects of the implantable collamer lens (ICL) on the axial length measurement were investigated. METHODS: The axial lengths of 141 eyes of 76 highly myopic patients were measured before ICL implantation and 1 month postoperatively using applanation A-scan ultrasound. RESULTS: The measured axial lengths before ICL implantation and 1 month after the surgery were 28.03 +/- 1.91 mm and 28.08 +/- 1.86 mm respectively, with a statistically significant difference of 0.05 mm (p = 0.036). These 2 values showed a high correlation (R2 = 0.9829, p < 0.0001). CONCLUSIONS: Even though the axial length after ICL implantation significantly increased, the 0.05 mm change was too small to influence the determination of the IOL diopters in cataract surgery. Therefore, ICL implantation history may be reflected when measuring the axial length for the IOL power calculation in cataract surgery, but the axial length measured immediately before the cataract surgery may be used to calculate the IOL power regardless of the ICL implantation history.

Corneal Endothelial Cell Changes after LASEK and M-LASEK

PURPOSE: In this study we evaluated the changes in the corneal endothelial cells before and after the operation among myopes in the M-LASEK group, on whom 0.02% mitomycin C (MMC) was used and in the LASEK group, on whom MMC was not used. METHODS: The corneal endothelial cell analysis was performed in 104 eyes of 57 subjects in the LASEK group and in 86 eyes of 48 subjects in the M-LASEK group before the operation, and 3 months and 12 months postoperatively. RESULTS: There were no statistically significant differences in the corneal endothelial cell density (CD), the cell area coefficient of variance (CV), and hexagonal cell rate (6A) between the 2 groups before the operation, and 3 months and 12 months postoperatively (p > 0.05). In the LASEK group, there were no statistically significant differences (p > 0.05) in CD when the numerical values before the operation and 3 months and 12 months after the operation were compared, but there were statistically significant differences in CV and 6A when comparing before the operation and 12 months postoperatively (p = 0.001, p = 0.034, respectively). In the M-LASEK group, there was a 2.8% statistically significant decrease (p = 0.004) in CD when the numerical values before the operation and 3 months after the operation were compared, but there were no statistically significant difference (p > 0.05) when the numerical values before the operation and 12 months after the operation were compared. In addition, there were no statistically significant differences (p > 0.05) in CV and 6A when the numerical values before the operation and 3 months and 12 months after the operation were compared. CONCLUSIONS: M-LASEK, contrary to LASEK, showed statistically significant differences in CD in short-term results such as 3 months postoperatively, but in long-term observation such as 12 months postoperatively, both groups showed no statistically significant differences.