Clinical Outcomes of Diffractive Aspheric Trifocal Intraocular Lens Implantation

PURPOSE: To evaluate the clinical outcomes of patients with diffractive aspheric trifocal intraocular lens FineVision Pod F IOL (PhysIOL, Liège, Belgium) implantation. METHODS: Thirty eight eyes received phacoemulsification and implantation of FineVision Pod F IOL. Uncorrected distant visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), refractive values, and defocus curve were evaluated at postoperative 1 month and 3 months. Optical quality was evaluated with the contrast sensitivity test, OQAS® (Optical Quality Analysis System, Visiometrics, Cerdanyola del Vallès, Spain) and questionnaire. RESULTS: At the 3-month postoperative follow-up, the mean spherical equivalent was 0.01 ± 0.31 D and the mean UDVA, UIVA and UNVA were 0.04 ± 0.07, 0.19 ± 0.12, and 0.04 ± 0.07, respectively. Mean contrast sensitivities at 0.75, 1.5, 3, 6, 12, and 18 cycles per degrees were 2.00 ± 1.54, 2.16 ± 1.60, 2.25 ± 1.76, 2.16 ± 1.83, 1.52 ± 1.47 and 1.03 ± 0.95 respectively and mean objective scatter index by OQAS® (Optical Quality Analysis System, Visiometrics) was 1.54 ± 0.74. In satisfaction analysis, general satisfaction with surgery was 89% and spectacle independence were 89% at far, 78% at intermediate and 83% at near distance. Postoperative dissatisfaction factors were dryness (36%), glare at night (32%), halo (18%). CONCLUSIONS: The FineVision Pod F IOL showed excellent distant and near visual acuities with an effective intermediate visual acuity. The eyes with FineVision Pod F IOL expected to achieve the favorable visual outcome and patient satisfaction.

Comparison of Ocular Biometry Using New Swept-source Optical Coherence Tomography-based Optical Biometer with Other Devices

PURPOSE: To evaluate the agreement between optical biometry with swept-source optical coherence tomography-based optical biometry (IOLMaster 700) and other devices. METHODS: A total of 137 eyes (78 patients) with cataracts were included in this retrospective study. Axial length (AL), anterior chamber depth (ACD), keratometry, and white-to-white (WTW) distance measured using IOLMaster 700 were compared with results for the following five different biometers: IOLMaster 500, A-scan, automated refractor, manual keratometry, and Galilei G4. Differences and correlations among the devices were assessed using the Bland-Altman plot and intraclass correlation coefficient (ICC). RESULTS: For AL values, the IOLMaster 700, IOLMaster 500, and A-scan measurements showed excellent agreement (all ICC >0.99). For ACD values, ICC of IOLMaster 700 and Galilei G4 was 0.965 but A-scan was poorly correlated with either IOLMaster 700 or Galilei G4. The ICCs of IOLMaster 700 and other devices were all greater than 0.9 for average keratometry, but those of the mean cylinder keratometry were all between 0.7 and 0.8. The mean difference in the WTW distance between the IOLMaster 700 and Galilei G4 was 0.029 mm, but the ICC was 0.525. AL measurements were not possible for 10 eyes with the IOLMaster 500 but were obtained in all eyes with the IOLMaster 700. CONCLUSIONS: In clinical practice, AL, ACD, and average keratometry values of IOLMaster 700 can be used interchangeably with those of the other devices tested. However, the ACD value between IOLMaster 700 and A-scan or the WTW distance between IOLMaster 700 and Galilei G4 are not interchangeable because of clinical and statistical differences in measurements between the devices.

Comparison between Active and Gravity-based Phacoemulsification Fluidics Systems in Immediate Sequential Bilateral Cataract Surgery

PURPOSE: To compare the clinical outcomes during phacoemulsification when using active fluidics (Centurion®) and gravity-based fluidics (Infiniti®) in immediate sequential bilateral cataract surgery. METHODS: From January 2015 to September 2015, 68 eyes of 34 patients with bilateral cataract were assigned to receive immediate sequential bilateral cataract surgery by Centurion® in one eye and Infiniti® in the other eye. We measured and compared intraoperative factors, including cumulative dissipated energy (CDE), ultrasound time, mean amount of balanced salt solution (BSS) used, and pain using a scale. Best corrected visual acuity (BCVA), central corneal thickness (CCT), and endothelial cell density (ECD) were also evaluated preoperatively and 1 month postoperatively. RESULTS: Intraoperative measurements showed significantly less CDE (5.05 ± 2.18 vs. 7.05 ± 3.82), ultrasound time (24.65 ± 9.68 vs. 34.95 ± 17.95 seconds), and mean amount of BSS used (37.06 ± 10.25 vs. 44.88 ± 16.38 mL) in the Centurion® group than in the Infiniti® group (p = 0.011, p = 0.005, p = 0.021, respectively). The intraoperative pain scale was 0.26 ± 0.51 in the Centurion® group and 0.50 ± 0.71 in the Infiniti® group, and was not significantly different (p = 0.121). BCVA, increase of CCT and decrease of ECD were not significantly different between the two groups at 1 month postoperatively. CONCLUSIONS: The efficacy of phacoemulsification in the Centurion® group was superior to that in the Infiniti® group. The level of intraoperative pain and clinical outcomes 1 month after surgery were not significantly different between the two groups.

Comparison of Clinical Outcomes between Laser Blended Vision and Monovision Laser Refractive Surgery for Presbyopia

PURPOSE: To compare the efficacy and safety of Laser Blended Vision (LBV) and monovision laser refractive surgery (monovision) for presbyopia correction in patients with myopia. METHODS: This retrospective comparative study included 42 eyes of 21 patients with LBV and 50 eyes of 25 patients with monovision. Monocular and binocular distance, intermediate and near visual acuity, and refractive changes were evaluated preoperatively and 3 months after the surgery and compared. The patients in the LBV group underwent further evaluation of spherical aberration 3 months after the surgery and treatment satisfaction 3-6 months after the surgery. RESULTS: The mean age of the patients was 47.9 years in the LBV group and 41.7 years in the monovision group. Three months after surgery, the spherical equivalents were +0.11 ± 0.17 D in the dominant eye and -1.52 ± 0.36 D in the non-dominant eye in the LBV group. In contrast, the spherical equivalents were +0.23 ± 0.26 D in the dominant eye and -0.82 ± 0.28 D in the non-dominant eye in the monovision group. All patients achieved a binocular uncorrected distance visual acuity of 0.10 (log MAR) or better, and 86% of the LBV group and 100% of the monovision group achieved a binocular uncorrected intermediate visual acuity of better than 0.10. Moreover, 95% of the LBV group and 100% of the monovision group achieved a binocular uncorrected near visual acuity of better than 0.18. In the LBV group, mean spherical aberration increased after surgery than before, but it was not statistically significant. Complications such as corneal opacity that could decrease visual acuity were absent in both groups. Overall patient satisfaction after surgery was 80% in the LBV group. CONCLUSIONS: Despite the relatively higher mean age of the LBV group, both groups showed similar results regarding presbyopia correction in patients with myopia.

Pigment Dispersion Syndrome and Reverse Pupillary Block after Implantable Collamer Lens with Central Hole Implantation

PURPOSE: To report a case of pigment dispersion syndrome and reverse pupillary block secondary to the implantation of implantable collamer lens (ICL) with a central hole (AQUA ICL®) that was treated with ICL removal and laser peripheral iridotomy (LPI). CASE SUMMARY: A 29-year-old woman with myopia in both eyes underwent implantation of AQUA ICL®. Four weeks postoperatively, the intraocular pressure (IOP) increased to 34 mm Hg and the patient showed pigment dispersion syndrome in both eyes. Since the IOP did not reduce with the maximum tolerable medical therapy, the ICLs were removed 8 weeks after implantation. The pigment dispersion subsided and IOP reduced shortly after ICL removal. However, 4 weeks after removal of ICL, posterior iris bowing and reverse pupillary block occurred in the right eye and the IOP increased to 46 mm Hg. LPI was performed in the right eye, and the reverse pupillary block was dissolved after a reduction in pigment dispersion. The IOP subsequently normalized to 13 mm Hg. Two weeks later, prophylactic LPI was performed in the left eye. Four weeks after prophylactic LPI, selective laser trabeculoplasty was performed on both eyes. As a result, the IOP was 11 mm Hg in the right eye and 12 mm Hg in the left eye after 4 weeks of treatment with topical IOP-lowering medications. CONCLUSIONS: The present case indicates that implantation of ICL with a central hole can lead to early postoperative pigment dispersion syndrome. When this condition persists and is accompanied by reverse pupillary block after ICL removal, LPI can be partially effective.

Comparison of Clinical Outcomes in Implantable Collamer Lens Implantation between AQUA ICL(R) and Conventional ICL

PURPOSE: To compare the clinical outcomes between AQUA ICL(R) (V4C) and conventional implantable collamer lens (ICL, V4B) in patients with high myopia. METHODS: We compared preoperative and postoperative visual acuities, spherical equivalent, intraocular pressure, postoperative vault and visual quality assessed using optical quality analyzing system (OQAS(R)) between 20 eyes implanted with ICL (V4B) and 22 eyes implanted with AQUA ICL(R) (V4C). RESULTS: Visual acuity (log MAR) and spherical equivalent at postoperative 3 months were 0.06 +/- 0.09 and -0.26 +/- 0.17 D in the V4B group and 0.03 +/- 0.03 and -0.23 +/- 0.19 D in the V4C group, respectively. There was no statistical difference in visual acuity and spherical equivalent between the 2 groups (p > 0.05). Postoperative intraocular pressure (IOP) elevated significantly in both groups until 6 hours after the operation (p 0.05). V4C resulted in lower IOP than V4B 6 hours postoperatively. In ICL (V4B) and AQUA ICL(R) (V4C) groups, the objective scattering index (OSI) was 1.29 +/- 0.90 and 1.36 +/- 0.68, modulation transfer function (MTF) cut off value was 29.62 +/- 11.31 c/deg and 29.61 +/- 9.56 c/deg and Sterhl ratio was 0.18 +/- 0.07 and 0.17 +/- 0.04, respectively, 3 months postoperatively. None of these values were significantly different between the 2 groups. CONCLUSIONS: AQUA ICL(R) (V4C) implantation is an effective, convenient and safe surgery for myopia correction and yields better outcome than ICL (V4B) in terms of early postoperative IOP.

Clinical Outcomes of Diffractive Aspheric Trifocal Intraocular Lens Implantation

PURPOSE: To evaluate the clinical outcomes of patients with diffractive aspheric trifocal intraocular lens (AT.LISA tri839 MP(R) IOL, Carl Zeiss Meditec, Jena, Germany) implantation. METHODS: Forty eyes of 53 patients received phacoemulsification and implantation of AT.LISA tri839 MP(R) IOL (Carl Zeiss Meditec). Uncorrected distant visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), refractive values, and defocus curve were evaluated at postoperative 1 month and 3 months. Optical quality was evaluated with the Optical Quality Analysis System (OQAS(R), Visiometrics, Castelldefels, Spain). RESULTS: At the 3-month postoperative follow-up, the mean spherical equivalent was 0.01 +/- 0.31 D and the mean UDVA, UIVA and UNVA were 0.023 +/- 0.020, 0.155 +/- 0.091, and 0.139 +/- 0.069, respectively. The means of the objective scatter index, modulation transfer function cut-off value, Strehl ratio measured by OQAS(R) (Visiometrics) were 1.83 +/- 0.52, 33.58 +/- 14.27 cycle per degree and 0.18 +/- 0.11, respectively. Intermediate visual acuity did not fall sharply at defocus curve. CONCLUSIONS: Implantation of the diffractive aspheric trifocal intraocular lens in patients with cataracts provided excellent distant, intermediate and near visual acuities with high visual quality.

Anterior and Posterior Corneal Spherical Aberration Measured With Pentacam in the Korean

PURPOSE: To evaluate the spherical aberrations of the anterior and posterior surfaces of normal corneas using Pentacam in a Korean sample population and determine their ranges and changes with age. METHODS: We used Pentacam (Oculus Inc.,Germany) to measure the anterior and posterior corneal spherical aberrations of 240 eyes in 240 patients with normal corneas who visited our clinic. The means and ranges of spherical aberrations and their changes with age were determined. We examined both eyes of 90 patients to confirm the inter-ocular symmetry in spherical aberration. RESULTS: The mean age of the 240 patients (M:F=103:137) was 49.8 years (range: 20-79), and the mean spherical aberrations of the anterior and posterior surfaces of the cornea were 0.230+/-0.078 micrometer, and -0.04+/-0.021 micrometer, respectively. The mean total corneal spherical aberration was 0.19+/-0.087 micrometer. There were no differences between males and females, and inter-ocular symmetry was observed in all tested patients. There was a tendency for the values of anterior, posterior and total corneal spherical aberration to increase with age. Ranges of spherical aberrations were from -0.177 micrometer to 0.423 micrometer in the anterior cornea, from -0.083 micrometer to 0.034 micrometer in the posterior cornea, and from -0.238 micrometer to 0.410 micrometer in the total cornea. CONCLUSIONS: In a Korean population, the mean total corneal spherical aberration was 0.19 micrometer, which was shown to increase with age. Some patients were shown to have an extreme value. Based on these results, a preoperative analysis for corneal spherical aberration may be helpful when selecting aspheric intraocular lenses.

Corneal Melting and Descemetocele Resulting From Noninfectious Keratitis Related to the Cosmetic Contact Lenses

PURPOSE:To report 2 cases of corneal melting and corneal melting with descemetocele that occurred in users of cosmetic contact lenses. CASE SUMMARY: A-12-year-old and a 13-year-old female who used cosmetic contact lenses were referred to our clinic under the preliminary diagnosis of keratitis and corneal melting. The patients had purchased the lenses from an optician and had worn the lenses for approximately 1 month without being educated on their proper use. The signs and symptoms improved after 2 weeks of treatment with oral steroid and 1% topical prednisolone acetate. However, descemetocele occurred in the 12-year-old patient. Reepithelization of the cornea had been completed within the treatment period. However, corneal thinning with mild opacity remained in the lesions, and the best corrected visual acuities on the Snellen chart were 20/30 in both patients.

Epidemiology of Infectious Keratitis(II): A Multi-center Study

To identify risk factors and causative organisms, and to evaluate clinical manifestations, methods and results of treatment in infectious keratitis, an epidemiological study was performed prospectively under the identical protocol from April 1995 to March 2000.Logistic regression analysis was used to evaluate possible risk factors. The 1474 cases of infectious keratitis reported from 22 hospitals were studied. Five hundred forty-four organisms(442 bacteria, 82 fungi, 20 A c a n t h a m o e b a)were detected in 1320 eyes with infectious keratitis excluding 154 herpetic keratitis. The Pseudomonas aeruginosa was the most common organism in bacterial keratitis, and Fusariumspp. was the major isolate in fungal keratitis. Contact lens wear and occupation(industry, forester, miner, fisherman)were the risk factors for bacterial keratitis. Risk factors in fungal keratitis were fifth decade of age, farmer, and systemic diseases(diabetes mellitus etc.). Risk factors in herpetic keratitis were male and occupation(office worker, service, student, housewife). Risk factors in Acanthamoeba keratitis was contact lens wear.

The Effect of Preoperative Keratometric Value on Corneal Flap Dimensions in LASIK

PURPOSE: To evaluate the effect of preoperative keratometric value on corneal flap dimensions, records of 81 eyes of 45 patients who had LASIK were analyzed retrospectively. METHOD: Corneal thickness and diameter , and keratometric value were measured preoperatively. RESULTS: In this study, SCMD Turbokeratome was set for making a corneal flap with 150 micron thickness and 8.25 mm diameter. In reality, however, the mean corneal flap thickness was 110.7+/-15.7 micron and the mean corneal flap diameter was 7.89+/-0.33 mm. The lower mean preoperative keratometric value, the thicker(r=-0.325, p=0.003) and the smaller(r=0.460, p=0.009) diameter flap was made. When we divided eyes into three groups according to their keratometric values, eyes with keratometric values lower than 42.5 D resulted in corneal flap with 116.70+/-12.6 micron thickness and 7.65(0.28mm diameter as opposed to 102.16+/-13.41 micron thickness and 8.05+/-0.37 mm diameter flap in corneas having keratometric values above 44.5 D(p<0.05). CONCLUSION: When a LASIK flap was made using SCMD manual keratome, steeper corneas tend to have larger and thinner corneal flaps. In conclusion, for making the corneal flap according to the intended thickness and diameter in LASIK, preoperative keratometric value should be considered carefully.

Balanced Salt Solution Contained within Plastic Bag and the one Encased within Bottle

PURPOSE: Air bubbles developed during phcoemulsification procedure are known to be harmful to corneal endothelial cells and balanced salt solution(BSS) contained within plastic bag(Bag BSS) has been thought to be more prone to the air bubble formation than the one encased within bottle(Bottle BSS). For the above reason, we tried to see whether there is any difference in corneal endothelial cell changes between two groups of patients who underwent phacoemulsification using Bag BSS and Bottle BSS respectively. METHODS: 85 cataract eyes of 60 patients were randomly assigned to two groups of Bag BSS(43 eyes) and Bottle BSS(42 eyes), on which phacoemulsification was performed through scleral tunnel incision followed by silicone PCL placement. Corneal endothelial cells were examined using specular microscopy postoperatively at 1 month and compared with preoperative specular microscopic data. RESULTS: The percent loss of corneal endothelial cell density at postoperative 1 month for the Bag BSS group(13.02+/-0.7%) was not significantly different from the Bottle BSS group(12.8+/-8.1%)(p>0.05). Coeffcient of variation in cell size(p>0.05) and mean endothelial cell size(p>0.05) also showed no significant difference between the two groups. CONCLUSION: In conclusion, Bag BSS and Bottle BSS have similiar protective effect on the corneal endothelial cell damage during phocoemulsification.

The Effect of Environmental Humidity on LASIK Results

It is known that humidity in the laser room might affect the outcomes of excimer laser refractive surgery. This study evaluated the outcomes of laser in situ keratomileusis (LASIK)according to humidity changes in laser room. Hinged flap was made by SCMD turbokeratome and photoablation was performed by utilizing VISX 20/20 excimer laser system. The differences between targeted refraction and actual refractive error, namely, refractive correction errors (defined by authors)were calculated. We have divided LASIK patients into two groups. Group A consisting of 61 eyes of 31 patients underwent LASIK when laser room humidity was over 70% (average 73%) and Group B includes 49 eyes of 28 patients when laser room humidity was under 40% (average 35%). Each group was broken into two subgroups, that is high myopia (> or= -6 D)and mild to moderate myopia ( or= -6 D)was 1.28+/-1.42 D in the group A (n=46 eyes)and 1.99 +/-1.38 D in the group B (n= 26 eyes). In both groups, the difference between two subgroups was statistically significant and high myopes group B was overcorrected compared with ones in group A (t-test, p0.05). The proper room humidity is critical for LASIK results, particularly in the high myopia (> or= -6 D)because humidity can affect outcomes of LASIK. Therefore, the humidity should be maintained properly for enhancement of surgical outcome predictability in the high myopia.

Relationship between Optic Disc Parameters and Myopic Refractive Errors in Myopia

Myopic discs(range: -0.5D) which were taken a confocal scanning laser ophthalmoscope(HRT, Heidelberg Engineering) were analyzed to determine the relationship between optic disc parameters and myopic refractive errors. Regression analysis and coefficient variation were used for a statistic tool. The disc area was not correlated with the myopic refractive error(p=0.21) and showed 16.0% of coefficient of variation. Cup area, cup disc area ratio, rim area, cup volume, rim volume, mean cup depth, maximum cup depth and cup shape measure showed statistically significant correlation with myopic refractive error, respectively(p<0.05). Among these parameters, rim area varied least(within all myopic eyes) with 16.5% of coefficient of variation. As the rim area is the most stable optic disc parameter interindividually in myopic population, it seem to be valuable for follow-up evaluation when a glaucomatous damage is suspected in myopic eyes by calculating its expected normal value with a regression equation.

Relationship between Optic Disc Parameters and Myopic Refractive Errors in Myopia

Myopic discs(range: -0.5D) which were taken a confocal scanning laser ophthalmoscope(HRT, Heidelberg Engineering) were analyzed to determine the relationship between optic disc parameters and myopic refractive errors. Regression analysis and coefficient variation were used for a statistic tool. The disc area was not correlated with the myopic refractive error(p=0.21) and showed 16.0% of coefficient of variation. Cup area, cup disc area ratio, rim area, cup volume, rim volume, mean cup depth, maximum cup depth and cup shape measure showed statistically significant correlation with myopic refractive error, respectively(p<0.05). Among these parameters, rim area varied least(within all myopic eyes) with 16.5% of coefficient of variation. As the rim area is the most stable optic disc parameter interindividually in myopic population, it seem to be valuable for follow-up evaluation when a glaucomatous damage is suspected in myopic eyes by calculating its expected normal value with a regression equation.

Changes in Corneal Sensitivity after Laser in-situ Keratom ileusis

To evaluate the changes of corneal sensitivity after LASIK, we measured corneal sensitivity threshold at 5 regions of cornea using Cochet-Bonnet aesthesiometer in 41 myopic eyes of 23 patients who underwent LASIK. Corneal sensitivities were tested in the Central, medial, superior, temporal and inferior region of cornea preoperatively and postoperatively. Central corneal sensitivity was reduced to 1.1+/-4.6% of preoperative sensation at 1 day postoperatively and gradually recovered showing 40.3+/-27.8% at 3 months postoperatively. The sensitivity of the central region was the lowest of all significantly and medial region was the highest(p0.05). There were no overall differences in the sensitivities of the superior, temporal and inferior regions(p>0.05) and their sensitivities were higher than that of central region and lower than that of medial region. The amount of preoperative myopia and the thickness of corneal flap showed no significant correlation with the decrease of postoperative corneal sensitivity(r0.05).

The Change in Palpebral Fissure Height of Bilateral Eyes after Uniateral Cataract Operation

To investigate the change in upper eyelid position after cataract operation, We studied 40 eyes of 40 patients prospectively who underwent phacoemulsification and intraocular lens implantation. Levator function and vertical palpebral lid fissure height were measured preoperatively and at postoperative day 1, 7, 28 and 56 in and the surgical and the fellow eyes. Postoperative mean vertical lid fissure height decreased compared with preoperative mean vertical lid fissure height in both eyes. The postoperative decrease in vertical lid fissure height tended to decrease with times and these trends had statistically significant correlation between both eyes. This suggests that both eyes are affected by factors unassociated with the cataract surgery and it is most apparent in the immediate postoperative period. In conclusion, we recommend not only the surgical eye but the fellow eye should be evaluated preoperatively and postoperatively to understand the eyelid position after cataract operation.

Epidemiology of infectious KeratitisI A Multi-center Study

Infectious keratitis is the most common serious ocular infection, and may be caused by various bacteria, fungi, viruses and parasites. The authors performed prospectively an epidemiological study to identify risk factors and causative organisms, and to evaluate clinical manifestations, methods and results of treatment in infectious keratitis under the identical protocol from April 1995 to September 1997. Logistic regression analysis [univariate analysis and multivariate analysis] was used to evaluate possible risk factors. Six hundred sixty cases of infectious keratitis reported from 19 hospitals were studied. Two hundred eighty-three organisms[247 bacteria, 32 fungi, 4 acanthamoeba] were detected in 626 eyes with infectious keratitis excluding 34 pherpetic keratitis. The Pseudomonas aeruginosa, coagulase negative staphylococcus, Staphylococcus aureus and Serratia marcescens were the major orgnisms in bacterial keratitis. Aspergillus, Fusarium and Candida were the major isolates in fungal keratitis. Contact lens wear was a risk factor for bacterial keratitis. Female, age[less than 40 years] and occupation[student, house-wife, office worker, servise] were associated with bacterial keratitis. Risk factors in herpetic keratitis were age[between 40 and 59 years] and ocular adnexal diseases. Male was associated factor with herpetic keratitis.

Reproducibility of the Peripapillary and Retinal Perfusion Measurement with Confocal Scanning Laser Flowmetry

Confocal scanning laser flowmetry(HRF: Heidelberg Retina Flowmetry) is a new kind of instrument which enables non-invasive two-dimentional mapping of perfusion of the retina and optic disc and to evaluate the clinically available reproducibility of the peripapillary and retinal perfusion measurement with the confocal scanning laser flowmetry, the authors calculate the coefficient of variation (CV) from the parameters(volume, flow, velocity). The authors indicate two region of interest in the peripapillary region and retina, not overlapping the large vessels and measure the parameters three times consecutively(one session) while visiting three times intervalled(three session), thereafter calculate the mean CV of parameters in ten healthy eyes of ten subject. The CV of parameters obtained with the confocal scanning laser flowmetry was low relatively and therefore reproducibility was high as the CV lower, the reproducibility higher. Comparing the CV between one session and three session measurement to know the clinically available measurement frequency, the CV of three session (volume 13%, flow 16.7%, velocity 16%) was lower than the CV of one session (volume 16.7%, flow 20.7%, velocity 20.1%) in the peripapillary region(Students t test; volume p=0.009, flow p=0.03, velocity p=0.016) and the CV of three session (volume 16.7%, flow 20.7%, velocity 17%) was lower than the CV of one session (volume 18.2%, flow 21.8%, velocity 21.7%) in the retina(Students t test; volume p=0.017, flow p=0.0009, velocity p=0.0004). Above the results, the CV of parameters(13~21.8%) in one and three session had relatively high reproducibility. Also the CV between two measurements had a difference statistically but the difference was not so high, the authors concluded the confocal scanning laser flowmetry which have high resolution measure the peripapillary region and retina reproduciblly with only one time visit, three consecutive measurements.

Long-term Results and Complications using Scleral-fixated Posterior Chamber Intraocular Lenses

The scleral fixation of a posterior chamber intraocular lens is known to be a technique for managing cataract, aphakia, lens dislocation, pseudophakic bullous keratopathy with incomplete zonular or capsular support. We performed a retrospective review of longterm results and complications of 86 patients(103 eyes) who had a minimum of 12 months follow-up after scleral fixation of a posterior chamber intraocular lenses. At the last examination, mean postoperative corrected visual acuity is 0.7 +/- 0.28 and 62 eyes(57.4%) had a vision of 0.8 or better. Especially in aphakia, postoperative corrected visual acuity was significantly improved. The complications related to scleral fixation were exposed scleral fixation suture, glaucoma, cystoid macular edema, subluxation of intraocular lenses, retinal detachment, herpetic keratitis, vitreous hemorrhage and vitreous opacity. The other factors influenced on visual acuity were age-related macular degeneration, optic atrophy, diabetic retinopathy and clinical significant macular edema, and corneal opacity. Though these longterm results suggest that overall prognosis for visual acuity is quite good, careful assessment preoperatively and proper management are important.