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Purpose@#We compared anterior segment measurements obtained using a Scheimpflug-Placido topographer (SIRIUS®, Costruzione Strumenti Oftalmici, Florence, Italy) and a new anterior module for a swept-source optical coherence tomography system (ANTERION®, Heidelberg Engineering Inc., Heidelberg, Germany). @*Methods@#Anterior segment measurements were evaluated in 74 eyes of 101 patients with the two devices. Central corneal thickness (CCT), anterior chamber depth (ACD), corneal refractive power (K), J0 (Jackson cross-cylinder with axes at 180° and 90°), J45 vector (Jackson cross-cylinder with axes at 45° and 135°), and white-to-white corneal diameter (WTW) measurements obtained using the SIRIUS® system and the new anterior segment module of ANTERION® were compared. @*Results@#The mean CCTs measured by SIRIUS® and ANTERION® were 558.69 ± 44.65 and 540.26 ± 36.57 μm, respectively. The difference was statistically significant (p < 0.005), and there were high correlations between the two methods (r = 0.915, p < 0.001). The mean ACD measurements were 3.34 ± 0.53 and 3.34 ± 0.51 mm (p = 0.856), respectively, for SIRIUS® and ANTERION®. The measurements were strongly correlated (r = 0.966, p < 0.001). The measurements of WTW, total mean K, and J0 obtained with the two systems differed significantly (p < 0.005, p = 0.017, and p < 0.005, respectively), with high correlations between the two systems (r = 0.875, r = 0.967, and r = 0.933, respectively; all p < 0.001). @*Conclusions@#There were significant differences in measurements of K, CCT, WTW, and J0 between the two devices. Agreement analysis suggests that SIRIUS® and ANTERION® should not be used interchangeably.
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Purpose@#To report a case of subacute methicillin-resistant coagulase-negative Staphylococcus hominis endophthalmitis after re-operation for penetrating keratoplasty in a patient who had a penetrating keratoplasty rejection.Case summary: A 74-year-old man with underlying diabetes and hypertension who underwent bilateral penetrating keratoplasty at another hospital underwent penetrating keratoplasty reoperation due to corneal transplant rejection in the right eye. He had a history of end-stage glaucoma in the right eye and the visual acuity was finger counting at 30 cm. About 25 days postoperatively, the corneal epithelial defect was first found. Treatment based on suspicion of herpes simplex virus infection did not result in improvement and endophthalmitis was suspected in the right eye about 35 days after surgery. Anterior chamber irrigation, pars planar vitrectomy, and intravitreal antibiotic injection were performed. Culture revealed methicillin-resistant coagulase negative Staphylococcus hominis. After 2 months of treatment, the anterior chamber and vitreous inflammation decreased and best corrected visual acuity in the right eye recovered to 0.06. @*Conclusions@#Subacute endophthalmitis caused by methicillin-resistant coagulase-negative Staphylococcus may occur after penetrating keratoplasty. Transplant failure due to infection can be avoided with vitrectomy and antibiotic treatment at the right time.
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Purpose@#To evaluate the performance of two intraocular lenses (IOLs). The new monofocal IOL using a higher-order aspheric optic (Tecnis Eyhance ICB00) was compared to a standard monofocal IOL (Tecnis monofocal ZCB00) of the identical platform and material. @*Methods@#The medical records of the patients who had undergone cataract surgery with implantation of either the ZCB00 or the ICB00 in the dominant eye from March 2020 to August 2020 and with available data from the 3-month visit were reviewed. Subjects with ocular comorbidities or corneal astigmatism greater than 1.00 diopters were excluded. The uncorrected near, intermediate, distance visual acuity and corrected distance visual acuity were the main outcome measures. Optical quality parameters measured using an optical quality analysis system, clinical records including age, sex, laterality, ocular dominance, and information related to refractory errors was also collected. Parameters related to the refractory errors were all uniformly based on the Barrett Universal II formula. @*Results@#Of the 197 recruited patients, 111 and 86 were implanted with the ICB00 and ZCB00, respectively. No statistically significant differences in baseline parameters were observed between the two groups. While no statistically significant differences in distance visual acuity or optical quality were found between the two groups, compared to the ZCB00 group, the ICB00 group showed significantly higher intermediate visual acuity (p @*Conclusions@#ICB00 provided superior intermediate vision and comparable distance performance and photic phenomena compared to a standard monofocal IOL.
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Purpose@#We compared clinical outcomes between combined laser-assisted subepithelial keratomileusis and accelerated collagen cross-linking (Avedro-LASEK), and LASEK alone. @*Methods@#This retrospective study analyzed 38 eyes of 19 patients who had undergone Avedro-LASEK, and 34 eyes of 17 patients who received LASEK alone. Uncorrected distance visual acuity (UDVA), spherical equivalent (SE), keratometry, and corneal inflammation were evaluated preoperatively, and at 1 week, 1, 3, and 6 months, and 1 and 2 years after surgery. @*Results@#The Avedro-LASEK group had a higher preoperative SE (p < 0.05) and thinner central cornea compared with the control group (p < 0.05). There was no significant difference in UDVA, SE stability or keratometry between the two groups during the 2-year follow-up period. At the 2-year follow-up, the SE was ± 0.25 diopter (D) in 92% of the Avedro-LASEK patients and ± 0.5 D in 90.2% of the LASEK patients. Both groups showed high levels of refractive predictability. There was no significant difference between the flat K (p = 0.38) and steep K (p = 0.56) rates over time between the two groups. Corneal haze was observed in 21% of eyes in the Avedro-LASEK group, but neither decreased vision nor ectasia was observed during the follow-up period. @*Conclusions@#During the 2-year follow-up period, there were no significant differences in any parameters between the Avedro-LASEK and LASEK patients, and both procedures are considered effective for myopia correction because of their stability and effectiveness.
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Purpose@#We compared clinical outcomes between combined laser-assisted subepithelial keratomileusis and accelerated collagen cross-linking (Avedro-LASEK), and LASEK alone. @*Methods@#This retrospective study analyzed 38 eyes of 19 patients who had undergone Avedro-LASEK, and 34 eyes of 17 patients who received LASEK alone. Uncorrected distance visual acuity (UDVA), spherical equivalent (SE), keratometry, and corneal inflammation were evaluated preoperatively, and at 1 week, 1, 3, and 6 months, and 1 and 2 years after surgery. @*Results@#The Avedro-LASEK group had a higher preoperative SE (p < 0.05) and thinner central cornea compared with the control group (p < 0.05). There was no significant difference in UDVA, SE stability or keratometry between the two groups during the 2-year follow-up period. At the 2-year follow-up, the SE was ± 0.25 diopter (D) in 92% of the Avedro-LASEK patients and ± 0.5 D in 90.2% of the LASEK patients. Both groups showed high levels of refractive predictability. There was no significant difference between the flat K (p = 0.38) and steep K (p = 0.56) rates over time between the two groups. Corneal haze was observed in 21% of eyes in the Avedro-LASEK group, but neither decreased vision nor ectasia was observed during the follow-up period. @*Conclusions@#During the 2-year follow-up period, there were no significant differences in any parameters between the Avedro-LASEK and LASEK patients, and both procedures are considered effective for myopia correction because of their stability and effectiveness.
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Purpose@#To evaluate the performance of two intraocular lenses (IOLs). The new monofocal IOL using a higher-order aspheric optic (Tecnis Eyhance ICB00) was compared to a standard monofocal IOL (Tecnis monofocal ZCB00) of the identical platform and material. @*Methods@#The medical records of the patients who had undergone cataract surgery with implantation of either the ZCB00 or the ICB00 in the dominant eye from March 2020 to August 2020 and with available data from the 3-month visit were reviewed. Subjects with ocular comorbidities or corneal astigmatism greater than 1.00 diopters were excluded. The uncorrected near, intermediate, distance visual acuity and corrected distance visual acuity were the main outcome measures. Optical quality parameters measured using an optical quality analysis system, clinical records including age, sex, laterality, ocular dominance, and information related to refractory errors was also collected. Parameters related to the refractory errors were all uniformly based on the Barrett Universal II formula. @*Results@#Of the 197 recruited patients, 111 and 86 were implanted with the ICB00 and ZCB00, respectively. No statistically significant differences in baseline parameters were observed between the two groups. While no statistically significant differences in distance visual acuity or optical quality were found between the two groups, compared to the ZCB00 group, the ICB00 group showed significantly higher intermediate visual acuity (p @*Conclusions@#ICB00 provided superior intermediate vision and comparable distance performance and photic phenomena compared to a standard monofocal IOL.
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Purpose@#To investigate the efficacy of the combined phototherapeutic keratectomy (PTK) and peripheral anterior stromal puncture (ASP) compared with that of PTK alone in patients with recurrent corneal erosion syndrome (RCES). @*Methods@#The medical records of 25 patients (25 eyes) who underwent combined treatment of PTK and peripheral ASP for RCES from March 2016 to May 2017 were retrospectively reviewed. Twenty-three patients (23 eyes) treated with PTK alone from March 2015 to February 2016 served as a control group. All surgeries were performed by a single surgeon. This retrospective clinical study comprised 48 patients (48 eyes) who were followed up for more than 18 months. Clinical records of age, sex, laterality, etiology of RCES, and history of recurrence after treatment were evaluated. @*Results@#Twenty-five eyes were treated with combined PTK and ASP, and 23 eyes were treated with PTK only. The mean follow-up period was 19.63 ± 2.97 and 19.75 ± 6.83 months, respectively. There were no differences in baseline parameters between the groups. In the combined treatment group, one patient experienced recurrence 6 months after the surgery. In the single treatment group, five patients showed recurrence at 4, 7, 8, 11, and 13 months after the surgery, respectively.Compared to the single treatment group, the combined treatment group showed significantly lower recurrence rate (p < 0.05).All recurred patients required no additional treatment except temporary therapeutic contact lenses and topical lubricants. @*Conclusions@#Our findings suggest that combined treatment of PTK and peripheral ASP is effective in alleviation of symptoms and prevention of recurrence in refractory RCES compared with treatment using PTK alone.
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PURPOSE: To evaluate clinical findings in phlyctenular keratoconjunctivitis patients and assess the function and morphology of Meibomian glands using an interferometer (LipiView®, TearScience, Morrisville, NC, USA) in such patients.METHODS: This retrospective study included 19 eyes of 13 patients diagnosed with phlyctenular keratoconjunctivitis. The lipid layer thickness (LLT) and meibograph of each eye was quantified by tear interferometry. Tear film break-up time (TBUT) and corneal staining score were measured. Meibomian gland morphology (lid margin vascularity, plugging of gland orifices, lid margin irregularity, lid margin thickening, and partial glands) was evaluated based on anterior photographs and meibographs.RESULTS: The mean age was 21.3 years (8–44 years). Mean BUT and Oxford corneal staining scores were 2.6 ± 1.2 seconds and 1.9 ± 0.8, respectively. Abnormal findings of the Meibomian glands were observed in all patients. The mean LLT was 79.6 ± 27.4 µm and the incomplete eye blinking frequency was 3.8 ± 5.9 during 20 seconds. The graphs of the tear lipid layer showed various patterns such as flat, up-hill, down-hill, and mixed.CONCLUSIONS: Meibomian gland dysfunctions and changes in the tear film lipid layer were noted in patients with phlyctenular keratoconjunctivitis. These factors are to be considered for the treatment of phlyctenular keratoconjunctivitis in young patients under 10 years of age.
Subject(s)
Humans , Blinking , Interferometry , Keratoconjunctivitis , Meibomian Glands , Retrospective Studies , TearsABSTRACT
PURPOSE: To report the surgical results of unilateral pediatric cataracts from uncertain causes in relatively older children and to identify factors related to better visual outcomes. METHODS: We retrospectively evaluated the medical records of 39 patients who underwent surgery between the ages of 3 and 10 years for unilateral pediatric cataracts of no known cause. All patients underwent primary intraocular lens implantation and postoperative amblyopia treatment. A postoperative final visual acuity better than 20 / 30 was considered to be a good visual outcome. RESULTS: The mean age of patients was 6.0 ± 1.8 years at the time of surgery. The mean preoperative visual acuity was 1.07 ± 0.71 logarithm of the minimum angle of resolution (range, 0.15 to 3.00), while the mean final postoperative visual acuity was 0.47 ± 0.54 logarithm of the minimum angle of resolution (range, 0.00 to 2.00). Of 39 patients, 18 (46.2%) achieved a good visual outcome. Only the preoperative visual acuity maintained a significant association with a good visual outcome according to our multivariate analysis (p = 0.040). A preoperative visual acuity of 20 / 100 or better was found to increase the chance of achieving a good visual outcome by 13.79-fold (95% confidence interval, 1.13 to 167.58). CONCLUSIONS: The visual outcome of unilateral pediatric cataract surgery for cataracts with no specific cause identified in patients after three years of age could be satisfactory, especially with a preoperative visual acuity of 20 / 100 or better.
Subject(s)
Child , Humans , Amblyopia , Cataract , Lens Implantation, Intraocular , Medical Records , Multivariate Analysis , Phacoemulsification , Prognosis , Retrospective Studies , Visual AcuityABSTRACT
We report a case of complete surgical resolution of Valsalva retinopathy that manifested as a premacular hemorrhage involving a membrane followed by a macular hole (MH) resulting from the first vitrectomy. A 20-year-old female patient was referred to our hospital due to sudden vision loss in the left eye. Her best-corrected visual acuity (BCVA) in the left eye was hand motion. Fundus photographs and optical coherence tomography (OCT) revealed a premacular hemorrhage. Nine weeks later, the BCVA in the left eye had returned to 20 / 100 and the premacular hemorrhage had completely resolved, but residual sub-internal limiting membrane deposits and a preretinal membrane were present. The preretinal membrane was removed by core vitrectomy and preretinal membrane peeling, but the foveal deposits could not be excised. Two weeks after the first vitrectomy, the deposits resolved spontaneously, but a full-thickness MH was present. Six months after a second vitrectomy with fluid-gas exchange, the BCVA in the left eye had improved to 20 / 25 and OCT showed that the MH had closed. This case illustrates the possibility of MH formation following vitrectomy for Valsalva retinopathy.
Subject(s)
Female , Humans , Young Adult , Epiretinal Membrane/diagnosis , Postoperative Complications , Retinal Perforations/diagnosis , Tomography, Optical Coherence , Vitrectomy/adverse effectsABSTRACT
We report a case of complete surgical resolution of Valsalva retinopathy that manifested as a premacular hemorrhage involving a membrane followed by a macular hole (MH) resulting from the first vitrectomy. A 20-year-old female patient was referred to our hospital due to sudden vision loss in the left eye. Her best-corrected visual acuity (BCVA) in the left eye was hand motion. Fundus photographs and optical coherence tomography (OCT) revealed a premacular hemorrhage. Nine weeks later, the BCVA in the left eye had returned to 20 / 100 and the premacular hemorrhage had completely resolved, but residual sub-internal limiting membrane deposits and a preretinal membrane were present. The preretinal membrane was removed by core vitrectomy and preretinal membrane peeling, but the foveal deposits could not be excised. Two weeks after the first vitrectomy, the deposits resolved spontaneously, but a full-thickness MH was present. Six months after a second vitrectomy with fluid-gas exchange, the BCVA in the left eye had improved to 20 / 25 and OCT showed that the MH had closed. This case illustrates the possibility of MH formation following vitrectomy for Valsalva retinopathy.
Subject(s)
Female , Humans , Young Adult , Epiretinal Membrane/diagnosis , Postoperative Complications , Retinal Perforations/diagnosis , Tomography, Optical Coherence , Vitrectomy/adverse effectsABSTRACT
PURPOSE: To evaluate the effects of anterior capsulotomy extension on the rotational stability of four different types of intraocular lenses (IOLs) and to analyze factors influencing IOL rotation. METHODS: The present single-center prospective study was comprised of 128 cataract patients (151 eyes) who underwent cataract surgery and received AcrySof IQ SN60WF, Tecnis ZA9003, Akreos MI60, or Zeiss XL Stabi ZO from March 2010 to December 2010. Sixty-four eyes received an anterior capsulotomy extension which was unintentionally created or performed using Vannas scissors after capsulorrhexis to prevent anterior capsular contracture. After pupil dilation, a digital retroillumination image of the IOL was taken on the operative day and 7 days postoperatively. RESULTS: There was no statistically significant difference in IOL rotation between the 4 types of IOL (p > 0.05). The anterior capsulotomy extension group (2.72 +/- 2.42degrees) and the non-extension group (3.24 +/- 2.16degrees) did not show statistically significant differences in IOL rotation (p > 0.05). A positive correlation was observed between age and IOL rotation. Axial length, anterior chamber depth, and anterior chamber volume did not affect the degree of rotation. CONCLUSIONS: Among the 4 types of IOLs, there was no significant difference in rotational stability. Anterior capsulotomy extension to prevent anterior capsular contracture is not likely to significantly affect the rotational stability of IOLs; the 4 different types of IOL were stable in the eye and suitable as toric IOLs for correction of astigmatism.
Subject(s)
Humans , Anterior Chamber , Astigmatism , Capsulorhexis , Cataract , Contracture , Eye , Lenses, Intraocular , Prospective Studies , PupilABSTRACT
PURPOSE: To report a case of conjunctival lymphangioma with clinical manifestations of superior limbic keratoconjunctivitis after upper lid blepharoplasty. CASE SUMMARY: A 55-year-old woman who had upper lid blepharoplasty performed 1 year before complained of pain, injection, and blurred vision in her right eye, which lasted for 2 days. The slit lamp examination revealed a poorly demarcated hypertrophic lesion with central erosion on the superior bulbar conjunctiva and a diffuse corneal erosion and edema in the area of the superior limbus. Tenderness of the superior bulbar conjunctiva and corneal erosion were treated with artificial tears, antibiotic eye drops, and a therapeutic contact lens. Slight anterior chamber reaction was found and treated by steroid eye drops; however, there was no improvement. After eversion of the right upper eyelid with a Desmarres retractor, a hypertrophic lesion with central dimpling was found. However, no exposed sutures were observed. Resection and biopsy of the superior bulbar conjunctiva and a subtarsal triamcinolone injection were performed for diagnosis and treatment. A conjunctival biopsy specimen showed conjunctival lymphangioma. CONCLUSIONS: Conjunctival lymphangioma can occur due to pressure and friction of an eyelid lesion after upper lid blepharoplasty.