Outcomes after Implantable Contact Lens for Moderate to High Myopia

PURPOSE: To evaluate the efficacy, safety, predictability and subjective symptoms of the implantable contact lens to treat moderate to high myopia. METHODS: A Staar Collamer posterior chamber phakic IOL was implanted in 83 eyes of 44 patients with spherical equivalent -10.10D (-3.87~-19.37D). Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refraction, adverse events, subjective quality of vision and satisfaction were evaluated. Mean follow-up was 4.9 months (3~9 months). RESULTS: All patients had a UCVA of 0.7 or better, and 61.4% had UCVA of 1.0 or better. Gains of 2 or more lines of BCVA occurred in 15 eyes (18.1%). Mean spherical equivalent refraction at postoperative 3 months was -0.37D (+0.25~-1.75D) and remained stable. There was no change in cylinder diopters. 81.9% of eyes were within +/-0.5D, and 97.6% were within +/-1.0D of predicted refraction. Glare and halo was observed in 5 eyes (6%) after laser iridotomy, lens flipping in 1 eye (1.2%), corneal edema in 2eyes (2.4%), drug induced ocular hypertension in 4eyes (4.8%). There was no case of cataract, glaucoma, retinal detachment, and lens dislocation. There was significant decrease of pupil diameter at postoperative 1 month and decreased pupil diameter was maintained until the last examination. Generally patient satisfaction was very good. But, some patients reported poor in the category of glare and halo. CONCLUSIONS: ICL implantation had good visual, refractive results, and stability. Long term follow-up is required to confirm the significant complications that do not occur in most patients over time.

Evaluation of the Ocular Cyclotorsion During Laser in Situ Keratomileusis

PURPOSE: To evaluate the presence, degree and direction of ocular cyclotorsion in eyes undergoing laser in situ keratomileusis (LASIK). METHODS: We measured the presence, degree and torsional direction of 161 eyes of 88 patients who underwent LASIK for myopic and hyperopic astigmatism with LADARVision 4000 excimer laser (Alcon Summit Autonomous). Preoperatively, each eye was marked at the 3, 9-o'clock conjunctival area with marking pen under the slit lamp observation with a horizontal beam while the patient was seated upright. After lifting of corneal flap and acquiring of LADARVision4000 auto-tracking system, the presence and torsional direction was confirmed on the computer monitor and the rotational deviation degree was measured from horizontal reference line by software program built in laser computer system before the laser exposure. RESULTS: There was a cyclotorsional deviation in 144 eyes (89%). The counter-clockwise rotation was shown in 99 eyes (69%) and clockwise rotation in 45 eyes (31%). Mean ocular torsional misalignment was 3.8 +/- 2.9 degrees (right eye; 4.7 +/- 2.9 degrees, left eye; 3.5 +/- 2.4 degrees). 85 eyes (53%) had a torsional deviation less than 4 degrees and 5 eyes (3%) had a deviation greater than 10 degrees. CONCLUSIONS: A misalignment of astigmatism axis caused by ocular cyclotorsion was known as a reason of astigmatism undercorrection during LASIK. Thus, preoperative marking on conjunctiva and cyclotorsional axis alignment before laser treatment may reduce the incomplete astigmatism correction in LASIK.

The Effect of Endothelin-1 on IOP and Aqueous Outflow Facility in the Rabbit Eye

Endothelin(ET) is known as a family of potent hydrophobic, vasoactive peptide. We investigated the effect according to the concentrations of ET on intraocular pressure(IOP), aqueous outflow facility, pupillary diameter and light reflex and iris vessels. Twenty-four hours after injection of 2.5 microgram and 10 microgram of ET-1 into the anteriorvitreous of rabbit eyes, the IOP was reduced by 69% and 80%, respectively and did not return to the level of prefreatment until at least 14 days and 20 days, respectively. But the decrease of IOP was not due to the increased aqueous outflow. The pupillary diameter of ET-1 treated eyes was 1 to 2mm larger than the pretreatment. The time course of the pupillary effects generally ran paralled with the reduction of IOP. The iridial and conjunctival hyperemia was detectable during the pupillary dilatation. Endothelins are therefore potential participants in the local regulation of IOP, ocular blood vessel tone, and iris smooth muscle tone.

The Inspection for the Clinical Usefulness of the Pericecal Index in Early Glaucoma Automated Visual Fields

Many visual field indices have been used for the rapid, precise evaluation of the Humphrey automated visual field. The clinical usefulness of Pericecal Index(PI), the mean sensitivity of 11 test points around the blind spot, was studied in the diagnosis of early glaucoma. PI was calculated in 60 eyes with low tension glaucoma(LTG)[mean defect<10dB], 60 eyes with early visual field change[general reduction of sensitivity(GRS)] and in 60 normal eyes. The difference between glaucomatolls eyes and normal eyes was statistically significant(p<0.01). And also compared PI with the mean sensitivity of 11 control points, located at same eccentricity in lower field and used this as the Control Area(CA). More over, the mean sensitivity of these points in glaucomatous and normal eyes was compared. The difference between PI and CI was only statistically significant in glaucomatolls eyes. On the other hand, We found a significant difference between normal and glaucomatolls control points. Thus we concluded that PI can be the useful visual field indix for the diagnosis of early glaucoma.

Examination of The Visual Field Change Results using The Humphrey Visual Field Analyzer and The Octopus Visual Field Analyzer in Early Primary Open Angle Glaucoma

The Humphrey Visual Field Analyzer and The Octopus Visual Field Analyzer in Early Primary Open Angle Glaucoma Visual field measurements are useful tool not only for diagnosis but also for management ealuation of early glaucoma. To know the relationship between the results of visual field which were performed by the Humphrey and the Octopus, the 25 disc data which have shown the general reduction of sensitivity on two continuous separate sessions in Humphrey viual field analyzer were transmitted into the Peridata Standard Printout Mode of GIX program on the Octopus 1-2-3. We compared the aspect of Bebie curve of Octopus 1-2-3 and the difference of the global indices between Humphrey and Octopus in the basically input data of age related standard sensitivity of visual field. The general reduction of sensitivity in Humphrey visual field analyzer showed the sensitivity loss in Bebie curve of Octopus 1-2-3(p0.05) but were difference the CPSD and SF(p<0.05). In the comparison of the correlation on global indices between the two field analysis. MD and PSD were closely correlated r=0.657, PSD r=0.697, p<0.001), CPSD and SF were statistically correlated(p<0.001) but had lower correlation coefficients(CPSD r=0.478, SF r=0.389). Thus we conclude that there are little differences between the results of two field analyzers.