The Correlation of Quality of Life Impact of Refractive Correction Score with Visual Disturbances and Contrast Sensitivity in Spectacle Wearers: A Preliminary Study

@#Introduction: This study aimed to evaluate the correlation between Quality of Life Impact of Refractive Correction (QIRC) score with visual disturbances and contrast sensitivity in spectacle wearers. Methods: A total of 21 spectacle-corrected moderate myopes was recruited. Subjects completed the QIRC questionnaire for quality of life assessment. The functional and emotional QIRC scores were analysed separately. Visual disturbances were evaluated using the Halo and Glare Simulator, and contrast sensitivity was measured by the M&S Smart System II. All measurements were taken binocularly in 1 lux illumination. Spearman’s test was employed to evaluate the correlations. Results: The most common visual disturbance was diffuse glare. The functional QIRC score was significantly correlated with glare intensity (r = -0.54, P = 0.01). Whereas, the emotional QIRC score was significantly correlated with contrast sensitivity (r = 0.45, P = 0.04). Conclusion: The functional QIRC score is lower when the glare intensity is greater, and the emotional QIRC score is higher in person with greater contrast sensitivity. Hence, glare intensity and contrast sensitivity measurements are suggested to predetermine spectacle wearers’ functional vision and well-being, respectively

Clinical outcomes after femtosecond laser assisted cataract surgery with implantation of the tecnis symfony intraocular lens / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the clinical outcomes in terms of vision across distances(near, intermediate and far), contrast sensitivity and subjective patient satisfaction after femtosecond laser-assisted cataract surgery(FLACS)with implantation of an extended range of vision(ERV)intraocular lens(IOL).<p>METHODS: Forty patients(55 eyes)underwent bilateral or monocular FLACS with implantation of the ERV IOL Tecnis Symfony(Johnson & Johnson Vision)were enrolled. Uncorrected distance(UDVA), intermediate(UIVA)and near visual acuities(UNVA)were evaluated at 3mo after surgery, as well the defocus curve, contrast sensitivity, patient satisfaction and spectacle independence.<p>RESULTS:No severe complications occurred. All eyes showed a central position of the IOL in the capsular bag without tilting at 3mo after surgery. 3mo postoperative mean logMAR visual acuity at 5 m, 67 cm and 40 cm were -0.04 ±0.08, -0.17±0.22, 0.37±0.17, respectively. All patients obtained satisfactory UDVA and UIVA, as well as functional UNVA, meeting the needs of daily life. Spectacle independence rate was 94.55%. Contrast sensitivity results did not differ from those obtained with monofocal aspheric lenses. Likewise, no moderate and severe photic phenomena were reported. Mean patient satisfaction scores with distance, intermediate and near vision were 9.0, 9.0, and 7.0, respectively.<p>CONCLUSION: FLACS with implantation of the ERV IOL TECNIS Symfony provides a successful visual restoration at far, intermediate distance and a functional-range near vision acuity, with minimal level of disturbing photic phenomena, and high rates of spectacle independence and patient satisfaction.

Study of halo size and contrast sensitivity of myopia by vision monitor / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To assess the halo size and contrast sensitivity on different levels of myopia and to analyze their correlation.<p>METHODS: Screening total 156 myopic patients aged 18 to 39 years old included in our hospital from March 2018 to March 2019. There were 49 subjects in high myopia group(SER>-6.00D), 54 in medium myopia group(-3.00D<SER≤-6.00D)and 53 in low myopia group(SER≤-3.00D). Size of halo disk, and contrast sensitivity of 0.6, 1.1, 2.2, 3.4, 7.1, 14.2c/d were measured by vision monitor of MetroVision Monpack One. <p>RESULTS: The size of glare halo in high myopia group was 106.27±25.89arc min, and 103.81±31.41arc min in medium myopia group, 102.87±32.24arc min in low myopia group, and there was no significant difference among three groups(<i>F</i>=0.297, <i>P</i>=0.825). There was no significant difference among three groups on contrast sensitivity under any different spatial frequencies(<i>P</i>>0.05). Correlation analysis showed a significant negative relationship between glare halo radius and contrast sensitivity at the c/d of 1.1, 2.2, 3.4, 7.1(<i>r</i>s=-0.302, <i>r</i>s=-0.308, <i>r</i>s=-0.383, <i>r</i>s=-0.257, all <i>P</i><0.01), and no significant correlation was detected between halo radius and SER(<i>P</i>>0.05).<p>CONCLUSION: Glare halo size had no relationship with SE but mid-frequency contrast sensitivity.

Comparison of implantable collamer lens implantation and FS-LASIK for moderatetohigh myopia / 眼科新进展

Objective To evaluate and compare the primary clinical efficacy in high myopia patients undergoing implantable collamer lens (ICL) implantation or femtosecond laser-LASIK (FS-LASIK).Methods Totally 73 patients with myopia from August 2016 to March 2017 in our hospital were collected and divided into ICL group(35 patients with 69 eyes) who receiving ICL implantation and LASIK group (38 patients with 76 eyes) who underwent FS-LASIK.There was no significant difference in gender composition and age between the two groups (both P ＞ 0.05).In addition,there was no significant difference in contrast sensitivity function (CSF) and glare CSF (GCSF) between the two groups before operation (both P ＞ 0.05).After 6 months of follow-up,the patient's uncorrected visual acuity,best corrected visual acuity and equivalent spherical degree were detected,and efficacy index and safety index were calculated.Meanwhile,CSF and GCSF examination were performed,followed by the observation of the occurrence of complications.Results There was no significant difference in the uncorrected visual acuity and best corrected visual acuity between the two groups before surgery (all P ＞ 0.05).The preoperative spherical equivalent in the ICL group was -4.000 to-12.00 (-8.86 ±3.70)D,and-4.00 to-11.75 (-8.51 ±4.20)D in the LASIK group,with no statistically significant difference (P ＞ 0.05).There was no significant difference in the uncorrected visual acuity,best corrected visual acuity and spherical equivalent between the two groups after surgery (all P ＞ 0.05).The efficacy coefficient and safety index of the ICL group were better than those in the LASIK group after 6 months,and the differences were statistically significant (all P ＜ 0.05).The CSF in the ICL group was at 1.5 c · d-1,3.0 c · d-1,6.0 c · d 1,12.0 c · d-1,and 18.0 c · d-1 after surgery,which was superior to the LASIK group,and the differences were statistically significant (all P ＜ 0.05).The GCSF in the ICL group was at 1.5 c · d-1,3.0 c · d-1,6.0 c · d-1 and 18.0 c · d-1 after surgery,which was superior to the LASIK group,and the differences were statistically significant (all P ＜ 0.05).Four hours after operation,there were 4 patients (7 eyes) with increased intraocular pressure,which were controlled by anterior chamber puncture,but no lens opacity presented.Conclusion Both ICL and FS-LASIK can effectively correct moderateto highmyopia,but ICL is better than FS-LASIK at the effectiveness index,the safety index,CSF and GCSF.

Controlling optical complications after corneal refractory surgery and improving visual quality / 中华实验眼科杂志

In recent years,corneal refractive surgery continues to develop with becoming to be one of the most prevalent utilizations of correction of many patients and brings about better visual quality for ametropic patients.Meanwhile,some patients are subjected to optical complications,and poor night vision is one of the most serious problems which are complained by sufferers after refractive surgery,such as glare,halo and reduce of contrast sensitivity,and the affective factors include age,pupil diameter,high order aberation,scattering,pre-estimated diopter,corneal healing,individual sensitivity to surgery,which are supposed to attract the attention of the majority of clinicians and researchers,at the same time.Ophthalmic clinical doctors and researchers only fully understand the mechanism of the above factors and explore the corresponding measures in order to purposefully treat these complications.In addition,ophthalmologists should be aware of the interaction of these factors and their relationship with individual sensitivity and explore the impact of postoperative visual impairment and the way to avoid them in clinical practice inorder to improve the visual quality by controlling the postoperative optical complications.

Visual quality after epipolis laser in situ keratomileusis surgery in mild and moderate myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AlM: To comprehensively evaluate of visual quality after epipolis laser in situ keratomileusis ( EPl-LASlK) in mild to moderate myopia.METHODS: Sixty cases ( 120 eyes ) undergone EPl-LASlK with equivalent diopter ( SE ) were divided into two groups:mild myopia group (60 eyes) and moderate myopia group ( 60 eyes ) . Objective visual acuity, aberration, contrast sensitivity and glare sensitivity were measured before and 1wk; 1, 6mo after operation, and made comparative analysis. RESULTS: Postoperative uncorrected visual acuity ( UCVA ) of two groups were better than that of preoperative(P<0. 05). Postoperative 6mo, there were significant differences on total high RMS between two groups ( P < 0. 05 ). Before operation and 6mo after operation, higher - order aberrations had statistically significant difference between two groups (P<0. 05). After 1wk and 1mo, there were statistical significances at the five frequencies between two groups (P<0. 05). After 6mo, the mild myopia group returned to preoperative levels, however, moderate myopia group in the high frequency region ( 18. 0c/d ) had significant difference with before surgery (P<0. 05). 1wk after surgery, there were statistically significant differences on the 3. 0, 6. 0, 12.0, 18. 0c/d frequency in both groups (all P<0. 05), 1mo after surgery, there were significant difference at 12.0, 18.0c/d frequencies (all P<0.05), after 6mo, both groups returned to preoperative levels, showed no significant difference.CONCLUSlON:Visual quality is poorer in mild myopia patients than that in moderate myopia at early stage after EPl-LASlK. Better visual quality is observed at mid-late stage.

lnfluence of lOL refractive index on straylight level following cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

Abstract?AlM:To investigate the influence of lOL refractive index ( Rl ) on measurement of straylight following cataract surgery.?METHODS:ln this case-control study, 77 eyes of 77 age-related cataract patients who underwent cataract phacoemulsification with posterior chamber aspherical arylic lOL implantation surgery in the Eye Hospital of China Medical University from Aug 2013 to Mar 2014, with a best corrected visual acuity ( BCVA) of 0. 5 or better, were classified into 3 groups randomly using 3 types of lOL: Tecnis ZCB00 Group ( Rl = 1. 47, 22 eyes of 22 subjects); Hoya PY60AD Group ( Rl=1. 52, 24 eyes of 24 subjects);Alcon SN60WF or lQ Group ( Rl=1. 55, 31 eyes of 31 subjects ) . BCVA, pupil size, astigmatism, axial length, intraocular straylight were measured respectively.? RESULTS: Age, axial length, BCVA, pupil size, astigmatism of the three groups were not significant difference (P>0. 05). The straylight of Tecnis, Hoya, lQ group were 1.04±0. 15, 1. 19±0. 14, 1. 14±0. 18. Straylight levels had significant differences among three groups ( F=5. 352, P = 0. 007 0. 05).?CONCLUSlON:Patients chosen the higher Rl lOL may have a higher straylight level after the surgery.

Assessment of Posterior Capsular Opacification of Korean Using Straylight and Glare Sensitivity Meter

PURPOSE: To evaluate posterior capsular opacity (PCO) using straylight and glare sensitivity meter and to compare availability of straylight and glare sensitivity with known methods for PCO evaluation. METHODS: Thirty-six pseudophakic eyes with PCO were selected for this study. Best-corrected visual acuity (BCVA), straylight (C-quant, Oculus GmbH, Wetzlar, Germany) and glare sensitivity (Binoptometer, Oculus GmbH, Wetzlar, Germany) were measured before mydriasis. After mydriasis, PCO images were captured with a slit-lamp and analyzed using the Evaluation of Posterior Capsular Opacification (EPCO) program (EPCO software, University of Heidelberg, Heidelberg, Germany). The same measurements were taken after capsulotomy and compared with pre-capsulotomy data. RESULTS: After capsulotomy, BCVA, EPCO score and straylight were improved with statistical significance (p < 0.05). Cases of PCO with mildly decreased visual acuity showed statistically significantly improved EPCO score and straylight (p < 0.05). Glare sensitivity did not show significant improvement but was statistically significantly correlated with straylight (p = 0.023, Rho = 0.732). CONCLUSIONS: Straylight is an available measurement for evaluation of PCO. Glare sensitivity meter which correlates with straylight can be used as a supportive measurement.

Assessment of Posterior Capsular Opacification of Korean Using Straylight and Glare Sensitivity Meter

PURPOSE: To evaluate posterior capsular opacity (PCO) using straylight and glare sensitivity meter and to compare availability of straylight and glare sensitivity with known methods for PCO evaluation. METHODS: Thirty-six pseudophakic eyes with PCO were selected for this study. Best-corrected visual acuity (BCVA), straylight (C-quant, Oculus GmbH, Wetzlar, Germany) and glare sensitivity (Binoptometer, Oculus GmbH, Wetzlar, Germany) were measured before mydriasis. After mydriasis, PCO images were captured with a slit-lamp and analyzed using the Evaluation of Posterior Capsular Opacification (EPCO) program (EPCO software, University of Heidelberg, Heidelberg, Germany). The same measurements were taken after capsulotomy and compared with pre-capsulotomy data. RESULTS: After capsulotomy, BCVA, EPCO score and straylight were improved with statistical significance (p < 0.05). Cases of PCO with mildly decreased visual acuity showed statistically significantly improved EPCO score and straylight (p < 0.05). Glare sensitivity did not show significant improvement but was statistically significantly correlated with straylight (p = 0.023, Rho = 0.732). CONCLUSIONS: Straylight is an available measurement for evaluation of PCO. Glare sensitivity meter which correlates with straylight can be used as a supportive measurement.

Consensus and new improvements of disability glare / 国际眼科杂志(Guoji Yanke Zazhi)

Patients with early cataract may have normal visual acuity ( VA ) but complain that they have problems in driving at night, like seeing things through a veil. This phenomenon is defined as disability glare which maybe caused by growing stray light. Patients with intraocular lens following cataract surgery may complain about glare, halos and shadows in visual field, which are also resulted from dysphotopia. Disability glare is the VA loss due to disturbing luminance in visual field. ln other words, it's the retinal contrast sensitivity reduction because of the straylight. This article contains the consensus and new progress of disability glare. lt provides solutions according to its effect factors and offers clues for further study.

Functional vision barriers: a new concept analyzed in terms of human visual performance

In this work we introduce a new category of barriers that we call "functional vision barriers." This expression refers to lighting and visual elements that may complicate or hinder functional vision and may make life even more difficult for people with visual defects. These barriers appear as a consequence of certain negative effects caused by the poor design of the visual stimulus or visual environment that surrounds it in which lighting is one of the main factors. We use the term "functional vision" because this expression refers to the ability of the visual system to perform everyday tasks. We analyzed some of our previous results with regard to situations that can be considered "functional vision barriers": (1) stimuli with low luminance contrast information in which the addition of chromatic contrast improves visual performance and (2) tasks that are performed in the presence of a glare source in the visual field, diminishing visual performance and reducing brightness perception...

Quantitative examination of different types of intraocular straylight in age-related cataract and its clinical significance / 中华实验眼科杂志

Background The test for visual acuity is the conventional standard for evaluating visual quality.However,there is little correlation between visual acuity and visual disability.Therefore,other clinical observations such as contrast sensitivity or straylight have been used in the clinical assessment of visual quality after cataract surgery.Objective This study was to examine the change in the amount of straylight in cataractous eyes and to evaluate the correlation of the types of cataract with visual quality.Methods A non-randomized case-controlled study was designed.Eighty eyes of 40 patients with age-related cataract were enrolled in this study,including 22 eyes with hard nucleus cataract,19 eyes with cortical cataract,23 eyes with mixed cataract and 16 eyes with posterior subcapsular cataract diagnosed based on the criteria from Lens Opacities Classification System Ⅲ(LOCS Ⅲ).The values for straylight and best corrected visual acuity (BCVA) were measured with the C-quant straylight meter and Snellen chart,respectively.The differences in the straylight values among the different types of cataract were analyzed,and the correlation of the straylight value with age or BCVA was assessed.Forty eyes of 40 age-matched normal people served as controls.Results Examination was completed in sixty-two eyes of 31 patients in the cataract group at a completion rate of 77.5％,and all the subjects in the control group finished the examination at a rate of 100％.The mean straylight value was (2.06±0.88) log in the cataract group and (1.96±0.42) log in the control group,showing a significant difference between them (t =3.251,P＜0.01).The respective mean C-quant measurements for hard nucleus cataract,cortical cataract,nuclear-cortical cataract and posterior subcapsular cataract patients were (1.96±0.42) log,(1.91 ±0.16) log,(2.05 ±0.19) log and (2.48 ±0.66) log,respectively,with a significant difference among these four groups (F =2.156,P =0.019).The highest straylight value was detected in the posterior subcapsular cataract group.The straylight value was enlarged with the increase of age with a regression equation of Y=0.0010X+ 1.025 in the hard nucleus cataract group (r =0.455,P ＜ 0.05).In addition,the negative linear correlation was found between the straylight value and BCVA in both the hard nucleus cataract group and cortical cataract group (r=-0.590,-0.697,P＜0.01).However,no correlation was found in the mixed cataract group and posterior subcapsular cataract group (r =-0.240,-0.235,P＞0.05).Conclusions The C-quant straylight meter can objectively reflect the visual function for hard nucleus and cortical cataractous eye.Posterior subcapsular cataract produces straylight and exerts a great influence on visual quality due to early glare sensation,so it should be benefit to perform surgery earlier.

Quantitative Measurement of Glare Disability Using a Glaremeter

PURPOSE: To report glare disability measured by a glaremeter. METHODS: Glaremeter values were measured in 270 normal eyes and 100 pseudophakic eyes. The normal eyes were classified into 3 age groups (teenage to 60's) with 90 eyes in each group. The pseudophakic eyes were classified into the monofocal IOL (intraocular lens) and multifocal IOL implanted groups with 50 eyes in each group. Glaremeter values of each group were measured using a glaremeter under photopic (82.2 +/- 5.1 cd/m2) and mesopic (5.5 +/- 0.3 cd/m2) conditions. RESULTS: The highest mean glaremeter value in the normal eyes was 8657.34 +/- 691.04 mm2 under the photopic condition and 8837.97 +/- 805.83 mm2 under the mesopic condition in the oldest group. The glaremeter value of the multifocal IOL implanted group was 9390.87 +/- 846.7 mm2 under the photopic condition and 9799.87 +/- 823.72 mm2 under the mesopic condition, which was significantly higher than the normal eye and the monofocal IOL implanted groups (p < 0.05). CONCLUSIONS: In the normal population, the mean glaremeter values were increased according to age, and a significant increase was observed in the multifocal IOL implanted group. The present study results provide good basic data for cataract and presbyopia refractive surgery predicted to produce glare disability inevitably.

Determination of laser energy density threshold leading to glare-induced blindness by pattern visual evoked potential in guinea pigs / 解放军医学杂志

Objective To explore the application of pattern visual evoked potential (PVEP) in examination of energy density threshold of laser beam that may lead to glare-induced blindness in guinea pigs. Methods Stainless steel bolts (5mm in length, 1.2mm in diameter), as reference electrode and recording electrode for the PVEP measurement, were implanted into skulls of 27 guinea pigs, located in 6mm proximal to bregma and 10mm distal to bregma. These guinea pigs were randomly divided into three groups with 9 (18 eyes) for each group, and they were exposed to laser beam at wave length of 635nm, 660nm and 690nm, respectively. The PVEP was recorded in each group before and immediately after laser irradiation, and also on day 2 and day 4 after laser irradiation in guinea pigs blinded immediately after laser exposure. The latency and amplitude of P wave in PVEP before irradiation was considered as control value for each group. When PVEP could not be recorded instantly after laser irradiation, the intensity of electric current applied at that time was considered as threshold value of each laser beam. The power of electricity(P) values was then calculated, and energy density threshold that led to glare-induced blindness was figured out according to currentpower curve (P-I curve). On day 2 and day 4 after irradiation, PVEP was additionally recorded, and latency and amplitude of P wave were compared with that of control values to examine the recovery of visual function of the blind guinea pigs. Results The energy density thresholds of the three laser beams at wave length of 635nm, 660nm, 690nm respectively were 356.36 10-9J/cm2, 349.58 10-9J/cm2 and 343.93 10-9J/cm2. In guinea pigs became blind after exposure to laser beams at wave length of 635nm, 660nm, 690nm, the latencies of P wave recorded 2 days after blindness were not significantly different with control value of each group(t=-0.356, P=0.729; t=0.492, P=0.633; t=-0.445, P=0.666), while the difference in amplitudes was statistically significant (t=11.01, P=0.000; t=5.223, P=0.000; t=5.702, P=0.000). Four days after blindness, the latencies and amplitudes of P wave recorded on the guinea pigs were also compared with the control values, but no statistically significant difference was found (latency: t=1.329, P=0.213; t=2.040, P=0.069; t=-0.894, P=0.392; amplitude: t=-3.030, P=0.768; t=0.194, P=0.850; t=-0.948, P=0.365). Conclusions The energy density threshold of laser beams, at length wave of 635nm, 660nm, 690nm, may lead to glare-induced blindness in guinea pigs is around 350 10-9J/cm2. PVEP examination is a useful and harmless way to determine the energy density threshold of laser beam which will cause blindness.

The Effect of Two Different Opening Patterns of Neodymium:YAG Laser Posterior Capsulotomy on Visual Function

PURPOSE: To investigate the effects of two different opening patterns in neodymium:yttrium-aluminum-garnet (Nd:YAG) laser posterior capsulotomy on visual function. METHODS: A randomized prospective study was conducted on 62 pseudophakic eyes from 50 patients with posterior capsular opacification (PCO). Groups A and B underwent laser posterior capsulotomy with a cruciate opening and a modified circular opening, respectively. The best corrected visual acuity (BCVA), contrast sensitivity, and glare sensitivity were measured before and after laser posterior capsulotomy in both groups. The occurrences of intraocular lens (IOL) pittings were investigated and compared between the two groups. RESULTS: After laser capsulotomy, there were significant increases in BCVA, contrast and glare sensitivity in both groups and no significant differences between the two groups. However, group A had significantly more patients with three or more IOL pittings within a 1.5-mm radius from the IOL center (p = 0.047). In group A, these patients had significantly less contrast sensitivity (p = 0.023 in 1.6 cpd) and glare sensitivity (p = 0.043 in 1.6 cpd) than did patients with two or fewer IOL pittings. CONCLUSIONS: Nd:YAG laser posterior capsulotomy using a modified circular opening can be considered an effective method to manage PCO.

Pupil cycle time and contrast sensitivity in type II diabetes mellitus patients: A pilot study.

Context: Pupil cycle time (PCT) has been widely used for examination of ocular diabetic autonomic neuropathy (DAN). Aims: The primary aim of this study was to evaluate the difference of contrast sensitivity according to PCT results, and the secondary aim was to determine the factors associated with PCT difference for type II diabetes patients. Settings and Design: A clinical pilot study that included a total of 60 eyes of 60 type II diabetes patients. Materials and Methods: We divided all patients into three groups according to PCT results. Group A and Group C were composed of patients who had upper one third PCT and lower one third PCT, respectively. We analyzed difference of age, diabetes duration, hypertension duration, mean best corrected visual acuity (BCVA), mean spherical equivalent (SE), HbA1C, glomerular filtration rate (GFR), stage of diabetic retinopathy, and Cardiac Autonomic Function Score (CAFS). Contrast sensitivity and decrease of visual acuity by glare were also estimated and analyzed for 28 eyes of 28 non-proliferative diabetic retinopathy (NPDR) patients. Group [NPDR] A and Group [NPDR] C were defined as those who had lower one third PCT and upper one third PCT, respectively. Statistical Analysis: Statistical analysis was done using SPSS 17.0 software. Results and Conclusions: Each group contained 20 eyes. Significant differences between Group A and Group C were observed in duration of diabetes and CAFS (P ≤ 0.001 and P <0.001, respectively). Contrast sensitivity in Group [NPDR] A was significantly more than in Group [NPDR] C at all cpds (all P ≤ 0.001). We found that PCT can influence contrast sensitivity or glare in diabetes patients and also confirmed a significant correlation of PCT with CAFS and duration of diabetes.

Two Cases of Glare after Iridotomy for Phakic Intraocular Lens Implantation

PURPOSE: The present study is a case report of 2 patients (4 eyes) whose symptoms subsided after corneal tattooing over the iridotomy site for persistent and excessive glare, which developed after iridotomy for phakic intraocular lens implantation. CASE SUMMARY: Two patients developed excessive glare symptoms after receiving iridotomy as a pre-procedure for phakic intraocular lens implantation. Case 1 and Case 2 showed persistent glare symptoms over a period of 6 months. Corneal tattooing was performed on the patients by applying tissue dye to the corneal stroma over the iridotomy site. The symptom was evaluated by comparison of glare scores from 0 to 10 after the procedure with a score of 10 prior to the procedure. After corneal tattooing, patient 1 reported a score of 4 and patient 2 reported a score of 3, showing significant symptom improvements without additional complications. CONCLUSIONS: Corneal tattooing at the peripheral cornea in front of the iridotomy site for patients with persistent glare symptoms after prophylactic iridotomy was shown to be effective.

Comparison of Stray-light Effects of 7 Intraocular Lens Edge Designs / 中国医科大学学报

Objective To compare the stray-light effects caused by different parts of optic edge of 7 intraocular lens(IOL)edge designs.Methods Monochromatic laser beam was used to illuminate the upper edge and complex of three-piece and single-piece IOLs at several angles of incidence.Light images produced in the retinal plane were photographed with a digital camera.The differences in the light images were compared between three-piece and single-piece IOLs.Results There were differences in light images between 2 groups,which may be due to different shapes of edge design when the upper edge of IOL was illuminated.Three-piece IOL exhibited line images or dense patch,which differed with single-piece IOL when the complex of IOL was illuminated.Conclusion Both edge shape and irregular structure in three-piece IOL complex may be important factors for postoperative glare in pseudophakic patients.

One-year Outcome of Monocular Implant of Aspheric Multifocal IOL

PURPOSE: To evaluate near and far visual acuity, subjective visual symptoms, and patient satisfaction with a monocular implant of aspheric multifocal IOL (AMO Tecnis ZM900(R)). METHODS: Thirty eyes of 30 patients received phacoemulsifications and monocular implantation of Tecnis ZM900 IOL. The main outcome measures at postoperative 1 week, 1 month, 3 months, and 1 year were uncorrected and corrected near and distant visual acuity, refractory errors, contrast sensitivity, subjective visual symptoms (glare and halo), spectacle independency, and satisfaction. RESULTS: At a 3 month postoperative visit, the mean uncorrected near and distant visual acuities were 0.29+/-0.17 (logMAR) and 0.16+/-0.12 (logMAR),respectively. At 1 year, the mean uncorrected near and distant visual acuities were 0.25+/-0.17 (logMAR) and 0.11+/-0.08 (logMAR). Glare and halo decreased, and contrast sensitivity increased upon 1-year follow-up after monocular implantation of ZM900. Most patients (87%) were satisfied with their visual outcome. CONCLUSIONS: Monocular implantation of multifocal IOL Tecnis ZM900 shows stable surgical outcomes with a high satisfaction rate and enables a high rate of spectacle independency. Postoperative glare and halo, youth, and residual refractive error could be risk factors for dissatisfaction with monocular implantation of multifocal IOL Tecnis ZM900. Proper patient selection can lead to satisfying outcomes.

Clinical Results and Some Problems of Multifocal Apodized Diffractive Intraocular Lens Implantation

PURPOSE: To evaluate near and far visual outcomes, subjective visual symptoms, and patient satisfaction with AcrySof(R) ReSTOR(R) diffractive multifocal intraocular lenses (IOL), and to study the reasons for postoperative dissatisfaction. METHODS: Twenty-three eyes of 19 patients received phacoemulsifications and implantation of AcrySof(R) ReSTOR(R) IOL. The main outcome measures, taken at postoperative 1 day, 1 week, 1 month, and 3 months, were uncorrected and corrected near and distant visual acuity, refractory errors, subjective visual symptoms (glare, halo, and night vision), and satisfaction. RESULTS: At the 3-month postoperative visit, the mean uncorrected near and distant visual acuities were 0.59+/-0.24 (0.25+/-0.22 LogMAR unit) and 0.78+/-0.27 (0.13+/-0.10 LogMAR unit), respectively. In addition, patients' satisfaction with uncorrected near vision, intermediate vision, far vision, and general visual performance were better than their satisfaction with night vision. Glare and halos were reported as severe by only 10.2% and 5.3% of patients, respectively. The seven eyes with poor patient satisfaction included eyes with a high incidence of preoperative ocular diseases or preoperative and postoperative high corneal astigmatisms of more than 1.0 diopter. CONCLUSIONS: The AcrySof(R) ReSTOR(R) IOL demonstrated good near and distant visual acuity with good patient satisfaction. Previous ocular disease, corneal astigmatism less than 1.0 diopter, and patient lifestyle should be considered to enhance patient satisfaction.