Coinfection of Severe Fever With Thrombocytopenia Syndrome Virus and Coxiella burnetii in Developmental Stage of Hard Ticks in Subtropical Region of Korea

Background@#Severe fever with thrombocytopenia syndrome virus (SFTSV) is transmitted through tick bites. Ticks are potential vectors for the bacterium Coxiella burnetii that causes Query fever. Here, we analyzed SFTSV and C. burnetii co-infection rates in ticks in rural areas of Jeju Island, South Korea. @*Methods@#Free ticks were collected from the natural environment of the island between 2016 and 2019, and SFTSV RNA was extracted. Additionally, ribosomal RNA gene sequencing was used to identify Coxiella species. @*Results@#Haemaphysalis longicornis was the most common tick species followed by H. flava. Tick number gradually increased from April, peaked in August, and was lowest in March. Of all the collected ticks, 82.6% (2,851/3,458) were nymphs, 17.9% (639/3,458) adults, and 0.1% (4/3,458) larvae. SFTSV-infected ticks comprised 12.6% of all ticks; their numbers were the lowest in November–December, increased from January, and were mostly identified in the adult stage during June–August. C. burnetii infections were detected in 4.4% of the SFTSVinfected H. longicornis ticks. C. burnetii co-infection was mainly observed in the nymph stage of H. longicornis, with the highest infection rate in January, followed by December and November. @*Conclusion@#Our findings suggest that Jeju Island has a high SFTSV and potential C. burnetii infection in ticks. This study provides important insights regarding SFTS and Q fever risk to humans in South Korea.

Endophthalmitis after Removal of an Intralenticular Foreign Body in Place without Symptoms for 20 Years

PURPOSE: We report a case of postoperative endophthalmitis in the cataract patient, associated with removal of an intralenticular foreign body that had remained in place without symptoms for 20 years. CASE SUMMARY: A 45-year-old male visited our outpatient clinic complaining of gradual visual loss in his right eye over the past 3 months. In slit-lamp examinations, anterior capsular opacification, nuclear sclerosis, and posterior subcapsular opacity were observed in the right eye. Twenty years before, a tiny metallic projectile had hit his right eye, but slit-lamp examination at the time of injury did not reveal any intraocular foreign body. We decided to undergo cataract surgery. During phacoemulsification, a metallic foreign body was found in the lens and safely removed; then an intraocular lens was implanted. As hypopyon was evident 3 days later, we injected intravitreal antibiotics and applied fortified antibiotic eye drops to the right eye. The anterior chamber inflammation improved and the best-corrected visual acuity recovered to 1.0. CONCLUSIONS: Surgeon should be aware of that endophthalmitis could develop after cataract surgery with removal of an intralenticular foreign body that had been in place for 20 years. But did not trigger inflammation or cause any symptoms as the cataract progressed.

Incidence of Complications in Cataract Surgery according to the Availability of Partial Coherence Laser Interferometry

PURPOSE: To validate the possibility of IOLMaster measurement as a predictor of intraoperative and postoperative complications during phacoemulsification surgery. METHODS: In this study, 2,107 eyes from 1,456 patients who underwent phacoemulsification with intraocular lens (IOL) implantation were divided into two groups according to the possibility of performing optical biometry with the IOLMaster (measurable group: 1,746 eyes from 1,141 patients, unmeasurable group: 361 eyes from 315 patients). The intraoperative and postoperative complication rates were compared between the two groups. RESULTS: Three hundred sixty-one eyes (17.1%) could not be measured using optical biometry. Dense posterior subcapsular cataract (56.0%) was the main factor resulting in failed measurements with optical biometry, followed by anterior subcapsular cataract (12.5%). The rates of posterior capsule rupture and radial tear were significantly higher in the unmeasurable group than in the measurable group (p = 0.001, p < 0.001, respectively). Corneal edema was significantly higher in the unmeasurable group (16.1%) than in the measurable group (5.3%) at postoperative 1 week (p < 0.001). CONCLUSIONS: Possibility of optical biometry measurement can be used as a simple predictor of intraoperative and postoperative complications of phacoemulsification surgery. Surgeons should pay close attention to patients who cannot be measured using IOLMaster.

The Effects of Surgical Punctual Occlusion on Patients with Aqueous Deficient Dry Eye

PURPOSE: To analyze the improvement of symptoms and signs of dry eye after surgical punctual occlusion and to evaluate the effects of secondary systemic disease in dry eye patients. METHODS: From March 2011 to July 2014, 15 eyes of 8 dry eye patients with a history of punctal plug insertion underwent surgical punctal occlusion. Schirmer test was measured based on mean 2.9 mm. The patients consisted of 4 dry eye patients with Sjogren's disease, 1 with rheumatoid arthritis, 1 with graft-versus-host disease (GVHD), and 2 with no secondary systemic disease. Preoperative and postoperative ophthalmic examinations of log MAR visual acuity, subjective symptoms, corneal staining (National Eye Institute [NEI] score), and tear break-up time (BUT) were performed and the effects of secondary systemic disease in dry eye patients were evaluated. The results of surgical punctual occlusion were analyzed. RESULTS: All patients showed a statistically significant improvement of log MAR visual acuity, subjective symptoms, corneal staining (NEI score), and tear BUT. The patients with rheumatoid-related diseases showed improved symptoms after surgery, but the patient with GVHD showed no significant improvement after surgery. Among the study patients, 80.0% showed completely closed punctum and 20.0% showed partial recanalization. CONCLUSIONS: Surgical punctal occlusion is an effective alternative in patients with severe aqueous deficient dry eye who show recurrent punctal plug loss or complications associated with punctal plugs.

Evaluation of Objective Accommodation Power in Different Age Groups Using an Auto Accommodation Refractometer

PURPOSE: To evaluate the objective amplitude of accommodation in various age groups using an autorefractometer and to compare the results with subjective assessments on accommodation. Objective accommodative amplitude of artificial lenses in post-operative cataract patients was also measured. METHODS: In this study, 41 patients who visited Korea University Guro Hospital from July through August 2014 were categorized into 6 different age groups. Accommodative amplitude was measured using long-distance refraction at 5 m and short-distance refraction at 20 cm. In 20 patients, subjective amplitude of accommodation was measured using the minus lens technique and was compared with the measured objective accommodative amplitude. Accommodative amplitude was also measured in 8 patients who received cataract surgery. RESULTS: The mean accommodative ability in normal people was 2.38 D. The age groups of 10-19, 20-29, 30-39, 40-49, 50-59, and over 60 years showed accommodative amplitudes of 3.31 +/- 0.99 D, 3.25 +/- 0.34 D, 3.78 +/- 0.68 D, 1.00 +/- 0.60 D, 0.22 +/- 0.23 D, 0.00 +/- 0.00 D, respectively. The results showed a rapid decrease in accommodative ability of patients older than 40 years and demonstrated a correlation between objective and subjective amplitude of accommodation (Pearson's correlation coefficient 0.838). There was a significant difference between objective and subjective accommodative amplitudes in artificial lenses (p = 0.015), with average objective and subjective measures of 0.10 +/- 0.23 D and 0.59 +/- 0.35 D, respectively. CONCLUSIONS: Measuring amplitude of accommodation using an autorefractometer can be useful in assessing results of presbyopia treatment.

The Effects of Warm Compression on Eyelid Temperature and Lipid Layer Thickness of Tear Film

PURPOSE: Warm compression using a commercial heat pad was used to evaluate the effects of temperature on the eyelids and tear film lipid layer thickness. METHODS: Targeting 13 patients (26 eyes) with non-specific eye disease such as dry eye syndrome or Meibomian gland dysfunction, we measured the average thickness of the tear film lipid layer in both eyes with the LipiView 2® System (Tearscience®, Morrisville, NY, USA). We performed warm compression on the right eye only in order to evaluate the effectiveness of massage and measured the temperature of the right eye lid immediately, 3 minutes, and 5 minutes after compression in order to compare with the untreated left eye. After warm compression for 5 minutes, we measured tear film lipid layer thickness of both eyes and analyzed the effectiveness of warm compression. RESULTS: The average tear film lipid layer thickness was 55.1 ± 21.0 nm in the right eyes and 53.9 ± 13.9 nm in the left eyes (p = 0.474). Before performing the warm compression, the temperature of the right eye lid was 53.9 ± 13.9 nm, and that of the left was 35.9 ± 0.2℃. The eye lid temperature of the right eye immediately, 3 minutes, and 5 minutes after warm compression was 40.3 ± 1.3℃, 40.3 ± 1.3℃, and 40.3 ± 1.9℃, respectively, and these temperatures were relatively constant during the massage. Tear film lipid layer thickness after warm compression in the right eye was 83.5 ± 18.8 nm, which was increased compared to the original temperature (p = 0.001) and showed significant difference compared with the 65.5 ± 27.1 nm in the left eye (p = 0.005). CONCLUSIONS: Warm compression increased the tear film lipid layer thickness and showed a relatively constant increased temperature of 40.3℃ over 5 minutes. This technique will be helpful for maintaining tear film lipid layer thickness in patients with Meibomian gland dysfunction.

The Effects of Warm Compression on Eyelid Temperature and Lipid Layer Thickness of Tear Film

PURPOSE: Warm compression using a commercial heat pad was used to evaluate the effects of temperature on the eyelids and tear film lipid layer thickness. METHODS: Targeting 13 patients (26 eyes) with non-specific eye disease such as dry eye syndrome or Meibomian gland dysfunction, we measured the average thickness of the tear film lipid layer in both eyes with the LipiView 2® System (Tearscience®, Morrisville, NY, USA). We performed warm compression on the right eye only in order to evaluate the effectiveness of massage and measured the temperature of the right eye lid immediately, 3 minutes, and 5 minutes after compression in order to compare with the untreated left eye. After warm compression for 5 minutes, we measured tear film lipid layer thickness of both eyes and analyzed the effectiveness of warm compression. RESULTS: The average tear film lipid layer thickness was 55.1 ± 21.0 nm in the right eyes and 53.9 ± 13.9 nm in the left eyes (p = 0.474). Before performing the warm compression, the temperature of the right eye lid was 53.9 ± 13.9 nm, and that of the left was 35.9 ± 0.2℃. The eye lid temperature of the right eye immediately, 3 minutes, and 5 minutes after warm compression was 40.3 ± 1.3℃, 40.3 ± 1.3℃, and 40.3 ± 1.9℃, respectively, and these temperatures were relatively constant during the massage. Tear film lipid layer thickness after warm compression in the right eye was 83.5 ± 18.8 nm, which was increased compared to the original temperature (p = 0.001) and showed significant difference compared with the 65.5 ± 27.1 nm in the left eye (p = 0.005). CONCLUSIONS: Warm compression increased the tear film lipid layer thickness and showed a relatively constant increased temperature of 40.3℃ over 5 minutes. This technique will be helpful for maintaining tear film lipid layer thickness in patients with Meibomian gland dysfunction.

Sudden Loss of Endothelial Cell Density 7 Years after Receiving an Implantable Contact Lens: A Case Report

PURPOSE: To report a case of decreased endothelial cell density 7 years after posterior chamber phakic intraocular lens implantation. CASE SUMMARY: A 45-year-old man with high myopia combined with astigmatism was treated with Toric implantable Collamer Lens (ICL) implantation. The patient's best corrected visual acuity was 0.7 in both eyes before the operation. After the treatment, his uncorrected visual acuity was 0.9 and corrected visual acuity was 1.0 in both eyes, indicating an improvement in visual function. Preoperative endothelial cell density measured 3,063 cells/mm2 in the right eye and 3,126 cells/mm2 in the left eye. At 5 years postoperatively, measurements were 2,897 cells/mm2 in the right eye and 2,974 cells/mm2 in the left, showing little change. However, a 6-year postoperative measurement of 2,198 cells/mm2 in the right eye and 2,803 cells/mm2 in the left showed a slight decrease in endothelial cell density in the right eye, and a follow-up measurement one year later displayed a rapid decline to 1,272 cells/mm2 in the right eye and 2,852 cells/mm2 in the left eye. The Toric ICL lens was removed from the right eye and phacoemulsification and posterior chamber intraocular lens implantation was performed. Two-month postoperative endothelial cell density was 1,257 cells/mm2 and endothelial cell damage from the operation itself was minimal. CONCLUSIONS: ICL implantation may cause complications related to corneal endothelial cells as well as glaucoma. Patients should receive regular follow-up examinations for endothelial cell density.

Analysis of Internal Optical Aberrations in Eyes with Different Types of Cataract

PURPOSE: The present study investigates the patterns of internal optical aberrations in eyes with different types of cataract. METHODS: Eighty eyes of 70 cataract patients were included in the present study. Internal optical aberrations were measured with a KR-1W wavefront aberrometer before cataract operation. Types of cataract were classified into three groups; cortical, nuclear and posterior subcapsular cataracts. The differences in the results of the wavefront data of 6-mm pupil diameter zones were compared among three groups. The Kruskal-Wallis test and Mann-Whitney U test were used for comparing data. RESULTS: A total of 80 eyes consisting of 30 cortical cataracts, 30 nuclear cataracts and 20 posterior subcapsular cataracts were found. In the 6-mm pupil diameter zone, the average internal spherical aberrations by original value were 0.042 microm of cortical cataracts, -0.092 microm of nuclear cataracts and -0.109 microm of posterior subcapsular cataracts. The average internal spherical aberrations by absolute value were 0.122 microm of cortical cataracts, 0.533 microm of nuclear cataracts and 0.202 microm of posterior subcapsular cataracts. The internal spherical aberrations by original value were not statistically significantly different, but by absolute value were statistically significantly different (p = 0.003, Kruskal-Wallis test). Nuclear cataracts have a much higher positive or negative value than other cataract groups in the distribution of internal spherical aberrations by original value for each type of cataract. Other than this difference, the internal astigmatism and internal high order aberrations were not statistically significantly different. CONCLUSIONS: The change in internal spherical aberrations of nuclear cataract from the original value was larger than cortical and posterior subcapsular cataract. Therefore, nuclear cataracts have much higher positive or negative values than other cataract groups.

The Prediction of Changes in Mean Corneal Refractive Power by Pterygium Size after Pterygium Surgery

PURPOSE: To assess the changes in mean corneal refractive power (DeltaK) following pterygium surgery and to predict DeltaK in cases of combined cataract and pterygium surgery. METHODS: Thirty-seven eyes of unilateral pterygium patients who underwent pterygium surgery were analyzed retrospectively with at least more than 1 month of follow-up. Preoperative and postoperative 1 month corneal refractive power was measured using auto-keratometer (RK-F1, Canon, Tokyo, Japan). Pterygium horizontal extension, width, and area were measured and correlation with DeltaK before and after surgery analyzed. We also compared DeltaK of the contralateral normal eye. RESULTS: The mean corneal refractive (Km) power measured before and 1 month after surgery was 43.30 +/- 1.66 D and 44.07 +/- 1.42 D, respectively. The Km significantly increased at 4 weeks after surgery (p < 0.001). However, postoperative Km was not significantly different when compared with the contralateral normal eye (43.86 +/- 1.34 D; p = 0.59). All parameters of pterygium size including horizontal extension, width, and area were positively correlated with the mean DeltaK. Among parameters, horizontal extension was best correlated with mean DeltaK (p < 0.001). The mean DeltaK with horizontal extension was predicted using linear regression (2.5 mm to 1 D, 4.0 mm to 1.8 D). CONCLUSIONS: We recommend contralateral corneal refractive power or prediction of corneal refractive power using linear regression with pterygium horizontal extension for determining intraocular lens power in cases of combined cataract and pterygium surgery.

Paradoxical Trichomegaly of the Eyelashes During Treatment with EGFR Inhibitors: 2 Case Report

PURPOSE: To introduce 2 cases of trichomegaly associated with the use of systemic epidermal growth factor receptor (EGFR) inhibitors for the treatment of lung cancer. CASE SUMMARY: An 82-year-old female visited our clinic for ocular pain in both eyes. She was suffering from metastatic lung cancer and was under daily treatment with gefitinib (Iressa(R), AstraZeneca, London, UK) for 6 months. On ophthalmologic examination, she presented with abnormally elongated eyelashes, hyperemic conjunctiva and dense corneal erosion. A 52-year-old male who was diagnosed with non-small cell lung cancer 7 months before and treated with erlotinib (Tarceva(R) OSI Pharmaceuticals, Inc., Melville, NY, USA) was referred to our clinic for injection and foreign body sensation in both eyes. Although there were no remarkable changes in eyelashes at the initial visit, long, curly, uneven eyelashes were observed after 3 months. CONCLUSIONS: Due to the increased use of EGFR inhibitors in anti-cancer treatment, ophthalmologists should be aware of these chemotherapeutics' adverse effects.

The Effects of Pharmacologic Pupil Dilatation on Ocular, Corneal, and Internal Aberrations

PURPOSE: The present study investigates the effects of pharmacologic pupil dilatation on ocular, corneal and internal aberrations. METHODS: Sixty-two right eyes of 62 healthy participants were included in the present study. Ocular, corneal and internal aberrations were measured with a KR-1W wavefront aberrometer (Topcon Corp., Tokyo, Japan) before mydriasis in mesopic conditions. After pupil dilatation with a mydriatic drug (phenylephrine chloride 0.5% + tropicamide 0.5%) (Mydrin-P, Santen, Osaka, Japan), the measurements were repeated. The wavefront data of 4-mm and 6-mm diameter zones were analyzed. The changes of aberrations before and after mydriasis were evaluated by paired t-test. RESULTS: The values of ocular, corneal and internal spherical aberrations before and after mydriasis on the 4-mm diameter pupil zone were not statistically significantly different. On the 6-mm diameter zone, the ocular and internal spherical aberrations were statistically significantly different (p = 0.025, p = 0.002, respectively, paired t-test). However, the corneal aberrations did not show significant changes. The internal aberrations average before mydriasis was -0.043 (+/-0.21) microm and was shifted in a negative direction to -0.093 (+/-0.17) microm after mydriasis. The ocular aberrations average also changed toward negative after mydriasis. The high-order aberrations and astigmatism did not change significantly. CONCLUSIONS: The ocular and internal spherical aberrations changed toward negative with mydriasis in the participants' eyes suggesting the change of the ocular spherical aberration to be attributed to internal changes.

Prevalence of Dry Eye Disease among University Students

PURPOSE: To determine the prevalence of dry eye disease (DED) and risk factors among young people based on the Ocular Surface Disease Index (OSDI) questionnaire. METHODS: The authors of the present study distributed the OSDI questionnaire to 263 university students. DED was diagnosed when the OSDI score was greater than 13 points. According to the OSDI score, DED was classified as mild (13-22 points), moderate (23-32 points), or severe (33-100 points). Additionally, the associations between the OSDI score and possible risk factors such as gender, contact lens use and allergic conjunctivitis were studied. RESULTS: Of 263 students, diagnosed DED was present in 133 (50.6%) and severe cases of DED were observed in 49 (18.6%). A high OSDI score was associated with female sex (p < 0.01), a history of allergic conjunctivitis (p = 0.02), contact lens use (p < 0.01), self-awareness of the dry eye symptoms (p < 0.01) and a history of clinically diagnosed DED (p < 0.01). CONCLUSIONS: Prevalence of DED, which has been reported to be high in the elderly, was considered high at 50.6% among young people in the present study. Caution or education regarding DED is necessary for people who have a high OSDI score, particularly females, contact lens wearers and people with allergic conjunctivitis.

The Ocular Fatigue of Watching Three-Dimensional (3D) Images

PURPOSE: To compare ocular fatigue, non-ocular symptoms, and ocular surface changes, such as tear break-up time (BUT) and ocular surface temperature, after watching 2-dimensional (2D) and 3-dimensional (3D) images. METHODS: Fourteen volunteers were enrolled in the present study. Subjects watched 2D as well as 3D images and answered questions regarding ocular fatigue and general symptoms such as headache. Before and after watching images, the spherical equivalent, degree of conjunctival injection, tear BUT, and ocular surface temperature were measured and the amount of change was analyzed. While watching images, subjects answered questions regarding ocular fatigue and the time when they began to feel definitive symptoms. RESULTS: Watching 3D images induced a greater degree of ocular fatigue, headache, and decreasing concentration than watching 2D images (p = 0.038, 0.003, and 0.045, respectively). While watching images, 3D images induced a greater degree of ocular fatigue than 2D images and caused subjects to feel earlier ocular fatigue (3D: 54.86 min, 2D: 78.57 min, p = 0.002). Spherical equivalents became more myopic after watching 3D images. CONCLUSIONS: After watching 3D images, a greater degree of ocular fatigue, headache, and decreasing concentration was induced and a shorter time to feel definitive ocular fatigue was observed than after watching 2D images. In addition, spherical equivalents changed myopically after watching 3D images.

Which Keratometer is Most Reliable for Correcting Astigmatism with Toric Intraocular Lenses?

PURPOSE: To evaluate the accuracy of preoperative keratometers used in cataract surgery with toric intraocular lens (IOL). METHODS: Twenty-five eyes received an AcrySof toric IOL implantation. Four different keratometric methods, a manual keratometer, an IOL master, a Pentacam and an auto keratometer, were performed preoperatively in order to evaluate preexisting corneal astigmatism. Differences between the true residual astigmatism and the anticipated residual astigmatism (keratometric error) were compared at one and three months after surgery by using a separate vector analysis to identify the keratometric method that provided the highest accuracy for astigmatism control. RESULTS: The mean keratomeric error was 0.52 diopters (0.17-1.17) for the manual keratometer, 0.62 (0-1.31) for the IOL master, 0.69 (0.08-1.92) for the Pentacam, and 0.59 (0.08-0.94) for the auto keratometer. The manual keratometer was the most accurate, although there was no significant difference between the keratometers (p > 0.05). All of the keratometers achieved an average keratometric error of less than one diopter. CONCLUSIONS: Manual keratometry was the most accurate of the four methods evaluated, although the other techniques were equally satisfactory in determining corneal astigmatism.

A Survey Report on Cataract Surgical Experiences during Ophthalmology Residency in Korea

PURPOSE: To investigate cataract surgical experiences during ophthalmology residency in Korea. METHODS: A survey regarding cataract surgical experiences during residency was sent to 4th year ophthalmologic residents (112) from April to September 2010. RESULTS: Of the 112 individuals to whom the surveys were sent, 35 (31.3%) responded. The majority of the respondents (65.7%) performed their first cataract operation as the primary surgeon in their 4th year of residency. The majority of the respondents (42.9%) also thought that continuous curvilinear capsulorhexis (CCC) was the most difficult procedure followed by nucleus removal (31.4%). Fourteen respondents (40.0%) experienced loss of lens fragments into the vitreous cavity. Nine (25.7%) respondents had experienced performing ECCE (Extracapsular cataract extraction) during residency training. Also, 48.6% performed 1 to 5 cataract procedures during their entire residency training while 20.0% performed 6 to 10. CONCLUSIONS: The experiences in cataract surgery during residency were investigated for the first time through a questionnaire survey. The Korean ophthalmology residency program needs to provide more opportunities for residents to perform cataract surgery during their training period.

The Objective Methods to Evaluate Ocular Fatigue Associated With Computer Work

PURPOSE: To develop methods for the objective measurement of ocular fatigue. METHODS: Fifteen patients were enrolled in the present study. Subjects performed visual tasks on a computer for one hour. A survey of ocular fatigue was conducted with a questionnaire. Tear break-up time, blinking rate, ocular protection index, conjunctival injection, maximal blinking interval, temperature of the ocular surface, and visual evoked potential were evaluated before and immediately after the task. Surface electromyography of the orbicularis oculi muscle was performed before and during the task. RESULTS: The survey showed increases in subjective ocular fatigue in all subjects. Tear break-up time, ocular protection index and maximal blinking interval decreased, while temperature of the ocular surface increased after the task. Conjunctival injection showed a tendency to increase. Electromyography, and visual evoked potential did not change significantly. CONCLUSIONS: In the present study, tear break-up time, ocular protection index, maximal blinking interval, and temperature of the ocular surface changed as ocular fatigue increased. Therefore, these measures can be objectively used for the evaluation of ocular fatigue.

Comparison of the Effects of Prophylactic Nonsteroidal Anti-inflammatory Drugs on Macular Edema After Cataract Surgery

PURPOSE: To evaluate and compare the efficacy of prophylactic administration of topical nonsteroidal anti-inflammatory (NSAID) drugs on macular edema (ME) following cataract surgery. METHODS: The present open-label non-masked randomized (random number assignment) study was comprised of 90 eyes. Thirty eyes were administered Diclofenac sodium 0.1%, and 30 eyes were administered Pranoprofen 0.1% starting three days before surgery and continued for one month after surgery. The remaining 30 eyes made up the control group. The results consisted of the measurements of foveal thickness (FT), macular thickness (MT), and total macular volume (TMV), which were quantified by optical coherence tomography (OCT, Carl Zeiss Meditec) before and one month after phacoemulsification surgery. RESULTS: At one month, there were statistically significant differences in FT in the Diclofenac group (0.48+/-10.9 micrometer) and the Pranoprofen group (1.87+/-14.7 micrometer) (p<0.05) compared with the control group (11.65+/-18.6 micrometer). In addition, there was a statistically significant difference in MT between the control group (71.06+/-90.8 micrometer) and the Diclofenac group (15.19+/-36.1 micrometer) (p<0.05). However, no statistical difference in MT was noted between the control group and the Pranoprofen group (27.57+/-70.93 micrometer). Between the control group and the NSAID groups, only the Diclofenac group showed statistical differences in TMV throughout the observational period. CONCLUSIONS: Used prophylactically after cataract surgery, the NSAIDS eye drops were effective in reducing postoperative ME.

Comparative Analysis of Contact and Immersion Technique in Ultrasonographic Biometry

PURPOSE: To establish the accuracy of the newly released biometer Ocuscan RxP(R) (Alcon, USA) by comparison with the established Ultrasonic Biometer Model 820(R) (Allergan Humphrey, USA), and to compare the accuracy of contact and immersion biometries. METHODS: This is a prospective study involving 27 patients (40 eyes) who were scheduled for cataract surgery and had axial lengths measured with an Ocuscan RxP(R) biometer using both contact (Method 1) and immersion (Method 2) techniques. As a reference, a contact type Ultrasonic biometer 820(R) (Method 3) was also used. IOL(Intraocular Lens) power for the cataract surgery was calculated using this result. An axial length which would have caused no post-operative refractive error was reversely calculated from the difference of target diopter and post-operative refractive error. This length was compared with the axial lengths obtained via Methods 1, 2 and 3. RESULTS: The means and standard deviations for the measurement sets were compared. Methods 1 and 2 showed no significant difference (23.22+/-0.68, 23.24+/-0.69 mm, p=0.55). The axial length measured by Method 3 was 23.32+/-0.67 mm. The difference between the target refraction and post-operative refractive error was 0.29+/-0.60D. The axial length was reversely calculated from the difference (23.07+/-0.84 mm). The differences between the reversely calculated axial lengths and those of Methods 1, 2 and 3 were 0.15+/-0.31, 0.17+/-0.31 and 0.24+/-0.28 mm, respectively. CONCLUSIONS: Biometric results from Methods 1 and 2 caused less refractive error than did Method 3. The contact and immersion methods are both accurate for IOL power calculation if performed by a well-skilled examiner.

Clinical Outcome of Diffractive Multifocal Aspheric Intraocular Lens

PURPOSE: To compare the clinical outcome between Tecnis ZM900 and Tecnis ZA9003. METHODS: We reviewed 20 eyes of 11 patients implanted with Tecnis ZM900 and 20 eyes of 20 patients implanted with Tecnis ZA9003. The clinical outcomes of these two intraocular lenses were evaluated one month after operation and consisted of distant, intermediate, and near visual acuity; depth of focus; contrast sensitivity; wavefront aberration; and patient satisfaction. Six months after the operation a reevaluation was performed for the group who had received the Tecnis ZM 900 implant. RESULTS: Near and intermediate vision was better in the Tecnis ZM900 group. There were no statistical differences between the two groups with respect to distant vision and wavefront aberration. Contrast sensitivity was better in the Tecnis ZA9003 group and depth of focus was deeper in the Tecnis ZM900 group. There were no statically significant differences in the result between one month and six month after the operation. CONCLUSIONS: The Tecnis multifocal ZM900 IOL can be effective at improving patient satisfaction after cataract surgery as well as for correcting presbyopia.