Comparison of Visual Function Among Aspheric Intraocular Lenses

PURPOSE:To compare the visual function among 3 aspheric intraocular lenses (IOLs) after cataract surgery. METHODS: A prospective analysis among 70 eyes of 68 patients who had undergone phacoemulsification and implantation of aspheric IOLs (Acrysof IQ, 30 eyes; Tecnis ZA9003, 20 eyes; Akreos Adapt-AO, 20 eyes) was performed. The best corrected visual acuity (BCVA), refraction, coma, trefoil, spherical aberration, root-mean-square (RMS), contrast sensitivity test, satisfaction and glare was evaluated during the follow-up period of 3 months. RESULTS: There were no significant differences in BCVA, satisfaction, glare, coma, trefoil, RMS and contrast sensitivity test among the 3 aspheric IOLs. Spherical aberration in Akreos Adapt-AO (0.04+/-0.05 microm) was higher compared with Acrysof IQ (0.03+/-0.04 microm) and Tecnis ZA9003 (0.11+/-0.03 microm)(p<0.01). The predictability of postoperative spherical equivalent in the Akreos Adapt-AO group (-0.57+/-0.22D) represented a statistically significant myopic refractive error compared with the Acrysof IQ (0.01+/-0.77D) and the Tecnis ZA9003 (-0.20+/-0.71D) groups (p=0.04). CONCLUSIONS: There were no significant differences in visual function except spherical aberration, which was highest in the Akreos Adapt-AO group.

Clinical Results between Scleral Buckling and Vitrectomy in Pseudophakic Retinal Detachment with Intact Posterior Capsule

PURPOSE: To compare the clinical outcomes between scleral buckling and vitrectomy in the primary management of pseudophakic retinal detachment with an intact posterior capsule. METHODS: The medical records of 63 eyes that underwent scleral buckling (36 eyes) or vitrectomy (27 eyes) as a primary operation of uncomplicated pseudophakic retinal detachment with intact posterior capsules with a follow-up of more than one year were retrospectively reviewed from 2000 to 2005. We compared the clinical outcomes using anatomical and functional success rates at postoperative one year. Anatomical success was defined by a reattachment rate and functional success was measured by a change of more than 0.3 logMAR. RESULTS: Anatomical success rates were 86% in the scleral buckling and 82% in the vitrectomy, respectively (p=0.837). Functional success rates were 81% in the scleral buckling and 70% in the vitrectomy, respectively (p=0.065). There were no significant differences of anatomical and functional success rates according to each surgical procedure. CONCLUSIONS: Either scleral buckling or vitrectomy may be chosen as a primary operation in the management of pseudophakic retinal detachment with intact posterior capsule.

Clinical Features of Refractive Accommodative Esotropia: Long-term Study

PURPOSE: To analyze the long-term clinical features and functional outcomes of refractive accommodative esotropia. METHODS: Initial and final age, cycloplegic refraction, distance and near deviation with and without correction, stereoacuity and incidence of amblyopia were evaluated in 45 patients with accommodative esotropia. RESULTS: The follow-up duration was 65.77+/-43.98 (6~151) months, and the mean age was 4.02+/-1.97 and 9.42+/-3.77 years at the first and final visits, respectively. The cycloplegic refraction was decreased from 5.16+/-1.92 diopters (D) to 4.41+/-1.83D, averaging -0.09+/-0.40D annually (P<0.01). Of these hyperopic eyes, 55 (61.1%) experienced a decrease, 22 (24.4%) an increase, and 5 (5.6%) showed no changes. From 5 (31.2%) to 12 (75.0%) of 16 patients had a stereoacuity of 100 sec/arc or better (p<0.01). Fusion was achieved in 14 (87.5%) at the final visit, up from 11 (68.8%) at the first visit (P=0.39); 23 (51.1%) of the patients were amblyopic; and anisometropia was found in 9 (39.1%) patients. CONCLUSIONS: Patients whose esotropia was corrected with full cycloplegic hyperopic correction show decreased longitudinal changes in spherical equivalent refractive error with a time course and have excellent binocularity outcomes.

Changes of Tear Film and Ocular Surface with Time after Penetrating Keratoplasty

PURPOSE: To evaluate the parameters of tear function and ocular surface changes with time course after penetrating keratoplasty (PKP). METHODS: Corneal sensitivity test (CST), tear film break-up time (BUT), basal tear secretion test (BST), tear clearance test (Tcr), fluorescein staining and conjunctival impression cytology were evaluated in 21 eyes of 21 patients who underwent PKP at 1, 3 and 6 months postoperatively. RESULTS: CST (p=0.02), BST (p=0.04), fluorescein scoring (p=0.03), and goblet cell density (p=0.03) showed improving tendency during 6 month after surgery, but BUT (p=0.11), Tcr (p=0.65) and squamous metaplasia (p=0.20) did not change significantly. One month after surgery, CST (p<0.01), BUT (p=0.01), BST (p<0.01), and goblet cell density (p=0.01) were lower, while fluorescein staining score (p<0.01) and the grade of squamous metaplasia (p=0.03) were higher in PKP group. Six months after surgery, CST (p<0.01) and goblet cell density (p=0.04) were lower, and fluorescein staining score (p<0.01) was higher in PKP group. CONCLUSIONS: Tear film and ocular surface are compromised after PKP and improved gradually during postoperative 6 months. However, these parameters were not recovered completely to the normal level.

Clinical Aspect and Prognosis of Alternaria Keratitis

PURPOSE: To investigate the risk factor, clinical manifestations, treatment results, and prognosis in Alternaria keratitis. METHODS: Thirteen eyes of 13 patients who were diagnosed as Alternaria species by corneal smear and culture were included. The past history, visual acuity, location and size of ulceration, hypopyon, treatment results, and prognosis were analyzed retrospectively. RESULTS: Nine (69.2%) were women, and 4 were men. The mean age was 65.23+/-8.70 years. Eleven eyes (84.6%) had previous history of corneal traumas by soil or plant material. In 7 eyes (53.8%), the lesions were located at the corneal center. The average size of ulceration was 13.90+/-21.80 mm2. Four eyes (30.8%) had hypopyon. The initial visual acuity was less than 0.1 in 10 eyes (76.9%). The final visual acuity improved more than 2 lines in 10 eyes (76.9%) and more than 1 line in 12 eyes (92.3%), and did not change in 1 eye (7.7%). The treatment success was achieved in 12 eyes (92.3%). CONCLUSIONS: Early diagnosis and specific antifungal treatments of Alternaria keratitis can lead to a good prognosis.