Contrast Sensitivity Changes after Phototherapeutic Keratectomy in Heterozygote Granular Corneal Dystrophy Type 2

Purpose@#Contrast sensitivity, the ability to distinguish the relative difference in luminance of an object from its surrounding or adjacent objects, is a useful measure of visual function. In granular corneal dystrophy type 2 (GCD2), opacity of the corneal stroma causes deterioration in visual function. We compared the contrast sensitivity of GCD2 patients before and after phototherapeutic keratectomy (PTK) to evaluate the perioperative visual function in these patients. @*Methods@#This study included 22 eyes of heterozygote GCD2 patients. The visual acuity and contrast sensitivity were measured before and after PTK. The contrast sensitivity was measured in mesopic and photopic background luminances, with glare (G) levels of 0-2 (G0, G1, and G2, respectively) and spatial frequencies at 1.5, 3, 6, 12, and 18 cycles per degree (cpd). @*Results@#The contrast sensitivity increased after PTK at 1.5 and 3 cpd in mesopic and photopic conditions with G0-2 glare (p < 0.05). At 6 cpd, the contrast sensitivity increased in the mesopic condition with G1 glare, and in the photopic condition with G0-2 glare (p < 0.05). However, there was no change in contrast sensitivity at any glare level at 12 and 18 cpd after PTK. @*Conclusions@#In GCD2 patients, the contrast sensitivity increased significantly after PTK. The vision of GCD2 patients, which is decreased due to corneal opacity, is improved after PTK.

Short-term Comparison of Refractive Errors between Two Different Age Groups after LASEK for Moderate Myopia

Purpose@#To investigate the safety of laser epithelial keratomileusis (LASEK) by drawing a comparison between two groups divided according to age (18-19 vs. 20-21 years old). @*Methods@#The study was conducted as a retrospective analysis including 339 patients (678 eyes) who underwent LASEK between January 2017 and April 2020. Patients were divided by age group, group I (18-19 years old) and group II (20-21 years old). The objectives of the study included determination of visual acuity and refractive errors before and at 1, 3, and 6 months after the procedure. @*Results@#The preoperative mean spherical equivalents (SEs) were -4.73 ± 0.88 diopters (D) in group I and -4.58 ± 0.87 D in group II (p = 0.34). At 1 month postoperatively, mean SEs were 0.32 ± 0.46 D in group I and 0.26 ± 0.59 D in group II (p = 0.18). At 3 months postoperatively, the mean SEs were 0.30 ± 0.47 D in group I and 0.28 ± 0.50 D in group II (p = 0.67). At 6 months postoperatively, the mean SEs were 0.15 ± 0.47 D in group I and 0.14 ± 0.50 D in group II (p = 0.89). There were no significant differences in postoperative best corrected visual acuity between group I and group II at 1, 3, or 6 months (p = 0.20, p = 0.13, and p = 0.11, respectively). @*Conclusions@#There were no significant differences in postoperative mean SE or safety of LASEK between moderate myopia patients 18-19 years old and those 20-21 years old.

Clinical Outcomes of Lower Eyelid Epiblepharon Repair Combined with Minimal Incision of Medial Epicanthoplasty

Purpose@#To introduce a method of correcting lower eyelid epiblepharon with severe epicanthal fold combined with minimal incision of medial epicanthoplasty (Hiraga method) and to report its clinical outcomes. @*Methods@#We retrospectively reviewed the medical records of patients who underwent surgery for lower eyelid epiblepharon and minimal incision of medial epicanthus from January 2015 and January 2019. Seventy-eight eyes of 39 patients were analyzed for surgical outcomes, subjective symptoms, recurrence, and complications for more than six months of the follow-up period. @*Results@#A total of 39 patients (14 male, 25 female) were included in the analysis. The mean patient age was 8.4 ± 4.3 years, and the mean postoperative follow-up was 14 ± 5.2 months. Eyelid shape and function were well maintained in 39 patients (100%), with no recurrence during follow-up. @*Conclusions@#For patients with lower eyelid epiblepharon with severe medial epicanthal fold, lower eyelid epiblepharon with a minimal incision of medial epicanthoplasty (Hiraga method) is a simple surgical technique to prevent recurrence of medial cilia touch, showing successful results without complications.

A Case of Clozapine-induced Corneal and Lenticular Pigmentation

PURPOSE: To report a case of corneal and lenticular pigmentation after prolonged clozapine therapy. CASE SUMMARY: A 56-year-old male visited our hospital with a progressive decline in vision that affected both eyes. He had a history of schizophrenia. He was being treated with 200 mg clozapine and 1 mg lorazepam daily, and had been treated with clozapine for 5 years. At the first visit, his best-corrected-visual acuity was 20/32 in both eyes. Slit lamp examination of the corneas showed bright, fine, grayish-brown deposits on the endothelium, and on dilation, bilateral central stellate opacity of the anterior portion of the lens capsule was revealed. CONCLUSIONS: Clozapine may induce corneal and lenticular pigmentation and thus may lead to a decline in vision. Patients on long-term clozapine therapy should be considered for regular ophthalmic review.