Efficacy of low-concentration atropine (0.01%) eye drops for prevention of axial myopic progression in premyopes

Low?concentration atropine (LCA; 0.01%) is known to reduce the progression of myopia in axial myopes. The purpose of this study was to understand the role of LCA in premyopic children in preventing progression. Methods: A randomized case–control study of known premyopes was done between the use of LCA and no intervention. A total of 30 children were included in both groups. Results: The mean age in the LCA group was 7.7 ± 2.1 years (5–12 years), and in the control group, it was 7.2 ± 1.9 years (4–12 years). The mean baseline progression per year in the LCA group (before starting the eye drops) was ? 0.72 ± 0.3 D, and in the control group, it was ? 0.69 ± 0.4 D. At the end of the first year, the mean progression in the LCA group was ? 0.31 ± 0.3 D versus ? 0.76 ± 0.4 D, and the axial length increase was 0.12 ± 0.1 mm in the LCA group and 0.21 ± 0.2 mm in the control group. At the end of the second year, the mean progression compared with the baseline in the LCA group was ? 0.6 ± 0.3 D versus ? 1.75 ± 0.4 D, and the axial length showed an increase from baseline in the LCA group by 0.21 ± 0.2 mm, and in the control group, the increase was 0.48 ± 0.2 mm in 2 years. Conclusion: Low?concentration eye drops (0.01%) work in preventing the progression of axial myopia in premyopic children.

A Comparative Study of Corneal Endothelial Cell Count and Central Corneal Thickness in Emmetropia and Axial Myopia

The main attributes of cornea which makes it optically important is its ability to maintain its dehydrated state. This corneal dehydration can be achieved and maintained by various factors among which corneal endothelial cell count and morphology play a significant role. Corneal attributes considered in this study i.e. the corneal endothelial cell count and central corneal thickness are extremely variable, and changes are seen even with smaller changes in anterior segment or overall structural changes in eyes. We wanted to compare central corneal thickness in emmetropia and axial myopia and compare corneal endothelial cell count in emmetropia and axial myopia. METHODSThe sample size was decided taking into consideration various prevalence studies. The patients were consecutively recruited for the study considering the inclusion and exclusion criteria. The subjects were divided into two groups emmetropia and axial myopia and were differentiated on the basis of the axial lengths. Specular microscopy was performed for the subjects and corneal endothelial cell count, morphology and central corneal thickness were measured, and comparative study was performed. RESULTSThis study of 80 eyes shows us that the difference between mean the corneal endothelial cell count between emmetrope (2812.80 cells / mm2) and axial myopes (2653 cells / mm2) is statistically significant where p was < 0.05 while the mean central corneal thickness measurements didn’t show statistically significant change between emmetrope (490.05 microns) and axial myope. (489.37 microns). CONCLUSIONSAxial length has an indirect correlation with the corneal endothelial cell count which is statistically significant. While significant correlation between the central corneal thickness and axial length cannot be established in this study.

Complicaciones en cirugía de catarata por facoemulsificación en pacientes con miopía axial alta / Complications in cataract extraction by phacoemulsification in patients with high axial myopia

Objetivo: determinar la frecuencia de complicaciones en pacientes con miopía axial alta y catarata, a los que se les realizó extracción de catarata por facoemulsificación. Diseño del estudio: observacional descriptivo de frecuencia. Método: se incluyeron 107 ojos de pacientes con miopía axial alta, a los que se les realizó extracción de catarata por facoemulsificación más implante de LIO, operados en 2015. Se realizó una revisión de historias clínicas y descripciones quirúrgicas de los pacientes seleccionados y se evaluó la presentación de complicaciones con un seguimiento a un año después de la cirugía. Resultados: 2 ojos presentaron ruptura de cápsula posterior (1,8 %). Otros 2 ojos presentaron diálisis zonular (1,8 %) y en 3 ojos se evidenció pérdida de vítreo (2,7 %). Durante el primer año postoperatorio de seguimiento se observó desprendimiento de retina en 1 ojo (0,9 %). No se reportaron casos de luxación del LIO a cámara anterior. Conclusión: La frecuencia de complicaciones es similar a la reportada en la literatura mundial e inclusive más baja en algunas variables como la ruptura de capsula posterior y el desprendimiento de retina.

Background: Cataract extraction by phacoemulsifi cation plus intraocular lens (IOL) implant is the most used treatment against the main cause of reversible blindness in the world; the cataract. It is a very successful procedure due to its low frequency of complications and its high reproducibility. However, patients with high axial myopia do not behave in this way and tend to present more complications. Objective: to determine the frequency of complications in patients with high axial myopia and cataract, who underwent cataract extraction by phacoemulsifi cation. Study design: observational descriptive. Method: 107 eyes of patients with high axial myopia were included. All underwent cataract extraction by phacoemulsification plus IOL implantation, in 2015. A review of clinical histories and surgical descriptions of all patients was performed to determine the frequency of complications during a follow-up time of one year aft er surgery. Results: 2 eyes presented posterior capsule rupture (1.8%). Two other eyes presented zonular dialysis (1.8%) and 3 eyes had vitreous loss (2.7%). During the first postoperative year of follow-up, retinal detachment was observed in 1 eye (0.9%). No cases of IOL dislocation to the anterior chamber were reported. Conclusion: The frequency of complications in this population is similar to the one reported in other studies and even lower in some variables such as posterior capsule rupture and retinal detachment.

The Incidence of Retinal Detachment after Cataract Surgery according to Surgical Methods

We reviewed our medical records to evaluate the incidenee of and risk factors for retinal detachment after cataract surgery according to the surgical methods. Group 1 included 605 eyes operated on with corneoscleral incision, extracapsular cataract extraction(ECCE) and posterior chamber intraocular lens(PCL) implantation, and Group 2 included 600 eyes with scleral tunneling incision, phacoemulsification and PCL implantation. 8 eyes(1.3 %) developed retinal detachment in group 1, whereas 1 eyes(0.2%) in group 2. The difference in incid ence between the two groups was statistically significant(P<0.05). Axial length is longer than 25mm, intraoperative posterior capsule rupture, and scleral fixation were identified as risk factors for retinal detachment after cataract surgery. From the above results, suggest that phacoemulsification with scleral tunnel incision is preferable to extracapsular cataract extraction(ECCE) with cornea-scleral incision, in cataract surgery, to lower the post operative complication of retinal detachment.

Monocular Axial Myopia following Neonatal Eyelid Suture in The Rabbits

The exact etiology and pathogenesis of myopia are not known yet, although various studies of the development of myopia in experimental animals have been made. Authors attemtped whether rabbits developed axial myopia by fusing their lids at birth in one eye, or not. The monocular vision was deprived by suture of upper and lower lids in 12 rabbits which were 5 day-old. The other eye was unsutured as the control. Ten months later, we assessed refractive error, corneal curvature, axial length, and intraocular pressure and enucleation was done. We observed the histologic change of sclera with light microscope. The eyes with lid suture were more myopic(-3.35 +/- 0.99D) than the controlled eyes(-0.21 +/- 0.46D) (p<0.01). The corneal curvature and intraocular pressure were not significantly different between two groups. The axial lengths of the sutured eves were increased(21.27 +/- 1.70mm) in comparison with those of the controlled(17.39 +/- 1.83mm)(p<0.01). We conclude the difference in axial length was caused by the elongation of the posterior segment of eyeball. since lens thickness, depth of anterior chamber, and corneal curvature were identical in both groups. These were correlated with histologic change that showed thinner posterior parts of sclera of the sutured eyes than those of the controlled eyes. The results of this study demonstrate that monocular lid fusion in rabbits produced an expenmental axial myopia.