Influence of Nd:YAG laser capsulotomy on toric intraocular lens rotation and change in cylinder power.

PURPOSE: To investigate toric monofocal intraocular lens (TIOL) rotation and associated changes in cylinder power caused by Nd:YAG laser capsulotomy performed due to posterior capsule opacification (PCO). SETTING: Ekol Eye Hospital, Izmir, Turkey. DESIGN: Prospective case series. METHODS: 41 eyes of 20 women and 21 men were included in the study. Before and 1 month after Nd:YAG laser capsulotomy, TIOL tilt and decentration were determined with Scheimpflug camera, and TIOL axial rotation and the change in cylinder power induced by this rotation were measured by ray tracing aberrometry. The time interval between cataract surgery and Nd:YAG laser capsulotomy was noted. RESULTS: Rotational misalignment of the TIOL was measured as 4.65 ± 2.75 degrees (range 0 to 11 degrees) before vs 6.97 ± 2.92 degrees (range 0 to 13 degrees) after capsulotomy, and absolute rotation was 2.75 ± 1.94 degrees (range 0 to 7 degrees, P = .028). Before and after Nd:YAG laser capsulotomy, cylinder power was 0.24 ± 0.70 diopter (D) (range 0.00 to 0.63 D) vs 0.56 ± 0.77 D (range 0.02 to 0.91 D), respectively, with an absolute change in cylinder power of 0.34 ± 0.22 D (range 0.01 to 0.90 D, P = .001). After capsulotomy, there was a significant decrease in IOL tilt in the horizontal and vertical planes and an increase in decentration ( P < .05). Time interval (33.02 ± 12.9 months) and IOL horizontal decentration were independent factors affecting IOL rotation after capsulotomy ( P < .05). CONCLUSIONS: Nd:YAG laser capsulotomy may cause TIOL rotation as well as tilt and decentration, resulting in a change in the TIOL's corrective effect on corneal astigmatism. Although this change was clinically insignificant, it may be beneficial to consider that TIOL rotational misalignment may occur in patients undergoing early capsulotomy.

Vision outcomes with a new monofocal IOL.

PURPOSE: The aim of this study was to compare the distance, intermediate, and near visual performance of a new IOL (ICB00, Eyhance, Tecnis) and classic monofocal IOL (SN60WF IQ AcrySof, Alcon) after unilateral implantation. METHODS: Sixty-three patients were unilaterally implanted with the ICB00 Eyhance IOL (study group) and 65 patients with the SN60WF IQ AcrySof (control group). Visual performance was assessed with monocular corrected distance visual acuity (CDVA) and uncorrected distance visual acuity (UDVA) at 4 m, corrected intermediate visual acuity (CIVA) and uncorrected intermediate visual acuity (UIVA) at 60 cm, and corrected near visual acuity (CNVA) and uncorrected near visual acuity (UNVA) at 40 cm. RESULTS: CDVA, UDVA, CNVA, and UNVA values did not differ significantly between the study and control groups (0.02 ± 0.02 vs. 0.03 ± 0.02, p = 0.523; 0.05 ± 0.13 vs. 0.05 ± 0.15, p = 0.637; 0.46 ± 0.17 vs. 0.46 ± 0.15, p = 0.821; and 0.47 ± 0.21 vs. 0.49 ± 0.25, p = 0.612; respectively), whereas the study group showed significantly better results for CIVA (0.28 ± 0.12 vs. 0.38 ± 0.13, p = 0.001) and UIVA (0.31 ± 0.16 vs. 0.41 ± 0.12, p = 0.001). CONCLUSIONS: The Eyhance IOL, which features a new optical design based on a continuous power profile, was determined to be superior to a classic monofocal IOL for intermediate visual acuity and not inferior for corrected and uncorrected distance and near visual acuity.

Comparison of wavefront aberrations in eyes with multifocal and monofocal iols before and after Nd:YAG laser capsulotomy for posterior capsule opacification.

PURPOSE: The aim of this study was to compare wavefront aberrations before and after Nd:YAG capsulotomy in multifocal intraocular lens (MfIOL) and monofocal (MoIOL) pseudophakic eyes with posterior capsule opacification (PCO). MATERIALS AND METHODS: Wavefront aberrations were measured using a ARK-10000 topographer before and after Nd:YAG capsulotomy in eyes that underwent MfIOL or MoIOL implantation and developed PCO. Total and higher-order aberrations (HOAs) values were evaluated as root mean square (RMS). RESULTS: The study included 64 eyes with MfIOLs (64 patients) and 72 with MoIOLs (72 patients) that developed PCO. Total RMS values before and 1 month after Nd:YAG capsulotomy were 0.863 ± 0.27 and 0.504 ± 0.24 in the MFIOL group and 0.862 ± 0.31 and 0.466 ± 0.26 in the MoIOL group, respectively. Total RMS values did not differ significantly between the groups before (p = 0.914) or 1 month after Nd:YAG laser capsulotomy (p = 0.357), but decreased significantly after Nd:YAG capsulotomy compared to baseline in both the MfIOL (p = 0.027) and MoIOL (p = 0.012) groups. HOA values before and 1 month after Nd:YAG capsulotomy were 0.546 ± 0.23 and 0.364 ± 0.19 in the MfIOL group and 0.500 ± 0.21 and 0.346 ± 0.18 in the MoIOL group, respectively. HOA values did not differ significantly before (p = 0.828) or after Nd:YAG capsulotomy (p = 0.111), while both groups showed significant reduction in HOAs after Nd:YAG capsulotomy (MfIOL: p = 0.021, MoIOL: p = 0.027). CONCLUSIONS: Nd:YAG capsulotomy reduces total and HOAs to the same extent in eyes with both MfIOLs and MoIOLs, with no significant impact of the IOL design.

Effect of neuroprotective citicoline eye drops on macular microcirculation.

BACKGROUND AND OBJECTIVE: To use optical coherence tomography (OCTA) examination of the retinal microvascular structures to evaluate the effect of neuroprotective eye drops (citicoline, OMK1®) administered for laser in situ keratomileusis (LASIK) surgery. PATIENTS AND METHODS: This prospective study included 45 patients treated with citicoline after LASIK and 48 patients not treated with citicoline after LASIK as a control group. In both groups, the foveal avascular zone (FAZ), retinal superficial vascular density (SVD), and deep vascular density (DVD) in the foveal and parafoveal areas were measured preoperatively and at 1 and 3 months postoperatively using OCTA. RESULTS: No significant difference was detected between the groups in terms of preoperative SVD or DVD in the foveal and parafoveal zones and all quadrants (superior, inferior, temporal, and nasal) (P > 0.05). Similarly, no significant difference was detected between the citicoline group and control group in terms of SVD or DVD in the foveal and parafoveal zones at 1 and 3 months after LASIK (P > 0.05). CONCLUSIONS: Despite their neuroprotective effect, topical citicoline drops had no significant effect on the superficial and deep microvascular structures of the retina or choriocapillaris.

Comparison of Retinal Vascular Structure in Eyes With and Without Amblyopia by Optical Coherence Tomography Angiography.

PURPOSE: To evaluate the retinal vascular structure in amblyopic eyes by optical coherence tomography angiography (OCTA). METHODS: Thirty-seven eyes of 37 patients with anisometric amblyopia were compared with 37 eyes of 37 age- and gender-matched control subjects by OCTA in terms of superficial capillary plexus vessel density, deep capillary plexus vessel density, and foveal avascular zone. RESULTS: The mean age was 12 ± 4.2 years in patients with amblyopia and 13 ± 6.1 years in individuals without amblyopia. Foveal superficial capillary plexus vessel densities were 20.49% ± 3.27%, 19.70% ± 3.82%, and 19.96% ± 3.84%, and parafoveal superficial capillary plexus vessel densities were 48.50% ± 3.64%, 49.01% ± 3.33%, and 48.9% ± 2.98% in amblyopic, fellow, and control eyes, respectively. The foveal deep capillary plexus vessel densities were 18.95% ± 3.76%, 18.6% ± 4.50%, and 19.29% ± 4.01%, and parafoveal deep capillary plexus vessel densities were 51.0% ± 4.21%, 51.85% ± 4.12%, and 52.03% ± 3.57% in amblyopic, fellow, and control eyes, respectively. Superficial and deep capillary plexus vessel densities in the foveal and parafoveal areas were not significantly different between the groups (P > .05). The parafoveal area was evaluated in quadrants. In the superior quadrant, superficial and deep capillary plexus parafoveal densities were significantly lower in amblyopic eyes (P < .05). No significant difference was observed in the foveal avascular zone between the groups (P > .05). CONCLUSIONS: Although no significant vascular damage was demonstrated by OCTA in amblyopic eyes, localized defects may be specific for it. Additional studies are needed to evaluate any specific localization of vascular damage related to amblyopia. [J Pediatr Ophthalmol Strabismus. 2020;57(1):48-53.].

Neuroprotective Effect of Citicoline Eye Drops on Corneal Sensitivity After LASIK.

PURPOSE: To evaluate the accelerator role of a topically administered neuroprotective eye drop (citicoline) on the recovery of corneal sensitivity after laser in situ keratomileusis (LASIK). METHODS: In this prospective, controlled study, 78 eyes of 78 patients (mean age: 26.8 ± 7.6 years) were enrolled in the study group and their eyes were treated with topical citicoline three times a day for 1 month postoperatively. Seventy-eight eyes of 78 patients (mean age: 26.1 ± 7.4 years) were randomly selected as the control group and their eyes were treated with lubricant hyaluronic acid (0.15%) eye drops three times a day for 1 month. Corneal sensitivity was assessed in both groups using a Cochet-Bonnet esthesiometer at baseline and 1, 2, 3, 4, 6, 8, and 12 weeks after the LASIK procedure. RESULTS: Corneal sensitivity at 1, 2, 3, 4, and 6 weeks after LASIK was significantly better in the citicoline group than the control group (P < .05 for all). Differences between the groups at 8 and 12 weeks after LASIK were not significant (P > .05). CONCLUSIONS: Topically administered citicoline eye drops had beneficial effects in the early recovery of corneal sensitivity during the first 6 weeks after LASIK, suggesting that citicoline may play a significant role in accelerating corneal reinnervation. [J Refract Surg. 2019;35(12):764-770.].

Intraocular lens tilt and decentration after Nd:YAG laser posterior capsulotomy: Femtosecond laser capsulorhexis versus manual capsulorhexis.

PURPOSE: To compare intraocular lens (IOL) tilt and decentration after Nd:YAG laser posterior capsulotomy in eyes that had femtosecond laser-assisted capsulotomy versus manual capsulorhexis. SETTING: Ekol Eye Hospital, Izmir, Turkey. DESIGN: Retrospective case series. METHODS: Intraocular lens decentration and angle of tilt were measured using a Scheimpflug camera before and 1 month after Nd:YAG capsulotomy. RESULTS: Eighteen eyes had a femtosecond laser-assisted capsulotomy and 25 eyes a manual capsulorhexis. The mean age was 58.2 years ± 10.2 (SD) (range 44 to 69 years) and 60.6 ± 8.3 years (range 45 to 70 years), respectively. Before capsulotomy, the angle of tilt and decentration at both meridians did not differ significantly between the 2 groups (P > .05). After capsulotomy, the angle of tilt was significantly decreased in both groups (femtosecond: vertical 1.5 degrees and horizontal 1.2 degrees; manual: vertical 1.1 degrees and horizontal) and decentration was significantly increased (femtosecond: vertical 0.085 mm and horizontal 0.096 mm; manual: vertical 0.2 mm and horizontal 0.2 mm) at both meridians (P < .05). After capsulotomy, all tilt and decentration parameters were significantly different between the 2 groups (P < .05) except decentration on the horizontal meridian (P = .669). CONCLUSIONS: Nd:YAG posterior capsulotomy performed after femtosecond laser-assisted capsulotomy resulted in better mechanical stability of the IOL. This suggests that a femtosecond laser-created capsulotomy better maintains a proper IOL position. Although the differences were statistically significant, the tilt and decentration values were small and might not be clinically significant.