ABSTRACT
PURPOSE: To evaluate the diagnostic test properties of the Palm Scan VF2000â Virtual Reality Visual Field Analyzer for diagnosis and classification of the severity of glaucoma. METHODS: This study was a prospective cross-sectional analysis of 166 eyes from 97 participants. All of them were examined by the Humphreyâ Field Analyzer (used as the gold standard) and the Palm Scan VF 2000â Virtual Reality Visual Field Analyzer on the same day by the same examiner. We estimated the kappa statistic (including 95% confidence interval [CI]) as a measure of agreement between these two methods. The diagnostic test properties were assessed using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). RESULTS: The sensitivity, specificity, PPV, and NPV for the Virtual Reality Visual Field Analyzer for the classification of individuals as glaucoma/non-glaucoma was 100%. The general agreement for the classification of glaucoma between these two instruments was 0.63 (95% CI: 0.56-0.78). The agreement for mild glaucoma was 0.76 (95% CI: 0.61-0.92), for moderate glaucoma was 0.37 (0.14-0.60), and for severe glaucoma was 0.70 (95% CI: 0.55-0.85). About 28% of moderate glaucoma cases were misclassified as mild and 17% were misclassified as severe by the virtual reality visual field analyzer. Furthermore, 20% of severe cases were misclassified as moderate by this instrument. CONCLUSION: The instrument is 100% sensitive and specific in detection of glaucoma. However, among patients with glaucoma, there is a relatively high proportion of misclassification of severity of glaucoma. Thus, although useful for screening of glaucoma, it cannot replace the Humphreyâ Field Analyzer for the clinical management in its current form.
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INTRODUCTION: The present study compared visual outcomes in eyes with bilateral implantation of two multifocal intraocular lenses (MFIOLs)-the Eyecryl™ ACTV diffractive multifocal IOL (group 1) and AcrySof® IQ ReSTOR® multifocal IOL (group 2). METHODS: This was a prospective, two-group observational longitudinal study of 118 eyes from 59 patients conducted at Laxmi Eye Institute, Panvel, India. We evaluated the patients at 1, 3, and 6 months. We assessed visual acuity, contrast sensitivity, higher-order aberrations, reading speed, defocus curve, stereopsis, quality of life (QOL), and adverse events in these participants. RESULTS: The median (interquartile range) best-corrected distance visual acuity was 0.18 (0, 0.18) in group 1 and 0.18 (0, 0.18) in group 2 at 1, 3, and 6 months; the difference was not statistically significant (p = 0.48). The binocular defocus curve in both groups showed two peaks at 0.0 to -0.5 D and at -2.5 D. The mean (95% confidence interval) critical print size was significantly different between groups 1 and 2 at low illumination (0.918 [0.905, 0.931] vs 1.154 [1.128, 1.180]; p = 0.004). Contrast sensitivity was significantly better in group 1 under mesopic conditions but not under scotopic conditions. Though total QOL did not differ significantly between groups, the psychosocial quality of life was significantly better in group 1. About 23% of patients in group 2 reported unwanted images, compared with 0% in group 1 (p = 0.01). CONCLUSION: We found that the Eyecryl and AcrySof groups were comparable for best-corrected visual acuity, photopic contrast sensitivity, defocus curve, reading parameters, stereopsis, and quality of vision. However, the Eyecryl group had better mesopic contrast and a lower proportion of unwanted images. Psychosocial quality of life was significantly better in the Eyecryl group; however, satisfaction was similar between groups. The cost of one of the lenses is less than the other. Thus, individuals with limited resources may opt for the Eyecryl™ ACTV, with similar visual outcomes.
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PURPOSE: To compare incision size enlargement at different times of cataract surgery and visual outcomes after surgery in 2 different intraocular lens (IOL) delivery systems (Vivinex iSert and UltraSert Preloaded IOL Delivery System). SETTING: Tertiary care eye institution. DESIGN: Prospective nonrandomized comparison study. METHODS: All eyes had uneventful temporal clear corneal phacoemulsification cataract surgery. The surgery was done by standard direct horizontal chop with a bimanual irrigation aspiration of the cortex. The primary incision size was measured after clear corneal incision, after the completion of phacoemulsification, and after IOL implantation. RESULTS: The study comprised 276 eyes of 220 patients. The mean initial corneal incision was similar in both groups (2.2 mm). There was no significant difference in the mean incision size after phacoemulsification between the 2 groups (2.250 mm ± 0.068 mm [SD] vs 2.251 ± 0.066 mm [SD], P > .99). There was no significant difference in the mean (SD) incision size after IOL insertion between the 2 groups (2.367 ± 0.066 mm vs 2.369 ± 0.062 mm [SD], P = .815. The corrected distance visual acuity was 6/6 at 1 month in 80% of the participants in the UltraSert group and 86% in the Vivinex group. After adjusting for age, sex, grade of cataract, and IOL power, no significant difference was found in the magnitude of surgically induced astigmatism (SIA) in the Vivinex group compared with the UltraSert group (0.06, 95% CI, -0.11 to 0.24; P = .47). CONCLUSIONS: No significant difference was found in the change in the incision size, visual acuity, and SIA between UltraSert and Vivinex IOL delivery systems. This suggests that both IOL delivery systems are comparable in terms of post-IOL delivery incision enlargement for incisions of 2.2 mm.
Subject(s)
Cornea/surgery , Lens Implantation, Intraocular/instrumentation , Lenses, Intraocular , Phacoemulsification , Surgical Wound/surgery , Aged , Cornea/physiopathology , Female , Humans , Male , Middle Aged , Prospective Studies , Pseudophakia/physiopathology , Tertiary Care Centers , Visual Acuity/physiologyABSTRACT
AIM:To assess the anterior corneal astigmatism (ACA)and posterior corneal astigmatism (PCA) patterns across various age groups.We also evaluated the association between magnitudes and axes of the ACA and PCA across these age groups.METHODS:The present study was a cross-sectional analysis of clinical data of 381 eyes.We converted the clinical astigmatic notation to vector notation for analysis of ACA and PCA.We estimated the correlation between magnitude and axes of the ACA and PCA in the whole population and in four age groups (5-19,20-39,40-59,and ≥ 60y).We used random effects linear regression models for estimating the association between the magnitudes of ACA and PCA.RESULTS:The mean of the magnitude of the ACA (3.59D) and the PCA (0.50D) was highest in children (5 to 9y).Overall,the magnitude of the ACA ranged from 0D to 10.0 Diopters (D) and the magnitude of the PCA ranged from 0 to 3.5 D.There was a significant correlation between the ACA and the PCA in the younger age group (r=0.85,P＜0.001).In those 60y or older,the PCA increased by 0.04 units (95％ confidence intervals:0.005,0.07;P=0.03) with each unit increase in the ACA,the increase was the smallest in this age group.CONCLUSION:It will be prudent to measure the both the magnitude and axis of the PCA,particularly in those above 60y rather than rely on rule-of-thumb calculations based on ACA parameters for IOL power calculation.
