Evaluation of lamina cribrosa thickness and depth in ocular hypertension.

PURPOSE: To investigate the differences in thickness and depth of the lamina cribrosa (LC) between ocular hypertension (OH) patients and normal control subjects, using enhanced depth imaging (EDI) spectral-domain optical coherence tomography (SD-OCT). METHODS: EDI-OCT data were obtained from the subjects in a cross-sectional analysis of data from a retrospective study. After IOP correction according to central corneal thickness (CCT), we divided the OH patients into two groups based on the corrected IOP (cIOP)--OH with lower IOP (OH-L; cIOP < 23 mmHg) and OH with higher IOP (OH-H; cIOP ≥ 23 mmHg). Comparisons of LC thickness and depth among three groups were performed. RESULTS: Seventy-four OH patients and 45 normal control subjects were included in the analysis. Among the 74 OH patients, 41 were included in the OH-L group and 33 were included in the OH-H group. LC thickness was thicker in the OH-H group compared to normal controls both in superior (P = 0.02) and inferior (P = 0.01) portions. However, no difference was found in LC depth among the three groups in any portion (P = 0.36; P = 0.44; P = 0.31, respectively). CONCLUSION: OH patients may have a thicker LC than normal control subjects, especially in OH with definite high IOP.

Long-term outcomes of argon laser photocoagulation in small size cyclodialysis cleft.

BACKGROUND: To evaluate the long-term outcomes of Argon laser photocoagulation compared to surgical direct cyclopexy in small-size cyclodialysis cleft patients. METHODS: This is a retrospective study. Small-size cyclodialysis cleft patients who underwent Argon laser photocoagulation and surgical direct cyclopexy were reviewed. The mean follow-up period were 82.4 (range, 61 - 145) months and 99.9 (range, 62 - 184) months in both groups. The comparison of best corrected visual acuity (BCVA), intraocular pressure (IOP), postoperative peak IOP and time to normalization of IOP before and after the treatment. RESULTS: The causes of all included 15 cyclodialysis cleft cases were blunt trauma. seven patients underwent Argon laser photocoagulation and eight patients underwent surgical direct cyclopexy. The mean age of included patients was not significantly different (p = 0.38). Preoperatively, the mean logMAR BCVA (standard deviation, SD) was 0.7 (0.2) and 1.1 (0.9) and mean IOP was 4.4 (2.4) mmHg and 3.0 (1.5) mmHg in Argon laser group and surgical direct cyclopexy group (p = 0.24 and p = 0.18, respectively). The extension of cyclodialysis and duration of cyclodialysis cleft were not significantly different between the two groups (p = 0.08 and p = 0.24, respectively). The mean follow-up period were 82.4 (range, 61 - 145) months and 99.9 (range, 62 - 184) months in both groups (p = 0.41). Postoperatively, the mean logMAR BCVA was 0.0 (0.1) and 0.2 (0.3) and mean IOP was 14.5 (3.1) mmHg and 16.8 (2.5) mmHg (p = 0.15 and p = 0.16, respectively). Postoperative peak IOP and time to normalization of IOP were not different between the two groups (p = 0.75 and p = 0.91, respectively). DISCUSSION: It is necessary to use invasive treatment such as cryotherapy or surgical direct cyclopexy in cyclodialysis cleft with hypotonic maculopathy. In the present study, Argon laser photocoagulation showed good prognosis in a small-size cyclodialysis cleft below 1.5 clock-hours. Considering possible complications and cost of surgical direct cyclopexy, Argon laser can be more beneficial than surgical direct cyclopexy in small-size cyclodialysis cleft below 1.5 clock-hours. CONCLUSIONS: The clinical ourcome of Argon laser photocoagulation seems to be as good as surgical direct cyclopexy in small-size cyclodialysis cleft below 1.5 clock-hours.

Postoperative astigmatism and axis stability after implantation of the STAAR Toric Implantable Collamer Lens.

PURPOSE: To evaluate the efficacy, safety, and rotational and footplate stability of the STAAR Toric Implantable Collamer Lens (TICL; STAAR Surgical Co) for correction of myopic astigmatism. METHODS: In this prospective, consecutive, interventional case series, a TICL was implanted uneventfully in 30 consecutive eyes of 20 patients with myopia and astigmatism. The uncorrected visual acuity, best spectacle-corrected visual acuity, refraction, and astigmatism were measured preoperatively and at last follow-up. To evaluate postoperative axis deviation from the intended axis and footplate displacement, a digital anterior segment photograph was taken after full mydriasis and ultrasound biomicroscopy for the four footplates of the TICL in each eye at last follow-up. Possible risk factors for TICL rotation were analyzed through correlation analysis. RESULTS: After mean follow-up of 7.6 months, the mean refractive astigmatism decreased from 2.43 +/- 1.24 diopters (D) preoperatively to 0.73 +/- 0.47 D postoperatively, and the mean difference between intended and achieved TICL axes was 4.03 +/- 3.39 degrees. The absolute value of TICL rotation had significant correlation with the spherical power of the TICL (P = .037). The footplates of all TICLs were in situ in the ciliary sulcus except for one case in which one of the four footplates was located below the ciliary sulcus. CONCLUSIONS: Implantation of the STAAR TICL appears to be an effective and safe method for correction of myopic astigmatism. No clinically significant rotation or footplate displacement of the TICLs was detected postoperatively during mean follow-up of 7.6 months.