Small aperture IC-8 intraocular lens in cataract patients: achieving extended depth of focus through small aperture optics.

BACKGROUND: To investigate visual outcomes following cataract surgery in patients who were implanted monocularly with an extended range of focus IC-8 IOL. METHODS: A multicentre, non-randomised, retrospective case series of 126 consecutive patients implanted with the IC-8 IOL. Data were collected and pooled from six centres across Australia. Uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA) at 80 cm and uncorrected near visual acuity (UNVA) at 40 cm were measured in eyes implanted with the IC-8 IOL. Adverse events, spectacle independence, visual symptoms and patient satisfaction were assessed at final follow-up. RESULTS: Over 90% of the patients without pre-existing ocular pathology (n = 109) achieved UDVA, UIVA and UNVA of 6/12 or better in the IC-8 eye. Binocularly, in this group, 98% achieved UDVA of 6/9, 94% UIVA of 6/12 and 91% UNVA of 6/12 or better. By final follow-up, over 50% of patients reported complete spectacle independence for distance, intermediate and near visual activity, with the remainder only using spectacles for specific tasks such as near-vision hobbies and reading in dim light. CONCLUSIONS: The IC-8 IOL is capable of providing extended depth of focus following cataract surgery. It allows complete spectacle independence in more than half of the patients implanted with the IC-8 IOL.

Amadeus microkeratome: experience with the first 2000 cases and lessons learned.

BACKGROUND: To assess the safety and efficacy of the Amadeus microkeratome and to report on lessons learnt in optimizing results from its use. METHODS: A retrospective review of the flap-related complications of 2000 laser in situ keratomileusis (LASIK) procedures performed by one surgeon using the Amadeus microkeratome (AMO, Irvine, CA, USA) was conducted. One hundred consecutive cases had preoperative and intraoperative pachymetry to evaluate the relationship between flap thickness, corneal thickness and reuse of the blade. RESULTS: There were 35 cases of minor epithelial defects (1.8%) and four eyes with major epithelial defects (0.2%). There were no cases of suction loss, buttonholes, or incomplete or damaged flaps. There were four free caps (0.2%). Twenty-five cases had minor wrinkles and two cases had significant folds requiring relifts. Thinner corneas resulted in thinner flaps (P < 0.0001). Reuse of the blade resulted in thinner flaps (P = 0.0001). CONCLUSION: The Amadeus is a safe and reliable microkeratome. Although short, there is a learning curve with use of the instrument. Corneal thickness and reuse of the blade affect flap thickness.

Unilateral amiodarone keratopathy.

Vortex keratopathy is characterized by bilateral symmetrical superficial corneal deposits in a vortex pattern. It is the most common ocular finding among patients being treated with amiodarone. An unusual case of unilateral amiodarone vortex keratopathy in an elderly woman with corneal dysplasia in the second eye is presented. The pathophysiology of amiodarone keratopathy is explored, and a cause for the unilateral keratopathy in this patient proposed.

Uveal effusion following laser in situ keratomileusis (LASIK) for hypermetropia.

PURPOSE: To describe the first reported cases of uveal effusion syndrome following laser in situ keratomileusis (LASIK). DESIGN: Interventional case reports. METHODS: A 50-year-old woman developed bilateral submacular choroidal folds with subtle fluid elevation of the macula on the first day following uneventful LASIK for hypermetropia. A 48-year-old man developed right, prominent, 360-degree, peripheral choroidal effusions and submacular choroidal and retinal folds several months following LASIK for hypermetropia. RESULTS: Case 1 was treated with systemic diclofenac and case 2 with systemic prednisolone. Both cases showed gradual improvement in vision over several weeks, returning to best-corrected visual acuity of 6/6. CONCLUSIONS: Uveal effusion syndrome is a previously unreported complication that may occur following LASIK for hypermetropia.

Comparison of the Zeiss IOLMaster and applanation A-scan ultrasound: biometry for intraocular lens calculation.

PURPOSE: A comparison of axial length estimates using applanation A-scan ultrasound and the Zeiss IOLMaster was conducted. The accuracy in predicting postoperative refraction determined by each method was also compared. METHODS: A cross-sectional study was performed on 51 eyes in 46 patients presenting to clinical practice for cataract surgery assessment. Preoperative measurement of axial length was performed with applanation ultrasound and the IOLMaster. The IOLMaster measurements were used to determine the intraocular lens power based on the SRK/T formula. Postoperative refractive outcomes were obtained and spherical equivalent calculated and compared to the predicted refractive error with each biometric method. RESULTS: On average the axial lengths measured by the IOLMaster were longer by 0.15 mm compared to ultrasound biometry (P < 0.01). Using the IOLMaster over applanation ultrasound biometry significantly improved the postoperative refractive outcome from 0.65 D to 0.42 D (P = 0.011). CONCLUSIONS: The IOLMaster provides an accurate axial length measurement and results in accurate intraocular lens power calculation based on the SRK/T formula. It is quick and easy to use and provides a non-contact technique with no risk of infection or corneal abrasion.