Comparison of the Barrett toric calculator using measured and predicted posterior corneal astigmatism and the Kane and Abulafia-Koch calculators.

PURPOSE: To compare the accuracy of the Barrett toric calculator with measured and predicted posterior corneal astigmatism (MPCA and PPCA, respectively), the Abulafia-Koch (AK) formula, and the toric Kane formula. SETTING: Ein-Tal Eye Center, Tel-Aviv, Israel. DESIGN: Retrospective cohort. METHODS: Consecutive cases of patients who underwent uneventful cataract extraction surgery with implantation of a toric intraocular lens between March 2015 and July 2019 were retrospectively reviewed. 1 eligible eye from each patient was included. The predicted postoperative refractive astigmatism was calculated using each method and compared with the postoperative refractive astigmatism to give the prediction error. RESULTS: 80 eyes of 80 patients were included in this study. The mean centroid and the mean and median absolute prediction errors using Kane (0.25 diopters [D] ± 0.54 @ 6 degrees, 0.50 D ± 0.31 and 0.45 D, respectively) were significantly different compared with MPCA (0.12 D ± 0.52 @ 16 degrees, P < .001, .44 D ± 0.28 and 0.36 D, P = .027, respectively), PPCA (0.09 D ± 0.49 @ 12 degrees, P < .001, .41 D ± 0.27 and 0.35 D, P < .001, respectively), and AK (0.11 D ± 0.49 @ 11 degrees, P < .001, .42 D ± 0.27 and 0.35 D, P = .004, respectively). No significant differences were found between the calculators in the predictability rates within ±0.25 D, ±0.50 D, ±0.75 D, and ±1.00 D. CONCLUSIONS: The measured posterior corneal curvature in the Barrett calculator yielded comparable outcomes to its prediction by the Barrett and AK formulas. The Kane calculator showed a slight against-the-rule prediction error compared with the other methods, resulting in a small higher median absolute error with marginal clinical importance.

[OCULAR SARCOIDOSIS].

INTRODUCTION: A 68-year-old healthy female, with no past systemic or ocular history, presented with decreased vision in both eyes. On initial examination, there were extensive vitreal opacities in both eyes. On the following visit, bilateral panuveitis was newly observed, without otherwise systemic clinical manifestations. The patient responded well to treatment with systemic and topical steroids. Initial workup excluded tuberculosis and syphilis. Angiotensin-converting enzyme (ACE) was within normal range. In order to make a definitive diagnosis and to exclude lymphoma, we decided to perform a vitreous biopsy after 2-weeks of steroids withdrawal. After cessation of steroids, new lesions appeared beneath the right eye and over the nasal bridge. Moreover, iris nodules over the stroma, pupil's margin and anterior chamber angle were noticed in both eyes. Biopsy from a skin lesion demonstrated non-caseating granulomas, supporting diagnosis of sarcoidosis. A chest computed tomography (CT) scan demonstrated compatible radiologic findings of bilateral hilar and mediastinal lymphadenopathy. Sarcoidosis is a chronic multisystem, autoimmune, granulomatous disease. Ocular involvement is common among patients with sarcoidosis, with the most common ocular manifestation being uveitis. We report a case that presented with bilateral panuveitis due to sarcoidosis with no systemic manifestations or elevated serum biomarkers. Definitive diagnosis was verified in histopathological findings from a skin biopsy and radiological findings in chest CT.

Surgical outcomes of medial Rectus advancement for consecutive exotropia.

PURPOSE: To evaluate the surgical results of medial rectus muscle advancement for consecutive exotropia. METHODS: The medical data of patients that underwent reoperation between the years 2000-2020 were collected and reviewed retrospectively. Patients who underwent medial rectus advancement for consecutive exotropia were included. The exclusion criteria were follow-up period shorter than 6 months, past reoperations and restrictive or paralytic strabismus. Success was defined as alignment within 10 PD of orthophoria at last follow-up. The success group of patients was compared with the failure group. RESULTS: Twenty patients with mean postoperative follow-up from the second surgery of 34.7 ± 29.2 months were included. On last follow-up examination, 9 (45.0%) patients had a successful result. Nine patients had undercorrection and 2 had overcorrection. The two groups were similar in the preoperative amount of mean exotropia, 23.3 ± 9.9 PD in the success group and 29.8 ± 14.0 PD in the failure group. On last follow-up examination, the amount of mean deviation was 2.7 ± 2.6 PD exotropia in the success group and 13.4 ± 23.6 PD exotropia in the failure group. CONCLUSION: Medial rectus advancement for the correction of consecutive exotropia was successful in almost half of the cases. Failure was usually due to undercorrection.