Evaluation of Tamsulosin 0.4 mg versus 0.8 mg in management of lower urinary tract symptoms due to benign prostatic enlargement.

PURPOSE: To compare the efficacy and the safety of Tamsulosin 0.4 mg/day and 0.8 mg/day in patients suffering from lower urinary tract symptoms due to benign prostatic obstruction. PATIENTS AND METHODS: A prospective interventional, double-blinded, controlled study was carried out on 93 patients who met the criteria and divided randomly into two groups: group A for Tamsulosin 0.4 mg/day and group B for Tamsulosin 0.8 mg/day. International prostate symptom score, post void residual urine volume, and maximum flow rate of urine were assessed before and after 4 weeks of treatment. RESULTS: Both study groups showed a significant reduction in storage sub-score but only frequency was significantly reduced in group B (P < 0.001). On the other hand, Tamsulosin 0.8 mg was superior to Tamsulosin 0.4 mg regarding voiding sub-score except for straining (P = 0.325). Accordingly, the total international prostate symptom score was significantly improved in group B versus group A (P < 0.001). Furthermore, maximum flow rate and post-void residual urine volume were notably improved in Group B as compared to Group A (P < 0.001). Of all adverse events only dizziness was noted to be statistically significant in Group B versus Group A (P < 0.001). CONCLUSION: Tamsulosin 0.8 mg has shown better outcomes in treating patients who suffer from lower urinary tract symptoms due to benign prostatic enlargement than Tamsulosin 0.4 mg, and besides that, it is well tolerated. TRIAL REGISTRATION NUMBER: M S 292/2020, SID: 373, date: 22/4/2020.

Integrating patient-centered caries management in dental education-A practical approach.

Caries management is undergoing an evolution in dental education. This is part of a larger change in thinking focused on the person/patient as well as procedures to bring health to people. This perspective attempts to tell the story of the dental education culture regarding caries management from perspectives of evidence-based care; caries as a disease of a person, not only a tooth; and the management of high-risk and low-risk individuals. Culturally and organizationally, the integration of basic, procedural, behavioral, and demographic perspectives for dental caries has happened at different rates for some decades. The involvement of students, teaching faculty, course directors, and administration is essential in this process.

Short course of dutasteride in treatment of a refractory category IIIB chronic prostatitis (A placebo-controlled study).

Objective: To evaluate the short-term efficacy of Dutasteride in the management of chronic prostatitis (CP)/chronic pelvic pain syndrome. Materials and methods: A randomized placebo-controlled double-blind study was conducted that including 50 patients diagnosed with CP based on the presence of pelvic pain for ≥3 months of the preceding 6 months. Patients were randomized into 2 equal groups to evaluate Dutasteride of 0.5 mg once daily that was given for 3 months compared to a placebo. Results: Forty-nine patients were evaluated after the follow-up period with no statistically significant difference in the perioperative demographic data. The mean age of the Dutasteride group was 48.3 (range 41-62) compared to a mean age of 46.5 (range 44-60) in the placebo group. There was a highly statistically significant improvement in the Dutasteride group compared to its preoperative parameters and the placebo compared group in the terms of pain, urinary scores, and total National Institutes of Health CP symptom score. Moderate and marked improvement in patients' symptomatology was seen in 56% of the dutasteride group, while only 8% in the dutasteride group failed to show an improvement with no significant side effects noted in our study. Conclusion: The short-term outcome of dutasteride therapy showed an improvement in the National Institutes of Health-CP symptom score compared to a placebo in the treatment of category IIIB CP. The trial was registered in the clinical trialgov registry with a registration number: NCT04756206.

Performance of multi-parametric magnetic resonance imaging through PIRADS scoring system in biopsy naïve patients with suspicious prostate cancer.

Background: Use of multi-parametric magnetic resonance imaging (mp-MRI) and Prostate Imaging Reporting and Data System (PI-RADS) scoring system allowed more precise detection of prostate cancer (PCa). Our study aimed at evaluating the diagnostic performance of mp-MRI in detection of PCa. Methods: Eighty-six patients suspected to have prostate cancer were enrolled. All patients underwent mp-MRI followed by systematic and targeted trans-rectal ultrasound (TRUS) guided prostate biopsies. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of mp-MRI were evaluated. Results: Forty-six patients (53.5%) had prostate cancer on targeted and systematic TRUS biopsies. On mp-MRI, 96.6% of lesions with PI-RADS < 3 revealed to be benign by TRUS biopsy, 73.3% of lesions with PI-RADS 4 showed ISUP grades ≥1, whereas all PI-RADS 5 lesions showed high ISUP grades ≥ 3. For PI-RADS 3 lesions, 62.5% of them revealed to be benign and 37.5% showed ISUP grades ≥1 by TRUS biopsy. PI-RADS scores ˃3 had 69.57% sensitivity and 85% specificity for detection of PCa. On adding the equivocal PI-RADS 3 lesions, PI-RADS scores ≥3 had higher sensitivity (97.83%), but at the cost of lower specificity (32.5%). Conclusion: Mp-MRI using PI-RADS V2 scoring system categories ≤3 and >3 could help in detection of PCa. PI-RADS 3 lesions are equivocal. Including PI-RADS lesions ≥3 demonstrated higher sensitivity, but at the cost of lower specificity for mp-MRI in diagnosis for Pca. Abbreviations: CDR: cancer detection rates; DRE: digital rectal examination; ISUP: international society of urological pathology; mp-MRI: multi-parametric magnetic resonance imaging; NPV: negative predictive value; PCa: prosatate cancer; PI-RADS: Prostate Imaging Reporting and Data System; PPV: Positive predictive value; PSA: prostate specific antigen; TRUS: transrectal ultrasound.

Evaluation of Galdakao-modified Valdivia position in endoscopic management of malignant ureteric obstruction.

BACKGROUND: Malignant ureteric obstruction (MUO) due to pelvic malignancies is challenging for endourological management and carries high failure rates for retrograde cystoscopic ureteric stenting. METHODS: We adopted Galdakao-modified Valdivia (GMV) position in the management of MUO in an operating room equipped with a C-arm fluoroscopy unit and an ultrasound device. We prospectively studied the added value of this approach in 50 cases who failed retrograde ureteric stenting. RESULTS: Thirty-seven (74%) cases were done under a high level of spinal anesthesia. Mean operative time was 62 min. Antegrade ureteric stenting succeeded in 45/50 (90%) patients who failed retrograde ureteric stenting. GMV position facilitated simultaneous retrograde and antegrade management of MUO. Eight patients (16%) underwent auxiliary cystoscopic procedures to reduce the mass over the ureteric orifice (UO) guided by antegrade methylene blue or over a probing antegrade guidewire. Nephrostomy tube was inserted in the same setting in 16/50 (32%) cases. Antegrade flow of contrast to the bladder (P < 0.001) and ureteric kinks rather than tight stenosis or infiltration of UO (P = 0.014) were significantly associated with the success of antegrade ureteric stenting. No major complications were encountered. CONCLUSION: GMV position is an ideal choice for management of MUO as it allows simultaneous access to the lower and the upper urinary systems to accomplish ureteric stenting either in a retrograde or an antegrade fashion as well as the ability to insert a nephrostomy tube in the same setting, thus shortening the inpatient care and this should be the standard of care in cases with MUO.

Two-year Follow-up in Bipolar Transurethral Enucleation and Resection of the Prostate in Comparison with Bipolar Transurethral Resection of the Prostate in Treatment of Large Prostates. Randomized Controlled Trial.

OBJECTIVE: To assess the safety and long-term efficacy of bipolar transurethral enucleation and resection of the prostate (B-TUERP) in the treatment of enlarged prostate in comparison with bipolar transurethral resection of the prostate (B-TURP). MATERIALS AND METHODS: From June 2015 to March 2019, a total of 240 patients with enlarged prostates of more than 80 gm were randomized into 2 groups, each containing 120 patients. Patients in group A were subjected to B-TUERP while those in group B underwent B-TURP. The perioperative data and postoperative outcomes followed at 1, 6, and 24 months after surgery at which points they were analyzed, and a comparison made between the 2 groups. RESULTS: There were no significant differences in the preoperative parameters of the 2 groups. Comparing with B-TURP, B-TUERP had longer operative time (105.09 ± 31.08 vs 61.09 ± 29.28 min), more resected prostatic tissue (50.41 ± 13.07 vs41.12 ± 8.91 g) and had less hemoglobin drop (1.5 vs 2g/dL). In addition, indwelling catheter time, postoperative bladder irrigation duration, and hospital stay were significantly shorter in the B-TUERP group than in the B-TURP group. At 24 month after the procedure, patients with B-TUERP achieved better results of International Prostate Symptom Score (6 vs 7 P = .008), quality of life (1 vs 2, P = .243), maximal flow rate (24.9 ± 5.74 vs 20.09 ± 3.27mL/sec, P = .034), post-voiding residual urine volume (18.64 ± 3.28 vs 24.74 ± 4.02 mL, P = .001), and residual prostate volume (18.64 ± 3.28 vs 20.74 ± 4.02 mL, P < .001). On the other hand, there were no significant differences in postoperative complications between both groups. CONCLUSION: B-TUERP is a more effective modality in the treatment of enlarged prostate compared to B-TURP with almost no variation in safety.

Survival of occlusal ART restorations using high-viscosity glass-ionomer with and without chlorhexidine: A 2-year split-mouth quadruple-blind randomized controlled clinical trial.

The study question was whether the use of high-viscosity glass-ionomer with chlorhexidine (HVGIC/CHX) for the Atraumatic Restorative Treatment (ART) prepared cavities could achieve a higher restoration survival percentage and be more effective for preventing dentine carious lesions adjacent to the restoration than the use of HVGIC without CHX. The study followed a split-mouth, quadruple-blind, randomized controlled clinical design and lasted 2 years. Patients with at least two small- to medium-sized occlusal cavities were included. The occlusal cavities were prepared according to the ART method and restored with HVGIC/CHX (test) and HVGIC (control). A replica of all restorations available and digital photographs were fabricated at baseline and after 0.5, 1, 1.5 and 2 years and evaluated by two examiners using the ART and Federation Dentaire International (FDI) restoration assessment criteria. Survival curves were constructed using the Kaplan-Meier method, and the log-rank test was used to test for significance between the survival percentages. A total of 100 subjects with an average age of 14.4 years participated. According to the ART restoration assessment criteria, the 2-year survival percentages of ART/HVGIC/CHX (96.8%) and ART/HVGIC (94.8%) did not differ significantly and no significant difference was found between the test (97.9%) and control (96.9%) groups according to the FDI restoration assessment criteria. Eight and five occlusal restorations failed according to the ART and FDI restoration criteria, respectively. No dentine carious lesions along the restoration margin were observed. The 2-year survival of ART restorations in both groups was high. The development of carious dentine lesions adjacent to the restoration was not observed in either treatment group. There is no evidence for modifying HVGIC by incorporating chlorhexidine in order to prevent dentine carious lesion development or to improve the survival of ART restorations in occlusal surfaces in permanent teeth. HVGIC without chlorhexidine can be used successfully to restore occlusal 'ART-prepared' cavities in permanent teeth.

Evaluation of the risk factors associated with the development of post-transurethral resection of the prostate persistent bacteriuria.

OBJECTIVES: To determine the preoperative, intraoperative and postoperative risk factors that influence the development of persistent post-transurethral resection of the prostate (TURP) urinary tract infection (UTI) defined as pyuria and/or bacteriuria remaining for 3 weeks after surgery. PATIENTS AND METHODS: This is a prospective study including 100 patients scheduled for TURP. Urine analysis and culture was performed immediately after catheter removal, then at 1 and 3 weeks postoperatively, and the results were correlated to various preoperative, intraoperative and postoperative potential risk factors to detect any significant relation to persistent UTI. RESULTS: There was a statistically significant relationship between bacteriuria and the following risk factors: old age, past history of diabetes mellitus, large prostatic size, positive preoperative urine analysis and culture, preoperative catheter use, previous urological interventions, large size of sheath, long duration of operation, postoperative catheter events and postoperative manual wash. CONCLUSIONS: Many risk factors have been found to contribute to the development of post-TURP UTI and avoiding these factors can enhance recovery of patients undergoing TURP.

Corneal biomechanical properties in normal, post-laser in situ keratomileusis, and keratoconic eyes.

PURPOSE: To compare the biomechanical properties of normal, post-laser in situ keratomileusis (LASIK), and keratoconic corneas evaluated by corneal hysteresis and the corneal resistance factor measured with the Reichert Ocular Response Analyzer (ORA). SETTINGS: Instituto Oftalmológico de Alicante, Vissum, Alicante, Spain. METHODS: Two hundred fifty eyes were divided into 3 groups: normal (control group), post-LASIK, and keratoconus. The corneal biomechanical properties were measured with the ORA, which uses a dynamic bidirectional applanation process. The main outcome measures were intraocular pressure, corneal hysteresis, and the corneal resistance factor. RESULTS: The control group had 165 eyes; the LASIK group, 65 eyes; and the keratoconus group, 21 eyes. In the control group, the mean corneal hysteresis value was 10.8 mm Hg +/- 1.5 (SD) and the mean corneal resistance factor, 11.0 +/- 1.6 mm Hg. The corneal hysteresis value was lower in older eyes, and the difference between the youngest age group (9 to 14 years) and oldest age group (60 to 80 years) was statistically significant (P = .01, t test). One month after LASIK, corneal hysteresis and the corneal resistance factor decreased significantly, from 10.44 to 9.3 mm Hg and from 10.07 to 8.13 mm Hg, respectively. In the keratoconus group, the mean corneal hysteresis was 7.5 +/- 1.2 mm Hg and the mean corneal resistance factor, 6.2 +/- 1.9 mm Hg. There were statistically significant differences in both biomechanical parameters between keratoconic eyes and post-LASIK eyes (P<.001, t test). CONCLUSIONS: The corneal hysteresis and corneal resistance factor values were significantly lower in keratoconic eyes than in post-LASIK eyes. Future work is needed to determine whether these differences are useful in detecting keratoconus when other diagnostic tests are equivocal.

The risk of retinal detachment in high myopia after small incision coaxial phacoemulsification.

PURPOSE: Report incidence and risk of retinal detachment (RD)after coaxial phacoemulsification in high myopic patients. DESIGN: Retrospective consecutive interventional study. SETTING: Vissum-Instituto Oftalmologico de Alicante, Spain. PATIENT OR STUDY POPULATION: A total of 439 eyes from 274 high myopic patients with spherical equivalent (SE) >or= 6.00 diopters (D) or axial length >or= 26.00 mm. Mean age 62.2, axial length 27.88 +/- 2.11 mm (26.0 mm to 37.9 mm), SE -13.3 +/- 5.6 (-6.00 D to -46.0 D). MAIN OUTCOME MEASURES: Incidence of RD, vitreous loss, and neodymium yttrium aluminum garnet (Nd:YAG) capsulotomy were evaluated after surgery at one, three, six, and 12 months then annually with mean follow-up 61.5 +/- 29.6 months. RESULTS: Incidence of RD was 2.7% (12/439 eyes). In eyes with 50 years of age was 2.52% (nine eyes). Cumulative risk of RD development by Kaplan-Meier analysis in all patients was 0.47%, 0.71%, 1.71%, 2.59%, and 3.28% at three, six, 15, 48, and 63 months until 105 months, respectively. In eyes 50 years of age was 0.58% and 2.96% at six and 52 months until 118 months after cataract surgery, respectively. No significant correlation was found between the occurrence of RD and vitreous loss (P

Intrastromal corneal ring segment implantation by femtosecond laser for keratoconus correction.

PURPOSE: To report the outcomes after the implantation of intrastromal corneal ring segments (KERARING) aided by femtosecond laser for the correction of keratoconus. DESIGN: Prospective consecutive interventional study. PARTICIPANTS: Twenty-one eyes of 16 consecutive keratoconic patients with mean age 32+/-10.2 years. Forty-five percent were keratoconus grade I, 20% grade II, 15% grade III, and 20% grade IV. METHODS: Intrastromal corneal ring segments KERARING were implanted for keratoconus correction after corneal tunnel creation with the aid of femtosecond laser (IntraLase Corp, Irvine CA). MAIN OUTCOME MEASURES: Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), refractive outcome, complete ophthalmologic examination, videokeratography, and corneal higher order aberrations (HOA) were determined or performed before and after surgery at 1 day, 1 week, and 3 and 6 months. In addition, operative and postoperative complications were recorded. RESULTS: KERARING implantation significantly increased UCVA from 0.06 to 0.3 (P< or =0.0001), BSCVA from 0.54 to 0.71 (P< or =0.0003), and decreased the spherical equivalent by 2.28 diopters (D) and the average keratometric values (K value) by 2.24 D (P<0.001). There was no significant difference between the 3 and 6 months follow-up. Forty percent (8 eyes with a relatively low RMS of total HOA) showed a nonsignificant increase in the RMS of total HOA and 60% (12 eyes with a relatively higher RMS of total HOA> or =3.0 microm) showed significant (P< or =0.01) decrease in the RMS of total HOA due to a significant (P< or =0.003) reduction in coma and comalike aberrations. The amount of change in corneal curvature (biomechanical response) ranged from a decrease of 18% from its initial value to an increase of 2.75% and was not correlated to any preoperative parameter. Localized infectious keratitis occurred in only 1 eye (4.8%), and incision opacification occurred in 8 eyes (38%). CONCLUSION: Intrastromal corneal ring segment implantation with femtosecond laser is an effective method for correcting keratoconus with reduction in corneal HOA in eyes with coma aberration > 3.0 microm.

Intracorneal ring segments for keratoconus correction: long-term follow-up.

PURPOSE: To evaluate long-term results and stability of intracorneal ring segment (Intacs) implantation for keratoconus correction. SETTING: Vissum, Instituto Oftalmológico de Alicante and University of Miguel Hernandez, Alicante, Spain. METHODS: This retrospective study comprised 13 eyes operated on between April 2000 and December 2001 that had Intacs implantation for keratoconus correction. The outcomes were evaluated at 6, 12, 24, and 36 months in all eyes and at 48 months (6 eyes). RESULTS: Mean best spectacle-corrected visual acuity (BSCVA) increased from 0.46 (20/50) preoperatively to 0.66 (20/30) postoperatively (P< or =.001). Mean decrease of inferior-superior (I-S) asymmetry was 2.81 diopters (D) (P< or =.02), and the average K-value was 3.13 D (P< or =.001). Mean difference between 6 and 36 months (stability) showed no significant difference regarding BSCVA (P< or =.5) and I-S asymmetry (P< or =.6). Although a significant increase was noticed in the average K by 1.67 D (P< or =.002), at 36 months it did not reach the initial preoperative values. CONCLUSION: Intacs increased the BSCVA and decreased I-S asymmetry with stability up to 36 months. In spite of the decrease of the K-values at 6 months, a further significant increase was detected 36 months after surgery.

Corneal higher order aberrations: a method to grade keratoconus.

PURPOSE: To use the anterior corneal surface higher order aberrations as a tool to detect and grade keratoconus using corneal map analysis videokeratoscopy. METHODS: A prospective observational comparative study of 80 eyes was performed. The eyes were divided into two groups. Group A comprised 40 eyes of 20 asymptomatic individuals with no ocular pathology. Mean sphere was -0.03 diopters (D) (range: +0.75 to -0.75 D), mean cylinder was -0.27 D, mean average K was 43.28 D, and mean uncorrected visual acuity (UCVA) was 1.01. Group B comprised 40 eyes of 25 patients with keratoconus. Mean sphere was -3.70 D (range: +2.00 to -10.00 D), mean cylinder was -3.82 D, mean average K was 49.29, and mean best spectacle-corrected visual acuity (BSCVA) was 0.61. RESULTS: In group A, mean root-mean-square (RMS) of spherical (Z4 and Z6), coma-like (Z3, Z5, and Z7), and higher order aberrations (Z3-7) were 0.38 microm, 0.35 microm, and 0.52 microm, respectively. In group B, mean RMS of spherical, coma-like, and higher order aberrations were 1.06 microm, 2.90 microm, and 3.14 microm, respectively, for a 6.0-mm simulated pupil diameter. Mean RMS differences between the two groups were 0.68 microm (P < or = .0002), 2.55 microm (P < or = .0001), and 2.61 microm (P < or = .0001) for spherical, coma-like, and total higher order aberrations, respectively. In group B, according to Amsler-Krumeich classification, the mean RMS of coma-like aberration was 1.87 microm in grade I (14 eyes), 2.97 microm in grade II (11 eyes), 3.46 microm in grade III (12 eyes), and 5.20 microm in grade IV (3 eyes). CONCLUSIONS: Corneal higher order aberrations, especially coma-like aberrations, are significantly higher in eyes with keratoconus than normal eyes. Coma-like aberrations, with the aid of a corneal aberrometry map, are good indicators for early detection and grading of keratoconus.

Analysis of results related to good and bad outcomes of Intacs implantation for keratoconus correction.

PURPOSE: To evaluate factors influencing good and poor outcomes after intracorneal ring segment implantation to correct keratoconus. SETTING: Instituto Oftalmológico de Alicante (Vissum Corporation), University of Miguel Hernandez, Alicante, Spain. METHODS: A retrospective comparative study of the visual outcome, 25 eyes of 21 patients were implanted after intracorneal ring segments (Intacs, Addition Technology) as a method to correct keratoconus. Outcomes were evaluated 6 months after implantation based on the visual results. Group A comprised 20 eyes that gained 3 lines or more of best spectacle-corrected visual acuity (BSCVA) to correct keratoconus, and Group B comprised 5 eyes that lost 1 line of BSCVA. RESULTS: In Group A, the preoperative mean BSCVA was 0.43 (20/50) and the postoperative mean BSCVA, 0.82 (20/20) (P< or =.0001). In Group B, the preoperative mean BSCVA was 0.36 (20/63) and the postoperative mean BSCVA, 0.24 (20/80) (P< or =.02). The preoperative mean sphere power was 3.90 diopters (D) greater in Group B than in Group A (P< or =.007); the mean spherical equivalent was 4.36 D greater (P< or =.007), and the mean K-reading was 6.91 D greater (P< or =.001). The postoperative reduction in spherical dioptric power was 2.11 D (P< or =.027) and the mean spherical equivalent, 2.81 D (P< or =.003), significant only in Group A. The reduction in mean central K-readings was 4.30 D (P< or =.0001) in Group A and 6.19 D (P< or =.014) in Group B. The correlation of the preoperative mean K value to the postoperative BSCVA was significant at the .01 level by the Pearson test (-0.67). In Group A, all eyes (100%) had a mean K-reading < or =53 D. In Group B, 4 eyes (80%) had a mean K-reading > or =55 D. CONCLUSION: Intacs provided better results in visual acuity and corneal topography quality and significantly reduced the spherical equivalent in eyes with keratoconus with relatively low mean K values (< or =53 D) and a relatively low spherical equivalent. In advanced keratoconus (mean K-reading > or =55 D), poor results can be anticipated.

Intracorneal asymmetrical rings for keratoconus: where should the thicker segment be implanted?

PURPOSE: To report a 20-year-old man who presented with monocular diplopia in the right eye with uncorrected visual acuity (UCVA) of 0.3 and best spectacle-corrected visual acuity (BSCVA) of 1.0 with -0.50 -3.00 x 45 degrees. METHODS: Clinical examination and corneal topography revealed grade I keratoconus in the right eye. Intracorneal ring segments (INTACS; Addition Technology, Des Plaines, III) were implanted in May 2004 without surgical complications at 415 microm (70% of the corneal thickness), with the 450-microm segment implanted superiorly and the 250-microm segment inferiorly. RESULTS: For 2 months postoperatively, BSCVA remained at 0.4 with +1.50 -4.50 x 25 degrees. The segments were reversed, implanting the 450-microm (thick) segment inferiorly and the 250-microm (thin) segment superiorly. One week later, UCVA was 1.0 and remained stable for 3 months after reimplantation. CONCLUSIONS: This report shows that implanting the thicker segment inferiorly provides better visual results.

Hyperopic LASIK following intracorneal hydrogel lens explantation.

PURPOSE: To report hyperopic LASIK results after intracorneal hydrogel lens explantation in a bilateral hyperopic patient. METHODS: Slit-lamp examination showed diffuse corneal opacity around the lens edge and over the anterior lens surface affecting both eyes with uncorrected visual acuity of 0.4 in the right eye and 0.5 in the left eye. RESULTS: The intracorneal hydrogel lenses were explanted, and 6 months later hyperopic LASIK using the Schwind ESIRIS excimer laser (Schwind, Kleinostheim, Germany) was performed after lifting the same flap for the intracorneal hydrogel lens implantation. Six months after hyperopic LASIK, visual acuity recovered to the initial preoperative best spectacle-corrected levels: right eye 0.8 with +1.50 D sphere and left eye 0.9 with +1.00 -0.50 x 90 degrees. Central corneal transparency also fully recovered. CONCLUSIONS: Hyperopic LASIK is a possible alternative after intracorneal hydrogel lens explantation in hyperopic eyes.

Intracorneal hydrogel lenses and corneal aberrations.

PURPOSE: To investigate the optical performance of the cornea based on corneal aberrometry following intracorneal hydrogel lens implantation. METHODS: A retrospective, nonconsecutive, observational study of the anterior corneal surface aberration profile of four hyperopic eyes previously implanted with an intracorneal hydrogel lens were studied by videokeratographic elevation maps before and 6 months after surgery. RESULTS: Intracorneal hydrogel lenses reduced the optical performance in all four eyes by increasing the spherical aberrations by a mean factor of 1.87 and 1.95, coma aberrations by a mean factor of 2.98 and 3.01, and total higher order aberrations by a mean factor of 2.6 and 2.17 at 3.0-mm and 6.5-mm pupils, respectively (P<.005). CONCLUSIONS: Intracorneal hydrogel lenses decreased the optical performance of the cornea by significantly increasing spherical, coma, and total higher order aberrations.