ABSTRACT
PURPOSE: Vaping, or the use of electronic cigarettes, was initially introduced as a step toward smoking cessation, but has become an increasingly popular option for smokers. Though advertised as safer than conventional cigarettes, these devices have been found to contain carcinogenic chemicals, air pollutants, and heavy metals. The purpose of this article is to shed light on the known effects of vaping on the ocular setting and raise the discussion about additional potential effects that may call for further investigation. METHODS: A comprehensive literature search was conducted for publications pertaining to the effects of vaping on the eye. Relevant studies and findings were summarized in this article. RESULTS: It was found that aldehydes and free radicals present in electronic cigarettes may induce a disturbance in tear film stability, and vape flavorings may damage the lipid layer through peroxidation. Corneal staining has been shown to appear following exposure to e-cigarette vapor, with nicotine and acrolein potentially inducing an inflammatory response in corneal epithelial cells. In addition, nicotine has been shown to induce nystagmus, exert vasoconstrictive effects on ocular blood flow, and may interfere with retinal light-adapted vision. Vape-related explosions, though unpredictable, may also result in decreased visual acuity along with long-term ocular trauma. CONCLUSION: Research discussing both the short-term and long-term effects of vaping on the eye is limited. However, the potential harms of substances such as nicotine and aldehydes warrant additional investigation and increased education about the detriment that electronic cigarettes may inflict on sensitive organs.
Subject(s)
Electronic Nicotine Delivery Systems , Smoking Cessation , Vaping , Vaping/adverse effectsABSTRACT
PURPOSE: To report the outcomes of sequential posterior chamber phakic intraocular lens (PC-pIOL) with corneal refractive surgery in conventional (PC-pIOL prior to refractive surgery) and reverse (refractive surgery prior to PC-pIOL) bioptics for treating high myopic astigmatism. SETTING: Tertiary refractive center, Draper, Utah, USA. DESIGN: Retrospective case series. METHODS: Medical records of patients who underwent planned bioptics were reviewed. Surgery involved PC-pIOL placement using an implantable collamer lens (ICL) with preceding or subsequent LASIK or PRK. Pre- and postoperative manifest spherical equivalent (SEQ), visual acuity, and PC-pIOL vault were analyzed. RESULTS: Of the 51 eyes present at 12 months postoperatively, 49 eyes (96%) achieved target SEQ within ±1.00 D and an identical amount achieved refractive astigmatism ≤1.00 D. Post-bioptics eyes achieved a postoperative UDVA equal to or better than preoperative CDVA in 45 eyes (88%). Efficacy and safety indices were 1.08 ± 0.20 (41 eyes) and 1.13 ± 0.22 (44 eyes) for conventional bioptics and 0.99 ± 0.42 (7 eyes) and 1.15 ± 0.38 (7 eyes) for reverse bioptics eyes at 12 months. The maximum PC-pIOL vault of conventional bioptics eyes (27 eyes) within 6 months before and after LASIK/PRK was 385 ± 159 µm and 377 ± 135 µm, respectively (P = 0.71). CONCLUSION: Bioptics for high myopic astigmatism was safe and effective. Reverse bioptics, although not as traditional, could provide similar results. Additionally, the PC-pIOL vault does not appear to be affected by LASIK/PRK.
ABSTRACT
A 67-year-old woman was referred to our facility with declining vision in the right eye that has been present since her cataract surgery in 2016. The patient has a history of an 8-cut radial keratotomy (RK) with 2-cut astigmatic keratotomy (AK) along the vertical meridian in both eyes since 1993. She underwent superficial keratectomy of the right eye 3 times in 3 consecutive years after her cataract extraction with toric intraocular lens (IOL) implantation. She is hoping to improve her vision in the right eye with a corrected distance visual acuity (CDVA) of 20/50 with a manifest refraction of +2.00 -5.50 × 65. Keratometry readings are 39.4 @ 87/43.3 @ 177. Slitlamp examination shows a persistent raised white gelatinous tissue overlying the inferior AK at the 6 o'clock position (, , and ). The patient had attempted several failed trials of scleral lens and rigid gas-permeable (RGP) lens-fitting after each corneal scraping with intolerance and lack of improvement in her vision. Her left eye is an asymptomatic pseudophakic eye with uncorrected distance visual acuity (UDVA) and CDVA of 20/25.(Figure is included in full-text article.)(Figure is included in full-text article.)(Figure is included in full-text article.)What would be your next step? Would you request additional diagnostic workup? What medical and surgical interventions would you recommend?
