Agreement between IOLMaster 700 and Pentacam AXL for IOL power measurement in patients with high myopia.

PURPOSE: The anterior segment in individuals with high myopia has different features compared to those without myopia. IOLMaster 700 and Oculus Pentacam AXL are two accurate optical biometers. Both devices measure the cornea differently and thus yield different results when measuring intraocular lens (IOL) power. The purpose of this study is to assess the agreement of the IOL power calculation between IOLMaster 700 and Oculus Pentacam AXL in patients with high myopia. METHODS: A prospective, analytical cross-sectional study was conducted to assess the agreement between the IOL power calculation with IOLMaster 700 and Oculus Pentacam AXL. In this study, 44 eyes were examined using Oculus Pentacam AXL and IOLMaster 700, and IOL power was calculated using the Barret Universal II formula and the AMO Sensar AR40E. The Bland-Altman plot was used to evaluate the agreement between the two devices. RESULTS: Based on the IOLMaster 700 examination, 44 eyes with high myopia had axial lengths ranging from 26.05 to 34.02 mm. The mean IOL power was 8.26 ± 4.755 and 8.58 ± 4.776 based on IOLMaster 700 and Oculus Pentacam AXL, respectively. The Bland-Altman plot revealed good agreement between the two devices, with a mean difference of -0.3182 in the IOL power calculation and a 95% LoA of 0.88099-0.24462 with a 95% confidence interval. CONCLUSION: Both devices showed good agreement in the IOL power calculation in patients with high myopia.

Vision rehabilitation using microperimetric biofeedback training in age-related macular degeneration.

AIM: To determine the impact of microperimetric biofeedback training (MBFT) on the quality of vision in patients with age-related macular degeneration (AMD). METHODS: This study was a prospective, interventional, comparative study with subjects of patients diagnosed with AMD in the National Eye Center Cicendo Eye Hospital, Indonesia. Patients were randomly divided into two groups, intervention and non-intervention with 18 patients in each group. The intervention group would receive six MBFT training sessions of 10-minute time duration each. RESULTS: A statistically significant improvement of best corrected visual acuity (BCVA) was found after the intervention, from 1.24±0.416 to 0.83±0.242 (logMAR; P<0.001). A statistically significant improvement for near vision acuity (NVA) was also observed, from 1.02±0.307 logMAR to 0.69±0.278 logMAR (P<0.001). In addition, reading rate increased, from 40.83±30.411 to 65.06±31.598 words/min (P<0.001). Similarly, a comparison of changes in BCVA, NVA, and reading rate between intervention and non-intervention groups showed a significant difference (P<0.001). CONCLUSION: MBFT significantly and positively impacts visual acuity, NVA, and reading rate in patients with AMD.

Accuracy of the SRK/T Formula in Pediatric Cataract Surgery.

Purpose: Determining IOL power is an important step in achieving the desired postoperative refractive target, but this determination remains challenging, as currently the used formulas were developed using IOL power calculations derived from adults. Patients and Methods: This is a retrospective analytical study with the period of June 2018 to May 2019. All of the data were taken from medical records in referral tertiary eye hospital in Indonesia. All type of cataracts underwent uncomplicated surgeries and in-the-bag IOL implantation were included in this study, while aphakia, secondary IOL implantation, primary sulcus implantation, and history of ocular disorders were excluded. The data were analyzed using Wilcoxon sign-rank, paired t, and Kruskal-Wallis tests. Results: Sixty-seven patients (106 eyes) were found to meet the inclusion criteria, average age was 7.35 ± 4.61 years (1.00 to 17.00 years). Average targeted refraction was 1.69 ± 2.06 D (-0.38-+6.99 D), and spherical equivalent (actual postoperative refraction) was -0.90 ± 1.45 D (-4.38 to +2.75 D). There was statistically significant difference between preoperative targeted refraction and actual postoperative refraction (p < 0.001). Mean absolute prediction error (APE) in general was 1.34 ± 1.18 D, 1.22 ± 0.88 D (in short eyes), 1.52 ± 1.37 D (in moderate eyes), and 0.69 ± 0.52 D (in long eyes) (p = 0.202). Mean APE in age group <7 years old was 1.27 ± 1.18 D and ≥7 years-old was 1.42 ± 1.19 D (p = 0.429). Conclusion: SRK/T formula is fairly accurate in calculating IOL power in pediatric cataract surgery. Mean APE in this study was within the range of accurate mean APE in pediatric patients despite differentiated axial length and age.

Delivering a modified continuous objective structured clinical examination for ophthalmology residents through a hybrid online method.

Since coronavirus disease 2019 was declared a global pandemic by the World Health Organization, it has become a challenging situation to continue medical education, including in Indonesia. The situation prohibited face-to-face (direct) educational activities in clinical settings, therefore also postponing examinations involving especially procedural skills. Adaptations were urgently needed to maintain the delivery of high-stake examinations to sustain the number of ophthalmology graduates and the continuation of eye health service. Objective structured clinical examination (OSCE) has been one of our widely used method to assess clinical competencies for ophthalmology residents, and is the one method that involves gatherings, close contact of examiners, examinees and patients, therefore the most difficult to adjust. Pandemic challenges brought technical changes in our delivering the OSCE to online, maximizing digital platforms of meetings, while still concerned to guarding the safety of candidates, patients and staffs. OSCE scenarios were also made as timely efficient as possible by changing continuous station models to a cascade one. The purpose of this article is to document our experience in conducting a feasible and reproducible OSCE in this pandemic era filled with limitations.

The Superoxide Dismutase Mimetic TEMPOL and Its Effect on Retinal Ganglion Cells in Experimental Methanol-Intoxicated Rats.

INTRODUCTION: The incidence of blindness due to methanol intoxication is higher in males of productive age. The management of methanol-induced toxic optic neuropathy is yet to produce satisfactory results. Antioxidant therapy is now used as an alternative method of preventing methanol intoxication. The aim of this study was to observe the effect of TEMPOL (4-hydroxy-2,2,6,6-tetramethylpiperidinyl-1-oxyl), a superoxide dismutase (SOD) mimetic, on retinal ganglion cells in methanol-intoxicated rats. METHODS: This experimental study was conducted with 20 male Wistar rats that were 10-12 weeks old and weighed 300-350 g. The rats were divided into four groups that each received a different treatment: a negative control group, a positive control group, a methanol group, and a methanol + TEMPOL group. Enucleated eyes from all groups were sliced and stained using hematoxylin-eosin (HE). Retinal layer and ganglion cells were assessed based on cellular structure, cellular swelling, and vacuole formation in the ganglion cell layer as observed at × 200 magnification. The Kruskal-Wallis test and the Mann-Whitney test were used, with significance taken to correspond to p < 0.05. RESULTS: Retinal ganglion cells of the control group had fewer vacuoles and a more well-organized cellular structure compared to those of the methanol group. The histopathologic scores of the methanol-intoxicated group were lower than those of the TEMPOL therapy group; p = 0.011 (i.e., p < 0.05). CONCLUSIONS: TEMPOL had a positive impact on the cellular structure of retinal ganglion cells in methanol-intoxicated rats.

Visual Acuity Improvement in Continuous vs Divided Occlusion in Anisometropic Amblyopia.

PURPOSE: To compare visual acuity improvement between continuous and split part-time occlusion for the treatment of moderate and severe anisometropic amblyopia. METHODS: Randomised clinical trials in 6 - 13 y.o children with moderate and severe anisometropic amblyopia. Each patient was consecutively selected with continuous or split part-time occlusion. Best corrected visual acuity's improvement was followed up to six weeks and statistical data were analyzed using chi square and unpaired t-test. RESULTS: Best corrected visual acuity's improvement was comparable between continuous and split part-time occlusion (0.20±0.27 vs 0.21±0.25; p = 0.79). CONCLUSION: Split part-time occlusion may be considered as an alternative treatment for moderate and severe anisometropic amblyopia treatment.