The effect of Belin-Ambrósio Deviation (BAD-D) Index on two-year refractive outcomes of Photorefractive Keratectomy (PRK).

PURPOSE: To assess the effect of preoperative BAD-D index on two-year visual, refractive, and tomographic outcomes, as well as the efficacy and safety of PRK surgery. SETTING: Eye clinic, Mashhad, Iran. DESIGN: Prospective cohort study. METHODS: This study included 66 patients (66 eyes) who underwent PRK surgery, with a minimum follow-up period of 2 years. Participants were divided into two groups: preoperative BAD-D≥1.60 (high BAD-D) and preoperative BAD-D<1.60 (low BAD-D). Pre- and postoperative visual, refractive, and tomographic parameters were evaluated, and the efficacy and safety of the procedure were compared between groups. RESULTS: Sixty-six patients with a mean age of 35.50 years±8.21 (range 22 to 55 years) were included. Post-operatively, the mean spherical equivalent (SE) of refractive error was +0.32±0.65D in the high BAD-D group and +0.18±0.66D in the low BAD-D group (p=0.40). Also, at two years of follow-up, the mean uncorrected visual acuity was 0.98±0.07 in high BAD-D group and 0.97±0.08 in low BAD-D group (p=0.905). Among the postoperative tomographic parameters, front elevation thickness (F.EIe.Th), maximum Ambrósio relational thickness (ARTmax), astigmatism, and central corneal thickness were significantly different between the two groups (all, p< 0.05). At the two-year follow-up, the mean safety Index was 1.02±0.04, and 1.01±0.04 in high and low BAD-D groups respectively (p=0.37) and the mean efficacy Index was 0.99±0.07 and 0.98±0.06 in high and low BAD-D groups respectively (p=0.40). CONCLUSION: The preoperative BAD-D index does not predict postoperative visual, refractive, and tomographic outcomes in patients with low-to-moderate myopia. However, in patients with normal preoperative BAD-D values, higher agreement was expected between the attempted and achieved SE.

A sectional complete denture for microstomic patients.

Microstomic patients may experience a significant limitation in the mandibular opening. The prosthetic rehabilitation of microstomic patients presents difficulties at all stages, from preliminary impressions to prosthetic fabrication. This clinical report described the method of fabrication of sectional denture for patients with microstomia caused by burns. The denture was fabricated in two pieces, and patients inserted and removed the denture easily.