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Therapeutic Advances in Ophthalmology 2023Even after a successful corneal transplant, patients experience severe refractive errors, impeding their rehabilitation and satisfaction. Refractive errors can be caused... (Review)
Review
Even after a successful corneal transplant, patients experience severe refractive errors, impeding their rehabilitation and satisfaction. Refractive errors can be caused by recipient pathology and corneal thickness, as well as intraoperative factors such as donor-host discrepancy, recipient's eccentric trephination, vitreous length, wound apposition, technique of suturing, and suture material. Also, wound healing and the interim between keratoplasty and suture removal contribute to astigmatism. Lamellar keratoplasty outperforms penetrating keratoplasty in terms of endothelial cell loss and endothelial graft rejection, yet the risk of developing refractive errors is comparable. Nonsurgical interventions such as spectacles and lenses fail to provide desirable vision in cases with high astigmatism and corneal irregularity. When these limitations are encountered, surgical interventions including incisional keratotomy, wedge resection, laser refractive surgeries, intracorneal segments, and intraocular lens implantation are employed. However, occasionally, none of these approaches deliver the desired effects, leading to the need for a repeat keratoplasty.
PubMed: 37854948
DOI: 10.1177/25158414231204717 -
Acta Ophthalmologica Sep 2023To evaluate the 1-year myopia control efficacy of a spectacle lens with annular cylindrical microstructures. (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
To evaluate the 1-year myopia control efficacy of a spectacle lens with annular cylindrical microstructures.
METHODS
A total of 118 consecutive eligible children aged 8-12 years with -1.00 D to -4.00 D of spherical component myopia and <1.50 D astigmatism were enrolled between August 2020 and November 2020 at the Eye Hospital of Wenzhou Medical University. Participants were randomly assigned to wear cylindrical annular refractive element (CARE) (n = 61) or single-vision (n = 57) spectacle lenses. Cycloplegic autorefraction (spherical equivalent refraction [SER]) and axial length (AL) were measured at baseline and 6-month intervals. Adaptation and compliance questionnaires were administered during all visits.
RESULTS
Among 118 randomized participants, 96 (81.4%) were included in the analyses (mean [SE] age, 10.4 [0.6] years; 49 [51.0%] were female; mean [SE] spherical equivalent refractive error, -2.67 [0.66] D; mean [SE] axial length, 24.75 [0.77] mm). Adjusted 1-year myopia progression was -0.56 D for CARE and -0.71 D for single-vision spectacle lenses. The difference in progression was 0.14 D (95% CI, -0.04 to 0.32) for CARE vs single vision. Adjusted 1-year eye growth was 0.27 mm for CARE and 0.35 mm for single vision. The difference in eye growth was 0.09 mm (95% CI, -0.15 to -0.02) for CARE vs single vision. All groups adapted to their lenses with no reported adverse events, complaints, or discomfort.
CONCLUSIONS
Among children with myopia, treatment with cylindrical annular refractive element spectacle lenses significantly reduced the rate of axial elongation over 1 year compared with single-vision spectacle lenses.
Topics: Child; Humans; Female; Male; Eyeglasses; Refraction, Ocular; Myopia; Vision Tests; Astigmatism; Disease Progression
PubMed: 36779428
DOI: 10.1111/aos.15649 -
Current Opinion in Ophthalmology Jan 2024The aim of this study to provide an overview of recent publications and opinions in refractive cataract surgery. (Review)
Review
PURPOSE OF REVIEW
The aim of this study to provide an overview of recent publications and opinions in refractive cataract surgery.
RECENT FINDINGS
With the advent of intraocular lenses (IOLs) on different platforms, the surgeon has a wide arena of types of IOL to choose, depending on the patient's visual requirement. Optimization of the tear film, integrating tomography and topography devices for appropriate keratometry values, biometry, use of advanced formulas for IOL power calculation and application of newer IOLs can help achieve target refraction in cases scheduled for cataract surgery. Intraoperative aberrometry can be a useful aid for cataract surgery in postrefractive cases and can help minimize residual postoperative astigmatism.
SUMMARY
Evolvement and rapid advancement of technology allows to impart desired refractive outcomes in most of the cases postcataract surgery. Appropriate preoperative and intraoperative factors should be considered to achieve the desired postoperative outcome.
Topics: Humans; Lens Implantation, Intraocular; Refraction, Ocular; Lenses, Intraocular; Cataract Extraction; Cataract; Astigmatism; Biometry; Phacoemulsification
PubMed: 37962881
DOI: 10.1097/ICU.0000000000001005 -
Clinical Ophthalmology (Auckland, N.Z.) 2024Corneal transplantation, when used in the correct setting, can significantly improve visual acuity and therefore quality of life. One of the barriers to good vision... (Review)
Review
Corneal transplantation, when used in the correct setting, can significantly improve visual acuity and therefore quality of life. One of the barriers to good vision following keratoplasty is residual post operative surgical astigmatism. Following a thorough literature search, we present the different options available to readers, with regards to how post-operative astigmatism can be approached and managed in order to improve vision. We present available data from the literature, which in some areas are scarce, with a view to collating all of this information in one place, allowing comparison between different modalities of treatment.
PubMed: 38887510
DOI: 10.2147/OPTH.S393975