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Clinical Ophthalmology (Auckland, N.Z.) 2023We evaluate the reduction of corneal astigmatism and the improvement of visual outcomes of this surgical method in the Indonesian population. We also assess the accuracy...
PURPOSE
We evaluate the reduction of corneal astigmatism and the improvement of visual outcomes of this surgical method in the Indonesian population. We also assess the accuracy and predictability of using femtosecond laser astigmatic keratotomy (FLAK) combined with cataract surgery.
PATIENTS AND METHODS
In a retrospective study, a total of 275 subjects (78 with against-the-rule (ATR) astigmatism, 178 with with-the-rule (WTR) astigmatism, and 19 with oblique (OBL) astigmatism) with preexisting corneal astigmatism ranging from 0.75D to 3.00D underwent FLAK. All subjects completed a 3-month follow-up. The femtosecond laser used for creating paired AK 2.2 mm, primary incision, and paracentesis incision was the FEMTO Z8 NEO from Ziemer Ophthalmic System, Switzerland. The surgical approach was guided by the "NAPA" nomogram.
RESULTS
The reduction in postoperative astigmatism was 56.90% for the WTR group, 49.46% for the ATR group, and 47.33% for the oblique group. A significant reduction in astigmatism was observed at the 1-week, 1-month, and 3-month follow-up intervals in both the WTR and ATR groups. The reduction in astigmatism was more favorable in cases of moderate astigmatism within the WTR group, as compared to the ATR and oblique groups. Postoperative astigmatism reduction was found to be more predictable in the right eye than in the left eye.
CONCLUSION
The combination of FLAK can be considered as a potential method for reducing corneal astigmatism ranging from 1.00D to <3.00D. The highest reduction was observed in the WTR group, along with a higher rate of intended correction without astigmatism meridian shift in the right eye for the WTR group. However, factors such as cyclotorsion resulting from the surgical technique, alignment of docking, incision length, and preoperative astigmatism need to be taken into account for further enhancement and predictability of astigmatism reduction with this method.
PubMed: 37841901
DOI: 10.2147/OPTH.S416217 -
Clinical Ophthalmology (Auckland, N.Z.) 2023To compare intermediate visual outcomes in patients previously implanted with bilateral Clareon monofocal IOLs versus bilateral Eyhance IOLs.
PURPOSE
To compare intermediate visual outcomes in patients previously implanted with bilateral Clareon monofocal IOLs versus bilateral Eyhance IOLs.
METHODS
This was a non-interventional, single-center, examiner-masked, comparative study. Participants were cataract patients presenting at least 3 months after uncomplicated, bilateral implantation of either Clareon or Eyhance non-toric and toric IOLs. Outcomes measures included binocular distance-corrected intermediate visual acuity (DCIVA), binocular corrected distance visual acuity (CDVA), binocular best-corrected defocus curve, postoperative mean residual spherical equivalent (MRSE), and residual astigmatism.
RESULTS
A total of 620 eyes of 310 subjects (155 subjects per group) were evaluated. The mean difference in DCIVA was 0.05 logMAR between the Eyhance and Clareon IOLs which was significant (p < 0.01), but within the 0.1 logMAR non-inferiority margin. Mean CDVA of the Clareon group was 0.01 ± 0.03 logMAR compared to 0.02 ± 0.03 logMAR of the Eyhance Group (p > 0.05). Defocus curves from +1.0 D to -3.0 D were not clinically nor statistically different between the Clareon and Eyhance groups (p > 0.05).
CONCLUSION
The results of this study show that bilateral implantation of Clareon monofocal IOLs and Eyhance monofocal IOLs lead to similar distance and intermediate visual outcomes.
PubMed: 38146452
DOI: 10.2147/OPTH.S444696 -
Saudi Journal of Ophthalmology :... 2023To evaluate the corneal topography and aberrometry and their changes following ptosis surgery in patients suffering from unilateral congenital blepharoptosis.
PURPOSE
To evaluate the corneal topography and aberrometry and their changes following ptosis surgery in patients suffering from unilateral congenital blepharoptosis.
METHODS
The study included 15 eyes of 15 patients with unilateral congenital blepharoptosis who underwent surgical correction through anterior levator resection. Shack-Hartmann wavefront sensor was employed to assess Zernike coefficients and root-mean-square. Computerized corneal topography, Orbscan and aberrometry were measured pre-and 3 months post-surgery in the healthy and ptotic eyes. Aberrometric changes were compared between patients with more than one diopter of astigmatism and subjects with less amount of astigmatism. Data were analyzed using the SPSS version 16. < 0.05 was considered as significance level.
RESULTS
Following anterior levator resection, the amount of astigmatism decreased. However, the difference was not statistically significant. Changes in topographic indices were not statistically significant. Regarding tomographic indices, the change in minimum keratometry was significant. The amount of change in total higher-order aberrations (HOAs) was not statistically significant. However, there was a decrease in the amount of third-order aberrations (vertical coma and vertical trefoil) which was statistically significant for vertical coma (-0.002 ± 0.001 vs. -0.08 ± 0.02 µm, = 0.02). Comparing aberrometric changes in patients with more than 1 diopter astigmatism and less, there was a significant difference in the amount of HOA w/o Z400.
CONCLUSION
Surgical correction of ptosis could reduce the ocular aberrations, despite no significant change in astigmatism. Nonaxial high-order aberrations are mostly affected probably due to the meridional effect of ptosis on the cornea.
PubMed: 38074297
DOI: 10.4103/sjopt.sjopt_220_22 -
Clinical Ophthalmology (Auckland, N.Z.) 2023To compare refractive, visual, and patient-reported outcomes associated with a 1st generation wavefront-guided (WFG) treatment with those associated with a 3rd...
PURPOSE
To compare refractive, visual, and patient-reported outcomes associated with a 1st generation wavefront-guided (WFG) treatment with those associated with a 3rd generation WFG treatment.
PATIENTS AND METHODS
This retrospective study included patients who underwent femtosecond laser-assisted in situ keratomileusis (LASIK) for myopia/myopic astigmatism. Two random stratified samples of patients who underwent either 1stgeneration (WaveScan, Johnson & Johnson Vision, Santa Ana, CA) or 3rd generation (iDesign 2.0, Johnson & Johnson Vision, Santa Ana, CA) treatment matched on preoperative refraction were compared (4290 eyes of 2145 patients in each group). One-month postoperative visual, refractive, and patient-reported outcomes were analyzed. Refractive and monocular visual acuity analyses were performed using one random eye of each patient.
RESULTS
The percentage of eyes achieving 20/20 or better uncorrected vision was 91.3% (1958/2145) in the 1st generation group and 95.9% (2056/2145) in the 3rd generation group (p<0.01). Binocularly, the percentage of patients with 20/20 or better UDVA was 97.0% (2080/2145) and 99.2% (2127/2145) in the 1st and 3rd generation groups, respectively (p<0.01). The mean postoperative MSE was -0.01 ± 0.33 D in the 1st generation group and +0.19 ± 0.33 D in the 3rd generation group (p<0.01). Postoperative refractive astigmatism had a mean value of -0.20 ± 0.26 D and -0.18 ± 0.24 D in the 1st and 3rd generation groups, respectively (p<0.01). The mean correction index of refractive astigmatism was 1.09 ± 0.53 in the 1st generation group and 1.02 ± 0.38 in the 3rd generation group, p<0.01. The overall percentage of patients satisfied with vision was 92.8% (1991/2145 patients) in the 1st generation group and 97.3% (2087/2145 patients) in the 3rd generation group (p<0.01).
CONCLUSION
For the majority of postoperative variables, there were significant differences between 1st and 3rd generation treatments. The 3rd generation treatments had better visual acuity outcomes and higher patient satisfaction.
PubMed: 38026600
DOI: 10.2147/OPTH.S434037 -
Graefe's Archive For Clinical and... Jan 2024Corneal scars after infectious keratitis lead to insufficient transparency and irregular astigmatism, affecting visual acuity; therefore, they should be accurately... (Observational Study)
Observational Study
PURPOSE
Corneal scars after infectious keratitis lead to insufficient transparency and irregular astigmatism, affecting visual acuity; therefore, they should be accurately evaluated to estimate visual function. This study aimed to quantitatively evaluate corneal irregularity and scarring after infectious keratitis using anterior segment optical coherence tomography (AS-OCT).
METHODS
This was an observational clinical study. We included patients who had corneal scarring after treatment of infectious keratitis between 2014 and 2021 at University of Tokyo Hospital. We retrospectively examined best spectacle-corrected visual acuity (BSCVA), average keratometric power, central corneal thickness (CCT), and four components of the Fourier harmonic analysis including spherical and asymmetry components, as well as regular astigmatism and higher-order irregularity. We included anterior and posterior corneal data and compared results with those of contralateral healthy eyes. Additionally, we quantitatively evaluated the densitometry of the cornea obtained using AS-OCT.
RESULTS
A total of 122 eyes of 61 patients were examined; male predominance was observed (n = 37), and the mean patient age was 55.3 ± 19.4 years. Comparisons with contralateral healthy eyes showed that BSCVA worsened (0.30 ± 0.83 and 0.93 ± 1.36 logMAR, respectively, P = 0.003), and CCT (531.1 ± 46.2 and 591.8 ± 132.4 μm, respectively, P < 0.001) and corneal densitometry (84.4 ± 11.8 and 111.9 ± 19.2 grayscale units, respectively, P < 0.001) increased significantly in affected eyes. The asymmetry component and higher-order irregularities that were not corrected with spectacles significantly increased (both P < 0.001), and there were no significant differences in the changes among the bacterial, fungal, herpetic, and acanthamoeba types of keratitis.
CONCLUSION
Corneal scarring persisted after treatment for infectious keratitis, and the asymmetry and irregularities of corneal astigmatism increased as visual acuity deteriorated. AS-OCT with the Fourier harmonic analysis was useful for evaluating corneal topographic changes in patients with corneal scarring after keratitis.
Topics: Humans; Male; Adult; Middle Aged; Aged; Female; Tomography, Optical Coherence; Cicatrix; Astigmatism; Retrospective Studies; Cornea; Keratitis; Corneal Topography; Corneal Injuries
PubMed: 37470808
DOI: 10.1007/s00417-023-06157-3 -
BMC Ophthalmology Jul 2023To compare the 4-year visual outcomes of implantable collamer lens V4c (EVO-ICL) implantation and small incision lenticule extraction (SMILE) for high myopia and...
BACKGROUND
To compare the 4-year visual outcomes of implantable collamer lens V4c (EVO-ICL) implantation and small incision lenticule extraction (SMILE) for high myopia and astigmatism.
METHODS
This retrospective case study included 64 eyes of 40 patients. These patients with preoperative manifest refraction spherical equivalent (SE) between - 6.00 and - 10.00 diopters (D) were screened from the database of SMILE and EVO-ICL implantation procedures in 2015. The ICL group [32 eyes of 19 patients (mean age, 29.6 ± 6.3 years); mean SE, -8.71 ± 1.06 D] and SMILE group [32 eyes of 21 patients (mean age, 27.7 ± 5.6 years); mean SE, -8.35 ± 0.65D] were compared. All patients were then prospectively examined at a four-year follow-up for routine postoperative examinations, higher-order ocular aberrations, retinal image quality and a questionnaire.
RESULTS
The safety indexes were 1.15 ± 0.14 and 1.22 ± 0.21 (P = 0.36) for the SMILE and ICL groups, respectively. No eyes lost two or more lines of CDVA in either group. The efficacy indexes were 0.97 ± 0.16 and 0.96 ± 0.19 (P = 0.87), respectively. Twenty-three eyes (72%) in ICL and 26 eyes (81%) in SMILE groups were within ± 0.5 D of the attempted SE (P < 0.01). ICL-treated eyes had significantly less spherical aberration and coma (P < 0.01 and < 0.05, respectively) postoperatively. Halos were the prevalent visual disturbance in both groups.
CONCLUSION
SMILE and EVO-ICL implantation provided safe and effective correction of high myopia. SMILE showed slightly better long-term predictability. Mild postoperative visual disturbances were observed after ICL and SMILE at 4-year follow-up.
Topics: Humans; Young Adult; Adult; Retrospective Studies; Visual Acuity; Treatment Outcome; Lenses, Intraocular; Refraction, Ocular; Myopia; Follow-Up Studies
PubMed: 37525155
DOI: 10.1186/s12886-023-03050-9 -
Lasers in Medical Science Nov 2023This study aimed to compare higher-order aberrations (HOAs) after small incision lenticule extraction (SMILE) in patients with different angle kappa. This is a...
This study aimed to compare higher-order aberrations (HOAs) after small incision lenticule extraction (SMILE) in patients with different angle kappa. This is a retrospective report in which 341 right eyes of 341 patients who were subjected to SMILE, which used coaxially sighted corneal light reflex (CSCLR) as the treatment zone centered, treated by the same experienced surgeon (LHB) for correction of myopia and myopic astigmatism, preoperative and postoperative spherical equivalent (SE), angle kappa, total higher-order aberrations (total HOA), spherical aberration (SA), vertical coma (VC), horizontal coma (HC), oblique trefoil (OT), and horizontal trefoil (HT), were compared. SMILE showed outstanding performance in terms of safety, efficacy, and predictability. In addition, a comparison of preoperative and postoperative HOAs exhibited the difference of total HOA (P < 0.01), SA (P < 0.01), VC (P < 0.01), and HC (P < 0.01), which was statistically significant; however, for OT and HT with the longer follow-up time, the statistical difference gradually decreased. For stratification of angle kappa into groups based on decantation, angle kappa was divided into three major groups: r < 0.1 mm, 0.1 ≤ r < 0.2 mm, and r ≥ 0.2 mm; the changes of SA (F = 4.127, P = 0.021) and OT (F = 3.687, P = 0.031) exhibited significant difference after 1 year of SMILE. We performed a correlation analysis of all preoperative and postoperative parameters, and the results indicated that the preoperative total HOA was negatively correlated with preoperative cylindrical diopter (DC), and postoperative total HOA, SA, and coma were affected by spherical diopter (DS) and SE. Moreover, we also found a significant difference of SA and VC in the early postoperative with preoperative. SA was positively correlated with Y values and r of 1 year after SMILE. All of the analyzed parameters in the three groups, except for the trefoil, gradually increased over time; however, the trefoil could gradually stabilize over time. We also divided angle kappa into four groups by quadrants; the result showed that the effects of higher-order aberrations were markedly different from the various quadrants. Patients with large angle kappa were able to increase VC and SA postoperatively, and higher HOAs were more significant in patients with high myopia. The differences in quadrants exhibited a diversity of HOAs; this could be attributed to the corneal surface reestablishment and the alteration of angle kappa, but the trend was not apparent. Although all patients displayed increased HOAs after SMILE, the potential application of CSCLR as the treatment zone centered still showed excellent safety, efficacy, and predictability.
Topics: Humans; Visual Acuity; Retrospective Studies; Coma; Refraction, Ocular; Myopia; Surgical Wound; Lasers, Excimer
PubMed: 38012462
DOI: 10.1007/s10103-023-03934-8 -
Ophthalmology and Therapy Aug 2023This study aimed to describe the distribution and characteristics of ocular biometric parameters among a large Chinese population.
INTRODUCTION
This study aimed to describe the distribution and characteristics of ocular biometric parameters among a large Chinese population.
METHODS
This retrospective cross-sectional study included 146,748 subjects whose ocular biometric parameters were measured at the ophthalmology clinic of West China Hospital, Sichuan University, and recorded in the hospital database. Ocular biometric parameters, including axial length, anterior chamber depth, corneal keratometry, and keratometric astigmatism, were recorded. Only monocular data for each subject were analyzed to avoid bias.
RESULTS
Valid data from 85,770 subjects (43,552 females and 42,218 males) aged 3-114 years were included in this study. The mean axial length, mean anterior chamber depth, average corneal keratometry, and mean keratometric astigmatism were 24.61 mm, 3.30 mm, 43.76 D, and 1.19 D, respectively. The stratification of the ocular parameters by age and gender showed significant inter-gender and inter-age differences.
CONCLUSIONS
Analysis of a large population of subjects in western China aged 3-114 years showed that the distribution and characteristics of ocular biometric parameters, including axial length, anterior chamber depth, corneal keratometry, and keratometric astigmatism, differed by age and gender. This study is the first to describe ocular biometric parameters in subjects aged > 100 years.
PubMed: 37233976
DOI: 10.1007/s40123-023-00716-x -
Frontiers in Medicine 2024Myopia is causing a major public health concern, with its prevalence increasing globally. This study aimed to discuss posterior chamber phakic intraocular lens (pIOL)... (Review)
Review
INTRODUCTION
Myopia is causing a major public health concern, with its prevalence increasing globally. This study aimed to discuss posterior chamber phakic intraocular lens (pIOL) research publication trends and hotspots over the past 20 years.
METHODS
Bibliometric analysis was performed using the Web Science Core Collection to investigate posterior-chamber pIOL research publication trends. The extracted records were analyzed, and a knowledge map was built using VOSviewer v.1.6.20. The analysis included visualizing the annual publication count, countries/regions distribution, international and institutional collaborations, author productivity, and journal contribution, in addition to identifying knowledge bases and hotspots. Burst keywords were extracted using CiteSpace v.6.1.R.
RESULTS
In total, 791 articles on posterior chamber pIOLs published between 2003 and 2023 were retrieved. China had the highest number of publications, whereas Japanese papers received the most citations. Fudan University had the highest number of publications, with articles from Kitasato University having the highest number of citations. Regarding individual research, Xingtao Zhou has published the most significant number of articles, and Shimizu Kimiya had the highest number of citations. The top productive/influential journal was 'Journal of Cataract & Refractive Surgery'. The top cited references primarily focused on reporting the clinical outcomes of implantable collamer lens (ICL) for individuals with moderate to high myopia. The keywords primarily formed four clusters: posterior chamber pIOL clinical outcomes for myopic astigmatism correction, posterior chamber pIOL implantation complications, ICL size selection and postoperative vault predictions, and postoperative visual quality following posterior chamber pIOL implantation.
CONCLUSION
This study presents the first bibliometric analysis of research trends in posterior chamber pIOL over the past two decades. We investigated the current state and emerging trends of global collaboration and research focal points in this field, offering fresh insights and guidance for researchers.
PubMed: 38651068
DOI: 10.3389/fmed.2024.1391327 -
Translational Vision Science &... Jan 2024The purpose of this paper was to study the influence of astigmatism in optical coherence tomography angiography (OCTA) images in a quantitative and qualitative analysis.
PURPOSE
The purpose of this paper was to study the influence of astigmatism in optical coherence tomography angiography (OCTA) images in a quantitative and qualitative analysis.
METHODS
This was a prospective, cross-sectional study. We included 110 eyes of 110 patients: 20 eyes without astigmatism and 90 eyes with astigmatism ≥0.5 diopters (D). We performed a macula centered OCTA as a reference image. In patients without astigmatism, registered follow-up scans were performed after induction of -1 and -2 D astigmatism. In patients with astigmatism, we performed the follow-up scan after astigmatism correction. We used a set of cylindrical lenses attached to the camera head of the SPECTRALIS (Heidelberg Engineering, Heidelberg, Germany). A quantitative and qualitative analysis of the superficial vascular complex (SVC) and deep vascular complex (DVC) was performed. The main outcome measures were vessel density (VD), image quality, and the presence of artifacts.
RESULTS
Mean VD of the SVC was significantly higher in the reference images compared with the images after induction of -2 D. Differences with -1 D were nonsignificant. Higher degrees of astigmatisms had higher VD dropout (0.012-0.02 per diopter in SVC). Astigmatism axis showed no relevance in our cohort. Image quality assessed by two independent observers was graded as higher in images without astigmatism. Defocus and attenuation were more prevalent in images with astigmatism.
CONCLUSIONS
Astigmatism of -2 D affects quantification of VD in OCTA images, mainly affecting the SVC, as well as the subjective quality assessment. Correction of this refractive error might be necessary for an accurate quantitative assessment of OCTA images.
TRANSLATIONAL RELEVANCE
Correcting astigmatism of 2 D or greater appears to be necessary when analyzing OCTA images.
Topics: Humans; Tomography, Optical Coherence; Astigmatism; Cross-Sectional Studies; Prospective Studies; Macula Lutea; Angiography
PubMed: 38224331
DOI: 10.1167/tvst.13.1.10