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Clinical Ophthalmology (Auckland, N.Z.) 2024To evaluate the efficiency and associated costs of a digital cataract workflow system and manual cataract workflow system for patients, with astigmatism presenting for...
PURPOSE
To evaluate the efficiency and associated costs of a digital cataract workflow system and manual cataract workflow system for patients, with astigmatism presenting for cataract surgery in Brisbane, Australia.
PATIENTS AND METHODS
Sixty patients with bilateral cataract requiring toric intraocular lenses (IOL) were sequentially assigned to a manual cataract workflow (n = 30) or digital workflow (n = 30) using EQ Workplace (SW v1.7.0) running on FORUM (SW v.4.2.1.66) (Carl Zeiss Meditec, Jena, Germany). Each step of preoperative data acquisition and analysis was timed. Steps in each workflow were divided into presurgical planning time and total workflow time, the latter including the time required to input toric data into CALLISTO eye (Carl Zeiss Meditec). Secondary outcomes included staff costs within each workflow.
RESULTS
Median presurgical planning time using a digital workflow process was 6.51 ± 0.65 minutes, and using a manual workflow process, 12.32 ± 0.56 minutes (p < 0.001). Similarly, median total workflow time using a digital workflow process was 6.93 ± 0.57 minutes and using a manual workflow process, 13.49 ± 0.47 minutes (p < 0.001). Evaluating the staff remuneration during presurgical planning and the operating costs associated with running EQ Workplace, there was a cost-reduction of 35% per patient when using the digital cataract workflow process.
CONCLUSION
Using a digital cataract workflow process is more efficient and provides staff cost-savings compared to a manual workflow process when planning for toric IOL implantation.
PubMed: 38813538
DOI: 10.2147/OPTH.S454549 -
Cureus Apr 2024The most common cause of visual impairment globally is refractive error. The prevalence of refractive error has been on the rise since the coronavirus disease 2019...
BACKGROUND
The most common cause of visual impairment globally is refractive error. The prevalence of refractive error has been on the rise since the coronavirus disease 2019 (COVID-19) pandemic, possibly due to increased indoor activities and excessive use of electronic devices. Impaired vision during childhood can affect the overall development of a child adversely, and it often remains unreported due to the inability of children to complain about impaired vision.
AIM
The main aim of this study was to assess the prevalence of refractive errors among school-going children in urban and rural areas.
METHODS
This was a cross-sectional study that included 2024 children going to schools situated in urban and rural areas. All study subjects were tested for visual acuity for distance using Snellen's chart with and without glasses after taking a brief history regarding visual complaints. All children who had visual acuity less than 6/6 on Snellen's chart underwent refraction check-ups. Retinoscopy was performed in all study subjects. Analysis of the collected data was done using SPSS for Windows, Version 16.0 (Released 2007; SPSS Inc., Chicago, United States). The analysis of numerical data was done by an unpaired t-test, and the analysis of categorical data was done by a chi-square test. A P-value of less than 0.05 was considered statistically significant.
RESULTS
The mean age of the children was 10.92 ± 2.73 years, with 10.93 ± 2.73 years in urban and 10.91 ± 2.73 years in rural groups. Females (n=1031; 50.93%) were more in number than males (n=993; 49.06%). The overall prevalence of refractive error was 17.43%. The prevalence was higher in urban areas (22.14%) than in rural areas (12.71%). The age group below 10 years comprised 886 (43.77%) study subjects, and 218 (62.1%) children with refractive error had no ocular complaints. The most common refractive error found in this study was simple myopia in both groups, and the least common was astigmatism. The prevalence of uncorrected refractive error was higher in urban school-going children as compared to rural children.
CONCLUSION
The prevalence of refractive error was 17.43% in our study. The prevalence was high in urban areas (22.67%) as compared to rural areas (13.12%). Regular screening of school-going children for refractive errors should be done. Also, awareness regarding the use of electronic gadgets must be raised, especially among urban children.
PubMed: 38807816
DOI: 10.7759/cureus.59197 -
Cureus Apr 2024Introduction Refractive errors (REs) are on the rise among medical students due to the high academic pressure of long hours of reading and their association with close...
Introduction Refractive errors (REs) are on the rise among medical students due to the high academic pressure of long hours of reading and their association with close technology. Uncorrected REs cause impaired vision and blindness with considerable morbidity. Documenting the prevalence of REs among medical students helps with early detection and appropriate remedial measures to prevent eye morbidity. Aim The aim of the study was to find the prevalence of REs among medical students at Raichur Institute of Medical Sciences, a medical institution in Raichur City, Karnataka, India. Methodology This hospital-based cross-sectional study was conducted with a total of 425 medical students. An examination of the eye for REs was carried out using a streak retinoscope. The REs were noted in myopia <-0.5 diopters (D), hypermetropia >+0.5 D, and astigmatism >0.5 cylinder D. The data was statistically subjected. Categorical measurements have been presented as frequency (percentage). The chi-square test was applied to the association between the parameters. A p-value less than 0.05 was considered statistically significant. Results Among the 425 observed participants, 160 (37.6%) subjects had REs. Among the REs in the total population, myopia 78 (18.4%) was the most prevalent, followed by hypermetropia and astigmatism, both with 41 (9.6%) and 41 (9.6%) prevalence, respectively. Gender-wise and age-wise, myopia was highly prevalent in both genders and in all age groups except the 20 years age group. Conclusion The prevalence of REs in our study among medical students is a matter of concern, although it is less compared to other previous studies in different geographical areas of India. Regular checkups, early detection, and immediate treatment are very important to prevent further ocular complications.
PubMed: 38800198
DOI: 10.7759/cureus.58915 -
Journal of Clinical Medicine May 2024Presbyopia, a common age-related refractive error, affects over a billion people globally and significantly impacts daily life. This retrospective study analyzed 288...
Outcomes of Corneal Compound Myopic Astigmatism with Presbyopia by Zeiss PRESBYOND Laser Blended Vision LASIK Using Default CRS-Master Target Refractions for Reduced Anisometropia.
Presbyopia, a common age-related refractive error, affects over a billion people globally and significantly impacts daily life. This retrospective study analyzed 288 eyes of 144 patients undergoing LBV PRESBYOND treatment for myopic presbyopia with astigmatism, aiming to evaluate precision, efficacy, safety, and stability over six months. Key findings include high efficacy, with 99% of distance-eyes achieving uncorrected distance visual acuity (UDVA) of 20/25 or better, and 85% of near-eyes achieving UDVA of 20/32 or better. The results show excellent refractive outcomes, with 99% of long-sighted eyes and 97% of near-sighted eyes having a postoperative spherical equivalent within ±1.00 D. Safety was demonstrated by no loss of two or more Snellen lines after treatment, with 94% of patients maintaining corrected distance visual acuity (CDVA) before and after surgery. Overall, LBV PRESBYOND proved effective, safe, and well tolerated for myopic presbyopia correction, offering satisfactory visual outcomes and potential spectacle independence for various distances. This study underscores the importance of individualized treatment based on patient age, highlighting the positive impact of binocular summation on visual function. This study contributes to the growing body of evidence supporting LBV PRESBYOND as a viable option for addressing presbyopic myopia, offering insights into its efficacy and safety profile. Further research could explore postoperative stereopsis and long-term outcomes to enhance understanding and refine treatment protocols.
PubMed: 38792550
DOI: 10.3390/jcm13103011 -
Cureus Apr 2024This review provides a comparative analysis of visual outcomes and complications associated with three prominent refractive surgical techniques: intraocular collamer... (Review)
Review
Comparative Analysis of Visual Outcomes and Complications in Intraocular Collamer Lens, Small-Incision Lenticule Extraction, and Laser-Assisted In Situ Keratomileusis Surgeries: A Comprehensive Review.
This review provides a comparative analysis of visual outcomes and complications associated with three prominent refractive surgical techniques: intraocular collamer lens (ICL) implantation, small-incision lenticule extraction (SMILE), and laser-assisted in situ keratomileusis (LASIK). Refractive surgeries aim to correct myopia, hyperopia, and astigmatism, offering patients an alternative to corrective lenses. The review highlights the importance of comparing these procedures to guide clinical decision-making effectively. Each technique is described, emphasizing its unique advantages and considerations. While LASIK remains widely favored for its rapid visual recovery and high patient satisfaction, ICL is suitable for patients with higher refractive errors or corneal irregularities. Although relatively newer, SMILE shows promise with potential benefits such as corneal biomechanical stability and a reduced risk of dry eye syndrome. However, each procedure carries its distinct complications, reinforcing the need for personalized patient care and informed decision-making. Understanding these techniques' relative efficacy and safety profiles is essential for optimizing outcomes and enhancing patient satisfaction. Continued advancements in technology and surgical techniques promise further improvements in refractive surgery outcomes, underscoring the importance of ongoing research and innovation.
PubMed: 38779265
DOI: 10.7759/cureus.58718 -
Clinical Ophthalmology (Auckland, N.Z.) 2024To report the refractive and visual outcomes after implantation of a trifocal, diffractive, hydrophobic intraocular lens (IOL) in Japanese eyes following cataract...
PURPOSE
To report the refractive and visual outcomes after implantation of a trifocal, diffractive, hydrophobic intraocular lens (IOL) in Japanese eyes following cataract surgery.
METHODS
A total of 45 eyes implanted with FineVision HP IOLs (Beaver-Visitec International, Inc. USA) were enrolled in this retrospective study. The clinical outcomes assessed after 3-months were refraction and monocular logarithm of the minimum angle of resolution (LogMAR) uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), distance-corrected intermediate visual acuity (DCIVA) at 80 and 66 cm, uncorrected near visual acuity (UNVA), and distance-corrected near visual acuity (DCNVA) at 40 cm.
RESULTS
97.78% of the eyes were within ±0.50D of spherical equivalent and all of them were within ±1.00D (mean: -0.00±0.22 D, with 75.56% within ±0.13D), while 91.11% of the eyes had ≤0.50D residual astigmatism and all of them had ≤1.00D (mean: -0.08±0.24D, with 88.89% ≤0.25D). UDVA and CDVA showed mean values of -0.05±0.07 logMAR and -0.07±0.06 logMAR, respectively. 86.67% and 95.56% of the eyes had ≥20/20 UDVA and CDVA, respectively, with 100% achieving ≥20/25 for both UDVA and CDVA. At 80 cm, the mean monocular logMAR UIVA and DCIVA were 0.18±0.14 and 0.14±0.14, and at 66 cm the values were 0.20±0.15 and 0.19±0.15, respectively. At 80 cm 20% of the eyes had ≥20/25 DCIVA and 60% had ≥20/32 DCIVA. These values changed to 15.56% and 40% of the eyes at 66 cm. In terms of near vision, the mean monocular logMAR UNVA and DCNVA were 0.04±0.10 and 0.03±0.10, respectively. 53.33% of the eyes had ≥20/20 UNVA and DCNVA, with 86.67% achieving ≥20/25 UNVA and DCNVA.
CONCLUSION
The FineVision HP trifocal diffractive IOL provided accurate refractive outcomes with good visual acuity at different distances in Japanese eyes.
PubMed: 38779125
DOI: 10.2147/OPTH.S464432 -
Indian Journal of Ophthalmology May 2024To compare the visual outcomes and efficacy of opposite clear corneal incision (OCCI) and toric intraocular lens (IOL) implantation in correcting preexisting astigmatism...
PURPOSE
To compare the visual outcomes and efficacy of opposite clear corneal incision (OCCI) and toric intraocular lens (IOL) implantation in correcting preexisting astigmatism (PEA) in patients undergoing phacoemulsification.
METHODS
This prospective interventional comparative study was conducted between June 2022 and January 2023 in patients having cataract with PEA undergoing phacoemulsification. Patients were divided into two groups - group A underwent phacoemulsification with OCCI and group B underwent phacoemulsification with toric IOL implantation. Uncorrected distance visual acuity (UDVA), manifest refractive cylinder, and corneal astigmatism using corneal tomography were measured preoperatively and at 6 weeks postoperatively. The eyes were categorized into three groups with PEA ranging from 1 to 1.5 D, 1.6 to 2 D, and 2.1 to 3 D. Depending upon the white-to-white corneal diameter, the eyes were also categorized into four groups with corneal diameter ranging from 10.5 to 10.9 mm, 11 to 11.4 mm, 11.5 to 11.9 mm, and 12 to 12.4 mm.
RESULTS
Sixty eyes of 60 patients were studied. At postoperative 6 weeks, 83.3% (25 eyes) in the OCCI group and 96.7% (29 eyes) in the toric IOL group achieved UDVA of 6/9 or better. No statistically significant difference was noted between the groups (P = 0.37). The reduction in mean corneal astigmatism was 0.63 ± 0.37 D in the OCCI group and 0.15 ± 0.12 D in the toric IOL group (P < 0.001). The residual mean refractive cylinder was 0.60 ± 0.38 D in the OCCI group and 0.05 ± 0.15 D in the toric IOL group at 6 weeks (P = 0.007).
CONCLUSION
Both OCCI and toric IOL are effective in correcting PEA. However, in a resource-limited setting, OCCI is a better alternative surgical option for correcting astigmatism of 1-1.5 D during phacoemulsification without requiring additional skills or instruments.
PubMed: 38773910
DOI: 10.4103/IJO.IJO_3191_23 -
Indian Journal of Ophthalmology May 2024To compare the effective optical zones (EOZs) of small-incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (F-LASIK) by utilizing...
PURPOSE
To compare the effective optical zones (EOZs) of small-incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (F-LASIK) by utilizing topographic methods on the tangential curvature difference map at postoperative 1 year and to identify parameters linked to the EOZ alterations following both surgeries.
METHODS
Myopic patients who underwent SMILE or F-LASIK were included in the study. Patients with refractive error greater than -9.0 D sphere or -0.50 D of astigmatism were excluded from the study. EOZs were measured at postoperative 1 year by using the tangential curvature difference map of the Scheimpflug tomography system. Correlations between the EOZ alterations and relevant parameters were assessed.
RESULTS
In total, 59 eyes in the SMILE group and 65 eyes in the F-LASIK group were assessed. The decrease in EOZ compared with the programmed optical zone was significantly higher in the F-LASIK group (P < 0.001). The increase in corneal asphericity was significantly relevant to the decrease in EOZin both groups according to the multiple regression analysis (P < 0.001, B/95% CI: 0.62/0.34 and 0.90, standardized-Beta: 0.587 for the SMILE group; P < 0.001, B/95% CI: 0.74/0.41 and 1.07, standardized-Beta: 0.631 for the F-LASIK group).
CONCLUSION
The EOZ decreased 1 year after both SMILE and F-LASIK. The SMILE group showed less EOZ reduction than F-LASIK patients relative to the programmed optical zone. The decrease in EOZ was correlated with the increase in corneal asphericity in both groups.
PubMed: 38770606
DOI: 10.4103/IJO.IJO_133_24 -
Indian Journal of Ophthalmology May 2024To compare the safety, efficacy, and visual outcomes of topography-guided (TG) LASIK ablation versus advanced ablation algorithm (AAA) on Zeiss Mel 90 on virgin eyes.
PURPOSE
To compare the safety, efficacy, and visual outcomes of topography-guided (TG) LASIK ablation versus advanced ablation algorithm (AAA) on Zeiss Mel 90 on virgin eyes.
SETTING
A tertiary care hospital in north India.
DESIGN
A retrospective comparative study.
METHODS
Case sheets of 30 patients who underwent TG LASIK and 45 patients who underwent AAA LASIK between January 2021 and September 2022 were retrieved and reviewed. The TG group included 60 eyes of 30 patients, and the AAA group included age- and sex-matched 90 eyes of 45 patients. Both groups were compared for visual outcomes, residual refraction, and root-mean-square higher-order aberrations (rms HOA) at 1 week, 1 month, 3 months, and 6 months postoperatively and using unpaired t -test and Mann-Whitney U test.
RESULTS
The mean preoperative spherical equivalent in the TG group and AAA group was - 3.12 (1.67) and - 3.19 (1.61), respectively. The safety and efficacy of the treatment were 100% in both groups. The postoperative increase in rms HOA was comparable in both groups ( P = 0.55). The ablation duration was significantly longer in topo-guided LASIK ( P = 0.001).
CONCLUSION
AAA LASIK on MEL 90 is comparable to topography-guided LASIK for the management of low myopia and myopic astigmatism.
PubMed: 38767561
DOI: 10.4103/IJO.IJO_2012_23 -
International Journal of Ophthalmology 2024Keratoconus is an ectatic condition characterized by gradual corneal thinning, corneal protrusion, progressive irregular astigmatism, corneal fibrosis, and visual... (Review)
Review
Keratoconus is an ectatic condition characterized by gradual corneal thinning, corneal protrusion, progressive irregular astigmatism, corneal fibrosis, and visual impairment. The therapeutic options regarding improvement of visual function include glasses or soft contact lenses correction for initial stages, gas-permeable rigid contact lenses, scleral lenses, implantation of intrastromal corneal ring or corneal transplants for most advanced stages. In keratoconus cases showing disease progression corneal collagen crosslinking (CXL) has been proven to be an effective, minimally invasive and safe procedure. CXL consists of a photochemical reaction of corneal collagen by riboflavin stimulation with ultraviolet A radiation, resulting in stromal crosslinks formation. The aim of this review is to carry out an examination of CXL methods based on theoretical basis and mathematical models, from the original Dresden protocol to the most recent developments in the technique, reporting the changes proposed in the last 15y and examining the advantages and disadvantages of the various treatment protocols. Finally, the limits of non-standardized methods and the perspectives offered by a customization of the treatment are highlighted.
PubMed: 38766341
DOI: 10.18240/ijo.2024.05.21