Wagnerlamm8118

Intraocular lens (IOL) calcification has often been studied using imaging techniques that identify distinct morphological patterns. In this study, we used optical metrology to determine how the type of opacification would have compromised the IOLs' function prior to explantation.

David J Apple Laboratory, Heidelberg, Germany DESIGN A laboratory investigation.

Of 67 explanted IOLs, we identified 28 with homogeneous calcification, 21 with localized calcification, and 18 subluxated lenses without calcification that served as controls. We used the modulation transfer function (MTF) cut-off (0.43 at 100 lp/mm) to define decreased optical quality, following the manufacturers' guidelines for IOL testing. Light scattering was evaluated in vitro using a clinical device.

Only one control IOL demonstrated a decreased MTF compared to four and 15 in the homogeneous and localized groups, respectively. The MTF-derived metrics did not differ between the homogeneous and control IOLs (P=0.99), but both showed better pehe homogeneous form, both conditions may cause severe glare phenomena.

Management of dislocated intraocular lenses is a challenging surgical problem. There are different approaches for repositioning dislocated IOLs. Here we describe a novel, knot free technique and report its surgical outcome.

Beyoglu Eye Education and Research Hospital, Istanbul, Turkey DESIGN Retrospective observational clinical study METHODS The files 47 patients were retrospectively reviewed the patients who had a follow-up time of 6 months or more were included in this study. The surgery of every case was watched for the surgical complications and calculation of the surgical time. The postoperative complications and success rate was specifically tabulated.

Thirty-five eyes of 35 patients were included in this study (23 male, 12 female, mean age 63.1 ±19.2 years). Mean follow-up time was 22.5 ±9.9 months. Mean surgical time was 28.2 ±6.8 minutes. Best corrected visual acuity improved significantly after the operation (p=0.001). Anatomic success rate was 97.1% after a single surgery. Most common complications included transient intraocular pressure (IOP) elevation (n=2), persistent IOP elevation (n=1), mild IOL tilt (n=1), mild IOL decentration (n=1), secondary IOL dislocation requiring intervention (n=1), transient corneal edema (n=1) and bullous keratopathy (n=1).

Knot-free suture scleral fixation of dislocated intraocular lenses is a minimal invasive approach for the management of dislocated IOLs and required only two 20 G corneal incisions without the need of scleral flaps or incisions. This technique had a very low complication rate and delivered successful results in most of the cases.

Knot-free suture scleral fixation of dislocated intraocular lenses is a minimal invasive approach for the management of dislocated IOLs and required only two 20 G corneal incisions without the need of scleral flaps or incisions. This technique had a very low complication rate and delivered successful results in most of the cases.Suction loss is an intraoperative complication in SMILE that presents a management challenge for the refractive surgeon. The purpose of this review is to evaluate the visual, refractive, and wavefront outcomes following suction loss across the different stages of SMILE with various respective surgical treatments. Surgical management options include immediate re-SMILE by redocking or delayed re-SMILE, with or without adjustment of the laser parameters, conversion to femtosecond LASIK, transepithelial photorefractive keratectomy, refractive lenticule extraction, or pseudo-SMILE. The restart treatment module on VisuMax provides appropriate re-treatment recommendation. 4-MU inhibitor Most re-treatment options for suction loss, immediate or delayed, resulted in effective, safe, and predictable outcomes and patients were satisfied with their outcomes. Based on available level II evidence, immediate re-SMILE with or without adjustment to the laser settings achieve favorable visual and refractive outcomes in handling this intraoperative complication across all stages of SMILE.

To describe reoperations that occurred within 90 days of minimally invasive glaucoma surgery (MIGS) at a single institution over a 30-month period.

Tertiary care hospital.

Retrospective case series.

Charts of adult patients who underwent trabecular microbypass stents, gel microstents, and goniotomy procedures (including gonioscopy-assisted transluminal trabeculotomy) from October 1, 2017 to March 15, 2020 at Wills Eye Hospital were examined. Outcome measures were unanticipated reoperations within the first 90 days after MIGS procedures and the complications that led to these reoperations.

448 MIGS procedures were performed on 436 eyes of 348 patients over a 30-month period by 6 glaucoma surgeons. Of these, 206 (46.0 %) were trabecular microbypass stents (198 iStent/iStent inject, 8 Hydrus), 152 (33.9%) were gel microstents, 90 (20.1%) were goniotomy procedures. Combined phacoemulsification took place in 256 (58.7%) of eyes. Reoperation within 90 days took place in 23/436 eyes (5.3%), including 16/152 eyes in the gel microstent group (10.5%), 4/198 eyes in iStent/iStent inject group (2.0%), 3/90 eyes in the goniotomy group (3.3%). Indications for reoperation were elevated intraocular pressure (IOP) in 16/23 eyes (69.6%), gel microstent tip exposure with wound leakage in 3/23 eyes (13%), and early gel microstent encapsulation without elevated IOP in 1/23 eye (4.3%). 2/23 eyes (8.7%) required reoperation for lens complications while 1/23 eye (4.3%) had elevated IOP and aphakia requiring reoperation.

The rate of reoperation within the first 90 days after MIGS was low. Elevated IOP and complications associated with gel microstents were the main indications for reoperation.

The rate of reoperation within the first 90 days after MIGS was low. Elevated IOP and complications associated with gel microstents were the main indications for reoperation.

To compare the visual outcome and refractive results between presbyPRK and presbyLASIK in presbyopic hyperopic patients using micro-monovision and the SUPRACOR algorithm.

Percy Military Hospital and private Laser Victor Hugo Center.

Observational retrospective nonrandomized.

Twenty-three patients who had undergone presbyPRK or presbyLASIK were included and followed up for 12-months. Far and near visual acuity without correction in monocular and binocular, measurement of distance visual acuity with correction in monocular, evaluation of spherical equivalent, aberrometry, and patient satisfaction were measured and analyzed in this study.

The study included 26 eyes of 13 patients in the presbyLASIK group and 20 eyes of 10 patients in the presbyPRK group. The mean age was 55.43 ± 4.6 years. Uncorrected binocular distance visual acuity was 0.030 ± 0.05 logMAR in the presbyLASIK group and 0 logMAR in the presbyPRK group (p = 0.066). Binocular near visual acuity without correction was 0.21 ± 0.11 logMAR in the presbyLASIK group and 0.30 ± 0.15 logMAR in the presbyPRK group (p = 0.0398). For the dominant eyes,the spherical equivalent was -0.08 ± 0.48 D in the presbyLASIK group and 0.16 ± 0.82 D in the presbyPRK group (p = 0.3995). For non-dominant eyes, the spherical equivalent was -0.44 ± 0.5 D in the presbyLASIK group and 0.12 ± 0.65 D in the presbyPRK group (p = 0.0254).

PresbyPRK and presbyLASIK were comparable in terms of efficacy, stability, predictability and safety. PresbyPRK could be a safe and effective surgical alternative for the hyperopic presbyopic patient.

PresbyPRK and presbyLASIK were comparable in terms of efficacy, stability, predictability and safety. PresbyPRK could be a safe and effective surgical alternative for the hyperopic presbyopic patient.

Whether Bowman's layer is contributing to corneal biomechanics is subject to controversy surgical techniques such as Small Incision Lenticule Extraction (SMILE) and Bowman's layer transplantation suggest a role, whereas experimental studies performed on whole-thickness corneas failed to show a role. Here, the elastic modulus of thin corneal lamellae was measured, so that the potential relative biomechanical contribution of Bowman's layer would be greater.

Center for Applied Biotechnology and Molecular Medicine, University of Zurich, Switzerland; ELZA-Institute, Dietikon, Switzerland; Department of Ophthalmology, Philipps University of Marburg, Germany.

Prospective experimental laboratory study.

Twenty-six healthy human corneas were stripped of Descemet's membrane and the endothelium for DMEK. Following epithelium removal, corneas were divided into two groups. In group 1, Bowman's layer was ablated with an excimer laser (20μm-thick,10mmOZ). In group 2, Bowman's layer was left intact. Then, a lamella was cut from the anterior cornea with an automated microkeratome. Elastic-viscoelastic material properties were analyzed by 2D-stress-strain extensometry between 0.03-0.70N.

Mean lamella thickness was 160±37 μm in corneas with Bowman's layer, and 155±22 μm in corneas without. link2 No significant differences between flaps with and without Bowman's layer were observed in the tangential E-modulus between 5-20% strain (11.5±2.9 vs 10.8±3.7kPa, p>0.278).

The presence or absence of Bowman's layer did not reveal a measurable difference in corneal stiffness. This may indicate that the removal of Bowman's layer during photorefractive keratotomy (PRK) does not represent a disadvantage to corneal biomechanics.

The presence or absence of Bowman's layer did not reveal a measurable difference in corneal stiffness. This may indicate that the removal of Bowman's layer during photorefractive keratotomy (PRK) does not represent a disadvantage to corneal biomechanics.

Provide safety and effectiveness outcomes 12 months post-surgically for sequential canaloplasty and trabeculotomy with the OMNI system combined with cataract surgery in mild-to-moderate open-angle glaucoma (OAG).

Eleven ophthalmology practices and surgery centers located in eight states (AL, AR, CA, KS, LA, MO, NY, TX).

Retrospective, multicenter, single arm METHODS IRB approved. Twelve surgeons contributed 81 patients meeting eligibility criteria OAG, 12-month follow-up, medicated intraocular pressure (IOP) ≤36 mmHg on ≤ 4 medications preoperatively. Analysis stratified by baseline (BL) IOP; >18 mmHg (group 1), ≤ 18 mmHg (Group 2). link3 Success defined as proportion with ≥ 20% reduction in IOP OR IOP between 6 and 18 mmHg (inclusive) AND on the same or fewer medications without secondary surgical intervention (SSI). Other endpoints included mean IOP and medications at 12 months. Safety included best corrected visual acuity (BCVA) and adverse events (AE).

Primary success was met by 79% (Group 1) and 81% (Group 2). Mean IOP was reduced in Group 1 (21.9 to 15.1 mmHg, p < 0.0001), and remained controlled in Group 2 (14.1 to 13.4 mmHg, p = 0.3177). Medications went from 2.0 ± 1.3 to 1.1 ± 1.1 (Group 1) and from 1.6 ± 1.3 to 0.9 ± 1.2 (Group 2). AE were typical for cataract or angle surgery. Mild inflammation (11%), IOP spikes (5%), hyphema (4%). 4 patients (5%) required an SSI.

The OMNI system provides effective IOP reduction, sustained IOP control, and meaningful medication reduction for up to 12 months postoperative.

The OMNI system provides effective IOP reduction, sustained IOP control, and meaningful medication reduction for up to 12 months postoperative.