Stronghernandez4502
ve and safe option for patients with keratoconus and thin corneas, with results similar to A-CXL treatment in patients with a minimum corneal thickness of 400 µm or greater. [J Refract Surg. 2021;37(9)623-630.].
To evaluate the refractive and visual outcomes following cataract surgery and implantation of a new enhanced monofocal extended depth of focus (EDOF) intraocular lens (IOL).
Fifty eyes of 25 consecutive patients who underwent implantation of the xact Mono-EDoF IOL (Santen Pharmaceutical Co, Ltd) were enrolled in this study. Main outcome measures were refractive error and monocular corrected (CDVA) and uncorrected (UDVA) distance visual acuity values. Monocular visual acuity at different vergences (defocus curve) was obtained. Patients were evaluated at 12 months postoperatively.
At 1 year of follow-up, all eyes showed a postoperative spherical equivalent within ±1.00 diopters (D) and 95% of eyes within ±0.50 D. The mean postoperative spherical equivalent was -0.15 ± 0.28 D. A total of 88% and 100% of eyes showed UDVA and CDVA of 20/25 or better, respectively. The mean values of UDVA and CDVA (Snellen decimal) were 0.94 ± 0.09 (range 0.70 to 1.00) and 0.99 ± 0.03 (range 0.79 to 1.00), respectively. Defocus curve showed good visual acuity at distance and intermediate distances with a depth of focus value of 1.25 D. No visual disturbances were reported in the whole sample during the entire follow-up.
The current study shows that this EDOF IOL provides good visual performance at far and intermediate distances. The lens may be considered for patients interested in reducing spectacle independence at intermediate distances.
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The current study shows that this EDOF IOL provides good visual performance at far and intermediate distances. The lens may be considered for patients interested in reducing spectacle independence at intermediate distances. [J Refract Surg. 2021;37(9)595-600.].
To compare the axis position of the measured total corneal astigmatism (TCA) with the axis of the anterior keratometry and the calculated axis position of different toric intraocular lens (IOL) calculators.
A total of 163 astigmatic eyes of 163 patients were retrospectively analyzed. The axis of the actual TCA, measured with anterior segment optical coherence tomography, was compared to the anterior keratometric value (Group I) and three different methods of TCA calculation for toric IOL power determination Abulafia-Koch regression formula (Group II), Barrett Toric Calculator V2.0 (Group III), and Barrett Toric Calculator V2.0 including measured posterior keratometric value (Group IV). Eyes were assigned to three subgroups with-the-rule, against-the-rule, and oblique astigmatism.
The mean deviation calculated from measured TCA was +0.56° (Group I), -0.32° (Group II), -0.37° (Group III), and -1.00° (Group IV). For with-the-rule astigmatism, the TCA axis agreed most with Group I (6.5% outliers > 5° deviation). For against-the-rule astigmatism, Group IV and Group II were closest to the measured TCA axis (1.5% and 3% outliers with > 5° deviation).
The means of the calculated axis were similar to the measured TCA, but the proportion of outliers with an axis deviation of greater than 5° showed remarkable differences. Isolated anterior keratometric value measurements showed the fewest outliers in with-the-rule astigmatism. In against-the-rule astigmatism, Abulafia-Koch calculation should be used for axis determination.
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The means of the calculated axis were similar to the measured TCA, but the proportion of outliers with an axis deviation of greater than 5° showed remarkable differences. Isolated anterior keratometric value measurements showed the fewest outliers in with-the-rule astigmatism. In against-the-rule astigmatism, Abulafia-Koch calculation should be used for axis determination. [J Refract Surg. 2021;37(9)642-647.].
To determine patient preference and treatment outcomes with an intracanalicular dexamethasone 0.4 mg insert compared to a standard steroid drop regimen in the contralateral eye following bilateral photorefractive keratectomy (PRK).
In this randomized, prospective, self-controlled, open-label interventional study, one eye received the dexamethasone insert and the second eye received prednisolone acetate 1% taper following bilateral PRK surgery. Postoperative evaluations were performed on day 3, day 4, month 1, and month 3. Phone call surveys were performed on week 2. The Comparison of Ophthalmic Medications for Tolerability questionnaire was used to determine patient preference between postoperative regimens and postoperative pain. Corneal endpoints included time to epithelialization, presence of corneal haze, sodium fluorescein staining, and modified Standardized Patient Evaluation of Eye Dryness (SPEED) scores. Both corrected distance visual acuity (CDVA) and uncorrected distance visual acuity (UDVA) werealing time or visual outcomes. [J Refract Surg. 2021;37(9)590-594.].
To compare the efficacy of oral codeine plus acetaminophen versus oxycodone plus acetaminophen for severe pain control following photorefractive keratectomy (PRK).
This single-center trial randomized 200 patients to receive codeine 30 mg/acetaminophen 325 mg (codeine group) or oxycodone 5 mg/acetaminophen 325 mg (oxycodone group)every 4 hours as needed for severe pain for 4 days following PRK. Patients recorded postoperative pain, tablet consumption, and tetracaine use. Patients were monitored at postoperative 1 day, 1 week, and 1, 3, and 6 months for visual acuity and follow-up. Study outcomes were mean postoperative pain, treatment and tetracaine use, and visual acuity.
Analysis of 197 patients who completed the trial (97 codeine group and 100 oxycodone group) showed mean pain scores were lower in the codeine group throughout the intervention period. Mean pain scores were higher in the oxycodone group than the codeine group on postoperative days 2 and 4 (
= .017 and
= .034, respectively). The oxy Schedule III opioid (codeine) is effective and potentially decreases the risk of misuse by a higher regulated Schedule II opioid (oxycodone), lowering the potential for abuse and dependence. [J Refract Surg. selleck inhibitor 2021;37(9)582-589.].
To examine the vault size after Implantable Collamer Lens (ICL) (KS-AquaPORT; STAAR Surgical) surgery using the KS formula.
In this prospective study, the postoperative vault was examined using the KS formula in 121 eyes of 65 patients (28 men and 37 women) who underwent ICL implantation for myopia and myopic astigmatism. The mean horizontal angle-to-angle (ATA), anterior chamber depth, and axial length before surgery were 11.83 ± 0.40, 3.25 ± 0.34, and 26.52 ± 1.17, respectively. Anterior segment optical coherence tomography (CASIA2; Tomey Corporation) was used for ATA measurement.
Multiple regression analysis of the potential factors influencing the predicted vault error (postoperative vault - predicted vault by KS formula) showed that only ICL size was a significant factor (
< .001,
= 0.36). At an ICL size of 12.1 mm, the postoperative vault was smaller than the predicted vault, and the postoperative vault tended to be larger than the predicted vault at ICL sizes of 13.2 and 13.7 mm.
Vault prediction by the KS formula was generally good, but the ICL size influenced the vault prediction error; therefore, a modified KS formula was created to reduce the error in measurements of the postoperative vault.
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Vault prediction by the KS formula was generally good, but the ICL size influenced the vault prediction error; therefore, a modified KS formula was created to reduce the error in measurements of the postoperative vault. [J Refract Surg. 2021;37(9)636-641.].
To assess the precision of a new spectral-domain optical coherence tomographer (SD-OCT)/Placido topographer (MS-39; CSO) and its comparison with a swept-source OCT (SS-OCT) biometer (Argos; Movu, Inc) in patients with cataract.
Fifty-three right eyes from 53 patients were examined by two experienced operators three times using both devices randomly. Employing the within-subject standard deviation (S
), test-retest variability, coefficient of variation, and intraclass correlation coefficient to evaluate intraoperator repeatability and interoperator reproducibility; the double-angle plots to analyze astigmatism; and Bland-Altman plots and 95% limits of agreement to verify the agreement between devices.
The SD-OCT/Placido tomographer showed high precision, with coefficient of variation of 0.44% or less, intraclass correlation coefficient of 0.945 or greater for all parameters, test-retest variability of 4.21 µm or less for central corneal thickness (CCT), 0.03 mm or less for anterior chamber depth (ACD) and aqueous depth (AQD), and 0.25 diopters (D) or less for mean keratometry (Km), J
, and J
. The inter-device differences in Km, J
, and J
were statistically insignificant, whereas the remaining were statistically but not clinically significant. The 95% limits of agreement of CCT, ACD, AQD, Km, J
, and J
were -3.70 to 15.25 µm, -0.06 to 0.04 mm, -0.06 to 0.04 mm, -0.28 to 0.35 D, -0.27 to 0.26 D, and -0.27 to 0.21 D, respectively. The double-angle plot confirmed the high agreement in astigmatism.
For CCT, ACD, AQD, Km, and astigmatism measurements in patients with cataract, the new SD-OCT/Placido tomographer has excellent precision and high agreement with the Argos SS-OCT biometer, and can be used interchangeably.
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For CCT, ACD, AQD, Km, and astigmatism measurements in patients with cataract, the new SD-OCT/Placido tomographer has excellent precision and high agreement with the Argos SS-OCT biometer, and can be used interchangeably. [J Refract Surg. 2021;37(9)616-622.].
To evaluate whether intraoperative aberrometry improves the accuracy of refractive outcomes after cataract surgery in highly myopic, highly hyperopic, and post-refractive eyes.
This single-center, retrospective review compared the spherical equivalent of postoperative refraction to that predicted by the Barrett Universal II formula versus Optiwave Refractive Analysis (ORA) (Alcon Laboratories, Inc) for highly myopic and hyperopic eyes and to the Barrett True K formula versus ORA for post-refractive eyes. The number and magnitude of lens changes were analyzed and used to determine in how many cases refractive surprises were affected by ORA, with additional subanalysis of outcomes based on average keratometry values.
ORA led to a change in the lens power implanted in 48% (96 of 198) of eyes, and prevented hyperopic surprise in 27% (15 of 55) and excess myopia in 46% (19 of 41). Steeper keratometry values correlated with more frequent changes on ORA-recommended implanted intraocular lens (
= .0031). ORA 7 mm. [J Refract Surg. 2021;37(9)609-615.].
To evaluate a new extended depth of focus intraocular lens (IOL), the xact Mono-EDOF ME4 (Santen Pharmaceuticals), Conformitè Europëenne-marked as a monofocal IOL, which has four diffractive rings intended to enhance intermediate vision.
Results are reported for 47 IOLs implanted in 28 patients who underwent cataract surgery and implantation of the xact Mono-EDOF ME4 IOL in one (9 patients) or both (19 patients) eyes. Postoperative follow-up examinations included visual acuity testing (monocular and binocular; uncorrected distance visual acuity [UDVA], corrected distance visual acuity [CDVA], uncorrected intermediate visual acuity [UIVA], distance-corrected intermediate visual acuity [DCIVA]), defocus curve and contrast sensitivity testing, and dysphotopsia evaluation.
Follow-up at 6 months postoperatively revealed a monocular UDVA of 0.08 ± 0.15 logMAR, binocular UDVA of -0.02 ± 0.09 logMAR, monocular CDVA of -0.07 ± 0.08 logMAR, binocular CDVA of -0.09 ± 0.09 logMAR, monocular UIVA (70 cm) of 0.18 ± 0.
