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At least 199 records · Page 11Linked to original sources

Clear lens extraction with intraocular lens implantation for hyperopia.

PURPOSE: To analyze the results of clear lens extraction (CLE) with posterior chamber intraocular lens (IOL) implantation to correct hyperopia. SETTING: Eye Research Center and Dr. Agarwal's Eye Hospital, Chennai, India. METHODS: This prospective study comprised 20 hyperopic eyes of 12 patients between 19 and 50 years who had CLE with posterior chamber IOL implantation. Five patients had peripheral iridectomy during CLE as the angles were occludable. RESULTS: The mean hyperopic spherical equivalent refraction was +6.66 diopters (D) +/- 2.17 (SD) (range +4.75 to +13.00 D). The IOL power was calculated using the Holladay 2 formula. The mean follow-up was 16.96 months (range 6 to 35 months). The mean postoperative uncorrected visual acuity was 0.45 +/- 0.25 (range 0.10 to 1.00), a mean improvement of 3 Snellen lines from preoperatively. The mean postoperative best corrected visual acuity (BCVA) was 0.63 +/- 0.30, a mean improvement of 1 Snellen line. Three patients gained 2 lines of BCVA and 2 patients, 1 line. One patient lost 1 line of BCVA. Seventy percent of patients were within +/-0.50 D of the intended refraction. CONCLUSION: The results indicate that CLE with posterior chamber IOL implantation is safe, predictable, and effective.

Adult↗

High-frequency ultrasound biomicroscopy of silicone posterior chamber phakic intraocular lens for hyperopia.

PURPOSE: To study the intraocular position and anatomic relationships of the PRL-III phakic refractive lens (PRL), a posterior chamber phakic intraocular lens (PCP IOL), in cases of hyperopia using ultrasound biomicroscopy (UBM). SETTING: Centro Oftalmológico Real Vision, Madrid, Spain, and Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Universidad Complutense, Madrid, Spain. METHODS: Eleven phakic hyperopic eyes of 6 patients who had PRL implantation were examined by UBM 1 month after surgery. The PRL position, PRL-crystalline lens peripheral distance, and central distance between the corneal endothelium and the PRL were measured. RESULTS: Eight eyes had both haptics on the zonule, 2 had 1 haptic in the sulcus and 1 on the zonule, and 1 had 1 haptic in the sulcus and the other in the ciliary body. The mean PCP IOL-crystalline lens peripheral distance in the minor axis was 239.7 microm +/- 179.4 (SD) and the mean PCP IOL-endothelium central distance, 2146.98 +/- 219.6 microm. Contact between the PCP IOL and crystalline lens was observed in 1 eye. CONCLUSIONS: In this study of hyperopic eyes, the PRL was located on the zonule in most cases. However, the location of the haptics in the sulcus and contact between the PCP IOL and the crystalline lens that occurred in some cases suggest further study of possible long-term complications is needed.

Adult↗

Comparison of LADARVision and Visx Star S3 laser in situ keratomileusis outcomes in myopia and hyperopia.

PURPOSE: To compare visual outcomes with 2 commonly used excimer lasers, the Autonomous LADARVision (LV) (Alcon Laboratories Inc.) and the Visx Star S3 (S3), in the performance of myopic and hyperopic astigmatic laser in situ keratomileusis (LASIK). SETTING: Zale Lipshy University Hospital Laser Center for Vision, University of Texas Southwestern Medical Center, Dallas, Texas, USA. METHODS: In this retrospective single-center 3-surgeon cohort comparison, 100 consecutive LV-treated myopic eyes with a mean manifest refraction spherical equivalent (MRSE) of -3.22 diopters (D) (range 0 to -6.00 D) (mean astigmatism 0.95 D [range 0 to 4.00 D]) were compared with 100 consecutive S3-treated eyes with a similar MRSE (mean MRSE -3.19 D; mean astigmatism 0.66 D [range 0 to 2.75 D]). Forty-one consecutive LV-treated hyperopic eyes with a mean MRSE of +2.59 D (range +1.00 to +6.00 D) (mean astigmatism 0.89 D [range 0 to 3.50 D]) were compared with 25 consecutive S3-treated eyes with a similar MRSE (mean MRSE +2.70 D; mean astigmatism 0.87 D [range 0 to 2.75 D]). The following outcomes were compared: uncorrected visual acuity, refractive predictability and stability, gain or loss of best spectacle-corrected visual acuity, and need for enhancement. RESULTS: Statistically significant differences in outcomes were found between lasers in the treatment of hyperopia and hyperopic astigmatism. No outcome differences between lasers were found in the treatment of myopia and myopic astigmatism. CONCLUSION: The LV and S3 lasers yielded equivalent results in myopic LASIK between 0 and -6.00 D; however, the LADARVision yielded statistically significantly better results in hyperopic LASIK between +1.00 and +6.00 D.

Adult↗

Clinical evaluation of hexagonal keratotomy for the treatment of primary hyperopia.

We evaluated the effectiveness of spiral hexagonal keratotomy in correcting primary hyperopia in 199 eyes. One hundred eighty-four eyes (92.5%) had a minimum follow-up of three months. Mean follow-up was 11.9 months and maximum, 36.2 months. Secondary astigmatic keratotomy was performed on 54 eyes six to eight months after initial hexagonal surgery to correct induced astigmatism. The mean reduction in spherical equivalent was -1.6 +/- 0.9 diopters (D) (range -5.6 to +0.9 D). The mean increase in refractive cylinder was +0.5 +/- 0.9 D (range -2.3 to +3.0 D). Uncorrected acuity improved by +3.2 lines, while best corrected acuity decreased slightly by -0.26 lines. Loss of two or more lines of best corrected acuity that was attributable to surgery was between 0.5% and 4.0%.

Adult↗

Epikeratophakia for the treatment of hyperopia.

Nordan epikeratophakia technique (NET) is described for the treatment of hyperopia and the results in eight eyes are reported (mean = +5.09 +/- 0.85 diopters preoperatively and -2.09 +/- 1.22 diopters postoperatively). The Nordan epikeratophakia technique is a modification of Kaufman-McDonald epikeratophakia with advantages that are described. Data are analyzed according to traditional means in addition to newer indices that consider both the uncorrected visual acuity and the refractive error.

Adult↗

Corneal topographic changes after noncontact holmium:YAG laser thermal keratoplasty to correct hyperopia.

PURPOSE: To analyze the changes in corneal curvature induced by laser thermal keratoplasty (LTK) to correct hyperopia. SETTING: Cullen Eye Institute, Baylor College of Medicine, Houston, Texas. METHODS: We performed LTK on nine hyperopic eyes using a noncontact holmium: YAG (Ho:YAG) laser. Five eyes received a single ring of eight spots at the 6 mm zone (Group A); four received a second ring of eight at the 7mm zone (Group B). Computerized videokeratography (CVK) was obtained preoperatively and 1, 30, 90, 180, and 360 days postoperatively. We calculated the net dioptric changes in the following CVK values: corneal curvature at the 1, 3, 5, and 7 mm zones; effective corneal refractive power (Eff RP); and spherical equivalent of subjective manifest refraction (SE SMR). We classified difference maps according to the pattern of induced change. RESULTS: At 1 year, steepening at the 1, 3, 5, and 7 mm CVK zones was 0.5 diopter (D), 0.6 D, 0.1 D, and -0.42 D, respectively, in Group A and 1.5 D, 1.5 D, 1.1 D, and 0.54 D, respectively, in Group B. Effective corneal refractive power increased 0.6 D in Group A and 1.5 D in Group B. Mean change in SE SMR was -0.6 D in Group A and -1.4 D in Group B. Most regression occurred during the first 90 days. Difference maps showed five bow-tie, two irregularly irregular, one semicircular, and one homogeneous patterns. CONCLUSIONS: Noncontact Ho:YAG LTK produced peripheral corneal flattening and central corneal steepening. A greater change in curvature was produced using a two-ring treatment.

Adult↗

Excimer laser photorefractive keratectomy for hyperopia.

PURPOSE: To achieve less variation in the refractive outcome of hyperopic photorefractive keratectomy (PRK) by enlarging the treatment zone to 9.0 mm. SETTING: Marienhospital, Amberg, Germany, and Klinika Ocni A Esteticke Chirurgie, Zlin, Czech Republic. METHODS: This prospective clinical study was based on the results of PRK in 68 hyperopic eyes (62 patients) using an MEL 60 excimer laser. Mean attempted correction was +4.85 diopters (D) +/- 1.45 (SD) (range +2.00 to +8.25 D). Maximum follow-up was 12 months (68 eyes). RESULTS: One year after PRK, 55 eyes (81%) were within 1.00 D and 40 eyes (59%) were within 0.50 D of the intended correction (predictability). Best corrected visual acuity was unchanged or improved in 62 eyes (92%) (safety). Four eyes (6%) lost one line, 1 eye (1%), two lines, and 1 eye (1%), three lines. Sixty-six eyes (97%) had an uncorrected visual acuity of 20/40 or better (efficacy) and 27 (40%), 20/20 or better. CONCLUSION: Photorefractive keratectomy with a 9.0 mm treatment zone was an efficient and relatively safe procedure for correcting hyperopia of up to 8.25 D. The predictability was good. Great care must be taken to improve the centration of the optical zone.

Adult↗

Noncontact holmium:YAG laser thermal keratoplasty for hyperopia.

PURPOSE: To describe our experience with noncontact holmium:YAG laser thermal keratoplasty (Ho:YAG LTK). SETTING: Refractive Surgery and Cornea Department, Clinica de Ojos Dr. Nano, Buenos Aires, Argentina. METHODS: In this retrospective study, 182 hyperopic eyes from 116 patients were treated with noncontact Ho:YAG LTK. Mean age was 50 years +/- 7 (SD), and the spherical equivalent (SE) of the subjective mean refraction (SMR) was +2.50 +/- 0.87 diopters (D). Eyes with corneal power of more than 45 D, corneal pachymetry thicker than 550 microns, and previous corneal surgery or disease were excluded. Holmium:YAG laser parameters include one to three rings of eight spots arranged in a radial and symmetrical array. Pulse energy was 240 mJ, with five pulses per spot. Patients were followed for 12 months. RESULTS: The mean uncorrected visual acuity from 3 to 12 months was 20/40 (20/200 to 20/25), improving an average of three Snellen lines. Mean best spectacle-corrected visual acuity was 20/25 at all postoperative examinations, the same as preoperatively. Mean SE of the SMR was +1.50 +/- 0.98 D (range -0.75 to +4.50 D) at 6 months and +1.25 +/- 0.96 D (+0.25 to +3.25 D) at 1 year. After 9 months, 17% of operated eyes were retreated. CONCLUSION: In this study, Ho:YAG LTK was safe and effective, provided satisfactory correction of low hyperopia, and had a low complication rate. Good patient selection is the key to obtaining good results.

Adult↗

Staar Collamer posterior chamber phakic intraocular lens to correct myopia and hyperopia.

PURPOSE: To evaluate the efficacy, safety, stability, and predictability of implanting a collagen polymer (Staar Collamer), posterior chamber phakic intraocular lens (IOL) to correct myopia and hyperopia. SETTING: Centre for Advanced Refractive Eye Surgery at the BMI Alexandra Hospital, Cheadle, Manchester, United Kingdom. METHODS: A Staar Collamer posterior chamber phakic IOL was implanted in 25 eyes of 14 patients with a mean age of 37.9 years (range 20 to 50 years). Seven patients were men and seven, women. Sixteen were myopic and 9, hyperopic. Before treatment, each patient had a thorough evaluation including refractive, general, ocular, and social and personal histories. The examination included visual acuity, refraction, tonometry, topography, biometry, biomicroscopy, pupil size in dim illumination, and posterior segment evaluation by a vitreoretinal specialist. Patients were informed about the surgical process and expected outcome, their own expectations were discussed, and their consent to surgery was obtained. Surgical implantation was performed through a less than 3.0 mm clear corneal sutureless incision using brief general anesthesia on a day-case surgical basis. RESULTS: At 3 months postoperatively, all eyes had a significant increase in uncorrected visual acuity, allowing all but two patients (three eyes) to manage most activities without spectacles. Adjustment by incisional corneal surgery was planned for undercorrected myopic eyes (n = 3). Pupil block glaucoma and pigment deposits occurred in one patient each. CONCLUSION: In this short-term study, the posterior chamber phakic IOL was predictable, safe, and efficacious in the correction of myopic and hyperopic refractive errors, with good refractive stability. Long-term follow-up is required to validate that the absence of significant complications in most patients is a lasting phenomenon.

Adult↗

Excimer laser assisted in situ keratomileusis for hyperopia.

PURPOSE: To evaluate hyperopic surgical correction with 6.0 mm optical zone hyperopic laser in situ keratomileusis (LASIK) after various refractive procedures. SETTING: Buzard Eye Institute, Las Vegas, Nevada, USA. METHODS: This study followed 14 eyes of 14 patients who had hyperopic LASIK with a VISX Star laser. Mean follow-up was 8 months. The patients represented a variety of preoperative situations, including primary radial keratotomy (RK) (5 eyes) primary automated lamellar keratectomy (ALK) (2 eyes), primary LASIK (3 eyes), congenital hyperopia (1 eye), and combinations of ALK, RK, and LASIK. In all patients, a toroidal or "doughnut-shaped" ablation was constructed with the use of a 3.5 mm diameter soft contact lens as a blocking agent centrally with a 6.0 mm outside beam diameter. RESULTS: Mean preoperative spherical equivalent was +1.33 diopters (D) +/- 0.5 (SD) (range +0.50 to +1.88 D). The mean spherical equivalent was -0.32 +/- 1.20 D (range -1.25 to +2.63 D) at 1 month postoperatively and -0.15 +/- 0.60 D (range -1.13 to +1.25 D) at the last follow-up. Uncorrected visual acuity of 20/40 was obtained by 13 eyes (93%). No eye lost 2 or more lines of best corrected visual acuity at last follow-up. Four eyes required a postoperative LASIK enhancement procedure to correct induced myopia. No significant complications were seen. CONCLUSION: Hyperopic LASIK with the technique used in this study appeared safe, predictable, and stable. It represents a simple way to add hyperopic correction to existing laser systems.

Adult↗

Contact lens, hyperopia and endothelial changes. A case report.

INTRODUCTION: We report on a 62-year-old healthy woman who suffered from bilateral predescemetic opacities, where the underlying disorder could not be identified. She had bilateral keratopathy with corneal edema, a diffuse predescemetic avascular haze and deszemetic folds. Because of high hyperopia (right +7.50/left +7.75) she weared soft contact lenses for years. METHODS: Removal of contact lenses. Treatment with local steroids and tear substitutes. RESULTS: One year after cessation of contact lenses VA recovered from RE 0.3/LE 0.1 to 0.8/0.63, the deep stromal opacity cleared up, the corneal edema recessed slightly. DISCUSSION: The differential diagnosis concludes either a pure contact lens change that is not completely reversible or a possible posterior polymorphous dystrophy that worsens with long-term contact lens wear and improves on cessation.

Contact Lenses, Hydrophilic↗

Acquired hyperopia with choroidal folds.

Acquired hyperopia with choroidal folds is an uncommon but well recognized condition that is often benign and classically shows flattening of the posterior pole of the affected eye, variable enlargement of the optic nerve complex, and a space between the optic nerve and its sheath. A case is presented that shows the perineural space is best seen on magnetic resonance imaging. Lumbar puncture to exclude increased intracranial pressure should be performed even in the absence of papilloedema.

Choroid Diseases↗

Autosomal dominant stapes ankylosis with broad thumbs and toes, hyperopia, and skeletal anomalies is caused by heterozygous nonsense and frameshift mutations in NOG, the gene encoding noggin.

Although fixation of the stapes is usually progressive and secondary to otosclerosis, it may present congenitally, with other skeletal manifestations, as an autosomal dominant syndrome-such as proximal symphalangism (SYM1) or multiple-synostoses syndrome (SYNS1), both of which are caused by mutations in NOG, the gene encoding noggin. We describe a family that was ascertained to have nonsyndromic otosclerosis but was subsequently found to have a congenital stapes ankylosis syndrome that included hyperopia, a hemicylindrical nose, broad thumbs and great toes, and other minor skeletal anomalies but lacked symphalangism. A heterozygous nonsense NOG mutation-c.328C-->T (Q110X), predicted to truncate the latter half of the protein-was identified, and a heterozygous insertion in NOG-c.252-253insC, in which the frameshift is predicted to result in 96 novel amino acids before premature truncation-was identified in a previously described second family with a similar phenotype. In contrast to most NOG mutations that have been reported in kindreds with SYM1 and SYNS1, the mutations observed in these families with stapes ankylosis without symphalangism are predicted to disrupt the cysteine-rich C-terminal domain. These clinical and molecular findings suggest that (1) a broader range of conductive hearing-loss phenotypes are associated with NOG mutations than had previously been recognized, (2) patients with sporadic or familial nonsyndromic otosclerosis should be evaluated for mild features of this syndrome, and (3) NOG alterations should be considered in conductive hearing loss with subtle clinical and skeletal features, even in the absence of symphalangism.

Abnormalities, Multiple↗

Intraocular lens power calculation after laser in situ keratomileusis for myopia and hyperopia: a standardized approach.

PURPOSE: (1) To determine the effect of myopic and hyperopic laser in situ keratomileusis (LASIK) on calculation of intraocular lens (IOL) power. (2) To determine a standard way to approach the IOL power determination after LASIK, and (3) To compare different suggested methods. METHODS: Biometric analysis and theoretical calculation of IOL powers for eyes undergoing LASIK for myopia and hyperopia were performed. RESULTS: Manual keratometry after LASIK for myopia resulted in underestimation of IOL power. Manual keratometry after hyperopic LASIK resulted in overestimation of IOL power. The amount of error was directly related to the amount of correction by LASIK. CONCLUSION: The pre-LASIK refraction can be used theoretically to determine an accurate IOL power.

Cataract Extraction↗

Topography-based screening for previous laser in situ keratomileusis to correct myopia and hyperopia.

PURPOSE: To develop a screening tool based on corneal topography to detect previous myopic and hyperopic laser in situ keratomileusis (LASIK). METHODS: Clinical data from three private clinics were analyzed in a university setting. A total of 476 topographies (Orbscan II) were randomly selected (1 topography per patient): 338 from unoperated corneas, 81 from corneas that had LASIK to correct myopia, and 57 from corneas that had LASIK to correct hyperopia. The LASIK procedures were performed using a Technolas excimer laser (217C or 217Z) and a Hansatome microkeratome. The first set of algorithms (VESm and VESh) calculated the volume summation between the anterior corneal surface and the best-fit sphere in the central and mid-peripheral regions. The second set of algorithms (DCm and DCh) calculated the mean anterior tangential curvature difference between the central and mid-peripheral regions. RESULTS: The features VESm and DCm for the screening of a myopic LASIK yield, respectively, sensitivity rates of 92.7% and 95.1% and specificity rates of 94.9% and 96.5%. The features VESh and DCh for the screening of a hyperopic LASIK gave sensitivity rates of 93.1% for both and specificity rates of 94.8% and 97.1%. The performance of those features was superior to clinical assessment using topography color maps. CONCLUSIONS: Criteria based on Orbscan II corneal topography are proposed for the detection of previous hyperopic and myopic LASIK performed with a Technolas excimer laser (version 217C or 217Z).

Adolescent↗

Extended-wear, soft, contact lenses produce hyperopia in young monkeys.

To investigate the effects of experimentally induced defocus on eye growth and refractive development, one eye of four infant rhesus monkeys was fit with either a +3.0 D (N = 2) or -3.0 D (N = 2) extended-wear, soft, contact lens, and the other eye was fit with a zero-powered, control lens. The lens rearing regimen was started between 12 and 22 days of age and continued for 24 to 64 days. Hyperopic shifts in refractive error were found in all eyes, including the eyes treated with plano lenses. In addition to these absolute hyperopic shifts, 1.5 to 3.25 D of axial anisometropia were produced in all four monkeys, with the eyes wearing the powered lenses becoming relatively more hyperopic than the control eyes wearing the plano lenses. The induced hyperopia and anisometropia decreased rapidly after lens removal. The reapplication of the lenses at later ages in two animals produced smaller, but similar, changes. It appears that in very young primates extended-wear, soft, contact lenses can alter eye growth and refractive development through both visual and nonvisual mechanisms.

Aging↗

The autosomal dominant syndrome with congenital stapes ankylosis, broad thumbs and hyperopia.

A family is reported with conductive hearing loss, hyperopia, broad thumbs and broad first toes. The family resembles a previous reported family (Teunissen B, Cremers CWRJ (1990) Laryngoscope 100: 380-384) but additionally all affected members have a typical face. Overlap of the Teunissen and Cremers syndrome with the facio-audio-symphalangism syndrome and proximal symphalangism is discussed.

Abnormalities, Multiple↗