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At least 199 records · Page 11Linked to original sources
PubMedDate not supplied

Cost-effectiveness of the AMOArray multifocal intraocular lens in cataract surgery.

PURPOSE: To compare the cost and outcomes of bilateral cataract surgery with the foldable AMOArray multifocal intraocular lens (MIOL) versus the foldable monofocal intraocular lens from the health care payer perspective. METHODS: A cost-effectiveness analysis was used to evaluate treatment with the MIOL compared to monofocal lens, using data from clinical trials, literature, expert opinion, and a review of the German health care funding and reimbursement system. RESULTS: The average total direct medical cost per patient (per procedure) with the MIOL was DM 1,774 compared to DM 1,716 with the monofocal lens (1DM = US$0.558 in April 1998). The MIOL was more cost-effective than the monofocal lens in terms of cost per patient (spectacle-free). Cost per patient without overall limitation in vision-related function and cost per patient without limited night vision were similar for both patient groups. The incremental cost of the MIOL for a one-point increase was DM 52 in the self-rated score "quality of vision," DM 82 in "satisfaction with day vision," and DM 115 in "satisfaction with night vision." CONCLUSION: The small additional cost of the MIOL was outweighed by the increased satisfaction with vision experienced by MIOL patients.

Cataract Extraction↗
PubMed2006

Topography-guided CATz versus conventional LASIK for myopia with the NIDEK EC-5000: A bilateral eye study.

PURPOSE: To evaluate the difference in visual acuity, subjective night vision glare, and higher order aberrations in eyes with myopia with or without astigmatism operated with topography-guided customized corneal LASIK and conventional LASIK. METHODS: This contralateral study includes 46 eyes (23 patients) that underwent topography-guided corneal customized LASIK using the customized aspheric treatment zone (CATz) ablation profile in one eye and conventional LASIK using the NIDEK EC-5000 Advanced Vision Excimer laser system (NAVEX) in the other eye for myopia with or without astigmatism. Patients were masked to which eye underwent topography-guided CATz or conventional LASIK. Postoperative glare and root-mean-square (RMS) values for total higher order aberrations were measured at 1 and 3 months and compared between the two eyes. RESULTS: No significant difference was noted in uncorrected visual acuity between the two groups at 1 and 3 months postoperatively. Of all patients, 81% stated glare was higher in conventionally treated eyes than in the CATz-treated eyes at 1 and 3 months postoperatively. The RMS values for total coma (0.2385 vs 0.1522) and spherical aberration (0.2381 vs 0.1058) in conventionally treated and CATz-treated eyes were significantly higher in conventionally treated eyes (P=.029 and P=.004, respectively) at 3-month follow-up. CONCLUSIONS: Topography-guided corneal customized LASIK with the CATz profile gave better night vision quality as compared to conventional LASIK with expanded treatment zone. Better night vision quality was associated with less induced spherical aberrations and coma postoperatively in the CATz treatment group.

Adult↗
PubMed2003

Retinal image contrast and functional visual performance with aspheric, silicone, and acrylic intraocular lenses. Prospective evaluation.

PURPOSE: To compare the effects of an aspheric intraocular lens (IOL) (Tecnis Z-9000, Pharmacia Corp.) with those of conventional silicone (AA4207VF, Staar Surgical) and acrylic (AcrySof SA60AT, Alcon Surgical) lenses on retinal imaging and functional visual performance. SETTING: Eye Laser Center, Tucson, Arizona, USA. METHODS: In this prospective study, 221 eyes of 156 patients were randomly assigned to receive 1 of 3 IOLs. Visual acuity was measured preoperatively and 1 day, 1 and 3 weeks, and 1, 3, and 6 months postoperatively. Fundus photography and photopic and mesopic functional acuity contrast testing were performed preoperatively and 3 months postoperatively. RESULTS: The differences in the preoperative and postoperative spherical and astigmatic refractive errors and best corrected visual acuity among groups were not statistically significant. The postoperative uncorrected visual acuity was best in the aspheric group in the first month. Functional acuity contrast testing showed the aspheric IOL group had a 38% to 47% increase in photopic vision, 38% in photopic with glare, 43% to 100% in mesopic, and 9% to 100% in mesopic with glare. There was no increase in photopic vision in the acrylic group but increases of 38% in photopic with glare, 25% to 50% in mesopic, and 36% to 50% in mesopic with glare. The spherical silicone IOL group had no increase in contrast testing from preoperatively. Digital analysis of retinal imaging showed increased threshold luminance levels in the aspheric group (range 116 to 208 cd/m2) and a 4-fold increase in image contrast. CONCLUSIONS: All 3 IOLs led to improved visual acuity after cataract surgery. The aspheric IOL provided a significant improvement in retinal image contrast and visual performance measured by visual acuity and functional acuity contrast testing. This improvement was greatest in night vision and night vision with glare compared to the performance of conventional spherical silicone and acrylic IOLs.

Acrylates↗
PubMed1996

Effect of ablation profile on wound healing and visual performance 1 year after excimer laser photorefractive keratectomy.

BACKGROUND: Early photorefractive keratectomy ablations were of limited diameter and depth to maintain the integrity of the globe and to minimise postoperative haze. This study evaluated the effects of deeper, larger diameter wounds on refractive stability and corneal haze, and investigated the effects of ablation profile on wound healing and visual performance. METHODS: One hundred patients undergoing -3.00D and -6.00D corrections were randomised to receive 5 mm, 6 mm, or multizone treatments. The multizone treatment was 6 mm in diameter, but only the depth of the 5 mm treatment. Outcome was measured by Snellen visual acuity, residual refractive error, objective techniques for haze and halos, pupil diameter, subjective night vision, and requirement for retreatment. RESULTS: Overall, the results of 6 mm treatments were superior to those of 5 mm and multizone treatments: they had a smaller hyperopic shift (p < 0.01), a more predictable (p < 0.001) and stable refractive outcome, less haze (p < 0.05), smaller halos (p < 0.05), fewer subjective night vision problems, and fewer patients required retreatment. CONCLUSIONS: Analysis of these data and a literature review of corneal wound healing demonstrated that the improved outcome associated with the 6 mm beam did not relate to the depth of ablation. The factor with greatest apparent influence on the development of haze and regression was the slope of the wound surface over the entire area of the ablation. Tapering the wound edge provided no additional benefit, and contributed to night vision problems. It is, therefore, recommended that small diameter or multizone treatments should not be used in low and moderate myopia.

Adult↗
PubMed2000

Functional outcome and satisfaction after photorefractive keratectomy. Part 1: development and validation of a survey questionnaire.

OBJECTIVE: The aim of this study was to develop a valid, reliable, and easy-to-administer instrument to assess patient satisfaction and perceived outcome after bilateral excimer laser photorefractive keratectomy. DESIGN: Development and validation of a psychometric questionnaire. PARTICIPANTS: Consecutive patients who underwent bilateral excimer laser photorefractive keratectomy from May 1994 through May 1997 by 12 surgeons from four collaborating centers. To be eligible, a minimum of 4 months since the last surgery and a maximum of 30 months since the first surgery was required. METHODS: The new instrument was derived in part from the Prospective Evaluation of Radial Keratotomy (PERK) study 10-year psychometric questionnaire and the Visual Functional Index (VF-14), an index of functional impairment in patients with cataract. Questions were grouped in seven scales, each covering a specific aspect of quality of vision. These included global satisfaction, quality of uncorrected vision, quality of corrected vision, quality of night vision, glare, daytime driving, and night driving. MAIN OUTCOME MEASURES: Acceptability, reliability, validity, and interpretability of the instrument, as well as its ease of administration. RESULTS: The instrument scale structure was examined and scale scores were created. Item-discriminant validity ensured that questions belonged to their hypothesized scale, based on multitrait correlation analysis. The instrument was shown to be reliable by a high level of internal consistency, and all Cronbach's alpha coefficients were superior or equal to 0.83. Construct-related validity and interpretability were assessed based on correlations between scale scores and clinically recognized success criteria such as visual acuity and refraction. Respondent burden was shown to be minimal. Acceptability of the instrument was shown to be very good, with a participation rate of 74.3% (690 of 929 patients). The instrument is available in English and in French and the translation was shown to be reliable. CONCLUSIONS: The acceptability, reliability, and interpretability of the instrument, as well as its ease of administration, were shown to be adequate. This questionnaire appears clinically useful to document patient satisfaction after excimer laser photorefractive keratectomy.

Adolescent↗
PubMedDate not supplied

An informal satisfaction survey of 200 patients after laser in situ keratomileusis.

PURPOSE: Patient satisfaction following laser in situ keratomileusis (LASIK) is commonly reported as high. This paper reviews the outcome of LASIK both in terms of visual results and satisfaction. METHODS: Two-hundred patients were surveyed telephonically to establish their degree of satisfaction with LASIK and to enquire about postoperative use of glasses, and symptoms of light sensitivity and of night vision problems. Patient anonymity was assured. RESULTS: The majority of patients (95%) never wore distance glasses after LASIK. Reading glasses were used by 49 (24.5%), related to age and presbyopia. Light sensitivity was not a problem or was unchanged from baseline in 73% of patients; 27% said they were worse; a few (5.5%) said their symptoms were better. Night vision was not a problem or was unchanged from baseline in 76% of patients; 24% said they were worse; 17% said their symptoms were better. One hundred ninety-five patients (97.5%) were extremely happy with their results and 197 (98.5%) would have the procedure again. CONCLUSION: After LASIK, 95% of 200 patients wore no distance optical correction; 99% would have the procedure again; and light sensitivity and night vision problems bothered a significant number of patients.

Adolescent↗
PubMed1998

Effect of pupillary dilation on corneal optical aberrations after photorefractive keratectomy.

BACKGROUND: Complaints of glare, halos, and disturbances of night vision after photorefractive keratectomy (PRK) probably result from changes in the corneal aberration structure induced by the laser ablation procedure. The purpose of this article is to characterize changes in the corneal aberration structure after PRK and to demonstrate the effect of pupil dilation on these changes. METHODS: Videokeratographs obtained preoperatively (n = 112) and at 1 (n = 94), 3 (n = 103), 6 (n = 91), 12 (n = 60), 18 (n = 53), and 24 (n = 44) months postoperatively from 112 eyes of 89 patients who had undergone PRK for myopia were analyzed. The data were used to calculate the wavefront variance of the cornea for both small (3-mm) and large (7-mm) pupils. RESULTS: For both the 3- and 7-mm pupil, coma-like aberrations increased significantly from preoperative values to 1-month postoperative values (P < .05 and P < .001, respectively); for 7-mm pupils, the postoperative values never returned to preoperative values (P < .001, 24 months). For the 3-mm pupil, spherical-like aberrations decreased significantly 1 month after surgery (P < .001), and never returned to preoperative values. For the 7-mm pupil, spherical-like aberrations increased significantly 1 month after surgery (P < .001) and did not return to preoperative values. Opening the pupil from 3 to 7 mm increased spherical-like aberrations only 7-fold before PRK. After PRK, however, pupillary dilation caused a 300-fold increase in this type of aberration. For both pupil sizes at all times after PRK, the magnitude of the surgically induced aberration correlated with the amount of the attempted correction (P < .001, r2 = 0.6 at 1 month for a 7-mm pupil). CONCLUSIONS: Photorefractive keratectomy increases the wavefront variance of the cornea; PRK changes the relative contribution of coma-like and spherical-like aberrations; after PRK, the diameter of the entrance pupil greatly affects the amount and character of the aberrations; and the magnitude of the aberration increases with the attempted correction. CLINICAL RELEVANCE: Quantitative characterization of irregular astigmatism with the measurement of aberration structures following corneal surgery and the correlation of these data with visual performance in clinical trials provide the basis for understanding patient complaints and for improving surgical approaches. Our analysis shows that, whereas induced aberrations are minimal for simulated day-time vision (3-mm pupil), the increase in aberrations measured for simulated night vision (7-mm pupil) supports the use of large treatment zones to reduce visual disturbances such as glare and halos.

Adult↗
PubMed2001

Patient satisfaction after uneventful cataract surgery with implantation of a silicone or acrylic foldable intraocular lens. Comparative study.

PURPOSE: To compare patient satisfaction with vision 12 months after implantation of a silicone or acrylic foldable intraocular lens (IOL). SETTING: John A. Moran Eye Center, University of Utah Medical Center, Salt Lake City, Utah, USA. METHODS: Selection criteria included patients who had uneventful cataract extraction by phacoemulsification with a temporal clear corneal incision or superior scleral tunnel incision, a curvilinear capsulorhexis, and in-the-bag IOL placement. One hundred sixty-two patients surveyed had a mean follow-up of approximately 15 months (range 12 to 18 months). Patients were divided into 3 groups of 54 each based on IOL type: AMO SI-30/40, Alcon MA30BA, and Alcon MA60BA. All patients were surveyed over the telephone using a standardized questionnaire protocol. They were questioned about their perception of vision with best optical correction in relation to visual blurring symptoms, glare symptoms, night vision, near vision, and overall vision. RESULTS: There were no significant differences in patient satisfaction among the 3 IOL groups in visual blurring or night vision. Patients in the SI-30/40 and MA60BA groups reported significantly higher satisfaction with glare symptoms, near vision, and overall satisfaction than patients in the MA30BA group. CONCLUSION: The SI-30/SI-40 and the MA60BA IOLs received significantly higher patient satisfaction scores than the MA30BA IOL in glare symptoms, near vision, and overall satisfaction.

Acrylic Resins↗
PubMed2005

Evaluation of the Reading, PA nighttime safety belt enforcement campaign: September 2004.

PROBLEM: Safety belt use rates among front seat occupants of passenger vehicles are substantially lower at night than during the day despite the fact that night driving is more dangerous. METHOD: Recent advances in night vision equipment now make it possible to enforce belt use laws in darkness. Reading, Pennsylvania conducted a night belt use publicity and enforcement campaign during September 2004 using night vision equipment. RESULTS: Front seat occupant belt use at night increased significantly from 50% prior to the campaign to 56% just after the campaign. Daylight belt use also increased though to a lesser extent (56% to 59%). Survey data indicated that motorists had heard about the campaign in newspapers and on television. Belt use increases were not seen during the same time period in a comparison community.

Automobiles↗
PubMed1996

Preliminary results of photorefractive keratectomy in active-duty United States Navy personnel.

PURPOSE: To evaluate the safety, efficacy, and quality of vision after photorefractive keratectomy (PRK) in active-duty military personnel. METHODS: Photorefractive keratectomy (6.0-mm ablation zone) was performed on 30 navy/marine personnel(-2.00 to -5.50 diopters [D]; mean, -3.35 D). Glare disability was assessed with a patient questionnaire and measurements of intraocular light scatter and near contrast acuity with glare. RESULTS: At 1 year, all 30 patients had 20/20 or better uncorrected visual acuity with no loss of best-corrected vision. By cycloplegic refraction, 53% (16/30) of patients were within +/- 0.50 D of emmetropia and 87% (26/30) were within +/- 1.00 D. The refraction (mean +/- standard deviation) was +0.45 +/- 0.56 D (range, -1.00 to 1.63 D). Four patients (13%) had an overcorrection of more than 1 D. Glare testing in the early (1 month) postoperative period demonstrated increased intraocular light scatter (P<0.01) and reduced contrast acuity (with and without glare, (P<0.01). These glare measurements statistically returned to preoperative levels by 3 months (undilated) and 12 months (dilated) postoperatively. Two patients reported moderate to severe visual symptoms (glare, halo, night vision) worsened by PRK. One patient had a decrease in the quality of night vision severe enough to decline treatment in the fellow eye. Intraocular light scatter was increased significantly (>2S D) in this patient after the procedure. CONCLUSIONS: Photorefractive keratectomy reduced myopia and improved the uncorrected vision acuity of all patients in this study. Refinement of the ablation algorithm is needed to decrease the incidence of hyperopia. Glare disability appears to be a transient event after PRK. However, a prolonged reduction in the quality of vision at night was observed in one patient and requires further study.

Adult↗
PubMed2005

Identification of novel RPGR ORF15 mutations in X-linked progressive cone-rod dystrophy (XLCORD) families.

PURPOSE: To test the incidence of mutations in RPGR ORF15 in six families with X-linked progressive retinal degeneration (cone-rod dystrophy [XLCORD], macular or cone dystrophy) and to undertake a detailed phenotypic assessment of families in whom ORF15 mutations were identified. METHODS: To amplify and sequence ORF15 in its entirety, a cloning strategy was developed. Families with mutations in ORF15 underwent electrophysiological testing, color vision assessment, color fundus photography, and fundus autofluorescence (AF) imaging. RESULTS: Novel protein truncation mutations were identified in two families. In family A, a 2-bp mutation was identified in ORF15+A1094C G1095T, predicted to result in a truncated protein (E364D/E365X). In family B, a G-to-T transversion (ORF15+1176G>T) resulted in a nonsense mutation (G392X). Characteristics of phenotype in both families included progressive deterioration of central vision and subsequently night vision, mild photophobia, and moderate to high myopia. Ophthalmoscopic abnormalities were generally confined to the macula. A parafoveal ring of increased AF was observed, and electrophysiological evidence of a greater generalized abnormality in cone than rod responses were consistent with a cone-rod dystrophy phenotype. CONCLUSIONS: The cloning strategy for ORF15 facilitated comprehensive sequence analysis in patients. Two families were identified with nonsense mutations, and clinical evaluation revealed them both to have a similar phenotype. The presence of a parafoveal ring of increased AF was an early indicator of affected status in these families. No disease-causing mutations in ORF15 were detected in four other families, suggesting that ORF15 mutations may not be the most common cause of XLCORD.

Adult↗
PubMed2002

[A new study progress of molecular genetics in autosomal dominant retinitis pigmentosa].

Retinitis pigmentosa (RP) describes a genetically and clinically heterogeneous group of disorders that are characterized by gradual degeneration of photoreceptor cells. Common clinical features include a progressive loss of night vision,leading to night blindness and peripheral-visual-field loss. At least 12 loci have been mapped to chromosomes, and mutations in an ever increasing number of genes have been found to cause autosomal dominant retinitis pigmentosa (ADRP). Six of the 12 genes known to cause ADRP have been cloned. New progress has been made on the studies of structure, mutation and function of these genes.

English Abstract↗
PubMedDate not supplied

Discrimination between the origins and functional implications of haze and halo at night after photorefractive keratectomy.

A series of 84 eyes with up to -6.00 diopters (D) of myopia were treated by photorefractive keratectomy (PRK) using a 5.00 mm ablation zone. Three months postoperatively, 43 eyes (51%) complained of disturbed night vision, compared to 12 (14%) preoperatively. Ten (12%) had significant problems, ie, interference with driving at night. At 12 months, there were 32 patients (38%) with minor disturbances of night vision, 4 (5%) with significant problems.

Automobile Driving↗
PubMed2004

Spectral matching factors between Super S25 and New S25 photo cathodes and reflective radiation of objects.

According to the response of photoelectric device to a light source, the formula of spectral matching factor of photo cathode-object combination is deduced. The spectral matching factors of Super S25 and New S25 photo cathodes for green vegetation and rough concrete are calculated and compared. For Super S251, the spectral-matching factors for green vegetation and rough concrete are 0.707 and 0.743, respectively, under the full-moon radiation and are 0.504 and 0.577, respectively, under the clear-star radiation. For Super S252, the full-moon factors are 0.561 (green vegetation) and 0.732 (rough concrete), and those for clear-star radiation are 0.338 (green vegetation) and 0.471 (rough concrete). For New S25, the full-moon factors are 0.741 (green vegetation) and 0.762 (rough concrete), and those for clear-star radiation are 0.603 (green vegetation) and 0.657 (rough concrete). An analysis of results shows that the spectral-matching factor has influence on the performance of a low-light level night vision system and is essential for evaluating the visual range of a night-vision system.

Journal Article↗
PubMed1994

Visual acuity, color vision, and visual search performance at sea.

Visual acuity and color vision were tested during a search and rescue exercise at sea. Fifty-seven watchkeepers searched for orange and yellow life rafts during daylight and for lighted and unlighted life rafts at night with night vision goggles. There were 588 individual watches of one hour each. Measures of wind, waves, and weather were used as covariates. Daytime percentage detection was positively correlated with low-contrast visual acuity and negatively correlated with error scores on Dvorine pseudoisochromatic plates and the Farnsworth color test. Performance was better during the first half-hour of the watch. Efficiency calculations show that color vision selective screening at one standard deviation above the mean would increase daylight search performance by 10% and that one standard deviation visual acuity selection screening would increase performance by 12%. There was no relationship between either acuity or color vision and life raft detection using night vision goggles.

Color Perception↗
PubMed2001

Inhibition of the visual cycle in vivo by 13-cis retinoic acid protects from light damage and provides a mechanism for night blindness in isotretinoin therapy.

Isotretinoin (13-cis retinoic acid) is frequently prescribed for severe acne [Peck, G. L., Olsen, T. G., Yoder, F. W., Strauss, J. S., Downing, D. T., Pandya, M., Butkus, D. & Arnaud-Battandier, J. (1979) N. Engl. J. Med. 300, 329-333] but can impair night vision [Fraunfelder, F. T., LaBraico, J. M. & Meyer, S. M. (1985) Am. J. Ophthalmol. 100, 534-537] shortly after the beginning of therapy [Shulman, S. R. (1989) Am. J. Public Health 79, 1565-1568]. As rod photoreceptors are responsible for night vision, we administered isotretinoin to rats to learn whether night blindness resulted from rod cell death or from rod functional impairment. High-dose isotretinoin was given daily for 2 months and produced systemic toxicity, but this caused no histological loss of rod photoreceptors, and rod-driven electroretinogram amplitudes were normal after prolonged dark adaptation. Additional studies showed, however, that even a single dose of isotretinoin slowed the recovery of rod signaling after exposure to an intense bleaching light, and that rhodopsin regeneration was markedly slowed. When only a single dose was given, rod function recovered to normal within several days. Rods and cones both showed slow recovery from bleach after isotretinoin in rats and in mice. HPLC analysis of ocular retinoids after isotretinoin and an intense bleach showed decreased levels of rhodopsin chromophore, 11-cis retinal, and the accumulation of the biosynthetic intermediates, 11-cis and all-trans retinyl esters. Isotretinoin was also found to protect rat photoreceptors from light-induced damage, suggesting that strategies of altering retinoid cycling may have therapeutic implications for some forms of retinal and macular degeneration.

Animals↗