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At least 829 records · Page 46Linked to original sources
PubMed1999

Visual, refractive, and subjective outcomes after photorefractive keratectomy for myopia of 6 to 10 diopters using the Nidek laser.

PURPOSE: To analyze the results of photorefractive keratectomy (PRK) for myopia of 6.0 to 10.0 diopters (D) using the Nidek laser and compare them with those in other series, including LASIK, and to analyze the subjective aspects of vision. SETTING: Remuera Eye Clinic, Auckland, New Zealand. METHOD: One hundred ninety-two eyes of 162 consecutive PRK patients with a 6 month follow-up were studied. All had myopia in the range of 6.0 to 10.0 D by spherical equivalent. Astigmatism of up to 3.5 D was treated by laser simultaneously. At 6 months, uncorrected visual acuity, best spectacle-corrected visual acuity, residual refractive error, and corneal haze were recorded. After the 6 month examination, a questionnaire was sent to all patients. RESULTS: Uncorrected visual acuity of 20/20 was achieved in 59% of eyes and of 20/40 or better in 94%. The accuracy of correction was +/- 0.5 D of emmetropia in 77% and +/- 1.0 D in 94%. In 2 eyes (1.0%), corneal haze was assessed as 2+ and 2 Snellen lines of best corrected visual acuity were lost. The questionnaire revealed that 45% of patients had difficulties with night vision. This was better than before surgery in 35% but worse in 31%. Halos were seen around lights by 52%, but these were less than before surgery in 21% and worse in 26%. There was undue sensitivity to glare in 29%, but this was better than before surgery in 19% and worse in 28%. The overall quality of vision was better than before surgery in 60% and worse in 17%. Seventy-seven percent did not need spectacles. Ninety-eight percent said they would have the surgery again. CONCLUSIONS: As long as the patients are informed of the limitations of PRK for myopia, the results are acceptable.

Adolescent↗
PubMed1999

Photorefractive keratectomy for residual myopia after cataract surgery.

PURPOSE: To evaluate the effectiveness, predictability, and safety of photorefractive keratectomy (PRK) for correcting residual myopia and myopic astigmatism after cataract surgery with intraocular lens implantation. SETTING: Refractive Surgery and Cornea Unit, Instituto Oftalmológico de Alicante, Alicante, Spain. METHODS: Thirty consecutive eyes (30 patients) had PRK for residual myopia after cataract surgery. Surface PRK with a VISX Twenty-Twenty excimer laser was used in all patients. Follow-up was 1 year. RESULTS: Before PRK, no eye had an uncorrected visual acuity (UCVA) of 20/40 or better. Twelve months after PRK, 16 eyes (53.33%) had a UCVA of 20/40 or better. After PRK, best corrected visual acuity (BCVA) improved 1 line or more in 14 eyes (46.66%) over the preoperative values, and 15 eyes (50.00%) had the same BCVA as before PRK. Mean pre-PRK refraction of -5.00 diopters (D) +/- 2.50 (SD) decreased significantly to -0.25 +/- 0.50 D at 12 months (P < .001). At 12 months, the spherical equivalent was within +/- 1.00 D of emmetropia in 27 eyes (90.00%). No vision-threatening complications occurred. CONCLUSION: Photorefractive keratectomy was an effective, predictable, and safe procedure for correcting residual myopia and myopic astigmatism after cataract surgery.

Aged↗
PubMed1999

Phakic posterior chamber lens implantation in children with high myopia.

PURPOSE: To evaluate the anatomical and functional results after implantation of a phakic posterior chamber lens (implantable contact lens [ICL]) to correct high myopia with amblyopia in pediatric patients in whom conventional treatments had failed. SETTING: Department of Ophthalmology, Purpan Hospital, University of Toulouse, France. METHODS: An ICL was implanted in 5 eyes with amblyopic high myopia in 4 children aged 3 to 16 years. Mean preoperative spherical equivalent refraction was -12.8 diopters (D) (range -8.0 to -18.0 D) and best spectacle-corrected visual acuity (BSCVA) was counting fingers to 20/200. Mean follow-up was 11.8 months (range 4 to 21 months). RESULTS: Postoperatively, the ICLs appeared to be well tolerated, with no inflammatory reactions, stable intraocular pressure, and good positioning in all eyes. Predictability was +0.5 D (range -0.5 to +2.0 D) and BSCVA improved, with a gain of 3 or more Snellen lines with recovery of binocular vision in 2 cases and orthotropia in 3 patients. All parents reported an improvement in their children's quality of life. CONCLUSION: This preliminary study indicates that ICL implantation is a safe surgical procedure to correct amblyopia resulting from high myopia in children when conventional amblyopia treatments have failed. Longer follow-up of more patients is needed.

Adolescent↗
PubMed1998

Ocular haemodynamics in glaucoma associated with high myopia.

The ocular blood flow of a group of high myopic and glaucomatous eyes has been investigated by means of the Color Doppler Imaging (CDI) technique, comparing the results with those of some very myopic eyes without glaucoma, some non-myopic glaucomatous eyes and with a control group. The Ophthalmic Artery (OA), the Short Posterior Ciliary Arteries (SPCAs) and the Central Retinal Artery (CRA) were considered. For every vessel, peak systolic velocity (SV), end-diastolic velocity (DV) and the Pourcelot Resistivity Index were studied. The statistical analysis was performed by means of t-test according to Bonferroni procedure for multiple comparisons. The authors registered in the group of eyes with glaucoma associated with very severe myopia some abnormalities of the OA blood flow systolic velocity which might be interpreted as a vascular risk factor for the pathogenesis of the glaucomatous optic neuropathy; these abnormalities are more severe in glaucoma patients with high myopia than in an age-matched group of glaucoma patients without myopia.

Adult↗
PubMed2001

The natural history of juxtafoveal and subfoveal choroidal neovascularization in high myopia.

BACKGROUND: To assess the natural history of juxtafoveal and subfoveal choroidal neovascularization in eyes with high myopia. METHODS: We retrospectively reviewed the charts of 31 patients (31 eyes) with myopia > or = 6 diopters, well-defined juxtafoveal (1-200 microm from the foveal center) or subfoveal choroidal neovascularization (CNV) on fluorescein angiography at baseline, no prior laser treatment, age < or = 55 years and presenting visual acuity (VA) > or = 20/200. Initial and final VA were compared with the Wilcoxon signed rank test. Multifactor analysis of variance was used to assess the association between baseline characteristics of the lesion and final VA. RESULTS: Twenty-two patients were females and 9 males with a median age of 44 years (range 14-55). Median diopters spherical equivalent was -11.5 (range -6, -25). Follow-up ranged from 1 to 20 years (median, 3 years). Nine eyes had juxtafoveal CNV and 22 subfoveal involvement. Median final VA (20/100) was significantly worse than median initial VA (20/50)(p = 0.02). A decrease in VA > or = 2 lines occurred in 18 eyes, whereas 8 eyes remained stable and 5 improved (4 juxtafoveal membranes and 1 subfoveal membrane). Of the 9 juxtafoveal CNV, 7 had a final VA > or = 20/40 after a median follow-up of 4 years. By contrast, only 2 of the 22 subfoveal CNV had a final VA > or = 20/40 (median, 20/100) with a median follow-up of 2.5 years. The only factor associated with better final VA was the initial location of CNV (p = 0.0000). CONCLUSION: This study confirms the poor functional outcome of subfoveal CNV in degenerative myopia with more than 70% of patients having a final VA of 20/100 or less. Juxtafoveal CNV shows a better functional prognosis. These differences should be considered when planning treatment strategies.

Adolescent↗
PubMed1998

Excimer laser for various degrees of myopia. A new model estimating the immediate response, the regression, the final response and the time relationship.

PURPOSE: To demonstrate a unified model for various degrees of myopia, characterizing the response-time relationship and its influence of topical corticosteroids. METHODS: 84 eyes were treated with excimer laser for myopia (median -7.1 D). 50 eyes received topical NSAID for 4 days (group 1), and 34 eyes (group 2) were further treated postoperatively with bandage lens and topical corticosteroids for three months. The response-time relationship was expressed as P(t)=a+b*exp(k*t), where P(t) is the response expressed as the percent change in dioptric power to the postoperative time t, a is the final percent response, b is the total percent regression and k the time constant. a+b express the percent immediate response and T1/2=0.69/k denote the time within which half of the total regression has occurred. RESULTS: The immediate and final responses were significantly larger in group 2 (128.9% and 70.5%) compared with group 1 (110.5% and 59.8%). T1/2 was significantly longer in group 2 (2.1 month) compared with group 1 (0.8 month) CONCLUSION: Use of bandage lens together with steroids significantly influences the response-time relationship after excimer laser treatment for myopia.

Administration, Topical↗
PubMed2000

A DIDMOAD syndrome family with juvenile glaucoma and myopia findings.

We present here two DIDMOAD syndrome cases (Diabetes Mellitus, Diabetes Insipidus, Optic Atrophy, Deafness) in a Turkish family. In the examination of the propositus who had consanguineous parents, diabetes mellitus, diabetes insipidus, optic atrophy, and deafness were observed in addition to myopia, juvenile glaucoma, posterior polar cataract, and dilatation of the urinary tract. Diabetes mellitus, diabetes inspidus, optic atrophy, deafness, myopia, and ventricular septal defect were observed in his elder brother. Juvenile onset diabetes mellitus, congenital glaucoma, deafness, and heart disease were the other remarkable findings observed in relatives to this family. Juvenile glaucoma, posterior polar cataract observed in our propositus, and myopia in both our DIDMOAD syndrome cases are the first ophthalmic manifestations described in the DIDMOAD syndrome.

Adolescent↗
PubMed1998

Congenital-onset central chorioretinal dystrophy associated with high myopia.

We describe six siblings of a 12-member sibship affected with a macular dystrophy that is congenital in onset and is associated with progressive myopia. The age of these siblings ranged from 7 months to 19 years. The presenting feature was visual impairment and the best corrected visual acuity ranged between 1/60 and 6/36. Myopia ranged from -3.00 dioptres in the youngest to -10.50 dioptres in the second-eldest member. The macular lesions in our patients are characterised by a well-defined area of atrophy of choriocapillaris and retinal pigment epithelium. These lesions progressed with age in both size and depth. The extent of choroidal involvement in the lesions varied from only loss of superficial vasculature to sparing of large choroidal vessels as confirmed by fundus fluorescein angiography. One patient also exhibited bilateral Duane's syndrome (type III) and right unilateral ptosis. To the best of our knowledge such a fully established macular lesion presenting at the age of 6 months and associated with progressive myopia has never been described in literature.

Adolescent↗
PubMed2005

Photodynamic therapy with verteporfin for juxtafoveal choroidal neovascularization secondary to pathologic myopia-1-year results of a prospective series.

PURPOSE: To study the efficacy of photodynamic therapy (PDT) with verteporfin in the treatment of juxtafoveal choroidal neovascularization (CNV) secondary to pathologic myopia. METHODS: Prospective, open label, two-centre, noncomparative, interventional case series. Consecutive patients with juxtafoveal CNV associated with pathologic myopia were recruited and treated with a standard regimen of PDT with verteporfin. Patients were being followed up every 3-monthly and retreatment was considered when there was evidence of angiographic leakage. Outcome measures included changes in the mean best-corrected visual acuity (BCVA) at the 1-year follow-up when compared with the baseline, the proportion of patients who had stable (within 1 line) and improved visions. RESULTS: A total of 11 eyes from 11 patients with juxtafoveal CNV secondary to pathologic myopia were recruited and all completed the 1-year follow-up. The mean age at presentation was 44.8 years. The refractive error ranged from -6.0 to -15.0 D (+/-SD was -9.55+/-3.04 D). The logMAR BCVA improved from 0.57 to 0.39 at the 1-year follow-up (Wilcoxon signed-ranks test, P=0.027). The mean improvement was 1.8 lines. Five eyes (45.4%) had BCVA improved by >or=3 lines. None of the treated patients had visual loss of >or=1 line. The mean number of treatments over the 12-month study period was 2.3 sessions. CONCLUSIONS: The results are encouraging, especially on considering the low retreatment rate, stable or improved BCVA in all treated eyes, and consistently good safety profile. Juxtafoveal myopic CNV may be an expanded indication for PDT with verteporfin.

Adult↗
PubMed2005

Refractive lens exchange combined with pars plana vitrectomy to correct high myopia.

PURPOSE: To describe the results of refractive lens exchange (RLE) combined with simultaneous pars plana vitrectomy (PPV) in the management of severe myopia. METHODS: This retrospective study comprised 14 eyes of eight patients who had RLE to treat myopia of -19.0+/-5.4 diopters (D). Phacoemulsification, posterior chamber intraocular lens (IOL) implantation, and standard three-port vitrectomy were performed. Mean postoperative follow-up time was 30 months (range 12-49). RESULTS: The postoperative best-corrected visual acuity (BCVA) was 0.68+/-0.23 compared to 0.37+/-0.24 preoperatively. There was no postoperative decrease in visual acuity in any eye. Mean postoperative spherical equivalent was -0.7 D (+/-1.6). At 30 months mean follow-up time, the spherical equivalents of nine eyes (64.3%) were within +/-1 D of emmetropia. There was no significant change in astigmatism due to operative procedures. During the 30 months follow-up period three eyes (21.4%) required neodymium : yttrium-aluminium-garnet (Nd : YAG) capsulotomy for posterior capsule opacification. No retinal detachments or cases of cystoid macular oedema (CME) were observed during the follow-up. CONCLUSION: RLE was effective in correcting severe myopia. The simultaneously performed PPV may reduce the risk of postoperative retinal detachment. This was a pilot study, to draw definitive conclusions a prospective study has to be initiated.

Adult↗
PubMed1999

Oculomotor functions and late-onset myopia.

In order to elucidate the role of optical defocus in the development of late-onset myopia (LOM), we employed both theoretical and experimental approaches. In the theoretical study, which has been reported previously, we suggested a model in which an accommodative sensory operator was added to simulate the sensory part of the accommodation system. Results derived from the model showed that the sensory part might increase the system's threshold to the accommodative error (or defocus) signal. In this study, we measured the perceptual depth-of-focus and the system's threshold to the defocus signal for three refractive error groups: emmetropic (Emm), stable myopic (S.M.), and progressing myopic (P.M.). Results show that there are no significant differences in the perceptual depth-of-focus among the three groups. However, the defocus threshold values of the P.M. group are significantly higher than the values of the other two groups. This result in combination with our previous findings, leads us to suggest that individuals susceptible of developing myopia from sustained near-work have a specific oculomotor risk profile. Although we are still trying to determine the specific sequence of changes among dark-focus, AC/A ratio, the accommodative system's defocus threshold, and refractive error, we are convinced that the changes of oculomotor parameters underlie the type of myopia associated with near-work.

Accommodation, Ocular↗
PubMed2003

The effect of changing from glasses to soft contact lenses on myopia progression in adolescents.

At the end of a clinical trial of bifocals as myopia treatment, subjects were allowed to select any type of optical correction they wished and were asked to return in 1 year. This report gives results of that last examination with emphasis on how progression rates differed between those remaining in their original type of glasses compared with those who switched to soft contact lenses. We found that myopia progressed at an age-adjusted average rate of 0.74 D in 19 children who switched to soft contact lens wear compared with 0.25 D for 24 children remaining in glasses (p < 0.0001). Increased growth of the vitreous chamber appeared to account for much of this excess myopia progression, although the difference in that variable did not reach statistical significance (p = 0.101). We also noted a 0.203 D steepening in the corneal curvature in contact lens wearers compared with spectacle wearers whose corneas steepened very little (0.014 D, p = 0.007). Soft contact lens wear was also accompanied by a greater change in the near-point phoria which moved 4.5 prism dioptres in the exo direction compared with spectacle wearers who experienced only a 1.4 prism dioptre divergent shift (p = 0.048).

Adolescent↗
PubMed2003

Drug-induced bilateral transient myopia with the sulphonamide sulphasalazine.

Whereas there are numerous reported ocular side effects from systemic sulpha medication, most are rare and reversible, with myopia being the most common reaction observed. A case report is presented of sudden bilateral onset of -1.0 DS of myopia (from -3.0 to -4.0 DS) in a young adult female following the addition of a sulphonamide (sulphasalazine) to oral non-steroidal anti-inflammatory treatment (meloxicam) for rheumatoid arthritis. The myopia regressed to -3.50 DS after 2 weeks when all medication was withdrawn and stabilised at this level when subsequent treatment was resumed after 8 weeks with the non-steroidal anti-inflammatory drug celecoxib. The case indicates that account needs to be taken of the possibility that relatively modest myopic shifts encountered in young adult contact lens wearers may be associated with concomitant systemic medication.

Administration, Oral↗
PubMedDate not supplied

[Excimer laser subepithelial ablation (ELSA) or laser epithelial keratomileusis (LASEK) - a new kerato-refractive procedure for myopia. Surgical technique and first clinical results on 24 eyes and 3 months follow-up].

BACKGROUND: Laser epithelial keratomileusis (LASEK) is a new keratorefractive surgical procedure to treat myopia and possibly other refractive errors, which combines the advantages while eliminating the disadvantages of both PRK (pain, corneal haze) and LASIK (flap complications, interface complications). Our results with LASEK are very promising and because this technique is currently not very popular in Germany we here with introduce the surgical technique and our first clinical results. PATIENTS AND METHODS: We treated 24 eyes (18 patients) by LASEK. The preoperative myopia was between - 1.50 and - 6.00 D with an astigmatism less than 1.00 D. Surgery starts with an incision in the epithelium by using a special microtrephine. After the application of 20 % ethanol for 20 seconds a hinged epithelial flap is created and the laser ablation performed with a Keracor 117 excimer laser. Finally, the epithelial flap is repositioned and secured using a bandage contact lens and artificial tears for 3 days. RESULTS: In all eyes the creation of the epithelial flap and its repositioning presented no problems. None of the eyes showed any postoperative epithelial instability. However, one eye lost the contact lens and the epithelial flap during the first postoperative day. Postoperatively, none of the patients complained of significant pain; however, the contact lens caused some foreign body sensation. After 3 months all eyes were within +/- 1.0 D and 20/24 eyes (84 %) within +/- 0.50 D of emmetropia (spherical equivalent). None of the eyes showed significant haze. CONCLUSIONS: Although, the number of treated eyes is small and the postoperative follow-up is short LASEK seems to be an effective and safe procedure for the treatment of myopia.

Adult↗
PubMed1994

[2 years experience with the Excimer laser photorefractive keratectomy in myopia].

PATIENTS AND METHODS: Myopic PRK (Photorefractive Keratectomy) has been performed on 116 eyes (myopia of between -3.0 D and -25.5 D) in the eye clinic of Lucerne, since october 1990. 25 patients had both eyes treated, 7 eyes were retreated. RESULTS: Results are satisfactory for myopia of up to -10 D (-15 D); treatment of the higher myopia is problematic. CONCLUSION: Regression was the biggest problem in all patients, being the more pronounced the higher the ablation. Based on this experience recommendations for treatment are given.

Adult↗
PubMed1986

[Diminution of myopia following operation of macular hole-induced retinal detachment].

This paper presents an assessment of the diminution of myopia in 25 eyes after surgery according to the technique of G. P. Theodossiadis for retinal detachment due to a macular hole. The procedure consists in the stretching and fixation of a silicone sponge at the posterior pole and dispenses entirely with either cryocoagulation or light coagulation. The sponge is stretched and fixed to the sclera at both ends (12 and 6 o'clock), far from the posterior pole. The scleral protrusion thus obtained in the macular area leads to a considerable diminution of the high myopia usually present in such cases. The reduction of myopia is proportionate to the degree of protrusion of the scleral buckle, which in turn depends on the stretching of the sponge and on the amount of subretinal fluid released.

Humans↗
PubMed1985

[Myopia: causes and prevention].

Myopia is the most common disorder of visual function in many literate populations, affecting 70% of some specific groups. The causes may lie in genetic or environmental factors. This article discusses the arguments put forward to support of the biological and environmental theories of the cause of myopia. It is argued that the biological theory has never been proven empirically and that the evidence clearly points to the role of close-range work in the prevalence of myopia as a massdisease. Primary prevention is difficult in this situation and compensatory strategies (relaxation, eye exercises) are rather ineffective. Prevention strategies are discussed and a research program to evaluate their effectiveness and efficiency is proposed.

Accommodation, Ocular↗
PubMed2006

Form deprivation modulates retinal neurogenesis in primate experimental myopia.

Juvenile primates develop myopia when their visual experience is degraded by lid fusion. In response to this abnormal visual input, retinal neural networks cause an excessive growth of the postequatorial segment of the eye, but the mechanism underlying this axial elongation is unknown. After fusion of the lids in one eye of juvenile rhesus macaques and green monkeys, we combined cDNA subtractions, microarray profiling, and real-time PCR to compare gene expression in the retinas of the closed and open eyes. This molecular analysis showed up-regulation of a number of genes associated with cell division in the retina of the closed eye and differential expression of six genes localized to chromosomal loci linked to forms of human hereditary myopia. In addition, it substantiated a previous observation, based on immunocytochemistry, that synthesis of vasoactive intestinal polypeptide was increased upon lid fusion. Injection of 5-bromo-2'-deoxyuridine and immunocytochemistry showed that the primate retinal periphery harbors mitotically active neuroprogenitor cells that increase in number when the visual experience is altered by lid fusion. Furthermore, the number of dividing cells is highly correlated with axial elongation of the eye and the resulting myopic refractive error. Thus, the retina undergoes active growth during the postnatal development of the primate eye. This growth is modulated by the visual input and accelerates considerably when the eye develops axial myopia. Vasoactive intestinal polypeptide may be the molecule that stimulates retinal growth.

Animals↗