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PubMed1998

Ocular problems of young adults in rural Nigeria.

OBJECTIVES: To determine the common eye diseases as well as the prevalence and causes of blindness and visual impairment in young adult residents of rural areas of Anambra State, Nigeria. MATERIALS AND METHODS: Three rural villages in Anambra State, Nigeria were selected by simple random sampling. A structured questionnaire on demographic characteristics, symptoms and attitude to eye diseases was administered to residents aged 18-49 years. Ocular examination included visual acuity estimation, colour vision test, tonometry, refraction and ophthalmoscopy. Skin-snip was examined for microfilaria. RESULTS: The common ocular problems in the 510 young adults examined were presbyopia (33.3%), refractive errors (41.1%), allergic conjunctivitis (8.2%), pterygium (8.2%), pingueculum (5.9%) and colour vision defect (2.4%). Bilateral blindness occurred in 1.2%, uniocular blindness in 0.8% and 1.7% had visual impairment in their better eyes. Glaucoma and sequelae of congenital cataract caused bilateral blindness while visual impairment was due to refractive errors, cataract, corneal opacities and uveitis. Trauma predisposed to uniocular blindness and visual impairment. CONCLUSIONS: Eyeglasses alone would alleviate visual impairment and ensure good near vision in more than 47% of the subjects. The prevalence of blindness could be reduced through early detection of glaucoma, congenital cataract and ocular trauma.

Adult↗
PubMed1995

Fine matrix mapping of the macular region in normal subjects.

Using a Humphrey field analyzer and fine matrix mapping, we measured photopic and scotopic thresholds for a blue light stimulus at 100 locations on a 9 degrees by 9 degrees matrix of 1 degree spacing centered at the fovea in 14 normal subjects. Additionally, trial lenses were used to investigate the effect of refractive error. Under photopic conditions the mean sensitivity varied by less than 1 dB over this region. Under scotopic conditions the central values were reduced in sensitivity by 15 dB compared with those at 4 degrees eccentricity. Defocus showed less than 1.2 dB loss with 1.00D of refractive error under photopic condition. The results reflect the properties of rod and cone photoreceptors and the effects of the rod mosaic near the fovea. This technique is a sensitive test of macular visual function.

Adult↗
PubMed2000

Efficacy of removal of buckle after scleral buckling surgery for retinopathy of prematurity.

UNLABELLED: BACKGROUND OR PURPOSE: A series of encouraging reports over the past decade indicate that scleral buckling (SB) surgery may lessen or eliminate vitreoretinal traction in advanced retinopathy of prematurity (ROP). The effects of SB surgery on refraction and ocular growth, however, have not been demonstrated. We investigated the effects of postoperative removal of buckle in infants whose retinas were reattached in stage 4 ROP. METHODS: Selected for study were 6 eyes of 3 patients whose retinas had been reattached by placing an encircling buckle, 2.5 mm in width, around the eye and whose buckles were subsequently removed. Axial lengths and refractive errors were compared before and after removal of the buckles. The patients were examined for at least 3 years after removal. RESULTS: There was high myopia in all eyes treated for stage 4 ROP with SB. All retinas remained attached after removal of the buckle. Although there was a variable degree of increase in axial length, myopic refractive error tended to decrease after removal of the buckle. CONCLUSIONS: There was some decrease in degree of myopia without resulting in retinal detachment or continued vitreous traction after buckle removal following SB surgery for ROP.

Device Removal↗
PubMed2001

The visual profile of Romanian children and adults assessed through vision screenings.

BACKGROUND: The purpose of this study was to databank epidemiological information from Romanian children and adults. METHODS: A vision screening was performed on 690 children (2 to 18 years of age) and 190 adults (19 to 77 years of age). Prevalence of refractive errors, binocularity, and ocular health problems were recorded and evaluated. RESULTS: Data from the childrens' population showed that 45% were emmetropic, 27% were myopic, and 28% were hyperopic. For the adults, 42% were emmetropic, 16% were myopic, and 42% were hyperopic. When compared with other nations, the average refractive error of the Romanian children was more myopic, and for the adults it was slightly more hyperopic. With-the-rule astigmatism had the highest occurrence when compared to other axis orientations, yet the overall occurrence of astigmatism was less than that found in other nations for both children and adults. The prevalence of strabismus and ocular disease was less in the Romanian children in relation to other nations. CONCLUSION: Due to many years of isolation from the Free World, little information has been available on nations such as Romania relative to the health status of its people. This study begins an epidemiological base forthe nation. It is especially important to public health officials in planning health policy measures, and provides a basis for additional U.S.-based outreach missions to such nations in Europe. It also illustrates the efficacy of using a basic screening-type examination to determine vision care needs and the use of recycled eyewear to satisfy these needs.

Adolescent↗
PubMed2003

Myopic astigmatism and presbyopia trial.

PURPOSE: No prospective double-masked study has evaluated whether low astigmatism benefits or harms patients with presbyopia, whose intermediate and near vision might theoretically benefit from enhanced depth of focus provided by astigmatism. The purpose of the first Myopic Astigmatism and Presbyopia (MAP I) study was to determine whether low myopic astigmatism enhances or harms the visual acuity, stereopsis, or quality of life in patients with presbyopia. DESIGN: Prospective, randomized, double-masked, crossover design clinical trial. METHODS: Fifteen patients with presbyopia aged 45 to 68 years were recruited from an academic center population. These patients were given a baseline eye examination, including manifest refraction, Early Treatment of Diabetic Retinopathy Study (ETDRS) logarithm of minimal angle of resolution (logMAR) visual acuity at distance, intermediate, and near, accommodative amplitudes, and stereo vision. Each patient was then cycled in random order through three masked pairs of soft contact lenses. The power of each contact lens pair was calculated by the subtraction method to maintain a spherical equivalent of -0.5 diopters, while providing either no astigmatism (spherical arm, SPH), 1 diopter of with-the-rule (WTR) astigmatism, or 1 diopter of against-the-rule (ATR) astigmatism. Actual refractive errors produced were measured by masked examiner. Outcomes measured at the end of 1 week of usage of each contact lens arm were binocular (ETDRS) logMAR visual acuity at three distances (far [4 m], intermediate [1 m], and near [33cm]); near stereoacuity, using the quantitative Titmus Stereotest; and quality of life, measured using the Refractive Status and Vision Profile (RSVP), a standardized questionnaire. RESULTS: Visual acuity results across the three arms were similar. However, 1-m logMAR visual acuity was better for the spherical arm than either astigmatic arm (-0.06 SPH, +0.01 WTR, +0.02 ATR). Near (33 cm) and distance (4 m) acuities were similar across arms. Stereoacuity was better in ATR than WTR (50 vs 102 seconds, P =.01). Subjects preferred SPH slightly over the WTR astigmatic arm by the RSVP quality-of-life survey instrument (101 vs 104, P =.05). Other intergroup comparisons showed no difference in RSVP scores. CONCLUSIONS: This study has demonstrated that intermediate distance acuity and refractive quality of life are slightly better with spherical low myopic refractive error vs either astigmatic arm. Near and far distance acuity were unaffected by low myopic astigmatism compared with spherical low myopia. Near stereopsis was best in the ATR arms, but this did not produce better near visual acuity or RSVP quality of life.

Aged↗
PubMed1979

Myelinated retinal nerve fibers associated with ipsilateral myopia, amblyopia, and strabismus.

Four patients had extensive unilateral myelinated nerve fibers associated with ipsilateral myopia, amblyopia, and strabismus. Their profound visual impairment, exotropia, and the early age onset of symptoms indicated that the amblyopia may have been organically caused. Prognosis is poor for even partial correction but good results have been obtained with intense therapy that includes full correction of the refractive error in each eye and extraocular muscle surgery if cosmetically necessary. In patients with axial myopia, images of a similar size will be produced by placing a lens of the correct power at the spectacle plane. In younger patients, a contact lens should not be used to correct the refractive error because it creates an undesirable anisometropia. Younger patients who have parafoveal fixation and no strabismus respond best to amblyopia therapy.

Adolescent↗
PubMed2006

Peripapillary atrophy in elderly Chinese in rural and urban Beijing.

PURPOSE: To determine peripapillary atrophy in elderly Chinese in an urban and rural regions of Beijing. METHODS: The Beijing Eye Study a population-based, cross-sectional cohort study, included 4,439 subjects out of 5,324 subjects who were asked to participate (response rate 83.4%). Mean age was 56.2+/-10.6 years (range, 40-101 years). Colour optic disc photographs (30 degrees ) were morphometrically examined. Peripapillary atrophy was divided into alpha zone and beta zone. RESULTS: Optic disc photographs were available for 4,027 (90.7%) subjects. Alpha zone and beta zone, respectively, were present in 2,867 (71.2%) subjects and 802 (19.9%) subjects, respectively, measuring 0.52+/-0.64 mm(2) and measuring 0.46+/-1.82 mm(2). Both zones were significantly widest and found significantly (P<0.001) most often in the temporal peripapillary region, followed by the temporal inferior region, the temporal superior region, and finally the nasal region. Size of both zones was significantly correlated with optic disc size (P<0.001), age (P<0.001), and myopic refractive error (P<0.001). Both zones increased significantly with decreasing uncorrected visual acuity (P<0.001) and decreasing best-corrected visual acuity (P<0.001). They did not vary significantly (P=0.10; and P=0.78) between male and female subjects. In multivariate analysis, the relationships between both zones and age, myopic refractive error, disc size, and uncorrected and best-corrected visual acuity remained statistically significant (P<0.001). CONCLUSIONS: Alpha zone and beta zone of peripapillary atrophy, respectively, occur in about 70 and 20%, respectively, of elderly Chinese. As peripapillary atrophy changes in glaucomatous optic neuropathy, these normative data may be helpful for glaucoma detection.

Adult↗
PubMed2003

Factors influencing visual outcome after penetrating keratoplasty combined with intraocular lens implantation.

PURPOSE: To establish which factors influence visual outcome after penetrating keratoplasty combined with intraocular lens implantation. METHODS: This retrospective noncomparative clinical interventional case series study included 135 consecutive patients (mean age 70.2 +/- 13.6 years) who underwent central penetrating allogenic keratoplasty combined with intraocular lens (IOL) implantation, all operated by the same surgeon. There were 79 triple procedures, 33 keratoplasties combined t with an exchange of OL, and 23 penetrating keratoplasties combined with a secondary implantation of posterior chamber lens. Mean follow-up was 28.3 +/- 18.7 months (range 3.3-112 months). Reasons for keratoplasty were herpetic or traumatic corneal scars or defects (46), Fuchs corneal endothelial dystrophy (22), pseudophakic or aphakic bullous keratopathy (49), corneal endothelial decompensation due to other reasons (15), and keratoconus (3). Main outcome measures were postoperative visual acuity and agin in visual acuitvy RESULTS: Mean postoperative visual acuity and mean gain in visual acuity were 0.33 +/- 0.21 (median 0.30) and 0.25 +/- 0.20 (median 0.20), respectively. Compared with the preoperative measurements, mean visual acuity increased in 129 patients (129 /135, 95.6%). Factors influencing postoperative visual outcome and gain in visual acuity were preoperative visual acuity (p < 0.005), reason for keratoplasty (p < 0.005), and diameter of the graft (p = 0.046). ostoperative visual outcome was independent of age, sex, right or left eye, presence of diabetes mellitus, preoperative refractive error, length of follow-up, duration of surgery, and preoperative intraocular pressure. CONCLUSIONS: The most important factors influencing visual outcome after central penetrating allogenic keratoplasty combined with IOL surgery are preoperative visual acuity, graft size, and reason for keratoplasty. Other factors such as age, sex, diabetes mellitus, and preoperative refractive error do not substantially influence postoperative visual outcome.

Adolescent↗
PubMed2000

Unilateral visual impairment in an urban population in southern India.

This study assessed the prevalence and causes of unilateral visual impairment in the urban population of Hyderabad city as part of the Andhra Pradesh Eye Disease Study. Stratified, random, cluster, systematic sampling was used to select 2,954 subjects from 24 clusters representative of the population of Hyderabad. Eligible subjects underwent detailed eye examination including logMAR visual acuity, refraction, slitlamp biomicroscopy, applanation tonometry, gonioscopy, dilatation, cataract grading, and stereoscopic evaluation of fundus. Automated threshold visual fields and slitlamp and fundus photography were done when indicated by standardised criteria. Unilateral visual impairment was defined as presenting distance visual acuity < 6/18 in the worse eye and > or = 6/12 in the better eye, which was further divided into unilateral blindness (visual acuity < 6/60 in the worse eye) and unilateral moderate visual impairment (visual acuity < 6/18-6/60 in the worse eye). A total of 2,522 subjects (85.4% of eligible), including 1,399 > or = 30 years old, participated in the study. In addition to the 1% blindness and 7.2% moderate visual impairment (based on bilateral visual impairment criteria) reported earlier in this sample, 139 subjects had unilateral visual impairment, an age-gender-adjusted prevalence of 3.8% (95% confidence interval 2.7-4.9%). The major causes of this visual impairment 39.9% were refractive error (42.9%), cataract (14.4%), corneal disease (11.5%), and retinal disease (11.2%). Of this unilateral visual impairment was blindness. The major causes of unilateral blindness were corneal disease (23.2%), cataract (22.5%), retinal disease (18%), and optic atrophy (12.9%). On the other hand, the predominant cause of unilateral moderate visual impairment was refractive error (67%) followed by cataract (9%). Of the total unilateral visual impairment, 34.3% was present in those < 30 years old and 36.2% in those 30-49 years old. Unilateral visual impairment afflicts approximately 1 in 25 persons in this urban population. A large proportion of this unilateral visual impairment is present in younger age groups. The causes of unilateral visual impairment, like those of bilateral visual impairment in this population, are varied, suggesting therefore, that in addition to the current focus of eye care in India predominantly on cataract, other causes of visual impairment need to be addressed as well.

Adolescent↗
PubMed1996

Comparative double blind multicentric randomised placebo controlled clinical trial of a herbal preparation of eye drops in some ocular ailments.

A double masked placebo controlled multicentric randomised clinical trial was conducted in 157 patients suffering from different eye ailments namely, cataract, dry eye syndrome, ocular asthenia, refractive errors and allergic conjunctivitis with a herbal eye drop preparation and placebo. In both dry eye syndrome and ocular asthenia the herbal eye drop preparation was found better than placebo. In a few cases of cataract, the vision seems to be improved. In early myopia it seems to correct the refractive errors while in high myopic conditions it controlled the progressive deteriorations. Subjective improvements were also noted with hypermetropia, presbyopia and astigmatism. Its healing capacity in allergic conjunctivitis was certainly better than placebo. It had no short term or long term side-effects. It is considered to be a useful drug in all conditions studied.

Double-Blind Method↗
PubMed1983

Corneal change accompanying orthokeratology. Plastic or elastic? Results of a randomized controlled clinical trial.

Effects of orthokeratology on refractive error, visual acuity, and corneal curvature were monitored on two randomized comparison groups for 364 days of lens wear and 95 days of follow-up after lens wear was discontinued. Approximately 36% of the treatment group compared with 13% of the control group had 1 diopter or more change in refractive error; however, after lens wear was discontinued, there was substantial remission and differences between the groups were small. Although there was a positive correlation between the amount of change during lens wear and the persistence of change after discontinuation, neither the magnitude of persistence nor differences between groups were clinically important. The lack of persistence indicates that the cornea is either highly elastic or has some other memory mechanism. We conclude that orthokeratology produces modest reductions in myopia; however, the effect will not persist without continued lens wear and therefore is of limited clinical value in permanently reducing myopia.

Adaptation, Ocular↗
PubMed2002

Factors influencing visual outcome in anisometropic amblyopes.

AIM: To identify which factors influence the final visual acuity in children with anisometropic amblyopia. METHODS: A retrospective analysis of 112 children with anisometropic amblyopia, identified from examining all case notes of children who had failed preschool or school screening. RESULTS: The age at presentation had no effect on the final visual outcome (p=0.804). Both the degree of refractive error and the degree of anisometropia at presentation correlated with final visual acuity (p<0.001 and p=0.001). Those with strabismus had a poorer final outcome. CONCLUSIONS: The age at presentation of a child with anisometropic amblyopia appears to have no significant effect on the final visual acuity. The amount of refractive error and degree of anisometropia at presentation do correlate strongly with final visual acuity. This would suggest, firstly, that children with poorer visual acuity at presentation and higher degrees of anisometropia should be treated more aggressively and that, secondly, children with anisometropic amblyopia should be treated regardless of age.

Age Factors↗
PubMed2005

Laser in situ keratomileusis outcomes following radial keratotomy, astigmatic keratotomy, photorefractive keratectomy, and penetrating keratoplasty.

PURPOSE: To evaluate the safety and efficacy of laser in situ keratomileusis (LASIK) to enhance refractive status following other corneal surgical procedures. SETTING: Clinical office-based practice. METHODS: Seventy-one eyes of 57 patients had LASIK for refractive errors following radial keratotomy (n = 22), astigmatic keratotomy (n = 13), photorefractive keratectomy (n = 18), and penetrating keratoplasty (n = 18). A Moria LSK-1 microkeratome was used with a Visx S2 or Wavelight Allegretto excimer laser. Data were acquired by retrospective chart review of all appropriately qualified patients. RESULTS: The mean preoperative manifest refractive spherical equivalent (MRSE) was -3.93 diopters (D) +/- 2.83 (SD) in myopic eyes and +1.43 +/- 1.79 D in hyperopic eyes. The mean time from the initial corneal surgical procedure to LASIK was 65.0 months. The mean post-LASIK follow-up was 9.40 months (range 1 to 42 months). Postoperatively, the mean MRSE was -0.85 +/- 1.42 D in myopic eyes (P<.0001) and -0.16 +/- 1.09 D in hyperopic eyes (P<.0001). Enhancement by LASIK was required in 14% of eyes. CONCLUSION: In eyes that have had a variety of previous corneal surgeries, LASIK offers a safe and predictable method for enhancing refractive results.

Astigmatism↗
PubMed2002

The National Blindness and Low Vision Prevalence Survey of Bangladesh: research design, eye examination methodology and results of the pilot study.

PURPOSE To describe the research design and eye examination protocol of The National Blindness and Low Vision Prevalence Survey of Bangladesh and to present the main results of the rural pilot study. METHODS A thorough description of the sampling strategy, eye examination protocol and operational definitions are presented. Multi-stage stratified (rural/urban) cluster random sampling, with probability proportional-to-size procedures, will be used for selection of a cross-sectional, nationally representative sample (12,900 subjects) of the population aged > or = l30 years. Each subject will be tested for visual acuity, auto-refracted and undergo optic disc examination. Those with <6/12 visual acuity in either eye will be re-tested with their refractive correction, dilated and examined for anterior and posterior segment disease. A preliminary, separate rural pilot survey sample was conducted according to the eye examination procedures, with results reported herein. RESULTS Two-hundred-and-four (73.1%) of 279 eligible subjects were examined for the rural pilot. Forty-eight persons had presenting visual acuity worse than 6/12 in either eye. The presenting visual acuity of the better eye was used to group the subjects into the following WHO categories (brackets enclose the number of subjects after refractive correction): Blind: 4 [4]; Visually impaired: 29 [14]; Sighted: 171 [186], of whom 3 [3] were unilaterally blind. Cataract was the main cause of visual acuity of less than 6/12, followed by refractive error, and age-related macular degeneration. CONCLUSIONS The pilot survey demonstrated that the proposed examination process for the main survey was both feasible and appropriate for the purposes of this study. Particular strengths of the pilot and subsequent main survey include the use of logMAR visual acuity testing and auto-refraction of all subjects. The pilot study reveals the burden of cataract and refractive error, which are two of the five diseases specifically targeted by the WHO global blindness initiative 'Vision 2020'.

Adult↗
PubMed1996

Modification of the UniVision lens for a low-vision bifocal user.

BACKGROUND: A 5-year-old Hispanic male with an ocular history of retinopathy of prematurity was seen for an evaluation of his functional abilities and a determination of the possible treatment options for rehabilitation. The greatest concern was to provide the boy with the tools necessary to ensure success in the educational system. METHODS: A low-vision evaluation was performed and baseline information was obtained, including distance visual acuities, near visual acuities, visual fields and refractive error. This data was then used to determine if, in a classroom setting, the child would encounter any difficulties that could benefit from assistive optical devices or modifications of environment. RESULTS: The child demonstrated a large angle of head turn in order to eccentrically view to obtain his best visual acuity. His refractive error had no effect on this visual acuity at distance. Visual acuities taken at near demonstrated a working distance of 4 cm with preference to using the right eye. A gross confrontation field suggested a relatively full field in the right eye, but a temporal field loss in the left eye. CONCLUSIONS: A monocular bifocal system was prescribed for use in the classroom and at home when studying. The bifocal segment was a round +24 diopter aspheric lens, 22 mm in diameter, which was reshaped into a flat-top and adhered to a carrier lens. The carrier lens was ordered with 10 prism diopters base left in each eye. This system addressed both the large eccentric viewing position and the magnification necessary to alleviate the accommodative system.

Child, Preschool↗
PubMed2004

Autorefraction as an outcome measure of laser in situ keratomileusis.

PURPOSE: To determine the limits of agreement between subjective refraction and autorefraction before and after laser in situ keratomileusis (LASIK) to assess whether autorefraction is a valid refractive outcome measure of refractive surgery. SETTING: Ultralase, Leeds, United Kingdom. METHOD: The prospective study involved consecutive preoperative normal patients and post-LASIK patients who had autorefraction using the Nidek ARK 700A autorefractor and careful subjective refraction (masked to autorefraction). Inclusion criteria were age greater than 18 years and healthy eyes with a visual acuity better than 0.1 logMAR (6/7.5) with or without previous LASIK. Refractions were compared by spherical equivalent (SE) using Bland-Altman limits of agreement and astigmatic vector difference using the median and the 95th percentile. The effect of time after treatment and treatment strength were explored. RESULTS: Data were collected from 208 preoperative patients and 237 post-LASIK patients. Preoperatively, the agreement between subjective refraction and autorefraction for the SE was -0.10 diopter (D) +/- 0.35 (SD) and the median difference for the astigmatic vector was 0.28 D with a 95th percentile of 0.72 D. Post-LASIK, the SE agreement was similar, -0.09 +/- 0.39 D, but the astigmatic vector agreement decreased slightly with a median of 0.31 D and a 95th percentile of 1.02 D. This decrease reflected poorer agreement in patients whose pre-LASIK refractive error was greater than +4.00 D. Removing this group brought the median astigmatic difference post-LASIK to 0.27 D with a 95th percentile of 0.87 D, similar to that in the preoperative normals. The percentage within +/-0.50 D and +/-1.00 D of the attempted correction was 56.1% and 78.5%, respectively, with subjective refraction and 51.2% and 78.1%, respectively, with autorefraction. CONCLUSIONS: Autorefraction showed excellent agreement with subjective refraction and was unaffected by refractive surgery except after LASIK for high hyperopia. Most outcomes were correctly classified in the standard categories (+/-0.50 D, +/-1.00 D), illustrating that autorefraction is a valid outcome measure of refractive surgery.

Adult↗
PubMed1999

Electroretinographic profile in emmetropic Singaporean eyes.

OBJECTIVES: To characterise the electroretinographic (ERG) profile in 70 Singaporean emmetropic eyes. METHOD: Seventy eyes of thirty-five patients with refractive error of -1.00D or less and with a normal ophthalmic examination were chosen. They were subjected to three flash patterns generated with a Nihon-Kohden Flash Stimulator. The results were captured on a Nihon-Kohden Neuropack 8. RESULTS: The mean age of the patients was 25 years (range 20 to 30). The mean spherical refractive error was -0.3D (range 0D to -1.00D). For the scotopic dim flash, the mean amplitude for the 'b' wave was 304.6 +/- 69.2 mu v (range 175 mu v to 469 mu v) and the mean latency was 47.56 +/- 4.87 ms (range 41.2 ms to 62.0 ms). For the scotopic bright flash, the mean amplitude for the 'b' wave was 469.54 +/- 127.15 mu v (range 257 mu v to 750 mu v) and the mean latency was 40.54 +/- 3.91 ms (range 32.0 ms to 48.9 ms). In the flicker response, the mean amplitude for the 'b' wave was 34.19 +/- 12.97 mu v (range 14 mu v to 64 mu v) with mean latency at 34.46 +/- 0.58 ms (range 33.1 ms to 35.9 ms). CONCLUSION: With ERG normal values so generated, comparisons with these can then be made for abnormal cases.

Adaptation, Ocular↗
PubMedDate not supplied

Artisan phakic iris claw intraocular lens for high primary and secondary hyperopia.

PURPOSE: To evaluate the efficacy, predictability, and safety of the Artisan iris claw phakic intraocular lens for the correction of high primary and secondary hyperopia. METHODS: Fifty-seven eyes were divided into two groups: 29 eyes had primary hyperopia (mean refraction 6.06 +/- 1.26 D, and 28 eyes had secondary hyperopia, (mean refraction 5.88 +/- 1.88 D) induced or residual following a previous corneal refractive procedure. Consecutive implantation of the Artisan iris claw phakic intraocular lens was performed. Main outcome measures recorded were BSCVA, UCVA, refraction, and astigmatic change, intraocular inflammation, and endothelial cell loss. RESULTS: Primary hyperopic group: Preoperatively, mean UCVA was 0.4 +/- 0.7 and mean BSCVA was 0.2 +/- 0.6. After implantation, mean UCVA was 0.3 +/- 0.6 and BSCVA was 0.1 +/- 0.6. Mean cycloplegic residual spherical refractive error after surgery was 0.10 +/- 0.57 D (range -1 to +2 D). Mean surgically induced astigmatism was 1.48 +/- 0.89 D. Safety index was 1.11. Efficacy index was 0.83. Secondary hyperopic group: Preoperatively, mean UCVA was 0.5 +/- 0.7 and mean BSCVA was 0.2 +/- 0.6. Postoperatively, mean UCVA was 0.4 +/- 0.7 and mean BSCVA was 0.2 +/- 0.6. Mean cycloplegic residual spherical refractive error was 0.55 +/- 1.49 D. Mean surgically induced astigmatism was 1.85 +/- 1.19 D. Safety index was 1.05. Efficacy index was 0.7. Postoperative iridocyclitis was observed in one eye (3.4%) in the primary group and in three eyes (10.7%) in the secondary group. Overall corneal endothelial cell loss at 1 year of follow-up was 9.4%. CONCLUSION: The Artisan iris claw phakic intraocular lens was reasonably safe and predictable for correcting high hyperopia.

Adult↗