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At least 1,549 records · Page 86Linked to original sources
PubMed2002

Wavefront analysis of higher-order aberrations in patients with cataract.

PURPOSE: To determine local refractive changes and higher-order aberrations in patients with nuclear or cortical cataract. SETTING: Osaka University Medical School, Osaka, Japan. METHODS: Wavefront analysis of both ocular and corneal aberrations was performed with the Hartmann-Shack aberrometer in 2 patients, a 22-year-old woman with bilateral developmental nuclear cataract and a 68-year-old woman with mild bilateral cortical cataract. RESULTS: Case 1 showed a delay in the wavefront that caused a myopic shift in the central pupillary area in both eyes, associated with the nuclear cataract. The spherical-like aberration (right eye, 36%; left eye, 21%) was greater than the coma-like aberration in both eyes. Case 2 showed an advancement of the wavefront that caused a hyperopic shift, especially in the lower temporal pupillary area, that was associated with the cortical cataract. The coma-like aberration (right eye, 63%; left eye, 52%) was greater than the spherical-like aberration in both eyes. The polarity of the third-order spherical aberration was negative in Case 1 and positive in Case 2. Corneal higher-order aberrations were small and had a different distribution than ocular higher-order aberrations in both patients. CONCLUSIONS: The Hartmann-Shack aberrometer was useful in detecting local refractive changes and higher-order aberrations in patients with mild cataract. The polarity and the absolute value of ocular higher-order aberrations may be useful parameters to characterize eyes with cataract.

Adult↗
PubMed2002

Epithelial defect, diffuse lamellar keratitis, and epithelial ingrowth following post-LASIK epithelial toxicity.

This case reports an association between 2 uncommon flap complications in 1 eye related to epithelial toxicity and subsequent epithelial defect secondary to prolonged intraoperative exposure to topical anesthesia. A patient had hyperopic laser in situ keratomileusis (LASIK) for the correction of +2.75 +1.75 x 70 in the left eye. Because of the patient's anxiety and movement, additional topical local anesthesia was used and the flap remained reflected for 5 minutes. Immediately postsurgery, a toxic appearance was noted in the epithelium of the LASIK flap; 24 hours later, a large central epithelial defect was identified. Three days post- LASIK, the epithelial defect had healed but diffuse lamellar keratitis was noted in the interface, particularly underlying the location of the original epithelial defect. Over 6 weeks, a self-limiting epithelial ingrowth developed in the inferior interface. Fourteen months post-LASIK, the uncorrected visual acuity was 6/9 with a residual refraction of +0.50 +0.50 x 90.

Epithelium, Corneal↗
PubMed2002

Cataract surgery after holmium:YAG laser thermal keratoplasty.

A 64-year old man had noncontact holmium:YAG (Ho:YAG) laser thermal keratoplasty (LTK) performed in the left eye on March 10, 1998, and in the right eye on January 11, 1999. The patient achieved 1.3 diopters (D) and 1.4 D of corneal steepening in the right and left eye, respectively, which was the desired amount as his refractive error before Ho:YAG LTK was low. At the 3-month postoperative examination of the left eye, cortical cataracts were observed in both eyes. Approximately 1 year later, bilateral cataract extraction was recommended because of patient-reported decreased vision at distance and near and difficulty with vision in the presence of glare. Cataract surgery and intraocular lens (IOL) implantation was performed in both eyes in August 1999 using the keratotomy readings taken after noncontact Ho:YAG LTK to calculate IOL power. Although slight flattening of the cornea occurred after cataract extraction, the refractive outcomes achieved by noncontact Ho:YAG LTK were generally preserved.

Capsulorhexis↗
PubMed2002

Interlenticular opacification of piggyback acrylic intraocular lenses.

A dense interlenticular opacification developed 18 months after cataract surgery in a hyperopic patient with 2 acrylic piggyback intraocular lenses (IOLs) placed in the capsular bag. The patient developed a hyperopic shift with decreased vision, requiring explantation of the lenses. The dense interlenticular opacification did not allow separation of the lenses intraoperatively because of the tight adherence of the 2 IOLs.

Acrylic Resins↗
PubMed2002

Methods of estimating corneal refractive power after hyperopic laser in situ keratomileusis.

PURPOSE: To evaluate and compare methods of estimating corneal refractive power after hyperopic laser in situ keratomileusis (LASIK). SETTING: Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA. METHODS: Using the clinical history method (HisRP) as the standard, the accuracy of values of corneal refractive power derived from the EyeSys Corneal Analysis System or Humphrey Atlas computerized videokeratography, the thin lens formula, and corneal topographic measurements modified according to the amount of LASIK-induced refractive change were evaluated. RESULTS: Thirty-four eyes of 19 patients were evaluated using EyeSys and 27 eyes of 16 patients were examined using Humphrey Atlas. Although the values derived from corneal topography and the thin lens formula correlated well with HisRP, the differences between HisRP and topographic values increased significantly with increasing hyperopic correction. When the values of corneal topographic measurements were modified according to the amount of LASIK-induced refractive change, the accuracy was significantly improved (all P <.05) and the percentages of eyes within 0.5 diopter (D) and 1.0 D of the HisRP values exceeded 71% and 94%, respectively. CONCLUSION: Using the clinical history method as the standard, the most accurate method for determining corneal refractive power in hyperopic LASIK eyes was to adjust the postoperative corneal topographic measurement according to the amount of LASIK-induced refractive change.

Adult↗
PubMed2002

Ultrasound biomicroscopy of the Artisan phakic intraocular lens in hyperopic eyes.

PURPOSE: To study in situ the intraocular position of the Artisan iris-claw intraocular lens (IOL) (model 203) (Ophtec) in phakic hyperopic eyes using ultrasound biomicroscopy (UBM). METHODS: Echograms of the anterior chamber were taken preoperatively and 24 to 317 days postoperatively in 4 eyes implanted with the Artisan IOL (power +4.0 to +6.0 diopters). The preoperative anterior chamber depth (ACD) and the postoperative distance between the IOL and the corneal endothelium (endothelium-optic distance) and between the IOL and the lens were measured. The echograms were assessed for the effect of the IOL on iris tissue. RESULTS: The preoperative ACD ranged from 3.10 to 3.56 mm and the postoperative endothelium-optic distance, from 2.03 to 2.54 mm. The distance between the lens and the posterior surface of the IOL ranged from 0.35 to 0.79 mm. Several UBM echograms showed indentation of iris tissue by the IOL haptics and optic edge, although no pigmentary dispersion was noted. CONCLUSIONS: Adequate space was maintained between the Artisan hyperopic IOL and the corneal endothelium, angle, and crystalline lens. Haptic indentation of the iris, which could lead to pigment erosion, was observed. Preoperative gonioscopy and maintenance of normal intraocular pressure postoperatively suggest the indentation was secondary to inadequate lens vaulting relative to the high natural arch of the iris in hyperopic eyes. Shortening the haptics or increasing the lens vault might resolve this problem.

Anterior Chamber↗
PubMed2002

Pupil diameter changes and reaction after posterior chamber phakic intraocular lens implantation.

PURPOSE: To compare the different aspects of pupil constriction before and after the implantation of an implantable contact lens (ICL). SETTING: Augenabteilung der Schlosspark-Klinik Berlin, Berlin, Germany. METHODS: This study comprised 15 myopic and 9 hyperopic eyes that were evaluated before and after the implantation of an ICL using a compact integrated pupillograph (CIP, AMTech) under standardized conditions. The preoperative and postoperative pupil diameters, rate and latency of the pupil reaction, and amplitude of constriction were compared. RESULTS: The latency and the duration of pupil constriction were significantly prolonged after ICL implantation. The rate of pupil contraction and redilation, the pupil diameter, and the amplitude of pupil constriction were reduced after ICL implantation. CONCLUSIONS: The pupil reaction after implantation of a phakic posterior chamber ICL was slower. The postoperative pupil diameter was smaller, and the amplitude of constriction was reduced. The changes have not proved to be clinically significant to date.

Female↗
PubMed2002

Three-dimensional representation and qualitative comparisons of the amount of tissue ablation to treat mixed and compound astigmatism.

PURPOSE: To compare the shape and volume of the lenticules of corneal tissue ablated for the correction of spherical, cylindrical, and spherocylindrical refractive errors using Boolean operations of theoretical 3-dimensional (3-D) surfaces. SETTING: Department of Ophthalmology, Rothschild Foundation, Paris, France. METHODS: Digital modeling software was used to perform graphic representations of ablated lenticules on 3-D virtual surfaces. Various Boolean operations were performed between different preoperative and postoperative surfaces, and the additional and subtractive properties of ablated theoretical lenticules were analyzed to determine profiles of ablated lenticules for mixed and compound myopic and hyperopic astigmatism. RESULTS: Negative-cylindrical treatment, used to treat simple myopic astigmatism, was equivalent to the combination of a positive-cylindrical and a negative-spherical treatment of the same magnitude. Combining a pure negative-cylindrical and a positive-spherical treatment in a sequential strategy when treating compound astigmatism resulted in redundant ablation (plano lenticule), leading to an unnecessary increase in the amount of tissue ablation. CONCLUSIONS: Negative-cylindrical treatments result in greater tissue ablation than corresponding positive-cylindrical treatments. For any given compound astigmatic error, the strategy using the greater magnitude of positive cylinder incurs the minimal amount of tissue ablation.

Astigmatism↗
PubMed2002

Hyperopic laser in situ keratomileusis for refractive accommodative esotropia.

PURPOSE: To assess the efficacy of hyperopic laser in situ keratomileusis (LASIK) in creating orthophoria without optical correction in adult patients with refractive accommodative esotropia (RAE). SETTING: Instituto Oftalmológico de Sabadell, Sabadell, Barcelona, Spain. METHODS: This prospective single-center clinical trial studied 9 eyes (18 patients) with RAE having hyperopic LASIK. The mean follow-up was 20 months (range 12 to 24 months). The mean preoperative refraction was +5.01 diopters (D) and the mean deviation angle without optical correction, 36 prism diopters. The intervention was hyperopic LASIK using the Automated Corneal Shaper microkeratome (Bausch & Lomb) and the Apollo broad-beam excimer laser using a 5.5 mm optical zone and an 8.0 mm transition zone; astigmatism was treated by steepening the flattest meridian. RESULTS: All patients achieved orthophoria or the preoperative microtropia without optical correction immediately after surgery. This was maintained throughout the follow-up. Fifty-six percent of all cases were within +/-0.5 D of emmetropia, and 89% were within +/-1.0 D. The uncorrected visual acuity improved significantly (P <.005), especially at near, and the mean best corrected visual acuity (BCVA) was maintained, although 4 eyes (22%) lost 1 line of BCVA. There were no significant complications. CONCLUSIONS: In adult patients with RAE, treatment of the refractive error using hyperopic LASIK was safe and effective and corrected the esodeviation. Further studies in younger patients will help determine the age at which this intervention may be indicated.

Accommodation, Ocular↗
PubMed2002

Contact lens fitting to correct irregular astigmatism after corneal refractive surgery.

PURPOSE: To study a technique of contact lens fitting and its visual results in patients with irregular astigmatism induced by corneal refractive surgery. SETTING: Department of Cornea and Refractive Surgery, Instituto Oftalmológico de Alicante, Alicante, Spain. METHODS: This prospective noncomparative study comprised 29 eyes with irregular astigmatism after corneal refractive surgery. Different types of contact lenses were used to correct the astigmatism: hard, gas permeable, hybrid, and toric hydrophilic. Preoperative and postoperative data were analyzed for proper fitting including the preoperative keratometeric reading and corneal ablation zone. RESULTS: Proper contact lens fitting was achieved in 23 eyes (79.3%). In 6 eyes (20.7%), fitting was not possible despite an improvement in best corrected visual acuity (BCVA). Of the eyes with proper fitting, 14 (60.9%) had rigid gas-permeable lenses (9.80 mm), 6 (26.1%) had hydrophilic lenses (14.00 mm), and 3 (13.0%) had hybrid lenses (14.3 mm). Comparing the BCVA with that with spectacles, 23 eyes (79.3%) gained 2 lines or more of BCVA, 4 (13.8%) gained 1 line, and 2 (6.9%) maintained the same acuity as with spectacles. No eye lost lines of BCVA. CONCLUSIONS: Results indicate that contact lens fitting is a good-and sometimes the only-alternative for patients with induced irregular astigmatism. Rigid gas-permeable contact lenses provided the best visual performance and patient tolerance.

Adult↗
PubMed2003

Comparison of photorefractive keratectomy and laser in situ keratomileusis for the treatment of compound hyperopic astigmatism.

PURPOSE: To compare photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) for compound hyperopic astigmatism. SETTING: University laser center. METHODS: This prospective nonrandomized study evaluated 41 consecutive eyes (27 patients) that had PRK and 24 consecutive eyes (15 patients) that had LASIK to correct compound hyperopic astigmatism. RESULTS: The mean preoperative error was +3.06 diopters of sphere (DS) +/-1.73 (SD)/+1.31 +/- 0.60 diopters of cylinder (DC) in the PRK eyes and +2.86 +/-1.28 DS/+1.55 +/- 0.96 DC in the LASIK eyes. The mean maximal pain score in PRK eyes was 1.95 +/- 1.19 (range 0.0 to 3.0) in PRK eyes and 0.84 +/-1.12 in LASIK eyes (P=.0014). The uncorrected visual acuity was 20/20 or better in 7.7% of the PRK eyes and 58.3% of the LASIK eyes at 1 month (P<.001) and 57.9% and 66.7%, respectively, at 9 months (P=.586). The mean postoperative spherical error was -0.95 +/- 0.92 D in PRK eyes and +0.33 +/- 0.56 D in LASIK eyes at 1 month (P<.001) and +0.64 +/- 1.01 D and +0.44 +/- 0.57 D, respectively, at 9 months (P=.375). There was no statistically significant between-group difference in the mean residual astigmatic error. Mild peripheral haze (grade 0.5 to 1.0) occurred in 19.5% of PRK eyes and no LASIK eye. No eye in either group lost more than 2 lines of best spectacle-corrected visual acuity. CONCLUSIONS: Photorefractive keratectomy was more painful than LASIK and led to a slower visual recovery, a higher incidence of peripheral haze, and an initial myopic overcorrection, which self-corrected by 3 to 6 months. Efficacy and stability of the astigmatic correction were similar in both groups. Long-term stability of both procedures requires further study.

Adult↗
PubMed2003

Epithelial healing and ocular discomfort after photorefractive keratectomy in children.

OBJECTIVE: To document the rate of healing of the corneal epithelial defect created by photorefractive keratectomy (PRK) and the degree of discomfort experienced by children treated with PRK. SETTING: Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA. METHODS: Ten patients between 3 and 10 years of age were treated with PRK for severe anisometropia. All had anisometropic amblyopia refractory to conventional therapy with glasses or contact lenses and occlusion therapy. The size of the corneal epithelial defect was documented daily until the defect healed completely. Postoperative discomfort was documented daily using a pain-assessment scale until the epithelial defect healed completely. RESULTS: Two children were treated with PRK for hyperopic anisometropia; the rest were treated for myopic anisometropia. Cumulatively, the corneal epithelium had healed completely by day 3 in 6 patients (60%), by day 4 in 9 patients (90%), and by day 5 in all patients. The mean healing time was 3.5 days. Patients experienced mild discomfort on the day of surgery and on the first postoperative day. They had minimal pain on day 2. After day 2, no patient reported pain or other discomfort. CONCLUSIONS: The corneal epithelial defect created by PRK healed promptly and was associated with minimal postoperative discomfort in children treated with the protocol described.

Anisometropia↗
PubMed2003

Evaluation of the corneal endothelium after hyperopic laser in situ keratomileusis.

PURPOSE: To evaluate corneal endothelial changes after hyperopic laser in situ keratomileusis (LASIK) considering overestimation and underestimation of the cell count measurement. SETTING: Department of Ophthalmology, Nara Medical University, Nara, Japan. METHODS: The data were from the clinical trial of the Nidek EC-5000 excimer laser for hyperopic LASIK. The mean correction was 3.59 diopters (D) +/- 1.54 (SD) (range 2.0 to 6.0 D). Using noncontact specular microscopy, the corneal endothelial changes in 25 eyes of 15 patients who had hyperopic LASIK were measured. Follow-up ranged from 6 months (n = 25) to 1 year (n = 21). The overestimation and underestimation of the corneal endothelial cell count that would occur after +5.0 D hyperopic LASIK was hypothetically calculated. RESULTS: The measured endothelial cell count per 1.0 mm(2) did not significantly decrease up to 1 year after hyperopic LASIK (preoperatively, 2508 +/- 395; at 1 year, 2814 +/- 349). The hypothetical calculation revealed that a +5.0 D hyperopic correction corresponded to a 0.1% underestimation of the corneal endothelial cell count. CONCLUSIONS: Underestimation of the corneal endothelial cell count after hyperopic LASIK was negligible. Hyperopic LASIK with the Nidek EC-5000 excimer laser did not significantly decrease corneal endothelial cells up to 1 year after surgery.

Adult↗
PubMed1995

Photorefractive keratectomy in pediatric patients.

This article reports the results of photorefractive keratectomy in nine patients between 10 and 15 years of age who were treated for the following refractive errors: unilateral myopia, post intraocular lens myopia, and unequal hypermetropia with amblyopia. Visual acuity improved and spectacle correction decreased in all patients. There was significant visual improvement with pleoptic treatment in one amblyopic hypermetropic patient.

Adolescent↗