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At least 1,711 records · Page 95Linked to original sources
PubMed2005

Therapeutic effects of contact lenses after refractive surgery.

PURPOSE: Although highly successful, refractive surgery can have adverse effects, such as loss of best spectacle-corrected visual acuity, glare, haloes, monocular polyopia, and loss of contrast. Further surgical intervention may no longer be an adequate or appropriate response. The efficacy of rigid gas-permeable contact lenses and their therapeutic effects in managing these conditions are studied. METHODS: A retrospective review of the records of 67 eyes of 37 patients fitted with contact lenses after different refractive surgeries was performed. The most successful lens design for each patient was evaluated. Klyce corneal statistics of surface regularity index and surface asymmetry index, mean keratometric values, and optical zone diameter were measured before and after contact lens wear using the Tomey TMS-2 topographer. Comparative wavefront aberrometry was obtained for five eyes of three patients. RESULTS: The cohort had a mean uncorrected visual acuity of 20/40, a mean best spectacle-corrected visual acuity of 20/26, and a mean visual acuity with contact lenses of 20/20. Contact lens wear resulted in significant improvements in corneal regularity and symmetry, as indicated by Klyce corneal statistics, with concomitant improvements in visual acuity between wearing periods. The mean visual acuity on lens removal was 20/24. This lens molding effect lasted from several hours to several days. The lenses also had the effects of decreasing higher-order aberrations, as measured by wavefront aberrometry in three patients. CONCLUSIONS: Rigid gas-permeable contact lenses can dramatically improve visual acuity and higher-order aberrations in eyes of patients with unsatisfactory refractive surgery outcomes. Contact lenses can also have a measurable therapeutic effect on vision when the lenses are not being worn or cannot be worn full time.

Adult↗
PubMed2006

Varieties of contact lens fittings after complicated hyperopic and myopic laser in situ keratomileusis.

PURPOSE: To determine whether contact lenses with a special back surface design can improve visual acuity after complicated laser in situ keratomileusis (LASIK). METHODS: Fifteen eyes (six after myopic LASIK and nine after hyperopic LASIK) of eight patients were fitted with contact lenses with a special back surface design for optical rehabilitation. Four different types of lenses (aspheric, tricurve, keratoconus, and reverse) were used selectively, depending on the abnormal eccentricity (positive and exceeding 0.5-0.7 in all preoperatively hyperopic eyes, negative in all preoperatively myopic eyes) determined by videokeratoscope and on individual conditions. The patients were followed up retrospectively for an average period of 12.3 months. Lens tolerance and corrected visual acuity were evaluated and compared with the results obtained with spectacles. RESULTS: Visual acuity improved in nine (60%) of 15 eyes (three eyes by more than three lines and six eyes by three lines or fewer), with an absence of halos and ghost images in four (26.7%) of 15 eyes accompanied by good contact lens tolerance and a satisfactory contact lens fit. There were no noticeable complications. CONCLUSIONS: Contact lens fitting after LASIK is a safe and reliable procedure for improving visual acuity and reducing complications, such as ghost images or irregular corneal surface. Depending on the eccentricity and therefore on the preoperative refraction, contact lenses with a special back surface design can minimize problems in contact lens fitting and can improve tolerance and visual results.

Adult↗
PubMed2004

Goldmann tonometry after hyperopic laser in situ keratomileusis: comparison between retreated and nonretreated patients.

PURPOSE: To identify differences in applanation tonometry between retreated and nonretreated eyes (primary LASIK eyes) 6 months after hyperopic laser in situ keratomileusis. METHODS: In a prospective study 100 eyes (100 patients) underwent conventional hyperopic laser in situ keratomileusis under a 160-microm flap. Central Goldmann applanation tonometry was determined before and 6 months after surgery in 78 (78%) primary LASIK eyes and before surgery and 6 months after the retreatment date in 22 (22%) retreated eyes. RESULTS: Preoperative mean tonometry was 14.96 +/- 1.96 mm Hg and 15.30 +/- 1.95 mm Hg in primary LASIK and retreated eyes, respectively. Six months after surgery it was 12.99 +/- 2.03 mm Hg (P < 0.001) and 12.67 +/- 2.20 mm Hg (P < 0.001), respectively. No significant differences in mean tonometry were found between retreated and primary LASIK eyes 6 months after surgery (P = 0.537). Decreased tonometric values were found in 20 retreated eyes (90.91%) and in 62 primary LASIK eyes (79.48%). Increased tonometric values higher than 1 mm Hg were found in 3 primary LASIK eyes (3.84%), but no retreated eyes showed increased values 6 months after surgery. Two retreated eyes (9.09%) and 10 primary LASIK eyes (79.49%) presented the same tonometric values before surgery and at the end of the study. CONCLUSIONS: After hyperopic laser in situ keratomileusis there was no significant difference in Goldmann applanation tonometry between retreated and primary LASIK eyes.

Adult↗
PubMed2005

Excimer laser phototherapeutic keratectomy in eyes with anterior corneal dystrophies: short-term clinical outcomes with and without an antihyperopia treatment and poor effectiveness of ultrasound biomicroscopic evaluation.

PURPOSE: To evaluate the use of high-frequency ultrasound biomicroscopy (UBM) in determining the depth of corneal pathology in eyes undergoing excimer laser phototherapeutic keratectomy (PTK) for primary or recurrent anterior stromal corneal dystrophies. Corneal clarity, visual acuity, and refractive changes in eyes with and without an antihyperopia treatment were also analyzed. METHODS: Twenty eyes of 14 patients with anterior stromal corneal dystrophies were treated with PTK. Eyes were evaluated pre- and 6-8 weeks postoperatively with slit-lamp biomicroscopy, manifest refraction, keratometry, computerized corneal topography, ultrasound pachymetry, and UBM. RESULTS: Nineteen of 20 corneas (95%) had greatly improved corneal clarity after PTK. Mean uncorrected Snellen vision improved from 20/102 to 20/69, and best corrected vision improved from 20/62 to 20/38. Nine eyes (45%) improved two or more lines of uncorrected vision, and 13 eyes (65%) improved two or more lines of best corrected vision. Mean change in spherical equivalent was just -0.92 diopters (SD 4.3 diopters); however, the range was large (-13 to +3.88 diopters). UBM measurement of central corneal pathology did not correlate significantly with the actual PTK ablation depth (P = 0.07). The amount of antihyperopia treatment did not correlate with changes in manifest refraction spherical equivalent, keratometry, or computerized corneal topography readings but did correlate with length of time until corneal reepithelialization after PTK (P = 0.003). CONCLUSIONS: PTK resulted in improvements in corneal clarity and visual acuity in most patients with superficial corneal stromal dystrophies. UBM was not an effective tool to accurately measure the depth of corneal pathology preoperatively. The combined approach of minimizing ablation depth and selective use of an antihyperopia treatment resulted in minimal mean change in spherical equivalent; however, the range was large. PTK is a very good minimally invasive technique to improve vision in eyes with anterior stromal corneal dystrophies.

Adult↗
PubMed2005

Corneal irregular astigmatism after hyperopic laser in situ keratomileusis.

PURPOSE: To evaluate the changes in irregular astigmatism after hyperopic laser in situ keratomileusis (LASIK). METHODS: In a prospective case series, 15 eyes of 12 patients who had hyperopic LASIK were evaluated. Corneal topography was obtained before and after hyperopic LASIK. Corneal irregular astigmatism (asymmetry and higher-order irregularity) was calculated using Fourier harmonic analysis of the topography data. RESULTS: Hyperopic LASIK significantly increased the asymmetry component at 3 (P = 0.0085) and 6 months (P = 0.0307) postoperatively. The mean higher-order irregularity was not significantly changed at any postoperative time-point (P = 0.222). The achieved change in the spherical equivalent was significantly correlated with the post/preoperative ratio of asymmetry (R = 0.695, P = 0.0030). CONCLUSION: Hyperopic LASIK significantly increases the asymmetry component of the cornea, which is correlated with the achieved change in the spherical equivalent.

Adult↗
PubMed2006

Anterior cervical hypertrichosis and mental retardation.

Anterior cervical hypertrichosis or hairy throat is a rare dysmorphic sign described in a total of 19 patients so far. The association with a number of additional features has been reported, including mental retardation. We report on another patient with this condition who also had moderate mental retardation, mildly dysmorphic facial features, obesity, hypermetropia and additional hair anomalies (low dorsal hair line on the neck, lumbosacral hypertrichosis). Karyotype and array comparative genomic hybridization analysis at 1 Mb resolution were normal.

Abnormalities, Multiple↗
PubMed2006

Hypermetropia-succeeded myopia after hyperbaric oxygen therapy.

A 58-year-old man presented with a change in vision during hyperbaric oxygen (HBO) therapy. Subsequent follow-up visits showed a hypermetropic shift, which succeeded the myopic shift after each of two series of HBO treatments. The maximal refractive amplitude was 3.00 D (range -1.37 D to +1.62 D) in the right eye and 2.75 D (range -1.25 D to + 1.50 D) in the left eye. Refraction stabilized after 1.5 years at +0.62 D and +0.50 D to pretreatment values in the right and left eye, respectively. The findings are discussed with regard to possible changes in the structure of the lens.

Follow-Up Studies↗
PubMed1986

A family of squints: the differing effects of hypermetropia on four siblings.

Four siblings in a family of five were found to be affected with hypermetropia in differing degrees and with differing effects. These were unilateral hypermetropia, producing amblyopia; hypermetropia inducing an accommodative esotropia with minimal amblyopia and fully controlled with glasses; hypermetropia producing an accommodative esotropia with a high AC/A ratio, fully controlled with bifocals; and hypermetropia producing esotropia which was only partially corrected with glasses, therefore partially accommodative, with a residual squint which required surgery. This family of four nicely demonstrates all the permutations and combinations possible in accommodative-type esotropia and the pitfalls therein.

Accommodation, Ocular↗
PubMed2004

Choroidal neovascularization following hyperopic LASIK surgery.

Laser in situ keratomileusis (LASIK) is a well-accepted refractive surgical procedure; however, reports of complications of hyperopic surgery are scarce. This is the first report of bilateral macular choroidal neovascular membrane following bilateral hyperopic LASIK surgery. It highlights important considerations in older patients undergoing the procedure.

Choroidal Neovascularization↗
PubMed2004

Comparative study on the safety and efficacy of different cycloplegic agents in children with darkly pigmented irides.

BACKGROUND: The ideal cycloplegic drug that is safe, effective and convenient in children is not yet available. This study aimed to evaluate the safety and efficacy of three cycloplegic regimens in hyperopic children with pigmented irides. The responses to cycloplegia in different age groups and presence of strabismus were also compared. METHODS: Tropicamide 0.5% and phenylephrine 0.5% (regimen I), tropicamide 1.0% and cyclopentolate 1.0% (regimen II), and atropine 1.0% (regimen III) were evaluated in 25 children using a crossover study design. Cycloplegic refractions were assessed. RESULTS: The mean age of the children was 5.7 +/- 2.0 years (range 2.5-10.8 years). Six (24.0%) of them had strabismus. The spherical equivalent (SE) refraction for regimens I, II and III were +5.11 +/- 2.04 D, +5.29 +/- 1.89 D and +5.71 +/- 1.90 D, respectively, and were significant different from the manifest SE (+3.95 +/- 2.17 D) (P < 0.001). There was no statistical difference between regimen I and II in children without strabismus (P = 0.258) or aged older than 5 years (P > 0.050). CONCLUSION: In older children, regimen I was as effective as regimen II and can be used to avoid cyclopentolate toxicity.

Atropine↗
PubMed2003

The effect of central corneal thickness on estimates of the anterior chamber depth.

BACKGROUND: The slitlamp can be used to estimate the anterior chamber depth (ACD). The length of a slit object is increased until the corneal and iris/lens images appear to just touch. Multiplying the just-touching-slit-length (JTSL) by a conversion factor gives an estimate of the ACD as measured by ultrasonography. The purpose of this study was to determine if central corneal thickness (CCT) affects the accuracy of this technique. METHODS: The ACD of 50 subjects was measured by A-scan ultrasonography and estimated by the slitlamp technique. CCT was measured by ultrasonic pachometry. The refractive error was determined subjectively. RESULTS: The average ultrasonographic ACD for all subjects was 3.32 +/- 0.65 mm. The average JTSL was 2.46 +/- 0.38 mm. The conversion ratio between the ultrasonographic ACD and the average JTSL was 1.35. The predicted ACD using the regression equation of JTSL on the ultrasound anterior chamber depth (USACD) was 3.32 +/- 0.54 mm. The corresponding value using the regression equation of JTSL and CCT on USACD was exactly the same, that is, 3.32 +/- 0.54 mm. CONCLUSION: Incorporation of CCT into a regression equation does not improve the accuracy of the Smith technique.

Adult↗
PubMed1985

Educational attainment of 10-year-old children with treated and untreated visual defects.

Children with visual defects who took part in a 10-year survey were compared with their peers on measures of intelligence, reading, mathematics and sporting ability. Results are consistent with earlier findings of increased intelligence among children with myopia and slightly reduced intelligence among children with amblyopia. Those with other visual defects had normal intelligence scores. Once intelligence had been taken into account, only children with mild hypermetropia were under-achieving at reading. Those with severe myopia were reading better than expected. None of the children could be shown to be over- or under-achieving at maths, any variation being due to intelligence. The mothers of children with visual defects perceived them to be less able at sport. Comparison of the performances of children with minor visual defects who had and had not been prescribed spectacles did not suggest any disadvantage for those without spectacles, with the possible exception of children with mild hypermetropia. It is concluded that the majority of visual defects do not affect children's learning, and that current indications for prescribing spectacles need to be validated.

Achievement↗
PubMed1988

Refractive error, IQ and reading ability: a longitudinal study from age seven to 11.

Children from a population sample whose cycloplegic refractive errors included myopia, pre-myopia and hypermetropia were compared on measures of IQ and reading with a group of children without significance refractive errors. At age 11 both those with myopia and with pre-myopia had increased verbal and performance IQ, while those with hypermetropia had slightly reduced verbal and performance IQ, in comparison with the children without refractive errors. The differences in verbal IQ were not attributable simply to earlier differences, but the differences in performance IQ were attributable to earlier differences. No significant differences in reading scores were found at either age. It is concluded that differing abilities of myopic and other children at age 11 are not fully explained by differences in family background or in pre-existing ability.

Child↗
PubMed1984

A review and evaluation of theories of refractive error development.

A review of theories of the development of refractive errors is presented. These are classified into three major groups: the biological-statistical theories, the use-abuse theories and theories of emmetropization. They are commented upon and their merits contrasted. Current research developments which relate to these theories are discussed.

Adolescent↗