Change In Refractive Power Research Articles

Self-adjustable glasses in the developing world

Uncorrected refractive errors are the single largest cause of visual impairment globally. Refractive errors are an avoidable cause of visual impairment that are easily correctable. Provision of spectacles is a cost-effective measure. Unfortunately, this simple solution becomes a public health challenge in low- and middle-income countries because of the paucity of human resources for refraction and optical services, lack of access to refraction services in rural areas, and the cost of spectacles. Low-cost approaches to provide affordable glasses in developing countries are critical. A number of approaches has been tried to surmount the challenge, including ready-made spectacles, the use of focometers and self-adjustable glasses, among other modalities. Recently, self-adjustable spectacles have been validated in studies in both children and adults in developed and developing countries. A high degree of agreement between self-adjustable spectacles and cycloplegic subjective refraction has been reported. Self-refraction has also been found to be less prone to accommodative inaccuracy compared with non-cycloplegic autorefraction. The benefits of self-adjusted spectacles include: the potential for correction of both distance and near vision, applicability for all ages, the empowerment of lay workers, the increased participation of clients, augmented awareness of the mechanism of refraction, reduced costs of optical and refraction units in low-resource settings, and a relative reduction in costs for refraction services. Concerns requiring attention include a need for the improved cosmetic appearance of the currently available self-adjustable spectacles, an increased range of correction (currently −6 to +6 diopters), compliance with international standards, quality and affordability, and the likely impact on health systems. Self-adjustable spectacles show poor agreement with conventional refraction methods for high myopia and are unable to correct astigmatism. A limitation of the fluid-filled adjustable spectacles (AdSpecs, Adaptive Eyecare Ltd, Oxford, UK) is that once the spectacles are self-adjusted and the power fixed, they become unalterable, just like conventional spectacles. Therefore, they will need to be changed as refractive power changes over time. Current costs of adjustable spectacles are high in developing countries and therefore not affordable to a large segment of the population. Self-adjustable spectacles have potential for “upscaling” if some of the concerns raised are addressed satisfactorily.

Refractive Changes after Pharmacologic Resolution of Diabetic Macular Edema

To determine precisely the mean change in refractive power induced by treatment in patients with diabetic macular edema (DME). Prospective, randomized study. Fifty eyes of 50 consecutive patients with clinically significant macular edema receiving all 3 types of current state-of-the-art treatment with intravitreal antiedematous substances (ranibizumab, bevacizumab, or triamcinolone). Patients were followed up at monthly intervals and were treated following a standardized pro re nata regimen according to protocol. Best-corrected visual acuity (BCVA) was determined by certified visual acuity examiners. The refractive power of the treated eyes was determined using a push-plus technique. The change in refraction between baseline and the visit when the macula was completely dry or when the central subfield thickness (CST) measured by optical coherence tomography had reached the thinnest level was analyzed. Spherical equivalent refraction (SER) and CST. Fifty eyes of 50 patients received intravitreal therapy using ranibizumab (n = 11), bevacizumab (n = 20), or triamcinolone (n = 19). Mean BCVA was 0.33±0.23 logarithm of the minimum angle of resolution (logMAR) and mean CST was 492±130 μm. The mean SER was 0.41±2.06 diopters (D) at baseline. The BCVA at the time of optimal retinal morphologic features was 0.24±0.2 logMAR, mean CST was 300±78 μm, and mean change in SER was -0.01±0.46 D. Changes is BCVA and CST were statistically significant (P < 0.0001), but the SER change was not (P = 0.824). Appropriate spectacle correction can be prescribed to patients with DME any time during ongoing therapy using antiedematous substances because resolution of retinal thickening is not associated with an increased risk of a myopic shift.

The Prediction of Changes in Mean Corneal Refractive Power by Pterygium Size after Pterygium Surgery

Purpose: To assess the changes in mean corneal refractive power (ΔK) following pterygium surgery and to predict ΔK in cases of combined cataract and pterygium surgery. Methods: Thirty-seven eyes of unilateral pterygium patients who underwent pterygium surgery were analyzed retrospectively with at least more than 1 month of follow-up. Preoperative and postoperative 1 month corneal refractive power was measured using auto-keratometer (RK-F1, Canon, Tokyo, Japan). Pterygium horizontal extension, width, and area were measured and correlation with ΔK before and after surgery analyzed. We also compared ΔK of the contralateral normal eye. Results: The mean corneal refractive (Km) power measured before and 1 month after surgery was 43.30 ± 1.66 D and 44.07 ± 1.42 D, respectively. The Km significantly increased at 4 weeks after surgery (p < 0.001). However, postoperative Km was not significantly different when compared with the contralateral normal eye (43.86 ± 1.34 D; p = 0.59). All parameters of pterygium size including horizontal extension, width, and area were positively correlated with the mean ΔK. Among parameters, horizontal extension was best correlated with mean ΔK (p < 0.001). The mean ΔK with horizontal extension was predicted using linear regression (2.5 mm to 1 D, 4.0 mm to 1.8 D). Conclusions: We recommend contralateral corneal refractive power or prediction of corneal refractive power using linear regression with pterygium horizontal extension for determining intraocular lens power in cases of combined cataract and pterygium surgery. J Korean Ophthalmol Soc 2014;55(11):1613-1617

콘택트렌즈를 임시 제거한 상태에서의 착용 조건에 따른 굴절력 변화

목적: 소프트 콘택트렌즈를 일시 제거한 상태에서 굴절보정을 위한 굴절검사 시의 굴절력 변화를 평가하고자 하였다. 방법: 17세에서 39세(평균 <TEX>$24{\pm}4.8$</TEX>세)의 소프트 렌즈 착용자 91명(남자 15명, 여자 76명 총 182안)을 대상으로 하였다. 렌즈를 제거한 뒤 즉시, 30분, 60분, 90분 후 타각적, 자각적 굴절검사 및 각막곡률반경검사를 하였다. 렌즈의 종류, 피팅 및 착용 상태별로 측정 시간에 따른 굴절력 변화를 평가하였다. 결과: 타각적, 자각적 굴절검사 및 각막곡률반경검사에서 측정 시간대별로 유의한 변화를 보였다(p<0.0001). 굴절력은 측정 초기(렌즈 제거 후 30분 후)에서 완만한 근시화 경향을, 그리고 측정 후반(렌즈 제거 후 60분에서 90분)에서 미약한 근시화 경향을 보였다. 렌즈 종류, 피팅 상태, 착용 시간, 착용 일수 및 검사 전날의 수면 시간에 따른 유의한 차이는 없었으나, 각막곡률의 변화에서 측정 시간과 렌즈 종류(p=0.017), 피팅 상태(p=0.019) 및 수면 시간(p=0.010) 간의 상호작용 효과는 유의하였다. 결론: 소프트 콘택트렌즈의 종류, 피팅 및 착용 상태와 상관없이 렌즈 제거 후 굴절력과 각막곡률의 안정화 시점은 적어도 60분 이상으로 나타났다. 따라서 굴절보정을 위한 굴절검사 시 가능한 60분 이상 기다린 후 실시하여야 할 것이다. Purpose: To evaluate the changes of refractive power when worn soft contact lenses were temporarily removed. Methods: 91 soft contact lens wearers (15 males and 76 females; total 182 eyes) from 17 to 39 years of age (average: <TEX>$24{\pm}4.8$</TEX> years) were participated. Objective and subjective refraction, and corneal radius were measured at 0, 30, 60 and 90 min after lens removal. The changes in refractive power were evaluated between measurements over time. The other parameters such as types of lenses, fitting and wearing conditions were also assessed. Results: Objective refraction, subjective refraction and corneal radius were significantly changed according to measured time (p<0.0001). A moderate myopic shifts was observed at the beginning (30 min after lens removal) and a slight myopic shift at the late of measurement (60 min to 90 min after lens removal). There are no significant differences between lens types, fitting states, wearing time, wearing days and sleeping time in the previous day. However, there was significant interaction in changes for corneal radius between measuring time and lens type (p=0.017), fitting state (p=0.019), and sleeping time prior to the test (p=0.010). Conclusions: Time to reach refractive and corneal radius stability after contact lens removal revealed at least more than 60 min, regardless of types of lenses, fitting and wearing conditions. Therefore, refraction for correction should be performed after waiting for more than that time as possible.

역방향 실리콘 하이드로겔 렌즈 착용에 따른 각막 굴절력 변화

역방향 실리콘 하이드로겔 렌즈 착용에 따른 각막 굴절력 변화

연령대별 우세안과 비우세안의 비교 연구

목적: 양안으로 사물을 주시할 때 우세안을 주로 사용한다. 이러한 이유로 안경과 콘택트렌즈 처방 시 우세안의 중요성이 크다. 이를 위해 본 연구는 연령대별로 구분하여 양안에 있어서 굴절력의 변화에 따른 우세안과 비우세안의 시력 차이가 있는지 알아보았다. 방법: 안질환이 없는 186명을 대상으로 Hole-in-the-card test법을 통한 우세안을 검사하였다. 검사의 일관성을 위해 동일인이 측정하였으며, 검사의 신뢰성을 높이기 위해 3회 반복 실시하였다. Spss통계를 통해 굴절력에 따른 우세안과 비우세안의 상관관계를 알아보았다. 결과: 대상자 186명 중 우안 우세안은 135명, 좌안 우세안은 51명이었다. 굴절이상 환경에 노출되기 시작하는 10세 이전(평균 <TEX>$8.8{\pm}1.18$</TEX>세)과 본격적으로 굴절이상이 발생하는 10세에서 20세 사이(평균 <TEX>$14.1{\pm}2.58$</TEX>세), 그리고 시력안정화 시기에 접근하는 20세 이후(평균 <TEX>$51.8{\pm}17.51$</TEX>) 모두 우세안의 시력이 비우세안보다 시력이 높았지만 통계적으로 유의하지 않았다. 근시성 난시에 있어서 우세안의 난시 굴절력 평균값이 비우세안 난시안의 평균값보다 작게 나타났으며, 통계적으로 유의한 결과를 나타내었다(p=0.017<0.05). 결론: 양안 중에서 전체적으로 난시도가 작고 균형 잡힌 눈이 우세안으로 선택될 확률이 높다고 판단된다. Purpose: When we look at the object, we used the dominant eye mainly. For this reason, a prescription of the dominant eye is an important factor for glasses and contact lenses. This study evaluated visual acuity differences between dominant and nondominant eyes through analyzing refractive power changes in both eyes by the ages. Methods: This study was performed to investigate the relationship between refractive error and dominant eye which had the superiority in the function of binocular. 186 subjects without ocular disease were examined on the dominant eye. The dominant eye was examined by the Hole-in-the-card test. For the consistency of the measurements, we tested refractive power in three times by the same person. Results: Using SPSS, the relationship between vision and the dominant eye was analyzed. 135 people of the whole subjects have the dominant eye on right. The Number of the non-dominant eye is 51. We were divided into 3 types, the group under the age of 10 that begins to expose environment factor affect on vision (the average age <TEX>$8.8{\pm}1.18$</TEX>) and the age group of 10 to 20 that begins to change refractive power in earnest (the average age <TEX>$14.1{\pm}2.58$</TEX>) and the group after the age 20 that began to stabilize vision (the average age <TEX>$51.8{\pm}17.51$</TEX>). The visual acuity of dominant eye was higher than non-dominant eye in all age groups. Nevertheless, these results were not statistically significant. Mean astigmatism of dominant eye was smaller than the non-dominant eye, and this is significant, statistically (p=0.017<0.05). Conclusions: It is expected that the balanced eye with a lower level of astigmatism has a more possibility become a dominant eye.

Biomechanical and Refractive Behaviors of Keratoconic Cornea Based on Three-Dimensional Anisotropic Hyperelastic Models

To investigate the biomechanical and refractive behaviors of normal and keratoconic corneas based on three-dimensional anisotropic hyperelastic corneal models with two layers. Based on an anisotropic hyperelastic formula, the finite element method was employed to develop normal and keratoconic corneal models in which the fiber orientations and the biomechanical differences between corneal layers were taken into account. The displacements for normal and keratoconic corneal models were studied, as well as changes in corneal refractive power with intraocular pressure (IOP). There were different displacements for keratoconic and normal corneas. Positive correlations were found in the keratoconic cornea between IOP and apical displacement, as well as between IOP and corneal refractive power. Under normal IOP, both the corneal shape and refractive power map were affected by the stiffness distributions of the corneal layers. Finite element analysis can be used to demonstrate the biomechanical and refractive behavior of a cornea with keratoconus. From a biomechanical viewpoint, the displacement changes seen under normal IOP were due to the decreased stiffness in the keratoconic corneal tissue and local thinning disorders. Thus, the curvature and corneal refractive power map will be abnormal in keratoconus.

Evaluation of equations for describing the human crystalline lens

Accurate mathematical descriptions of the human crystalline lens surface shape are required to properly understand the nature of functional adaptations that occur when the lens shape alters to changes in refractive power. Using least squares method, the total mean normal distance, smoothness, rate of change of the transverse and sagittal radii of curvatures and continuity at the lens equator between eight mathematical functions: conic, figuring conicoid, generalized conic, Hermans conic patch, Urs polynomial, Urs 10th order Fourier series, Chien, and Giovanzana, and 17 human crystalline lenses were evaluated. The mean differences of the fits of all the equations to the whole lens and to the central 8 mm of the lens surfaces were >24 μm with comparable standard deviations. When considering fit smoothness and continuity at the equator, the Giovanzana and Chien functions are most representative of the lens surface.

One-Year Safety and Efficacy Results of a Hydrogel Inlay to Improve Near Vision in Patients With Emmetropic Presbyopia

To conduct a feasibility study of the safety and efficacy of a corneal contouring inlay as a treatment for emmetropic presbyopia. The Raindrop corneal inlay (ReVision Optics, Inc., Lake Forest, CA) was implanted on the corneal stromal bed beneath a keratotomy flap in 20 nondominant eyes of 20 patients. The implant is designed to cause a change in the curvature of the overlying cornea, with a subsequent multifocal change in refractive power. Efficacy outcome was defined as at least 75% of eyes with uncorrected near visual acuity of 0.3 logMAR (20/40 Snellen) or better at 6 months. Main safety outcomes were retention of preoperative best-corrected distance visual acuity and reports of adverse events. Other outcome measures included contrast sensitivity; near, intermediate, and distance visual acuities; patient satisfaction; spectacle use; and complications. All implanted eyes achieved uncorrected near visual acuity of 0.3 logMAR (20/40 Snellen) or better by the 1-week postoperative examination and remained so throughout the 1-year follow-up period, also averaging less than 0.1 logMAR (20/25 Snellen) monocularly and binocularly throughout that period. Mean binocular uncorrected distance visual acuity remained within 0.02 logMAR of the preoperative mean throughout the study. One patient who was dissatisfied with the resulting vision underwent explantation. At 1 year, 16 of 19 patients seldom or never wore glasses and all 19 were satisfied or very satisfied with their overall vision. The hydrogel corneal inlay improved uncorrected near and intermediate visual acuity in patients with emmetropic presbyopia, with high patient satisfaction and little effect on distance visual acuity.

Time course of the effects of orthokeratology on peripheral refraction and corneal topography

To describe the time course of changes in both peripheral refraction and corneal topography in myopic adults wearing myopic orthokeratology (OK) lenses. Nineteen adult myopes were fitted with OK lenses in both eyes for overnight wear. Central and peripheral refraction and corneal topography were measured along the horizontal meridian at baseline and after 1, 4, 7 and 14 nights of lens wear. At baseline, refraction was myopic at all positions along the horizontal meridian. Two weeks of OK lens wear caused a significant change in refraction where the general trend was a hyperopic shift in spherical equivalent (M) except at 35° in the nasal visual field where there was instead a myopic shift in M. The most significant change in M occurred between baseline and after 1 night of OK lens wear and the effect became less dramatic across subsequent days of OK treatment. Similarly, OK caused significant change in corneal refractive power at all positions along the horizontal corneal chord. There was a reduction in corneal power or flattening of the cornea at all positions except at 2.4 mm and 2.8 mm on the nasal cornea where there was an increase in corneal refractive power or steepening of the cornea. This change was most apparent after 1 night of OK lens wear and, similar to changes in peripheral refraction, changes in corneal refractive power on subsequent days of OK treatment became less marked. Orthokeratology caused significant changes in both peripheral refraction and corneal topography. The greatest change in refraction and corneal refractive power across the horizontal corneal meridian occurred during the first night of OK lens wear. Subsequent changes in both peripheral refraction and corneal topography were less dramatic, in the same manner as reported changes in apical radius and central refraction after OK. This study confirms that with OK treatment, the peripheral retina experiences myopic defocus, which is conjectured to underlie the observed slowing of myopia progression.

Transient response in ultra-high speed liquid lenses

Liquid lenses are appealing for applications requiring adaptive control of the focal length, but current methods depend on factors such as liquid inertia that limit their response time to tens of milliseconds. A tunable acoustic gradient index (TAG) lens uses sound energy to radially excite a fluid-filled cylindrical cavity and produce a continuous change in refractive power that, at steady state, enables rapid selection of the focal length on time scales shorter than 1 µs. However, the time to reach steady state is a crucial parameter that is not fully understood. Here we characterize the dynamics of the TAG lens at the initial moments of operation as a function of frequency. Based on this understanding, we develop a model of the lens transients which incorporates driving frequency, fluid speed of sound and viscosity, and we show that is in good agreement with the experimental results providing a method to predict the lens behaviour at any given time.

Endothelial keratoplasty: evolution and horizons

Endothelial keratoplasty has been adopted by corneal surgeons worldwide as an alternative to penetrating keratoplasty (PK) in the treatment of corneal endothelial disorders. Since the first surgeries in 1998, different surgical techniques have been used to replace the diseased endothelium. Compared with penetrating keratoplasty, all these techniques may provide faster and better visual rehabilitation with minimal change in refractive power of the transplanted cornea, minimal induced astigmatism, elimination of suture-induced complications and late wound dehiscence, and a reduced demand for postoperative care. Translational research involving cell-based therapy is the next step in work on endothelial keratoplasty. The present review updates information on comparisons among different techniques and predicts the direction of future treatment.

Multifocality changes after LASIK

PurposeTo analyze the differences in induced multifocality after LASIK surgery in myopic and hyperopic patients using conventional and aberration-free profiles. SettingAugenlaserzentrum, Recklinghausen, Germany. MethodsWe retrospectively evaluated four consecutive groups of 280 eyes treated by the ESIRIS laser platform: Group A myopic with conventional treatment (70 eyes), group B myopic with aspheric treatment (70 eyes), group C hyperopic eyes treated with conventional LASIK (70 eyes) and group D hyperopic eyes treated with aspheric profile (70 eyes). We used in all the cases the ESIRIS SCHWIND Laser Platform and the Carriazo Pendular Microkeratome. The Optikon Keratron Topographer obtained the measurement of change in corneal refractive power of the anterior surface at 3, 5, and 7mm meridionally and in the form of corneal wavefront analysis. ResultsWe compared the preoperative multifocality with the created multifocality measured in diopters (D) per achieved diopter of defocus correction after LASIK treatment. The created multifocality was in the myopic group A +0.12D per achieved diopter of defocus correction, in group B +0.08D per achieved diopter of defocus correction, in the hyperopic group C −0.51D per achieved diopter of defocus correction and in group D −0.14D per achieved diopter of defocus correction. ConclusionsAnalyzing the slope of the anterior corneal surface and the corneal wavefront the local refractive changes after LASIK can be characterized in the form of positive (relative central myopization) and negative multifocality (relative peripheral myopization). Less multifocality is created with the aberration-free pattern than with the classic pattern.

Corneal changes following short-term rigid contact lens wear

The aim of this cross-over study was to investigate the changes in corneal thickness, anterior and posterior corneal topography, corneal refractive power and ocular wavefront aberrations, following the short term use of rigid contact lenses. Fourteen participants wore 4 different types of contact lenses (RGP lenses of 9.5mm and 10.5mm diameter, and for comparison a PMMA lens of 9.5mm diameter and a soft silicone hydrogel lens) on 4 different days for a period of 8h on each day. Measures were collected before and after contact lens wear and additionally on a baseline day. Anterior corneal curvature generally showed a flattening with both of the RGP lenses and a steepening with the PMMA lens. A significant negative correlation was found between the change in corneal swelling and central and peripheral posterior corneal curvature (all p ≤ 0.001). RGP contact lenses caused a significant decrease in corneal refractive power (hyperopic shift) of approximately 0.5D. The PMMA contact lenses caused the greatest corneal swelling in both the central (27.92 ± 15.49 μm, p<0.001) and peripheral (17.78 ± 12.11 μm, p=0.001) corneal regions, a significant flattening of the posterior cornea and an increase in ocular aberrations (all p ≤ 0.05). The corneal swelling associated with RGP lenses was relatively minor, but there was slight central corneal flattening and a clinically significant hyperopic change in corneal refractive power after the first day of lens wear. The PMMA contact lenses resulted in significant corneal swelling and reduced optical performance of the cornea.

Silicon linkage with novel compliant mechanism for piezoelectric actuation of an intraocular implant

An implantable mechatronic microsystem is a new approach to restore the accommodation ability of the human eye. For change of refractive power a lens shift is performed by an actuator. This paper reports on the first actuator solution for such an implant. It is based on a piezoelectric bender the displacement of which has to be amplified in a very limited design space to sufficiently drive the optics of an Artificial Accommodation System. This challenge is solved by a novel compliant mechanism realized in single-crystal silicon that additionally ensures the tilt-free translational displacement of the lens required for optical imaging quality. The design is free of any surface-friction to achieve high durability. Finite element analysis is conducted to calculate and optimize the performance of three linkage design variants. They were fabricated on a scale of 1.5:1 using deep reactive ion etching. Measurements were carried out to characterize the geometry, elastic behavior, and kinematic performance of the linkage samples. The results are in very good agreement with the calculations and indicate sufficient amplification of the piezoelectric bender's displacement by the linkage to generate the required lens shift.

The influence of downward gaze and accommodation on ocular aberrations over time

A Shack-Hartmann wavefront sensor was modified to allow measurement of ocular aberrations in downward gaze with binocular fixation. Subjects first performed a control task prior to four different trials involving a distance task or a near task (accommodative demand of 2.5 D) performed in primary and downward gaze (25°). Immediately after beginning and then again 5 and 10 min after the commencement of each trial, ocular aberrations were measured. To observe the recovery in ocular aberrations following each test condition, subjects again viewed a distance target in primary gaze and aberration measurements were taken at 0, 5, and 10 min. During the distance task, small but significant changes in refractive power and higher order aberrations were observed in downward gaze compared to primary gaze. The changes in ocular aberrations that occurred in downward gaze recovered almost immediately after shifting gaze from downward back to primary gaze. During the accommodation tasks, there was a significant influence of gaze for changes in primary spherical aberration C(4, 0) [p=0.004] and secondary spherical aberration C(6, 0) [p=0.02]. There was also a significant gaze by time interaction (p=0.04) for changes in C(6, 0). These findings show that ocular aberrations change from primary to downward gaze, particularly during accommodation.

Refractive Changes after Descemet Stripping Endothelial Keratoplasty: A Simplified Mathematical Model

To develop a mathematical model that can predict refractive changes after Descemet stripping endothelial keratoplasty (DSEK). A mathematical formula based on the Gullstrand eye model was generated to estimate the change in refractive power of the eye after DSEK. This model was applied to four DSEK cases retrospectively, to compare measured and predicted refractive changes after DSEK. The refractive change after DSEK is determined by calculating the difference in the power of the eye before and after DSEK surgery. The power of the eye post-DSEK surgery can be calculated with modified Gullstrand eye model equations that incorporate the change in the posterior radius of curvature and change in the distance between the principal planes of the cornea and lens after DSEK. Analysis of this model suggests that the ratio of central to peripheral graft thickness (CP ratio) and central thickness can have significant effect on refractive change where smaller CP ratios and larger graft thicknesses result in larger hyperopic shifts. This model was applied to four patients, and the average predicted hyperopic shift in the overall power of the eye was calculated to be 0.83 D. This change reflected in a mean of 93% (range, 75%-110%) of patients' measured refractive shifts. This simplified DSEK mathematical model can be used as a first step for estimating the hyperopic shift after DSEK. Further studies are necessary to refine the validity of this model.

Surgical treatment for myopia

This article briefly explains surgical treatments of myopia. Laser refractive surgery using the excimer laser and/or femtosecond is the most commonly operated one. As the cornea has the greatest refractive power out of the ocular structures, the laser refractive surgery ablates the corneal stroma. Laser refractive surgeries are categorized by the surgical procedures basics: photorefractive keratectomy, laser in situ keratomilieusis (LASIK), laser epithelial keratomileusis, and Epi-LASIK. There are also some surgical treatment of myopia that does not use the laser ablation of the stroma. Intrastromal corneal ring segments implantation changes corneal shape which leads to the change of refractive power. Clear lens extraction reduces refractive power of crystalline lens by removal, and phakic intraocular lens implantation adds negative refractive power by implantation of intraocular lens. Patients are recommended to have a detailed consultation before choosing the surgical treatment based on their ocular status. There are several methods to treat myopia surgically, Laser reftractive surgery on cornea is most common method currently.

Effects of confined space and near vision stimulation on refractive status and vitreous chamber depth in adolescent rhesus monkeys

This study aimed to investigate the effects of sustained near vision stimulation, on the refractive development and elongation of the vitreous chamber in adolescent rhesus monkeys. A total of 12 adolescent rhesus monkeys (1.5-2.0 years old) were randomly assigned to 3 groups. In groups A (n=4) and B (n=4), monkeys were reared in close-vision cages for 8 and 4 h d(-1), respectively; tiny granules were added on the cage floor to avoid visual deprivation and to encourage near gaze. In group C (n=4), monkeys were reared in open-vision cages, with non-granule food as a control. Vitreous chamber depth, refractive status, and corneal refractive power were assessed over 18 months. Paired t-test was used to compare the differences and a P-value<0.05 was considered to be statistically significant. In group A, vitreous chamber depth and optical axis elongated significantly, and refractive error shifted towards myopia during the observation period. In group B, vitreous chambers and optical axis elongated but the refractive power did not show significant changes. In group C, there was no significant elongation in vitreous chambers and optical axis, and the refractive power changed slightly towards hypermetropia. There were no significant changes in corneal refractive power in each group. Sustained near vision can promote vitreous chamber growth and induce myopic shifts in refractive power in adolescent monkeys. Our results demonstrate the potential for a primate model of near-work-related myopia.

The Changes of Corneal Astigmatism and Refraction After Horizontal Rectus Muscle Surgery in Intermittent Exotropia

Purpose: To investigate changes in corneal astigmatism and refractive power in intermittent exotropia after lateral rectus recession with or without medial rectus resection. Methods: We compared visual acuity, spherical equivalent, refractive power, astigmatism from cycloplegic refraction, and Orbscan corneal topography in two groups consisting of 40 eyes from 20 patients who underwent bilateral lateral rectus recession (Group 1) and 33 eyes from 33 patients who underwent monocular medial rectus resection with lateral rectus recession (Group 2) immediately preoperatively and at 1 and 4 weeks postoperatively. Results: In Group 1, the refractive power changed +0.12 D on average in the horizontal median and -0.08 D on average in the vertical median at 1 week postoperatively. The refractive power changed +0.07 D on average in the horizontal median and -0.04 D on average in the vertical median at 4 weeks postoperatively. No significant change in the corneal astigmatic axis was detected. In Group 2, the refractive power changed +0.4 D on average in the horizontal median and -0.19D on average in the vertical median, and the corneal astigmatic axis significantly shifted by +0.51 D in the ‘with-the-rule astigmatism’ direction at 1 week postoperatively (p=0.02). However, the refractive power changed +0.2 D on average in the horizontal median and -0.09 D on average in the vertical median, and the corneal astigmatic axis changed +0.2 D at 4 weeks postoperatively, although these values were not statistically significant. Conclusions: Postoperative refractive power and corneal astigmatism did not change significantly, as compared to preoperative values, at 4 weeks postoperatively in the lateral rectus recession-only or medial-and-lateral rectus recession group.