Difference In Uncorrected Distance Visual Acuity Research Articles

Ten-year follow-up of posterior chamber phakic intraocular lens with central port design in patients with low and normal vault.

To assess the clinical outcomes and postoperative complications of the implantable collamer lens (ICL) with a central port throughout 10 years of follow-up in patients with low and normal vault. Fernández-Vega Ophthalmological Institute, Oviedo, Spain. Retrospective and comparative case series. This study included eyes that underwent a V4c ICL implantation with 10 years of follow-up. The eyes were divided into 2 groups according to the vault at 1 year postoperatively: vault <250 μm and between 250 μm and 800 μm. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell density (ECD), vault, complications, and secondary surgeries were analyzed. 37 and 90 eyes were enrolled in the low and normal-vault groups, respectively. No differences in UDVA, CDVA, and refraction were found between the groups over 10 years of follow-up. No cases developed ICL-induced anterior subcapsular opacity over the follow-up period. 2 (5.4%) and 8 (8.9%) eyes in the low and normal-vault groups, respectively, required ICL exchange. 1 (2.8%) and 2 (2.2%) eyes in the low and normal-vault groups, respectively, required excimer laser to correct residual refractive error. The IOP remained stable throughout the 10-year follow-up. The loss in ECD from that preoperatively to 10 years postoperatively was 3.8% and 4.5% in the low and normal-vault groups, respectively ( P = .4). No pigment dispersion glaucoma or other vision-threatening complications were reported. This study shows good long-term outcomes of the V4c ICL, supporting that the central hole provides safety to the procedure and prevents the potential risk associated with low vault.

Short-term clinical outcomes after implantation of monofocal intraocular lens with enhanced intermediate function in eyes with epiretinal membrane

Our study evaluated the clinical outcomes after implantation of a monofocal intraocular lens (IOL) with enhanced intermediate function in eyes with epiretinal membrane (ERM). Patients with preexisting ERM who underwent cataract surgery with implantation of monofocal IOL with enhanced intermediate function were included retrospectively. According to the ERM grade and central subfield thickness (CST) obtained from preoperative optical coherence tomography, patients were divided into non-fovea-involving and fovea-involving ERM groups. At 1 month after surgery, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), contrast sensitivity, defocus curve, and satisfaction questionnaire were evaluated. Postoperative clinical findings were compared with age-matched controls without ERM. A total of 50 patients’ eyes (28 and 22 in the non-fovea-involving and fovea-involving ERM groups, respectively) were compared with 42 control eyes. One month post-surgery, significant differences in UDVA, CDVA, and CST (corrected P was < 0.001, = 0.001, and < 0.001, respectively) were observed between the fovea-involving ERM and control group; however, no significant differences in UIVA and UNVA were observed between the two groups. Contrast sensitivity showed inferior results in the fovea-involving group without significance. Photic phenomena were reported less in the fovea-involving group than in the non-fovea-involving group. More than 70% of patients in both ERM groups were satisfied. Implantation of monofocal IOL with enhanced intermediate function could be a good option for patients with ERM that need intermediate vision.

Effect of femtosecond laser-assisted arcuate keratotomy versus toric intraocular lens implantation on correction of astigmatism in cataract surgery: a systematic review and meta-analysis.

To compare the efficacy of femtosecond laser-assisted arcuate keratotomy (FSAK) combined with non-toric intraocular lens (IOL) implantation versus Toric IOL (TIOL) implantation in correcting corneal astigmatism in cataract patients. Relevant literature was searched in databases including PubMed, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and SinoMed. Data from the included studies were extracted. A meta-analysis was conducted to compare the correction performance of FSAK combined with non-toric IOL implantation and TIOL implantation using postoperative refractive astigmatism, correction index, and uncorrected distance visual acuity (UDVA) outcomes. Publication bias assessment and sensitivity analysis were also performed. Five comparative studies were ultimately included in the meta-analysis. The TIOL group had smaller postoperative refractive astigmatism and a greater correction index compared to the FSAK group. The mean differences in postoperative refractive astigmatism and correction index between the two groups were - 0.19D (95% CI = 0.12 to 0.26, P < 0.01, I2 = 7%) and - 0.09 (95% CI = - 0.18 to 0.00, P = 0.04, I2 = 0%), respectively. We found no statistically significant difference in UDVA between the two groups (95% CI = - 0.01 to 0.11, P = 0.09, I2 = 70%). FSAK combined with non-toric IOL implantation was found to be less effective than TIOL implantation in correcting preoperative corneal astigmatism in cataract patients. The difference in the effectiveness of astigmatism correction between the two surgical methods seems to diminish, as the degree of preoperative corneal astigmatism decreases.

Influence of decentration of plate-haptic toric intraocular lens on postoperative visual quality

BackgroundTo evaluate the influence of decentration of plate-haptic toric intraocular lens (IOLs) on visual quality.MethodsThis study enrolled 78 eyes of 78 patients. Patients in group A were implanted with toric IOLs, and patients in group B were implanted with monofocal IOLs. All patients were divided into group A1 and B1 (decentration below 0.3 mm) and group A2 and B2 (decentration above 0.3 mm). The uncorrected distance visual acuity (UDVA), best corrected visual acuity (BCVA), modulation transfer function cutoff (MTF cutoff), objective scatter index (OSI), strehl ratio (SR), optical interference and patients’ satisfaction were measured in different pupils at three months postoperatively. The associations between decentration and visual quality were analyzed by Spearman correlation.ResultsThere were no significant differences in UDVA, BCVA, MTF cutoff, OSI, SR, optical interference and patients’ satisfaction among subgroups. The differences in decentration between groups A and B were not statistically significant. In group A2, the total higher order aberrations (tHOAs) at pupil sizes of 3 mm (P = 0.046), 5 mm (P = 0.014), spherical aberrations at pupil sizes of 3 mm (P = 0.011), 4 mm (P = 0.014), 5 mm (P = 0.000), secondary astigmatism at pupil sizes of 3 mm (P = 0.002), 4 mm (P = 0.005) were higher than in group B2. Compared to group A1, group A2 had higher spherical aberrations at pupil sizes of 4 mm (P = 0.042), 5 mm (P = 0.001), 6 mm (P = 0.038), secondary astigmatism at pupil sizes of 3 mm (P = 0.013), 4 mm (P = 0.005), 6 mm (P = 0.013). Group B2 has higher coma and secondary astigmatism than group B1 at 6-mm pupil (P = 0.014, P = 0.045). Significant positive correlations were found between spherical aberrations and the decentration of group A1 and A2 at 6-mm pupils.ConclusionThe decentration above 0.3 mm negatively affected visual quality due to increased tHOAs, spherical aberrations, coma and secondary astigmatism aberrations, the influence become larger with increasing pupil diameter. And toric IOLs are more affected by decentration than monofocal IOLs.

Effects of Chilled Saline Irrigation on SMILE Surgery.

To investigate the effect of ultra-early visual correction and prognosis of myopic astigmatism after irrigation with the chilled balanced salt solution (BSS) during small incision lenticule extraction (SMILE) surgery. A prospective case-control study was enrolled from 202 patients (404 eyes) who had SMILE, and randomly divided into an intervention group and a control group (each group was 101 cases [202 eyes]). After lenticule extraction on SMILE, the corneal cap and the corneal incision were flushed with chilled saline in the intervention group, whereas the control group was flushed with room temperature saline. All patients in the two groups were examined for early complications before and 2 hours, 24 hours, and 7 days after surgery and the results were compared, and statistically analyzed, including the recovery degree of naked eye vision, ocular irritation symptoms, opaque bubble layer, diffuse lamellar keratitis (DLK), uncorrected distance visual acuity (UDVA), and corrected distance visual acuity. The ocular irritation symptoms in the intervention group were milder than those in the control group at 2 hours after surgery, and the recovery of visual acuity at 2 and 24 hours after surgery was significantly faster than that in the control group, but there was no statistical difference in UDVA between the two groups at 7 days after surgery (P > .05). The incidence of DLK in the intervention group was lower than that in the control group, and the difference was significant (P = .041). Chilled BSS irrigation can reduce the emergency response of corneal tissue after SMILE, relieve ocular irritation, promote vision recovery, and relatively reduce incidence of early complications. [J Refract Surg. 2023;39(4):282-287.].

Comparison of visual outcomes after two types of mix-and-match implanted trifocal extended-depth-of-focus and trifocal intraocular lenses

To compare visual outcomes between two types of mix-and-match implanted trifocal extended-depth-of-focus (EDoF) and trifocal intraocular lenses (IOLs). A total of 212 eyes of 106 subjects with mix-and-match implanted FineVision Triumf and FineVision HP IOLs (Triumf-HP group) and 212 eyes of 106 subjects with mix-and-match implanted Zeiss AT LARA and AT LISA IOLs (AT LARA-LISA group) were enrolled in this retrospective case-control study. Uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), and binocular distance-corrected defocus curves were measured between 6 and 10weeks after cataract surgery. There was no significant difference in UDVA among the four IOLs. UNVA was the best in eyes with the FineVision HP IOL (0.04 ± 0.06 logMAR), followed by eyes with the AT LISA IOL (0.07 ± 0.07 logMAR), the FineVision Triumf IOL (0.09 ± 0.09 logMAR), and the AT LARA IOL (0.11 ± 0.08 logMAR), respectively. The AT LARA-LISA group had better visual acuity than the Triumf-HP group between - 1.00 D and - 1.50 D of defocus, and the Triumf-HP group had better visual acuity than the AT LARA-LISA group between - 3.00 D and - 4.00 D of defocus. Mix-and-match implantation of trifocal EDoF and trifocal IOLs provided good visual outcomes in far, intermediate, and near distances. The mix-and-match implantation of Triumf-HP IOLs led to better visual outcomes in near vision, while that of the AT LARA-LISA IOLs led to better visual outcomes in intermediate vision.

Comparison of Visual Outcomes and Quality of Life in Patients with High Myopic Cataract after Implantation of AT LISA Tri 839MP and LS-313 MF30 Intraocular Lenses.

Purpose To investigate the benefits of multifocal lens in patients with high myopic cataract and compare the clinical effects between AT LISA tri 839MP and MPlus LS-313 MF30 intraocular lenses (IOLs) in high myopic eyes. Methods This retrospective cohort study analyzed 60 eyes with axial length >26 mm in 40 patients. Thirty eyes were implanted with MF30, and the remaining 30 eyes were implanted with 839MP. Postoperative uncorrected distance visual acuity (UDVA), best corrected distance visual acuity (BCDVA), uncorrected intermediate visual acuity (UIVA) and uncorrected near visual acuity (UNVA), defocus curve, modulation transfer function (MTF) curve, Strehl ratio (SR), and complications were compared between the two groups. Results All vision outcomes were significantly improved in both groups (p < 0.05). There was no significant between-group difference in UDVA at 1 and 3 months postoperatively (p > 0.05). However, UIVA and UNVA were significantly better in the 839MP group (p < 0.05). The VF-14 score, especially for near vision quality, was significantly higher in the MF30 group (2.2 ± 0.9 vs. 0.8 ± 0.7; p ≤ 0.001). The SR of both groups significantly increased postoperatively (p < 0.05). All the 3-month MTF curve values (MTF 10 total, MTF 10 internal, MTF 30 total, and MTF 30 internal) were significantly better in the 839MP group (p < 0.05). Meanwhile, all the high-order aberration values (coma, spherical aberration, and trefoil) were significantly greater in the MF30 group (p < 0.05). Conclusion Multifocal IOL implantation achieves good quality of distance, intermediate, and near vision in patients with high myopia, improving their quality of life. Both 839MP and MF30 IOLs can provide good distance vision, but 839MP performs better in near and intermediate vision. However, for some patients with an extra-long optic axis, MF30 may be a good choice because of its wider range of degrees.

Visual Performance Following Bilateral Implantation of Refractive Rotationally Asymmetric Bifocal Intraocular Lens (LS-313 MF30) or Apodized Diffractive Bifocal Intraocular Lens (ReSTOR SN6AD1).

PurposeThis study compared the clinical outcomes after cataract surgery with implantation of refractive rotationally asymmetric bifocal intraocular lens (IOL) (LS-313 MF30) and apodized diffractive bifocal IOL (ReSTOR SN6AD1).MethodsThis was a prospective, non-randomized, controlled study, where patients diagnosed with age-related cataracts were selected for phacoemulsification combined with bilateral IOL implantation. Based on the type of IOL voluntarily implanted, the patients were divided into two groups, ie, refractive and diffractive groups. In total, 30 cases (60 eyes) were in a refractive group, while 30 cases (60 eyes) were in diffractive group. Three months after surgery, we examined the uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), defocus curve, objective visual quality, and subjective questionnaire.ResultsThree months after surgery, the UIVA of the refractive group (0.18 ± 0.08) logMAR was better than that of the diffractive group (0.29 ± 0.16) logMAR (P < 0.05). No significant difference in UDVA and UNVA was noted between the two groups. For a 4mm pupil diameter, the intraocular and total eye aberration, higher-order aberration (HOA), coma, spherical aberration, and trefoil in the refractive group were significantly higher than those in diffractive group (P < 0.05). The intraocular modulation transfer function (MTF), intraocular strehl ratio (SR), total eye MTF, and total eye SR in the refractive group were lower than those in diffractive group (P < 0.05). No significant difference in glare incidence, spectacle independence rate, and patient satisfaction was observed between the two groups (P > 0.05). The halos incidence in the refractive group was lower than the diffractive group (P < 0.05).ConclusionBoth bifocal IOLs obtained satisfactory UDVA and UNVA, with higher patient satisfaction. Unlike the apodized diffractive bifocal IOL, the refractive rotationally asymmetric bifocal IOL yielded slightly better UIVA, lower halos incidence, whereas the apodized diffractive bifocal IOL showed a better objective visual quality.

Visual outcomes after three different surgical procedures for correction of refractive error in patients with thin corneas.

To investigate and compare the visual and refractive outcomes of small incision lenticule extraction (SMILE), laser assisted sub-epithelial keratomileusis (LASEK), and LASEK combined with corneal collagen cross-linking (LASEK-CXL) surgery in patients with less than 500 µm of central corneal thickness (CCT). The retrospective medical records review was conducted on the patients with CCT less than 500 µm treated with SMILE, LASEK, and LASEK-CXL. There was a total of 172 eyes, 76 eyes were in the SMILE group, 53 eyes in the LASEK group, and 43 eyes in the LASEK-CXL group. Uncorrected distance visual acuity (UDVA), spherical equivalent refraction (SE), and corneal haze were followed up in the three groups for 12mo. At 12mo postoperatively, there were no statistically significant differences in UDVA and in the absolute value of SE between the three groups. The predictability within ±0.50 D in the SMILE group (85.5%) was significantly higher than in both the LASEK group (64.2%, P<0.01) and the LASEK-CXL group (69.8%, P=0.04). The efficacy index and safety index were not significantly different among the three groups. Corneal haze at 12mo postoperatively was higher in the LASEK-CXL group (27.9%) than in the SMILE group (2.6%, P<0.01) and in the LASEK group (7.5%, P<0.01). In patients with CCT less than 500 µm, SMILE, LASEK, and LASEK-CXL appear to be effective for myopic correction. Among them, SMILE surgery shows the highest predictability.

Refractive characteristics of keratoconus eyes with corneal Vogt's striae: A contralateral eye study

PurposeThe aim of this study was to assess and compare clinical characteristics of bilateral keratoconus patients with unilateral Vogt's striae. MethodsIn this contralateral eye study, refractive status were evaluated in patients with bilateral keratoconus whose corneas had definite slit-lamp biomicroscopic evidence of unilateral Vogt's striae. All cases underwent a comprehensive ophthalmic examination. Some refractive errors components provided by autorefraction were converted to vectorial notation for power vector analysis. Finally, the outcomes were compared between keratoconus eyes with and without Vogt's striae. ResultsFifty patients aged 20 to 38 years (27.43±5.5) were recruited in this study. The results showed a significant difference in uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), non-cycloplegic and cycloplegic autorefraction including sphere, cylinder, spherical equivalent, and J0, between keratoconus eyes with and without Vogt's striae (all P<0.05), except for J45 (P=0.518 in non-cycloplegic autorefraction and P=0.574 in cycloplegic autorefraction). Comparison of cycloplegic and non-cycloplegic autorefraction in both study groups showed significant differences in the sphere and spherical equivalent (all P<0.001), but no significant difference was found in cylinder, J0, and J45 between the study groups (all P>0.05). ConclusionsComparison of the cycloplegic and non-cycloplegic autorefraction in keratoconus eyes with and without Vogt's striae showed significant differences in UDVA, CDVA, and some refractive errors components provided by autorefraction between the two groups, with a worse condition in KCN eyes with Vogt's striae.

Influence of Cap Thickness on Corneal Curvature and Corneal Biomechanics After SMILE: A Prospective, Contralateral Eye Study.

To evaluate the impact of cap thickness for small incision lenticule extraction (SMILE) on changes in corneal curvature and biomechanics. One hundred eyes (50 patients) were enrolled in this prospective contralateral eye study. The difference in manifest refraction spherical equivalent (MRSE) in the same patient was less than 0.50 diopters. SMILE was performed with a randomized cap thickness of 110 µm in one eye and 140 µm in the other eye. MRSE, uncorrected distance visual acuity (UDVA), and corneal curvature and biomechanics were evaluated. The anterior and posterior surfaces of the corneal curvature (mean keratometry [Km] values 2, 4, and 6 mm from the pupil center) were measured by Pentacam HR (Oculus Optikgeräte, Wetzlar, Germany) and changes in corneal biomechanics at 6 months postoperatively by Scheimpflug technology. There was no significant between-group difference in UDVA or MRSE postoperatively. Postoperative changes in Km at the anterior surface (ΔKm-ant) in the 4-mm zone were significantly higher in the 110-µm group than in the 140-µm group at 1 day and 1, 3, and 6 months postoperatively (P = .043, .045, .003, and .049, respectively); at 3 months, the ΔKm-ant in the 6-mm zone was higher in the 110-µm group (P = .035). The changes in second appla-nation time, deformation amplitude, and integrated radius were significantly less in the 110-µm group (P = .031, .049, and < .001, respectively). A thicker corneal cap caused less change in anterior surface curvature after SMILE for moderate or low myopia, with no significant difference in UDVA and MRSE. [J Refract Surg. 2020;36(2):82-88.].

Prospective 2-year study of accelerated pulsed transepithelial corneal crosslinking outcomes for Keratoconus.

To report 2-year outcomes of transepithelial, accelerated, pulsed, corneal crosslinking (t-ACXL) for patients with progressive keratoconus. Prospective, interventional case series at a university hospital tertiary referral centre. Forty eyes with progressive keratoconus undergoing t-ACXL were included. Treatment was performed with pulsed illumination (1 s on/1 s off) using 45 mW/cm2 for 5 min and 20 s, for a surface dose of 7.2 J cm2. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent (MRSE), corneal tomography, anterior segment optical coherence tomography (OCT) and confocalmicroscopy were evaluated preoperatively and at 12 and 24 months postoperatively. The mean patient age was 23.32 ± 5.18 years (SD) (range 14-42 years). The mean CDVA significantly improved from 0.38 ± 0.32 logMAR at baseline to 0.30 ± 0.21 logMAR at 24 months (P < 0.01). There was no significant difference in UDVA, MRSE, asymmetry indices, tomographic parameters and endothelial density. The improvement in visual acuity was inversely correlated with preoperative CDVA and preoperative KMax. No complications were encountered. In this prospective study, t-ACXL appeared safe and effective in halting progression of keratoconus within a follow-up period of 24 months.

Comparison of clinical and functional results of conventional and femtosecond laser-assisted cataract phacoemulsification

To perform a comparative analysis of ultrasound and hydrodynamic parameters, and the outcomes of femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification cataract surgery (CPCS). This prospective cohort study included 246 eyes. The first group consisted of 138 patients who underwent FLACS, second group - 108 patients after CPCS. Total ultrasound time was 95.36±47.93 and 113.3±97.71 seconds (p=0.04) in the 1st and the 2nd groups, respectively. The duration of torsional ultrasound was 84.72±50.03 seconds in 1st group (p=0.04) and 113.3±97.71 seconds in the 2nd group (p=0.04). Aspiration time was 208.3±95.86 seconds in the 1st group (p=0.04) and 258.43±158.81 seconds in the 2nd group (p=0.04). On the 3-4th day after the surgery, uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were significantly better in the 1st group - 0.62±0.21 (LogMAR 0.20±0.19) and 0.53±0.15 (LogMAR 0.30±0.21) (p=0.01), respectively, compared to the 2nd group with UDVA of 0.75±0.18 (LogMAR 0.10±0.16) and CDVA of 0.69±0.19 (LogMAR 0.20±0.15) (p=0.04). Central corneal thickness (CCT) was 573.41±33.12 and 632.43±58.30 μm in the 1st and 2nd groups, respectively (p=0.020). At 1 month post-op there were no statistically significant differences in UDVA (p=0.17), CDVA (p=0.40) or CCT (p=0.50) between the groups. Compared with CPCS, total ultrasound time (p=0.04), torsional ultrasound time (p=0.04) and aspiration time (p=0.04) were significantly lower in the FLACS group. CCT was significantly lower (p=0.02), while UDVA (p=0.04) and CDVA (p=0.01) were significantly higher in the FLACS group in the early post-operative period (3-4 days after surgery). There were no statistically significant differences in the parameters between the groups 1 month after the surgery.

Effect of astigmatism on visual acuity after multifocal versus monofocal intraocular lens implantation

To determine whether there is a difference in how much residual astigmatism impacts uncorrected distance visual acuity (UDVA) after multifocal versus monofocal intraocular lens (IOL) implantation. Database study. Retrospective data review. An online toric IOL back-calculator allows users to input preoperative toric planning information and postoperative IOL orientation and refractive results. These data are used to determine the optimal orientation of the IOL to minimize residual refractive astigmatism. Aggregate data were extracted from this calculator to investigate factors associated withUDVA and relative magnitudes of residual astigmatic refractiveerror up to 2.5 diopters (D) after implantation of toric IOLs. Of 1919 pertinent records (455 multifocal toric IOLs and 1464 monofocal toric IOLs), a statistically significant difference by refractive cylinder category (P<.01) and a statistically significant difference by IOL type (P=.042) were noted.This difference was mostly driven by patients with residual refractive astigmatism of 1.5 D. The mean change in UDVA was 0.16 logarithm of the minimum angle of resolution per 1.0 D of astigmatism. Evaluating amore homogenous dataset withthe same monofocal and multifocal IOL design, therewas a statistically significant effect of refractive cylinder(P<.01) but nosignificant effect of IOL type (monofocal or multifocal, P=.45). The differences in UDVA at differentrefractive cylinder values was not statistically significantly different by orientation of the current astigmatism (P=.28). Residual astigmatism after toric IOL implantation impacts visual acuity similarly in patients who had multifocal and monofocal toric IOL implantation.

Therapeutic Effects of Lamellar Keratoplasty on Terrien Marginal Degeneration.

To evaluate the therapeutic effects of lamellar keratoplasty (LK) on Terrien marginal degeneration (TMD). Retrospective interventional case series. Medical records of 63 patients (71 eyes) who received LK for TMD at Qingdao Eye Hospital, Shandong Eye Institute from December 1995 to March 2014 were reviewed. A total of 56 eyes were treated with partial LK and 15 eyes with total LK. Complications, visual acuity recovery, and graft status were evaluated. Mean age of the patients was 50.4 ± 16.8 years. The follow-up period was 2.5 ± 0.9 years. The uncorrected distance visual acuity (UDVA) increased from preoperative 0.90 ± 0.44 logarithm of the minimum angle of resolution (logMAR) to 0.53 ± 0.27 logMAR at 1 year after surgery (t = 16.256, P < 0.001). The corrected distance visual acuity (CDVA) was 0.69 ± 0.30 logMAR preoperatively, and increased to postoperative 0.38 ± 0.22 logMAR (t = -19.982, P < 0.001). After surgery, mean astigmatism was 5.33 ± 2.44 diopters (D) compared with preoperative 10.19 ± 4.32 D (t = 7.351, P < 0.001), and the spherical equivalent decreased from preoperative -2.23 ± 2.34 D to -0.75 ± 2.04 D (t = -2.677, P = 0.012). There was a significant difference in UDVA, ΔUDVA, CDVA, ΔCDVA, and refractive astigmatism between the partial LK and total LK groups. The most common intraoperative complication was corneal perforation. The postoperative complications included double anterior chamber, persistent graft epithelium defects, corneal vascularization, immune rejection, graft ulcers, cataract, and recurrence of marginal degeneration. LK can effectively reduce refractive errors, improve visual acuity, and reduce the risk of corneal perforation for patients with TMD. The visual acuity after partial LK is superior to that after total LK.

Association of Visual Acuity with Ocular Dominance in 2045 Myopic Patients

ABSTRACTPurpose: Previous studies of the relationship between visual acuity (VA) and ocular dominance have produced conflicting results. We hypothesized that (1) the discrepancies were related mostly to sample size and interocular visual acuity difference (IOVAD); (2) in large samples of individuals with marked IOVADs, the eye with the better uncorrected distance visual acuity (UDVA) would be dominant. These hypotheses were tested in a large group of myopic patients.Methods: This prospective study of cycloplegic refraction involved 2045 myopic refractive surgery candidates. Patients with amblyopia or strabismus were excluded. Ocular dominance was assessed using the hole-in-the-card test.Results: In 2045 patients, the dominant eye had significantly better UDVA (p = 0.028) and was less astigmatic (p = 0.000) than the nondominant eye. In 426 patients with marked interocular difference in the UDVA (≥0.2 logMAR), the dominant eye not only had significant UDVA (p = 0.022) but also significantly less myopic (p = 0.028) and had a shorter axial length (AL; p = 0.001). In patients with smaller differences in UDVA (0.1 logMAR, n = 411) or no difference (n = 1208), the dominant and nondominant eyes did not differ significantly with respect to UDVA, myopic power, and AL (p > 0.05).Conclusions: The present study showed that the dominant eyes had significantly better UDVA than the nondominant eyes, especially in individuals with marked differences in UDVA. These results supported our hypothesis regarding the relationship between better VA and ocular dominance.

Comparison of ocular higher-order aberrations after SMILE and Wavefront-guided Femtosecond LASIK for myopia

BackgroundTo compare changes in higher-order aberrations (HOAs) following small incision lenticule extraction (SMILE) and wavefront-guided femtosecond laser-assisted in situ keratomileusis (WFG FS-LASIK), and to investigate correlations between preoperative spherical equivalence (SE) and components of HOAs affecting visual quality.MethodsSixty-five myopic eyes from 38 patients were enrolled in the study retrospectively, either having undergone SMILE or WFG FS-LASIK. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive error, and individual Zernike coefficients of 3rd- to 6th-order HOAs were measured before and 3 months after the surgeries and were compared using the Mann-Whitney test or Student’s t-test. Additional generalized estimating equation analyses (GEE) were used to control for within-subject biases in individual Zernike coefficients between the right and left eyes of the same patients.ResultsThere was no significant difference in UDVA or CDVA after WFG FS-LASIK (Mean ± SD: −0.02 ± 0.07 and −0.04 ± 0.22 respectively, in logMAR) and after SMILE (−0.01 ± 0.06 and −0.04 ± 0.04 respectively). However, greater vertical coma aberration was found after SMILE (p = 0.036). Preoperative SE was correlated to induced horizontal coma (r = −0.608, p = 0.001) in WFG FS-LASIK, and correlated to induced vertical coma (r = −0.459, p = 0.003) in SMILE.ConclusionsBoth SMILE and WFG FS-LASIK can achieve planned visual outcomes in correcting myopia and myopic astigmatism. However, higher vertical coma was shown in SMILE than WFG FS-LASIK which might be a potentially impact factor for patients’ vision under certain lighting conditions and needs further investigation.

A Meta-Analysis Comparing Postoperative Complications and Outcomes of Femtosecond Laser-Assisted Cataract Surgery versus Conventional Phacoemulsification for Cataract.

Objective. This meta-analysis aimed to compare the outcomes and postoperative complications between femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification cataract surgery (CPCS). Methods. Bibliographic databases, including PubMed, Embase, and Cochrane library, were systematically searched for references on or before September 2015 regarding the outcomes and complications by FLACS or CPCS. Data on corneal endothelial cell loss, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive outcomes, and postoperative complications were retrieved. Results. A total of 9 trials were included in this analysis. Refractive outcomes (MD = −0.21, 95% CI: −0.39~0.03, P = 0.02) were significantly improved after FLACS. Although corneal endothelial cell loss was not significantly reduced after FLACS, there was a trend towards lower corneal endothelial cell loss (mean difference (MD) = 197.82, 95% confidence interval (CI): 2.66~392.97, P = 0.05) after FLACS. There was no significant difference in UDVA (MD = −0.01, 95% CI: −0.13~0.10, P = 0.80) or CDVA (MD = −0.03, 95% CI: 0.07~0.00, P = 0.09) between the two surgeries. Elevated intraocular pressure and macular edema were most commonly developed complications after cataract surgery, and the incidence of these complications associated with the two surgeries was similar. Conclusion. Compared with CPCS, FLACS might achieve higher refractive stability and corneal endothelial cell count. Nevertheless, further study is needed to validate our findings.

Comparison of visual quality after the implantation of different types of intraocular lens

Objective To compare the efficacy of different types of intraocular lens (IOL) implantation for age-related cataract. Methods A retrospective case series. Clinical data of 148 eyes of 162 cases of age-related cataract, were collected from April to December in 2014 at our hospital and all subjects were divided into three groups: simple cataract surgery combined with the traditional spherical IOL implantation in 44 eyes, zero spherical aberration AO IOL implantation in 56 eyes and negative spherical aberration ZCB IOL implantation in 48 eyes. The differences in patients age, preoperative uncorrected distance visual acuity and axial length among three groups were not statistically significant (P>0.05). The corneal astigmatism of all patients were less than 0.75 D. Uncorrected distance visual acuity (UCVA), best corrected distance visual acuity (BCVA), uncorrected near visual acuity (UNVA) and best corrected near vision (BCNA) were assessed preoperatively, 1 week, 1 month and 3 months after the surgery. And the ocular spherical aberration of the patients in 3 groups were assessed 3 months after the surgery. The total ocular spherical aberration of all subjects were measured by using the Ray tracing methed with pupil diameters of 4.0 mm. Results After three months, there were not statistically significant differences in UCVA, BCVA, UNVA and BCNA among three groups. After three months there was statistically significant difference among groups in total ocular spherical aberration. According to the data of corneal spherical aberration, the total ocular spherical aberration of patients in each group was divided into 3 grades. It is founded that the total ocular spherical aberration had no statistically significant defferences among groups when the corneal spherical aberration grade was less than 0.15 μm or greater than 0.45 μm. However, there was statistically significant difference when corneal spherical aberration grade was from 0.15 m to 0.45 μm. Conclusion Our earlier observation shows that negative spherical aberration IOL implantation is superior to traditional spherical IOL and aspheric IOL. Key words: Lens, intraocular, various types; Spherical aberration; Visual quality; Comparation

Objective and subjective visual quality after implantation of all optic zone diffractive multifocal intraocular lenses: a prospective, case-control observational study

Background and aimsTo evaluate the objective and subjective optical quality of all optic zone diffractive multifocal intraocular lens (IOL).MethodsFifty patients (50 eyes) having phacoemulsification and IOL implantation surgery were enrolled....