Snellen Lines Of Best-corrected Visual Acuity Research Articles

Comparison between patching and interactive binocular treatment in amblyopia: A randomized clinical trial

PurposeTo compare the effect of amblyopia therapy on cases who received interactive binocular treatment (I-BiT™) with those who received standard patching of the dominant eye with placebo I-BiT™. MethodsIn this randomized clinical trial, 38 unilateral amblyopic children (3–10 years old) were studied. All unilateral amblyopic children who had best corrected visual acuity (BCVA) worse than 0.30 logMAR or a difference of two Snellen lines of BCVA between their two eyes were included, and children who did not complete at least 75% of amblyopia treatment were excluded from this study. Eventually, a total of 19 and 21 subjects were included in case and control groups, respectively. Cases played I-BiT™ games, while controls had standard patch therapy and played with placebo I-BiT™ games, both for one month. All subjects were examined at baseline and after one-month therapy. ResultsBCVA improved significantly in both groups after one-month treatment (case: P = 0.003, control: P < 0.001), while in comparison with each other, there was not any difference between them (P = 0.52). Although stereopsis improved in the case (P < 0.001) and control (P < 0.001), there was no significant difference between them pre and post-therapy. Our children played games for about 6 h total during one month in both groups, and their compliance was 87.5% and 76% in cases and controls, respectively. Two children were excluded due to their lower compliance of playing I-BiT™ games (n = 38). ConclusionsI-BiT™ game and patching with placebo game had similar BCVA improvement in amblyopic children after one-month treatment. It is suggested to conduct further randomized clinical trials with a larger sample size and longer duration of study and assessment of its recurrence.

Epiretinal Membrane Surgery Outcomes in Eyes with Subretinal Drusenoid Deposits: A Case Control Study

To evaluate outcomes of epiretinal membrane (ERM) surgery in eyes with subretinal drusenoid deposits (SRDDs) and to compare them with those with isolated ERM. Retrospective case-control study of consecutive patients who underwent pars plana vitrectomy (PPV) with ERM peeling. Twenty-five patients with SRDDs on spectral-domain (SD)-OCT who underwent surgery for ERM were included in the study. From the same cohort, for each case, we selected 2 age-matched control participants (50 eyes with isolated ERM). Preoperative best-corrected visual acuity (BCVA) also was matched as closely as possible. All participants underwent PPV and ERM peel for primary ERM. Postoperative BCVA, improvement in BCVA, preoperative and postoperative central macular thickness, surgical complications, and development of age-related macular degeneration (AMD) were recorded. At final examination, mean postoperative BCVA was significantly less for eyes with SRDDs (0.51 logarithm of the minimal angle of resolution [logMAR] vs. 0.21 logMAR; P= 0.0001). Eyes with SRDDs demonstrated less improvement in BCVA after ERM surgery (0.13 logMAR vs. 0.30 logMAR; P= 0.0032). Eyes with SRDDs were significantly less likely to gain 2 or more Snellen lines of BCVA after ERM surgery (28% vs. 56%; P= 0.028). Three of 25 patients (12%) undergoing ERM surgery showed worsening of Snellen BCVA by 2 lines ormore. Three of 25 eyes (12%) with SRDDs demonstrated advanced AMD after surgery, compared with 0 participants in the control group (P= 0.034). Epiretinal membrane surgery in eyes with SRDDs is associated with less favorable visual outcomes. Fewer patients demonstrate gain in BCVA, whereas a significant number show a deleterious decline. After surgery, AMD incidence seems high and patients may have an increased risk of raised intraocular pressure. These findings require further study to establish whether this represents a causal relationship. Surgeons should be vigilant for these complications. Appropriate patient counseling during the consenting process must be made.

Internal limiting membrane inverted flap technique: a new paradigm in large macular holes surgery

Purpose: To evaluate the efficacy and safety of the internal limiting membrane (ILM) inverted flap technique (IFT) in large macular hole (MH) surgery. Material and Methods: Retrospective analysis of eyes of patients with large MHs who underwent vitrectomy with ILM IFT between January 2013 and December 2014, with a minimum follow-up of 6 months. Myopic macular holes were excluded. We evaluated best-corrected visual acuity (BCVA), hole closure documented by OCT and complications. We compared preoperative and postoperative values. The Wilcoxon test was used for comparing BCVA (p <0.05). Results: 17 eyes of 17 patients with a mean age of 63.24 years were studied. 76.5% of eyes had primary MHs, 11,8% post-vitrectomy and 11,8% post-traumatic. Mean minimum MH diameter was 578,5 ± 147μm and the mean MH duration was 35,9 months. According to lens status, 47,1% were phakic, 11,8% had cataract and 41,2% were pseudophakic. Concomitant cataract surgery was performed in 47,1% of cases. At the mean follow-up of 7,76 months, closure rate was 100%, with BCVA improving from 1,20 ± 0,48 to 0,68 ± 0,36 logMar units. All patients improved BCVA, with 64,7% gaining two or more Snellen lines of BCVA. Complication rate was 5.6%. Conclusions: ILM IFT is an effective and safe technique in MH surgery. In this study, with large MH, the anatomic success rate was 100% and BCVA improvement was significant.

Evaluation of Laser in Situ Keratomileusis Outcomes in Cipto Mangunkusumo Hospital

Background: The aim of this study is to evaluate the efficacy, predictability and safety of the first experience in laser in situ keratomileusis (LASIK) surgery using Wavelight Refractive Suite in Kirana Cipto Mangunkusumo HospitalMethods: Design of this study was descriptive retrospective. Data of patients who underwent LASIK surgery from April 2012 to January 2013 were collected. The data consist of pre and post operative refractions, uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA).Results: Fifty eight eyes of 31 patients, 13 males and 18 females, mean age of 28 year-old were analyzed. The mean spherical error corrected was -6,42 ± 3,37 D with range of -1.25 D to -16,87D. Median UCVA post surgery 1 day, 1 week, and last follow up time were 6/7,5, 6/6, and 6/6 respectively. Postoperatively, 91,67% eyes achieved UCVA of 6/12 or better with 77,78% achieving 6/7,5 or better. One patient lost 1 Snellen line of BCVA became 6/6,6. The mean postoperative manifest refraction spherical equivalent was -0,24 (±0,42) D. The general refractive predictability was 88,2% within ±0.5D from the target refraction, while 94,1% within ±1D ofthetarget.Conclusion: LASIK surgery performed in Kirana Cipto Mangunkusumo Hospital is safe and effective with good refractive predictability.

Long-term results of clear lens extraction combined with piggyback intraocular lens implantation to correct high hyperopia.

To assess the refractive outcome of clear lensectomy combined with piggyback intraocular lens implantation in highly hyperopic patients. This case review included 19 eyes of 10 patients with high hyperopia and axial length less than 21mm. Intraocular lens power was calculated for emmetropia using the Holladay II formula in 17 eyes, and SRK/T formula in 2 eyes following clear lens extraction and piggyback intraocular lens implantation. Patients were examined periodically over 24 months for visual acuity and spherical equivalent (SE). The mean postoperative SE at 24 months was 0.20±1.39D (range, -3.00 to 2.50D), better than preoperative 9.81±2.62D (range, +6.00 to +14.50D) (P<0.001). Five eyes had SE within ±0.5D of emmetropia and 11 eyes within ±1.00D at postoperative 24 months. The mean postoperative uncorrected visual acuity (UCVA) at 24 months was 0.60±0.36, significantly improved compared to preoperative 1.39±0.33 (P<0.001). The mean best-corrected visual acuity (BCVA) at 24 months was 0.49±0.35, not statistically different compared to preoperative 0.38±0.30 (P=0.34). Twelve eyes maintained and 1 gained 1 or more Snellen line of BCVA, 4 eyes lost 1 line, and 2 eyes lost 2 lines at 24 postoperative months. Twelve eyes best-corrected near visual acuity (BCNVA) achieved J1 at postoperative 24 months compared to preoperative 7 eyes and the other 7 eyes better than J3. Clear lens extraction combined piggyback intraocular lens implantation appears to be an effective procedure to correct high hyperopia but mild overcorrection and intralenticular opacification may require secondary procedure.

Posterior chamber phakic intraocular lens (ICL) for hyperopia: Ten-year follow-up

To evaluate the long-term safety, efficacy, predictability, and stability of implantation of a Collamer implantable contact lens (ICL) (Staar) to correct hyperopic refractive errors. Ophthalmology Department, Santa Rita Hospital, Vercelli, Italy. Fifty-nine eyes of 34 patients with hyperopia had implantation of an ICL. Patients were examined preoperatively (baseline) and 1 day, 1 week, 1, 3, and 6 months, and 1, 2, 4, 6, 8, and 10 years postoperatively. Main outcome measures were subjective and objective refractions, uncorrected visual acuity, best corrected visual acuity (BCVA), variation in intraocular pressure (IOP), anterior chamber depth (ACD), variation in endothelial cells, adverse events, and patient satisfaction. Nine patients had ICL implantation in 1 eye and 25 patients, in both eyes. Preoperatively, the spherical equivalent (SE) was between +2.75 diopters (D) and +11.75 D and astigmatism was between +0.50 D and +1.00 D. The mean SE of the manifest refraction was +0.07 +/- 0.54 D; refraction stabilized quickly and remained stable throughout the follow-up period. At 10 years, the safety index was 111 and the efficacy index, 96.8. Of the eyes, 86.5% had a change in SE refraction within +/-0.50 D; 1.6% lost 1 Snellen line of BCVA. The mean endothelial cell loss was 4.7%, which remained almost unchanged throughout the follow-up period. The mean variation in ACD was -14.9% and in IOP, +5.3%. The results confirmed the long-term safety, efficacy, accuracy, and predictability of ICL implantation for hyperopia. The Collamer material was well tolerated in all eyes.

Long-term Study of Artisan Phakic Intraocular Lens Implantation for the Correction of Moderate to High Myopia: Ten-Year Follow-up Results

Purpose To determine the long-term performance of the Artisan phakic intraocular lens (PIOL) for the correction of myopia. Design Long-term (10 years) retrospective follow-up study. Participants Eighty-nine eyes of 49 patients who underwent Artisan PIOL implantation for the correction of myopia. Methods Comparisons were made between preoperative clinical data and the clinical data at 1, 6, and 10 years after surgery. Main Outcome Measures Refractive stability, refractive predictability, safety, efficacy, best-corrected visual acuity (BCVA), uncorrected visual acuity (UCVA), intraocular pressure, intraoperative problems, corneal endothelial cell density, corneal endothelial cell loss, and glare levels were evaluated. Results The mean spherical equivalent (SE) after 10 years was −0.70±1.00 diopters (D; range, −4.00 to 2.00 D), with no significant change in mean SE between 1, 6, and 10 years. At 10 years, 68.8% of all eyes were within 1.0 D of the intended correction. At 10 years, 31.2% (n = 24) gained 1 or more Snellen lines of BCVA and 2.6% (n = 2) lost more than 2 Snellen lines of BCVA; 93.3% reached a BCVA of 20/40 or better, and 82.0% reached a UCVA of 20/40 or better. The mean intraocular pressure remained stable and was 15.5±3.5 mmHg (range, 7–25 mmHg) at 10 years. The mean endothelial cell loss was −8.86±16.01% (range, −51.69% to 34.43%) at 10 years. Conclusions Long-term results demonstrate that the implantation of an Artisan PIOL for the correction of moderate to high myopia is a stable, predictable, and safe method when strict inclusion criteria for surgery are applied. There was no significant loss of corneal endothelial cells and no reports of long-term glare. To determine the long-term performance of the Artisan phakic intraocular lens (PIOL) for the correction of myopia. Long-term (10 years) retrospective follow-up study. Eighty-nine eyes of 49 patients who underwent Artisan PIOL implantation for the correction of myopia. Comparisons were made between preoperative clinical data and the clinical data at 1, 6, and 10 years after surgery. Refractive stability, refractive predictability, safety, efficacy, best-corrected visual acuity (BCVA), uncorrected visual acuity (UCVA), intraocular pressure, intraoperative problems, corneal endothelial cell density, corneal endothelial cell loss, and glare levels were evaluated. The mean spherical equivalent (SE) after 10 years was −0.70±1.00 diopters (D; range, −4.00 to 2.00 D), with no significant change in mean SE between 1, 6, and 10 years. At 10 years, 68.8% of all eyes were within 1.0 D of the intended correction. At 10 years, 31.2% (n = 24) gained 1 or more Snellen lines of BCVA and 2.6% (n = 2) lost more than 2 Snellen lines of BCVA; 93.3% reached a BCVA of 20/40 or better, and 82.0% reached a UCVA of 20/40 or better. The mean intraocular pressure remained stable and was 15.5±3.5 mmHg (range, 7–25 mmHg) at 10 years. The mean endothelial cell loss was −8.86±16.01% (range, −51.69% to 34.43%) at 10 years. Long-term results demonstrate that the implantation of an Artisan PIOL for the correction of moderate to high myopia is a stable, predictable, and safe method when strict inclusion criteria for surgery are applied. There was no significant loss of corneal endothelial cells and no reports of long-term glare.

Topography-driven photorefractive keratectomy : Results of corneal interactive programmed topographic ablation software

Objective: This study evaluated the efficacy, predictability, stability, and safety of a software program (Corneal Interactive Programmed Topographic Ablation (CIPTA) LIGI, Taranto, Italy) which, by transferring programmed ablation from the corneal topography to a flying-spot excimer laser, provides customized laser ablation. Design Noncomparative consecutive case series. Participants Forty-two eyes of 34 subjects with a mean age of 33.9 (range, 20–54) had CIPTA at the Cattedra di Ottica Fisiopatologica of Bari (Italy). Twenty-eight eyes were treated for hyperopic astigmatism and 14 for myopic astigmatism. All the subjects had irregular astigmatism. Operation Topography was acquired by a corneal topography mapping system (Orbscan, Orbtek, Inc., Salt Lake City, UT). These data were processed to obtain a customized altimetric ablation profile, which was transferred to a flying-spot laser (Laserscan 2000, Lasersight, Orlando, FL). Main outcome measures Data on uncorrected (UCVA) and best-corrected visual acuity (BCVA), predictability, and stability of refraction and any complications were analyzed. Results Mean follow-up was 13.2 months. At the last postoperative examination, 26 eyes (92.8%) in the hyperopic group and 12 eyes (85.7%) in the myopic group had an UCVA superior to 20/40. Twelve hyperopic eyes (42.8%) and five myopic eyes (35.7%) had a UCVA of 20/20. All patients fell between 1 diopter of attempted correction in the spherical equivalent. Only 1 (2.4%) of the 42 eyes, belonging to the hyperopic group, lost 1 Snellen line of BCVA. We did not observe any decentration and/or haze after photorefractive keratectomy treatment or any irregularity in the flap-stroma interface in the three laser in situ keratomileusis operations performed in this study. Conclusions The combination of topographic data with computer-controlled flying-spot excimer laser ablation is a suitable solution for correcting irregular astigmatism due to different causes.