Uncorrected Visual Acuity Research Articles

Evaluation of retinal and choroidal microvascular alteration after ICL V4c implantation based on OCTA

BackgroundTo evaluate the changes of retinal and choroidal microvascular including the superficial retinal capillary plexus (SCP), deep retinal capillary plexus (DCP), choriocapillaris (CC), and central retinal thickness (CRT) in high myopic eyes after the implantable collamer lens with a central hole (ICL V4c) implantation using optical coherence tomography angiography (OCTA).MethodsThis retrospective study included 30 eyes of 30 patients (14 males and 16 females) who underwent ICL V4c implantation in Tianjin Aier Eye Hospital from October 2022 to May 2023. Uncorrected distant visual acuity (UDVA), best corrected distance visual acuity (BDVA), intraocular pressure (IOP), spherical equivalent (SE), axial length (AL), and optical coherence tomography angiography (OCTA) were measured and assessed before surgery, and 1 week, 1 month, and 3 months after surgery. OCTA was used to image and measure several key indicators: the foveal avascular zone (FAZ), vascular density (VD) of the SCP and DCP, blood flow density (BD) of the CC, and CRT. All measurement data were obtained utilizing the instrument’s proprietary software, ensuring accuracy and consistency.ResultsUDVA were significant improvements at the 1 week, 1 month, and 3 months after ICL V4c implantation surgery. BDVA, FAZ, and CRT maintained stable, however, IOP was higher at 1 week and 3 months post-operation compared to 1-month post-operation. The statistically significant difference was identified within the S3, S7, and S9 of SCP at each time point before and after the surgery (P1 = 0.004; P2 = 0.014; P3 = 0.037). However, paired analyses showed that there was a significant decrease in VD of S3 at 1 week after ICL V4c implantation surgery (P < 0.05), which then returned to preoperative levels by 1 month (P > 0.05), and the increase in VD of the S7 region at 1 month after ICL V4c implantation, which is significant compared to 1 week post-surgery, but not compared to preoperative levels. An overall comparison of the BD of the CC (2 mm) at each time point showed a statistically significant difference (P = 0.029).ConclusionICL V4c implantation offers a safe and efficient therapy to the high myopic patients. However, the retinal and choroidal microvascular changes need to be paid attention to in post-ICL implantation patients.

Correlation of angle kappa and angle alpha on visual outcomes in eyes implanted with three types of multifocal intraocular lenses.

To evaluate the correlation between preoperative, postoperative, and change in angle kappa and alpha to visual outcomes following implantation of three multifocal intraocular lenses. This is a retrospective study which included 122 eyes of 61 patients. There were 38 eyes in the Synergy (Johnson & Johnson, USA) group and 42 eyes each from both the Panoptix (Alcon Laboratories, USA) and FineVision (Physiol BVI, Belgium) groups. Visual outcome parameters (uncorrected distance, intermediate, near vision, halo and starburst) and angle kappa and alpha were recorded preoperatively and at three months postoperatively. The preoperative, postoperative and the amount of change in angle kappa and alpha were correlated to visual outcomes and photic phenomena among the three different diffractive trifocal IOLs. There were no significant differences in the preoperative and postoperative magnitude of angle kappa and alpha among the Synergy, Panoptix, and FineVision groups. There was no significant correlation between the preoperative and postoperative magnitude, and change in angle kappa and alpha with the postoperative uncorrected distance, intermediate and near visual acuity, and halo and starburst scores of the three different diffractive IOLs. The frequency of eyes with greater than 0.5mm angle kappa and alpha values were low. Visual outcomes can be good even in eyes in which the angle kappa and alpha were greater than 0.5mm. The newer diffractive multifocal IOLs were observed to be more tolerant to low and intermediate levels of angle kappa and alpha.

Comparison of visual outcomes in patients with cataracts and high myopia after implantation of a zonal refractive multifocal or diffractive bifocal intraocular lens

This study compares the optical quality of zonal refractive multifocal and diffractive bifocal intraocular lenses (IOLs) and visual outcomes after implantation in 93 patients(93 eyes) with cataracts and high myopia. A retrospective analysis was conducted to measure visual acuity at far, intermediate, and near distances, defocus curves, wavefront aberrations, modulation transfer function (MTF), a Quality of Vision questionnaire (QoV) and visual quality self-evaluation were examined at 3 months. The results demonstrated the ZMB group showed better uncorrected near visual acuity (P < 0.01), and the MF15 group showed better uncorrected intermediate visual acuity (P < 0.001). The ZMB group provided better MTF than the MF15 group (P < 0.01) but demonstrated a worse QoV score, especially for the severity of glare, halo, and starburst (P < 0.05). The satisfaction score and spectacle independence rate in the ZMB group were higher than in the MF15 group (P < 0.01). LS-313MF15 and TecnisZMB00 offered excellent visual restoration, stable distance visual acuity, and good subjective visual function.

Comparison of bilateral implantation of monofocal intraocular lenses with enhanced intermediate function targeting with − 2.00 D and emmetropia in moderate to high myopic Asian patients

BackgroundTo investigate the outcomes of bilateral implantation of enhanced monofocal intraocular lenses (IOLs, ICB00) with a − 2.00 diopter (D) target in patients with moderate to high myopia and to compare the clinical outcomes of a − 2.00 D binocular target with an emmetropia target in patients who underwent cataract surgery.MethodsIn this retrospective study, we reviewed the medical records of patients who underwent uncomplicated phacoemulsification with ICB00 IOL implantation. Emmetropia (Group 1) and − 2.00 D (Group 2) were targeted in 60 and 20 eyes of 30 and 10 patients, respectively. Three months after surgery, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), and uncorrected near visual acuity (UNVA) were measured. Defocus curves were measured under the photopic condition by intervals of 0.50 D from + 0.50 D to − 4.00 D.ResultsThe postoperative binocular logMAR UDVA, UIVA, and UNVA were 0.01 ± 0.03, 0.08 ± 0.11, and 0.33 ± 0.15 in Group 1 and 0.31 ± 0.13, 0.04 ± 0.05, and 0.11 ± 0.07 in Group 2, respectively. Group 2 showed a significantly superior postoperative binocular UNVA (P = 0.027) and inferior binocular UDVA (P = 0.003) than Group 1. Binocular UIVA and CDVA did not significantly differ between the groups although UIVA was better in Group 2 than in Group 1. Near glasses were needed by 66% of Group 1 and 0% of Group 2.ConclusionsBilateral implantation of ICB00 IOL with − 2.00 D of residual myopia is suitable for patients with moderate to high myopia to improve UDVA, UIVA, and UNVA.

Ten-year evaluation on efficacy, safety, and predictability of femtosecond laser corneal small incision lenticule extraction for correction of myopia and myopic astigmatism: a case series

Objective: The objective was to evaluate the 10-year long-term outcomes of patients undergoing small incision lenticule extraction (SMILE). Methods: In this continuous case series, the authors enrolled a total of 113 patients (208 eyes) who underwent SMILE 10 years prior. Measured parameters included uncorrected visual acuity (UCVA), corrected distance visual acuity (CDVA), and cycloplegia spherical equivalent error (SER). Results: One hundred thirteen patients were enrolled in this study. Patients’ age ranged from 18 to 44 years (mean: 30.2 years). One hundred ninety-three eyes (92.8%) and 176 eyes (84.6%) had an UCVA≥20/20 at 3 months and 10 years postoperatively. The mean efficacy index, measured at 3 months and 10 years postoperatively, were 1.041 and 1.023, respectively; the difference was not statistically significant. Three months after the operation, best-corrected visual acuity (BCVA) decreased by 1 line in 19 eyes (9.1%), remained unchanged in 158 eyes (76.0%), and increased by ≥1 line in 31 eyes (14.9%). Ten years after operation, BCVA decreased by 2 lines in 15 eyes (7.2%) and by 1 line in 35 eyes (16.8%); remained unchanged in 142 eyes (68.3%); increased ≥1 line in 16 eyes (7.7%). The mean safety index, measured at 3 months and 10 years postoperatively, were 1.147 and 1.331, respectively; the difference was not statistically significant. The mean SER at 3 months and 10 years postoperatively was −0.112 and −0.276, respectively; the difference was statistically significant. Conclusion: There was a decrease in SER 10 years after SMILE surgery compared with 3 months postoperatively, there was no significant decrease in the efficacy index or safety index.

Effect of Belin-Ambrósio deviation index on 2-year refractive outcomes of PRK.

To assess the effect of preoperative Belin-Ambrósio deviation (BAD-D) index on 2-year visual, refractive, and tomographic outcomes, as well as the efficacy and safety of photorefractive keratectomy (PRK) surgery. Eye clinic, Mashhad, Iran. Prospective cohort study. This study included 66 patients (66 eyes) who underwent PRK surgery, with a minimum follow-up period of 2 years. Participants were divided into 2 groups: preoperative BAD-D ≥1.60 (high BAD-D) and preoperative BAD-D <1.60 (low BAD-D). Preoperative and postoperative visual, refractive, and tomographic parameters were evaluated, and the efficacy and safety of the procedure were compared between groups. 66 patients with a mean age of 35.50 ± 8.21 years (range 22 to 55 years) were included. Postoperatively, the mean spherical equivalent (SE) of refractive error was +0.32 ± 0.65 diopters (D) in the high BAD-D group and +0.18 ± 0.66 D in the low BAD-D group ( P = .40). In addition, at 2 years of follow-up, the mean uncorrected distance visual acuity was 0.98 ± 0.07 in the high BAD-D group and 0.97 ± 0.08 in the low BAD-D group ( P = .905). Among the postoperative tomographic parameters, front elevation thickness, maximum Ambrósio relational thickness, astigmatism, and central corneal thickness were significantly different between the 2 groups (all, P < .05). At the 2-year follow-up, the mean Safety Index was 1.02 ± 0.04, and 1.01 ± 0.04 in high and low BAD-D groups, respectively ( P = .37), and the mean Efficacy Index was 0.99 ± 0.07 and 0.98 ± 0.06 in high and low BAD-D groups, respectively ( P = .40). The preoperative BAD-D index does not predict postoperative visual, refractive, and tomographic outcomes in patients with low-to-moderate myopia. However, in patients with normal preoperative BAD-D values, higher agreement was expected between the attempted and achieved SE.

Visual quality following FS-LASIK with Q-value-guided optimized monovision in patients with myopia and presbyopia: Custom-Q in treating myopia and presbyopia

PurposeTo evaluate the objective and subjective visual quality 3 months after femtosecond laser‐assisted laser in situ keratomileusis (FS-LASIK) performed with Q-value–guided optimized monovision scheme (Custom-Q) for correction of myopia with or without astigmatism and compensate for age-related accommodation deficiency. DesignProspective before-and-after study. MethodsPatients who had Custom-Q FS-LASIK for myopia with age-related accommodation deficiency were included in this prospective study. Distance, intermediate, and near visual acuities; refraction; Q value; corneal higher-order aberrations (HOAs); accommodative and binocular function measurements; defocus curve; contrast sensitivity and a subjective questionnaire assessing near visual ability and visual discomforts were evaluated before and after surgery. ResultsClinical data of 48 cases were analyzed. The mean age was 42.73 ± 2.67 years (40 to 50 years). At the 3-month follow-up, there were 100% (48/48), 92% (44/48), and 56% (27/48) patients who achieved a binocular uncorrected distance, intermediate and near visual acuity (UDVA, UIVA, UNVA) not less than 20/20 separately. Defocus curves revealed better results postoperatively at – 1.00 D and – 1.50 D. The Q value in the dominant eyes was more positive postoperatively (P<0.001), and in the non-dominant eyes, the Q value and corneal spherical aberration (SA) became more negative (P<0.05). The accommodative amplitude (AA) and relative accommodation improved binocularly (P<0.001). The questionnaire demonstrated high patient satisfaction with near vision, and patients’ perceptions of visual discomforts had no significantly difference compare with preoperative. ConclusionFor myopic patients with age-related accommodation deficiency, the Custom-Q ablation could improve near vision without compromising distance vision. It also led to minimal changes in objective optical quality, coordination of accommodative and binocular functions, contrast sensitivity, and subjective visual discomforts perceptions.

Evaluation of the Safety and Efficacy of Foldable One-Piece Intraocular Lens A1-UV for the Treatment of Cataracts: Summary of Two Clinical Trials

Objective: Through the combined analysis of data from two clinical trials, the clinical safety and efficacy of aspheric intraocular lens A1-UV implantation in cataract patients was evaluated at 1 year after surgery. Methods: A total of 239 subjects (239 eyes) were enrolled, including 117 subjects in the A1-UV group (study group), 61 subjects in the SN60WF group (control group 1) and AQBHL group (control group 2), respectively. Follow-up time points included: preoperative, intraoperative and postoperative 1~2days, 1 week, 1 month, 3 months, 6 months and 1 year. The evaluation indexes included: visual acuity, refraction, contrast sensitivity, intraocular pressure and complications. Statistical methods mainly include Wilcoxon rank-sum test, independent samples t-test, chi-square test or Fisher exact probability test. Results: The uncorrected distance visual acuity of the A1-UV group increased from logMAR 0.77±0.33 preoperatively to 0.15±0.22 at 1 year after surgery, from 0.74±0.33 in the SN60WF group to 0.18±0.23 at 1 year after surgery, and from 0.78±0.34 in the AQBHL group to 0.21±0.24 at 1 year after surgery. For best-corrected distance visual acuity, the A1-UV group increased from logMAR 0.60±0.36 preoperatively to 0.05±0.10 at 1 year after surgery, the SN60WF group increased from 0.59±0.36 preoperatively to 0.07±0.15 at 1 year after surgery, and the AQBHL group increased from 0.59±0.35 preoperatively to 0.08±0.11 at 1 year after operation. There was no significant difference between the A1-UV group and the other two groups (all P&gt;0.05). At different follow-up times after surgery, the residual diopters was significantly lower than that before operation (all P&lt;0.05), and the refractive error before operation was effectively corrected. The contrast sensitivity was high, and the visual function was better. The mean intraocular pressure of the subjects implanted with A1-UV was within the normal range during each follow-up period after surgery. None of the patients had serious adverse events related to intraocular lens. Conclusion: The efficacy and safety of A1-UV foldable one-piece intraocular lens in cataract treatment are good

Suture Less and Glue-Free Inferior Limbal Conjunctival Autograft Transplantation in Primary Pterygium Surgery: A Case Series

Introduction: Conjunctival autografting which is the mainstay in the management of pterygium. The conjunctival graft is most commonly harvested superiorly. However, superior bulbar conjunctiva may not be available for harvesting a graft in all cases and it would affect the outcome. This study aims at the efficacy of the inferior bulbar conjunctival grafting without using any suture or glue. Methods: This was a prospective observational study conducted in the Department of Ophthalmology, Pabna Medical College Hospital, Pabna, Bangladesh during the period from January 2019 to December 2020. In our study, we included 100 eyes of 98 patients with primary pterygium who underwent surgical procedures in Pabna Medical College Hospital. Results: A total of 100 cases were included in this case series. Patient’s age ranged from 18 to 83 years (mean 48.08±12.76 years). Total graft dehiscence occurred in 2 eyes (2%), graft retraction in 10 eyes (10%), and recurrence was seen in 1 eye (1%). At 3 months postoperatively, the gain in uncorrected visual acuity ranged from 2-3 lines in the Snellen chart in 9 eyes, symblepharon does not occur in any patient and no other complication was noted. Conclusion: Our study shows that this simple technique for pterygium surgery may prevent the potential risk of bad outcomes of future filtration surgery and overcome the conditions when superior bulbar conjunctiva may not be available for harvesting a graft.

Effects and safety of combined corneal collagen crosslinking and intrastromal corneal ring segment treatment in patients with keratoconus: a retrospective study

PurposeTo evaluate the safety and efficacy of different time-point combinations of intrastromal corneal ring segment (ICRS) implantation using femtosecond technology) and corneal collagen crosslinking (CXL) for the treatment of moderate-to-severe keratoconus (KCC).MethodsThis study included 69 eyes of 69 patients with keratoconus who underwent ICRS and CXL treatment at an Eye Hospital between March 2020 and March 2023. The patients were divided into two groups: Group 1 (n = 33 eyes of 33 patients), which received ICRS and CXL treatment in one session, and Group 2 (n = 36 eyes of 36 patients), which included treatment with ICRS for at least 6 months following CXL application. Preoperative and postoperative evaluations included visual acuity, autorefractometer refraction, corneal tomographic measurements using the Sirius (CSO) Scheimpflug camera and the TONOREF™ III device, and documentation of observed complications. Uncorrected visual acuity (UCVA) and best-corrected spectacle visual acuity (BCVA) were measured in each eye individually, and visual acuity was assessed using the logarithm of the minimum angle of resolution (logMAR).ResultsIn Group 1, mean UCVA improved from 0.81 ± 0.34 to 0.45 ± 0.25 (p < 0.01), and mean BCVA improved from 0.76 ± 0.35 to 0.38 ± 0.20 (p < 0.01). In Group 2, mean UCVA improved from 0.71 ± 0.32 to 0.43 ± 0.30 (p < 0.01), and mean BCVA improved from 0.65 ± 0.25 to 0.31 ± 0.23 (p < 0.01). Both groups showed significant reductions in manifest spherical and cylindrical refraction (p < 0.01). Group 1 exhibited greater reductions in maximum keratometry (Kmax), flat keratometry (K1), steep keratometry (K2) (p < 0.05), and astigmatic aberration compared with group 2 (p < 0.01). The use of simultaneous or separate CXL and ICRS does not significantly increase the incidence of complications.ConclusionsBoth combined and separate CXL and ICRS treatments resulted in significant improvement in UCVA and BCVA and reduced manifest refraction. Although improvements were observed in groups 1 and 2 in terms of K1, K2, and Kmax at 6 months, the improvements were more pronounced in Group 1. These results highlight the potential benefits of simultaneous ICRS + CXL treatment and underscore the importance of optimising the timing of CXL treatment to achieve the best visual outcomes.

Visual outcomes following high water-content hydrophobic acrylic trifocal intraocular lens implantation

BackgroundTo prospectively evaluate binocular visual outcomes after implantation of trifocal intraocular lenses (IOLs) with high-water-content hydrophobic acrylic material in Japanese patients.MethodsIn 59 patients (mean age 65.1 ± 7.9 years), Clareon PanOptix (CNWTT0: Alcon) with a high-water-content hydrophobic acrylic material was implanted bilaterally. Three months postoperatively, binocular uncorrected visual acuity (BUCVA) and distance-corrected visual acuity (BDCVA) at distances of 5 m, 80, 60, and 40 cm, binocular defocus curves, and binocular photopic contrast sensitivity were examined. Subjective symptoms (night vision disturbance, glare, halos, haze, or blurry vision) were also assessed.ResultsThe mean postoperative BUCVA/BDCVA at 5 m, 80 cm, 60 cm, and 40 cm were − 0.115/-0.163, -0.052/-0.047, -0.054/-0.075, and − 0.043/-0.067 logMAR, respectively. A smooth defocus curve, contrast sensitivity within the normal range, and acceptable subjective symptom rates were obtained.ConclusionsThe trifocal IOL, composed of a high-water-content hydrophobic acrylic material, provides good continuous binocular vision from distance to near.Trial registrationThis investigator-initiated study was registered in the Japan Registry for Clinical Trials (identifier: jRCTs032220042) on April 26, 2022.

Effect of Nd:YAG laser posterior capsulotomy on higher order aberrations in different types of posterior capsule opacification: A prospective study.

To evaluate higher order aberrations (HOA) in different types of posterior capsule opacification (PCO) and analyze its changes fosllowing Nd:YAG laser posterior capsulotomy (LPC). Tertiary care ophthalmic hospital. Prospective, comparative, observational study. One hundred ninety-three pseudophakic eyes with PCO were evaluated over 3 months. PCO was classified into pearly, fibrous, and mixed types. Their uncorrected visual acuity (UCVA), corrected distance visual acuity (CDVA), intraocular pressure (IOP), evaluation of posterior capsule opacification (EPCO) scoring and root mean square values of HOA (total, coma, spherical, and trefoil) were measured using a wavefront aberrometer before and after LPC. Pearly, fibrous, and mixed PCO were observed in 89 (46.1%), 47 (24.4%), and 57 (29.5%) eyes respectively. The UCVA and CDVA showed improvement in all types of PCO post-procedure. The total HOA was 0.48 ± 0.47, 0.43 ± 0.42, 0.37 ± 0.34, and 0.76 ± 0.53, the coma aberrations were 0.18 ± 0.15, 0.18 ± 0.14, and 0.19 ± 0.19, spherical aberrations were 0.07 ± 0.12, 0.09 ± 0.12, and 0.05 ± 0.06, whereas the trefoil aberrations were 0.35 ± 0.44, 0.24 ± 0.26, and 0.21 ± 0.20, 15-day post-Nd:YAG LPC in pearly, fibrous, and mixed PCO respectively, all of which showed a significant reduction. The EPCO score showed no significant difference between different subtypes of PCO and had no correlation with the HOA. Post Nd:YAG LPC showed improvement in visual acuity with significant reduction in HOA in all types of PCO.

Clinical Evaluation of Violet Light Filtration and High-Resolution Lathing on a Diffractive Extended Depth of Focus IOL.

This study is a prospective, randomized, subject/evaluator-masked clinical trial in a single-center clinical setting. The purpose of the study is to compare the clinical performance of Tecnis Symfony Optiblue IOL (models ZXR00V and ZXW150) with violet light filter (VLF) and manufacturing improvements versus Tecnis Symfony IOL (models ZXR00 and ZXT150) with ultraviolet light filter (UVF) in patients undergoing cataract surgery. Patients with cataracts aged ≥ 22years were randomly assigned 1:1 to bilateral implantation with ZXR00V/ZXW150 (VLF group) or ZXR00/ZXT150 (UVF group). Key endpoints at 6months postoperative included patient reported nighttime dysphotopsia symptoms, 25% low contrast visual acuity with glare, and patient satisfaction. Sixty patients were implanted with ZXR00V/ZXW150 (30) or ZXR00/ZXT150 (30). At 6months, the VLF group did not show a statistically significant differences in mean monocular photopic uncorrected distance visual acuity (UCDVA), best-corrected distance visual acuity (BCDVA), uncorrected near visual acuity (UCNVA) (40cm), or distance-corrected near visual acuity (DCNVA) (40cm) compared to the UVF group. At 1month, patients in the VLF group reported significantly less difficulty due to halo (p = 0.016) and starburst (p = 0.028) symptoms. By the 6months, dysphotopsia complaints were no longer significantly different between the groups. Although the VLF group trended toward better low contrast visual acuity and patient satisfaction, statistical significance was not reached. Managing the patients' expectations is key to achieving success. At the 1-month visit the patients who reported dysphotopsia complaints in the VLF group had significantly less difficulty with starbursts and halos as compared to the UVF group. By the 6-month visit, there was no significant difference between the two groups in the difficulty with starbursts and halos. ClinicalTrials.gov identifier, NCT06567834.

Improvements in visual function early after cataract surgery in eyes implanted with multifocal intraocular lenses.

To compare the improvements in all-distance visual acuity (VA) and contrast sensitivity early after cataract surgery among eyes implanted with multifocal and monofocal intraocular lenses (IOLs). Nonrandomized comparative study. Forty-two eyes with a trifocal IOL (Alcon, PanOptix®), 42 eyes with a combined bifocal and extended-depth-of-focus (EDF) IOL (Johnson & Johnson, Synergy®), and 84 eyes with a monofocal IOL were recruited. Uncorrected or corrected VA at various distances, and photopia and mesopic contrast VA were examined at 1day and 3 months postoperatively. Improvements in these VAs were compared between time points and among groups. Mean uncorrected as well as corrected VA improved significantly between 1day and 3 months postoperatively at almost all distances in the trifocal and combined bifocal + EDF groups (P ≤ 0.018), and at the intermediate distance of 1.0m and far distances in the monofocal group (P ≤ 0.031). Mean improvements in near uncorrected VA at 0.3m, intermediate VA at 0.5m, and far VA at 2.0, 3.0, and 5.0m were significantly greater in the multifocal groups than in the monofocal group (P ≤ 0.032). Improvements in photopic and mesopic contrast VA at most contrasts were significantly better in the multifocal groups (P ≤ 0.021). Mean uncorrected or corrected VA at almost all distances and contrast sensitivity at most contrasts improved significantly early after surgery in eyes implanted with multifocal IOLs, and the improvements in VA at most distances and in contrast sensitivity were better with multifocal IOLs than with monofocal IOLs.

Clinical safety and efficacy of elliptical thin-flap LASIK using a low-pulse energy femtosecond laser.

This study assessed the clinical safety and efficacy of elliptical thin-flap LASIK with a low-pulse energy femtosecond laser in 3 thickness subgroups (85, 90, and 100μm). A total of 80 patients who underwent bilateral LASIK surgery at Taiwan between April and September 2019 were retrospectively enrolled. Elliptical corneal flaps with wide temporal hinges and inverted-angled side cuts were created. Target flap thickness was calculated on the basis of residual stromal bed thickness and percent tissue altered. Before flap creation, an optical coherence tomography image for visualization of the precut flap position was obtained with the built-in camera. At postoperative month 1, the overall mean logMAR uncorrected distance visual acuity (UDVA) was - 0.04 ± 0.07 (20/18 Snellen), with 96% of eyes achieving UDVA of 20/20 or better. Postoperative mean manifest spherical equivalent was - 0.37 ± 0.42 D at 1 month. The visual and refractive outcomes in each of the 3 subgroups were similar. The achieved flap thicknesses were found to be highly predictable and consistent in the respective thickness subgroups. Optical coherence tomography-guided thin-flap LASIK performed with the low-pulse energy femtosecond laser was found to be safe with no intraoperative or postoperative complications.

Analysis of the effectiveness of the effect on accommodation of phenylephrine in comparison with the combination of tropicamide and phenylephrine in children with mild myopia

At the moment there is a rapid increase in the number of children with myopia, including high degree, which undoubtedly leads to further disability of the population. This problem is more relevant for developing and developed countries. Purpose of the study: to carry out a comparative analysis of the effectiveness of the effect of phenylephrine instillations on the accommodative apparatus of the eye in comparison with the combination of tropicamide and phenylephrine in children with mild myopia. The study analyzed the results of examination of 2 groups of children. At the initial examination, as well as after a course of drug therapy for 1 month. The following parameters were evaluated: determination of uncorrected visual acuity, spherical correction index, autorefractometry, relative accommodation reserve, relative accommodation volume and absolute accommodation volume. In the first group, which included 76 children (152 eyes), phenylephrine 2.5 % injections were performed once a day for 1 month. In the second group, which included 24 children (48 eyes), tropicamide 0.8 % in combination with phenylephrine 5 % 1 time a day for 1 month was administered. The analysis of the obtained data revealed positive dynamics to the improvement of uncorrected visual acuity, reduction of the index of spherical correction required to achieve the maximum corrected visual acuity. The reserves of relative accommodation, the volume of relative and absolute accommodation in both studied groups increased. However, the data obtained in the study of the second group, where the effect of tropicamide 0.8% in combination with phenylephrine 5% in the form of instillations was investigated.

Research on the Z.S. technique for 8 − 0 polypropylene suture in scleral fixation of one-piece intraocular lens

BackgroundTo introduce a new flange technique (called the Z.S. fixation technique) for 8 − 0 polypropylene suture in scleral fixation of a one-piece intraocular lens (IOL) and evaluate its effectiveness and safety.MethodsAll surgeries were performed using two strategies. First, the Z.S. fixation technique was used to fix 8 − 0 polypropylene sutures to the sclera and the two haptics of a one-piece IOL, respectively. The one-piece IOL previously implanted in the anterior chamber was then relocated to the posterior chamber. Finally, the suture ends outside the sclera were cauterized into flanges and buried in the sclera. All effectiveness and safety data related to the Z.S. technique were recorded and compared.ResultsThe Z.S. fixation technique was employed in 16 eyes of 13 patients, with a follow-up duration of at least 6 months. Postoperative uncorrected distance visual acuity (UDVA) was greatly improved in most of the operated eyes (11/16). The mean log MAR UDVA after surgery was significantly improved compared with that before surgery (0.93 ± 0.72 vs. 1.53 ± 0.73, P = 0.002). IOLs in the vast majority of operated eyes (15/16) remained stable during half-year follow-up. No severe intra-/post-operative complications were observed in any of the operated eyes.ConclusionThe Z.S. fixation technique for 8 − 0 polypropylene suture in scleral fixation of one-piece IOL reduced surgical injuries and had ideal surgical effectiveness and safety.

Features of the development and progression of diabetic macular edema in patients with type 2 diabetes

Background. In the developed world, the prevalence of type 2 diabetes in the population aged 65 years and older is 33 %, and prediabetes is 50 %. Macular edema can be the first symptom of diabetic retinopathy or occur at any stage of its development. In developed countries, the most common cause of central vision loss in people under the age of 50 is diabetic macular edema (DME). Long-term studies have found that the risk of developing DME is higher in patients with type 2 diabetes. The purpose was to investigate the features of the development and progression of DME in patients with type 2 diabetes. Materials and methods. A total of 180 patients (360 eyes) with non-proliferative diabetic retinopathy and type 2 diabetes were examined. The nature, frequency, and features of the development and progression of DME were evaluated. All patients were examined for uncorrected visual acuity, best corrected visual acuity, intraocular pressure, static computed perimetry, optical coherence tomography and optical coherence tomography angiography. We used the Student’s t-test to determine the statistical significance of the mean differences in two independent groups. The null hypothesis was rejected and the differences between indicators were considered statistically significant at a significance level of p &lt; 0.05. Results. In patients of the Ukrainian population with non-proliferative diabetic retinopathy and type 2 diabetes, the incidence of DME 0 averaged 55.56 %, DME 1 — 15.0 %, DME 2 — 15.56 %, DME 3 — 13.89 %. There was a statistically significant relationship between the frequency of DME of different stages and the duration of type 2 diabetes. At presentation, the frequency of DME 0 was on average 55.56 %; with the duration of type 2 diabetes of up to 10 years, it was 3 and 24 % statistically significantly higher (p &lt; 0.05) than in patients with duration from 11 to 20 and above 20 years, respectively. The incidence of DME 1 was 15.0 %, DME 2 was 15.56 %; with the duration of type 2 diabetes of up to 10 years, it was 2 times lower (p &lt; 0.05) than in patients with duration of 11 to 20 years and more than 20 years, respectively. The incidence of DME 3 was 13.89 %; with the duration of type 2 diabetes of up to 10 years, it was 3 times lower (p &lt; 0.05) than in patients with duration of 11 to 20 years and above 20 years, respectively. A statistically significant dependence of the incidence of diabetic macular edema on treatment in patients with non-proliferative diabetic retinopathy and type 2 diabetes has been found. When taking hypoglycemic drugs, the incidence of DME 0 increases statistically significantly, and when insulin therapy is used, the incidence of DME 1–3 increases. Conclusions. A statistically significant relationship was found between the frequency of DME of different stages and the duration of type 2 diabetes. The longer the duration of type 2 diabetes, the higher the frequency of DME stages 1, 2 and 3. The incidence of DME 1–3 in patients on insulin therapy is 2 times higher compared to patients taking hypoglycemic drugs (p &lt; 0.01).

Efficacy of enhanced monofocal intraocular lens in combined phacovitrectomy for patients with photoreceptor-preserving epiretinal membrane

The aim of this study is to evaluate the visual outcomes and quality of an enhanced monofocal intraocular lens (IOL), compared to a conventional monofocal IOL in patients with epiretinal membrane (ERM). This retrospective comparative study reviewed medical records of 110 eyes of 110 patients with photoreceptor-preserving ERM (55 patients in each group) who underwent phacovitrectomy and received either a conventional monofocal IOL (Tecnis PCB00) or an enhanced monofocal IOL (Tecnis Eyhance ICB00) from March 2021 to October 2021. Baseline examination included corrected (CDVA) and uncorrected (UDVA) distance visual acuity, and measurement of pupil size. Postoperative evaluation included uncorrected intermediate (UIVA) and near (UNVA) visual acuity, and defocus curve. Contrast sensitivity was assessed using CGT-2000 (Takagi, Seiko, Japan). The baseline parameters showed no difference between PCB00 and ICB00 groups. At 3 months, there was no difference of UDVA and CDVA, but UIVA (0.27 vs. 0.39 LogMAR; p = 0.001) and UNVA (0.35 vs. 0.45 LogMAR; p = 0.014) were better in ICB00 group. On the defocus curve, the ICB00 group demonstrated a slower slope decrease, with higher visual acuity from − 1.5 to -3.0 diopters when compared to the PCB00 group. The distant contrast sensitivity showed no significant difference between two groups. In conclusion, the enhanced monofocal IOL improved intermediate visual outcomes, achieving equivalent distance visual acuity and similar contrast sensitivity to the conventional monofocal IOL. It could be an alternative option to conventional monofocal IOL when planning combined phacovitrectomy for patients with photoreceptor-preserving ERM.

Refractive outcomes following simultaneous silicone oil removal and ciliary sulcus intraocular lens implantation.

This study aimed to assess the refractive outcomes following the combined intervention of silicon oil (SO) removal and ciliary sulcus intraocular lens (IOL) implantation in aphakic eyes after phacovitrectomy. A retrospective examination of medical records from patients who underwent a combined procedure of SO removal and ciliary sulcus IOL implantation from 2019 to 2022 was performed. The primary outcomes of interest included uncorrected distance visual acuity (UDVA), predictive error (PE) and mean absolute predictive error (MAE). Subgroup analyses were performed to compare outcomes between patients with and without intraoperative posterior capsulotomy. The cohort comprised 40 eyes from 40 patients, with a mean duration of SO tamponade of 5.17 ± 1.48 months. A significant improvement in UDVA was observed from 1.58 ± 0.31 logMAR to 0.99 ± 0.31 logMAR one month postoperatively (P < 0.01). The PE was -0.73 ± 0.86 diopters (D), and the MAE was 0.90 ± 0.67 D, with 37.50% and 57.50% of cases achieving PE within ±0.5 D and ±1.0 D, respectively. No significant differences in UDVA, PE, or MAE were found between the capsulotomy and non-capsulotomy subgroups (all P > 0.05). However, a lower proportion of eyes in the capsulotomy group achieved PE within ±1.0 D compared to the non-capsulotomy group one month postoperatively (38.90% vs. 72.70%, P = 0.03). The combined procedure of SO removal and sulcus IOL implantation resulted in a mild myopic shift in postoperative refraction. Intraoperative posterior capsulotomy seems to increase the lability of postoperative refractive outcomes.