Acuity In Group Research Articles

The effect of adherence to spectacle wear on early developing literacy: a longitudinal study based in a large multiethnic city, Bradford, UK

ObjectivesTo determine the impact of adherence to spectacle wear on visual acuity (VA) and developing literacy following vision screening at age 4–5 years.DesignLongitudinal study nested within the Born in Bradford...

Two-year follow-up of corneal cross-linking and refractive surface ablation in patients with asymmetric corneal topography

AimsTo evaluate the safety and efficacy of corneal cross-linking (CXL) followed by photorefractive keratectomy (PRK) for refractive correction in patients with bilateral asymmetric topography.MethodsForty-four patients (88 eyes) were enrolled in...

Transepithelial corneal collagen crosslinking in patients with progressive keratoconus

To assess the effectiveness of transepithelial collagen crosslinking (CXL) in patients with keratoconus. The study involved 44 patients (44 eyes) with stage I-II progressive keratoconus. Patients were divided into two groups. The 1st group included 22 patients that had underwent transepithelial CXL. The 2nd group included 22 patients that had underwent traditional CXL. All patients of the group 2 all patients had corneal syndrome, which lasted 2-4 days. In the 1st group, 98% of the patients did not have corneal syndrome and their visual acuity (VA) was same as preoperative on the next day after the surgery. In the 2nd group, the mean level of postoperative pain was 1.7 times higher than in group 1 (p<0.05). Six months after the treatment, uncorrected VA (UCVA) in the 1st group has increased by 52%, the best corrected VA (BCVA) - by 17%, in the 2nd group UCVA increased by 53%, BCVA - by 20% (p<0.05). The demarcation line in the 2nd group was 2.2 times deeper than in the 1st group (p<0.05). Six months after the treatment in the 1st group mean K1, K2 and Km decreased by 1.5%, 2.3% and 1.7% respectively (p>0.05); in the 2nd group - by 3.6%, 3.9% and 4.1% (p<0.05) compared with the data before the surgery. One year after the treatment, mean Kmax in the 1st group decreased by 2.1%, in the 2nd group - by 3.9%. Differences with preoperative values were statistically significant only in the 2nd group. Transepitelial CXL is a safe procedure well tolerated by patients and leading to a rapid restoration of visual function. Transepithelial CXL proved to have reduced effectiveness in inducing improvement in keratometric values, its effect on visual acuity was likely to be similar to that of epithelium-off CXL.

Optical Coherence Tomography Measurement and Visual Outcome in Acute Central Retinal Artery Occlusion.

PurposeThis study investigated visual acuity (VA) values and differences depending on optical coherence tomography (OCT) findings in patients with acute central retinal artery occlusion (CRAO).MethodsA retrospective chart review was performed on patients with acute CRAO who underwent macular and disc OCT. We evaluated changes in macular thickness and retinal nerve fiber layer (RNFL) thickness after acute CRAO onset based on OCT. We also determined the association of thickness changes with VA improvement.ResultsThis study involved both eyes in a total of 12 patients with acute CRAO. A significant increase was observed in foveal (1 mm) thickness (p = 0.002), parafoveal (3 mm) thickness (p = 0.002), and peripapillary RNFL thickness (p = 0.005) in affected eyes with CRAO, but not in central foveal thickness (p = 0.266). A significant small difference in both eyes (affected eye – fellow eye) was shown in foveal (1 mm) and mean parafoveal (3 mm) thickness in the improved VA group (p = 0.008 and p = 0.004, respectively), but not in central foveal or peripapillary RNFL thickness (both p = 0.283).ConclusionsBoth macular and RNFL thickness increased in patients with acute CRAO. RNFL thickness decreased over time with progression of RNFL atrophy. Less macular damage caused by acute CRAO could be predicted by a small difference in macular thickness between eyes (affected eye – fellow eye). In such cases, patients had a greater chance of VA improvement.

Recurrence rate and need for reoperation after surgery with or without internal limiting membrane removal for the treatment of the epiretinal membrane

PurposeTo compare the recurrence rate and need for reoperation after epiretinal membrane surgery with and without removal of the internal limiting membrane.MethodsIn this retrospective study, 125 patients operated for epiretinal membrane removal were evaluated, with a minimum 6-month follow-up. Removal of the epiretinal membrane (ERM) was performed in 78 patients, while 47 had removal of the epiretinal membrane associated with internal limiting membrane peeling (ERM + ILM).ResultsThe mean age in the ERM group was 65.8 years old, ranging from 41 to 80 years old. In the ERM + ILM group, the mean age was 67.2 years old, ranging from 52 to 82 years old. The mean preoperative visual acuity in the ERM group was 20/80p, and in the ERM + ILM group, it was 20/80. The mean postoperative visual acuity in both groups was 20/30. The mean preoperative macular thickness in the ERM group was 467 µm ranging from 281 to 663 µm; in the ERM + ILM group, the preoperative macular thickness was 497 µm, ranging from 172 to 798 µm. After surgery, a reduction in macular thickness was observed in both groups. In the ERM group, the mean macular thickness reduction was 361 ± 101. µm, whereas in the ERM + ILM group, it was 367 ± 75.2 µm. Twenty-two patients presented with a recurrence of epiretinal membrane, of which 16 (20.5%) were from the ERM group and 6 (12.8%) were from the ERM + ILM group (p = 0.39); one patient (2%) was retreated in the ERM + ILM group, whereas 5 patients (6%) where retreated in the ERM group.ConclusionWe postulate that ILM peeling for the treatment of epiretinal membrane is not a relevant factor either for visual recovery or macular thickness reduction, but it may reduce the recurrence and reoperation rate.

Real-World Results of Intravitreal Ranibizumab, Bevacizumab, or Triamcinolone for Diabetic Macular Edema

Objective: To compare the visual and anatomical outcomes of intravitreal ranibizumab (group 1), bevacizumab (group 2), and triamcinolone (group 3) for center-involving diabetic macular edema. Methods: We retrospectively enrolled 275 eyes of 208 consecutive patients. Visual acuity (VA) in Early Treatment Diabetic Retinopathy Study (ETDRS) letters and central macular thickness (CMT) values on optical coherence tomography were extracted. Reported side effects were noted. Results: At 6 months, the mean changes in VA in group 1, group 2, and group 3 were +4.9, +4.3, and +4.6 letters, respectively (p = 0.911). Improvement of CMT at 6 and 24 months was significantly better in group 3 compared to groups 1 and 2 (p = 0.012 and p = 0.001, respectively). At 24 months, the only independent variable affecting the change in VA was initial VA (p = 0.020). Cataract and glaucoma prevalences were higher in group 3 (p = 0.000 and p = 0.001, respectively). Conclusions: Three treatment methods had similar effects with regard to improvement in VA; however, intravitreal triamcinolone provided additional anatomical improvement.

Glaucoma drainage device implantation with adjunctive intravitreal bevacizumab in neovascular glaucoma: 3-year experience.

PurposeTo evaluate the outcome of glaucoma drainage device (GDD) implantation with and without intravitreal bevacizumab (IVB) injection in treating neovascular glaucoma (NVG) at Cipto Mangunkusumo Hospital Jakarta, Indonesia.Patients and methodsThis retrospective study involved 39 eyes with NVG which underwent GDD implantation between 2012 and 2014. Thirty eyes underwent GDD implantation alone (control group) while 9 eyes underwent GDD implantation and IVB injection (IVB group). Visual acuity (VA), intraocular pressure (IOP), number of antiglaucoma medications, and success rate were compared between groups.ResultsThere were no significant differences in preoperative characteristics. On the last visit, VA was 2.6 (0.2–4.0) logMAR in the control group and 2.3 (0.4–4.0) logMAR in the IVB group (P=0.97). In the control group, final VA was significantly worse compared to initial VA (P<0.01), while in IVB group VA was apparently stable (P=0.24). Final IOP was 16.3±10.3 mmHg in the control group and 12.0 (2.0–49.0) mmHg in IVB group (P=0.40). The number of antiglaucoma medications was similar between groups (P=0.57). Surgical success rate in the IVB group (66.7%) was better than the control group (56.7%), but this difference was not statistically significant (P=0.71). Kaplan–Meier survival analysis showed the probability of success 37 months after surgery as 53.6% in the IVB group and 31.6% in the control group. No significant difference was found between the groups (P=0.45).ConclusionIn cases of NVG, GDD combined with IVB could maintain VA compared to GDD alone. However, there were no significant differences in final IOP, number of antiglaucoma medications, and surgical success rate.

Enzymotherapy of toxic anterior segment syndrome after phacoemulsification

Purpose. To investigate the efficacy of recombinant prourokinase (RPU) treatment in patients with toxic anterior segment syndrome after phacoemulsification.&#x0D; Material and methods. We observed 123 patients (123 eyes) with toxic anterior segment syndrome after phacoemulsification; patients of the group I (n = 30) received only antiinflammatory treatment; in treatment of patients of the group II (n = 31), instillations of the RPU solution were used, in the group III (n = 31), RPU solution was injected subconjunctivally, in the group IV (n = 31) RPU solution electrophoresis was used. Treatment result analysis was carried out within 30 days.&#x0D; Results. Initial mean visual acuity in groups was 0.09 0.04; 0.1 0.04; 0.09 0.04; 0.08 0.04, and was virtually the same (p 0.05). In 24 hours after treatment initiation, mean visual acuity in the group III was higher, than in the others. In three days and up to the end of observation period, the lowest mean visual acuity was noted in the group I (p 0.05). Anterior chamber assessment showed that beginning from the first 24 hours after treatment initiation, in groups III and IV, fibrin lysis in the anterior chamber was more pronounced, than in groups I and II (p 0.05); by the end of the observation period, worst indices of anterior chamber state were found in the group I (p 0.05), in other groups, they were almost identical (p 0.05). When using RPU, no allergic reaction was noted.&#x0D; Conclusions. RPU use in combined toxic anterior segment syndrome therapy after phacoemulsification allows increasing visual acuity, reducing convalescence time, and reducing the number of laser dissections. It was established that all methods of RPU administration are effective. RPU may be administered as eye drops on an outpatient basis, receiving efficacy similar to other administration methods.

Clinical efficacy of intravitreal conbercept injection and macular grid pattern photocoagulation in treating macular edema secondary to non-ischemic branch retinal vein oclussion

Objective To study and compare the clinical efficacy between intravitreal conbercept injection and (or) macular grid pattern photocoagulation in treating macular edema secondary to non-ischemic branch retinal vein occlusion (BRVO). Methods Ninety eyes of 90 patients diagnosed as macular edema secondary to non-ischemic BRVO were enrolled in this study. Forty-eight patients (48 eyes) were male and 42 patients (42 eyes) were female. The average age was (51.25±12.24) years and the course was 5–17 days. All patients were given best corrected visual acuity (BCVA), intraocular pressure, slit lamp with preset lens, fluorescence fundus angiography (FFA) and optic coherent tomography (OCT) examination. The patients were divided into conbercept and laser group (group Ⅰ), laser group (group Ⅱ) and conbercept group (group Ⅲ), with 30 eyes in each group. The BCVA and central macular thickness (CMT) in the three groups at baseline were statistically no difference (F=0.072, 0.286;P=0.930, 0.752). Patients in group Ⅰ received intravitreal injection of 0.05 ml of 10.00 mg/ml conbercept solution (conbercept 0.5 mg), and macular grid pattern photocoagulation 3 days later. Group Ⅱ patients were given macular grid pattern photocoagulation. Times of injection between group Ⅰ and Ⅲ, laser energy between group Ⅰ and Ⅱ, changes of BCVA and CMT among 3 groups at 1 week, 1 month, 3 months and 6 months after treatment were compared. Results Patients in group Ⅰ and Ⅲ had received conbercept injections (1.20±0.41) and (2.23±1.04) times respectively, and 6 eyes (group Ⅰ) and 22 eyes (group Ⅲ) received 2-4 times re-injections. The difference of injection times between two groups was significant (P<0.001). Patients in group Ⅱ had received photocoagulation (1.43±0.63) times, 9 eyes had received twice photocoagulation and 2 eyes had received 3 times of photocoagulation. The average laser energy was (96.05±2.34) μV in group Ⅰ and (117.41±6.85) μV in group Ⅱ, the difference was statistical significant (P=0.003). BCVA improved in all three groups at last follow-up. However, the final visual acuity in group Ⅰ and group Ⅲ were better than in group Ⅱ (t=4.607, –4.603;P<0.001) and there is no statistical significant difference between group Ⅲ and group Ⅰ (t=–0.802,P=0.429). The mean CMT reduced in all three groups after treating for 1 week and 1 month, comparing that before treatment (t=–11.855, –10.620, –10.254;P<0.001). There was no statistical difference of CMT between group Ⅰand Ⅲ at each follow up (t=0.404, 1.723, –1.819, –1.755;P=0.689, 0.096, 0.079, 0.900). CMT reduction in group Ⅰ was more than that in group Ⅱ at 1 week and 1 month after treatments (t=–4.621, –3.230;P<0.001, 0.003). The CMT in group Ⅲ at 3 month after treatment had increased slightly comparing that at 1 month, but the difference was not statistically significant (t=1.995,P=0.056). All patients had no treatment-related complications, such as endophthalmitis, rubeosis iridis and retinal detachment. Conclusions Intravitreal conbercept injection combined with macular grid pattern photocoagulation is better than macular grid pattern photocoagulation alone in treating macular edema secondary to non-ischemic BRVO. Combined therapy also reduced injection times comparing to treatment using conbercept injection without laser photocoagulation. Key words: Retinal vein occlusion/therapy; Macular edema /therapy; Angiogenesis inhibitors/therapeutic use; Antibodies, monoclonal/therapeutic use; Laser coagulation

Real-World Outcomes of Anti-VEGF Treatment for Retinal Vein Occlusion in Portugal.

Retinal vein occlusion (RVO) is an important cause of visual disability in the modern world. We aim to evaluate the real-world outcomes of patients with RVO treated with anti-vascular endothelial growth factor (VEGF) in Portugal. We performed a retrospective, observational, multicenter study including 8 centers across Portugal and 200 patients treated with either ranibizumab or bevacizumab. Data were collected at 3 time points: time of diagnosis (0 time point) and 6 and 12 months after initiating treatment. Demographic and clinical data were collected. Median visual acuity (VA) and central macular thickness (CMT) improved in the branch RVO (BRVO), central RVO (CRVO), bevacizumab, and ranibizumab groups at 6 and 12 months compared to baseline, with CMT improving further only in the CRVO and ranibizumab groups between 6 and 12 months (p = 0.002 and p = 0.001, respectively). The CMT was lower in the ranibizumab group compared to the bevacizumab group both at 6 and 12 months (p<0.02). Median CMT improved in both the good and poor baseline VA groups at 6 and 12 months compared to baseline (p<0.001). Median VA only improved for the group with poor baseline VA at 6 and 12 months of follow-up (p<0.001). Regression analysis identified several baseline variables as predictors of visual outcomes at 6 and 12 months, with different results depending on the analyzed group. Both treatments were effective, although less effective than results reported in clinical trials. The morphologic response was better with ranibizumab compared to bevacizumab, although functionally there were no differences.

A comparative evaluation between megadose intravenous dexamethasone and intravenous methyl prednisolone in the treatment outcome of optic neuritis

To compare the efficacy of intravenous methylprednisolone and intravenous dexamethasone for the treatment of optic neuritis in terms of visual recovery and side-effects and to evaluate the clinical profile of optic neuritis patients admitted in BPKLCOS. 60 patients of acute idiopathic typical optic neuritis presenting to our centre were included in this prospective, randomized comparative study. Study population was randomly divided into two groups. Group I received intravenous dexamethasone 200 mg once daily for three days and Group II received intravenous methylprednisolone 500 mg/twelve-hourly for three days followed by oral prednisolone for 11 days. Optic neuritis was found to be common in the age group of 21 to 30 years with female preponderance. The most frequent mode of presentation was abrupt loss of vision. Retrobulbar optic neuritis dominated the study group. Both groups were age and sex-matched. The mean presenting visual acuity in group I was 0.065±0.59. The mean presenting visual acuity in group II was 0.1±0.15. On day 90 of steroid therapy, visual acuity improved to 0.98±0.073 in Group I and 0.88±0.16 in Group II (p=0.23). At three months, there was statistically significant improvement in both groups in terms of colour vision, contrast sensitivity and Goldmann visual fields as well but difference between the two groups was statistically insignificant. Intravenous dexamethasone is an effective treatment for optic neuritis, which is comparable to intravenous methylprednisolone. However, larger studies are required to establish it as a safe, inexpensive and effective modality for the treatment of optic neuritis.

Clinical results of aphakia correction with multifocal intraocular lenses

to assess visual functions and ergonomics after bilateral versus unilateral implantation of Lentis Comfort LS-313 MF15 multifocal intraocular lenses (MIOL) in aphakic eyes. A total of 20 patients with М LENTIS LS-313 MF15 MIOLs were followed up. Group 1 consisted of 12 patients after bilateral symmetric implantation, group 2 - of 8 patients after unilateral procedure. The following parameters were examined: uncorrected binocular visual acuity at far, near, and intermediate distances under photopic and mesopic conditions, the range of pseudoaccommodation, spatial contrast sensitivity to achromatic sinusoidal gratings, lens stability with account to its optical design, and patient satisfaction with the resultant vision. In both groups, distance visual acuity was high under any lighting conditions. At near and intermediate distances as well as at 5-6 m, binocular visual acuity in group 1 was higher than in group 2, regardless of the lighting conditions. The range of pseudoaccommodation was 3.5 D and 3.25 D in groups 1 and 2, respectively. Spatial contrast sensitivity function appeared typical, with maximum values at intermediate frequencies and lower values at higher frequencies. None of the patients required distance correction. Of 32 eyes, 7 exhibited MIOL rotation of 10-25 degrees at 1 month after surgery, however, none of the patients presented complaints characteristic of IOL decentration. Bilateral symmetric implantation of М LENTIS LS-313 MF15 MIOLs has the advantage over a unilateral procedure, since it enables a wider range of pseudoaccommodation and less dependence on lighting conditions with no compromise of high visual acuity at far and intermediate distances.

Binocular visual acuity interaction in children: summation and inhibition

ObjectiveTo compare binocular visual acuity with the monocular visual acuity of the better eye and investigate the factors contributing to binocular interaction. DesignRetrospective observational study. ParticipantsWe enrolled 332 children. They were divided into 3 groups according to binocular interaction: group A (binocular equivalency), group B (binocular summation), and group C (binocular inhibition). MethodsMonocular visual acuity, binocular visual acuity, and stereoacuity were evaluated. The main outcome measures were the prevalence rates of binocular interaction and factors associated with binocular interaction, including monocular visual acuity of the better eye, interocular difference of monocular visual acuity, and stereopsis. ResultsOf 332 children, binocular summation and equivalency were noted in 218 (65.7%) and 95 (28.6%), respectively, and binocular inhibition in 19 (5.7%). The binocular visual acuity and monocular visual acuity of the better eye in group B were better than those in groups A and C, respectively (p = 0.000). There was a significant correlation between monocular visual acuity of the better eye and binocular visual acuity in groups B and C (r = 0.884, p = 0.000; r = 0.797, p = 0.000, respectively). The interocular difference of monocular visual acuity in group B (0.05 ± 0.07) was smaller than that in group C (0.13 ± 0.06) (p = 0.000). The proportion of children with good stereopsis was 74.3% in group B but only 31.6% in group C (p = 0.001). ConclusionsAbout 66% of 332 patients had better binocular visual acuity than monocular visual acuity of the better eye. Our results suggest that the monocular visual acuity of the better eye, interocular difference of monocular visual acuity, and stereopsis affect binocular interaction.

Comparison of visual and refractive outcomes after implantation of a new diffractive trifocal toric lens, a trifocal lens and a monofocal toric lens

PurposeTo evaluate a diffractif trifocal toric intraocular lens (IOL) comparated with a trifocal IOL and a monofocal toric IOL.MethodsThis retrospective comparative study included patients with visually significant cataract or presbyopia who were scheduled for lensectomy and implantation of IOL. They were included in 3 groups according to the IOL implanted: multifocal group, multifocal toric group and toric group. At 1 month postoperatively, visual acuity (VA) at long and near distance, and refractive outcomes were examined.Results70 eyes of 45 patients were included. 21 eyes in the multifocal group, 22 in the multifocal toric group, and 27 in the toric group. The mean age of patients was 70.7 years +/− 10.6 (range 52–91 years). Postoperatively, the mean refractive astigmatism decreased to 0.71D, 0.77D and 0.72D respectively in the 3 groups. The distance uncorrected VA was 0.13logMar +/− 0.11 for multifocal group, 0.13logMar +/− 0.16 for multifocal toric group and 0.12logMar +/− 0.11 for toric group. There were no statistically differences between the 3 groups for the uncorrected distance VA, and between multifocal group and multifocal toric group for the uncorrected near VA.ConclusionsDiffractif trifocal toric IOL provided useful VA at any distance. The addition of a toric surface to the aspheric diffractive multifocal IOL resulted in a comparable visual performance.

Binocular Visual Acuity and Corrective Lens Use in the United States Army.

To assess uncorrected and corrected distance and near binocular visual acuity (VA) and the use of corrective lenses in U.S. Army Active Duty, Guard, and Reserve Soldiers. A descriptive statistical analysis of VA group data from the U.S. Army Vision Readiness Classification Screening system was performed. Data pulls from June 2012 to January 2015 were compared. In January 2015, 62.3% of Soldiers had an uncorrected binocular distance VA of 20/20, 21.2% of Soldiers were worse than 20/40, and 41.4% of Soldiers wore corrective eyewear for distance vision. With correction, 92.5% had a binocular distance VA of 20/20 and 1.4% were worse than 20/40. In January 2015, 32.6% of Soldiers age >45 had an uncorrected binocular near VA of 20/20, 28.4% of Soldiers age >45 were worse than 20/40, and 61.9% of Soldiers age >45 wore corrective eyewear for near vision. With correction, 74.6% had a binocular near VA of 20/20 and 3.0% were worse than 20/40. Data for both years were similar, although there were differences between individual service components. In comparison to the U.S. adult population, U.S. Army Soldiers have better uncorrected and corrected vision and are less likely to wear vision correction.

Evaluation of Visual Outcome after Cataract Surgery in Patients Aged 85 Years or Older

A (86 eyes of 53 patients between 55 and 69 years of age), B (85 eyes of 53 patients between 70 and 84 years of age), and C (143 eyes of 98 patients 85 years of age or older), and the medical records of the patients were reviewed and analyzed. Results: The postoperative best-corrected visual acuity (BCVA) improved in 95% of group A patients, 87% of group B, and 81% of group C. When compared with the log MAR BCVA before and after surgery, the visual acuity after cataract surgery was improved effectively from 0.40 to 0.06 in group A, from 0.50 to 0.16 in group B, and from 0.75 to 0.31 in group C (p < 0.001). In group C, preoperative and postoperative BCVAs were significantly worse than in other groups (p < 0.001 and < 0.001, respectively) and the ratio of patients with vision improvement and patients with BCVA of 20/40 or better was significantly lower than in the other groups (p = 0.009 and < 0.001, respectively). Conclusions: The ratio of visual acuity improvement was decreased among the patients over 85 years of age. Pre and postoperative visual acuities in group C were observed worse than in other groups. Additionally, the postoperative visual acuity was low. However, average visual acuity improved in 81% of patients. Therefore, cataract surgery should be strongly recommended for very old patients. J Korean Ophthalmol Soc 2016;57(2):214-220

Fundus autofluorescence findings in central serous chorioretinopathy using two different confocal scanning laser ophthalmoscopes: correlation with functional and structural status.

To compare autofluorescence (AF) findings using wide-field (Optomap) and conventional (HRA-AF) confocal scanning laser ophthalmoscopy (cSLO) systems in patients with central serous chorioretinopathy (CSC), and to investigate the correlations between AF findings and functional and anatomical status. Optical coherence tomography (OCT) and AF images were compared in 73 eyes with serous retinal detachment (SRD) (group A) and 30 eyes without SRD (group B). We evaluated AF findings from the SRD region, atrophic area, and foveola. Correlations between AF findings and outer retinal abnormalities in OCT and visual acuity (VA) were analyzed. Optomap-AF was more effective than HRA-AF in identifying the margins of a detached area (P = 0.001) in group A, and for monitoring mild outer retinal damage (P = 0.041) in group B. The foveolar AF grades in both instruments were significantly correlated with VA and central foveal thickness (CFT) in both group A (Optomap, VA r s = 0.33, P = 0.012; CFT r s = -0.38, P = 0.002; HRA, VA r s = 0.62, P < 0.001; CFT r s = -0.70, P < 0.001) and group B (Optomap, VA r s = 0.71, P < 0.001, CFT r s = -0.78, P < 0.001; HRA, VA r s = 0.40, P = 0.026, CFT r s = -0.40, P = 0.030). Optomap-AF was found to be advantageous for monitoring subretinal status in eyes with SRD, and more accurately reflected mild outer retinal changes in eyes without SRD. Foveolar AF grades of both imaging modalities were significantly correlated with functional and anatomical status.

Postoperative Perfluro-N-Octane tamponade for complex retinal detachment surgery

To study outcomes after using perfluoro-n-octane (PFO) as a short-term postoperative vitreous substitute in eyes undergoing primary vitrectomy with or without sclera buckling for complex rhegmatogenous retinal detachments with inferior/multiple breaks or giant retinal tears (GRTs) or retinal detachment with extensive proliferative vitreoretinopathy (PVR). A prospective study was carried out where in 43 patients (Group 1) PFO was exchanged with silicon oil in the same surgical procedure and in 22 patients (Group 2) PFO was kept for 3 days and then exchanged with silicon oil by a separate surgical procedure. The respective surgeon took the decision whether to exchange PFO on the same day or after 3 days. The patients were followed up for 6 months to analyze the anatomical attachment rates, visual acuity gain, and postoperative complications in both the groups. There were 33 male and 10 female patients in group 1 and 18 male and 4 female patients in group 2. Mean age distribution in group 1 was 38.88 years (SD ± 21.45) and in group 2 was 38.09 years (SD ± 16.36). Mean preoperative best corrected visual acuity in group 1 was 2.02 ± 0.58 and in group 2 was 2.01 ± 0.53 logarithm of the minimum angle of resolution (LogMAR). The LogMAR Visual acuity in group 1 improved to 1.76 ± 0.43 after 1 month (P = 0.01, paired t test) and to 1.62 ± 0.62 after 6 months (P = 0.01, paired T test). This visual acuity in group 2 improved to 1.85 ± 0.42 after 1 month (P = 0.24, paired T test) and 1.90 ± 0.72 after 6 months (P = 0.49, paired T test). There was no difference regarding visual improvement in between two groups after 1 month and 6 months of follow-up (P = 0.125, independent sample T test). The retina was detached in 6 patients (14%) in group 1 and in 7 patients (31%) in group 2 after 6 months of follow-up. There was no statistically significant difference in between two groups regarding final attachment of retina (P = 0.109, Fisher exact test). There was also no significant complication. like increased posterior capsular opacification or glaucoma found after retaining PFO for 3 days. Conclusion: Perfluoro-n-octane is efficacious and safe as a short-term vitreous substitute in primary rhegmatogenous retinal detachment repair cases with inferior/multiple breaks or GRTs or with extensive PVR. But keeping perfluoro-n-octane for 3 days does not significantly reduce the risk of re-detachment with complex rhegmatogenous retinal detachment cases.

Optical coherence tomography can be used in evaluation of morphological and functional results after successful rhegmatogenous retinal detachment surgery with different tamponade agents

Background: Optical coherence tomography (OCT) findings are helpful in assessing the cause of reduced visual acuity (VA) after successful rhegmatogenous retinal detachment (RRD) surgery. Objective: To study anatomical and functional results after successful RRD surgery with gas-air mixture or silicone oil (SO) tamponade using OCT. Materials and methods. 70 patients were divided into 2 groups: group I (n = 34) - gas-air mixture tamponade; group II (n = 36) - SO tamponade. At baseline, were no significant differences by gender, age and VA between the groups. Follow-up was 12 months after the surgery. OCT was performed with the Cirrus HD-OCT 4000, CARL ZEISS MEDITEC, USA. Results: VA increased significantly in both groups. Regression analysis showed lower VA in group II and statistically significant association between VA and IS/OS and ELM defects. Сonclusions. There is a strong association of disruption of the IS/OS and ELM with reduced vision after successful retinal detachment surgery. Gas-air mixture tamponade showed some benefits in comparison with SO tamponade.

Comparison of Visual Recovery Following Ex-PRESS Versus Trabeculectomy

To compare the rate of visual recovery after Ex-PRESS implantation versus standard trabeculectomy. Subjects enrolled in a prospective randomized controlled trial comparing Ex-PRESS to trabeculectomy were analyzed for postoperative changes in visual acuity (VA). Risk factors for visual loss (split fixation, cup-disc ratio, intraocular pressure, visual field mean deviation, and hypotony) were evaluated. Sixty-four subjects were enrolled (33 Ex-PRESS, 31 trabeculectomy). There was no significant difference in mean logMAR VA between groups at baseline or any study visit. VA was significantly reduced up to week 2 following surgery in both the groups. However, by month 1, VA in the Ex-PRESS group was no longer significantly different from baseline (P=0.23) and remained nonsignificant at subsequent visits up to 6 months. In the trabeculectomy group, VA remained significantly lower than baseline at each study visit. At 6 months, 47% of the trabeculectomy eyes compared with 16% of the Ex-PRESS eyes had lost ≥2 Snellen lines (P=0.01). Reasons for VA loss included cataract, central retinal vein occlusion, and diabetic retinopathy, however, in a significant number of cases no cause could be determined. None of the risk factors evaluated were associated with vision loss. Although there was no difference in mean VA between the Ex-PRESS and trabeculectomy groups at any time point, trabeculectomy eyes were more likely to lose ≥2 Snellen lines. In addition, VA recovered faster in the Ex-PRESS group.