Our initial outcome [abstract]

We have been using an Excimer Laser with flying spot technology to perform LASIK for the past 3 months. Both eyes are treated at the same sitting unless surgery is indicated in only one. Thirty-one patients have been treated, 30 had both eyes done while one had only one. The author has been privileged to follow the progress of 32 eyes of 16 patients. Target correction was achieved in 72 percent; correction acceptable to patient in 87.5 percent, enhancements were required in (4 eyes) 12.5 percent. Follow-up extended over 2 weeks to 3 months. Refractive errors corrected: hyperopia (two eyes), myopia (2 eyes) hyperopic astigmatism (10), myopic astigmatism (14), mixed astigmatism (4) Range of errors -8:50 DS to + 3:00 DS, and up to -4.25 DC. Age ranged from 26-68yrs; with 2 patients in their 60s and 3 in their 40s. Pre-operative best corrected visual acuity (BCVA) was 20/20 for distance and 20/20 for near, in all eyes. No loss of BCVA was recorded. COMPLICATIONS AND SIDE EFFECTS: One eye suffered a button-hole flap leading to minor off-axis scarring. Uncorrected vision of 20/20 for near was achieved as desired. One patient needs spectacles for glare at night. One patient is experiencing fluctuating vision at 2 weeks post op. (20/20 to 20/40). One eye with undesired astigmatism of -1.75 DC. Undercorrection in one eye: myopic ending -0.75; -1.50 being desired. These results have been very encouraging. The patients came from businesses and professional groups with one office clerk, an airline pilot and a sporting personality. With enhancements and the development of personal nomograms, a high success rate is anticipated. (AU)

Lasik monovision correction for Presbyopia [abstract]

Selection of patients, identification of the dominant eye and several other issues are analyzed. The results in 167 patients are presented. The best results were obtained in previous hyperopic patients in whom, of the 100 percent of patients with previous vision worse than 20/40 and J4, 90 percent were better than 20/25 and J2. In hyperopia, an overcorrection of the nondominant eye was induced while in myopia an undercorrection of the nondominant was the target. In this group 93 percent of the patients had vision worse than 20/100, J1 and 86 percent obtained better vision of 20/25 preserving J1. Examples of the different procedures are presented and at the end recommendations to get good results given. (AU)

Refractive errors in a black adult population: the Barbados Eye Study

PURPOSE: To describe the prevalence of refractive errors in a black adult population. METHODS: The Barbados Eye Study, a population-based study, included 4709 Barbados-born citizens, or 84 percent of a random sample, 40 to 84 years of age. Myopia and Hyperopia were defined as a spherical equivalent <-0.5 diopters and >+0.5 diopters, respectively, based on automated refraction. Analyses included 4036 black participants without history of cataract surgery. Associations with myopia and hyperopia were evaluated in logistic regression analyses. RESULTS: The prevalence of myopia was 21.9 percent and was higher in men (25.0 percent) than in women (19.5 percent). The prevalence of hyperopia was 46.9 percent and was higher in women (51.8 percent) than in men (40.5 percent). The prevalence of myopia decreased from 17 percent in persons 40 to 49 years of age to 11 percent in those 50 to 59 years of age, but increased after 60 years of age. The prevalence of hyperopia increased from 29 percent at 40 to 49 years of age to 65 percent at 50 to 59 years of age, and tended to decline thereafter. A higher prevalence of myopia was positively associated (P < 0.05) with lifetime occupations requiring nearwork, nuclear opacities, posterior subcapsular opacities, glaucoma, and ocular hypertension. Factors associated with hyperopia were the same as for myopia, except for occupation, and in the opposite direction. CONCLUSION: High prevalences of myopia and hyperopia were found in this large black adult population. The prevalence of myopia (hyperopia) increased (decreased) after 60 years of age, which is inconsistent with data from other studies. The high prevalence of age-related cataract, glaucoma, and other eye conditions in the Barbados Eye Study population may contribute to the findings.(AU)

Phakic intraocular lens in pigmented eyes

39 eyes in 20 patients with high hyperopia ranging from +3.00 to +7.00, high myopia ranging from -6.00 to -20.00 with accompanying astigmatism from -1.00 to -5.00, were implanted with the anterior chamber phakic intraocular lens from Ophthalmic Innovations International, Inc. Resulting visual acuities, avoidance of complications, special considerations for heavy iris pigmentation and general outcomes are discussed.(AU)