Short-term and long-term results after intravitreal bevacizumab therapy for macular oedema in branch retinal vein occlusion.

Objectives: The aim of this study was to determine the possible correlation between the short- and long-term effects of intravitreal bevacizumab on macular oedema after branch retinal vein occlusion (BRVO). Material and methods: This prospective clinical study included fifteen eyes of patients with macular oedema after BRVO. Corrected distance visual acuity (CDVA), recorded in LogMAR units, central foveal thickness (CFT) and maximum foveal thickness (MFT) were evaluated at one month after first application and at least every 2 months for one year. PRN treatment protocol was used for all patients. Statistical calculation was performed with SPSS for Windows and Microsoft Excel. Results: Mean CFT decreased significantly (p<0,0001) from baseline 471,2 ± 151,7 µm to 285,9 ± 79,82 µm at 12 months. CDVA improved significantly (p<0,0001) from baseline 0,58 ± 0,34 to 0,1 ± 0,25 at the end of follow up period. Change from baseline in the CDVA after one month was significantly positively correlated with the change in CDVA after 12 months (r=0,76, p=0,001). Change in CFT after one month had a strong positive correlation (r=0,78, p=0,001) with change after 12 months. There was no statistically significant correlation between the number of injections and the changes in CDVA, CFT, MFT after a single injection. Conclusions: Single injection effects of bevacizumab may indicate long-term results on macular oedema after BRVO, but further and larger studies are necessary. Abbreviations: BRVO = Branch retinal vein occlusion, RVO = Retinal vein occlusion, CFT = Central foveal thickness, MFT = Maximum foveal thickness, VEGF = Vascular endothelial growth factor, MO = Macular oedema, CDVA = Corrected distance visual acuity, PRN = Pro-re-Nata, SD-OCT = Special-domain optical coherence tomography, FT = Foveal thickness, LogMAR = Logarithm of the Minimum Angle of Resolution, WHO = World Health Organization, RPE = Retinal pigment epithelium.

Retinal changes in febrile seizures in children: a retrospective analysis in Tuzla Canton, Bosnia and Herzegovina.

Aim To evaluate the possibility of retinal haemorrhages or any other retinal pathology caused by febrile seizures alone in children aged between 2 months and 15 years. Methods Children aged between 2 months and 15 years admitted to the hospital following seizures were examined within 48 hours of admission. The seizures were classified by a paediatric neurologist and a detailed ocular examination, including indirect ophthalmoscopy, was performed by an ophthalmologist. Results In the period between May 2019 and May 2020 a total number of 106 children were examined. There were 66 (62.3%) male and 40 (37.7%) female children. The youngest patient was 2 months old and the oldest patient was 15 years old. None of the children was found to have retinal haemorrhages or any other retinal pathology. Conclusion Retinal haemorrhages or any other acute retinal findings in children with febrile seizures are very rare, but we cannot rule out its occurrence. The finding of retinal haemorrhages in a child admitted with a history of seizure should trigger a detailed search for other causes of those haemorrhages, especially shaken baby syndrome. Due to the lack of any manifestations on the retina after febrile seizure, maybe it is time that the current protocol and guidelines, considering obligatory fundus examination, should be re-examined.

Maculopathy, Fundus Changes and Anterior Lenticonus in Alport Syndrome.

Alport syndrome is a rare basement membrane disorder that may include ocular manifestations: dot-and-fleck retinopathy, anterior lenticonus, posterior polymorphous corneal dystrophy, or temporal macular thinning. It is primarily an X-linked inheritance condition (85%). This case report describes a 51-year-old male patient with Alport syndrome who was diagnosed due to ocular manifestations that were subsequently linked with a history of renal failure and bilateral sensorineural hearing loss. The diagnostic tools used were biomicroscopy, ultrasound, corneal topography, endothelial microscope analysis, macula optical coherence tomography, and fundus photography. Clear lens extraction was performed and improved his visual acuity. Further genetic analysis revealed a mutation in the COL4A5 gene on the X chromosome. Ocular manifestations can help determine the right diagnosis and help in multisystemic disease assessment. In cases of Alport syndrome, a nephrologist should be informed about the potential development of a specific antiglomerular basement membrane antibody that may lead to graft rejection. The patient's close relatives should also be examined.

The relationship between patient age and residual refractive error after uneventful laser in situ keratomileusis for moderate-to-high hyperopia.

PURPOSE: To determine if the manifest sphero-cylindrical residual refractive error, at various time points over a 12-month postop period after laser in situ keratomileusis (LASIK) was associated with patient age at time of surgery. METHODS: Patients with moderate to high hyperopia (3.00-7.00 DS) and astigmatism ⩽2 DC underwent LASIK using Wavelight Allegretto Eye Q (400 Hz). Treatments were centered on corneal vertex, flaps were made with Moria M2 mechanical microkeratome. Pre-and postoperative uncorrected and corrected distant visual acuity, best corrected spherical equivalent (SEQ) were measured. Measurements were taken at 1 week, 1, 3, 6, and 12 months after the surgery. Target refraction was emmetropia. Total of 161 patients were treated. In binocular cases, data from the right eyes were included for analysis. In this article, we report on refraction data only. Raw data were subjected to several permutations to elicit any links between refractive outcomes and patient age. RESULTS: The key findings were as follows y = postop SEQ (diopters), x = patient age (years), ln(x) = natural logarithm of patient age: At 1 month, y = x[0.049 -0.011.ln(x)] (R = -0.205, p = 0.001, n = 161). At 3 months, y = x[0.077 -0.017.ln(x)] (R = -0.355, p < 0.001, n = 161). At 6 months, y = x[0.088 -0.020.ln(x)] (R = -0.382, p < 0.001, n = 161). At 12 months, y = x[0.093 -0.021.ln(x)] (R = -0.409, p < 0.001, n = 161). There was no significant association between x and y at 1 week (p > 0.05). CONCLUSION: Residual postop refractive error after LASIK for hyperopia has a logarithmic association with patient age at time of surgery. In younger patients there is tendency toward undercorrection, the opposite occurs in older patients and this persists 1 year after treatment.

Keratoconus Progression Classification One Year After Performed Crosslinking Method Based on ABCD Keratoconus Grading System.

INTRODUCTION: Keratoconus is described as a degenerative bilateral, progressive, noninflammatory corneal disorder characterized by ectasia, thinning, and increased curvature. Keratoconus progression classification 1 year after performed crosslinking method in this study is based on the ABCD keratoconus grading system. AIM: To evaluate the possible keratoconus progression one year after performed a crosslinking (CXL) method based on the ABCD keratoconus grading system. Methods: Seventeen keratoconus patients (22 eyes) were included in this prospective study. CXL procedure was performed using the standard Dresden protocol at Eye Clinic Svjetlost Sarajevo with the inclusion period from January 2017 to January 2018. Twelve patients had monocular, and 5 patients had binocular treatments with follow up of 12 months. Preoperative and postoperative stages were compared using the ABCD keratoconus grading system measured on rotating Scheimpflug corneal tomography-based machine - Pentacam (Pentacam HR, Oculus Optikgeräte GmbH, Wetzlar, Germany). RESULTS: Out of 22 eyes, one eye had keratoconus stage I-II, 6 eyes had stage II, 4 eyes had stage III, and 9 eyes had stage III-IV. There was no statistically significant gradient change of keratoconus in comparison to one month after the surgery, p>0.05. There was no progression of the gradient when comparing to the preoperative stage. CONCLUSIONS: Corneal cross-linking could effectively stabilize the progression of keratoconus, as assessed by key corneal topographic parameters. Analyzing the trend of stage change in 12 months follow up after the crosslinking procedure of keratoconus patients there was no progression of a gradient in comparison to the preoperative stage. According to our results, we can conclude that CXL is a safe and effective procedure in treating keratoconus.

Vector Analysis of Changes in the Higher Order Ocular Aberrations and Central Corneal Thickness After T-PRK and Fs-LASIK.

INTRODUCTION: Refractive surgery procedures, transepithelial photorefractive keratectomy (T-PRK) and femtosecond laser in situ keratomileusis (Fs-LASIK) are regarded as safe and efficacious methods for correcting myopia and myopic astigmatism. These two methods do not have much differences in results when treating spherical myopia, while some differences does exist in treatment of myopic astigmatism. Vector analysis presents powerful tool to show the real differences between these two methods regarding higher order ocular aberrations and central corneal thickness of treated eyes. AIM: The aim of the study is to investigate changes in higher order ocular aberrations (HOAs) and central corneal thickness (CCT) following treatment of myopia and myopic astigmatism above -5.00DS and up to -2.00DC after either T-PRK or Fs-LASIK. METHODS: Patients (30 eyes per group) underwent T-PRK (group I) or Fs-LASIK (group II) procedure using Schwind Amaris 750S laser. HOAs (3mm&5mm pupil) and CCT were measured objectively at pre-, 1,3 & 6 months postop in each case. RESULTS: Key results at 6 months were: i) mean values of trefoil (5mm pupil) were 0.092µm (sd,0.055,95% CI 0.072 to 0.112) & 0.126µm (sd,0.078,95% CI 0.098 to 0.154) in group I, and 0.088µm (sd,0.058,95% CI 0.067 to 0.109) & 0.064µm (sd,0.034,95% CI 0.052 to 0.076) in group II (P=0.001 at 6 months); ii) Changes in CCT (ΔCCT) and best spherical equivalent correction (ΔBSE) was significant in group II (ΔCCT=-26.55[ΔBSE]-14.06,R=0.486,P=0.006) but not in group I (p=0.034). CONCLUSIONS: After T-PRK trefoil is worse than Fs-LASIK. The predictability of corneal changes is better following Fs-LASIK. .

Cross-linking treatment for better visual acuity.

Aim To correlate the maximum anterior sagittal curvature (Kmax) changes and uncorrected (UDVA) and corrected distance visual acuity (CDVA) in keratoconus patients after the cross-linking (CXL) procedure. Methods Forty-four eyes of 34 patients with keratoconus were analysed after the standard Dresden protocol CXL procedure had been performed. All patients underwent complete preoperative examination with a follow-up of 12 months with focus on UDVA, CDVA and Oculus Pentacam (Scheimpflug technology) analysis. We analysed and correlated Kmax changes in the postoperative period of 12 months together with visual acuity changes. Results Visual acuity improved significantly in the first 3 months after the procedure and even more significantly until the end of the first year. Even Kmax is the most relevant and most followed parameter for progression and regression of keratoconus, its lowering was not directly correlated with the visual acuity improvement (both uncorrected and corrected) in the first 6 months after corneal CXL procedure. Kmax was changed significantly in the period of 12 months post cross linking, but not in the first 6 months. Conclusion Corneal CXL should be considered as a procedure not just for corneal stiffening and stabilization, but also for visual acuity improvement in keratoconus patients.

Marcus Gunn Jaw-Winking Syndrome: a Case Report.

INTRODUCTION: Marcus Gunn syndrome is a rare phenomenon with very less number of cases reported in literature. It may be congenital or acquired. AIM: The aim of this case report was to report the clinical characteristics of Marcus Gunn patient from our Clinic. CASE REPORT: A comprehensive opthalmologic examination, CDVA (corrected distance visual acuity), fundus examination and photography, was conducted in Marcus Gunn patient. Clinical findings of patient presented as - chin positioned slightly upwards, extraocular motility normal on both eyes, cover test with normal findings, pupillary examination normal on both eyes. Left upper eyelid was in a lower position than the right one. On right eye, rima interpalpebrarum was 9 mm with upgaze of 13mm. On the left eye, rima interpalpebrarum was 5 mm with upgaze of 6 mm, and with open mouth, left rima interpalpebrarum was 10 mm. Visual acuity on both eyes was 1.0. Cycloplegic refraction on both eyes was +0,75 diopters (D), and Lang test was normal. In the differential diagnosis of patients with ptosis, Marcus Gunn jaw winking syndrome should be considered especially if it improves during feeding, sucking, chewing, smiling or any kind of mouth movement. In case of ptosis always do the jaw test. Have the infant bottle-feed. An older child can chew gum. Have the patient open the mouth, move the jaw from side to side, or protrude the jaw forward. CONCLUSION: Address first to treatment of any amblyopia if present - eyeglasses, patching etc., or strabismus. Think twice before deciding to operate.

Treatment of High Astigmatism with WaveLight Allegretto Eye-Q Excimer Laser Platform.

INTRODUCTION: The WaveLight Allegretto Eye-Q is a flying-spot excimer laser, with a pulse repetition rate of 400Hz, with two galvanometric scanners for positioning laser pulses. The system has an infrared high speed camera operating at 400Hz to track the patient's eye movements that either compensates for changes in eye position or interrupts the treatment if the eye moves outside a preset predetermined range. AIM: The purpose of this study was to investigate WaveLight Allegretto Eye-Q 400Hz laser delivery platform aimed to correct astigmatism by subjecting the pre and postoperative astigmatic values to vector analysis. METHODS: Patients were divided into two groups, depending on the type of astigmatism. Astigmatism was between 2 and 7 diopters (D). A total of 188 eyes (110 patients), 127 eyes (71 patients) with myopic astigmatism and 61 eyes (39 patients) with mixed astigmatism underwent unremarkable LASIK correction on WaveLight Allegretto Eye-Q 400Hz. The preoperative and postoperative sphere, negative cylinder [C] and axis (ø) of manifest refractions were subjected to vector analysis by calculations of the standard J0 (cos [4π(ø-90)/360]xC/2) and J45 (sin[4π(ø-90)/ 360]xC/2). RESULTS: Reporting the key results, we found that J0 significantly reduced after LASIK (p<0.001) but not J45. There was no significant association between individual pairs of pre and postoperative J0 &J45 values. CONCLUSION: WaveLight Allegretto 400Hz showed excellent results for treating patients with high astigmatism, regardless whether it is mixed or myopic astigmatism. The J45 did not reduce significantly possibly because of the low number of eyes with oblique astigmatism. There was no genuine difference postoperatively between groups treated on WaveLight Allegretto platform according to the vector analyses.

Lasik as a Solution for High Hypermetropia.

AIM: To evaluate safety and efficacy of Laser in situ Keratomileusis (LASIK) procedure for the correction of high hypermetropia. METHODS: Retrospective study of 160 patients (266 eyes) who underwent LASIK procedure for the correction of hypermetropia between +3.00 and +7.00 diopters(D) and cylinder up to 2.00D from January 2013 and August 2015. All ablations were performed with Wavelight Allegretto Eye-Q400Hzexcimer laser (Alcon, Forth Worth, TX, USA) with aberration free module and were centered on a corneal vertex. All flaps were made with Moria M2 (Moria, Antony, France) mechanical microkeratome (90µm head). Preoperative and postoperative uncorrected and corrected distant visual acuity (UDVA, CDVA), spherical equivalent (SE) and a berrometry for 5mm pupil were measured. Measurements were taken at 1 week, 1,3,6 and 12 months after the surgery. Wilcoxon Signed Ranks Test was used for statistical analysis. RESULTS: Postoperative UDVA was lower than preoperative CDVA at 1 week(p=0.001), at 1 month there was no difference (p=0.099), and at 3,6 and 12 months UDVA was better (p<0.0001). Preoperative SE was 4.69±1.20D (+3.75 to +7.50D). At 1 week SE was 0.03±0.67D (-0.50 to +0.63D), while at 1 year regressed to 0.58±0.56D (+0.25 to +0.88D). Sphere shifted from negative values targeted in treatment planning to compensate for regression to positive values. There was significant difference in SE at every time point (p<0.0005). There was a significant increase in coma (p<0.0001), trefoil (p<0.0001, p=0.0006) and spherical aberration (p=0.022, p=0.0052) at 1 week and 1 month postoperatively, without change throughout the rest of follow up. CONCLUSION: LASIK for high hypermetropia showed satisfactory results in postoperative refraction with reasonable regression without significant loss of lines of visual acuity. However, more test are necessary to asses optical quality.

A Case Study of Choroideremia and Choroideremia Carrier.

AIM: The aim of this case report was to report the clinical and genetic characteristics of choroideremia patient and a family member carrier. CASE REPORT: A comprehensive ophthalmologic examination, BCVA (best corrected visual acuity), fundus examination and photography, optical coherence tomography (OCT), OCT-angiography (OCTA), perimetry was conducted in choroideremia patient and a family member carrier. Clinical findings of choroidermia patient presented as significant atrophy of the choroid and retinal pigment epithelium (RPE) with the exception of a portion of preserved tissue in the macula. OCT showed foveal thickening with parafovoal RPE and fotoreceptor (FR) atrophy. OCTA revealed loss of choriocapillaris vasculature. Clinical diagnosis of CHM mutation was confirmed by multiplex ligation-dependent probe amplification assay (MLPA), followed by sequencing which revealed pathogen variance (c.1584_1587delTGTT). Clinical findings of carrier: small peripheral zones of atrophy and hyper pigmentation, without any symptoms or major visible changes on OCT or OCTA. CONCLUSION: Following new frontiers in gene therapy it is of curtail importance to diagnose patients correctly as well as confirm clinical diagnosis by genetic testing.

Evaluation of refractive errors in retinopathy of prematurity screening.

Aim To evaluate the frequency of refractive errors in premature children in retinopathy of prematurity (ROP) screening to find mutual connection of the prematurity level, disease activity and refractive errors. Methods A retrospective study was conducted in the Eye Clinic of the University Clinical Centre Sarajevo, between December 2013 and January 2017. A total of 126 patients of gestational age ≤ 34 weeks and birth weight ≤ 2000 g underwent ROP screening program. The patients were divided into three groups: patients without ROP (n=15), patients with spontaneous regression (n=106) and those with active form of ROP (n=5). Results There were 68 (54.0%) patients with refractive errors: 45 (35.7%) had hyperopia, 17 (13.5%) myopia and six (4.8%) astigmatism. There were three (60.0%) patients with an active form of ROP who had refractive errors: two (40.0%) had myopia and one (20.0%) hyperopia. The group without active ROP had hyperopia as most frequent refractive error, with 10 (66.7%) patients. The average birth weight of the patients without refractive errors was 1403.9±43.4 g compared to 1390.3±104.2 g of the patients with refractive errors (p=0.498). The average gestational age was 29.7±0.3 weeks in patients without and 29.0 ± 0.3 weeks in patients with refractive errors (p=0.126). Conclusion The birth weight and the gestational age were significantly lower in patients with the active form of ROP. Lower gestational age and birth weight of premature children increase the chance for the development of refractive errors such as hyperopia in all premature children and myopia in patients with active form of ROP.

Different Surgical Approaches for Treatment of Dissociated Vertical Deviation (DVD).

INTRODUCTION: DVD is a rare, poorly understood eye motility disorder of unknown etiology. In socially unacceptable deviation, surgical treatment is an option. We present patients operated with three different surgical methods. AIM: To evaluate and compare different surgical approaches for treatment of dissociated vertical deviation (DVD). METHODS: Total amount of 20 patients with DVD of ≥ 20 PD are operated with three different techniques on superior rectus (SR) muscle: Group I with preoperative angle of 20-30 PD was operated with 8 mm recession of SR, Group II with preoperative angle of ≥ 30 PD undergo 3 mm recession with posterior fixation on SR and Group III with preoperative angle of ≥ 30 PD undergo-splitting of SR muscle. Surgeries for associated horizontal deviations were performed before surgery for DVD. Follow up was three years. RESULTS: In all cases amount of DVD deviation was significantly reduced. No binocularity was gained. Although hyperdeviation of affected eye was reduced in all patients, we didn't eliminate deviation completely. Despite smaller preoperative angle, residual angle was bigger (6-12 PD) in the patients in group I where only recession of SR was performed, compared to Group II and III where postoperative angle was 4-8 PD in both groups. CONCLUSION: There are no recommended guidelines for the surgical treatment of DVD and treatment is based more on the surgeon's experience than evidence based data. In our experience recession of the SR should be method of choice in the cases of smaller deviation. SR recession combined with posterior fixation suture and Y-splitting seems to be a safe and effective method for surgical treatment of unilateral DVD with bigger deviation angles. Y splitting with less surgical complications and increasing effect with time can be a good alternative to posterior fixation surgery.

Epidemiology of Diabetic Retinopathy at Eye Clinic Svjetlost Sarajevo: Two Years Retrospective Single Center Study.

INTRODUCTION: Diabetic retinopathy (DR) is an important cause of blindness, and occurs as a result of long-term accumulated damage to the small blood vessels in the retina. 2.6% of global blindness can be attributed to diabetes. Disease severity was most often classified by the Early Treatment Diabetic Retinopathy Study (ETDRS) classification for DR severity. Patients are usually categorized based on the severity of DR as having mild nonproliferative diabetic retinopathy (NPDR), moderate NPDR, severe NPDR, or proliferative diabetic retinopathy (PDR). AIM: To evaluate DR status among patients at Eye Clinic Svjetlost Sarajevo , both, type 1 and type 2 DM patients who presented in our clinic at 2 years period - from June 2016 to June 2018. This is single center study. METHODS: Retrospective analysis of 753 diabetic patients that came for the first check up in our institution during those two years, 363 patients were male and 390 were female. Patients were divided in 3 groups (based on DR changes): a) No changes, b) Nonproliferative DR (with and without Diabetic macular edema-DME), c) Prolipherative DR (with and without DME + Advanced PDR). RESULTS: There were 35% of patients with no ocular changes, 41.2% had NPDR and 24% had PDR. Prevalence of DR in our study was 65.32%. Distribution of NPDR was 66.27%, and PDR was 33.73%. DME was present in 33.70% cases. In NPDR, DME was presented in 51% of the cases, while in PDR was presented in 49% of the cases. In state of advanced PDR, PDR was presented in 30.52% cases, tractional detachment and haemophtalmus in 50.20% of cases and neovascular glaucoma in 19.28%. Sixty-three patients ended up with vitroretinal surgery (8.4%) while in other studies that number is up to 3%. Out of that number 9 patients were patient with virgin eyes (14.28%). Neovascular glaucoma occurred in 19.28% of diabetics with proliferative retinopathy and 4.60% in all of diabetics. CONCLUSION: Diabetic retinopathy status of patients presenting at Eye clinic Svjetlost Sarajevo, Bosnia and Herzegovina is quite poor. There is a big need for early DR screening measures, good prevention and management of DR risk factors. Adequate and ON TIME management of DM and its vision threatening complications is of major importance.

Excimer Lasers in Refractive Surgery.

INTRODUCTION: In the field of ophthalmology, laser technology is used in many basic and clinical disciplines and specialities. It has played an important role in promoting the development of ophthalmology. AIM: This article is designed to review the evolution of laser technology in refractive surgeries in ophthalmology, mainly focusing on the characteristics of the excimer laser applied in corneal refractive surgery. METHODS: This article was performed based on a literature review and Internet search through scientific databases such as PubMed, Scopus, Web of Science and Google Scholar. RESULT: The literature on excimer laser technology addresses the technical and physical aspects of excimer lasers including types, characteristics and commercially available lasers on the market. CONCLUSION: The conclusion on this forum aims to help understand the benefits of excimer laser use in ophthalmology, with focus on correction of refractive errors.

Refractive Outcomes of Posterior Chamber Phakic Intraocular Lens Implantation for Correction of Myopia and Myopic Astigmatism.

OBJECTIVES: The aim was to examine efficacy and safety after Implantable Collamer Lens (ICL) implantation for correction of myopia et myopic astigmatism. METHODS: This prospective clinical study included 28 eyes of 16 patients which underwent implantation of ICL for correction of myopia up to -18,00 diopters (D) and myopic astigmatism up to -6,00 D in the Eye Clinic Svjetlost Sarajevo, from January 2013 to January 2016. Uncorrected distance visual acuity (UDVA), spherical equivalent (SE), corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell (EC) density were evaluated at one, six and twelve months. For statistical analysis SPSS for Windows and Microsoft Excel were used. RESULTS: Out of 16 patients, with mean age of 28,21 ± 4,06 years, 12 of them had binocular and 4 of them had monocular procedure. After 12 months mean UDVA was 0,76 ± 0,16 compared to UDVA 0,04 ± 0,03 preoperatively. Mean SE preoperatively was -0,21 ± 0,27 D compared to -9,52 ± 3,69 D preoperatively. At 12 months one eye (3,57%) lost 2 Snellen lines. In this study 8 eyes (28,57%) gained 1 line, 5 eyes gained (17,56%) 2 lines, and 3 eyes (10,72%) gained 3 lines. EC loss was 5,50±4.71% after 12 months. There was no significant change of IOP by the end of 12 months follow up period. One haptic crack was reported as the only intraoperative complication. Three postoperative complications were: two lens rotations and one retinal detachment. CONCLUSION: Implantation of ICL is an effective and safe method for reducing or correcting myopia and myopic astigmatism.

One Year Follow-Up After Veriflex Phakic Intraocular Lenses Implantation for Correction of Myopia.

OBJECTIVES: The aim of this study was to evaluate visual and refractive outcomes after Veriflex phakic intraocular lenses (pIOL) implantation in moderately myopic eyes as well as postoperative complications. METHODS: This prospective clinical study included 40 eyes of 26 patients which underwent implantation of Veriflex for correction of myopia from -6.00 to -14.50 diopters (D) in the Eye Clinic Svjetlost Sarajevo, from January 2011 to January 2014. Uncorrected distance visual acuity (UDVA), manifest residual spherical equivalent (MRSE), intraocular pressure (IOP), endothelial cell (EC) density were evaluated at one, three, six and 12 months. Other complications in postoperative period were evaluated. For statistical analysis SPSS for Windows and Microsoft Excel were used. RESULTS: Out of 26 patients 14 had binocular and 12 monocular procedure, with mean age of 29.8±6.5 years. After 12 months mean UDVA was 0.73±0.20. Mean MRSE was -0.39±0.31D and 90% of eyes had MRSE within ±1D. EC loss was 7.18±4.33%. There was no significant change of IOP by the end of 12 months follow up period. The only intraoperative complication was hyphema and occurred in one eye. Few postoperative complications were: subclinical inflammation in three eyes (7,5%), pigment dispersion in four eyes (10%), ovalisation of papilla in 2 eyes (5%) and decentration of pIOL in 2 eyes (5%). CONCLUSION: Implantation of iris-claw phakic lenses Veriflex for treating moderately high myopia is a procedure with good visual and refractive results and few postoperative complications.

Efficacy and safety of iris-supported phakic lenses (Verisyse) for treating moderately high myopia.

AIM: To evaluate efficacy and safety of iris-supported phakic lenses (Verisyse) for treating moderately high myopia. METHODS: This prospective clinical study included 40 eyes from 29 patients, who underwent implantation of Verisyse for correction of myopia from -6.00 to -14.50 diopters (D) in the Eye Clinic ''Svjetlost'', Sarajevo, from January 2011 to January 2014. Uncorrected distance visual acuity (UDVA), manifest residual spherical equivalent(MRSE), postoperative astigmatism, intraocular pressure(IOP), endothelial cell (EC) density were evaluated at one, three, six and twelve months. Corrected visual acuity (CDVA), index of safety and efficacy were evaluated after 12 months. RESULTS: Out of 29 patients 15 were males and 14 females, with mean age of 27.9 ± 5.0. After 12 months 77.5% eyes had UDVA ≥ 0.5 and 32.5% had UDVA ≥ 0.8. Mean MRSE was 0.55D ±0.57D and mean postoperative astigmatism -0.86D ± 0.47D. Efficacy index was 1.09 ± 0.19 and safety index 1.18 ± 0.21. One eye(2.5%) lost two Snellen lines and three eyes (7.5%) one line, 11 eyes (27.5%) gained one line, and five eyes (15.5%) gained two lines. EC loss after 12 months was 7.59 ± 3.05%. There was no significant change of IOP after one year follow up. CONCLUSION: Implantation of iris-supported phakic lenses (Verisyse) for treating moderately high myopia is an efficient and safe procedure.