TFOS Lifestyle: Impact of contact lenses on the ocular surface.

Several lifestyle choices made by contact lens wearers can have adverse consequences on ocular health. These include being non-adherent to contact lens care, sleeping in lenses, ill-advised purchasing options, not seeing an eyecare professional for regular aftercare visits, wearing lenses when feeling unwell, wearing lenses too soon after various forms of ophthalmic surgery, and wearing lenses when engaged in risky behaviors (e.g., when using tobacco, alcohol or recreational drugs). Those with a pre-existing compromised ocular surface may find that contact lens wear exacerbates ocular disease morbidity. Conversely, contact lenses may have various therapeutic benefits. The coronavirus disease-2019 (COVID-19) pandemic impinged upon the lifestyle of contact lens wearers, introducing challenges such as mask-associated dry eye, contact lens discomfort with increased use of digital devices, inadvertent exposure to hand sanitizers, and reduced use of lenses. Wearing contact lenses in challenging environments, such as in the presence of dust and noxious chemicals, or where there is the possibility of ocular trauma (e.g., sport or working with tools) can be problematic, although in some instances lenses can be protective. Contact lenses can be worn for sport, theatre, at high altitude, driving at night, in the military and in space, and special considerations are required when prescribing in such situations to ensure successful outcomes. A systematic review and meta-analysis, incorporated within the review, identified that the influence of lifestyle factors on soft contact lens dropout remains poorly understood, and is an area in need of further research. Overall, this report investigated lifestyle-related choices made by clinicians and contact lens wearers and discovered that when appropriate lifestyle choices are made, contact lens wear can enhance the quality of life of wearers.

Accuracy of five intraocular lens formulas in eyes with trifocal lens implant.

Accuracy of intraocular lens (IOL) calculation formulas SRK/T, Hoffer Q, Holladay 1, Haigis and Barrett Universal II were compared in prediction of postoperative refraction for multifocal and implants using a single optical biometry device. The authors included 88 refractive lens exchange and cataract surgeries, with AcrySof IQ PanOptix implant (Alcon Laboratories, Inc.). All eyes were divided into three groups based on axial length (AL), group 1: <22 mm (14 eyes), group 2: 22-24.5 mm (68 eyes) and group 3: >24.5 mm (6 eyes). The refractive prediction error (RPE) and mean absolute error (MAE) were calculated for 5 different formulas: SRK/T, Hoffer Q, Holladay 1, Haigis and Barrett Universal II. For eyes with the AL between 22 mm and 24.5 mm the greatest percentage of eyes with RPEs within ±0.25 D was 32.4% for Haigis formula, followed by Barrett Universal II, Hoffer Q and Holladay 1 with 29.4%. The percentage of eyes with RPEs within ±0.50 D was 100% only for Barrett Universal II and Holladay 1, 94.1% for SRK/T and 91.2% for Haigis and Hoffer Q. The first and third group with AL <22 and >24.5 mm were too small to have statistical significance due to the reluctancy to use multifocal IOLs on extreme ALs. ANOVA test showed no statistical difference (P=0.166) between the RPEs measured for each formula in this cohort. This study showed no statistical difference between formulas for this trifocal lens implant. There was a tendency for the RPE to be within ±0.25 D for most of the eyes with the Haigis formula, and within ±0.50 D for all the eyes with the Barrett Universal II formula in the group with the AL between 22 and 24.5 mm.

TFOS European Ambassador meeting: Unmet needs and future scientific and clinical solutions for ocular surface diseases.

The mission of the Tear Film & Ocular Surface Society (TFOS) is to advance the research, literacy, and educational aspects of the scientific field of the tear film and ocular surface. Fundamental to fulfilling this mission is the TFOS Global Ambassador program. TFOS Ambassadors are dynamic and proactive experts, who help promote TFOS initiatives, such as presenting the conclusions and recommendations of the recent TFOS DEWS II™, throughout the world. They also identify unmet needs, and propose future clinical and scientific solutions, for management of ocular surface diseases in their countries. This meeting report addresses such needs and solutions for 25 European countries, as detailed in the TFOS European Ambassador meeting in Rome, Italy, in September 2019.

Endothelial cells loss to the hyperopic pacients during phacoemulsification.

INTRODUCTION: The phacoemulsification cataract surgery is the most frequently performed surgery and it generally improves vision in over 90% of the patients. Hyperopic patients are a challenge during phacoemulsification especially because of their short eyeball and shallow anterior chamber. A shallow anterior chamber is associated with overall reduction of the safe zone, which may lead to difficulty in creating the corneal incisions, harder capsulorhexis performing, or endothelial complications. PURPOSE: The aim of the study was to present the endothelial cells loss after the phacoemulsification procedure in the hyperopic patients. MATERIAL AND METHODS: A number of 1775 patients operated in the Ophthalmology Department of the Clinical Hospital Sibiu from January 11, 2011 to December 20, 2013 have been included in our study; 595 cases with emmetropia and the rest of the 1180 patients had the following refraction errors: 216 - myopia and 964 - hypermetropia. From the total cases of the hypermetropia, we selected 72 patients to measure the endothelial cells density and the corneal thickness by using specular microscopy, one day before and 7-14 days after surgery. RESULTS AND DISCUSSIONS: The preexisting hypermetropia might modify the intraoperative and postoperative cataract surgery evolution. Endothelial cell loss is potentially higher from surgical trauma so that the endothelium must be protected with viscoelastics. The loss of endothelial cells in hyperopic eyes occurred with an average of 267 cell/ mm² and the thickness of the cornea increased by 13 µm. CONCLUSION: The phacoemulsification surgery in the presence of hypermetropia requires more attention. The biometry and the specular microscopy are very important tasks for the preoperative assessment, surgery, and postoperative care. The protection of the corneal endothelium with viscoelastics leads to an insignificant modification of the endothelial cells in hyperopic patients compared to an anterior study of the patients with all ametropies.

Survey on retrobulbar blood flow in glaucomatous optic neuropathy (normotensive and hypertensive).

The aim of this study was to analyze the possible differences between retrobulbar blood flows in normotensive glaucomatous optic neuropathy patients versus patients with hypertensive glaucomatous optic neuropathy, with intraocular pressure controlled treatment. All the patients in the study group were subjected to a color Doppler echography of retrobulbar vessels. Afterwards, systolic and diastolic blood velocities were measured in both eyes in ophthalmic artery (OA), central retinal artery (CRA) and posterior ciliary arteries (PCA). The device calculated the Resistivity index Pourcelot (RI) automatically.

Color Doppler imaging of the retrobulbar circulation in progressive glaucoma optic neuropathy.

It is known that elevated intraocular pressure (IOP) is the primary risk factor for glaucoma. Recently, more and more evidences have shown that the vascular deficit also plays an important role in the pathogenesis and progressions of glaucomatous optic neuropathy. This issue is backed up by glaucomatous optic neuropathy (GON) cases drug compensated in which the progression of the disease in one or both eyes is ascertained despite a normal and relatively constant IOP. The present study evaluated the hemodynamic parameters in the retrobulbar circulation in patients with progressive glaucomatous optic neuropathy in one eye, who received compensated medication. The hemodynamic parameters (PSV, EDV, IR) were measured by using color Doppler ultrasound and progression was evaluated by a repeated automated perimetry. The obtained values were statistically analyzed and compared with those obtained for the stable eye.

[Effect of phacoemulsification on the cornea]. / Impactul facoemulsificarii asupra cornei.

INTRODUCTION: Cataracta is the more common surgical diesease of the eye. The removal of the cataract is done my phacoemulsification. PURPOSE: To evaluate the effect of phacoemulsifcation on the cornea. MATERIAL AND METHOD: We have studied 80 patients with cataract that underwent cataract surgery by phacoemulsification. We measured the corneal thickness and the number of endothelial cell before and after the surgery. REZULTS AND DISCUSSIONS: Corneal thickness grew with 3% and the number of endothelial cells decresed with 13%. CONCLUSIONS: Phacoemulsification with the use of vascoelastic substancees is a very safe method of lens extraction

[Treating anisometric amblyopia with HTS Amblyopia iNet Software--preliminary results]. / Tratamentul ambliopiei anisometropice cu programul hts amblyopia iNet--rezultate preliminare.

Amblyopia or "lazy eye" represents a disorder of the visual system characterized by poor vision in an eye that is otherwise physically normal. Anisometropia, the condition in which the two eyes have an unequal refractive error, is considered the second most common cause of amblyopia. The purpose of this study is to determine the efficiency of HTS Amblyopia iNet Software by studying the progress of visual acuity, contrast sensitivity and stereopsis vision in anisometropic amblyopic children. 5 patients (age: 5-13 years), treated with HTS Amblyopia iNet Software at OftaTotal Clinic from Sibiu, between 2010-2013, participated in this clinical trial. Initially, visual acuity ranged from 0.25 to 0.8, contrast sensitivity from 1.35 to 1.65 Log. Unit. and 1 patient presented stereoscopic vision. After treatment, visual acuity ranged from 0.8 to 1, contrast sensitivity from 1.35 to 1.95 Log. Unit., also all patients presented stereoscopic vision. HTS Amblyopia iNet Software represents an effective modern approach in the treatment of anisometropic amblyopia.

[Functional amblyopia]. / Ambliopia functionala.

Amblyopia is a disorder of the visual system that represents unilateral or bi-lateral reduction of visual acuity in which an organic cause cannot be detected. The illness represents a syndrome of visual deficits, not only a deterioration of visual acuity. This syndrome includes: presence of crowding phenomena, contrast sensitivity deterioration, deficits in accommodation, deterioration of spatial orientation and ocular motility dysfunction. Depending on its etiology, amblyopia is classified into four main types: strabismic amblyopia, anisometropic amblyopia, isoametropic amblyopia and stimulus deprivation amblyopia. To successfully treat the "lazy eye" it is essential to remove the amblyopic factor with techniques addressing each disturbing factor. Techniques used for treating amblyopia include: occlusion, optical penalty or pharmacological, therapy with Levodopa and computer vision therapy. Amblyopia treatment is lengthy and it is very important to counsel not only the child but the whole family and to establish a relationship of trust between doctor and patient in order to get high treatment compliance and high child motivation.

[The therapeutic contact lens--advantages and limits]. / Lentila de contact terapeutica--avantaje si limite.

INTRODUCTION: The therapeutic use is one of the major indications of the contact lenses, near the correction of the refraction. MATERIAL AND METHOD: The study analyzed 86 patients who wore one TCL. The data was analyzed concordant with the main effects of the TCL and their limits. RESULTS AND DISCUSSIONS: The main positive effects of the TCL were: relief of pain, improving of re-epithelization, the tectonic effect, mechanic protection and hydratation of the cornea, visual improving and the permitting of the binocularity. The limits of the TCL are related to: susceptibility of infections, non adaptation or loosing of the lens in irregularity of the cornea. CONCLUSIONS: TCL: Efficient in majority of cases; Permits the binocular vision; The complications occur rarely and are minor.

[Lagophthalmy of VII nerve palsy--therapeutical approaches]. / Posibilitati curative în lagoftalmia prin paralizia de nerv facial.

Facial nerve palsy is impairing orbicular muscle function leading to lagophthalmos. This disease impairs patients' quality of life by exposure keratopathy which is accompanied by ocular pain and deteriorate visual acuity at a variable degree. The paper's aim is to show up the place of lagophthalmos in anterior ocular segment pathology and to evidence the results obtained by us with a new therapeutical method applied in several cases. All cases with lagophthalmos have ocular complications like exposure kerato-conjunctivitis. The treatment was both conservative and surgical which consisted in majority of cases in blepharoraphy with its inconveniencies, aesthetical and functional. We have applied a new surgical method--gold weight superior lid implantation--in 4 cases and the results are promising.

[Treatment difficulties in ocular toxoplasmosis]. / Dificultati de tratament în toxoplasmoza oculara.

PURPOSE: To determine the increased incidence of ocular infection with Toxoplasma gondii, the variety of ocular manifestations and therapeutical problems of this potential blind disease. We analyzed 22 patients hospitalized in our clinic in last 2 years at whom clinical diagnosis was confirmed by positive serological tests. Is discussed the correlation between serum level antibody(IgG and IgM) and ocular manifestations and the opportunity of beginning specific treatment depend on these two parameters. CONCLUSIONS: The incidence of ocular toxoplasmosis is increasingly, the ophthalmologist must be open on atypical manifestations of this disease. The treatment remains controversial, we believe that it must be specific and correlated with ocular lesions evolutions and serum antibody level in time.

[Anterior uveitis in seronegative spondylarthropathies]. / Uveita anterioara în spondilartropatiile seronegative.

PURPOSE: To study the implication of seronegatives spondylarthropaties in anterior uveitis ethiology. We analyzed 51 patients with rheumatologic disease related uveitis hospitalized in our clinic in last 4 years. We discussed sex and age group repartition of patients, type of rheumatologic disease, recurrencies, complications and patients evolutions under treatment. CONCLUSIONS: Seronegatives spondylarthtropaties related uveitis represent 26% from 208 patients with uveitis household in our clinic in period mentioned above. They have a slow evolution with multiples recurrences and complications, requiring long period of treatment and follow-up. Visual prognosis is reserved because of multiples recurrences which accentuate morfofunctional deficit every time.

[Refractive changes in concomitant exodeviations]. / Vicii de refractie în exodeviatiile concomitente.

UNLABELLED: The paper represents the analysis of 27 patients with a form of exodeviation examined în the Department of Ophthalmology Sibiu (jan. 1999-jan. 2003). METHOD: The evaluated parameters were: debut age, sensorial status, refraction, type of exodeviation related with refractive errors and treatment. RESULTS: The predominant refractive error was hyperopia (low degree)-40.74%, exophoria was the most frequent type of exodeviation (44.44%). Amblyopia was present în 11.2% of cases, 25.9% of patients had no stereopsis. CONCLUSIONS: In the studied group 81.48% of cases had refractive errors. Exophoria and intermittent exotropia were related with emetropia or minor refractive errors. Mixed astigmatism with amblyopia and anizometropia presented constant exodeviation.

[Preliminary study about therapeutical contact lenses use]. / Studii preliminare asupra folosirii lentilelor de contact terapeutice.

THE AIM OF THE PAPER: The goal of the paper is to emphasize the advantages of the application of therapeutical contact lenses as compared to the eye patch. MATERIAL AND METHOD: There have been taken into study 42 patients-43 eyes, to whom we applied therapeutical contact lenses. RESULTS AND DEBATES: In the studied cases there have been taken into discussion the type of corneal diseases, the treatment prescribed, the period of time that the lenses have been worn and the possible complications. There have been prevailed herpetic keratopathies (12 cases), edemato-bullous keratopathies--aphakic and pseudophakic (12 cases), followed by recurrent corneal erosions (4 cases), full thickness corneal and corneoscleral lacerations (4 cases) and alkali chemical corneo-conjunctival burns of II-nd/III-rd degree and III-rd degree. CONCLUSIONS: 1. The wearing of therapeutical contact lens determined the improvement of the pain, of the eye discomfort and the corneal epithelium healing. 2. A therapeutical alternative clearly superior to the occlusive eye patch, the therapeutical contact lens limits the indications of tarsorrhaphy and conjunctival flap. 3. The therapeutical contact lens find their usefulness in a tectonic aim until the final surgical solution.