Efficacy of Multifocal Soft Contact Lenses in Reducing Myopia Progression Among Taiwanese Schoolchildren: A Randomized Paired-Eye Clinical Trial.

INTRODUCTION: To evaluate the efficacy and safety of myopia control using a multifocal soft contact lens designed with high peripheral add power in schoolchildren. METHODS: This 1-year multi-center, prospective, randomized, double-blind, controlled study enrolled myopic schoolchildren aged 6-15 years with refractive errors between - 1.0 D and - 10.0 D. Each participant was randomly allocated to wear a daily disposable multifocal soft contact lens as the treatment in one eye and a single-vision soft contact lens as the control in the other eye. The primary endpoints were changes in the cycloplegic spherical equivalent (SE) and axial length at 1 year. RESULTS: Fifty-two of the 59 participants (88.1%) completed the study protocol. The mean change in SE was - 0.73 ± 0.40 D in the treatment group. and - 0.85 ± 0.51 D in the control group (mean difference: - 0.12 ± 0.34 D, p = 0.012). The mean change in axial length was 0.25 ± 0.14 mm in the treatment group, and 0.33 ± 0.17 mm in the control group (mean difference: 0.08 ± 0.10 mm, p < 0.001). The treatment was well tolerated, and no serious adverse events were observed. CONCLUSIONS: Treatment with multifocal soft contact lenses with high peripheral add power was effective in controlling the progression of myopia and axial length elongation in myopic schoolchildren.

Estimation accuracy of surgically induced astigmatism on the cornea when neglecting the posterior corneal surface measurement.

PURPOSE: To evaluate the accuracy of corneal surgically induced astigmatism (SIA) estimation when neglecting the posterior corneal surface measurement. METHODS: Fifty right eyes undergoing phacoemulsification were measured with a rotating Scheimpflug camera (Pentacam; Oculus Inc., Wetzlar, Germany) both before and after surgery. Clear corneal incisions with one suture were used in the phacoemulsification surgery. The keratometric corneal SIA (KSIA) was derived using the anterior corneal surface measurement and the keratometric index (1.3375) while neglecting the posterior corneal surface measurement. The Pentacam-derived total corneal SIA (PSIA) was derived by vergence tracing and polar value analysis [KP(135) and KP(180)] of the measurements on both corneal surfaces. RESULTS: The mean arithmetic estimation errors of the KSIA for the PSIA were 0.16 ± 0.32 (-0.52 to 1.14) D for the KP(135), and -0.02 ± 0.30 (-0.75 to 1.29) D for the KP(180). There was a significant difference between the KP(135) components of the KSIA and PSIA. Bivariate analysis revealed a statistically significant difference between the combined means of the KSIA and PSIA. Overall, 24% had either a KP(135) component of the KSIA that differed by > 0.50 D from that of the PSIA or a KP(180) component of the KSIA that differed by > 0.50 D from that of the PSIA. The blurring strength caused by neglecting the posterior corneal measurement was > 0.50 D in 24% of eyes. CONCLUSION: Neglecting the posterior corneal surface measurement may lead to significant deviation in the corneal SIA estimation after phacoemulsification in a proportion of eyes.

Laser photocoagulation combined with subtenon injection of triamcinolone acetonide for diabetic cystoid macular edema.

BACKGROUND: To compare the effects of laser photocoagulation combined with subtenon injection of triamcinolone acetonide with photocoagulation alone, for diabetic cystoid macular edema. METHODS: This retrospective comparative study analyzed data for 34 eyes with cystoid macular edema treated with photocoagulation alone (n=17) or combined with triamcinolone (n=17). All patients were followed for 6 months after the procedure. Laser photocoagulation included focal photocoagulation focused on microaneurysms and light grid photocoagulation spread over the edematous retina. Subtenon injection of triamcinolone (20 mg/0.5 cc) was performed in the superior-temporal conjunctiva. RESULTS: In the photocoagulation only group, the pretreatment mean visual acuity (VA) measured by the logarithm of the minimum angle of resolution (LogMAR) was 1.06+/-0.49. The number of laser spots was 34+/-10. The 6 -month post- treatment mean LogMAR was 1.13+/-0.60. In the photocoagulation combined with triamcinolone group, the pretreatment mean LogMAR was 1.31+/-0.49. The number of laser spots was 42+/-14. The 6 -month post- treatment mean LogMAR was 1.26+/-0.49. In the photocoagulation only group, 7 eyes had stable vision (improved, stable or loss of <2 lines) and 8 eyes had vision loss (loss>or=2 lines). In the photocoagulation combined with triamcinolone group, 15 eyes had stable vision and 2 eyes had vision loss. Fewer eyes had vision loss in the photocoagulation combined with triamcinolone group. (chi-square test, p=0.024). CONCLUSIONS: This study, with a follow-up of 6 months, suggests that subtenon injection of triamcinolone combined with macular photocoagulation provides a better chance of stabilizing vision loss in patients with diabetic cystoid macular edema than photocoagulation alone.

[Effects of host plants on development and fecundity of Brontispa longissima (Gestro)].

With Cocos nucifera, Hyophorbe lagenicaulis, Washingtonia filifera, Roystonea regia and Areca catechu as test host plants, this paper studied the effects of their un-spread leaves on the development and fecundity of experimental population of Brontispa longissima. The results showed that the development duration of one generation B. longissima fed on different hosts varied significantly, with the longest (72.8 days) on W. filifera and the shortest (39.8 days) on H. lagenicaulis. The average pupa weight of B. longissima was bigger on H. lagenicaulis than on the other four host plants, and the female B. longissima had the highest fecundity (157.6 ova) on W. filifera while the lowest one (65.2 ova) on A. catechu. The longevity of B. longissima adults fed on H. lagenicaulis was 207.52 days, being significantly longer than that on the other host plants. The trend index of experimental population of B. longissima fed on the five host plants was 53.57, 54.98, 48.56, 20.46 and 11.54, respectively.

Surgical results of persistent fetal vasculature.

BACKGROUND: To evaluate the surgical results of patients with persistent fetal vasculature (PFV), also known as persistent hyperplastic primary vitreous (PHPV). METHODS: From 1991 to 2001, a retrospective, noncomparative study of 7 eyes of 7 patients diagnosed with PFV was conducted. In each case, type of anterior and/or posterior PHPV findings, preoperative testing, surgical procedures, and visual outcomes were obtained from the records. Follow-up ranged from 12 to 43 months, with a mean of 15 months. RESULTS: Of the 7 eyes, one (14%) had strictly anterior PFV, 1 (14%) had strictly posterior PFV, and 5 (71%) had components of both anterior and posterior disease. Initial lens aspiration only was performed in 3 (43%) eyes. Initial vitrectomy only was performed in 1 eye (14%). Initial lensectomy and vitrectomy was performed in 3 (42.8%) eyes. The reoperation rate was 43% for membrane reproliferation, glaucoma, vitreous hemorrhage, and retinal detachment. Final best-corrected visual acuity ranged from light perception only to 20/70 on the Snellen chart. CONCLUSIONS: Functional vision is possible in selected patients. However, poor final visual outcome despite adequate anatomic success were noted in this study. The poor outcomes might have been due to patients delaying vitrectomy until retinal detachment developed or that the patients had poor compliance with postoperative ocular rehabilitation.