Keratoprosthesis surgery as an alternative to keratoplasty.

Corneal transplant surgery after chemical or thermal burns has a very low success rate. Vision in these patients can be restored by using an artificial cornea (keratoprosthesis). In this report, we present 5 clinical cases of implanting a fresh corneal graft with Boston type 1 keratoprosthesis in patients with corneas inappropriate for standard corneal transplantation. The mean follow-up was 26.4 months (range, 12 to 36 months; SD, 13.1). The main measures of outcomes were visual acuity and keratoprosthesis stability. At least 1 year after the operation (5 eyes), vision acuity was >0.1 in 100% of the eyes and >0.4 in 50% of the eyes. Retention of the initial keratoprosthesis was 100%. The results of this study seem to be similar to those reported internationally. The anatomical and visual functions of the eyes were stable after keratoprosthesis implantation, though for a longer follow-up period, additional surgical procedures may be required.

Relations between patient personality and patients' dissatisfaction after multifocal intraocular lens implantation: clinical study based on the five factor inventory personality evaluation.

To assess the level of visual function and the influence of personality traits on patients' (pts) satisfaction with the visual function following the four different MIOL implantation. METHODS: We evaluated the visual outcomes over a 6 months follow-up period after cataract surgery with bilateral implantation of four different multifocal IOLs. The spectacle independence, photic phenomena, the influence of personality traits on patients' satisfaction with the visual function were assessed. RESULTS: A total of 170 eyes of 85 pts were included. There was no statistically significant difference in UDVA (F = 1.6 p = 0.177) and CNVA (F = 1.2 p = 0.30) between the groups 6 months after the surgery. The ReSTOR group had a worse CDVA than the M-flex (p = 0.019) and TECNIS (p = 0.005) groups. The ReSTOR and AT.LISAtri groups had a statistically significantly better UNVA than the M-flex (p = 0.020 and p = 0.013) and TECNIS groups (p = 0.001 both). The independence on spectacles for near distance was from 71.8% (in M-flex group) to 100% (in ReSTOR). The answers of the pts with the prevailing neurotic personality type contradicted the answers given by the pts with other prevailing personality types (p < 0.01). CONCLUSIONS: MIOL implantation helped ensure better postoperative visual acuity, but some pts were unhappy with the postoperative outcomes. It was established that the subjective satisfaction or dissatisfaction of patients after MIOL implantation is related to certain personality traits: pts with neuroticism as the dominant personality trait were least happy with the postoperative outcomes; pts with conscientiousness and agreeableness as dominant personality traits demonstrated the highest satisfaction with the postoperative outcomes.

Influence of +3.00 D and +4.00 D near addition on functional outcomes of a refractive multifocal intraocular lens model.

PURPOSE: To clinically evaluate different near additions (adds) (+3.00 diopters [D] and +4.00 D) of the M-flex 630F refractive multifocal intraocular lens (IOL). SETTING: Departments of Ophthalmology, University of Heidelberg, Germany, and Lithuanian University of Health Sciences, Kaunas, Lithuania. DESIGN: Clinical prospective nonrandomized unmasked study. METHODS: Preoperatively, cataract patients were assigned to receive bilateral +3.00 D IOLs, +4.00 D IOLs, or +3.00 D (dominant eye) and +4.00 D (nondominant eye) IOLs. Follow-up examinations were performed up to 6 months postoperatively and included refraction, visual acuity (near at 40 cm and distance), the defocus curve, contrast sensitivity, and a subjective questionnaire. RESULTS: Fifty-two patients were enrolled. No significant differences were found in the visual acuity results (P>.05). Four to 6 months postoperatively, the following median uncorrected and corrected distance visual acuity, uncorrected and distance-corrected near visual acuity, and corrected near visual acuity (logMAR) were found in all patients: -0.08, -0.12, 0.20, 0.10, and 0.10. Ninety-eight percent of patients reported being satisfied. The highest near peak versus the biggest intermediate decline in the median monocular defocus curves comparing +3.00 D and +4.00 D multifocal IOLs (logMAR) were 0.16 at 40 cm versus 0.22 at 33 cm (P=.24) and 0.38 at 66 cm versus 0.54 at 50 cm (P<.01). CONCLUSION: Compared with the +4.00 D add, the +3.00 D near add gave better intermediate results in the defocus curve without compromising distance or near visual acuity.