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1.
BMC Ophthalmol ; 24(1): 138, 2024 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-38539111

RESUMO

PURPOSE: To assess the level of agreement and evaluate the reliability of measurements between two Scheimpflug imaging modalities, Scansys (MediWorks, China) and Sirius (CSO, Italy), in quantifying the anterior segment parameters in healthy eyes. METHODS: In a cross-sectional study, the right eyes of 38 healthy participants without any ocular or systemic diseases were examined. A range of anterior segment parameters including anterior and posterior flat and steep keratometry, central corneal thickness (CCT), thinnest corneal thickness (TCT), anterior chamber depth (ACD), anterior chamber angle (ACA), corneal volume, anterior chamber volume, and horizontal white to white diameter, derived from the sagittal curvature maps were measured. To evaluate the reliability of the measurements, intraclass correlation coefficient (ICC) and correlation coefficient were measured. Additionally, Bland-Altman plots were employed to examine the agreement in mean (bias line) and 95% limits of agreement between the two devices. RESULTS: The mean age was 31.5 ± 6.9 (range: 19-47) years. The ICC indicated that the majority of anterior segment parameters had an excellent or good level of reliability, surpassing the threshold of 0.9. Nevertheless, CCT and ACA exhibited a moderate level of reliability, with ICC values of 0.794 and 0.728, respectively. The correlation analysis showed a strong correlation for all the variables tested. The Bland-Altman plots revealed that the bias line was near zero and the 95% limits of agreement were narrow for most variables, except for the anterior flat and steep keratometry, which were found to range from - 0.57 to 0.84 D and - 0.68 to 0.87 D, respectively. CONCLUSION: Scansys and Sirius devices can be effectively used interchangeably for the evaluation of most anterior segment parameters; however, for anterior corneal curvatures, CCT and ACA, their alternative use is not recommended.


Assuntos
Córnea , Tomografia , Humanos , Adulto Jovem , Adulto , Reprodutibilidade dos Testes , Estudos Transversais , Estudos Prospectivos , Córnea/diagnóstico por imagem , Topografia da Córnea/métodos , Tomografia de Coerência Óptica
2.
Ophthalmology ; 127(4): 557, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32200842

RESUMO

This article has been retracted: please see Elsevier policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). The editors wish to note that concerns were raised regarding coding errors in the data set that formed the basis of this study. Patient record numbers were found to be duplicated, so that the number of endophthalmitis cases was unclear as was the associated treatment, and the number of unique patients estimated to be far less than the 480,000 reported. Upon review of the information provided, Ophthalmology has determined the dataset to be flawed with unverifiable elements from which reliable conclusions cannot be drawn, and therefore has made the decision to issue a retraction of the manuscript.

3.
Ophthalmology ; 123(2): 295-301, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26704882

RESUMO

PURPOSE: To report the incidence of endophthalmitis after senile cataract surgery and to describe the epidemiology and main risk factors. DESIGN: Retrospective, single-center, cross-sectional descriptive study. PARTICIPANTS: Patients who underwent cataract surgery in Farabi Eye Hospital from 2006 through 2014. METHODS: All patients were evaluated retrospectively to compare risk factors, epidemiologic factors, and prophylaxis methods related to endophthalmitis. Patient records were used to gather the data. MAIN OUTCOME MEASURES: Epidemiologic factors, systemic diseases, other ocular pathologic characteristics, complications during the surgery, technique of cataract surgery, intraocular lens type, method of antibiotic prophylaxis, surgeon experience, vitreous culture, and vision outcome were evaluated in these patients. RESULTS: One hundred twelve endophthalmitis cases among 480 104 operations reported, equaling an incidence of 0.023%. Patients with diabetes mellitus (14.3%) and of older age (mean age, 81 years), perioperative communication with the vitreous (17.9%), extracapsular cataract surgery procedure (11%), and surgery on the left eye (58.9% vs. 41.1% for right eye; P = 0.03) showed a statistically significant association with endophthalmitis. Short-term treatment with topical or systemic preoperative antibiotics or postoperative subconjunctival injection was associated with a 40% to 50% reduced odds of endophthalmitis compared with no prophylaxis (P = 0.2). No cases of endophthalmitis were observed among the 25 920 patients who received intracameral cefuroxime, suggesting that this approach to antibiotic prophylaxis may be far more effective than traditional topical or subconjunctival approaches. CONCLUSIONS: The incidence of endophthalmitis after cataract surgery in our center was 0.023%, comparable with that of other previously published international studies. Older rural patients with immune suppressive diseases, such as diabetes mellitus, are particularly more prone to endophthalmitis. Vitreous loss at the time of surgery was associated with a significantly increased risk. Whereas antibiotic prophylaxis overall showed a 40% to 50% reduction in risk, intracameral cefuroxime was 100% effective in preventing endophthalmitis in this series.


Assuntos
Extração de Catarata/estatística & dados numéricos , Endoftalmite/epidemiologia , Infecções Oculares Bacterianas/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Câmara Anterior/efeitos dos fármacos , Antibacterianos/uso terapêutico , Antibioticoprofilaxia , Extração de Catarata/métodos , Cefuroxima/uso terapêutico , Estudos Transversais , Endoftalmite/microbiologia , Estudos Epidemiológicos , Infecções Oculares Bacterianas/microbiologia , Feminino , Humanos , Incidência , Complicações Intraoperatórias , Irã (Geográfico)/epidemiologia , Implante de Lente Intraocular , Lentes Intraoculares/classificação , Masculino , Estudos Retrospectivos , Fatores de Risco
4.
J Refract Surg ; 30(12): 837-42, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25437483

RESUMO

PURPOSE: To evaluate the outcome of accelerated and conventional corneal cross-linking (CXL) procedures regarding their effect on morphological and optical properties of the cornea. METHODS: One hundred fifty-three eyes of 153 patients were evaluated before and during a 15-month follow-up period after CXL (76 eyes in the conventional group and 77 eyes in the accelerated group). Measured variables include corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), refraction, maximum keratometry, endothelial cell density, anterior and posterior stromal keratocyte density, and subbasal nerve density. All variables were compared between the two study groups. RESULTS: Cylindrical and spherical components of refraction improved significantly during 15 months of follow-up. No difference was observed between the two study groups. UDVA and CDVA improved in the same manner, with no intergroup differences. Endothelial cell density did not change significantly during the follow-up period in either group. K-max increased slightly in the first month of the follow-up, but started to decrease at postoperative visits without any significant difference in the two groups. Anterior stromal keratocyte density and subbasal nerve density decreased significantly in both groups 1 month postoperatively. Both variables had a more significant decrease in the conventional group at all visits before the 1-year visit. At the final 15-month visit, there were no significant differences in any value between the two groups. CONCLUSIONS: Accelerated and conventional CXL seem to have a comparable and acceptable effect on keratoconus in the short-term follow-up period.


Assuntos
Colágeno/metabolismo , Substância Própria/metabolismo , Reagentes de Ligações Cruzadas/uso terapêutico , Ceratocone/tratamento farmacológico , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Contagem de Células , Ceratócitos da Córnea/patologia , Endotélio Corneano/patologia , Feminino , Humanos , Ceratocone/metabolismo , Ceratocone/fisiopatologia , Masculino , Estudos Prospectivos , Refração Ocular/fisiologia , Riboflavina/uso terapêutico , Raios Ultravioleta , Acuidade Visual/fisiologia , Adulto Jovem
5.
J Refract Surg ; 30(7): 462-6, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24877554

RESUMO

PURPOSE: To evaluate the effect of MyoRing implantations (DIOPTEX GmbH, Linz, Austria) in patients with ectasia after LASIK. METHODS: MyoRing implantation was performed in 15 eyes of 14 patients with ectasia after LASIK using a femtosecond laser. Uncorrected and corrected distance visual acuity, refraction, keratometry, central corneal thickness, corneal biomechanical profile, and corneal aberrometry were evaluated preoperatively and at 1, 3, and 6 months, and 1 year postoperatively. RESULTS: Uncorrected distance visual acuity (1.02 ± 0.48 to 0.30 ± 0.18 logMAR), maximum keratometry (50.14 ± 1.82 to 43.80 ± 1.21 diopters), and sphere (-4.4 ± 4.8 to +1.50 ± 0.61 diopters) were significantly improved from preoperative values at 1 month after surgery with no significant change afterward. Corrected distance visual acuity did not improve significantly 1 month after implantation, but between the 1- and 3-month follow-up visits, a significant improvement (0.30 ± 0.1 to 0.17 ± 0.13 logMAR) was observed without any additional improvement thereafter. A nearly significant (P = .05) increase in central corneal thickness (439.4 ± 19 to 452.2 ± 20 µm) was observed during the 1-month postoperative period. Primary coma, higher-order aberrations, and trefoil showed an insignificant decrease 1 month after surgery and afterward. Spherical aberration significantly increased between the preoperative visit and the first postoperative visit. Corneal hysteresis and corneal resistance factor showed no significant change between visits. CONCLUSIONS: MyoRing is a safe and effective method in patients with ectasia after LASIK. It can improve corrected distance visual acuity and reduce refractive error in these patients.


Assuntos
Ceratomileuse Assistida por Excimer Laser In Situ/efeitos adversos , Lasers de Excimer , Miopia/cirurgia , Complicações Pós-Operatórias/cirurgia , Implantação de Prótese , Transtornos da Visão/reabilitação , Aberrometria , Adulto , Paquimetria Corneana , Dilatação Patológica/cirurgia , Feminino , Humanos , Masculino , Estudos Prospectivos , Refração Ocular/fisiologia , Retalhos Cirúrgicos , Acuidade Visual/fisiologia
6.
Indian J Ophthalmol ; 72(1): 66-72, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38131572

RESUMO

PURPOSE: This study aimed to evaluate the corneal epithelial thickness changes after photorefractive keratectomy (PRK) and the impact of long-term artificial tear usage on epithelial thickness changes in these patients. METHODS: This study was performed on 71 patients (142 eyes) without dry eye disease who received PRK for myopic refractive correction. The corneal epithelial thickness profile was obtained before, one, three, and six months after surgery using anterior segment optical coherence tomography. Patients were randomly divided into two groups: group A, who received preservative-free artificial tears post-surgery, and group B, who did not receive artificial tears. RESULTS: The epithelial thickness decreased universally in the first month and then increased in the 3- and 6-month follow-ups. Group A had a significantly thicker epithelium in central, paracentral, and midperipheral zones compared with group B in the 3-month follow-up. In the 6-month follow-up, no significant differences were detected between groups. At the last follow-up, the central, paracentral, and midperipheral zone epithelial thicknesses in all patients were significantly higher than preoperative values, but peripheral zone thickness only increased to preoperative values. CONCLUSIONS: Patients using artificial tears showed a faster thickening, especially in the central and paracentral zones, but there were no significant differences between the two groups in the final follow-up. Artificial tear usage may increase the rate of the epithelial remodeling process in post-PRK patients without significantly altering the final epithelial thickness profile. Further studies are warranted to evaluate the influence of different factors on epithelial remodeling.


Assuntos
Epitélio Corneano , Miopia , Ceratectomia Fotorrefrativa , Humanos , Ceratectomia Fotorrefrativa/métodos , Lubrificantes Oftálmicos/farmacologia , Refração Ocular , Miopia/cirurgia , Lasers de Excimer/uso terapêutico
7.
J Refract Surg ; 29(5): 364-6, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23496020

RESUMO

PURPOSE: To describe the outcome of complete intrastromal ring (MyoRing, DIOPTEX GmBH, Linz, Austria) implantation following intrastromal corneal ring segment (Intacs, Addition Technology, Inc., Sunnyvale, CA) implantation for severe keratoconus. METHODS: Case report. RESULTS: A MyoRing was implanted in a keratoconic patient who had undergone a previous Intacs implantation surgery 4 years previously without Intacs explantation and had residual refractive error. There were no intraoperative or postoperative complications. After 1 year; mean keratometric power decreased from 50.3 to 43.6 diopters, uncorrected distance visual acuity improved from 20/400 to 20/50, and corrected distance visual acuity improved from 20/200 to 20/30. CONCLUSIONS: In selected severe keratoconus cases with high myopia and steep keratometry previously treated with Intacs implantation, if significant residual refractive error is observed, secondary implantation of MyoRing over Intacs may improve vision and refraction.


Assuntos
Substância Própria/cirurgia , Ceratocone/cirurgia , Próteses e Implantes , Implantação de Prótese , Adulto , Paquimetria Corneana , Topografia da Córnea , Humanos , Masculino , Refração Ocular/fisiologia , Erros de Refração/fisiopatologia , Acuidade Visual/fisiologia
8.
J Optom ; 16(4): 284-295, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37567838

RESUMO

PURPOSE: To compare the reliability and agreement of axial length (AL), anterior chamber depth (ACD), and lens thickness (LT) measurements obtained with optical biometry based on swept-source optical coherence tomography (IOLMaster 700; Carl Zeiss, Germany) and an ultrasound biometry device (Nidek; US-4000 Echoscan, Japan) in different qualities of AL measurement. METHODS: A total of 239 consecutive eyes of 239 cataract surgery candidates with a mean age of 56 ± 14 years were included. The quality measurements were grouped according to the quartiles of SD of the measured AL by IOLMaster 700. The first and fourth quartile's SD are defined as high and low-quality measurement, respectively, and the second and third quartiles' SD is defined as moderate-quality. RESULTS: The reliability of AL and ACD between the two devices in all patients and in different quality measurement groups was excellent with highly statistically significant (AL: all ICC=0.999 and P<0.001, ACD: all ICC>0.920 and P<0.001). AL and ACD in all quality measurements showed a very strong correlation between devices with highly statistically significant. However, there was poor (ICC=0.305), moderate (ICC=0.742), and good (ICC=0.843) reliability in measuring LT in low-, moderate-, and high-quality measurements, respectively. LT showed a very strong correlation (r = 0.854) with highly statistically significant (P<0.001) between devices only in patients with high-quality measurements. CONCLUSIONS: AL and ACD of the IOLMaster700 had outstanding agreements with the US-4000 ultrasound in different quality measurements of AL and can be used interchangeably. But LT should be used interchangeably cautiously only in the high-quality measurements group.


Assuntos
Catarata , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Reprodutibilidade dos Testes , Ultrassom , Comprimento Axial do Olho/diagnóstico por imagem , Interferometria/métodos , Tomografia de Coerência Óptica/métodos , Biometria , Câmara Anterior/diagnóstico por imagem , Câmara Anterior/anatomia & histologia
9.
Ophthalmology ; 124(2): e16, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-28126083
10.
Ophthalmology ; 124(1): e4, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27993275
11.
Int Ophthalmol ; 32(5): 449-54, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22805881

RESUMO

The purpose of this study was to describe the results of a new modification of the trabeculectomy technique, sutureless tunnel trabeculectomy without peripheral iridectomy (PI), in a group of patients with chronic open-angle glaucoma (COAG). Patients with uncontrolled COAG who were candidates for trabeculectomy underwent sutureless tunnel trabeculectomy without PI. Patients were examined before surgery and at 1, 3, 6 and 12 months after surgery. Pre- and post-operative data including intraocular pressure (IOP), visual acuity, number of anti-glaucoma medications and intraoperative and post-operative complications were recorded. Surgical success was defined as final IOP < 21 mmHg and > 20 % reduction from baseline (criterion A) and as final IOP < 18 mmHg and > 25 % reduction from baseline (criterion B), without further glaucoma surgery or complications that required returning the patient to the operating room. Success was further classified as complete when these criteria were obtained without medications and qualified with or without medical therapy. Eighteen eyes of 18 patients were recruited into the study. All patients had 6 months of follow-up and 15 patients (83.3 %) completed 12 months of follow-up. Mean (SD) age of the patients was 57.2 (5.7) years. Mean (SD) IOP decreased from 23.7 (4.5) mmHg pre-operatively to 14.7 (3.4) mmHg at final follow-up visit (p < 0.001), and the mean (SD) number of glaucoma medications decreased from 2.89 (0.32) pre-operatively to 1 (0.84) at last visit (p < 0.001). Post-operatively, IOP and number of glaucoma medications were decreased in comparison with baseline at all follow-up visits (p < 0.001 for all visits). Qualified and complete surgical success rates were 78 and 50 % for criterion A, and 72 and 50 % for criterion B. Sutureless tunnel trabeculectomy without PI effectively reduced IOP and number of medications in COAG patients during 6-12 months of follow-up. Further controlled studies are needed to better characterize the safety and efficacy of this technique.


Assuntos
Glaucoma/cirurgia , Pressão Intraocular , Iridectomia , Esclera/cirurgia , Técnicas de Sutura , Trabeculectomia/métodos , Contraindicações , Feminino , Seguimentos , Glaucoma/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento , Acuidade Visual
12.
Cornea ; 41(4): 435-442, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-34267059

RESUMO

PURPOSE: The purpose of this study was to evaluate the efficacy and safety of implantation of a new continuous corneal ring in keratoconic corneas of an Iranian population. METHODS: This study was conducted on 95 contact lens-intolerant keratoconic eyes with clear central corneas. A continuous corneal ring, annular intrastromal corneal inlay (AICI), was inserted using femtosecond laser in all cases. Patients were followed up for 1, 3, and 12 months postsurgery. Visual and subjective refractive outcomes were evaluated in each examination. Besides, keratometry and aberrometric values were recorded before and 12 months after surgery. Finally, vector analysis of refractive astigmatism was performed using the Alpins method. RESULTS: The uncorrected and corrected distance visual acuities improved significantly 12 months after surgery from 0.91 ± 0.39 to 0.38 ± 0.22 (P < 0 0.001) and 0.33 ± 0.21 to 0.13 ± 0.11 logMAR (P < 0.001), respectively. Moreover, spherical and cylindrical refractive components reduced from -2.52 ± 2.62 to -0.76 ± 1.78 D (P < 0.001) and -4.14 ± 1.64 to -1.91 ± 1.18 D (P < 0.001), respectively. The mean anterior keratometry had a significant reduction 12 months after AICI insertion (P< 0.001). Primary coma and spherical aberration values showed a significant increase (both, P < 0.05). Our results showed 100% safety (safety index: 1.8) and 45% efficacy (efficacy index: 1). CONCLUSIONS: AICI implantation seemed to be a safe and effective procedure for improving visual acuity and refractive outcomes in subjects with keratoconus.


Assuntos
Substância Própria/cirurgia , Ceratocone/cirurgia , Próteses e Implantes , Implantação de Prótese/métodos , Aberrometria , Adulto , Topografia da Córnea , Aberrações de Frente de Onda da Córnea/fisiopatologia , Feminino , Seguimentos , Humanos , Irã (Geográfico) , Ceratocone/fisiopatologia , Masculino , Desenho de Prótese , Refração Ocular/fisiologia , Resultado do Tratamento , Acuidade Visual/fisiologia
13.
Eur J Ophthalmol ; 32(6): 3312-3320, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35175136

RESUMO

PURPOSE: To evaluate the refractive outcomes of small-incision lenticule extraction (SMILE) surgery in moderate to high myopic astigmatism. STUDY DESIGN: Prospective interventional case series. METHODS: This study evaluated 111 eyes of 68 patients treated with femtosecond SMILE surgery for the correction of myopia and astigmatism. Inclusion criteria were myopia of - 0.5 D or more and astigmatism between - 1.0 D and -5.0 D. Refractive and visual measurements were obtained preoperatively, 1 and 12 month(s) postoperatively. Vector analysis was used to study the astigmatic outcomes at 12-month follow-up. Comparison of results in two groups of patients with astigmatism below and over 3.00 D was performed. RESULTS: The preoperative mean spherical equivalent was -5.48 ± 2.17 D (range - 1.75 to - 10.00 D) and the mean cylinder was -2.02 ± 1.09 D (range - 1.00 to - 5.00 D). The mean postoperative cylinder value was -0.60 ± 0.52 D at 12-month visit. The 12-month safety and efficacy indices were 0.98 ± 0.07 and 0.97 ± 0.12, respectively. The high astigmatism group showed significantly lower safety and efficacy indices. The postoperative residual astigmatism was 0.5 D or less in 73% of the eyes. Higher amount of residual astigmatism was observed in the high astigmatism group. The angle of error was ± 5 degrees in 49% and ± 15 degrees in 87% of the eyes. CONCLUSION: SMILE surgery is effective and safe method for correcting myopic astigmatism. Vector analysis indicated a tendency for the under correction of astigmatism in subjects with high astigmatism.


Assuntos
Astigmatismo , Miopia , Ferida Cirúrgica , Astigmatismo/cirurgia , Substância Própria/cirurgia , Seguimentos , Humanos , Lasers de Excimer/uso terapêutico , Miopia/cirurgia , Estudos Prospectivos , Refração Ocular , Resultado do Tratamento , Acuidade Visual
14.
Ophthalmology ; 123(12): e70-e71, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27871402
15.
Ophthalmology ; 123(8): e49-e50, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27450827
16.
J Curr Ophthalmol ; 33(1): 23-30, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34084953

RESUMO

PURPOSE: To investigate the changes in the optical corneal densitometry as an objective method in assessing the corneal light back-scattering before and 1 year after the annular intracorneal inlay (AICI) implantation into the keratoconic corneas. METHODS: Changes in the optical corneal densitometry, visual acuity, refractive, and tomographical status were assessed before and 1 year after the AICI implantation into the corneas with different stages of keratoconus. Optical corneal densitometry was evaluated using the Pentacam-HR in 0-2, 2-6, 6-10, and 10-12 mm rings in the anterior 120 µ, central layers, posterior 60 µ and also the total value were measured for cornea in the Grey Scale Unit criterion. RESULTS: Totally, 34 patients with keratoconus were studied; the uncorrected and best corrected visual acuity were increased after the surgery (0.98 ± 0.25 to 0.53 ± 0.30 logMAR, P < 0.001 and 0.26 ± 0.18 to 0.19 ± 0.14, P = 0.007 logMAR, respectively); the spherical equivalent was decreased from -4.45 ± 2.25 to - 2.06 ± 2.01 D (P = 0.004). AICI implantation led to an increase in the amount of optical corneal densitometry in 0-2 mm central, 2-6 mm central, 6-10 mm central, total central, 2-6 mm posterior, and 2-6 mm total rings (all, P < 0.05); however, a decrease was observed in 0-2 mm anterior ring (P = 0.049). Results of statistical analysis showed that the total optical corneal densitometry, anterior total, and posterior total back-scattering did not change after the AICI implantation (all, P > 0.05). CONCLUSIONS: Our results revealed a significant improvement in the visual function, including refractive error and visual acuity following the AICI implantation. Changes in the optical corneal densitometry were different in distinct regions and layers however, the total amount did not change after the AICI implantation.

17.
Cornea ; 39(9): 1184-1189, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32558727

RESUMO

PURPOSE: To evaluate the safety and efficacy of a bioengineered corneal implant using femtosecond laser-assisted anterior lamellar keratoplasty for superficial corneal opacities. METHODS: Six eyes of 6 consecutive patients with superficial corneal stromal opacities involving <220 µm owing to various pathologies were included in the study. Preoperatively, all patients underwent anterior segment optical coherence tomography (Visante; Carl Zeiss Meditec AG) to evaluate the depth of the corneal opacity. All patients underwent sutureless femtosecond laser-assisted anterior lamellar keratoplasty using a bioengineered collagen corneal implant (linkcor). Visual indices, refraction, and keratometry were evaluated preoperatively and 12 months postoperatively. RESULTS: Corrected distance visual acuity improved significantly in all patients (P = 0.02). A significant decrease was seen in refractive astigmatism postoperatively (P = 0.04). Flat keratometry reduced significantly 12 months after the intervention (P = 0.04). No intraoperative or early postoperative complications were noticed. All implants were fully covered by healthy epithelium within a month after the surgery and remained clear at follow-up visits. The results of this procedure remained stable throughout the follow-up period. In 1 patient, mild inferior collagen melting and epithelial defect formation occurred at 1-year follow-up. Despite frequent topical corticosteroid therapy the melting progressed, the collagen tissue was removed and the patient was treated accordingly with good visual outcomes. CONCLUSIONS: Femtosecond laser-assisted anterior lamellar keratoplasty with bioengineered corneal (linkcor) implantation is an effective treatment for improving vision quality in anterior stromal opacities. This procedure reduces the need for human donor tissue and avoids human donor-related and suturing complications.


Assuntos
Bioengenharia/métodos , Opacidade da Córnea/cirurgia , Substância Própria/cirurgia , Transplante de Córnea/métodos , Terapia a Laser/métodos , Refração Ocular/fisiologia , Procedimentos Cirúrgicos sem Sutura/métodos , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Doadores de Tecidos , Acuidade Visual
18.
Clin Optom (Auckl) ; 11: 73-75, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31372081

RESUMO

INTRODUCTION: We report a case of a 35-year-old man who presented with headache followed by decreased vision, metamorphopsia, and altered color perception in his left eye, after repeated intake of sildenafil citrate (four times; 100 mg) in a limited period (3 days). METHODS: On the first ocular examination, best-corrected distance visual acuity (CDVA) was 20/80 in his left eye and 20/20 in his right eye. On fundus examination, loss of foveal reflex and serous retinal detachment in the foveal region were detected. Fluorescein angiography of the left eye was compatible with a leakage area with determined borders. The patient was advised to stop sildenafil intake. RESULTS: After 4 weeks, CDVA increased to 20/25, and the fundus examination revealed significant improvement of the macular edema. Optical coherence tomography showed increased foveal thickness to 350 µm. CONCLUSION: Advising patients with central serous chorioretinopathy to stop sildenafil intake should be considered.

20.
Artigo em Inglês | MEDLINE | ID: mdl-29560367

RESUMO

Considering the rising number of MyoRing implantation procedures in keratoconic corneas and the refractive outcomes associated with this treatment modality, this study aimed to evaluate and compare the magnitude and axis orientation of total and corneal astigmatism between before and after MyoRing implantation in 34 eyes of 28 patients with keratoconus (KCN) (mean age: 29.41 ± 7.0 years). The inclusion criterion was a reliable diagnosis of clinical KCN based on corneal biomicroscopic and tomographic findings. The mean total astigmatism of ocular refraction decreased significantly from -4.27 ± 3.15 D (before MyoRing implantation) to -2.18 ± 1.63 D (after MyoRing implantation) (P < 0.001). The mean astigmatism in the anterior and posterior surface of the cornea decreased significantly by 1.16 D (P = 0.001) and 0.24 D (P = 0.009), respectively, after MyoRing implantation. Before MyoRing implantation, the axis orientation of total ocular astigmatism for with-the-rule, oblique, and against-the-rule astigmatism was 21%, 42%, and 37%, respectively; at 6 months after MyoRing implantation, it was 18%, 24%, and 58%, respectively. Before MyoRing implantation, the axis orientation for with-the-rule, against-the-rule, and oblique astigmatism of the anterior surface of the cornea was 59%, 24%, and 17%, respectively; at 6 months after MyoRing implantation, it was 52%, 24%, and 24%, respectively. Before MyoRing implantation, the axis orientation of with-the-rule, oblique, and against-the-rule astigmatism of the posterior surface of the cornea was 68%, 29%, and 3%, respectively; at 6 months after MyoRing implantation, it was 67%, 12%, and 12%, respectively. MyoRing implantation significantly decreased the amount of total, anterior, and posterior corneal astigmatism.

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