Grading nuclear cataract opacity by densitometry and objective optical analysis.

PURPOSE: To evaluate the optical quality and densitometric characteristics in eyes with early stages of crystalline lens opacification. SETTING: Vissum-Instituto de Oftalmológico de Alicante, Alicante, Spain. METHODS: The study included 34 eyes of 24 consecutive patients with nuclear opacity (NO) between NO1 and NO3 on the Lens Opacities Classification System III, normal corneas, and no previous ocular surgery. Intraocular aberrations were obtained by subtraction between the total and corneal optical aberrations. Modulation transfer function (MTF) was measured using a double-pass device. Lens photography and density (optical density units, Scheimpflug photography) were also evaluated. The main outcome measures were (1) spatial frequencies at 0.5 MTF and the cutoff point and (2) intraocular total and lower- and higher-order aberrations (root mean square). RESULTS: There was an increase in lens density with the cataract grade (mean 96.7 +/- 26.0 [SD], grade NO1; 125.1 +/- 25.9, grade NO2; 167.3 +/- 40.6, grade NO3). No statistically significant differences were found in intraocular higher aberrations between groups. Significant negative correlations were found between lens density and the spatial frequency at 0.5 MTF (r = -0.400, P = .026) or the cutoff MTF (r = -0.480, P = .006). CONCLUSIONS: The optical quality of eyes degraded with increasing cataract grade due to morphological changes such as an increase in lens density. Scheimpflug photography and MTF analysis helped objectively characterize early to moderate grades of nuclear cataract.

Optical Coherence Tomography in Children With Microtropia.

PURPOSE: To assess whether optical coherence tomography (OCT) could be useful for detecting and documenting fixation in patients with microtropia. METHODS: Retinal fixation observation was performed using spectral-domain OCT on amblyopic children with microtropia. The position between the retinal fixation point and the anatomical fovea was measured, in microns, using the system software tools. Only patients with a high level of cooperation, OCT scan quality signal of 7 or better, and visual acuity of 0.70 logarithm of the minimum angle of resolution (logMAR) or worse in the amblyopic eye were included. RESULTS: A total of 25 patients were included: 15 with microtropia (study group) and 10 without tropia and with foveal fixation and stereopsis (control group). In the study group, microtropia was previously diagnosed in 67% of cases through the cover test, and was predominantly in the left eye (73%). The average visual acuity of the sound eye was 0.03 decimal and 0.18 logMAR in the amblyopic eye. The microtropia was 3.73 ± 3.34 prism diopters and eccentric fixation (387 ± 199 µm) with OCT was observed in all cases except one. Eccentricity was predominantly in the superonasal quadrant (57%). Both eyes in the control group and the contralateral eyes of the study group showed foveal fixation. CONCLUSIONS: OCT can play an important role in the diagnosis and measurement of eccentric fixation in eyes with microtropia, providing high sensitivity. [J Pediatr Ophthalmol Strabismus. 2018;55(3):171-177.].

Use of autologous platelet-rich plasma in the treatment of dormant corneal ulcers.

PURPOSE: To investigate the potential role of autologous platelet-rich plasma in promoting healing in dormant corneal ulcers. DESIGN: Prospective, consecutive, interventional, noncomparative, nonrandomized, observational study. PARTICIPANTS: Forty eyes of 38 patients with dormant corneal ulcers. METHODS: Autologous platelet-rich plasma was used in a total of 40 eyes with dormant corneal ulcers divided into 2 groups: group I, 26 eyes treated with topical eyedrops of autologous platelet-rich plasma (12 neurotrophic, 9 herpetic, and 5 immunological ulcers), and group II, 14 eyes treated surgically with a solid clot of autologous platelet-rich plasma combined with amniotic membrane transplantation in perforated corneas or with impending perforation. The treatment was used in patients with chronic nonhealing ulcers (mean, 2 years of evolution) that had been unresponsive to conventional topical therapy. Autologous blood from each patient was obtained by venipuncture, and platelet-rich plasma was prepared from each blood sample without additives. MAIN OUTCOME MEASURES: Ulcer size, inflammation, healing, visual acuity, and patient's subjective symptoms. RESULTS: Autologous platelet-rich plasma promoted healing of ulcers. In group I, 13 eyes healed, 11 eyes improved significantly, and 2 eyes showed no change. In group II, 10 eyes healed and 4 eyes improved significantly. Inflammation and subjective symptoms, particularly pain, improved in all patients. Vision remained stable or improved in all cases. CONCLUSION: Autologous platelet-rich plasma promoted healing of dormant corneal ulcers even in eyes threatened by corneal perforation and was accompanied by a reduction in pain and inflammation.

Treatment of ocular surface syndrome after LASIK with autologous platelet-rich plasma.

PURPOSE: To ascertain the usefulness of platelet-rich plasma in the treatment of patients suffering from symptomatic ocular surface syndrome following LASIK. METHODS: Twenty-six eyes (9 women and 4 men) affected by symptomatic ocular surface syndrome were treated with topical eye drops of autologous platelet-rich plasma and results were reported at 4 weeks. Topical platelet-rich plasma was prepared from total blood and enriched in platelets by centrifugation. RESULTS: Eighty-five percent of patients experienced significant improvement of symptoms; best spectacle-corrected visual acuity increased 1 to 2 lines in 54%; fluorescein staining analysis showed a 69% full fluorescein disappearance; and tear break-up time increased > 2 seconds in 46%. Only one patient developed intolerance to platelet-rich plasma after 4 weeks. CONCLUSIONS: Autologous platelet-rich plasma was effective in the treatment of patients with ocular surface syndrome following LASIK, with symptoms generally relieved and a positive effect on punctate keratitis.