Comparative Analysis of Central Corneal Thickness in Ocular Hypertension and Healthy Individuals.

OBJECTIVE: This study aimed to compare the central corneal thickness (CCT) between patients with ocular hypertension (OHT) and healthy individuals, and to investigate the relationship between CCT and intraocular pressure (IOP), diopter, and corneal endothelium cell count (CECC). METHODS: The CCT of 30 healthy subjects and 38 patients with OHT was measured using a non-contact specular microscope. IOP, diopter, and CECC were also assessed for all participants. Comparative analysis of CCT between the two groups was performed, along with correlation analysis between CCT and each parameter. RESULTS: The average CCT for all participants was 527.57 ± 35.84 µm. The average CCT was 516.07 ± 34.76 µm for healthy subjects and 536.66 ± 34.46 µm for patients with ocular hypertension, showing a significant difference between the two groups (P ≤ 0.05). CCT was not correlated with age (Pearson r = -0.098, P = 0.426), diopter (spherical equivalent refraction) (Pearson r = -0.158, P = 0.197), or corneal endothelium cell count (Pearson r = 0.065, P = 0.598). However, a positive correlation was found between ocular hypertension and central corneal thickness (Pearson r = 0.278, P = 0.022). CONCLUSION: Patients with ocular hypertension of members of the Chinese Han population exhibited greater CCT compared to healthy subjects in this study. CCT showed no association with age, diopter, or corneal endothelium cell count; however, a positive correlation was observed between intraocular pressure and CCT. With CCT as the abscissa and IOP as the ordinate, the linear regression equation is Y=0.05+0.021X (F = 5.508, P = 0.022). The use of non-contact tonometers for measuring CCT may impact the accuracy of diagnosing and treating glaucoma and ocular hypertension.

Refractive index adjustable intraocular lens design to achieve diopter control for improving the treatment of ametropia after cataract surgery.

Intraocular lens (IOL) implantation is currently the most effective clinical treatment for cataracts. Nevertheless, due to the growth of the eye axis in patients with congenital cataracts during the process of growth and development, the progressive incapacity of an IOL with a fixed focus does not meet the demands of practical usage, leading to the occurrence of ametropia. This work describes an innovative class of an IOL bulk material that offers good biosafety and light-controlled refractive index adjustment. Acrylate materials were synthesized for the preparation of IOLs by free radical polymerization of ethylene glycol phenyl ether methacrylate (EGPEMA), hydrophilic monomer 2-(2-ethoxyethoxy) ethyl acrylate (EA), and functional monomer hydroxymethyl coumarin methacrylate (CMA). Under 365/254 nm ultraviolet (UV) irradiation, the coumarin group could adjust the polymer material's refractive index through reversible photoinduced dimerization/depolymerization. Meanwhile, the potential for the IOL use is enabled by its satisfactory biosafety. Such a light-induced diopter adjustable IOL will be more appropriate for implantation during cataract surgery since it will not require the correction needed for ametropia and will offer more accurate and humane treatment. STATEMENT OF SIGNIFICANCE.

IRIS® Registry (Intelligent Research In Sight) Analysis of the Incidence of Monovision in Cataract Patients with Bilateral Monofocal Intraocular Lens Implantation.

Purpose: To determine the incidence of pseudophakic monovision among patients bilaterally implanted with monofocal intraocular lenses (IOLs) and to characterize the distribution of myopic offsets achieved. Patients and Methods: This retrospective database study included data on patients receiving care from ophthalmologists who contributed to the Academy IRIS® (Intelligent Research In Sight) Registry. Anonymized data were collected, including patient age, ethnicity, procedure data (CPT code, date, laterality), and postoperative manifest refractive spherical equivalent (MRSE) in both eyes implanted with monofocal or monofocal toric IOLs. No data regarding IOL manufacturer, model, or power were collected. One primary outcome measure was the percentage of patients achieving monovision (defined as emmetropia within ±0.25 diopters [D] in one eye and a myopic offset of ≥0.50 D in the fellow eye) among all patients receiving bilateral monofocal IOLs at the time of cataract surgery between January 1, 2016, and September 1, 2019, with at least 90 days of follow-up. Other primary outcomes included the distribution and frequency of myopic offsets (anisometropia) between eyes. Results: Of the 16,765 people receiving bilateral monofocal IOLs within the study period, 4796 (28.6%) achieved emmetropia in at least one eye, as defined by an MRSE within ± 0.25 D. The incidence of monovision among these patients was 34.2% (1638/4796). One-quarter (24.7%; 405/1638) of patients who achieved monovision had a myopic offset between 0.50 and 0.74 D, with more than one-third (35.2%; 576/1638) falling within 0.75-1.24 D and 18.0% within 1.25-1.74 D. A myopic offset ≥1.75 D was observed in 22.1% (362/1638) of patients who achieved monovision. Conclusion: Pseudophakic monovision for presbyopia correction was achieved in ~34% of patients in the IRIS Registry bilaterally implanted with monofocal IOLs, with myopic offsets typically ranging from 0.5 to 1.24 D.

Effect of 0.01% Atropine on diopter and optic axis in adolescents and children with myopia.

The purpose of this study was to investigate the effect of 0.01% Atropine eye drops on diopter and optic axis in adolescents and children with myopia. A total of 164 children with myopia were randomly divided into two groups, Group A and Group B with 82 patients in each group, according to the digital table method. Group A was treated with 0.01% Atropine eye drops, while Group B was treated with single vision lenses. Before the treatment, there was no significant difference in diopter and axial length between the two groups (P=0.624 and P=0.123). After 12 months of treatment, the diopter and axial length of Group A were lower than those of Group B (P < 0.001 and P = 0.005). There were no obvious adverse reactions during corrective therapy in the two groups. The results show that compared with single vision lenses, 0.01% Atropine is more effective in correcting myopia, and may control the increase of optic axis in adolescents and children with myopia, in a better way, with high safety..

Randomized Trial of Soft Contact Lenses with Novel Ring Focus for Controlling Myopia Progression.

Purpose: To evaluate efficacy and vision with 2 prototype myopia control soft contact lenses with noncoaxial ring-focus designs (for enhancing efficacy [EE] and enhancing vision [EV]) compared with dual-focus (DF) and single-vision (SV) designs. Design: Multicenter, 6-month, randomized, controlled, double-masked clinical trial. Participants: One hundred ninety-nine myopic (-0.75 diopters [D] to -4.50 D) children aged 7 to 12 years. Methods: Participants were randomized with stratification into myopia control (EE, EV, or DF) or SV arms at 9 clinical sites in 3 countries. Postcycloplegia axial length (AL) and spherical equivalent autorefraction (SECAR) were measured at baseline and 26 weeks. Axial length was also measured without cycloplegia at baseline, 1, 4, 13, and 26 weeks. Progression was analyzed using linear mixed models by intention-to-treat population. Visual acuity (VA) and vision quality were monitored. Main Outcome Measures: Axial elongation, change in SECAR. Results: A total of 185 subjects completed the study (n = 44, 49, 45, and 47 for EE, EV, DF, and SV, respectively). There were no serious/significant ocular adverse events. After 26 weeks, EE, EV, and DF all had statistically significantly less axial elongation than SV (unadjusted mean [standard deviation]: EE, 0.079 [0.125]; EV, 0.119 [0.101]; DF, 0.135 [0.117]; SV; 0.189 [0.121] mm). The estimated least-square mean (LSM) differences (adjusted 95% confidence interval) compared with SV were -0.105 (-0.149, -0.062), -0.063 (-0.106, -0.020), and -0.056 (-0.100, -0.013) mm for EE, EV, and DF, respectively. Enhancing efficacy alone had statistically significantly less progression of SECAR than SV (EE: -0.12 [0.27] D vs. SV: -0.35 [0.33] D; LSM difference: 0.22 D [0.09, 0.35]). Enhancing efficacy also had statistically significantly less axial elongation than DF (-0.049 mm [-0.093, -0.004]). Changes in AL and SECAR of EV and DF were not statistically different. All 3 myopia control lenses had mean VA close to 0.00 logarithm of the minimum angle of resolution (logMAR) with estimated 95% upper confidence limits <0.10 logMAR. Enhancing efficacy and DF produced similar reports of halos but more than EV and SV. Conclusions: The prototype contact lenses met the design intent; EE was more efficacious in slowing axial elongation than DF with comparable vision performance, whereas EV produced comparable efficacy to DF with similar vision performance to SV.

Modified transposition using silicone band for multiple rectus muscle palsies.

Purpose: To report the results of partial vertical rectus muscle transposition using a silicone band. Observations: We retrospectively gathered data on two patients with multiple vertical and horizontal extraocular muscle paresis and diplopia who had been treated with vertical rectus muscle transposition with the aid of a silicone band. Both patients had acceptable results on follow-up. Conclusion: Using the silicone band, we tried to effectively transpose the target muscles to obtain acceptable results.

Augmenting Kalman Filter Machine Learning Models with Data from OCT to Predict Future Visual Field Loss: An Analysis Using Data from the African Descent and Glaucoma Evaluation Study and the Diagnostic Innovation in Glaucoma Study.

Purpose: To assess whether the predictive accuracy of machine learning algorithms using Kalman filtering for forecasting future values of global indices on perimetry can be enhanced by adding global retinal nerve fiber layer (RNFL) data and whether model performance is influenced by the racial composition of the training and testing sets. Design: Retrospective, longitudinal cohort study. Participants: Patients with open-angle glaucoma (OAG) or glaucoma suspects enrolled in the African Descent and Glaucoma Evaluation Study or Diagnostic Innovation in Glaucoma Study. Methods: We developed a Kalman filter (KF) with tonometry and perimetry data (KF-TP) and another KF with tonometry, perimetry, and global RNFL data (KF-TPO), comparing these models with one another and with 2 linear regression (LR) models for predicting mean deviation (MD) and pattern standard deviation values 36 months into the future for patients with OAG and glaucoma suspects. We also compared KF model performance when trained on individuals of European and African descent and tested on patients of the same versus the other race. Main Outcome Measures: Predictive accuracy (percentage of MD values forecasted within the 95% repeatability interval) differences among the models. Results: Among 362 eligible patients, the mean ± standard deviation age at baseline was 71.3 ± 10.4 years; 196 patients (54.1%) were women; 202 patients (55.8%) were of European descent, and 139 (38.4%) were of African descent. Among patients with OAG (n = 296), the predictive accuracy for 36 months in the future was higher for the KF models (73.5% for KF-TP, 71.2% for KF-TPO) than for the LR models (57.5%, 58.0%). Predictive accuracy did not differ significantly between KF-TP and KF-TPO (P = 0.20). If the races of the training and testing set patients were aligned (versus nonaligned), the mean absolute prediction error of future MD improved 0.39 dB for KF-TP and 0.48 dB for KF-TPO. Conclusions: Adding global RNFL data to existing KFs minimally improved their predictive accuracy. Although KFs attained better predictive accuracy when the races of the training and testing sets were aligned, these improvements were modest. These findings will help to guide implementation of KFs in clinical practice.

The Refractive Error and Vision Impairment Estimation with Spectacle Data Study.

Purpose: To investigate whether spectacle lens sales data can be used to estimate the population distribution of refractive error among patients with ametropia and hence to estimate the current and future risk of vision impairment. Design: Cross-sectional study. Participants: A total of 141 547 436 spectacle lens sales records from an international European lens manufacturer between 1998 and 2016. Methods: Anonymized patient spectacle lens sales data, including refractive error information, was provided by a major European spectacle lens manufacturer. Data from the Gutenberg Health Survey was digitized to allow comparison of a representative, population-based sample with the spectacle lens sales data. A bootstrap analysis was completed to assess the comparability of both datasets. The expected level of vision impairment resulting from myopia at 75 years of age was calculated for both datasets using a previously published risk estimation equation combined with a saturation function. Main Outcome Measures: Comparability of spectacle lens sales data on refractive error with typical population surveys of refractive error and its potential usefulness to predict vision impairment resulting from refractive error. Results: Equivalent estimates of the population distribution of spherical equivalent refraction can be provided from spectacle lens data within limits. For myopia, the population distribution was equivalent to the Gutenberg Health Survey (≤ 5% deviation) for levels of -2.0 diopters (D) or less, whereas for hyperopia, the distribution was equivalent (≤ 5% deviation) for levels of +3.0 D or more. The estimated rates of vision impairment resulting from myopia were not statistically significantly different (chi-square, 182; degrees of freedom, 169; P = 0.234) between the spectacle lens dataset and Gutenberg Health Survey dataset. Conclusions: The distribution of refractive error and hence the risk of vision impairment resulting from refractive error within a population can be determined using spectacle lens sales data. Pooling this type of data from multiple industry sources could provide a cost-effective, timely, and globally representative mechanism for monitoring the evolving epidemiologic features of refractive error and associated vision impairment.

Most nonpathological eyes present a small area of hyperreflective Henle's fiber layer on pupil-centered optical coherence tomography.

PURPOSE: Henle's fiber layer (HFL) is hyporeflective and indistinct on pupil-centered optical coherence tomography (OCT). However, a small area of HFL is also found to be hyperreflective on pupil-centered OCT. This study characterized the hyperreflective HFL of healthy eyes on pupil-centered OCT and investigated the possible physiological and functional relationship of hyperreflective HFL. METHODS: Subjects with different degrees of ametropia underwent a complete ophthalmologic examination, including binocular function by synoptophore and Titmus test, ocular axial length, refractions, and pupil-centered OCT angiography coupled with OCT. The area of hyperreflective HFL was manually plotted and calculated using the Optovue AngioVue system technology. The possible ocular physiological and functional relationship with the area of hyperreflective HFL was investigated. RESULTS: A total of 111 subjects (222 eyes) without other ocular diseases were enrolled, of which 164 eyes (74%) presented hyperreflective HFL. The average area of hyperreflective HFL was 0.71 ± 0.07 mm2. The area of hyperreflective HFL was significantly related to spherical diopters (P = 0.032). The average binocular area of hyperreflective HFL was 1.38 ± 0.17 mm2. The binocular area of hyperreflective HFL was significantly related to the angle of superposition and far stereoacuity (P = 0.013 and 0.038, respectively). CONCLUSION: Most healthy eyes present a small area of hyperreflective HFL, which might be due to alternation of the orientation of some Henle fibers by ametropia during the development of visual function postpartum. The small area of hyperreflective HFL may serve as a marker in identifying the boundary of HFL on OCT.

Comparative Study of Relative Peripheral Refraction in Children With Different Degrees of Myopia.

Purpose: To investigate the difference in the retinal refraction difference value (RDV) using multispectral refractive topography (MRT). Methods: Ninety myopic participants, who met the enrolment requirements, were examined with an automatic optometer after mydriasis. According to the value of the spherical equivalent (SE), the participants were divided into Emmetropia group (E, +0.5D < SE < -0.5D), Low Myopia (LM, -0.5D < SE ≤ -3D), and Moderate and high Myopia (MM, -3D < SE ≤ -10D). The ocular biological parameters were detected by optical biometrics (Lenstar 900, Switzerland), including axial length (AL), lens thickness (LT), and keratometry (K1, K2). Furthermore, the MRT was used to measure the retinal RDV at three concentric areas, with 15-degree intervals from fovea into 45 degrees (RDV-15, RDV 15-30, and RDV 30-45), and four sectors, including RDV-S (RDV-Superior), RDV-I (RDV-Inferior), RDV-T (RDV-Temporal), and RDV-N (RDV-Nasal). Results: In the range of RDV-15, there was a significant difference in the value of RDV-15 between Group E (-0.007 ± 0.148) vs. Group LM (-0.212 ± 0.399), and Group E vs. Group MM (0.019 ± 0.106) (P < 0.05); In the range of RDV 15-30, there was a significant difference in the value of RDV 15-30 between Group E (0.114 ± 0.219) vs. Group LM (-0.106 ± 0.332), and Group LM vs. Group MM (0.177 ± 0.209; P < 0.05); In the range of RDV 30-45, there was a significant difference in the value of RDV 30-45 between Group E (0.366 ± 0.339) vs. Group LM (0.461 ± 0.304), and Group E vs. Group MM (0.845 ± 0.415; P < 0.05); In the RDV-S position, there was a significant difference in the value of RDV-S between Group LM (-0.038 ± 0.636) and Group MM (0.526 ± 0.540) (P < 0.05); In the RDV-I position, there was a significant difference in the value of RDV-I between Group E (0.276 ± 0.530) vs. Group LM (0.594 ± 0.513), and Group E vs. Group MM (0.679 ± 0.589; P < 0.05). In the RDV-T position, there was no significant difference in the value of RDV-T among the three groups. In the RDV-N position, there was a significant difference in the value of RDV-N between Group E (0.352 ± 0.623) vs. Group LM (0.464 ± 0.724), and Group E vs. Group MM (1.078 ± 0.627; P < 0.05). The RDV analysis in all directions among the three groups showed a significant difference between RDV-S and RDV-I in Group LM (P < 0.05). Moreover, the correlation analysis showed that SE negatively correlated with AL, RDV 30-45, RDV-S, RDV-I, and RDV-N. Conclusions: In this study, there was a significant difference in the value of RDV among Group E, Group LM, and Group MM, and the value of RDV in Group MM was the highest on the whole. In the range of RDV 30-45, there was a growing trend with the increase in the degree of myopia among the three groups. Furthermore, the SE negatively correlated with AL, RDV 30-45, RDV-S, RDV-I, and RDV-N.

Anti-Fatigue Glasses Based on Microprisms for Preventing Eyestrain.

Although microprisms have become an important medical means of strabismus treatment, related research concerning the design, fabrication, and testing of microprismatic glasses for preventing eyestrain has rarely been reported. In this study, the structure of microprismatic glasses for preventing eyestrain related to using electronic monitors, including computers and mobile phones, is introduced. A designing theory of anti-fatigue glasses with microprisms is developed. The fabrication technique and the process are described, and the performances of the fabricated microprisms are characterized. Finally, a compact testing system for the measurement of prismatic diopter is designed and constructed. This measuring system can be used not only for Fresnel microprisms, but also for other types of prisms. The measured results agree with our calculations. Although this study is focused on optimizing the objective prismatic diopter for anti-fatigue microprismatic glasses, 2.0-3.0 prismatic diopters (Δ) for each eye in the anti-fatigue glasses are suggested according to our experience on strabismus treatments. The clinical research for patients using the developed anti-fatigue glasses will be fully implemented in our further research to confirm the optimal subjective prismatic value.

Novel application of multispectral refraction topography in the observation of myopic control effect by orthokeratology lens in adolescents.

BACKGROUND: Myopia, as one of the common ocular diseases, often occurs in adolescence. In addition to the harm from itself, it may also lead to serious complications. Thus, prevention and control of myopia are attracting more and more attention. Previous research revealed that single-focal glasses and orthokeratology lenses (OK lenses) played an important part in slowing down myopia and preventing high myopia. AIM: To compare the clinical effects of OK lenses and frame glasses against the increase of diopter in adolescent myopia and further explore the mechanism of the OK lens. METHODS: Changes in diopter and axial length were collected among 70 adolescent myopia patients (124 eyes) wearing OK lenses for 1 year (group A) and 59 adolescent myopia patients (113 eyes) wearing frame glasses (group B). Refractive states of their retina were inspected through multispectral refraction topography. The obtained hyperopic defocus was analyzed for the mechanism of OK lenses on slowing down the increase of myopic diopter by delaying the increase of ocular axis length and reducing the near hyperopia defocus. RESULTS: Teenagers in groups A and B were divided into low myopia (0D - -3.00 D) and moderate myopia (-3.25D - -6.00 D), without statistical differences among gender and age. After 1-year treatment, the increase of diopter and axis length and changes of retinal hyperopic defocus amount of group A were significantly less than those of group B. According to the multiple linear analysis, the retinal defocus in the upper, lower, nasal, and temporal directions had almost the same effect on the total defocus. The amount of peripheral retinal defocus (15°-53°) in group A was significantly lower than that in group B. CONCLUSION: Multispectral refraction topography is progressive and instructive in clinical prevention and control of myopia.

Analysis of ocular structural parameters and higher-order aberrations in Chinese children with myopia.

BACKGROUND: Myopia and high myopia are global public health concerns. Patients with high myopia account for 0.5%-5.0% of the global population. AIM: To examine diopters, axial length (AL), higher-order aberrations, and other ocular parameters in Chinese children with myopia, to analyze the influence of structural parameters associated with myopia on visual quality, and to provide a theoretical basis for the prevention and treatment of childhood myopia and high myopia. METHODS: This study included 195 children aged 6-17 years with myopia. The AL was measured with an ultrasonic ophthalmic diagnostic instrument, and the aberrations, corneal curvature (minimum K1, maximum K2, and average Km), central corneal thickness, anterior chamber depth, and anterior chamber angle were measured using a Sirius three-dimensional anterior segment analyzer. Using a standard formula, the corneal radius of curvature R (337.3/Km) and AL/R values were obtained. RESULTS: The diopter of high myopia compared with low-middle myopia was correlated with age and AL (r = -0.336, -0.405, P < 0.001), and AL of high myopia was negatively correlated with K1, K2, and Km (r = -0.673, -0.661, and -0.680, respectively; P < 0.001), and positively correlated with age and the anterior chamber depth (r = 0.214 and 0.275, respectively; P < 0.05). AL/R was more closely related to diopter than AL in children with myopia, and 94.4% of children with myopia had an AL/R of > 3.00. CONCLUSION: The ocular structural parameters of children change because of different diopters. AL/R is more specific and sensitive than AL in evaluating the refractive status of myopia in children. An AL/R of > 3.00 may be used as a specific index of myopia in children. There are differences in AL/R between high myopia and low-middle myopia, which can be used for the classification of ametropia. The degree of myopia has a certain influence on higher-order aberrations.

Factors associated with corneal high-order aberrations before and after femtosecond laser-assisted in situ keratomileusis.

BACKGROUND: Corneal high-order aberrations (HOAs) are related to visual quality. However, the factors associated with corneal HOAs before and after femtosecond laser-assisted in situ keratomileusis (FS-LASIK) have not yet been elucidated. The aim of this study is to observe the factors related to corneal HOAs before and after FS-LASIK. METHODS: Prospective observational study was designed to measure corneal HOAs in 149 eyes of 75 patients before and 6 months after FS-LASIK. The relationship between spherical diopter and corneal parameters, including K1 and K2 (horizontal and vertical refractive power of the cornea, respectively), the aspheric characteristics of the cornea (Q), mean radius of the curvature of the cornea (Rm), and central corneal thickness (CCT), with corneal HOAs were analyzed. RESULTS: The spherical diopter was correlated with trefoil at 30° before surgery and with vertical coma, four-order astigmatism at 0°, trefoil at 30°, spherical aberration, and six-order spherical aberration after surgery (P<0.05). CCT was correlated with vertical coma, four-order astigmatism at 0°, trefoil at 30°, and six-order spherical aberration after surgery (P<0.05). K1 was correlated with spherical aberration and six-order astigmatism at 0° before surgery (P<0.05). K2 was correlated with spherical aberration, six-order astigmatism at 45°, astigmatism at 0°, six-order astigmatism at 0° before surgery, and trefoil at 30° after surgery (P<0.05). Q was correlated with spherical aberration, six-order spherical aberration, and six-order astigmatism at 45° (P<0.05). Rm was correlated with six-order astigmatism at 0°, spherical aberration, six-order astigmatism at 45° before surgery, and astigmatism at 0° after surgery (P<0.05). CONCLUSIONS: Corneal parameters and spherical diopter are related to the HOAs of the cornea before and after FS-LASIK.

Short Axial Length Is Related to Asymmetric Vortex Veins in Central Serous Chorioretinopathy.

Purpose: To investigate the clinical and morphologic factors related to asymmetric dilated vortex veins in central serous chorioretinopathy (CSC). Design: Retrospective, comparative study. Participants: One hundred fifty-eight eyes of 158 patients with CSC. Methods: All patients with CSC underwent ophthalmic examination and multimodal imaging, including measurements of axial length (AL), fluorescein angiography, indocyanine green angiography, swept-source OCT, and anterior segment OCT. Using en face OCT images at the level of the outer choroid, the eyes were divided into 2 groups: eyes with symmetric vortex veins (symmetry group) and those with asymmetric vortex veins (asymmetry group). Main Outcome Measures: Clinical and morphologic factors related to asymmetric vortex veins in CSC. Results: Of the 158 eyes, 120 eyes (75.9%) were classified into the asymmetry group and 38 eyes (24.1%) were classified into the symmetry group. The asymmetry group showed significantly greater spherical equivalent (-0.32 ± 1.78 diopters [D] vs. -1.35 ± 2.64 D; P = 0.033), shorter AL (23.52 ± 0.86 mm vs. 24.10 ± 1.06 mm; P = 0.005), and greater subfoveal choroidal thickness (414.6 ± 105.3 µm vs. 360.4 ± 91.8 µm; P = 0.005) than the symmetry group. No significant differences existed between the 2 groups regarding age, sex, or all scleral thicknesses at the superior, temporal, inferior, and nasal points. In the multivariate analyses, shorter AL (odds ratio, 0.56; 95% confidence interval, 0.36-0.88; P = 0.011) was found to be significantly associated with the presence of asymmetric vortex veins. Conclusions: The asymmetric dilated vortex vein is a common finding in patients with CSC. Our results suggest that certain biometric factors, such as short AL, may be associated with asymmetric dilated vortex veins developing in patients with CSC.

Prevalence of Vitreoretinal Interface Disorders in an Australian Population: The Blue Mountains Eye Study.

Purpose: To describe the prevalence, risk factors, and associations of vitreoretinal interface (VRI) abnormalities in a population-based study of older adults. Design: Cross-sectional analysis of cohort study participants. Participants: Of the 1149 participants (mean age, 76.1 ± 6.9 years) in the 15-year Blue Mountains Eye Study follow-up examination from 2007 through 2009, 905 (1791 eyes) had gradable time-domain or spectral-domain OCT scans of the macula from at least 1 eye. Methods: OCT scans were graded according to the International Vitreomacular Traction Study Group classification system of VRI abnormalities. Best-corrected visual acuity (BCVA) was recorded. Main Outcome Measures: Prevalence of VRIs. Results: Overall, 451 participants showed any VRI abnormality (49.8%). Prevalence of VRI abnormality by person was: vitreomacular adhesion (VMA), 33.6%; vitreomacular traction (VMT), 1.6%; epiretinal membrane (ERM), 21.4%; full-thickness macular hole (FTMH), 0.7%; and lamellar macular hole (LMH), 0.7%. Twenty-two percent of VMAs were focal, and 78% were broad based; 76% of VMTs were focal, and 24% were broad based. All FTMHs observed were large (>400 µm), with mean aperture size of 573 µm (range, 459-771 µm). Increased age was associated with higher ERM and lower VMA prevalence (P < 0.001 for both). Pseudophakia and myopia were associated with ERM (age- and sex-adjusted odds ratios [ORs], 1.48 [95% confidence interval (CI), 1.01-2.17] and 1.72 [95% CI, 1.05-2.81], respectively). Moderate or severe ERM and FTMH were associated with worse BCVA of 9.2 Early Treatment Diabetic Retinopathy Study (ETDRS) letters (95% CI, 3.4-15.0 ETDRS letters; P = 0.008) and 26.0 ETDRS letters (95% CI, 10.9-41.1 ETDRS letters; P = 0.001), respectively. Conclusions: The prevalence of VRI abnormalities is high in older individuals. Epiretinal membrane was associated with increasing age, pseudophakia, and myopia. Epiretinal membrane and FTMH may account for significant visual loss in the affected eye. This study provided useful population-based data on the prevalence of VRI abnormalities in older individuals.

First Experiences with Implantation of Phakic Lenses in Correction of Myopia in R. N. Macedonia.

Objective: Analysis of visual acuity parameters in patients with moderate to high myopia and myopic astigmatism 1 year after treatment with phakic intraocular lenses. Material and methods: This was a retrospective study on 35 patients (52 eyes) with moderate to high myopia who were implanted with the Visian V4c phakic implantable Collamer lens (Staar Surgical, Nidau, Switzerland). Examined parameters were: uncorrected distance visual acuity (UDVA) and best corrected visual acuity (CDVA), manifest and cycloplegic refraction, intraocular pressure, and endothelial cell count. The investigated parameters were measured preoperatively, 1, 3, 6 and 12 months postoperatively. Results: In 17 patients, phakic lenses were implanted binocularly and in 18 patients monocularly. Preoperatively 34.62% of patients had CDVA from 0.9 to 1.0. One year after the surgery 48.08% of patients had UDVA from 0.9 to 1.0. Preoperatively 80.77% of patients had diopter range from -6.00 Dsph to -10.00 Dsph. At 1 year postoperatively 78.85% of patients were within 0.00 Dsph to -1.00 Dsph. Preoperatively, in patients with astigmatism -4 Dcyl to -2 Dcyl dominated, as opposed to significant improvement postoperatively when 94.23% had astigmatism ranging from -1.0 Dcyl to 0 Dcyl. Conclusion: The implantation of phakic lenses demonstrated a successful postoperative outcome in the treatment of myopia and myopic astigmatism. Visual acuity and refraction show a gradual and significant improvement in visual function parameters within 1 year of lens implantation.

Clinical Outcome of Lentis Comfort Intraocular Lens Implantation.

PURPOSE: To evaluate visual outcome and patient satisfaction following Lentis Comfort intraocular lens (IOL) implantation. METHOD: This retrospective case series examined 68 eyes of 41 patients (mean age 72.0 ± 8.1 years) who underwent Lentis Comfort (LS-313 MF15, Oculentis GmbH, Berlin, Germany; Santen, Osaka, Japan) implantations. Patients were evaluated for visual acuity (VA) at several distances (0.3, 0.5 and 5 meters), refractive error, defocus curve and contrast sensitivity, in addition to answering a questionnaire on photic phenomena, visual discomfort and patient satisfaction. RESULTS: Uncorrected visual acuity was 0.05 ± 0.13 (logMAR) for distance, 0.23 ± 0.17 (logMAR) for intermediate, and 0.52 ± 0.20 (logMAR) for near. Defocus curve showed the binocular visual acuity attained was almost 20/20 within the range of +0.5 D to -1.5 D. Contrast sensitivity was within the normal range. The Lentis Comfort IOL tolerated astigmatism to some extent. Patient age could potentially be related to uncorrected visual acuity. Questionnaire results showed almost all patients were satisfied with Lentis Comfort IOL implantation. CONCLUSION: Lentis Comfort IOLs provided better visual function at far and intermediate distances.

Intraocular Lens Power, Myopia, and the Risk of Nd:YAG Capsulotomy after 15,375 Cataract Surgeries.

The present study estimated the 5-year cumulative probability of Nd:YAG laser posterior capsulotomy according to the diopter power of implanted hydrophobic acrylic intraocular lenses (IOLs). Data were retrospectively collected of 15,375 eyes having cataract surgery and in-the-bag implantation of hydrophobic acrylic monofocal IOLs at the Ophthalmology Unit of Kymenlaakso Central Hospital, Kotka, Finland between the years 2007 and 2016. The cumulative probability of Nd:YAG capsulotomy was calculated by Kaplan-Meier estimates, and potential risk factors were analyzed using the Cox proportional hazards model. The 5-year cumulative probability of Nd:YAG capsulotomy after cataract surgery was 27.4% (95% confidence interval (CI) 22.9-32.6%) for low-diopter (5-16.5 D) IOLs, 14.6% (13.8-15.5%) for mid-diopter (17-24.5 D) IOLs, and 13.6% (11.7-15.6%) for high-diopter (25-30 D) IOLs. A multivariate Cox regression analysis showed that low-diopter IOLs (HR 1.76; 95% CI 1.38-2.25; p < 0.001) were associated with an increased risk of Nd:YAG capsulotomy compared to mid-diopter IOLs over the follow-up period after accounting for other predictors. Real-world evidence shows that low-diopter IOLs are associated with significantly higher risk of Nd:YAG capsulotomy within five years following implantation. Estimation should help in evaluating the risks of cataract surgery in myopic eyes.

Clinical outcomes after mix-and-match implantation of diffractive multifocal intraocular lenses with + 2.75 and + 4.00 diopter add powers.

BACKGROUND: To evaluate the clinical outcomes of bilateral mix-and-match implantation of diffractive multifocal intraocular lenses (IOLs) with different add powers. METHODS: We retrospectively reviewed the medical records of 18 patients who underwent bilateral mix-and-match implantation of diffractive multifocal IOLs with different add powers. Multifocal IOLs with add powers of + 2.75 diopters (D) and + 4.00 D were implanted into the patients' dominant and nondominant eyes, respectively. At 1 and 3-month postoperatively, monocular and binocular visual acuity was measured using logMAR charts and manifest refraction was performed. Specifically, logMAR charts were used to measure uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), and corrected distance visual acuity (CDVA). Defocus curves, contrast sensitivity, and patient satisfaction were assessed at 3-month postoperatively. RESULTS: Binocular logMAR measurements (mean ± standard deviation) at 3-month postoperatively were 0.01 ± 0.04 (UDVA), 0.16 ± 0.05 (UIVA), and 0.11 ± 0.07 (UNVA). Postoperative spherical equivalent was - 0.43 ± 0.35 D and - 0.39 ± 0.21 D in the dominant and nondominant eyes, respectively. Defocus curves showed significant differences between - 1.50 and - 4.00 D among binocular, dominant, and nondominant eye measurements, except between - 2.50 and - 3.00 D. Eyes implanted with + 2.75 and + 4.00 D IOLs showed good contrast sensitivity under photopic and mesopic conditions. Over 80% of patients reported high satisfaction with their near vision. CONCLUSIONS: Bilateral mix-and-match implantation of diffractive multifocal IOLs with add powers of + 2.75 D and + 4.00 D showed good near, intermediate, and far vision.