A 3-year follow-up study of a new corneal inlay: clinical results and outcomes.

PURPOSE: Here, we report the results of a 3-year follow-up analysis of the outcomes of the Flexivue Microlens corneal inlay. PATIENTS: Non-dominant eyes (n=31) of emmetropic presbyopic patients (spherical equivalent: -0.5 to 1.00 dioptre). METHODS: A Flexivue Microlens corneal inlay was implanted after the creation of a 300 µm deep stromal pocket using a femtosecond laser. Patients were followed up according to a clinical protocol involving refraction, anterior segment imaging analysis (Oculyser), optical quality analysis (OPD-Scan), monocular binocular uncorrected and corrected visual acuity tests, contrast sensitivity measurements (photopic and mesopic), satisfaction questionnaire results and adverse event reporting. RESULTS: Thirty patients were examined at the 3-year follow-up in this ongoing study. The mean uncorrected near visual acuity improved to Jaeger 1 in 76.9% of eyes treated with the inlays (vs 87.1% at the 1-year follow-up). All eyes improved four lines in all visits, except for four patients for whom the inlay was explanted. Patients reported that their near vision was good or excellent in 73.3% of cases (vs 90.3% in the first year). The UDVA remained stable over time. Three patients were explanted due to blurred vision for near-point and far-point distances. One patient developed a superficial corneal ulcer after 20 months. Two patients underwent cataract removal. Four patients underwent inlay exchange to increase near power correction. CONCLUSIONS: The Presbia Flexivue Microlens provided presbyopia treatment by improving near vision. Manageable complications may occur over the long term. CLINICAL TRIAL REGISTRATION NUMBER: U1111-1185-5684 and 0310451200000550.

Sectorial and annular quantitative area pachymetry with the Orbscan II.

PURPOSE: To present a new application of quantitative area pachymetry of the cornea. METHODS: Sectorial quantitative area pachymetry of small corneal zones located at the center and surrounding areas is possible by means of the statistical analysis device and tools menu of Orbscan II (Bausch and Lomb). RESULTS: Average pachymetry of 1 central zone and 12 small zones around the center may be shown in the pachymetry map by simply formatting the system. Average pachymetry, standard deviation, rate of thickness variation (slope), and volume of analyzed annular corneal zone can also be automatically shown in a data window. The examination results can be printed and kept on record. CONCLUSIONS: The method is simple and descriptive. This type of preoperative evaluation may guide the manual or laser preparation of channels for intracorneal segments and the corneal trephination for lamellar or penetrating keratoplasty.

Avaliaçäo clínica do tratamento cirúrgico da hipercorreçäo pós-ceratotomia radial / Surgical correction of hyperopia after radial keratotomy: a clinical evaluation

Hipermetropia secundária a ceratotomia radial pode resultar de uma hipercorreçäo inicial ou de um efeito contínuo da cirugia. Nós avaliamos o efeito do tratamento cirúrgico da hipermetropia pós-ceratotomia radial em 5 pacientes (6 olhos) que consistiu em reabertura e lavagem das incisöes radiais, e sutura das mesmas com pontos separados de náilon 10-0. Foram utilizados 4 ou 8 pontos colocados em zonas ópticas de 5 e/ou 7 mm. Os pacientes foram acompanhados por um período mínimo de 24 semanas. Todos os pacientes apresentaram reduçäo da hipermetropia e melhora da acuidade visual pré-operatória. O equivalente esférico foi reduzido de 4,87 + ou - 2,02 D para 1,16 + ou - 1,99 D e 2,60 + ou - 0,96 D para 38,02 + ou - 2,39 D e 37,00 + ou - 2,34 D, quatro e 24 semanas após a cirurgia. Todos os pacientes apresentaram variável grau de astigmatismo refracional, também detectado com a topografia corneana computadorizada. A sutura das incisöes radiais para tratamento da hipercorreçäo parece ser um tratamento efetivo para a hipercorreçäo após ceratotomia radial

Transplante autógeno de conjuntiva no tratamento de queimaduras graves / Limbal autograft transplantation for severe ocular burn

Dez pacientes com queimaduras oculares unilaterais graves, oito por agentes químicos e dois por agentes térmicos, foram submetidos ao transplante de conjuntiva limbar autógena. A técnica cirúrgica consistiu em transferir dois retalhos da conjuntiva limbar autôgena. A técnica cirúrgica consistiu em transferir dois retalhos da conjuntiva limbar do olho contralateral, para regiöes comprometidas do olho acometido. O acompanhamento variou de 8 a 48 meses. Todos os pacientes apresentaram melhora da acuidade visual, estabilidade epitelial e regressäo da neovascularizaçäo estromal. O transplante de conjuntiva limbar autógeno parece ser indicado para o tratamento de queimaduras oculares químicas ou térmicas severas, associadas à perda de células primordiais limbares.