Efficacy and safety of iris-supported phakic lenses (Verisyse) for treating moderately high myopia.

AIM: To evaluate efficacy and safety of iris-supported phakic lenses (Verisyse) for treating moderately high myopia. METHODS: This prospective clinical study included 40 eyes from 29 patients, who underwent implantation of Verisyse for correction of myopia from -6.00 to -14.50 diopters (D) in the Eye Clinic ''Svjetlost'', Sarajevo, from January 2011 to January 2014. Uncorrected distance visual acuity (UDVA), manifest residual spherical equivalent(MRSE), postoperative astigmatism, intraocular pressure(IOP), endothelial cell (EC) density were evaluated at one, three, six and twelve months. Corrected visual acuity (CDVA), index of safety and efficacy were evaluated after 12 months. RESULTS: Out of 29 patients 15 were males and 14 females, with mean age of 27.9 ± 5.0. After 12 months 77.5% eyes had UDVA ≥ 0.5 and 32.5% had UDVA ≥ 0.8. Mean MRSE was 0.55D ±0.57D and mean postoperative astigmatism -0.86D ± 0.47D. Efficacy index was 1.09 ± 0.19 and safety index 1.18 ± 0.21. One eye(2.5%) lost two Snellen lines and three eyes (7.5%) one line, 11 eyes (27.5%) gained one line, and five eyes (15.5%) gained two lines. EC loss after 12 months was 7.59 ± 3.05%. There was no significant change of IOP after one year follow up. CONCLUSION: Implantation of iris-supported phakic lenses (Verisyse) for treating moderately high myopia is an efficient and safe procedure.

1-year follow-up study of endothelial cell density loss after penetrating keratoplasty.

High endothelial cell density (ECD) is essential for the corneal graft clarity. We evaluated ECD loss in 120 eyes that underwent penetrating keratoplasty (PK) in Eye Clinic Svjetlost in a one year follow up period. Patients were divided into 3 groups of high (N = 35), intermediate (N = 31) and low risk (N = 54) for graft failure. Postoperative central endothelial density, coefficient of variation in cell area (polymegathism), percentage of hexagonal cells (pleomorphism) in comparison to preoperative donor cell measurements were determined in the following postoperative time-points of 1, 2, 3, 6, 9 and 12 months. There were no significant differences in the preoperative ECD values, storage time, donor age or surgical procedures between groups. Throughout all time points intermediate group had the greatest statistically significant ECD loss as compared to high and low risk groups. There were no significant differences between high and low risk group. After 12 month post PK, intermediate risk group had 28.38% ECD loss as compared to 24.07% in high and 23.03% ECD loss in low risk group. Coefficient of variation in cell area (CV) was for high risk group 0.34, intermediate 0.40 and low risk 0.31 which was not significantly different between groups. Percentage of plemorphism in high risk was 54%, intermediate 58% and in low risk 48% which was significantly different as compared to other two groups. Our study showed that corneal pathology is among others, very important prognostic factor for ECD after PK. However, longer follow up period is needed.

Surgical treatment of residual esotropia.

Residual esotropia is a common problem following bilateral medial rectus (MR) recessions for esotropia. The patient was 30 years old men who underwent bilateral MR recession of both eyes in the childhood. Recession was repeated on the right eye few years after the first surgery, but residual esotropia progressed. Prior to our surgery residual angle of esotropia was 50PD degrees with restriction of abduction and elevation of the left eye. Sinechiolysis et myectomia of right MR and sinechiolysis and recession of left MR were performed using operating microskop. One week after surgery residual angle was 4 PD. Motility of both eyes was free except slight residual reduction of left eye elevation. During postoperative period of 2 years residual angle was not greater than 8 PD, with good motility of both eyes. We suggest that sinechiolysis and myectomia of MR together with recession of the prior operated muscle, when possible, can be a reasonable surgical option in the treatment of large-angle residual esotropia.