Refractive outcomes of immediately sequential bilateral cataract surgery in eyes with long and short axial lengths.

PURPOSE: To report the refractive outcomes of long (≥25.00 mm) and short (≤22.00 mm) axial length (AL) eyes undergoing immediately sequential bilateral cataract surgery (ISBCS). METHODS: In this retrospective cohort study, patients who underwent ISBCS were identified and eyes of patients with bilateral long and short ALs were included. Pre- and postoperative biometry, autorefraction, and ocular comorbidities or complications were recorded. The primary outcome was the mean refractive prediction error. RESULTS: Thirty-seven patients (74 eyes) with long ALs and 18 patients (36 eyes) with short ALs were included. The means ± standard deviations of the ALs were 26.40 ± 1.38 mm and 21.44 ± 0.46 mm in the long and short AL groups, respectively. In long AL eyes, the mean absolute error from the biometry-predicted refraction was - 0.16 ± 0.46 D, corresponding to 74% of eyes achieving a refraction within ±0.50 D of the predicted value. In short AL eyes, the mean absolute error was - 0.63 ± 0.73 D, corresponding to 44% of eyes achieving a refraction within ±0.50 D of the predicted value. Eight (44.4%) patients with short AL eyes had a myopic deviation greater than ±0.50 D from the predicted result in both eyes. CONCLUSIONS: Compared to patients with long AL eyes, ISBCS in patients with short ALs had a wider variance in refractive outcome and a lower rate of achieving a postoperative refraction within ±0.50 D of the predicted target.

Refractive Changes After Horizontal Strabismus Surgery.

PURPOSE: To investigate the changes in refractive status after surgery in patients with horizontal strabismus and high refractive error. METHODS: This was a prospective study of patients with horizontal strabismus and high refractive error. The patients were divided into a horizontal rectus recession group (group 1) and a horizontal rectus recession combined with horizontal rectus resection group (group 2). The postoperative follow-up duration was 3 months. The refractive status of the patients was evaluated at each postoperative examination, and the refractive changes in the two groups were compared. RESULTS: The spherical equivalent in group 1 changed by -0.26 D at 3 months postoperatively relative to the preoperative value (p = 0.078), indicating gradual progression toward myopia over time, but the difference was not significant; however, the postoperative cylinder in group 1 significantly increased by 0.34 D at 3 months postoperatively relative to the preoperative value (p = 0.03). The spherical equivalent in group 2 also indicated progression toward myopia; compared with the preoperative value, the spherical equivalent significantly decreased by -0.28 D (p = 0.019) at 1 month postoperatively and decreased by -0.21 D at 3 months postoperatively. The regression line drawn among the points also indicated a progression in the spherical equivalent toward myopia. In group 2, the cylinder increased by 0.30 D (p = 0.004) from the preoperative level at 1 month postoperatively, peaked, then decreased by 3 months postoperatively. CONCLUSIONS: Patients with high refractive error who undergo horizontal strabismus correction will experience myopic shift. Patients who undergo rectus recession surgery should be fully informed of the possibility of changes in astigmatism preoperatively. For patients who undergo horizontal rectus recession combined with horizontal rectus resection, it is not recommended that glasses be changed within 1 month after surgery.

[The effect of keratoconus-associated refractive errors on the results of tomographic methods of studying the posterior structures of the eye]. / Vliyanie opticheskikh narushenii pri keratokonuse na rezul'taty tomograficheskikh metodov issledovaniya struktur zadnego segmenta glaza.

PURPOSE: The study assesses the potential influence of refractive errors in keratoconus (KC) on the results of tomographic methods of studying the structures of the posterior eye segment. MATERIAL AND METHODS: The study included 30 patients with bilateral stabilized KC of stages I-IV in classification by M. Amsler. Spherical and cylindrical components of refractions were determined using automatic refractometry, keratometry measurements - based on scanning keratotopography with Scheimpflug analyzer. Aberrometry was performed to evaluate corneal wave front according to the following parameters: root mean square for lower order aberrations (RMS LOA), root mean square for higher order aberrations (RMS HOA), vertical trefoil, vertical coma, horizontal coma and spherical aberrations. Optical coherence tomography (OCT) and laser confocal scanning ophthalmoscopy (HRT 3) data was used in morphometric analysis of the optic nerve head and peripapillary retina. The following morphometric parameters were analyzed: optic nerve head (ONH) area, optic disc cup area, optic disc cup volume, ratio of optic disc cup area to ONH area, neuroretinal rim area, neuroretinal rim volume, peripapillary retinal nerve fiber layer (RNFL) thickness. All studies were performed first without correction, and 30 minutes after installing customized scleral hard contact lenses (SHCL). RESULTS: Compensation of the refractive errors characteristic for KC was achieved as expected with contact correction. OCT revealed a general trend for reduction in the area and volume of the optic disc cupping, ratio of area to volume of the optic disc cupping, as well as an increase in other parameters. As such, with correction the values for area and volume of the neuroretinal rim according to OCT were 2.2 and 13%, HRT 3 - 18 and 51.6%; comparable increase in mean RNFL thickness - 2.8 and 28.5%, respectively (p<0.001). According to HRT 3 data, the area and volume of optic disc cupping statistically significantly decreased (by 21 and 28%, respectively), while OCT showed statistically significant decrease only in cupping area (by 5.7%). The ratio of cupping to ONH area decreased by 6.6 and 23% relative to the initial data obtained with OCT and HRT 3, respectively. Significant decrease in ONH area amid SHCL correction was observed only with HRT 3. The revealed changes in morphometric parameters were analyzed using the fundamental principles of physiological optics. Changes in interference pattern and, consequently, morphometric parameters of structures of the eye fundus in KC are of multifactorial nature, and are mostly associated with refractive and wave artefacts occurring when the rays pass through the irregular corneal surface and cannot be optically compensated by the device. The use of SHCL as means for making the optic system relatively regular can significantly decrease the artefacts in morphometric measurements. CONCLUSION: The results obtained in this study demonstrate the practicality of tomographic examination in KC with contact correction. The optimal choice is custom-fit SHCL, which along with proper correction of refractive errors also ensures stable position of the lens on the cornea. In standard examination specialists should take into account the «false¼ decrease in parameters of the peripapillary retinal nerve fiber layer and increase in ONH cupping.

Aberraciones corneales de bajo orden en pacientes con ametropías miópicas / Low-order Corneal Aberrations in Patients with Myopic Ametropias

Objetivo: Caracterizar las aberraciones corneales de bajo orden en pacientes con ametropías miópicas. Métodos: Se realizó un estudio descriptivo, observacional y transversal, con una muestra de 104 ojos de 104 pacientes adultos con ametropías miópicas y un grupo control de 104 ojos de 104 voluntarios emétropes, que asistieron a consulta de Cirugía Refractiva del Instituto Cubano de Oftalmología. Se definieron las variables demográficas, clínicas y para la cuantificación de las aberraciones corneales la elevación-depresión y el valor cuadrático medio, aportadas mediante el mapa aberrométrico del Pentacam HR. Resultados: Hubo un predominio del sexo femenino, el rango de edad estuvo comprendido entre 18 y 39 años en ambos grupos. La mediana del equivalente esférico de los pacientes de ametropías miópicas fue -3,25 dioptrías, con agudeza visual sin corrección de 0,10, esfera de -2,63 D y cilindro de -1,00 D, 91 ojos (87,50 por ciento) tenían astigmatismo miópico compuesto. Los valores de elevación-depresión y el valor cuadrático medio de bajo orden fueron mayores en los pacientes con ametropías miópicas que los emétropes (p< 0,001). El astigmatismo vertical, desenfoque y el astigmatismo horizontal no presentaron diferencia estadísticamente significativa entre ambos grupos. Conclusiones: La miopía con o sin astigmatismo se debe estudiar y tratar como una aberración de bajo orden. Los valores de elevación-depresión y cuadrático medio son superiores en los ojos con ametropías miópicas respecto a los emétropes(AU)

Objective: To characterize low-order corneal aberrations in patients with myopic ametropia. Methods: A descriptive, observational and cross-sectional study was carried out with a sample of 104 eyes of 104 adult patients with myopic ametropia and a control group of 104 eyes of 104 emmetropic volunteers, who attended the Refractive Surgery Clinic of the Cuban Institute of Ophthalmology. Demographic and clinical variables were defined, and for the quantification of corneal aberrations, elevation-depression and average square value, provided by means of the Pentacam HR aberrometric map. Results: There was a predominance of female sex, the age range was between 18 and 39 years in both groups. The median spherical equivalent of myopic ametropia patients was -3.25 diopters, with uncorrected visual acuity of 0.10, sphere of -2.63 D and cylinder of -1.00 D, 91 eyes (87.50 percent) had compound myopic astigmatism. Elevation-depression values and low-order root average square value were higher in patients with myopic ametropes than emmetropes (p< 0.001). Vertical astigmatism, defocus and horizontal astigmatism showed no statistically significant difference between the two groups. Conclusions: Myopia with or without astigmatism should be studied and treated as a low-order aberration. The elevation-depression and average square values are higher in eyes with myopic ametropia than in emmetropic eyes(AU)

Clinical Performance of New Enhanced Monofocal Intraocular Lenses: Comparison of Hydrophobic C-loop and Hydrophilic Plate-Haptic Platform.

INTRODUCTION: Enhanced monofocal intraocular lenses (IOLs) represent a new type of lens, which should lead to a very good distance vision similar to monofocal IOLs and an improved intermediate vision without increasing the risk for photic phenomena. METHODS: The aim of this clinical observation/registry study was to directly compare two different IOL platforms (hydrophilic acrylic L-333 (group A) vs hydrophobic acrylic AN6Q (group B)) with the same enhanced monofocal optic principle but different material and haptic design in clinical routine. A total of 102 cataract cases (51:51) were included in the study. Groups A and B were similar regarding demographics, age (71.6 ± 9 years for L-333 and 73.6 ± 8 years for AN6Q) and their calculated IOL power (20.9 ± 2.0 D for L-333 and 21.5 ± 3.4 D for AN6Q). Spherical equivalent (SE), (un)corrected distance, intermediate visual acuity, the surgeons' experience and patient feedback were assessed postoperatively. RESULTS: SE improved significantly in the AN6Q group, while the L-333 group showed a slightly smaller standard deviation postoperatively. In group A the uncorrected distance visual acuity (UDVA) improved from pre-op (0.43 ± 0.16 logMAR) to 1 month post-op (0.06 ± 0.04 logMAR) significantly and in group B from pre-op (0.54 ± 0.19 logMAR) to (0.05 ± 0.06 logMAR) postoperatively. Both groups showed excellent outcomes for distance without negative side effects. On testing uncorrected intermediate vision (80 cm) with Radner charts, 80% reached line 5 (0.0 logRAD) with fewer than one mistake and 10% reached line 4 (- 0.1 logRAD) in group A; 74% reached line 5 with fewer than one mistake and 4% reached line 4 in group B. CONCLUSION: Both IOL models (groups A and B) provided satisfying results regarding implantation behaviour, refractive error, visual acuity and overall patient satisfaction. The haptic design might influence the outcome of refractive error. Long-term follow-up data should be considered in multicentre studies to further characterize both platforms and to optimize IOL power calculation (constants, surgeon factor). It was shown that the enhanced monofocal optic can provide good visual acuity for far distance and improve intermediate distance. This type of new monofocal optic design, which however must be strictly separated from typical refractive/diffractive multifocal, presbyopia-correcting lenses, could be a good option in standard cataract care.

Refractive error changes and associated asthenopia observed after COVID-19 infection: Case reports from two continents.

COVID-19 infection has been linked to various ocular complications and complaints, but not to refractive errors. In this case report, we present ethnically diverse patients who reported asthenopic symptoms shortly after recovering from COVID-19 infection. The hyperopic shift in the refractive error, post-COVID could indicate the ciliary body muscle's inability to sustain accommodation, resulting in asthenopia. Hence, refractive errors should also be considered as a post-COVID complication, even if the magnitude is small, especially when patients have a headache and other asthenopic symptoms. Performing dynamic retinoscopy and cycloplegic refraction will also aid in the better management of these patients.

Influence of endotamponade on anterior chamber depth and refractive outcome after combined phacovitrectomy: case-control study.

PURPOSE: To compare the changes in the anterior chamber depth (ACD) and in the refractive outcomes after combined phacovitrectomy with respect to the endotamponade (balanced salt solution, air, sulfur hexafluoride [SF 6 , gas]). SETTING: Department of Ophthalmology, University Hospital Ulm, Ulm, Germany. DESIGN: Retrospective, longitudinal case-control study. METHODS: 160 eyes of 160 patients were included in the study. 120 eyes underwent phacoemulsification with in-the-bag implantation combined with vitrectomy and were divided into 3 groups according to tamponade (balanced salt solution, air, gas). 40 control eyes with cataract surgery only were included. Further inclusion criteria were uneventful surgery, no postoperative complications and absence of corneal pathology. Endpoints were ACD as measured by swept-source optical coherence tomography-based biometry (IOLMaster 700) preoperatively, 1 to 2 days and 6 weeks postoperatively and refractive prediction error (PE) using the Barrett and Haigis formulas. RESULTS: Within the first 2 days after surgery the ACD was shallower in the eyes left with gas or air tamponade, when compared with balanced salt solution or cataract surgery alone ( P < .001). This effect diminished 6 weeks later, and all eyes reached comparable ACD ( P = .396). The refractive PE was slightly, but statistically significantly higher in the gas group when compared with cataract surgery alone ( P = .012 for Barrett, P = .006 for Haigis). CONCLUSIONS: The resulting ACD after combined phacovitrectomy was independent of the tamponade used, but a gas-tamponade was associated with a higher refractive PE.

Contact lenses for the treatment of ocular surface diseases.

Contact lens wear is useful in ocular conditions such as high refractive errors, irregular astigmatism, corneal ectasias, corneal dystrophies, post-keratoplasty, post-refractive surgeries, trauma, and ocular surface diseases. The new innovations of highly oxygen-permeable contact lens materials have broadened the applications of contact lens suitability. Therapeutic contact lenses are medically used in the management of a wide variety of corneal conditions and ocular surface diseases. These lenses aid in pain relief, enhance corneal healing, maintain ocular homeostasis, and act as a drug delivery system. Drug delivery applications of contact lenses hold promise for improving topical therapy. The modern rigid gas permeable scleral contact lens provides symptomatic relief in painful corneal diseases such as bullous keratopathy, corneal epithelial abrasions, and erosions. It has been useful in therapeutic management as well as visual rehabilitation by enhancing the ocular surface and protecting the cornea from adverse environmental conditions. This review provides a summary of contact lenses used for the treatment of ocular surface diseases based on the current evidence available in the literature. This can help enhance the understanding and management of ocular surface diseases with respect to contact lens use in our day-to-day ophthalmology practice.

The Recurrence of Ptosis after Correction Surgery Is Associated with Refractive Error.

Background and objectives: Previous studies on ptosis recurrence after correction surgery have tended to focus on postoperative complications, surgical methods and suspension materials, few have mentioned refractive error. This research is to investigate the potential relation between refractive error and recurrence after correction surgery in pediatric patients with simple congenital ptosis. Materials and Methods: We conducted a retrospective analysis of data from patients with simple congenital ptosis who were treated at Zhongshan Ophthalmic Center (ZOC) between 2017 and 2020. In total, 111 eyelids of 85 patients without surgery-related complications who underwent frontalis muscle flap suspension (FMFS) for simple congenital ptosis were included. Postoperative changes in eyelid height were assessed. Cycloplegic refraction was assessed before surgery and during the follow-up period (every 3 months after surgery). Recurrence in the postoperative period was defined as a marginal reflex distance 1 (MRD1) of <1 mm. Results: There were 16 recurrence and 69 non-recurrence cases, with no statistically significant differences, in terms of patient age at the time of surgery, patient sex, or preoperative MRD1, between the recurrence and non-recurrence groups. The postoperative cylindrical diopter (adjusted odds ratio [OR] = 0.432, p = 0.005), laterality (adjusted OR = 0.202, p = 0.006), and preoperative MRD1 (adjusted OR = 0.617, p = 0.019) were associated with ptosis recurrence after surgery. Differences between the recurrence and non-recurrence groups in spherical diopter and spherical equivalent (SE) before and after surgery were not statistically significant. In addition, preoperative refractive error and postoperative spherical diopter were not significantly associated with ptosis recurrence after correction surgery. Conclusions: Ptosis recurrence after FMFS in pediatric cases of congenital ptosis is associated with refractive error. Timely refractive correction and amblyopia treatment may help to reduce ptosis recurrence.

Success rate in micropulse diode laser treatment with regard to lens status, refractive errors, and glaucoma subtypes.

PURPOSE: To evaluate the efficacy of micropulse transscleral cyclophotocoagulation (MP-TSCPC) considering different characteristics: glaucoma subtypes and lens status. METHODS: A retrospective case-series study was designed to evaluate intraocular pressure (IOP), and the number of IOP-lowering medications, used by glaucoma patients treated with MP-TSCPC between 2016 and 2019. Cases had a follow-up period of 12 months. Achieving an IOP reduction higher than 20%, or the decrease of at least one IOP-lowering medication, was considered a successful outcome. The same population was analyzed by classifying them in two groups as: glaucoma subtypes and lens status. The baseline spherical equivalent (SE) was also calculated for considering association with the achieved IOP. RESULTS: A total of 86 eyes were included. In most cases, IOP and IOP-lowering medications were decreased with a statistically significant difference (p < 0.0001), and all of them had a successful outcome. The percentage of IOP drop oscillated between 25.9% (open-angle glaucoma sub-group) and 37.5% (pseudoexfoliative glaucoma sub-group), 12 months after surgery. The difference between the groups was not statistically significant (p 0.20 and 0.32 for glaucoma subtypes and lens status, respectively). The Pearson's coefficient obtained was low for the SE and IOP association, at the 12 -month postoperative mark (- 0.009; p < 0.001). CONCLUSIONS: The MP-TSCPC treatment was successful in decreasing IOP and IOP-lowering medications, in different glaucoma subtypes. Differences between groups (glaucoma subtypes, phakic and pseudophakic eyes) were not statistically significant. No association was found between the SE and the IOP achieved value after MS-TSCPC treatment.

Refractive surgery after deep anterior lamellar keratoplasty: a review of the literature.

PURPOSE: The main objective of this work is to present an updated review of the different surgical procedures for the correction of residual refractive errors following deep anterior lamellar keratoplasty (DALK) surgery. METHODS: A review of the literature was conducted using PubMed, Web of Science, and Scopus databases. The search was conducted in January 2022 and was limited to articles published in peer-reviewed journals. The information extracted from each publication included sample size, mean follow-up time, pre- and post-operative uncorrected (UDVA) and corrected distance visual acuity (CDVA), pre- and post-operative refraction and spherical equivalent (SE), safety and efficacy indexes and complications. RESULTS: Residual ametropias, mainly high astigmatism and myopia, and the resulting anisometropia are likely to occur following DALK. They become a limiting factor and may lead to unsatisfactory visual restoration, therefore affecting patients' quality of vision and life. Alternative surgical interventions may be required to treat this residual ametropia, such as corneal refractive surgery or intraocular lens implantation. A total of 47 relevant articles were studied in detail. Different refractive surgery techniques have been shown to be effective and safe for the correction of ametropia following the DALK procedure and to improve the patient's quality of vision, although more research is needed to confirm long-term results. CONCLUSION: The final refractive technique will depend on different factors, such as the amount of ametropia, the condition of the cornea or the patient's individual needs, economics, and occupational demands.

Influence of combined phacovitrectomy without tamponade on intraocular lens displacement and postoperative refraction.

PURPOSE: To compare phacoemulsification versus phacovitrectomy regarding postoperative intraocular lens (IOL) shift and refraction. METHODS: This prospective bilateral comparison study included 40 eyes of 20 patients. Inclusion criteria were combined phacovitrectomy without gas/air tamponade in one eye and cataract surgery in the contralateral eye with implantation of the same IOL. Postoperative anterior chamber depth (ACD) was compared between both groups 1-5 hr, 1 day and 8 weeks after surgery. Postoperative refraction was compared after 8 weeks using the Holladay I, HofferQ, SRK/T, Haigis and Barrett formulae. RESULTS: There were no intergroup differences in ACD (8 weeks: 0.02 mm absolute difference, SD 0.22, range -0.36 to 0.65, p = 0.401), mean absolute refractive error (8 weeks: Holladay I p = 0.452; HofferQ p = 0.475; SRK/T p = 0.498; Haigis p = 0.869; and Barrett p = 0.352) or percentages within the 0.5 D and 1.0 D range at any time-point. All formulae were optimized for the phacovitrectomy and the cataract groups. There was no correlation of macular thickness change and refractive error (cataract group r2 = -0.13, p = 0.58; phacovitrectomy group r2 = -0.10, p = 0.68). CONCLUSION: Combined phacovitrectomy without air/ gas tamponade caused neither ACD displacement nor refractive shifts compared to phacoemulsification alone. Surgically induced macular thickness change had no significant influence on postoperative refraction in this study. All five IOL formulae showed comparable postoperative refractive outcomes.

Long-term ophthalmological outcomes in patients with anterior plagiocephaly managed with a fronto-orbital advancement procedure.

BACKGROUND: Anterior plagiocephaly results from early fusion of a unilateral coronal cranial suture, which affects 1/10,000 infants at birth and can be associated with ophthalmological complications. The study aimed to evaluate the frequency of oculomotor disorders and refractive errors in children with non-syndromic anterior plagiocephaly. METHODS: Patients with anterior plagiocephaly undergoing surgery using a fronto-orbital advancement technique were included in this retrospective study between 2011 and 2017. The following data were collected: cycloplegic refraction in diopters (D), best-corrected visual acuity, manifest strabismus in primary position, ocular motility, head tilt in primary position, slit-lamp and fundus examination. The refractive errors were determined by autorefraction after cycloplegia with cyclopentolate. RESULTS: Among the sixteen patients included, hyperopia >2.5D was found in 10 patients, astigmatism >1D in 10 patients and anisometropia >1D in 7 patients. Astigmatism was contralateral to the synostosis in 7 cases. In total, significant refractive errors were found in 92.9%. Amblyopia was found in 33.3% patients. Strabismus was found in 11 patients, most frequently combined horizontal and vertical, of which 4 required strabismus surgery. The most frequent vertical deviation was ipsilateral hypertropia in 54.5%. We found superior oblique muscle limitation in 3 patients. Optic disc pallor was found in 2 patients. CONCLUSION: In the years following fronto-orbital advancement for non-syndromic anterior plagiocephaly, refractive errors and oculomotor disorders are frequently encountered, mainly contralateral astigmatism and strabismus with both horizontal deviation and ispilateral hypertropia.

Risk factors for predicted refractive error after cataract surgery in clinical practice. Retrospective observational study.

OBJECTIVES: To describe the preoperative characteristics of patients undergoing cataract surgery in our hospital, to determine the final visual and refractive results and to determine the preoperative characteristics that conditioned the presence of a residual refractive error (RRE) greater than one diopter. METHODS: Retrospective analysis of cataract surgeries performed at Araba University Hospital between February 2017 and December 2019. Sociodemographic, eye comorbidity, biometric, surgical and post-surgical characteristics were collected. RESULTS: A total of 1419 patients and 1578 surgeries were included for analysis. Of these, 9.07% had preoperative legal blindness, 31.69% eye comorbidity and 4.18% had previous surgery. Overall, 95.82% of patients achieved a corrected final visual acuity (VA) ≥ 0.5 Snellen decimal and 63.12% ≥ 1, and 96.70% of patients improved VA after surgery. RRE was between ±0.5 diopters in 77.82% of patients and between ±1 diopter in 94.74%. The most prominent risk factors that conditioned the presence of RRE greater than 1 diopter were the use of ultrasonic contact biometer, a history of glaucoma surgery, the presence of white or hard cataract, and prior legal blindness. CONCLUSIONS: The visual results of cataract surgery were excellent, with 63.12% of patients obtaining corrected VA ≥ 1 and an RRE of ±1 diopter in 94.74%. Different risk factors influenced the achievement of poor refractive outcomes: preoperative conditions (previous surgeries, white/hard cataract, previous VA) and biometrics.

Factores de riesgo asociados al error refractivo residual tras cirugía de catarata en práctica clínica. Estudio observacional retrospectivo / Risk factors for predicted refractive error after cataract surgery in clinical practice. Retrospective observational study

Objectives: To describe the preoperative characteristics of patients undergoing cataract surgery in our hospital, to determine the final visual and refractive results and to determine the preoperative characteristics that conditioned the presence of a residual refractive error (RRE) greater than one diopter.MethodsRetrospective analysis of cataract surgeries performed at Araba University Hospital between February 2017 and December 2019. Sociodemographic, eye comorbidity, biometric, surgical and post-surgical characteristics were collected.ResultsA total of 1,419 patients and 1,578 surgeries were included for analysis. Of these, 9.07% had preoperative legal blindness, 31.69% eye comorbidity and 4.18% had previous surgery. Overall, 95.82% of patients achieved a corrected final visual acuity (VA) ≥ 0.5 Snellen decimal and 63.12% ≥ 1, and 96.70% of patients improved VA after surgery. RRE was between ± 0.5 diopters in 77.82% of patients and between ± 1 diopter in 94.74%. The most prominent risk factors that conditioned the presence of RRE greater than 1 diopter were the use of ultrasonic contact biometer, a history of glaucoma surgery, the presence of white or hard cataract, and prior legal blindness.ConclusionsThe visual results of cataract surgery were excellent, with 63.12% of patients obtaining corrected VA ≥ 1 and an RRE of ± 1 diopter in 94.74%. Different risk factors influenced the achievement of poor refractive outcomes: preoperative conditions (previous surgeries, white/hard cataract, previous VA) and biometrics (AU)

Objetivos: Describir las características preoperatorias de la población intervenida de cataratas en nuestro hospital, determinar los resultados visuales y refractivos finales y determinar las características previas a la intervención que condicionan la presencia de un error refractivo residual (ERR) mayor de una dioptría.MétodosEstudio retrospectivo de cirugías de catarata realizadas en el Hospital Universitario Araba, entre febrero de 2017 y diciembre de 2019. Se recogieron características sociodemográficas, de comorbilidad ocular, biométricas, quirúrgicas y postquirúrgicas.ResultadosSe incluyeron 1.419 pacientes y 1.578 cirugías para su análisis. El 9,07% presentaron ceguera legal preoperatoria, el 31,69% comorbilidad ocular y el 4,18% había sido previamente intervenido. El 95,82% de los pacientes alcanzaron una agudeza visual (AV) final corregida ≥ 0,5 Snellen decimal y el 63,12% ≥ 1. El 96,70% de los pacientes mejoraron la agudeza visual (AV) tras la intervención. El ERR estuvo entre ± 0,5 dioptrías en el 77,82% de los pacientes y entre ± 1 dioptría en el 94,74%. Los factores de riesgo más destacados que condicionan la presencia de ERR mayor de una dioptría fueron la utilización de biómetro ultrasónico de contacto, el antecedente de cirugía de glaucoma, la presencia de catarata blanca o dura y una AV previa de ceguera legal.ConclusionesLos resultados visuales de la cirugía de cataratas fueron excelentes, alcanzando el 63,12% de los pacientes una AV corregida ≥ 1 y quedando un ERR entre ± 1 dioptría en el 94,74%. Diferentes factores de riesgo influyen en la consecución de peores resultados refractivos: condiciones preoperatorias (intervención previa, catarata blanca/dura, AV previa) y biométricas (AU)

Ophthalmological findings in children with unicoronal craniosynostosis.

INTRODUCTION: Among non-syndromic, single-suture craniosynostoses, unicoronal craniosynostosis (UCS) presents the highest rate of ophthalmic manifestations requiring a visual follow-up, due to the high risk of amblyopia. After birth or during childhood, children with UCS have a high risk to present an aniso-astigmatism and a strabismus. The aim of this study was to characterize clinical ophthalmologic findings associated with UCS in a paediatric cohort. METHODS: This retrospective study included children admitted in our unit between 2015 and 2021, with isolated UCS treated in our institution and complete ophthalmological assessment comprising visual assessment, refractive status and oculomotor examination. Children with associated craniofacial disorders were excluded. RESULTS: A total of 28 children met the inclusion criteria. Median age was 62 [13-192] months with a large proportion of girls (86%) and 71% of right-sided UCS. The mean best corrected visual acuity was 0.07 (±0.13) LogMAR, including 10 (36%) children with an amblyopia or history of amblyopia. Astigmatism was significantly higher on the contralateral side of the UCS than on the ipsilateral side, with a refractive cylinder error of 0.97 (±1.06) vs 0.56 (±0.68) diopters, respectively (p = 0.03). Strabismus was observed in 20 patients (71%) with a main pattern of esotropia with a vertical component. A pseudo-superior oblique palsy was found in 13 children (65%) with a median cyclodeviation of 8.7° [-5,4°-20.6°]. CONCLUSION: Children with UCS experience a high rate of various visual manifestations. This study highlights their need for a strict ophthalmological follow-up, in order to early diagnose and prevent visual complications.

Effect of laser photocoagulation, antiangiogenic therapy or a combined treatment on refractive outcomes of newborns with ROP.

PURPOSE: To determine the refractive outcome after treatment with laser photocoagulation, intravitreal antiangiogenic injection or both, for the treatment of type 1 ROP and/or aggressive posterior ROP using defocus equivalent terms. These results will be compared with the spherical equivalent (SE) notation in an initial refraction (during the first 3 years after treatment) and in a final evaluation (three years after treatment). METHODS: Clinical charts review of preterm patients who developed type 1 ROP and/or aggressive posterior ROP who were treated with laser photocoagulation, intravitreal antiangiogenic injection, or both, between January 2007 and December 2014 at Fundación Oftalmológica de Santander were reviewed. Refractive error was evaluated at two different time points in three different treatment groups. RESULTS: Seventy-seven eyes (56 patients) with ROP diagnosis treated with laser, antiangiogenics or in a combined scheme were included. Median gestational age was 29 weeks (IQR = 3), median birth weight was 1100 (IQR = 335) and mean corrected age at the time of treatment was 37.3 weeks (SD 2.2). Refractive outcomes in SE terms for the first refraction had a median of -0.50 diopters and in defocus terms, 4.00 diopters (D). For the second refraction, -3.00 diopters and 4.00 diopters (D), respectively. Pearson correlation test result for the first measurement was 93% (p = 0.000) and for the second evaluation was 99% (p = 0.000). CONCLUSIONS: Low birth weight had a statistically significant association to the increase of the refractive outcome. The high correlation between SE and DE for refractive errors allows us to confirm that DE is an appropriate metric to report refractive outcomes in this group of patients due to the presence of combined refractive ametropias.

Refractive error induced by intraocular lens tilt after intrascleral intraocular lens fixation.

PURPOSE: To investigate the spherical shift of intraocular lens (IOL) tilt after intrascleral fixation. METHODS: We retrospectively reviewed the medical records of patients who underwent flanged intrascleral IOL fixation with transconjunctival 25- or 27-gauge pars plana vitrectomy at the Department of Ophthalmology of the Jikei University Hospital. The minimum follow-up duration was 3 months. Second-generation anterior segment optical coherence tomography (CASIA2; TOMEY) was used to obtain the values of tilt and decentration of the intrasclerally fixated IOL and postoperative anterior chamber depth. We investigated the relationship between refractive error and various parameters, such as IOL tilt and decentration, axial length, and keratometry. In addition to our clinical investigation, we conducted optical simulations using Zemax to evaluate the spherical shift of the IOL tilt by means of the through-focus response and change in spherical equivalent power. RESULTS: The study involved 72 eyes of 67 patients. The degree of IOL tilt was correlated with the amount of refractive error (Spearman's rank correlation coefficient [CC] = - 0.32; P = 0.006). In particular, a tilt angle greater than 10° strongly affected the refractive error. The postoperative anterior chamber depth also correlated with the refractive error (CC = 0.50; P < 0.001), as opposed to decentration (CC = - 0.17; P = 0.15), axial length (CC = - 0.08; P = 0.49), and keratometry (CC = - 0.06; P = 0.64). Optical simulations also revealed a myopic shift that exponentially increased as the tilt became greater. CONCLUSION: IOL tilts that are greater than 10° induce refractive error.

Refraction and its development in young adults born prematurely and screened for retinopathy of prematurity.

PURPOSE: To evaluate refraction and its development in young adults born prematurely, screened for retinopathy of prematurity, and to compare with individuals of the same age born at term. MATERIALS AND METHODS: The participants were 59 preterms, with a birthweight of ≤ 1500 g, and 43 term-born controls, all born during 1988-1990. The refraction was measured in cycloplegia, and the spherical equivalent (SE) was calculated. The axial length (AL), anterior chamber depth and corneal radius (CR) were measured, and the AL/CR ratio was calculated. RESULTS: The mean SE was -0.5 dioptres (D) (SD 2.5) in right eyes (REs) and -0.4 D (SD 2.3) in left eyes (LEs) of preterms, and -0.2 D (SD 1.5) in REs and -0.2 D (SD 1.5) in LEs of controls. The distribution of refraction was wider in the preterm group compared to the control group. In the preterm group, 12% had a SE ≥ 1.5 D, but none of the controls. Ten preterms, but none of the controls, had anisometropia ≥ 1.0 D. The prevalence of astigmatism ≥ 1.0 D was higher in preterms than controls. The SE decreased around 1 D in both preterms and controls from 10 to 25 years of age. The AL and CR were shorter in the preterms; however, the AL/CR ratio was similar in both groups. Within the preterm group, cryotherapy was correlated with astigmatism, but not with SE and anisometropia at this age. CONCLUSION: Prematurely born individuals had higher prevalence of refractive errors in young adulthood compared to term-born controls.