Chronic and Recurrent Herpes Zoster Ophthalmicus.

Background and Objectives: This study sought to investigate the natural course, the chronicity and recurrence rate, and the risk factors of chronic and recurrent herpes zoster ophthalmicus (HZO). We also evaluated the effects of long-term treatment for HZO. Materials and Methods: Patients diagnosed and treated for HZO were included in the retrospective medical chart review. Multivariable-adjusted logistic and Cox regression models were used to show risk factors for chronic and recurrent HZO along with hazard ratios (HRs) and 95% confidence intervals (CIs). Results: Among a total 130 of HZO patients, 31 patients (23.85%) had chronic disease and 19 patients (14.62%) had recurrent disease. The rate of chronic disease was higher in HZO with conjunctivitis, epithelial keratitis, and stromal keratitis. The recurrence rate increased in patients with chronic HZO (HR: 34.4, 95% CI: 3.6-324.6), epithelial keratitis (HR: 5.5, 95% CI: 1.3-30.0), stromal keratitis (HR: 18.8, 95% CI: 3.0-120.8), and increased intraocular pressure (IOP) (HR: 7.3, 95% CI: 1.6-33.2). Length of systemic antiviral therapy and anti-inflammatory eyedrop treatment were not associated with recurrent HZO (p = 0.847 and p = 0.660, respectively). The most common ocular manifestation for recurrent HZO was stromal keratitis. Conclusions: This study demonstrated a considerable frequency of chronic and recurrent HZO. Chronic HZO in the form of epithelial or stromal keratitis with increased IOP provoked a significant rise in the risk of recurrence.

Comparing the visual outcome, visual quality, and satisfaction among three types of multi-focal intraocular lenses.

This study compared the visual outcome, visual quality, and satisfaction following implantation of the Mix-and-Match bifocal IOLs (+ 2.75 D and + 3.25 D add power Tecnis Multifocal Model), EDOF IOL (Tecnis Symfony IOL), and Trifocal IOL (FineVision PodFT, PhysIOL). All outcomes were compared among the three groups. The manifest refraction indicated that the EDOF group had significantly higher myopic spherical equivalent values than did the others. In the terms of visual acuity, there were no significant differences in far or intermediate visual acuity among the three groups. Only in near (33 cm), the EDOF group had significantly worse binocular visual acuity than did the Trifocal group (p = 0.002). Regarding to defocus curve, the Trifocal group had better defocus curves at near distances (- 2.0 to - 3.5 D; p = 0.001 vs. EDOF) than did the other two groups. In contrast sensitivity test, the EDOF group had relatively lower value than did the other two groups. In reading speed, only at 0.3 logMAR (6.5-point font), Mix-and-Match group had a significantly higher reading speed than did the other two groups (p = < 0.001 vs. EDOF, p = 0.007 vs. Trifocal). also Mix-and-Match group showed significantly fewer visual artifacts. There were no differences between the three groups in terms of patient satisfaction.ClinicalTrials.gov number: NCT04019691.

Comparison of two swept-source optical coherence tomography biometers and a partial coherence interferometer.

PURPOSE: To compare biometry and prediction of postoperative refractive outcomes obtained by two swept-source optical coherence tomography (SS-OCT) biometers (IOLMaster 700 and Argos), and a partial coherence interferometry (IOLMaster ver 5.4). METHODS: Biometric values were measured using two SS-OCT and PCI device and evaluated against one another. Predictive errors were compared at one month after cataract surgery. RESULTS: One hundred forty six eyes were considered. Axial length (AXL) measurements were not successful in 3 eyes measured by IOLMaster 700 and Argos devices, and in 17 eyes measured by IOLMaster ver. 5.4 devices. AXL as measured by Argos showed a tendency to be shorter in long eyes with AXL more than 26.0 mm (p < .001) and to be longer in short eyes with AXL less than 22.5 mm (p = .005). Anterior chamber depth as measured by IOLMaster ver. 5.4 was longer than that measured by the other two SS-OCT devices (vs. IOLMaster 700: p = .003; vs. Argos: p = .006). White-to-white diameter measured using Argos was significantly different measurements obtained using two IOLMaster (p < .001, respectively). The mean absolute postoperative prediction errors were 0.41 ± 0.31 diopters (D), 0.42 ± 0.32 D, and 0.35 ± 0.30 D for IOLMaster ver. 5.4, IOLMaster 700, and Argos, respectively. CONCLUSION: The ocular biometric measurements using three devices showed high agreement. AXL measured by Argos showed a significant difference compared with the measurements from two IOLMaster. ACD was highly correlated between two SS-OCT devices except IOLMaster ver 5.4. LT and CCT values between IOLMaster 700 and Argos were different significantly. SS-OCT devices demonstrated a superior ability to successfully perform measurements compared with PCI device.

Ten-year clinical outcomes after implantation of a posterior chamber phakic intraocular lens for myopia.

PURPOSE: To report the long-term clinical outcomes, including efficacy and safety, of implantable collamer lens (ICL) implantation to treat myopia. SETTING: Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. DESIGN: Retrospective case series. METHODS: Medical records of patients who had ICL implantation were reviewed. The preoperative and postoperative visual acuity, spherical equivalent (SE), endothelial cell density (ECD), and intraocular pressure (IOP) were analyzed. The postoperative vault and complication rate, including cataract and glaucoma, were evaluated. Patients were placed in the lens opacity group or clear lens group based on whether lens opacity developed postoperatively. RESULTS: One hundred ten eyes (60 patients) were analyzed. The mean preoperative age was 30.3 years ± 8.3 (SD). The mean SE was -12.01 ± 3.70 diopters (D) preoperatively and -0.65 ± 1.09 D 10 years postoperatively. The mean vault height was 562.4 ± 175.9 µm 6 months postoperatively, decreasing to 352.9 ± 171.8 µm at 10 years. There were no significant changes in the ECD and IOP at any timepoint. Lens opacities developed in 21 eyes (12.1%) during the 10-year follow-up. The mean vault in the lens opacity group was significantly lower than in the clear lens group after 4 years. No patient who had ICL implantation when they were 30 years or younger developed lens opacity or required phacoemulsification. CONCLUSIONS: The results indicate that ICL implantation provided long-term stability and good refractive outcomes. Performing this surgery in young patients, especially those 30 years or younger, may be safe in terms of long-term cataract formation.

Topography-guided versus wavefront-optimized laser in situ keratomileusis for myopia: Surgical outcomes.

PURPOSE: To compare the outcomes of topography-guided and wavefront-optimized surgery in patients having laser in situ keratomileusis (LASIK) for myopia. SETTING: Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, and BALGEUN-EYE21 Operation Center, Gwangju, South Korea. DESIGN: Prospective case study. METHODS: Patients had topography-guided LASIK in 1 eye and wavefront-optimized LASIK in the contralateral eye using Contoura Vision software and the WaveLight EX500 excimer laser. Refractive and visual outcomes were analyzed 3 months postoperatively. RESULTS: The study comprised 43 patients. In both groups, the postoperative uncorrected distance visual acuity (UDVA) was 0.0 logarithm of the minimum angle of resolution or better in 90.7% of eyes and the residual spherical equivalent (SE) refractive error was ±0.75 diopter (D) in 81.4% of eyes. The UDVA, residual SE refractive error, and astigmatism did not differ significantly between the 2 groups. There was significant induction of higher-order aberrations (HOAs) in both groups, although corneal coma and trefoil did not increase and ocular trefoil decreased significantly in the topography-guided group (P = .038). However, in the wavefront-optimized group, corneal coma and trefoil increased significantly (P < .001 and P = .046, respectively) and ocular trefoil did not change significantly. In addition, topography-guided LASIK induced significantly fewer corneal total HOAs (P < .001), coma (P < .001), and trefoil (P = .020) than wavefront-optimized LASIK. CONCLUSION: Although both topography-guided LASIK and wavefront-optimized LASIK safely and effectively achieved the predicted refractive and visual outcomes, topography-guided LASIK induced fewer HOAs and significantly decreased ocular trefoil, corneal total HOAs, and coma.

Refractive corneal inlay for presbyopia in emmetropic patients in Asia: 6-month clinical outcomes.

BACKGROUND: To evaluate the 6-month clinical outcomes of Flexivue Microlens refractive corneal inlay in emmetropic patients in Asia for the surgical compensation of presbyopia. METHODS: In this retrospective study, corneal inlay implantation was done using a femtosecond laser. The follow-up period was 6 months. Near/intermediate/distant visual acuities, refraction, keratometry, defocus curve, wavefront aberrations, contrast sensitivity, Scheimpflug corneal scanning, endothelial cell density, dry eye test, confocal microscopy scanning, and patient questionnaires were evaluated. RESULTS: The inlay implantation was performed in 21 eyes from June 2015 to April 2017. 6 months after surgery, the uncorrected near visual acuity of the operated eyes increased significantly from 0.55 ± 0.22 logMAR preoperatively to 0.25 ± 0.15 logMAR (p < 0.05) but mean bilateral uncorrected distant visual acuity did not change significantly (p = 0.90). Total higher-order aberration and spherical aberration increased, and the contrast sensitivity of the operated eyes decreased. Endothelial cell density and central corneal thickness did not change from preoperative values. Patient satisfaction for near vision was increased 6 months after implantation, and 50.0% of patients were independent of near spectacles. Explantation was done in 2 cases. CONCLUSION: The Flexivue Microlens refractive corneal inlay was effective for improving near visual acuity at 6 months follow-up But proportion of spectacle independency and patient satisfaction were lower in this Korean population than in previous reports. Further study with a longer follow-up period is needed.

Comparison of Intraocular Lens Power Calculation Methods Following Myopic Laser Refractive Surgery: New Options Using a Rotating Scheimpflug Camera.

PURPOSE: To evaluate and compare published methods of calculating intraocular lens (IOL) power following myopic laser refractive surgery. METHODS: We performed a retrospective review of the medical records of 69 patients (69 eyes) who had undergone myopic laser refractive surgery previously and subsequently underwent cataract surgery at Samsung Medical Center in Seoul, South Korea from January 2010 to June 2016. None of the patients had pre-refractive surgery biometric data available. The Haigis-L, Shammas, Barrett True-K (no history), Wang-Koch-Maloney, Scheimpflug total corneal refractive power (TCRP) 3 and 4 mm (SRK-T and Haigis), Scheimpflug true net power, and Scheimpflug true refractive power (TRP) 3 mm, 4 mm, and 5 mm (SRK-T and Haigis) methods were employed. IOL power required for target refraction was back-calculated using stable post-cataract surgery manifest refraction, and implanted IOL power and formula accuracy were subsequently compared among calculation methods. RESULTS: Haigis-L, Shammas, Barrett True-K (no history), Wang-Koch-Maloney, Scheimpflug TCRP 4 mm (Haigis), Scheimpflug true net power 4 mm (Haigis), and Scheimpflug TRP 4 mm (Haigis) formulae showed high predictability, with mean arithmetic prediction errors and standard deviations of -0.25 ± 0.59, -0.05 ± 1.19, 0.00 ± 0.88, -0.26 ± 1.17, 0.00 ± 1.09, -0.71 ± 1.20, and 0.03 ± 1.25 diopters, respectively. CONCLUSIONS: Visual outcomes within 1.0 diopter of target refraction were achieved in 85% of eyes using the calculation methods listed above. Haigis-L, Barrett True-K (no history), and Scheimpflug TCRP 4 mm (Haigis) and TRP 4 mm (Haigis) methods showed comparably low prediction errors, despite the absence of historical patient information.

Prospective study of bilateral mix-and-match implantation of diffractive multifocal intraocular lenses in Koreans.

BACKGROUND: To evaluate monocular and binocular visual outcomes for near, intermediate, and far distance in patients implanted with diffractive multifocal intraocular lenses (IOLs) with different add power contralaterally. METHODS: This is a prospective contralateral study. Two diffractive multifocal IOLs with different added power were implanted bilaterally in twenty patients. TECNIS® ZKB00 (+ 2.75 D) was implanted in a dominant eye, and TECNIS® ZLB00 (+ 3.25 D) was implanted in a non-dominant eye. Uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), and manifest refraction (MR) values were measured at 1 month and 3 months postoperatively. At the 3-month follow-up, defocus curve, contrast sensitivity, and reading performance were evaluated. Quality of vision, overall satisfaction, and spectacle independence were evaluated by questionnaire. RESULTS: Postoperative binocular UDVA, visual acuity at 80 cm, 60 cm, 50 cm, 43 cm, 33 cm were - 0.08 ± 0.10, 0.12 ± 0.14, 0.09 ± 0.09, 0.07 ± 0.11, 0.14 ± 0.09, 0.25 ± 0.11 logMAR. The binocular defocus curve showed an extended range of good visual acuity with sharp vision being observed from 0 D to - 2.50 D defocus (logMAR≤0.1). Reading performance was significantly improved compared to baseline. All patients were spectacle-free at distance, and 94.74% of the patients did not require glasses for near and intermediate vision. CONCLUSIONS: Mix-and-match implantation of diffractive multifocal IOLs with different add power provides an excellent wide range of vision, as well as high levels of visual quality and patient satisfaction. TRIAL REGISTRATION: ClinicalTrials.gov , NCT02556944, https://clinicaltrials.gov/show/NCT02556944.