Comparison of visual outcomes between 120-µm and 140-µm cap thicknesses 12 months after small incision lenticule extraction.

To compare visual and refractive outcomes as well as changes in high-order aberrations in patients with 120- versus 140-µm cap thicknesses 12 months after small incision lenticule extraction. Ninety-four patients were randomized to receive small incision lenticule extraction with either a 120-µm cap thickness (n = 47) or a 140-µm cap thickness (n = 47) to treat myopia or myopic astigmatism, if not both. In an analysis of right eyes only during the 12-month follow-up period, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive outcomes, and high-order aberrations were evaluated. The distribution of patients by age and sex between the groups did not differ significantly (P = .803 and P = .680, respectively). CDVA, spherical and cylindrical refraction, and changes in total high-order aberration, spherical aberration, coma, and trefoil were similar between the groups at 6 and 12 months, postoperatively. However, UDVA was statistically significantly higher in patients with 140-µm cap thicknesses than with 120-µm cap thicknesses at 6 and 12 months postoperatively (P < .001 and P < .001, respectively). Patients with 140-µm cap thickness showed greater improvement in UDVA than ones with 120-µm cap thickness at 12-month follow-up (P = .005). Both 120- and 140-µm cap thicknesses in small incision lenticule extraction were safe and effective thicknesses for correcting myopia or myopic astigmatism. The patients with 140-µm cap thickness had better improvement in UDVA after 12-month follow-up compared to patients with 120-µm cap thickness.

Comparison of visual and refractive outcomes of diffractive bifocal toric and trifocal toric intraocular lenses 12 months after implantation in patients with moderate to high myopia.

PURPOSE: To compare the visual and refractive outcomes of bifocal toric and trifocal toric intraocular lenses (IOL) in patients with moderate to high myopia at 12 months after implantation. METHOD: This is a prospective and comparative study. In 120 eyes with moderate to high myopia and astigmatism, bifocal toric IOLs (n = 60 eyes) or trifocal toric IOLs (n = 60 eyes) were implanted. Eyes with axial lengths from 24.0 to 26.5 mm were included. Postoperative examinations measured near, intermediate, and distance visual acuity (VA), along with refractive measurements, binocular defocus curves, and patient satisfaction with the National Eye Institute Visual Function Questionnaire. RESULTS: For uncorrected- and corrected distance intermediate VA, the trifocal group showed significantly better VA at 1, 3, 6, and 12 months than the bifocal group. Driving subscale scores from the questionnaire were significantly better in the trifocal than the bifocal group. Concerning the binocular defocus curve, uncorrected distance VA was significantly higher in the trifocal than bifocal group at test distances of -1.5 D. CONCLUSIONS: Both trifocal and bifocal toric IOLs effectively corrected the near, intermediate, and distance vision in patients with moderate to high myopia and astigmatism. However, intermediate vision was significantly better in eyes with trifocal than bifocal toric IOLs.

Comparison of refractive outcomes and high-order aberrations after small incision lenticule extraction and wavefront-guided femtosecond-assisted laser in situ keratomileusis for correcting high myopia and myopic astigmatism.

PURPOSE: To compare the results of using small incision lenticule extraction (SMILE) and wavefront-guided femtosecond-assisted laser in situ keratomileusis (WFG FS-LASIK) to correct high myopia and myopic astigmatism. MATERIAL AND METHODS: The 94 eyes of 47 patients with high myopia or myopic astigmatism, if not both, who had undergone SMILE were compared with the 94 eyes of 47 patients with high myopia or myopic astigmatism, also if not both, who had undergone WFG FS-LASIK. Only eyes with high myopic or myopic astigmatism errors greater than - 6.0 diopter (D) spherical refraction and 0-3 D cylindrical refraction were included. Values of uncorrected distance visual acuity, corrected distance visual acuity, efficacy index, safety index, predictability, and high-order aberration between the patient groups were compared. RESULTS: The SMILE and WFG FS-LASIK groups did not significantly differ according to sex or age. Values of preoperative and postoperative spherical refraction, cylindrical refraction, spherical equivalent, uncorrected distance visual acuity, and corrected distance visual acuity between the groups also did not significantly differ nor did values of predictability, the efficacy index, or the safety index. SMILE induced more coma and trefoil (p < 0.001), whereas WFG FS-LASIK induced more spherical aberration (p < 0.001). CONCLUSION: Both SMILE and WFG FS-LASIK are efficient, safe, predictable procedures for correcting high myopia and myopic astigmatism. SMILE may induce more coma and trefoil, whereas WFG FS-LASIK may induce more spherical aberration.

BLOOD PRESSURE VARIABILITY IN PATIENTS WITH BRANCH RETINAL VEIN OCCLUSION.

PURPOSE: To evaluate short-term blood pressure variability over 24 hours in patients with branch retinal vein occlusion (BRVO) versus controls. METHODS: A sample of 80 patients with BRVO (i.e., Group 1) and 75 controls (i.e., Group 2) was formed for a prospective, cross-sectional, comparative, case-control study. In a 24-hour period, each participant's blood pressure was measured by ambulatory monitoring every 15 minutes during the day and every 30 minutes at night. Mean values of systolic blood pressure (SBP), diastolic blood pressure (DBP), arterial blood pressure (ABP), and a variability index recorded during the day, at night, and throughout the 24-hour period were subjected to statistical analyses. RESULTS: Mean daytime, night-time, and 24-hour SBP, DBP, and ABP values did not significantly differ between the groups. However, mean variability index values of daytime, night-time, and 24-hour SBP, DBP, and ABP significantly increased in patients with BRVO versus controls. Multivariate logistic regression analyses revealed that 24-hour blood pressure variability in each of SBP, DBP, and ABP was an independent determinant of BRVO. CONCLUSION: Because the daytime, night-time, and 24-hour blood pressure variability in SBP, DBP, and ABP was significantly greater among patients with BRVO than among controls, blood pressure variability could factor into the pathogenesis of BRVO.

Corneal sublayer thickness in patients with pseudoexfoliation syndrome evaluated by anterior segment optical coherence tomography.

PURPOSE: The aim of the study was to evaluate the thickness of each corneal sublayer in patients with pseudoexfoliation syndrome (PXS). METHODS: The study's sample consisted of the 74 eyes of 74 patients with PXS (group 1) and the 80 eyes of 80 individuals without PXS (group 2). Each participant was performed anterior segment optical coherence tomography (AS-OCT) and Pentacam-Scheimpflug imaging. The thicknesses of corneal epithelium, Bowman's layer, stroma, and Descemet membrane-endothelial complex were measured separately from the AS-OCT images, on the central, 2 mm superior and inferior of the cornea. Central corneal thickness (CCT), apical corneal thickness (ACT), thinnest corneal thickness (TCT), and corneal volume were also evaluated. RESULTS: According to the measurements of corneal topography, in group 1 versus group 2, mean CCT (529.85 ± 32.33 µm vs 551.36 ± 39.12 µm, p < 0.001), mean ACT (532.21 ± 35.56 µm vs 552.26 ± 49.24 µm, p < 0.001), and mean TCT (527.54 ± 51.45 µm vs 546.20 ± 49.20 µm, p = 0.002) were significantly thinner in group 1. In AS-OCT, the thickness of the epithelium, stroma, and Descemet membrane-endothelial complex in the central, inferior, and superior cornea were significantly thinner in group 1 than in group 2. However, the thickness of Bowman's layer did not significantly differ between the groups. CONCLUSIONS: Our results indicate that all corneal sublayers except Bowman's layer were thinner in eyes with PXS than in healthy ones. Therefore, caution should be exercised for corneal involvement in patients with PXS.