Correction to: Visual, refractive and topographic outcomes of progressive thickness intrastromal corneal ring segments for keratoconic eyes.

In the original publication, the Results paragraph of the abstract was published incorrectly. The correct version should read as follows.

Visual, refractive and topographic outcomes of progressive thickness intrastromal corneal ring segments for keratoconic eyes.

PURPOSE: To evaluate one-year visual, refractive, and topographic outcomes of 58 eyes of 53 keratoconus patients who underwent surgery with a progressive thickness intrastromal corneal ring segment (ICRS). METHODS: This multi-center, retrospective, observational study evaluates the one-year effects of progressive thickness ICRS implanted in keratoconus patients meeting the inclusion criteria. One or two progressive ICRS were implanted in the selected eyes after creating an intrastromal tunnel with a femtosecond laser. Pre- and postoperative uncorrected distance visual acuity, best-corrected distance visual acuity, manifest refraction (both spherical equivalent and cylindrical refractions), corneal astigmatism, maximum keratometry, corneal thickness, and corneal topography measurements and indices were evaluated. RESULTS: In this retrospective case series, 58 eyes of 53 keratoconus patients were included with a follow-up of 12 months. The mean age was 30.89 ± 11.90 years. There were improvements postoperatively in mean values of visual acuities, both uncorrected from 0.71 (preoperatively) to 0.28 (log MAR), and best-corrected from 0.28 to 0.10 (log MAR), mean cylindrical refraction from - 2.35 ± 1.51 to - 4.15 ± 2.23 D, and mean spherical equivalent from - 2.10 ± 2.25 to - 4.64 ± 3.2 D. There was also a reduction in maximal keratometry from 54.21 D preoperatively to 50.93 D postoperatively. CONCLUSION: The implantation of the progressive thickness ICRS is an effective and safe method to improve the vision of keratoconic eyes. Corneal stability was maintained at the 12-month mark.

Refractive and visual outcomes after Intacs vs ferrara intrastromal corneal ring segment implantation for keratoconus: a comparative study.

PURPOSE: To evaluate the refractive, topographic, optical, visual acuity, and quality outcomes of two types of intrastromal corneal ring segments (ICRS) in the treatment of keratoconus. METHODS: In this retrospective study, 16 eyes that had been implanted with Intacs ICRS (Addition Technology Inc) (Intacs group) and 17 eyes implanted with Ferrara ICRS (Ferrara Ophthalmics Ltda) (Ferrara group) were evaluated. Pre- and postoperative examinations included uncorrected and corrected distance visual acuities (UDVA and CDVA, respectively), manifest refraction, slit-lamp examination, topography, and ocular wavefront analysis. Contrast sensitivity measurements under photopic, scotopic, and scotopic with glare conditions were performed 1 year postoperatively. RESULTS: One year postoperatively, a significant decrease was noted in spherical equivalent refractive error of 3.76 ± 0.39 diopters (D) and 3.42 ± 0.88 D and keratometry of 3.43 ± 0.24 D and 3.28 ± 0.78 D in the Intacs and Ferrara groups, respectively; and increase in mean UDVA and CDVA in Snellen lines of 0.18 ± 0.04 and 0.21 ± 0.05, respectively, in the Intacs group and 0.21 ± 0.09 and 0.26 ± 0.08, respectively, in the Ferrara group (P<.01 for all). The postoperative increase in UDVA and CDVA and decrease in keratometry readings were not significantly different between groups (P>.05 for all). Mean higher order aberrations decreased in the Intacs group and increased in the Ferrara group (P>.05 for both). Postoperatively, a significant decrease was noted in scotopic contrast sensitivity when glare was introduced in the Ferrara group, which was positively correlated with pupil diameter (r(15)=0.50, P=.04). CONCLUSIONS: Both ICRS types provided comparable refractive, topographic, and optical quality outcomes. Eyes with Ferrara ICRS experienced greater decrease in scotopic contrast sensitivity under glare, which was significantly correlated with pupil diameter.

Effects of the COVID-19 Pandemic on Turkish Ophthalmologists

Objectives: To assess the effects of the coronavirus disease-2019 (COVID-19) pandemic on Turkish ophthalmologists. Materials and Methods: In this survey study, an online questionnaire consisting of 40 questions was directed to actively working ophthalmologists. The questions asked about demographic characteristics, working conditions and schedule, follow-up of ophthalmology patients, and levels of knowledge and anxiety about the pandemic. Results: This study included 161 ophthalmologists (78 women and 83 men). They were predominantly consultant ophthalmologists (71%), with 128 living in metropolitan areas. More than half (54.4%) reported decreased weekly working hours, 52.5% were attending routine outpatient clinics, 52.8% were working in COVID-19-related units, 67.1% were performing only emergency operations, and 52% reported disrupted follow-up of chronic eye patients. Sixty-four percent thought that ophthalmologists were in the high-risk group, and nearly all participants used masks while working (99%). Additionally, 91% expressed high anxiety regarding the pandemic, most commonly due to the risk of transmitting the disease to family (83%), and 12.5% considered their level of knowledge about the pandemic to be insufficient. Forty-six percent of the participants thought that daily life conditions would normalize in 2 to 5 months. Conclusion: Close proximity during patient examination causes ophthalmologists concern about their risk. The increasing number of COVID-19 cases resulted in a proportional decrease in the number of patients and surgeries in ophthalmology clinics in our country. As a result, ophthalmologists are unwillingly appointed to high-risk units. The COVID-19 pandemic has caused a substantial increase in anxiety levels among Turkish ophthalmologists.

Refractive Outcomes of 20 Eyes Undergoing ICL Implantation for Correction of Hyperopic Astigmatism.

PURPOSE: To analyze 1-week, 1-month, and 12-month postoperative refractive outcomes of eyes that under-went ICL implantation to correct hyperopic astigmatism. METHODS: The study enrolled 20 eyes of patients with an average age of 32 years (range: 21 to 40 years). The outcomes of spherical and cylindrical refraction, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), vault, and angle parameters were evaluated 1 week, 1 month, and 12 months postoperatively. RESULTS: The preoperative mean UDVA was 0.15 ± 0.11 (decimal) (20/133 Snellen) and increased to 0.74 ± 0.25 (20/27 Snellen) postoperatively, with a change of 0.59 (decimal) (20/33.9 Snellen) (P < .0001), which was statistically significant. The preoperative mean CDVA was 0.74 ± 0.25 (decimal) (20/27 Snellen) and increased to 0.78 ± 0.21 (20/25 Snellen), with a change of 0.03 (decimal) (20/666 Snellen) (P < .052), which was not statistically significant. The mean preoperative sphere was 6.86 ± 1.77 diopters (D) and the mean preoperative cylinder was -1.44 ± 0.88 D. The mean 12-month postoperative sphere decreased to 0.46 ± 0.89 D (P < .001) and cylinder decreased to -0.61 ± 0.46 D (P < .001), with a change of 6.40 D, both of which were statistically significant. The mean 1-month postoperative vault was 0.65 ± 0.13 mm and decreased to 0.613 ± 0.10 mm at 1 year postoperatively, with a change of 0.44 mm (P < .003). The preoperative/12-month and 1-month/12-month trabecular-iris angle (TIA), trabecular-iris space area 500 mm from the scleral spur (TISA500), and angle opening distance 500 mm from the scleral spur (AOD500) values were analyzed nasally, temporally, and inferiorly. All differences were statistically significant between preoperative/12-month analysis. The only differences between 1- and 12-month analysis were on TISA500 inferior (P < .002) and AOD500 nasal (0.031) values. CONCLUSIONS: ICL hyperopic toric implantation is a safe method and provides stable refractive outcomes in patients with high hyperopia (up to 10.00 D) and astigmatism (up to 6.00 D). [J Refract Surg. 2017;33(9):604-609.].

Is Duane retraction syndrome part of the VACTERL association?

We report here a patient with type 1 Duane's retraction syndrome and multiple congenital abnormalities as a result of the VACTERL association. The presented combination of Duane's retraction syndrome and the VACTERL association has not been reported in the literature. The present case was instructive for reviewing the continuous spectrum of ocular anomalies that accompany the VACTERL association.