PURPOSE: To assess the impact of the use of artificial tears during the preoperative work-up performed before age-related cataract surgery, when a toric intraocular lens (IOL) was indicated. METHODS: This was a monocentric prospective study assessing 73 eyes of 51 patients, included consecutively after a preoperative work-up performed without artificial tears (no artificial tears group), when a toric IOL was indicated. Each included patient underwent a second series of examinations: biometry using the IOLMaster 700 (Carl Zeiss Meditec AG) and topography using the OPD-Scan II (Nidek), 1 minute after artificial tears instillation (artificial tears group; hyaluronate de sodium 0.15%, threalose 3% [Théalose; Théa]). Changes in anterior corneal astigmatism and subsequent changes in toric IOL calculation were analyzed. The error in predicted residual astigmatism was calculated. RESULTS: Anterior corneal astigmatism and total corneal astigmatism measured with the IOLMaster 700 were significantly modified when artificial tears were instilled before the examinations (1.51 ± 0.57 diopters [D], range: 0.75 to −3.55 vs 1.42 ± 0.63 D, range: 0.42 to 3.35 D; P = .043 and 1.59 ± 0.54 D, range: 0.87 to 3.48 vs 1.51 ± 0.59 D, range: 0.56 to 3.27 D, P = .038, respectively). This modification led to a change in IOL cylinder calculation in 43.8% of cases and to a change in implantation axis greater than 10° in 17.7% of cases. These changes were significantly greater in patients with a breakup time (BUT) less than 5 seconds (57.5% and 27.8%, with P = .009 and .029, respectively). In the subgroup of patients with a BUT of less than 5 seconds, the mean absolute error in predicted astigmatism was significantly lower after artificial tears instillation (0.48 ± 0.50 D, range: 0.00 to 2.79 vs 0.37 ± 0.25 D, range: 0.00 to 1.10 D, P = .048). CONCLUSIONS: Dry eye significantly impacted toric IOL calculations and should be taken into account during the preoperative assessments. Using artificial tears reduced the number of refractive errors. [ J Refract Surg . 2021;37(11):759–766.]
Background: The pathophysiological origin of the retinal damage present in ocular contusion is not clearly established. It is not known whether it is initially neurodegeneration or vascular ischaemia that leads to retinal atrophy. Methods: The aim of this study was to evaluate the retinal microvasculature with optical coherence tomography (OCT) - angiography of the eyes affected by severe ocular contusion as compared to the contralateral non-traumatised eyes. The retinal vessel density of superficial (SVP) and deep vascular plexus (DVP), area of choriocapillaris flow voids and foveal avascular zone area were evaluated. The macular thickness in OCT in the acute and late stages of the trauma was also analysed. Results: A total of 48 patients were included and at both 72 hours and 55 days after severe ocular contusion, there were no significant differences between traumatised and non-traumatised eyes for the vascular density of the SVP, the DVP, the choriocapillaris and area of the foveal avascular zone. But we observed significant increase in macular thickness in traumatised eyes compared to non-traumatised eyes at the initial emergency visit and a decrease in traumatised eyes at follow-up examination. Conclusions: These results suggest that the micro-vascularisation of the retina and the choriocapillaris are not initially affected in severe ocular contusions. The damage to the retina after trauma is therefore probably neurodegenerative rather than vascular.
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