Purpose:
To compare the impact of total corneal astigmatism (TCA) estimated with the Abulafia-Koch formula (TCA
ABU
) versus measured by Total Keratometry (TK), swept-source optical coherence tomography (OCT) coupled with telecentric keratometry (TCA
TK
) on the refractive outcomes after cataract surgery with toric intraocular lens (IOL) implantation.
Methods:
Two hundred one eyes of 146 patients who underwent cataract surgery with toric IOL implantation (XY1AT; HOYA Corporation) were included in this single-center, retrospective study. For each eye, TCA
ABU
(estimated from the anterior keratometry values measured with the IOLMaster 700 [Carl Zeiss Meditec AG]) and TCA
TK
(measured using TK IOLMaster 700) were entered into the HOYA Toric Calculator. Patients were operated on based on TCA
ABU
. For each eye, centroid and mean absolute error in predicted residual astigmatism (EPA) were calculated according to TCA used (TCA
ABU
or TCA
TK
). The cylinder power and the axis of the posterior chamber IOL were compared.
Results:
The mean uncorrected distance visual acuity was 0.07 ± 0.12 logMAR, the mean spherical equivalent was 0.11 ± 0.40 D, and mean residual astigmatism was 0.35 ± 0.36 D. Mean centroid EPA was 0.28 D at 132° with TCA
ABU
and 0.35 D at 148° with TCA
TK
(
P
(x) < .001;
P
(y) < .01). Mean absolute EPA was 0.46 ± 0.32 D with TCA
ABU
and 0.50 ± 0.37 D with TCA
TK
(
P
< .01). In the with-the-rule astigmatism subgroup, a deviation from the target of less than 0.50 D was achieved in 68% of eyes with TCA
ABU
versus 50% of eyes with TCA
TK
. The proposed posterior chamber IOL was different depending on the calculation methods used in 86% of cases.
Conclusions:
Both calculation methods showed excellent results. However, the predictability error was significantly reduced when TCA
ABU
was used compared to TCA
TK
measured with the IOLMaster 700 in the whole cohort. Finally, TCA was overestimated by TK in the with-the-rule astigmatism subgroup.
[
J Refract Surg.
2023;39(3):171–179.]
Purpose To report the rate of intraocular pressure elevation following repeated intravitreal injections (IVI) of anti‐VEGF agents or dexamethasone intravitreal implant and to determine the risk factors.
Methods A prospective study of 166 eyes undergoing IVI of ranibizumab (n=126), bevacizumab (n=19), or dexamethasone implant (n=12) was carried out. A total of 886 IVI were performed. The development of ocular hypertension (OHT) following these injections was investigated with respect to number of injections, pre‐existing glaucoma, diabetes and YAG capsulotomy.
Results After a mean of 5.34 +/‐ 5.1 IVI (range, 1‐30), 8.4% (n=14) had IOP elevation above 25 mmHg and required medical treatment (3% of them peaked above 30mmHg).Patients with pre‐existing glaucoma experienced highter rates of OHT were compared to patients without pre‐existing glaucoma (21.7mmHg +/‐12.4 versus 17.23mmHg +/‐4.5, p=0.06). No significant difference was found in diabetes subgroup (n=40, p=0.32), nor in YAG capsulotomy subgroup (n=12, p=0.8) compared to the control group. The peak of IOP was significatively correlated with the total number of IVI (p=0.01, R=0.19).The mean highest IOP was 17.2mmHg in ranibizumab group, 18.8mmHg in bevacizumab group and 19.9mmHg in dexamethasone intravitreal implant. No difference was found between these molecule subgroups (Kruskal‐Wallis p=0.38).
Conclusion Serial intravitreal injections may lead to persistent IOP elevations that require IOP lowering therapies. This risk is correlated with the number of injections and must be checked during the follow‐up. Pre‐existing glaucoma could be a risk factor but larger prospective studies are needed to verify these results.
PurposePeripheral exudative hemorrhagic chorioretinopathy (PEHCR) is a rare disorder characterized by subretinal or sub‐pigment epithelial hemorrhage and exudation localized outside the macular region.Some authors consider PEHCR as the peripheral version of age‐related macular degeneration while others believe PEHCR is a specific variant of polypoidal choroidal vasculopathy (PCV).MethodsWe report 4 cases of PEHCR (3 women and 1 man) treated by intravitreal injections of Aflibercept. The mean age was 78 years (range 62–83 years). In all cases the presence of PCV was confirmed with indocyannine green angiography. Examination revealed peripheral subretinal or sub‐pigment epithelial hemorrhage with exudation extented into the macula in all patients. After 2 or 3 intravitreal injections of Aflibercept, PEHCR lesions and submacular exudation significantly regressed.ResultsGenerally PEHCR has a favorable prognosis, hovewer vision can be threated because of subretinal hemorrhage and fluid extension into the macula. In cases in which the macula appears threatened, intravitreal antivascular endothelial growth factor therapy and/or laser‐based therapies may be indicated. Peripheral lesion can be difficult to reach with photodynamic therapy. Intravitreal Aflibercept, with its mechanism of action, may be an effective treatment option to reduce subretinal fluid.ConclusionsPEHCR is not well‐recognized by the ophthalmologist and is often misinterpreted as a choroidal melanoma. To our knowledge this is the first report of Aflibercept use and efficacy in this indication.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.