In a prospective, randomized study, the nondiffractive presbyopia-correcting IOL, DFT015, demonstrated superior intermediate and near vision, noninferior distance vision, and a similar visual disturbance profile compared with a monofocal IOL.

Purpose: To clinically evaluate visual performance of the AcrySof IQ PanOptix TFNT00 and AT LISA tri 839MP intraocular lenses (IOLs) in binocular visual acuity (VA) and to characterize low-contrast visual performance at 6 months postimplantation. Setting: Multicenter, 15 sites. Design: Prospective, parallel-group, randomized, double-masked, postmarketing clinical study. Methods: Binocular uncorrected distance (UDVA, 4 m), intermediate (UIVA, 60 cm), and near (UNVA, 40 cm) visual acuities and binocular defocus curves were evaluated under photopic lighting conditions. Photopic and mesopic contrast sensitivities with and without glare were assessed. Results: The study included 182 subjects (62% women; mean age, 66 ± 9.4 years) who were implanted bilaterally with the TFNT00 IOL (n = 93) or 839MP IOL (n = 89), and binocular VA was evaluated 4 to 6 months (120–180 days) postimplantation. The TFNT00 IOL group showed superior visual outcomes compared with the 839MP IOL group in binocular UIVA (P = .001) and UNVA (P = .003) and noninferior outcomes in UDVA (95% CI, −0.023 to 0.041; upper limit <0.1 logarithm of the minimum angle of resolution [logMAR] [margin of noninferiority]). Mean defocus curve from 0.00 to −3.00 diopter (D) ranged from 0.1 to 0.0 logMAR for both IOLs; better mean VA values (logMAR) were observed in the TFNT00 IOL group between −1.50 and −2.50 D compared with those of the 839MP IOL group. Contrast sensitivity values were similar between the 2 groups in all conditions. Conclusions: The results of this study showed improved visual performance at near and intermediate distances with the TFNT00 IOL compared with that of the 839MP IOL.

SUMMARYSteroid creams applied topically to the skin are routinely used in the treatment of many dermatoses. Their use on the face in severe atopic eczema is relatively common. We report a series of three patients who whilst using topical facial steroids developed advanced glaucoma. A further two cases of ocular hypertension secondary to topical facial steroids are also described. This is the first series of cases to be reported demonstrating the potentially blind ing complications of topical facial steroids. Recommend ations are made with regard to screening such patients for glaucoma.The risk of glaucoma with the use of topical steroid to the eye is well known.I-3 The risk associated with systemic steroids, although uncommon, has been described.4,5 Glaucoma developing secondary to the use of topical ster oids to the face, first described in 1975 by Cubey,6 has attracted little attention; to our knowledge the literature contains only a few isolated case reports. 7,8 The real risk of visual loss in young people who use steroid preparations to their face remains unrecognised. We describe the first series of patients who developed an elevation in intra ocular presssure (lOP) secondary to the use of topical facial steroids. They presented between June 1991 and September 1992; three were found to have advanced glau coma and a further two had ocular hypertension. CASE REPORTS Case 1A 24-year-old Asian man presented with a history of blurred vision in the left eye. He had eczema involving the skin of the face including the eyelids and had been using 0.25% desoxymethasone cream on these areas for over 2 years. On examination unaided visual acuities were 6/5 right and 6/60 left, with no improvement on refraction. He had a left relative afferent pupillary defect and the lOPs were 44 mmHg right and 74 mmHg left. On gonioscopy there was no angle abnormality, and both anterior chamber angles were wide open (Shaffer grade III to IV). Both optic discs exhibited extensive pathological cupping (cup/ disc ratio 0.8 right, 0.95 left). Goldman perimetry revealed marked glaucomatous visual field defects in both eyes, particularly on the left. On discontinuing the steroids and with the use of guttae timolol 0.5%, the right lOP was con trolled. The left eye, however, failed to respond to topical treatment, necessitating a trabeculectomy. Although this controlled the lOP, 12 months following presentation the patient was totally blind in his left eye. Case 2A 23-year-old Chinese man presented with a 6-month history of gradual visual loss affecting his left eye. He had severe atopic eczema of the periorbital skin, for which he had been using 1 % hydrocortisone cream intermittently for about 12 years. On examination, with a myopic correc tion of -6.75 D sphere, visual acuities were 6/5 right and 6/36 left. His lOPs were 28 mmHg right and 54 mmHg left. He had a left posterior subcapsular cataract. There was no gonioscopic abnormality found and both anterior chamber angles were open (Shaffer grade III). On fun doscopy both optic discs were ...

The risk of endophthalmitis was minimised by administration of subconjunctival antibiotics (cefuroxime) at induction of anaesthesia, followed by lid and conjunctival toilet with 5% aqueous povidine-iodine. The usual strict aseptic technique associated with intraocular surgery was observed. The procedures were treated as two separate operations under one anaesthetic. The surgeon, assistant, and instrument nurse rescrubbed and regowned before operating on the second eye. A separate irrigation system and theatre trolley were used for each eye. Postoperatively two bottles of topical steroid-antibiotic preparation (Betnesol-N, Evans Medical, Horsham, Sussex) were used, one for each eye.Our results are analysed and 95%/o confidence intervals calculated.

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To compare the visual disturbances experienced by patients receiving 1 of 3 extended depth-of-focus (EDOF) intraocular lenses (IOLs) or a monofocal IOL as the control.

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IntroductionMaximal medical therapy (MMT) is the use of ≥3 classes of topical anti-glaucoma agents to achieve maximal intraocular pressure (IOP) reduction while minimizing adverse effects and compliance challenges.PurposeTo evaluate the additive IOP-lowering effect of twice-daily brinzolamide 1%/brimonidine 0.2% fixed-dose combination (BBFC) used adjunctively with once daily travoprost 0.004%/timolol 0.5% fixed-dose combination (TTFC) in patients with open-angle glaucoma (OAG)/ocular hypertension (OHT).MethodsIn this phase IV, double-masked study, patients on TTFC for ≥28 days, aged ≥18 years, with mean IOP ≥19 and ≤28 mmHg in at least 1 eye were randomized to receive BBFC+TTFC (n=67) or vehicle+TTFC (n=67) for 6 weeks. The primary endpoint was mean change in diurnal IOP from baseline (BL, averaged over 09:00 and 11:00) at Week 6.ResultsThe study was terminated prematurely due to recruitment challenges. BL mean IOP was similar in both groups (BBFC+TTFC: 21.6±1.78 mmHg; vehicle+TTFC: 21.8±1.90 mmHg). Mean change in diurnal IOP from BL at Week 6 was greater with BBFC+TTFC (−4.25 mmHg, 95% confidence interval [CI]: −4.7, −3.8) than with vehicle+TTFC (−2.11 mmHg, 95% CI: −2.6, −1.6, treatment difference, −2.15 mmHg (95% CI: −2.8, −1.5; P<0.001). Ocular adverse events (AEs) were reported in 11.9% of patients given BBFC+TTFC and 7.5% of patients given vehicle+TTFC. The AE with highest frequency was punctate keratitis (3%) in the BBFC+TTFC group; eye irritation (3%) in the vehicle+TTFC group.ConclusionBBFC+TTFC as MMT demonstrated clinically relevant and statistically significant reductions in mean diurnal IOP in patients with OAG/OHT. AEs were consistent with known safety profiles of individual medications.