Objectives: To compare visual outcomes and clinical performance of diffractive trifocal and extended depth of focus (EDOF) intraocular lenses (IOLs). Methods: This prospective, consecutive, nonrandomized, comparative study of 6-month duration included assessment of 160 eyes of 80 patients (40 patients in each group). The patients had bilateral cataract surgery with implantation of a trifocal (FineVision Micro F; PhysIOL SA, Liège, Belgium) or EDOF IOL (TECNIS Symfony; Abbott Medical Optics, Inc., Abbott Park, IL) in both eyes. Ophthalmological evaluation included measurement of monocular uncorrected distance visual acuity (UDVA) and corrected distance VA (CDVA), uncorrected intermediate VA (UIVA) and distance-corrected intermediate VA (DCIVA), uncorrected near VA (UNVA) and distance-corrected near VA (DCNVA). Analysis of point-spread function and modulation transfer function was also performed postoperatively, and quality of vision and spectacle-dependence questionnaires were assessed. Results: There was no statistically significant difference between groups in monocular UDVA (P=0.65), CDVA (P=0.82), and binocular UDVA (P=0.81). The monocular UIVA, monocular DCIVA, and binocular UIVA were also comparable among the two groups (P=0.70, 0.74, and 0.81, respectively). Monocular UNVA, DCNVA, and binocular UNVA were statistically and significantly better for the trifocal group than for the EDOF (P=0.01, P=0.009, and P=0.001, respectively). There were no differences in visual symptoms and quality among groups. Conclusions: Trifocal IOL had a clear advantage over EDOF IOLs in near VA, while both IOLs showed excellent performance in distance and intermediate VA. Both IOLs provided high percentage of spectacle independence and patient satisfaction with minimal level of disturbing photic phenomena.
PURPOSE: To investigate the predictability and accuracy of active cyclotorsion compensation during LASIK for myopia with astigmatism. Figure 4. Double angle plot of cylinder 3 months postoperatively of 52 eyes that underwent myopic LASIK A) with (TEC group, n=30) or B) without (control group, n=22) active torsion error correction (TEC) during laser ablation.
We report a rare case of bilateral keratoglobus with hypermature intumescent cataract in a 55-year-old woman. Clinical examination and corneal topography confirmed generalized corneal bulging and global corneal thinning. A Pentacam® (Oculus Optikgerate, Wetzlar, Germany) demonstrated bilateral diffuse corneal thinning (368 μm in the right eye and 371 μm in the left eye). Phacoemulsification was performed in the right eye after thorough workup and modification of the surgical technique. This case report helps in better understanding of the challenges of cataract surgery and intraocular lens selection in a keratoglobus patient, and stresses the need for both thorough preoperative planning and intraoperative surgical modifications.
PURPOSE: To compare the safety and efficacy of laser in situ keratomileusis (LASIK) in correcting high myopic astigmatism using two different ablation profiles using the Nidek EC-5000 CX II laser). METHODS: Fifteen patients (25 eyes) had LASIK for compound myopic astigmatism, using the Optimized Ablation Transition Zone (OATz) ablation profile and activated torsion error detection (TED). Results were compared with those obtained with a cross cylinder ablation profile for myopic astigmatism. RESULTS: For eyes treated with TED, on postoperative day 7, 76% had visual acuity equal to or better than baseline best spectacle-corrected visual acuity (BSCVA) and 56% of eyes had overcorrected astigmatism. On postoperative day 20, none of the eyes had residual astigmatism more than 1.00 D and 72% eyes were within ±0.50 D cylinder; 92% of eyes had residual astigmatism within 30° of the preoperative axis and 12% remained astigmatically overcorrected at 20 days. Eighty-eight percent of eyes were either fully corrected or had mild myopic astigmatism. Comparison of results with cross cylinder ablation showed that 24% had overcorrection and 60% of patients with high astigmatism were overcorrected up to 1.75 D and developed hyperopic astigmatism in the opposite axis. Results with the cross cylinder ablation profile were good up to 2.00 D of myopic astigmatism. CONCLUSIONS: Correction of astigmatism using the OATz profile and TED with the Nidek EC-5000 CX II laser produced good results in high as well as pure astigmatism treatments, compared to the cross cylinder ablation profile. Ablation depth was greater in OATz with TED-based corrections. Overcorrections were less with OATz with TED, and residual astigmatism was at the same baseline axis, thereby increasing patient satisfaction. [J Refract Surg 2004;20(suppl):S663-S665]
Reticular pseudo drusen also known as Reticular Soft Drusen 1 , reticular drusen or sub-retinal drusenoid deposits 2 , is a terminology used to describe drusen-like deposits occurring in the subretinal space on OCT. History of RPD RPD were first described by Mimou and colleagues in 1990 as yellow interlacing structures seen in the outer macula with variable diameter of about 100 microns that did not fluoresce on FFA but demonstrated fluorescence on blue light filter. 1 Arnold J and colleagues further described these structures as first appearing in the superior macula and then spreading circumferentially. In 2013, Curcio and colleagues coined the term Subretinal drusenoid deposits as these appeared in the subretinal space on OCT 2. Pathophysiology of Reticular Pseudo drusen: The key feature causing the occurrence of RPD is para inflammation (Figure 1). Ageing leads to chronic insults to the retino choroidal tissue. This in turn activates the microglial cells and causes accumulation of macrophages in the subretinal space and activation of the compliment cascade. In a healthy individual maintaining a healthy immune system and a healthy lifestyle, these changes are reverted, and no damage ensues. However, in a dysregulated immune system there is retinal para-inflammation that will cause healing by forming a scar leading to age related macular degeneration (ARMD). Secondly a chronically inflamed retina at the molecular level leads to RPE and photoreceptor damage which will again contribute to the development of ARMD. Para inflammation results from the mal response of the RPE and retinal immune system to the age related chronic oxidative insults. Genetic predisposition (CFH, Cx3cr1), Environmental factors and epigenetic modifications are some of the factors responsible for the maladaptive retinal response to oxidative stress. Burden and pathophysiology of ARMD: ARMD is known to be the leading cause of irreversible blindness in the West. It is postulated to affect 14 million people worldwide. 3 4 main processes are responsible for causing ARMD (Figure 2
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