Opaque Intraocular Lens for Intractable Diplopia—UK Survey

Kwok, Thomas; Watts, Patrick

doi:10.3109/09273970903353253

Cited by 16 publications

(5 citation statements)

References 4 publications

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“…Our findings are comparable with others, where patients have tried strabismus surgery, occlusion, opaque contact lenses, and induced ptosis via botulinum toxin and found all methods to be either ineffective or unacceptable 7. We found opaque IOLs to be by far the most successful method (diplopia eliminated in 86%) and is reasonably comparable with a survey of ophthalmologists that reported 67% of patients were asymptomatic on discharge following this procedure 9. Satisfaction with this treatment has also been documented via the Visual Function Index (VF-14),19 where 12 patients unresponsive to Blenderm/Bangerter filters, Fresnel prisms, occlusive contact lenses, botulinum toxin and strabismus surgery received opaque IOLs and had a mean postoperative VF-14 score of 91 out of 100 6…”

Section: Discussionsupporting

confidence: 89%

Incidence, risk factors and management of intractable diplopia

2017

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Intractable diplopia is a relatively rare but important condition. The main risk factor is a pre-existing strabismus, and careful counselling is needed when planning surgical correction in patients with no demonstrable binocular function. Treatment success of intractable diplopia is high when using opaque IOLs, although with additional risk, but is often disappointing via other methods where it can be difficult to eradicate the diplopia successfully.

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Section: Discussionsupporting

confidence: 89%

Incidence, risk factors and management of intractable diplopia

2017

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“…4,5 High rates of postoperative satisfaction are reported in patients with NIR-transmitting black IOLs, 6 despite near universal postoperative light perception. 5 We have suggested previously that trans-optical NIR light transmission across NIR-transmitting black IOLs may underlie intractable ghosting and treatment failure.…”

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confidence: 99%

Opaque intraocular lens implantation

Gong

O'Colmain

MacEwen

2015

Eye

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Sir, Methodological remarks concerning the recent metaanalysis on the effect of intravitral bevacizumab in central serous chorioretinopathyWe read with great interest the recent meta-analysis by Chung et al, 1 which reached important conclusions about the effect of intravitral bevacizumab in central serous chorioretinopathy; nevertheless, some methodological issues need to be addressed concerning this meta-analysis. 1 Specifically, the authors state that 'The mean difference and SD at the 6-month follow-up were calculated from the data in the included studies.' This seems an intriguing statement that should be further clarified by the authors to substantiate the validity of the meta-analysis and guarantee the reproducibility of their results. The included studies presented mean ± SD at baseline and at the 6-month time point; the SD of the difference (with the latter representing a new measure) was not provided by the included articles.Given that the variance of a an A-B difference inherently necessitates knowledge about the covariance (A, B), any attempt to estimate the SD of the difference would imply assumptions about the covariance; the latter is not negligible and seems of corollary importance in light of the longitudinal nature of the baseline-6-month comparison. Therefore, the authors should disclose their assumptions regarding the calculation of covariance and provide the relevant formulas with the corresponding statistical references supporting their approach; critical discussion of any limitations potentially stemming from such assumptions would be of interest.An alternative way would be contact with the authors of each study, asking them to calculate de novo the difference and provide the meta-analysts with the exact SD data. Nevertheless, Chung et al did not provide any statement disclosing contact with the authors of individual studies.In conclusion, thorough clarification of the methods used by Chung et al 1 seems desirable, so as to further solidify the validity of their approach. Reliable calculation of variance often represents a challenging notion in the field of meta-analysis. Conflict of interestThe authors declare no conflict of interest. We appreciate the interest of Sergentanis and Chatziralli in our published manuscript, 'Lack of positive effect of intravitreal bevacizumab in central serous chorioretinopathy: meta-analysis and review.' 1 They have addressed methodological issues concerning metaanalysis because the SD of difference was not provided in the manuscript. We absolutely agree that it would have been more meaningful meta-analysis if we contacted the authors of each study, asking them to calculate de novo the difference as Sergentanis and Chatziralli have rightly pointed out. Alternatively, Hedges g formula for pooled SD was used to estimate difference SD. And then, paired SD was calculated, as follows, pooled SD × sqrt(2 × 1 − r)).Although our meta-analysis failed to verify the positive effect of IVB in CSC, the outcome of this treatment is still unknown owing to many limitations,...

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“…In the UK a large survey has been held among ophthalmologists regarding opaque IOLs (Kwok & Watts 2009). An opaque IOL was implanted in 46 patients and was successful in 31 patients (including 9 patients who needed pilocarpine for miosis because of light transmission around the IOL optic).…”

Section: Discussionmentioning

confidence: 99%

Grey Filter Contact Lens as Therapeutic Option for Acquired Reduced Binocular Visual Performance

Vliet

Jellema

Nieuwendaal

et al. 2021

British and Irish Orthoptic Journal

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Disturbing binocular problems can be too complex to be treated in such a way that comfortable binocular single vision is restored. The grey filter contact lens could offer a safe and clinically useful way to help these patients. Background:In unilateral acquired reduced visual performance or intractable diplopia the binocular performance often is less than the performance of the better eye, possibly leading to complaints of binocular visual functioning. The hypothesis is to use a grey filter contact lens on the affected eye to obtain more binocular visual comfort. The grey filter changes the binocular central visual image in the brain through delaying the image of the affected eye and has minimal effect on the peripheral vision. The purpose of this study was to evaluate the effect of the grey filter contact lens on the reduction of patients' binocular complaints in daily life. Methods:In 19 consecutive patients with unilateral acquired reduced visual performance or intractable diplopia a grey filter contact lens was fitted. The contact lens was chosen from six available filters with different transmissions, based on patient preference. The chosen filter contact lens was fitted according to the normal practice of contact lens fitting. Results:The results of 18 patients are reported, one patient was lost to follow-up. Twelve patients (67%) reported good results when wearing the grey filter contact lens. Five patients (28%) discontinued wear of the grey filter contact lens because their binocular visual complaints disappeared during filter contact lens wear and remained absent after contact lens wear was terminated. Conclusion:The grey filter contact lens is a clinically useful, safe, and easily reversible treatment option for patients with binocular visual complaints due to an acquired monocular reduction in visual quality.

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Opaque Intraocular Lens for Intractable Diplopia—UK Survey

Abstract: An opaque IOL is a safe method for treating intractable diplopia. This survey confirms that its practice is widely accepted in the UK.

Cited by 16 publications

References 4 publications

Incidence, risk factors and management of intractable diplopia

Incidence, risk factors and management of intractable diplopia

Opaque intraocular lens implantation

Grey Filter Contact Lens as Therapeutic Option for Acquired Reduced Binocular Visual Performance

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