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Kang NW, Jang K, Song E, Han U, Seo YA, Chen F, Wungcharoen T, Heilshorn SC, Myung D. In Situ-Forming, Bioorthogonally Cross-linked, Nanocluster-Reinforced Hydrogel for the Regeneration of Corneal Defects. ACS NANO 2024. [PMID: 39106436 DOI: 10.1021/acsnano.4c02345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/09/2024]
Abstract
Corneal defects can lead to stromal scarring and vision loss, which is currently only treatable with a cadaveric corneal transplant. Although in situ-forming hydrogels have been shown to foster regeneration of the cornea in the setting of stromal defects, the cross-linking, biomechanical, and compositional parameters that optimize healing have not yet been established. This, Corneal defects are also almost universally inflamed, and their rapid closure without fibrosis are critical to preserving vision. Here, an in situ forming, bioorthogonally cross-linked, nanocluster (NC)-reinforced collagen and hyaluronic acid hydrogel (NCColHA hydrogel) with enhanced structural integrity and both pro-regenerative and anti-inflammatory effects was developed and tested within a corneal defect model in vivo. The NCs serve as bioorthogonal nanocross-linkers, providing higher cross-linking density than polymer-based alternatives. The NCs also serve as delivery vehicles for prednisolone (PRD) and the hepatocyte growth factor (HGF). NCColHA hydrogels rapidly gel within a few minutes upon administration and exhibit robust rheological properties, excellent transparency, and negligible swelling/deswelling behavior. The hydrogel's biocompatibility and capacity to support cell growth were assessed using primary human corneal epithelial cells. Re-epithelialization on the NCColHA hydrogel was clearly observed in rabbit eyes, both ex vivo and in vivo, with expression of normal epithelial biomarkers, including CD44, CK12, CK14, α-SMA, Tuj-1, and ZO-1, and stratified, multilayered morphology. The applied hydrogel maintained its structural integrity for at least 14 days and remodeled into a transparent stroma by 56 days.
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Affiliation(s)
- Nae-Won Kang
- Department of Ophthalmology, Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California 94304, United States
| | - Kyeongwoo Jang
- Department of Ophthalmology, Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California 94304, United States
| | - Euisun Song
- Department of Ophthalmology, Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California 94304, United States
| | - Uiyoung Han
- Department of Ophthalmology, Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California 94304, United States
| | - Youngyoon Amy Seo
- Department of Ophthalmology, Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California 94304, United States
| | - Fang Chen
- Department of Ophthalmology, Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California 94304, United States
| | - Thitima Wungcharoen
- Department of Ophthalmology, Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California 94304, United States
| | - Sarah C Heilshorn
- Department of Materials Science and Engineering, Stanford University, Stanford, California 94305, United States
| | - David Myung
- Department of Ophthalmology, Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California 94304, United States
- Department of Chemical Engineering, Stanford University, Stanford, California 94305, United States
- VA Palo Alto HealthCare System, Palo Alto, California 94304, United States
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Wallerstein A, Tai P, Gauvin M. Comparison of higher-order corneal irregularities in eyes with oblique, with-the-rule, and against-the-rule astigmatism. J Cataract Refract Surg 2024; 50:428-429. [PMID: 38523279 DOI: 10.1097/j.jcrs.0000000000001392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/22/2023] [Indexed: 03/26/2024]
Affiliation(s)
- Avi Wallerstein
- From the Department of Ophthalmology and Visual Sciences, McGill University, Montreal, Québec, Canada (Wallerstein, Gauvin); LASIK MD, Montreal, Québec, Canada (Wallerstein, Gauvin); Faculty of Medicine, McGill University, Montreal, Québec, Canada (Tai)
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Ichikawa K, Ono T, Chen L, Kitamoto K, Taketatni Y, Toyono T, Yoshida J, Aihara M, Miyai T. Quantitative evaluation of corneal irregularity and scarring after infectious keratitis using anterior segment optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 2024; 262:133-141. [PMID: 37470808 PMCID: PMC10805989 DOI: 10.1007/s00417-023-06157-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/04/2023] [Accepted: 06/14/2023] [Indexed: 07/21/2023] Open
Abstract
PURPOSE Corneal scars after infectious keratitis lead to insufficient transparency and irregular astigmatism, affecting visual acuity; therefore, they should be accurately evaluated to estimate visual function. This study aimed to quantitatively evaluate corneal irregularity and scarring after infectious keratitis using anterior segment optical coherence tomography (AS-OCT). METHODS This was an observational clinical study. We included patients who had corneal scarring after treatment of infectious keratitis between 2014 and 2021 at University of Tokyo Hospital. We retrospectively examined best spectacle-corrected visual acuity (BSCVA), average keratometric power, central corneal thickness (CCT), and four components of the Fourier harmonic analysis including spherical and asymmetry components, as well as regular astigmatism and higher-order irregularity. We included anterior and posterior corneal data and compared results with those of contralateral healthy eyes. Additionally, we quantitatively evaluated the densitometry of the cornea obtained using AS-OCT. RESULTS A total of 122 eyes of 61 patients were examined; male predominance was observed (n = 37), and the mean patient age was 55.3 ± 19.4 years. Comparisons with contralateral healthy eyes showed that BSCVA worsened (0.30 ± 0.83 and 0.93 ± 1.36 logMAR, respectively, P = 0.003), and CCT (531.1 ± 46.2 and 591.8 ± 132.4 μm, respectively, P < 0.001) and corneal densitometry (84.4 ± 11.8 and 111.9 ± 19.2 grayscale units, respectively, P < 0.001) increased significantly in affected eyes. The asymmetry component and higher-order irregularities that were not corrected with spectacles significantly increased (both P < 0.001), and there were no significant differences in the changes among the bacterial, fungal, herpetic, and acanthamoeba types of keratitis. CONCLUSION Corneal scarring persisted after treatment for infectious keratitis, and the asymmetry and irregularities of corneal astigmatism increased as visual acuity deteriorated. AS-OCT with the Fourier harmonic analysis was useful for evaluating corneal topographic changes in patients with corneal scarring after keratitis.
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Affiliation(s)
- Kazunori Ichikawa
- Department of Ophthalmology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- Department of Ophthalmology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Takashi Ono
- Department of Ophthalmology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- Department of Ophthalmology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Lily Chen
- Department of Ophthalmology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- Department of Ophthalmology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Kohdai Kitamoto
- Department of Ophthalmology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- Department of Ophthalmology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Yukako Taketatni
- Department of Ophthalmology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- Department of Ophthalmology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Tetsuya Toyono
- Department of Ophthalmology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- Department of Ophthalmology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Junko Yoshida
- Department of Ophthalmology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- Department of Ophthalmology, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-Ku, Tokyo, Japan
| | - Makoto Aihara
- Department of Ophthalmology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- Department of Ophthalmology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Takashi Miyai
- Department of Ophthalmology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
- Department of Ophthalmology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, Japan.
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Chen Q, Zhou M, Cao Y, Zheng X, Mao H, Lei C, Lin W, Jiang J, Chen Y, Song D, Xu X, Ye C, Liang Y. Quality assessment of non-mydriatic fundus photographs for glaucoma screening in primary healthcare centres: a real-world study. BMJ Open Ophthalmol 2023; 8:e001493. [PMID: 38092419 PMCID: PMC10729214 DOI: 10.1136/bmjophth-2023-001493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND This study assessed the quality distribution of non-mydriatic fundus photographs (NMFPs) in real-world glaucoma screening and analysed its influencing factors. METHODS This cross-sectional study was conducted in primary healthcare centres in the Yinzhou District, China, from 17 March to 3 December 2021. The quality distribution of bilateral NMFPs was assessed by the Digital Reading Department of the Eye Hospital of Wenzhou Medical University. Generalised estimating equations and logistic regression models identified factors affecting image quality. RESULTS A total of 17 232 photographs of 8616 subjects were assessed. Of these, 11.9% of images were reliable for the right eyes, while only 4.6% were reliable for the left eyes; 93.6% of images were readable in the right eyes, while 90.3% were readable in the left eyes. In adjusted models, older age was associated with decreased odds of image readability (adjusted OR (aOR)=1.07, 95% CI 1.06~1.08, p<0.001). A larger absolute value of spherical equivalent significantly decreased the odds of image readability (all p<0.001). Media opacity and worse visual acuity had a significantly lower likelihood of achieving readable NMFPs (aOR=1.52, 95% CI 1.31~1.75; aOR=1.70, 95% CI 1.42~2.02, respectively, all p<0.001). Astigmatism axes within 31°~60° and 121°~150° had lower odds of image readability (aOR=1.35, 95% CI 1.11~1.63, p<0.01) than astigmatism axes within 180°±30°. CONCLUSIONS The image readability of NMFPs in large-scale glaucoma screening for individuals 50 years and older is comparable with relevant studies, but image reliability is unsatisfactory. Addressing the associated factors may be vital when implementing ophthalmological telemedicine in underserviced areas. TRIAL REGISTRATION NUMBER ChiCTR2200059277.
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Affiliation(s)
- Qi Chen
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Department of Ophthalmology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Mengtian Zhou
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yang Cao
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xuanli Zheng
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Huiyan Mao
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Changrong Lei
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wanglong Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Junhong Jiang
- Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yize Chen
- Department of Ophthalmology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Di Song
- Department of Ophthalmology, The First People's Hospital of Huzhou, The First Affiliated Hospital of Huzhou Teacher College, Huzhou, China
| | - Xiang Xu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Cong Ye
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yuanbo Liang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Glaucoma Research Institute, Wenzhou Medical University, Wenzhou, China
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Hayashi K, Uno K, Manabe SI, Hirata A. Prevalence and characteristics of oblique astigmatism. Eye (Lond) 2023; 37:3174-3179. [PMID: 36928225 PMCID: PMC10564798 DOI: 10.1038/s41433-023-02470-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/02/2023] [Accepted: 02/24/2023] [Indexed: 03/18/2023] Open
Abstract
OBJECTIVE To examine the incidence and characteristics of eyes with oblique astigmatism stratified by meridian, age, sex, and eye side (left to right). METHODS One thousand eyes of 1000 patients with oblique corneal astigmatism underwent videokeratographic examination and was classified into 4 meridian categories: (1) 31°-45°, (2) 46°-59°, (3) 121°-135°, and (4) 136°-149°. Amounts of regular and irregular astigmatism, and the vertical/horizontal (Rx) and oblique astigmatism components (Ry) decomposed using vector analysis were compared among the 4 categories and age groups, and between sexes and eye sides. RESULTS Incidences of the 4 meridian categories were similar and did not differ significantly among age groups or between sexes. The incidence was significantly greater in eyes in meridian categories 1 and 2 in the left eye and categories 3 and 4 in the right eye, and significantly greater in men in their 40 s and 50 s and in women in their 70 s and 80 s (P < 0.0001). The mean regular astigmatism, asymmetry and higher-order irregularity components, and Rx and absolute Ry significantly increased with age (P ≤ 0.0372). The mean regular and irregular astigmatism, and absolute Rx and Ry did not differ significantly among the 4 categories, or between sexes or left and right eyes. CONCLUSIONS The incidence of oblique astigmatism was significantly greater in the temporal side meridians, and the incidence in women increased with age. The degree of oblique astigmatism increased with age, with an increase in irregular astigmatism.
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Brunson P, Mann PM, Mann PM, Potvin R. Comparison of refractive and visual acuity results after Contoura® Vision topography-guided LASIK planned with the Phorcides Analytic Engine to results after wavefront-optimized LASIK in eyes with oblique astigmatism. PLoS One 2022; 17:e0279357. [PMID: 36534673 PMCID: PMC9762561 DOI: 10.1371/journal.pone.0279357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To compare visual acuity and refractive results between topography-guided laser in situ keratomileusis (LASIK) planned with the Phorcides Analytic Engine (PAE) to results after wavefront-optimized (WFO) LASIK in subjects with preoperative oblique astigmatism in their manifest refraction. METHODS This was a retrospective chart review of clinical results from eyes treated with topography-guided LASIK planned with PAE compared to eyes treated with WFO LASIK using the same Wavelight® excimer laser system. All included subjects had preoperative oblique astigmatism. Residual refractive error and visual acuity (uncorrected and corrected) were the measures of interest, at the visit closest to 90 days postoperative. RESULTS A matched data set from 100 WFO and 97 PAE eyes was extracted from clinical records. At the postoperative visit the PAE group showed lower residual refractive cylinder (p = 0.04), uncorrected distance visual acuity (UDVA) (-0.06 PAE vs. -0.02 WFO, p < 0.01) and distance corrected visual acuity (CDVA) (p < 0.01). The percentage of eyes with a mean refraction spherical equivalent (MRSE) magnitude within 0.25 D and 0.50 D of plano was statistically significantly higher in the PAE group (p = 0.04 and 0.01, respectively). A statistically significantly higher percentage of eyes in the PAE group had UDVA better than or equal to -0.10 logMAR (20/16 Snellen, 36% vs 22%, p = 0.04). More eyes gained CDVA after surgery in the PAE group (53% vs 32%, p < 0.01). There were five enhancements in the WFO group versus none in the PAE group, a statistically significant difference (p = 0.03). CONCLUSIONS Visual acuity and refractive outcomes after LASIK using PAE in eyes with oblique astigmatism in their preoperative refraction were statistically significantly better than those obtained when WFO treatment was used. The number of refractive outliers and the number of retreatments were also significantly lower with PAE treatment.
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Affiliation(s)
- Phillip Brunson
- Mann Eye Institute and Laser Centers, Houston, TX, United States of America
- * E-mail:
| | - Paul M. Mann
- Mann Eye Institute and Laser Centers, Houston, TX, United States of America
| | - Paul Michael Mann
- Mann Eye Institute and Laser Centers, Houston, TX, United States of America
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Regular and irregular astigmatism of bullous keratopathy using Fourier harmonic analysis with anterior segment optical coherence tomography. Sci Rep 2022; 12:17865. [PMID: 36284222 PMCID: PMC9596404 DOI: 10.1038/s41598-022-22144-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 10/10/2022] [Indexed: 01/20/2023] Open
Abstract
Bullous keratopathy (BK) is known to present with corneal edema and Descemet's folds, which can cause corneal astigmatism. However, no report quantitatively evaluated BK astigmatism by separating it into regular and irregular astigmatism. This study investigated the regular and irregular astigmatism of the anterior and posterior corneal surface with Fourier harmonic analysis and anterior segment optical coherence tomography. Preoperative data from 43 eyes of 41 BK patients who received corneal endothelial transplantation were compared with the data from 43 eyes of 43 subjects without corneal disease. Anterior and posterior cylinder power, central corneal thickness (CCT) and thinnest corneal thickness were significantly greater in BK. With Fourier harmonic analysis, BK eyes were found to have significantly larger anterior and posterior regular astigmatism, asymmetry component and higher-order irregularity. Asymmetry component and higher-order irregularity that accounted for the posterior irregular astigmatism increased as CCT increased in BK. Higher-order irregularity in the posterior cornea also positively correlated with worsening best corrected visual acuity. Subgroup analysis found significant correlations between CCT and posterior higher-order irregularity for intraocular surgery and laser iridotomy, but not Fuchs endothelial corneal dystrophy. This study has significance in that it revealed the characteristics of the corneal posterior irregular astigmatism of BK.
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Fourier analysis on irregular corneal astigmatism using optical coherence tomography in various severity stages of keratoconus. Am J Ophthalmol 2022; 243:55-65. [PMID: 35850250 DOI: 10.1016/j.ajo.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 11/23/2022]
Abstract
PURPOSE To investigate the diagnostic capability of Fourier indices in detecting clinical or subclinical keratoconus (KC). DESIGN Prospective cross-sectional study METHODS: : The study included 126 eyes with clinical KC (50 KC without any corneal scar, 50 KC with anterior corneal scar, and 26 KC with posterior scar having a history of acute corneal hydrops), 50 with topographic KC (without clinical signs), 50 with pre-topographic KC (normal topography without clinical signs), and 50 controls. Corneal tomographic data were obtained using anterior segment optical coherence tomography (OCT). Fourier analysis decomposed dioptric data from both anterior and posterior corneal surface into spherical, regular astigmatism, asymmetry, and higher-order irregularity components. The discriminating ability of the Fourier indices of pre-topographic KC, topographic KC, and clinical KC from controls were assessed after quantitative Fourier analysis of irregular corneal astigmatism. RESULTS Posterior asymmetry and higher-order irregularity components were significantly greater in pre-topographic KC eyes than those in controls (p<0.001 for both), with the highest area under the receiver operating characteristic curve (AUROC) of 0.778 and 0.709, respectively. The same was true for anterior asymmetry, posterior asymmetry, and posterior higher-order irregularity components in topographic KC (AUROC of 0.945, 0.941, and 0.893, respectively), whereas it was >0.948 for all Fourier components in clinical KC. CONCLUSIONS Fourier analysis using OCT can evaluate anterior and posterior corneal irregular astigmatism of various KC stages, from very mild to advanced, including severe cases with corneal scar. Irregular astigmatism indices from the posterior corneal surface showed the highest AUROC values in discriminating early KC stages.
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Oshika T, Nakano S, Fujita Y, Nomura Y, Inoue Y, Takehara H, Miyata K, Honbou M, Sugita T, Kaneko T. Long-term outcomes of cataract surgery with toric intraocular lens implantation by the type of preoperative astigmatism. Sci Rep 2022; 12:8457. [PMID: 35589932 PMCID: PMC9120159 DOI: 10.1038/s41598-022-12426-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 05/10/2022] [Indexed: 12/02/2022] Open
Abstract
Surgical outcomes of toric intraocular lens (IOL) implantation for 8 years after surgery were analyzed. Data were retrospectively collected in 176 eyes of 176 patients before and 1 month, 1, 3, 5, and 8 years after phacoemulsification and implantation of a toric IOL. Preoperative corneal and postoperative manifest astigmatism was analyzed by converting to power vector notations; horizontal/vertical (J0) and oblique (J45) astigmatism components. Toric IOL implantation significantly reduced pre-existing astigmatism by decreasing J0 in eyes with preoperative with-the-rule (WTR) astigmatism, increasing J0 in eyes with against-the-rule (ATR) astigmatism, and correcting J45 in eyes with oblique astigmatism. After surgery, the eyes with preoperative ATR astigmatism showed a significant ATR astigmatic shift, and J0 at 5 and 8 years was significantly smaller than that at 1 month postoperatively. Uncorrected distance visual acuity was also significantly worse at 5 and 8 years than at 1 month postoperatively. In eyes with WTR and oblique astigmatism, the effects of toric IOLs on astigmatism and visual acuity were sustained for 8 years. The long-term astigmatism-correcting effects did not differ among the models of toric IOL used in this study, SN6AT3–8 (Alcon Laboratories). In eyes with preoperative ATR astigmatism, astigmatism-correcting effects of toric IOLs decreased at 5 years and later postoperatively, indicating that overcorrection may be considered at the time of cataract surgery. In eyes with WTR and oblique astigmatism, the effects of toric IOLs were maintained throughout the 8-year follow-up period.
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Affiliation(s)
- Tetsuro Oshika
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Shinichiro Nakano
- Division of Ophthalmology, Ryugasaki Saiseikai Hospital, Ryugasaki, Ibaraki, Japan
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Harbiyeli II, Gul Olke K, Erdem E, Yagmur M. Correction of moderate to high refractive astigmatism with extended range toric soft contact lenses in patients with different patterns of astigmatism. Ophthalmic Physiol Opt 2022; 42:807-813. [PMID: 35333414 DOI: 10.1111/opo.12980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 02/20/2022] [Accepted: 02/21/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed to evaluate the visual performance of extended range, toric soft contact lenses (TSCLs) in patients with keratoconus and moderate to high astigmatism with different astigmatic patterns. METHODS This was a retrospective, cross-sectional clinical study. Extended range TSCL users with astigmatism ≥3.0 D were included. Cases were categorised into three subgroups, namely regular, irregular (non-keratoconus) and keratoconic based on the topographic pattern of astigmatism. In addition, subjects were subdivided based on the degree of astigmatism. RESULTS Fifty five patients (82 eyes) were enrolled, of whom 28 (51%) were female. The mean age was 24.2 ± 7.5 (range: 8-41 years) years. Thirty-six eyes with regular astigmatism (43.9%), 34 eyes with irregular astigmatism (41.5%) and 12 eyes with keratoconus (14.6%) were included. The percentage improvement in visual acuity (VA) was significantly higher with contact lenses compared with spectacles in all groups (p < 0.001), with the highest improvement in subjects with keratoconus (p = 0.03). Twenty six (31.7%), 30 (36.6%) and 26 eyes (31.7%) had moderate (-3.0 to -4.24 D), moderate/high (-4.25 to -5.99 D) and high (≤-6.0 D) astigmatism, respectively. The percentage improvement in VA with contact lenses was statistically significantly higher than for spectacle wear in all groups (p < 0.001). CONCLUSIONS This study demonstrated that satisfactory visual outcomes can be obtained with extended range TSCLs in patients having moderate to high astigmatism with different astigmatic patterns.
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Affiliation(s)
| | - Kubra Gul Olke
- Department of Ophthalmology, Seyhan State Hospital, Adana, Turkey
| | - Elif Erdem
- Department of Ophthalmology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Meltem Yagmur
- Department of Ophthalmology, Faculty of Medicine, Cukurova University, Adana, Turkey
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