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Salgado RMPC, Torres PFAAS, Marinho AAP. Pupil versus 1st Purkinje capsulotomy centration with femtosecond laser: Long term outcomes with a sinusoidal trifocal lens. JOURNAL OF BIOPHOTONICS 2024; 17:e202300446. [PMID: 38414335 DOI: 10.1002/jbio.202300446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/01/2023] [Accepted: 01/28/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE To assess the role of femtosecond laser-assisted capsulotomy centration in the long-term intraocular positioning of a multifocal intraocular lens. DESIGN Prospective comparative study. METHODS A total of 60 eyes of 30 patients underwent femtosecond laser-assisted Refractive Lens Exchange (RLE). For every patient, capsulotomy centration was randomly performed according to pupil centre (PC) in one eye and first Purkinje reflex (FPR) in the other. The intraocular lens (IOL) positioning, visual acuities, spherical equivalent, internal aberrometry and quality of vision were assessed and compared at 3 years' follow-up between groups (PC and FPR). RESULTS Intraocular lens positioning showed a statistically significant difference between groups, with a closer centration to the visual axis in the FPR patients (p < 0.001). Internal aberrometry showed higher values in the PC capsulotomy centration group (p < 0.01). CONCLUSIONS FPR centered capsulotomy is associated to a closer centration of the IOL to the visual axis.
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Affiliation(s)
- Ramiro M P C Salgado
- Departamento de Oftalmologia do Hospital da Arrábida, Hospital de Santo António, Centro Hospitalar e Universitário do Porto, Portugal
| | - Paulo F A A S Torres
- Departamento de Oftalmologia do Hospital da Prelada, Universidade do Porto, Portugal
| | - António A P Marinho
- Departamento de Oftalmologia do Hospital da Luz Arrábida, Universidade do Porto, Portugal
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Ye Y, Zhao Y, Zhang Z, Wei R, Xian Y, Huang Y, Liu F, Xu Y, Zhou X. Correlation analysis of angles κ and α with the refraction and anterior segment parameters in children. BMC Ophthalmol 2024; 24:143. [PMID: 38549060 PMCID: PMC10976721 DOI: 10.1186/s12886-024-03409-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 03/24/2024] [Indexed: 04/01/2024] Open
Abstract
AIM To investigate the correlation of angles α and κ with the refractive and biological parameters in children. METHODS This case-series study included 438 eyes of 219 children (males/females = 105/114, age: 3-15 years). Ocular biometric parameters, including axial length, corneal radius of curvature (CR), white-to-white distance (WTW), angle κ and angle α, were measured using IOL Master 700; auto-refraction were assessed under cycloplegia. The eyes were assigned to different groups based on CR, WTW, and gender to compare the angles α and κ, and analyze the correlations between the differences of biological parameters on angles α and κ. RESULTS The means of axial length, CR, WTW, angle α, and angle κ were 23.24 ± 1.14 mm, 7.79 ± 0.27 mm, 11.68 ± 0.41 mm, 0.45 ± 0.25 mm, and 0.27 ± 0.22 mm, respectively. Angle α was correlated with CR and WTW (fixed effect coefficient [FEC] = 0.237, p = 0.015; FEC = -0.109, p = 0.003; respectively), and angle κ also correlated with CR and WTW (FEC = 0.271, p = 0.003; FEC = -0.147, p < 0.001, respectively). Comparing subgroups, the large CR and small WTW group had larger angles α (0.49 ± 0.27 vs. 0.41 ± 0.21, p < 0.001; 0.46 ± 0.27 vs. 0.44 ± 0.21, p < 0.05, respectively) and κ (0.29 ± 0.25 vs. 0.24 ± 0.15, p < 0.01; 0.29 ± 0.25 vs. 0.26 ± 0.19, p < 0.05, respectively). The differences in interocular angles α and κ showed correlation with interocular WTW (r = - 0.255, p < 0.001; r = - 0.385, p < 0.001). Eyes with smaller WTW tended to have larger angle κ (0.28 ± 0.27 vs. 0.25 ± 0.15, p < 0.05). CONCLUSION The size of angle α/κ may be correlated to CR and WTW, and a larger WTW eye may suggest a smaller angle κ compared with the fellow eye.
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Affiliation(s)
- Yuhao Ye
- Department of Ophthalmology and Optometry, Eye and ENT Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Yu Zhao
- Department of Ophthalmology and Optometry, Eye and ENT Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Zhe Zhang
- Department of Ophthalmology and Optometry, Eye and ENT Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Ruoyan Wei
- Department of Ophthalmology and Optometry, Eye and ENT Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Yiyong Xian
- Department of Ophthalmology and Optometry, Eye and ENT Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Yangyi Huang
- Department of Ophthalmology and Optometry, Eye and ENT Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Fang Liu
- Department of Ophthalmology and Optometry, Eye and ENT Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Ye Xu
- Department of Ophthalmology and Optometry, Eye and ENT Hospital of Fudan University, Shanghai, China.
- NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China.
| | - Xingtao Zhou
- Department of Ophthalmology and Optometry, Eye and ENT Hospital of Fudan University, Shanghai, China.
- NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China.
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Qian Y, Ding L, Ding Y, Jiang L, Liu Z, Zhou X. Measurement of the distance between corneal apex and pupil center in patients following small-incision lenticule extraction or implantable collamer lens implantation and its correlation with the surgical-induced astigmatism. BMC Ophthalmol 2024; 24:110. [PMID: 38454381 PMCID: PMC10918991 DOI: 10.1186/s12886-024-03352-6] [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: 08/13/2023] [Accepted: 02/15/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND To investigate the change in the distance between corneal apex and pupil center after small-incision lenticule extraction (SMILE) or implantable collamer lens (ICL) implantation and its correlation with surgical-induced astigmatism (SIA). METHODS This study included patients who had undergone SMILE (n = 112) or ICL implantation (n = 110) to correct myopia and myopic astigmatism. The angle kappa was measured using a Scheimpflug imaging device (Pentacam) and represented as Cartesian values between the pupil center and the corneal vertex (X, Y) and chord u ([Formula: see text]orientation), and was compared pre- and post-operative. RESULTS Following SMILE, the magnitude of chord u[Formula: see text]) significantly increased in both eyes (Wilcoxon signed-rank test, OD: P<0.001; OS: P=0.007), while no significant change was observed in the orientation. A significant correlation was found between the J0 component of SIA and the change in the magnitude of chord u for both eyes (OD: R2=0.128, P<0.001; OS: R2=0.033, P=0.004). After ICL implantation, the orientation of the chord u was significantly different in the right eye (Wilcoxon signed-rank test, P = 0.008), and the Y-intercept significantly decreased in both eyes (Wilcoxon signed-rank test, P<0.001). A significant correlation was found between J0 of SIA and the change in the magnitude of chord u for the right eyes (R2=0.066, P=0.002). A significant correlation was found between J45 of SIA and the change in the magnitude of chord u for the left eyes (R2=0.037, P=0.044). CONCLUSIONS The magnitude of the chord u increased following the SMILE procedure, whereas the Y-intercept significantly decreased after ICL implantation. SIA was related to the change in the magnitude of chord u.
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Affiliation(s)
- Yishan Qian
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, People's Republic of China.
- NHC Key Laboratory of Myopia, Fudan University, 83th Fenyang Rd, Shanghai, 200031, People's Republic of China.
| | - Lan Ding
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, People's Republic of China
- NHC Key Laboratory of Myopia, Fudan University, 83th Fenyang Rd, Shanghai, 200031, People's Republic of China
| | - Yanlan Ding
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, People's Republic of China
- NHC Key Laboratory of Myopia, Fudan University, 83th Fenyang Rd, Shanghai, 200031, People's Republic of China
| | - Lin Jiang
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, People's Republic of China
- NHC Key Laboratory of Myopia, Fudan University, 83th Fenyang Rd, Shanghai, 200031, People's Republic of China
| | - Zesheng Liu
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, People's Republic of China
- NHC Key Laboratory of Myopia, Fudan University, 83th Fenyang Rd, Shanghai, 200031, People's Republic of China
| | - Xingtao Zhou
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, People's Republic of China.
- NHC Key Laboratory of Myopia, Fudan University, 83th Fenyang Rd, Shanghai, 200031, People's Republic of China.
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Pašková B, Marešová K, Schreiberová Z, Malušková M, Karhanová M. Evaluation of Clinical Results of Implantation of Toric Intraocular Lenses Including their Rotational Stability. CESKA A SLOVENSKA OFTALMOLOGIE : CASOPIS CESKE OFTALMOLOGICKE SPOLECNOSTI A SLOVENSKE OFTALMOLOGICKE SPOLECNOSTI 2024; 80:146-153. [PMID: 38413224 DOI: 10.31348/2024/10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
PURPOSE The aim of the study was to evaluate the clinical results of the implantation of the toric intraocular lens Acrysof IQ Toric SN6AT3_8 (Alcon Laboratories, Inc., Fort Worth, TX, USA), including an evaluation of its rotational stability. MATERIAL AND METHODS 30 eyes of 16 patients (4 males, 12 females; mean age 68 years) with regular corneal astigmatism ranging from -1.5 to -4.0 Dcyl were included in this retrospective study. All the patients underwent uncomplicated cataract surgery with the implantation of a toric intraocular lens (TIOL) at the Department of Ophthalmology of the Faculty of Medicine and Dentistry of Palacký University in Olomouc and University Hospital Olomouc during the course of 2020. Follow-up examinations were performed 3-6 months after cataract surgery. We monitored the resulting uncorrected distance visual acuity (UDVA), postoperative refraction, rotational stability of the implanted lens and subjective patient satisfaction. RESULTS mean preoperative corneal astigmatism was -2.41 ±0.67 Dcyl. UDVA improved from a mean value of 0.45 ±0.25 (expressed in decimal Snellen optotype values) to 0.91 ±0.16. The spherical equivalent value of 0.41 ±2.92 improved to -0.11 ±0.27 postoperatively. The mean deviation from the planned axis was 4.87 ±4.75. Subjective satisfaction was rated by patients on a scale of 1-5, with a mean score of 1.5. CONCLUSION TIOL implantation is a safe and effective solution for patients with corneal astigmatism and cataract. Our results demonstrate improved UDVA, rotational stability of the TIOL and subjective patient satisfaction with the outcome of the surgery.
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Kim NH, Kim HJ, Cho SC, Han KE. Repeatability and Agreement of Chord Mu between Scheimpflug Tomography and Swept-Source Optical Coherence Tomography. KOREAN JOURNAL OF OPHTHALMOLOGY 2023; 37:510-517. [PMID: 37899279 PMCID: PMC10721399 DOI: 10.3341/kjo.2023.0092] [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: 09/07/2023] [Revised: 10/01/2023] [Accepted: 10/13/2023] [Indexed: 10/31/2023] Open
Abstract
PURPOSE To evaluate repeatability and agreement of chord mu between Scheimpflug tomography (Pentacam HR) and sweptsource optical coherence tomography-based optical biometer (IOLMaster 700). METHODS In this retrospective study, 63 eyes from 33 patients were included. Chord mu, X and Y Cartesian distances between the corneal vertex and the pupil center (Px and Py), and the pupil diameter were compared using two instruments. Repeatability was evaluated using intraclass correlation coefficient (ICC), coefficient of variation (CoV), and within-subject standard deviation (Sw). Interdevice agreement was evaluated using paired t-tests and Bland-Altman plots. RESULTS Although Sw values for all parameters were similar between the two devices, CoV values of chord mu and pupil diameter were lower, and ICC values of those parameters were higher, in the IOLMaster 700 than in the Pentacam HR. Chord mu and pupil diameter values were higher in IOLMaster 700 than Pentacam HR (p < 0.01). The width of the 95% limit of agreement was wide for all parameters. CONCLUSIONS IOLMaster 700 showed better repeatability than Pentacam HR in chord mu, Px, Py, and pupil diameter values. Because there were statistically significant differences and a low level of agreement in chord mu and pupil diameter values between the two devices, they cannot be used interchangeably.
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Affiliation(s)
- Na Hyun Kim
- Department of Ophthalmology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hyun Jin Kim
- Department of Ophthalmology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea
| | - Soo Chang Cho
- Department of Ophthalmology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea
| | - Kyung Eun Han
- Department of Ophthalmology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea
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Wallerstein A, Ridgway C, Gatinel D, Debellemanière G, Mimouni M, Albert D, Cohen M, Lloyd J, Gauvin M. Angle Kappa Influence on Multifocal IOL Outcomes. J Refract Surg 2023; 39:840-849. [PMID: 38063828 DOI: 10.3928/1081597x-20231101-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
PURPOSE To characterize angle kappa and study the relationship between preoperative angle kappa and postoperative refractive accuracy, visual outcomes, and patient satisfaction in a large population of eyes with multifocal intraocular lens (MIOL) implantation. METHODS A comprehensive electronic medical record chart review of 26,470 consecutive eyes that underwent immediate sequential bilateral cataract or refractive lens exchange with MIOLs was conducted. The primary outcome measures were postoperative monocular uncorrected distance visual acuity (UDVA), manifest refraction sphere and cylinder, spherical equivalent (SEQ), defocus equivalent (DEQ), subjective quality of vision at near, intermediate, and distance, and the likelihood of recommending the procedure. Relationships between preoperative angle kappa and postoperative outcomes were assessed with Pearson correlations. RESULTS Angle kappa followed a right-skewed normal distribution (R2 = 0.99) with a mean ± standard deviation of 0.64 ± 0.27 mm. No clinically meaningful relationship was found between preoperative angle kappa and postoperative sphere, cylinder, SEQ, and DEQ, all with R2 ⩽ 0.0005. Similarly, there was no clinically meaningful relationship between preoperative angle kappa and postoperative UDVA (R2 = 0.001), postoperative satisfaction for near, intermediate, and distance vision (all R2 ⩽ 0.0023), or for recommending the MIOL surgery to friends and relatives (R2 = 0.0000). CONCLUSIONS Preoperative angle kappa does not have a predictive clinical impact on postoperative MIOL visual outcomes, refractive accuracy, or subjective patient satisfaction. Angle kappa as a single variable cannot be used to determine MIOL candidacy. [J Refract Surg. 2023;39(12):840-849.].
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Guo L, Cheng Z, Kong X, Huang Z, Xu X, Wu J, Lv H. The effect of different angle kappa on higher-order aberrations after small incision lenticule extraction. Lasers Med Sci 2023; 38:277. [PMID: 38012462 PMCID: PMC10682276 DOI: 10.1007/s10103-023-03934-8] [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: 02/20/2023] [Accepted: 11/12/2023] [Indexed: 11/29/2023]
Abstract
This study aimed to compare higher-order aberrations (HOAs) after small incision lenticule extraction (SMILE) in patients with different angle kappa. This is a retrospective report in which 341 right eyes of 341 patients who were subjected to SMILE, which used coaxially sighted corneal light reflex (CSCLR) as the treatment zone centered, treated by the same experienced surgeon (LHB) for correction of myopia and myopic astigmatism, preoperative and postoperative spherical equivalent (SE), angle kappa, total higher-order aberrations (total HOA), spherical aberration (SA), vertical coma (VC), horizontal coma (HC), oblique trefoil (OT), and horizontal trefoil (HT), were compared. SMILE showed outstanding performance in terms of safety, efficacy, and predictability. In addition, a comparison of preoperative and postoperative HOAs exhibited the difference of total HOA (P < 0.01), SA (P < 0.01), VC (P < 0.01), and HC (P < 0.01), which was statistically significant; however, for OT and HT with the longer follow-up time, the statistical difference gradually decreased. For stratification of angle kappa into groups based on decantation, angle kappa was divided into three major groups: r < 0.1 mm, 0.1 ≤ r < 0.2 mm, and r ≥ 0.2 mm; the changes of SA (F = 4.127, P = 0.021) and OT (F = 3.687, P = 0.031) exhibited significant difference after 1 year of SMILE. We performed a correlation analysis of all preoperative and postoperative parameters, and the results indicated that the preoperative total HOA was negatively correlated with preoperative cylindrical diopter (DC), and postoperative total HOA, SA, and coma were affected by spherical diopter (DS) and SE. Moreover, we also found a significant difference of SA and VC in the early postoperative with preoperative. SA was positively correlated with Y values and r of 1 year after SMILE. All of the analyzed parameters in the three groups, except for the trefoil, gradually increased over time; however, the trefoil could gradually stabilize over time. We also divided angle kappa into four groups by quadrants; the result showed that the effects of higher-order aberrations were markedly different from the various quadrants. Patients with large angle kappa were able to increase VC and SA postoperatively, and higher HOAs were more significant in patients with high myopia. The differences in quadrants exhibited a diversity of HOAs; this could be attributed to the corneal surface reestablishment and the alteration of angle kappa, but the trend was not apparent. Although all patients displayed increased HOAs after SMILE, the potential application of CSCLR as the treatment zone centered still showed excellent safety, efficacy, and predictability.
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Affiliation(s)
- Lu Guo
- The First Affiliated Hospital of Jinan University, Guangzhou, 510000, Guangdong Province, China
- The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Zixuan Cheng
- The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Xiangmei Kong
- The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Zhaoxia Huang
- The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Xue Xu
- The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Jinchuan Wu
- The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Hongbin Lv
- The First Affiliated Hospital of Jinan University, Guangzhou, 510000, Guangdong Province, China.
- The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan Province, China.
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Kaya Ünsal S, Sunay E. The Impact of Angle Lambda on Patient Satisfaction after Optiflex Trio Trifocal Intraocular Lens Implantation. J Ophthalmol 2023; 2023:7911449. [PMID: 37362312 PMCID: PMC10290561 DOI: 10.1155/2023/7911449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 06/07/2023] [Accepted: 06/09/2023] [Indexed: 06/28/2023] Open
Abstract
Purpose To evaluate the vision-related quality of life (QOL), visual acuities, and refractive outcomes of patients with different angle lambda (λ) after a trifocal intraocular lens (IOL) implantation at Veni Vidi Eye Hospital, İstanbul, Turkey. Methods This retrospective, nonrandomized, and noncomparative case series included patients who had phacoemulsification bilaterally with the implantation of a trifocal IOL (Optiflex Trio) and responded to a vision-related QOL questionnaire measuring patient satisfaction. The patients were divided into two groups according to the angle λ with a cutoff value of 0.5 mm. Evaluations were conducted to examine the monocular visual acuities, spherical equivalents, corneal astigmatism measured 3 months after surgery, and outcomes of the QOL questionnaire in the two groups. Results The study examined 130 eyes from 65 patients aged from 41 to 78 years old. There were no statistically significant differences between the two groups at 3 months after surgery in terms of uncorrected distance visual acuity (UDVA), monocular uncorrected intermediate visual acuity (UIVA), monocular uncorrected near visual acuity (UNVA), spherical equivalent, and corneal astigmatism (P > 0.05). Patients with a greater angle λ had significantly more difficulty going out to see movies, plays, or sporting events (P=0.02), driving at night (P=0.002), and driving in difficult conditions (P < 0.001) than patients with a lower angle λ. Conclusions The Optiflex Trio showed good results in terms of visual acuity at all distances, positive refractive outcomes, and high patient satisfaction in daily life according to the QOL questionnaire. An angle λ greater than 0.5 mm may potentially cause dysphotopsia symptoms, especially during nighttime activities.
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Affiliation(s)
| | - Ertan Sunay
- Veni Vidi Eye Hospital, Istanbul 34728, Turkey
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Liu Z, Zhao Y, Sun S, Wu Y, Wang G, Zhao S, Huang Y. Effect of preoperative pupil offset on corneal higher-order aberrations after femtosecond laser-assisted in situ keratomileusis. BMC Ophthalmol 2023; 23:247. [PMID: 37264322 DOI: 10.1186/s12886-023-02960-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 05/04/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND This study aimed to investigate the relationship between multiple higher-order aberrations (HOAs) subgroups and pupil offset, as well as to analyze the factors affecting postoperative corneal HOAs in patients with different degrees of refractive errors. METHODS We enrolled 160 patients (316 eyes) aged ≥ 18 years who had undergone femtosecond laser-assisted in situ keratomileusis (FS-LASIK) treatment. Based on the relationship between the preoperative pupil offset and the postoperative ΔHOAs, all patients were divided into two groups: group I (pupil offset ≤ 0.20 mm) and group II (pupil offset > 0.20 mm). All of the eyes had low to high myopia with or without astigmatism (manifest refraction spherical equivalent (MRSE) < -10.00 D). Uncorrected distance visual acuity, corrected distance visual acuity, MRSE, pupil offset, central corneal thickness, corneal HOAs, vertical coma (Z3-1), horizontal coma (Z31), spherical aberration (Z40), trefoil 0° (Z33), and trefoil 30° (Z3-3) over a 6 mm diameter central corneal zone diameter were evaluated preoperatively and at 1 and 3 months postoperatively. RESULTS Our result revealed significant differences in postoperative corneal total root mean square (RMS) HOAs, RMS vertical coma, RMS horizontal coma, RMS spherical aberration, and RMS trefoil 30° between group I and group II. ΔMRSE was found to be an effective factor for ΔRMS HOAs (R2 = 0.383), ΔRMS horizontal coma (R2 = 0.205), and ΔRMS spherical aberration (R2 = 0.397). In group II, multiple linear regression analysis revealed a significant correlation between preoperative pupillary offset and Δtotal RMS HOAs (R2 = 0.461), ΔRMS horizontal coma (R2 = 0.040), and ΔRMS trefoil 30°(R2 = 0.089). The ΔRMS vertical coma effect factor is the Y-component, and the factor influencing ΔRMS spherical aberration was ΔMRSE (R2 = 0.256). CONCLUSION A small pupil offset was associated with a lower induction of postoperative corneal HOAs. Efforts to optimize centration are critical for improving surgical outcomes in patients with FS-LASIK.
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Affiliation(s)
- Zhanglin Liu
- Tianjin Medical University Eye Hospital, Eye Institute and School of Optometry, Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin, 300384, China
| | - Yang Zhao
- Tianjin Medical University Eye Hospital, Eye Institute and School of Optometry, Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin, 300384, China
| | - Shengshu Sun
- Tianjin Medical University Eye Hospital, Eye Institute and School of Optometry, Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin, 300384, China
| | - Yuan Wu
- Aier Eye Hospital, Shanxi, 030006, China
| | - Guiqin Wang
- Tianjin Medical University Eye Hospital, Eye Institute and School of Optometry, Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin, 300384, China
| | - Shaozhen Zhao
- Tianjin Medical University Eye Hospital, Eye Institute and School of Optometry, Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin, 300384, China
| | - Yue Huang
- Tianjin Medical University Eye Hospital, Eye Institute and School of Optometry, Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin, 300384, China.
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Xie M, Deng Y, Sun C, Qiu L, Tang J. Higher-order aberrations and visual quality after incision lenticule extraction surgery with intraoperative angle kappa adjustments between small and large kappa patients: A 2-year follow-up. Indian J Ophthalmol 2023; 71:1849-1854. [PMID: 37203043 PMCID: PMC10391436 DOI: 10.4103/ijo.ijo_3017_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
Purpose To evaluate the postoperative visual outcomes, that is, corneal higher-order aberrations (HOAs) and visual quality, of patients with an angle kappa greater than 0.30 mm who underwent angle kappa adjustment during small-incision lenticule extraction (SMILE) 2 years after surgery compared to eyes with an angle kappa less than 0.30 mm. Methods This was a retrospective study and included 12 patients from October 2019 to December 2019 who underwent the SMILE procedure for correction of myopia and myopic astigmatism and had one eye with a large kappa angle and another eye with a small kappa angle. Twenty-four months after surgery, an optical quality analysis system (OQAS II; Visiometrics, Terrassa, Spain) was used to measure the modulation transfer function cutoff frequency (MTFcutoff), Strehl2D ratio, and objective scatter index (OSI). HOAs were measured with a Tracey iTrace Visual Function Analyzer (Tracey version 6.1.0; Tracey Technologies, Houston, TX, USA). Assessment of subjective visual quality was achieved using the quality of vision (QOV) questionnaire. Results At 24 months postoperatively, the mean spherical equivalent (SE) refraction was - 0.32 ± 0.40 and - 0.31 ± 0.35 in the S-kappa group (kappa <0.3 mm) and the L-kappa group (kappa ≥0.3 mm), respectively (P > 0.05). The mean OSI was 0.73 ± 0.32 and 0.81 ± 0.47, respectively (P > 0.05). There was no significant difference in MTFcutoff and Strehl2D ratio between the two groups (P > 0.05). Total HOA, coma, spherical, trefoil, and secondary astigmatism were not significantly different (P > 0.05) between the two groups. Conclusion Adjustment of angle kappa during SMILE helps reduce the decentration, results in less HOAs, and promotes visual quality. It provides a reliable method to optimize the treatment concentration in SMILE.
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Affiliation(s)
- Mengzhen Xie
- Department of Ophthalmology, West China Hospital, Sichuan University; West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Yingping Deng
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chengshu Sun
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lemei Qiu
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jing Tang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Garcia Espinilla O, Sanchez I, Martin R. Intrasession repeatability and agreement of a new method to measure the foveal fixation axis. PeerJ 2023; 11:e14942. [PMID: 36860763 PMCID: PMC9969851 DOI: 10.7717/peerj.14942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 02/01/2023] [Indexed: 02/26/2023] Open
Abstract
Purpose Ophthalmic lens adaptation, particularly with progressive addition lenses, requires accurate measurements of the patient nasopupillary distance (NPD) and interpupillary distance (IPD), which are usually collected using the pupil centre as a reference. However, differences between the pupil centre and visual or foveal axis could induce some subsidiary effects of correcting lenses. This study aimed to assess the intrasession repeatability of a new prototype (Ergofocus®; Lentitech, Barakaldo, Spain) that can measure the foveal fixation axis (FFA) distance and assess the agreement with the NPD measurements collected using a traditional method (frame ruler). Methods The FFA at far and near distances was measured three consecutive times in 39 healthy volunteers to determine the intrasession repeatability according to the British Standards Institute and International Organization for Standardization. Additionally, the FFA and NPD (standard frame ruler) were measured in 71 healthy volunteers and compared using Bland-Altman analysis. Two blinded experienced practitioners conducted each FFA and NPD measurement. Results The FFA measurements showed acceptable repeatability at far distances (right eye (RE): Sw = 1.16 ± 0.76 mm and coefficient of variation (CV) = 3.92 ± 2.51%; left eye (LE) Sw = 1.11 ± 0.79 mm and CV = 3.76 ± 2.51%) and at near distances (RE: Sw = 0.97 ± 0.85 mm and CV = 3.52 ± 3.02%; LE: Sw = 1.17 ± 0.96 mm and CV = 4.54 ± 3.72%). Additionally, agreement with the NPD showed large differences at far distances (RE: -2.15 ± 2.34, LoA = -6.73 to 2.43 mm (P < 0.001); LE: -0.61 ± 2.62, LoA = -5.75 to 4.53 mm (P = 0.052)) and near distances (RE: -3.08 ± 2.80, LoA -8.57 to 2.42 mm (P < 0.001); LE: -2.97 ± 3.97, LoA: -10.75 to 4.80 mm (P < 0.001)). Conclusions FFA measurements showed clinically acceptable repeatability at both far and near distances. Agreement with the NPD measured using a standard frame ruler showed significant differences, suggesting that both measurements are not interchangeable in clinical practice to prescribe and center ophthalmic lenses. Further research is necessary to assess the impact of FFA measurement in ophthalmic lens prescriptions.
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Affiliation(s)
- Oscar Garcia Espinilla
- Optometry Research Group, IOBA Eye Institute, School of Optometry, Universidad de Valladolid, Valladolid, Castilla y Leon, Spain,Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Castilla y Leon, Spain,Departamento de Física Teórica, Atómica y Óptica, Universidad de Valladolid, Valladolid, Castilla y Leon, Spain
| | - Irene Sanchez
- Optometry Research Group, IOBA Eye Institute, School of Optometry, Universidad de Valladolid, Valladolid, Castilla y Leon, Spain,Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Castilla y Leon, Spain,Departamento de Física Teórica, Atómica y Óptica, Universidad de Valladolid, Valladolid, Castilla y Leon, Spain
| | - Raul Martin
- Optometry Research Group, IOBA Eye Institute, School of Optometry, Universidad de Valladolid, Valladolid, Castilla y Leon, Spain,Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Castilla y Leon, Spain,Departamento de Física Teórica, Atómica y Óptica, Universidad de Valladolid, Valladolid, Castilla y Leon, Spain
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Reliability and agreement of apparent chord mu measurements between static and dynamic evaluations. J Cataract Refract Surg 2023; 49:21-28. [PMID: 36573762 DOI: 10.1097/j.jcrs.0000000000001036] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 07/26/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE To assess the repeatability and agreement of Cartesian coordinates and the length of apparent chord mu and pupil diameter measurements during static (Galilei G4) and dynamic (Topolyzer Vario) evaluations. SETTING IOBA-Eye Institute, Valladolid, Spain. DESIGN Case series. METHODS 3 consecutive measurements per scenario (Galilei G4 and Topolyzer Vario under low mesopic and photopic conditions) were performed by the same clinician. The intrasession repeatability was assessed using the within-subject SD (Sw), the precision, the coefficient of variation, and the intraclass correlation coefficient (ICC). The agreement was analyzed using repeated-measures analysis of variance and the Bland-Altman method. RESULTS Thirty-seven healthy participants were recruited. The Sw values for chord mu parameters and pupil diameter ranged from 0.01 to 0.03 and 0.08 to 0.21, respectively. The ICC was ≥0.89 for all parameters. Galilei G4 and Topolyzer Vario under low mesopic and photopic conditions provided significantly different measures of apparent chord mu length (0.23 ± 0.11 mm, 0.30 ± 0.10 mm, and 0.25 ± 0.11 mm, respectively, P ≤ .02), X-coordinate (-0.18 ± 0.12 mm, -0.27 ± 0.11 mm, and -0.21 ± 0.12 mm, respectively, P < .001), and pupil diameter (3.38 ± 0.50 mm, 6.29 ± 0.60 mm, and 3.04 ± 0.41 mm, respectively, P < .001). Y-coordinate values obtained by Galilei G4 and Topolyzer Vario under low mesopic conditions were significantly different (0.06 ± 0.13 mm vs 0.03 ± 0.11 mm, respectively, P = .02), in contrast to Galilei G4 and Topolyzer Vario under photopic conditions (0.05 ± 0.13 mm, P = .82) and both illumination conditions of Topolyzer Vario (P ≥ .23). CONCLUSIONS Galilei G4 and Topolyzer Vario provide consistent measurements of apparent chord mu Cartesian coordinates and length, as well as pupil diameter; however, the measurements are not interchangeable. Ophthalmic surgeons should consider these findings when planning customized intraocular lens implantation and refractive surgery procedures.
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Awad-Allah MAA, Gharieb HM, Zaki RGE, Othman IS. Angle Kappa agreement between Scheimpflug tomography, combined placido Scheimpflug and combined slit scanning placido systems. Int Ophthalmol 2023; 43:381-386. [PMID: 35902424 PMCID: PMC9971106 DOI: 10.1007/s10792-022-02433-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 07/05/2022] [Indexed: 10/16/2022]
Abstract
PURPOSE To compare the measured or calculated angle Kappa using Oculus pentacam HR, Sirius and Orbscan III devices. PATIENTS AND METHODS A prospective randomized cohort study, conducted on 47 eyes of 47 healthy orthotropic individuals, with an age range of 18-50 years and a corrected Snellen's distance visual acuity (CDVA) of 0.8 decimal or better. Angle Kappa is assessed directly using Orbscan® III software version 1.8.165.1. (Bausch and Lomb Rochester, New York, United States), while Pentacam® HR 1.21r.65 (Oculus Optikgeräte GmbH, Wetzlar, Germany) and Sirius device (CSO, version 3.2.1.60, Costruzione Strumenti Oftalmici, Florence, Italy) were used to calculate angle kappa indirectly. RESULTS Least mean difference of estimated angle Kappa was between Orbscan and Pentacam devices (- 0.18° ± 1.8), and it was statistically insignificant (p value = 0.1294). Differences between both Orbscan and Sirius, and Pentacam and Sirius were statistically significant (p value = 0.0004 and < 0.0001 consecutively). Bland Altman analysis showed a 95% confidence interval between Orbscan III and Pentacam of - 3.76 to 3.4 and between Orbscan III and Sirius of - 3.79 to 2.26. CONCLUSION Pentacam parameters can be used as a reliable method to calculate angle kappa indirectly, without usage of any additional measurements from other machine. Sirius device parameters could also be used, but with less accurate results. A simple modification to those devices' software to calculate it, and incorporate it in the printout is possible, and highly recommended.
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Bang SP, Lyu J, Ng CJ, Yoon G. Visual Axis and Stiles-Crawford Effect Peak Show a Positional Correlation in Normal Eyes: A Cohort Study. Invest Ophthalmol Vis Sci 2022; 63:26. [PMID: 36306143 PMCID: PMC9624269 DOI: 10.1167/iovs.63.11.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 10/03/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to locate the visual axis and evaluate its correlation with the Stiles-Crawford effect (SCE) peak. Methods Ten young, healthy individuals (20 eyes) were enrolled. An optical system was developed to locate the visual axis and measure SCE. To locate the visual axis, 2 small laser spots at 450 nm and 680 nm were co-aligned and delivered to the retina. The participants were asked to move a translatable pinhole until these spots were perceived to overlap each other. The same system assessed SCE at 680 nm using a bipartite, 2-channel (reference and test) Maxwellian-view optical system. The peak positions were estimated using a two-dimensional Gaussian fitting function and correlated with the visual axis positions. Results Both the visual axis (x = 0.24 ± 0.35 mm, y = -0.16 ± 0.34 mm) and the SCE peak (x = 0.27 ± 0.35 mm, y = -0.15 ± 0.31 mm) showed intersubject variability among the cohort. The SCE peak positions were highly correlated in both the horizontal and vertical meridians to the visual axes (R2 = 0.98 and 0.96 for the x and y coordinates, respectively). Nine of the 10 participants demonstrated mirror symmetry for the coordinates of the visual axis and the SCE peak between the eyes (R2 = 0.71 for the visual axis and 0.76 for the SCE peak). Conclusions The visual axis and SCE peak locations varied among the participants; however, they were highly correlated with each other for each individual. These findings suggest a potential mechanism underlying the foveal cone photoreceptor alignment.
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Affiliation(s)
- Seung Pil Bang
- Department of Biomedical Engineering, University of Rochester, Rochester, New York, USA
| | - Jiakai Lyu
- Institute of Optics, University of Rochester, Rochester, New York, USA
| | - Cherlyn J. Ng
- College of Optometry, University of Houston, Houston, Texas, USA
| | - Geunyoung Yoon
- College of Optometry, University of Houston, Houston, Texas, USA
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Salouti R, Nowroozzadeh MH, Azizi A, Salouti K, Ghoreyshi M, Oboodi R, Tajbakhsh Z. Angle κ and its effect on the corneal elevation maps in refractive surgery candidates. J Cataract Refract Surg 2022; 48:1148-1154. [PMID: 35404317 DOI: 10.1097/j.jcrs.0000000000000953] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 04/03/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess the associations of angle κ and Pentacam decentration indices with elevation maps in normal refractive surgery candidates. SETTING Salouti Cornea Research Center, Salouti Eye Clinic, Shiraz, Iran. DESIGN Retrospective observational study. METHODS In this research, the right eyes of 173 refractive surgery candidates were assessed. Data of front and back corneal elevation maps, keratometric data, decentration indices, and corneal astigmatism obtained by Pentacam HR system and angle κ obtained by Orbscan IIz were extracted. Maximum elevation (or depression) for each of the 4 quadrants was recorded. Correlations of elevation values with angle κ, Pentacam decentration indices, keratometry, and astigmatism were examined by Pearson correlation coefficient. 148 age- and sex-matched cases with keratoconus grade 1 were selected as a positive control group, and Pentacam variables were compared between the groups. RESULTS Overall, data from 173 eyes of 173 normal refractive surgery candidates and 148 eyes of 148 patients with keratoconus were recorded and analyzed. In normal refractive surgery candidates, the mean of angle κ was 5.32 ± 1.36 (SD) degrees. Angle κ had a positive correlation with front and back temporal elevations based on a best-fit sphere (BFS) ( r = 0.339, P = .001; r = 0.300, P < .001, respectively). Front and back keratometric astigmatisms were positively correlated with front and back nasal and temporal elevations ( r ≥ 0.543, P < .001) and negatively correlated with superior and inferior elevations ( r ≤ -0.547, P < .001). These associations no longer existed when using best-fit toric ellipse (BFTE) for calculating elevation data. The thinnest point to vertex decentration was significantly associated with the back temporal elevation (based on the BFTE) in both normal ( r = 0.311, P < .001) and keratoconus ( r = 0.190, P = .021) eyes. CONCLUSIONS This study showed that elevation maps obtained by the Pentacam system using BFS might be affected by both the large angle κ and corneal astigmatism, confounding the preoperative assessment of refractive surgery candidates. Using BFTE as a reference for calculating elevation data should eliminate most diagnostic issues and thus is encouraged in this context.
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Affiliation(s)
- Ramin Salouti
- From the Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran (R. Salouti, Nowroozzadeh, Oboodi); Salouti Cornea Research Center, Salouti Eye Clinic, Shiraz, Iran (R. Salouti, Azizi, Ghoreyshi); Science Department, The University of British Columbia, Vancouver, Canada (K. Salouti); Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran (Ghoreyshi); School of Optometry and Vision Science, University of New South Wales, Sydney, Australia (Tajbakhsh)
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Deng WQ, Fang YH, Lin SH, Li YJ. Dynamic distribution and correlation analysis of the angle kappa in myopia patients undergoing femtosecond-assisted laser in situ keratomileusis. Medicine (Baltimore) 2022; 101:e29425. [PMID: 35713451 PMCID: PMC9276180 DOI: 10.1097/md.0000000000029425] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 04/19/2022] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To explore the offset distribution of pupillary centres, the offset between the pupil centre and the coaxially sighted corneal light reflex (P-Dist) and their correlation in femtosecond laser combined with excimer laser in situ keratomileusis. METHODS Randomly selected 194 patients (398 eyes) who underwent femtosecond-assisted laser in situ keratomileusis with preoperative use of WaveLight Allegro Topolyzer Corneal Topography (WaveLight Laser Technologies AG, Erlangen, Germany) to measure the pupil size and centre position. The P-Dist of the patients was recorded by the X and Y axis eyeball tracking adjustment program of the WaveLight Eagle Vision EX500 excimer laser system. RESULTS The P-Dist was 0.214 ± 0.092 mm in the right eyes and 0.228 ± 0.105 mm in the left eyes (P = .041). Under scotopic conditions, the pupil centre of left eye X-axis was -0.046 ± 0.091 mm, the right eye was -0.152 ± 0.084 mm, with significant differences (P = .015), and the Y-axis direction showed no significant changes (P = .062). The white to white was positively correlated with changes of pupil diameter (scotopic pupil diameter-photopic pupil diameter) (r = 0.270, P < .001). The equivalent spherical mirror and measured centroid shift were negatively correlated (r = -0.214, P = .002). CONCLUSION The angle kappa of the right eye is smaller than that of the left eye and from scotopic to photopic condition, the pupil centroid shift of both eyes to the nasal inferior side. If the cornea is too large, the low illumination environment should be maintained during the operation to improve the efficiency of pupil matching.
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Affiliation(s)
- Wen-Qing Deng
- Department of Ophthalmology, Fuyang People's Hospital of Anhui Medical University, Fuyang, Anhui, China
- Department of Ophthalmology, Affiliated Hospital of Yanbian University, Yanji, Jilin, China
| | - Yu-Hui Fang
- Department of Dermatology, Fuyang People's Hospital of Anhui Medical University, Fuyang, Anhui, China
| | - Shu-Hua Lin
- Department of Ophthalmology, Affiliated Hospital of Yanbian University, Yanji, Jilin, China
| | - Ying-Jun Li
- Department of Ophthalmology, Fuyang People's Hospital of Anhui Medical University, Fuyang, Anhui, China
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Sun S, Liu Z, Wu Y, Sun X, Zhao S, Huang Y. Characteristics of Pupil Offset in Young Asian Adults With Mild-Moderate and High Myopia. Transl Vis Sci Technol 2022; 11:13. [PMID: 35696132 PMCID: PMC9202332 DOI: 10.1167/tvst.11.6.13] [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] [Indexed: 11/27/2022] Open
Abstract
Purpose The purpose of this study was to explore the characteristics of pupil offset in young Asian adults with myopia. Methods In total, 1200 eyes (600 young adults, 18–35 years old) were divided into mild-moderate and high groups according to equivalent spherical diopters (SEQ). The pupil offset and its X and Y components were compared between the groups. Linear correlation was analyzed among pupil offset, X and Y components, and SEQ. Multiple linear regression analysis was conducted for pupil offset and eye parameters. Results The mean age of all subjects was 22.5 ± 4.8 years. The mean magnitude of the pupil offset (0.18 ± 0.09 mm vs. 0.15 ± 0.08 mm) and Y component (0.12 ± 0.08 mm vs. 0.10 ± 0.07 mm) were larger in the high group than in the mild-moderate group (P < 0.05). The magnitude of pupil offset, X and Y components, and SEQ were positively correlated. The pupil center (PC) of the right eye in the mild-moderate group was mainly superotemporal to the corneal vertex and mainly superonasal for the left eye and both eyes in the high group. Multiple linear regression analysis revealed that the magnitude of pupil offset correlated with central corneal thickness, intraocular pressure, and mean corneal curvature (P < 0.05). Conclusions The magnitude of the pupil offset that correlated with partial eye parameters and its X and Y components increased as the SEQ increased, and the PC gradually shifted toward the superonasal direction in young Asian adults with myopia. Translational Relevance Subjects with high myopia with a larger pupil offset should be considered for better postoperative visual quality during refractive surgery.
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Affiliation(s)
- Shengshu Sun
- Tianjin Medical University Eye Hospital, College of Optometry, Institute of Ophthalmology, National Clinical Medical Research Center for Eye, Ear, Nose and Throat Diseases, Tianjin Branch, Tianjin Key Laboratory of Retinal Function and Diseases, Tianjin, China
| | - Zhanglin Liu
- Tianjin Medical University Eye Hospital, College of Optometry, Institute of Ophthalmology, National Clinical Medical Research Center for Eye, Ear, Nose and Throat Diseases, Tianjin Branch, Tianjin Key Laboratory of Retinal Function and Diseases, Tianjin, China
| | - Yuan Wu
- Tianjin Medical University Eye Hospital, College of Optometry, Institute of Ophthalmology, National Clinical Medical Research Center for Eye, Ear, Nose and Throat Diseases, Tianjin Branch, Tianjin Key Laboratory of Retinal Function and Diseases, Tianjin, China
| | - Xiaowen Sun
- Tianjin Medical University Eye Hospital, College of Optometry, Institute of Ophthalmology, National Clinical Medical Research Center for Eye, Ear, Nose and Throat Diseases, Tianjin Branch, Tianjin Key Laboratory of Retinal Function and Diseases, Tianjin, China.,Department of Ophthalmology, People's Hospital of Rizhao, Rizhao, Shandong, China
| | - Shaozhen Zhao
- Tianjin Medical University Eye Hospital, College of Optometry, Institute of Ophthalmology, National Clinical Medical Research Center for Eye, Ear, Nose and Throat Diseases, Tianjin Branch, Tianjin Key Laboratory of Retinal Function and Diseases, Tianjin, China
| | - Yue Huang
- Tianjin Medical University Eye Hospital, College of Optometry, Institute of Ophthalmology, National Clinical Medical Research Center for Eye, Ear, Nose and Throat Diseases, Tianjin Branch, Tianjin Key Laboratory of Retinal Function and Diseases, Tianjin, China
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Koc H, Kaya F. Pupil barycenter configuration in patients with myopia and hyperopia. Int Ophthalmol 2022; 42:3441-3447. [PMID: 35583683 DOI: 10.1007/s10792-022-02343-0] [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: 02/18/2021] [Accepted: 04/18/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To compare the apparent chord mu between hyperopia and myopia cases and investigate the usefulness of iris barycenter configurations as an alternative for performing kappa angle distance calculations. METHODS This prospective study evaluated 394 eyes of 197 patients classified into two groups according to their spherical equivalent values: the myopic (mean spherical equivalent refraction ≤ - 0.50 D) and the hyperopia group (mean spherical equivalent refraction ≥ + 0.50 D). The two groups were further subdivided according to severity (myopic group: mild, ≤ - 0.50 and ≤ - 3.00 D; moderate, < - 3.00 and ≤ - 6.00 D; severe, < - 6.00 D; hyperopic group: mild, ≥ + 0.50 and ≤ + 2.00 D; moderate, > + 2.00 and ≤ + 4.00 D; severe, > + 4.00 D). The pupil and iris barycenter distance measurements and other parameters were obtained through optical low-coherence reflectometry. RESULTS Of the 197 patients, 109 (55.3%) were female and 88 (44.7%) were male individuals; their ages ranged from 7 to 60 years (mean, 35.16 ± 14.75 years). The average pupil barycenter distances were 0.38 ± 0.15 and 0.21 ± 0.11 mm in hyperopia and myopia patients, respectively (p < 0.01). Corneal and lens thickness measurements were higher in hyperopia patients (p < 0.01, p < 0.01, respectively), whereas anterior chamber depth and pupil diameter measurements were higher in myopia patients (p < 0.01, p < 0.01, respectively). No significant difference in astigmatism or white-to-white measurements was observed between hyperopia and myopia patients (p > 0.05). CONCLUSION The measurements for the apparent chord mu of the pupil and iris barycenter origins were higher in hyperopic than in myopic cases.
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Affiliation(s)
- Haci Koc
- Ophthalmology Department, Private Adatip Hospital, Sakarya, Turkey.
| | - Faruk Kaya
- Ophthalmology Department, Istanbul Medipol University, Istanbul, Turkey
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Langenbucher A, Szentmáry N, Cayless A, Weisensee J, Wendelstein J, Hoffmann P. Translation model for CW chord to angle Alpha derived from a Monte-Carlo simulation based on raytracing. PLoS One 2022; 17:e0267028. [PMID: 35576202 PMCID: PMC9109904 DOI: 10.1371/journal.pone.0267028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 03/31/2022] [Indexed: 11/18/2022] Open
Abstract
Background The Chang-Waring chord is provided by many ophthalmic instruments, but proper interpretation of this chord for use in centring refractive procedures at the cornea is not fully understood. The purpose of this study is to develop a strategy for translating the Chang-Waring chord (position of pupil centre relative to the Purkinje reflex PI) into angle Alpha using raytracing techniques. Methods The retrospective analysis was based on a large dataset of 8959 measurements of 8959 eyes from 1 clinical centre, using the Casia2 anterior segment tomographer. An optical model based on: corneal front and back surface radius Ra and Rp, asphericities Qa and Qp, corneal thickness CCT, anterior chamber depth ACD, and pupil centre position (X-Y position: PupX and PupY), was defined for each measurement. Using raytracing rays with an incident angle IX and IY the CW chord (CWX and CWY) was calculated. Using these data, a multivariable linear model was built up in terms of a Monte-Carlo simulation for a simple translation of incident ray angle to CW chord. Results Raytracing allows for calculation of the CW chord CWX/CWY from biometric measures and the incident ray angle IX/IY. In our dataset mean values of CWX = 0.32±0.30 mm and CWY = -0.10±0.26 mm were derived for a mean incident ray angle (angle Alpha) of IX = -5.02±1.77° and IY = 0.01±1.47°. The raytracing results could be modelled with a linear multivariable model, and the effect sizes for the prediction model for CWX are identified as Ra, Qa, Rp, CCT, ACD, PupX, PupY, IX, and for CWY they are Ra, Rp, PupY, and IY. Conclusion Today the CW chord can be directly measured with any biometer, topographer or tomographer. If biometric measures of Ra, Qa, Rp, CCT, ACD, PupX, PupY are available in addition to the CW chord components CWX and CWY, a prediction of angle Alpha is possible using a simple matrix operation.
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Affiliation(s)
- Achim Langenbucher
- Department of Experimental Ophthalmology, Universität des Saarlandes, Homburg/Saar, Germany
- * E-mail:
| | - Nóra Szentmáry
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Universität des Saarlandes, Homburg/Saar, Germany
- Department of Ophthalmology, Semmelweis-University, Budapest, Hungary
| | - Alan Cayless
- School of Physical Sciences, The Open University, Milton Keynes, United Kingdom
| | - Johannes Weisensee
- Department of Experimental Ophthalmology, Universität des Saarlandes, Homburg/Saar, Germany
| | - Jascha Wendelstein
- Department of Experimental Ophthalmology, Universität des Saarlandes, Homburg/Saar, Germany
- Medical Faculty, Johannes Kepler University Linz, Linz, Austria
| | - Peter Hoffmann
- Augen- und Laserklinik Castrop-Rauxel, Castrop-Rauxel, Germany
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Qin M, Yuan Y, Wang Y, Li P, Chen W, Wang Y, Yang M, Wu J, Ji M, Luo J, Tang J, Chen X, Huang Y, Guan H. Comparison of preoperative angle kappa measurements in the eyes of cataract patients obtained from Pentacam Scheimpflug system, optical low-coherence reflectometry, and ray-tracing aberrometry. BMC Ophthalmol 2022; 22:153. [PMID: 35366842 PMCID: PMC8976989 DOI: 10.1186/s12886-021-02116-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 09/24/2021] [Indexed: 12/01/2022] Open
Abstract
Background Angle kappa plays a vital role in the implantation of multifocal intraocular lens (MIOL). Large angle kappa is related to a higher risk of postoperative photic phenomena. This study aims to compare preoperative angle kappa in the eyes of cataract patients obtained from the Pentacam Scheimpflug system (Pentacam), optical low-coherence reflectometry (Lenstar), and ray-tracing aberrometry (iTrace). Methods One hundred thirteen eyes of 113 patients with cataracts were included. Each eye was examined 3 times using all devices to obtain angle kappa and pupil diameter. When considering dependent eyes for one individual, angle kappa in both right eyes and left eyes should be analysed separately. The repeatability and reproducibility were evaluated using the within-subject standard deviation (Sw), repeatability (2.77 Sw), and intraclass correlation coefficient (ICC). The difference, correlation, and agreement between devices were evaluated by paired t-tests, Pearson tests, and Bland-Altman analysis, respectively. Results Intraoperator repeatability and interoperator and intersession reproducibility of angle kappa showed an Sw of less than 0.05 mm, a 2.77 Sw of 0.14 mm or less, and an ICC of more than 0.96. Angle kappa was not significantly different between Pentacam and Lenstar (P > 0.05), while angle kappa was significantly different between Pentacam and iTrace and between Lenstar and iTrace (P < 0.05). There was a strong correlation between Pentacam and Lenstar for angle kappa (r =0.907 to 0.918) and a weak or moderate correlation between Pentacam and iTrace and between Lenstar and iTrace (r =0.292 to 0.618). There were narrow 95% limits of agreement (LoA) between Pentacam and Lenstar for angle kappa and wide 95% LoA between Pentacam and iTrace and between Lenstar and iTrace. No significant differences in pupil diameter were found between Pentacam and Lenstar in either eye (P > 0.05). Positive angle kappa (nasal light reflex) was found in most cataract patients (79.25% to 84.91%) through 3 different devices in both eyes. Conclusions The 3 devices provided high intraoperator repeatability and interoperator and intersession reproducibility for angle kappa measurements. The measurement of preoperative angle kappa in the eyes of patients with cataracts by Pentacam and Lenstar has good agreement.
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The Influence of Angle Alpha, Angle Kappa, and Optical Aberrations on Visual Outcomes after the Implantation of a High-Addition Trifocal IOL. J Clin Med 2022; 11:jcm11030896. [PMID: 35160346 PMCID: PMC8836565 DOI: 10.3390/jcm11030896] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 01/26/2022] [Accepted: 02/04/2022] [Indexed: 12/28/2022] Open
Abstract
The aim of our investigation was to examine the possible correlations between optical aberrations, angle kappa, angle alpha, and visual outcomes following cataract surgery. In total, 56 eyes of 28 patients were implanted with the Liberty 677MY trifocal intraocular lens (IOL). Pre- and postoperative higher-order aberrations, coma, astigmatism, angle alpha, and angle kappa were registered, along with uncorrected and corrected visual acuities at multiple distances. Visual acuity and contrast sensitivity defocus curves were plotted, and the areas under the curve were calculated 1 and 3 months postoperatively. Excellent visual outcomes were found at all distances. Patients reported low levels of dysphotopsia, and 96.4% of patients achieved complete spectacle independence. While angle kappa significantly decreased during cataract surgery (p = 0.0007), angle alpha remained unchanged (p = 0.5158). Angle alpha correlated with postoperative HOAs and had a negative impact on near vision (p = 0.0543). Preoperative corneal HOA and coma had a strong adverse effect on future intermediate and near vision. Residual astigmatism significantly affected postoperative intermediate vision (p = 0.0091). Our results suggest that angle kappa is not an optimal predictive factor for future visual outcomes, while angle alpha and the preoperative screening of optical aberrations might help patient selection prior to multifocal IOL implantation.
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Yang LWY, Ong HS, Chiam N, Mehta JS. Centration and Stability of Small-Aperture Intraocular Lens in Aberrated Eyes. J Refract Surg 2022; 38:98-105. [DOI: 10.3928/1081597x-20211116-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Singh VM, Ramappa M, Murthy SI, Rostov AT. Toric intraocular lenses: Expanding indications and preoperative and surgical considerations to improve outcomes. Indian J Ophthalmol 2021; 70:10-23. [PMID: 34937203 PMCID: PMC8917572 DOI: 10.4103/ijo.ijo_1785_21] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Since the introduction of the first toric intraocular lens (IOLs) in the early 1990s, these lenses have become the preferred choice for surgeons across the globe to correct corneal astigmatism during cataract surgery. These lenses allow patients to enjoy distortion-free distance vision with excellent outcomes. They also have their own set of challenges. Inappropriate keratometry measurement, underestimating the posterior corneal astigmatism, intraoperative IOL misalignment, postoperative rotation of these lenses, and IOL decentration after YAG-laser capsulotomy may result in residual cylindrical errors and poor uncorrected visual acuity resulting in patient dissatisfaction. This review provides a broad overview of a few important considerations, which include appropriate patient selection, precise biometry, understanding the design and science behind these lenses, knowledge of intraoperative surgical technique with emphasis on how to achieve proper alignment manually and with image-recognition devices, and successful management of postoperative complications.
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Affiliation(s)
| | - Muralidhar Ramappa
- Cataract and Refractive Services; The Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Somasheila I Murthy
- Cataract and Refractive Services; The Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
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Langenbucher A, Szentmáry N, Cayless A, Weisensee J, Wendelstein J, Hoffmann P. Prediction of CW chord as a measure for the eye's orientation axis after cataract surgery from preoperative IOLMaster 700 measurement data. Acta Ophthalmol 2021; 100:e1232-e1239. [PMID: 34850585 DOI: 10.1111/aos.15071] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/28/2021] [Accepted: 11/19/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The angles alpha and kappa are widely discussed for centring refractive procedures, but they cannot be determined with ophthalmic instruments. The purpose of this study is to investigate the Chang-Waring chord (position of the Purkinje reflex PI relative to the corneal centre) derived from an optical biometer before and after cataract surgery and to study the changes resulting from cataract surgery. METHODS The analysis was based on a large dataset of 1587 complete sets of preoperative and postoperative IOMaster 700 biometry measurements from two clinical centres, each containing: valid data for pupil and corneal centre position, the position of the Purkinje reflex PI originated from a coaxial fixation target, keratometry (K), axial length (AL), anterior chamber depth (ACD), lens thickness (LT), central corneal thickness CCT, and horizontal corneal diameter W2W. The Chang-Waring chord CW was derived from pupil centre and Purkinje reflex PI analysed preoperatively and postoperatively, and a multilinear regression model together with a feedforward neural network algorithm was set up to predict postoperative CW chord from preoperative CW chord, K and biometric distances of the eye. RESULTS The Y component of CW chord shows a slight shift in the inferior direction in both left and right eyes, before and after cataract surgery. The X component shows some shift in the temporal direction, which is more pronounced preoperatively and slightly reduced postoperatively but with a larger variation. The change in CW chord from preoperative to postoperative shows a slight shift in the superior and nasal directions. Our algorithms for prediction of postoperative CW chord using preoperative CW chord, keratometry and biometry as input data performed with a multilinear regression and a feedforward neural network approach were able to reduce the variance, but could not properly predict the postoperative CW chord X and Y components. CONCLUSION The CW chord as the position of the Purkinje reflex PI with respect to the pupil centre can be directly measured with any biometer, topographer or tomographer with a coaxial fixation light. The mean Y component does not differ between right and left eyes or preoperatively and postoperatively, but the mean temporal shift of the X component preoperatively is slightly reduced postoperatively, but with a larger scatter of the values.
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Affiliation(s)
- Achim Langenbucher
- Department of Experimental Ophthalmology Saarland University Homburg/Saar Germany
| | - Nóra Szentmáry
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research Saarland University Homburg/Saar Germany
- Department of Ophthalmology Semmelweis‐University Budapest Hungary
| | - Alan Cayless
- School of Physical Sciences The Open University Milton Keynes UK
| | - Johannes Weisensee
- Department of Experimental Ophthalmology Saarland University Homburg/Saar Germany
| | - Jascha Wendelstein
- Department of Ophthalmology Johannes Kepler University Linz Linz Austria
| | - Peter Hoffmann
- Augen‐ und Laserklinik Castrop‐Rauxel Castrop‐Rauxel Germany
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Tutchenko L, Patel S, Skovron M, Horak O, Voytsekhivskyy O. The relationship between angle kappa and astigmatism after phacoemulsification with implanting of spherical and aspheric intraocular lens. Indian J Ophthalmol 2021; 69:3503-3510. [PMID: 34826984 PMCID: PMC8837301 DOI: 10.4103/ijo.ijo_572_21] [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] [Indexed: 11/21/2022] Open
Abstract
Purpose: To determine the significance of any association between either change in angle kappa (K°) or the rectilinear displacement (L, mm) of the first Purkinje image relative to the pupil center and unexpected changes in astigmatism after phacoemulsification. Methods: Orbscan II (Bausch and Lomb) measurements were taken at 1, 2, and 3 months after unremarkable phacoemulsification in patients implanted with spherical (group 1, SA60AT, Alcon) or aspheric (group 2, SN60WF, Alcon) nontoric IOLs. The outputs were used to calculate L. Astigmatism, measured by autorefractometry and subjective refraction, was subjected to vector analysis (polar and cartesian formats) to determine the actual change induced over the periods 1–2 and 2–3 months postop. Results: Chief findings were that the mean (n, ±SD, 95%CI) values for L over each period were as follows: Group 1, 0.407 (38, ±0.340, 0.299–0.521), 0.315 (23, ±0.184, 0.335–0.485); Group 2, 0.442 (45, ±0.423, 0.308–0.577), 0.372 (26, ±0.244, 0.335–0.485). Differences between groups were not significant. There was a significant linear relationship between (A) the change in K (ΔK = value at 1 month-value at 2 months) and K at 1 month (x), where ΔK =0.668-3.794X (r = 0.812, n = 38, P = <0.001) in group 1 and ΔK = 0.263x -1.462 (r = 0.494, n = 45, P = 0.002) in group 2, (B) L and the J45 vector describing the actual change in astigmatism between 1 and 2 months in group 2, where J45 (by autorefractometry) =0.287L-0.160 (r = 0.487, n = 38, P = 0.001) and J45 (by subjective refraction) =0.281L-0.102 (r = 0.490, n = 38, P = 0.002), and (C) J45 and ΔK between 2 and 3 months in group 2, where J45 (by subjective refraction) =0.086ΔK-0.063 (r = 0.378, n = 26, P = 0.020). Conclusion: Changes in the location of the first Purkinje image relative to the pupil center after phacoemulsification contributes to changes in refractive astigmatism. However, the relationship between the induced change in astigmatism resulting from a change in L is not straightforward.
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Affiliation(s)
- Larysa Tutchenko
- Department of Ophthalmology, Kyiv City Clinical Ophthalmological Hospital, Eye Microsurgical Center, Kyiv, Ukraine
| | - Sudi Patel
- Department of Ophthalmology, Specialty Eye Hospital Svjetlost, Zagreb, Croatia
| | - Mykhailo Skovron
- Department of Ophthalmology, Kyiv City Clinical Ophthalmological Hospital, Eye Microsurgical Center, Kyiv, Ukraine
| | - Olha Horak
- Department of Ophthalmology, Kyiv City Clinical Ophthalmological Hospital, Eye Microsurgical Center, Kyiv, Ukraine
| | - Oleksiy Voytsekhivskyy
- Department of Ophthalmology, Kyiv City Clinical Ophthalmological Hospital, Eye Microsurgical Center, Kyiv, Ukraine
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Rocha-de-Lossada C, Sánchez-González JM, Borroni D, Llorens-Bellés V, Rachwani-Anil R, Torras-Sanvicens J, Romano V, Peraza-Nieves J. Chord Mu (µ) and Chord Alpha (α) Length Changes in Fuchs Endothelial Corneal Dystrophy before and after Descemet Membrane Endothelial Keratoplasty (DMEK) Surgery. J Clin Med 2021; 10:jcm10214844. [PMID: 34768364 PMCID: PMC8584337 DOI: 10.3390/jcm10214844] [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: 08/10/2021] [Revised: 10/14/2021] [Accepted: 10/19/2021] [Indexed: 11/24/2022] Open
Abstract
This paper will evaluate chord mu and alpha length in patients with Fuchs endothelial corneal dystrophy (FECD) and its changes following Descemet membrane endothelial keratoplasty (DMEK). Patients with FECD that underwent DMEK surgery were included in this retrospective study. Scheimpflug Tomography was carried out in order to calculate chord mu and chord alpha lengths prior to surgery and at 3 and 12 months postoperative. This study included 27 eyes from 27 patients. Significant changes in chord mu were observed within the first three months (from 0.47 ± 0.32 to 0.29 ± 0.21 mm, p < 0.01) and remained stable 12 months postoperative (0.30 ± 0.21 mm, p > 0.05). However, chord alpha remained stable throughout the 12 months post surgery (from 0.53 ± 0.19 to 0.49 ± 0.14 mm, p > 0.05). In addition to the pupillary center distance from the corneal center (from 0.35 ± 0.25 to 0.34 ± 0.20 mm, p > 0.05) also remain stable. In FECD patients undergoing DMEK surgery, chord mu length decreased, and chord alpha length remained stable after 12 months of follow-up.
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Affiliation(s)
- Carlos Rocha-de-Lossada
- Department of Ophthalmology, Hospital Clinic de Barcelona Institut Clinic d’Oftalmologia, 08036 Barcelona, Spain; (C.R.-d.-L.); (V.L.-B.); (J.T.-S.); (J.P.-N.)
- Department of Ophthalmology (Qvision), VITHAS Hospital, 04120 Almería, Spain
- Department of Ophthalmology, Hospital Virgen de las Nieves, 18014 Granada, Spain
| | - José-María Sánchez-González
- Department of Physics of Condensed, Optics Area, University of Seville, 41012 Seville, Spain
- Department of Ophthalmology (Tecnolaser Clinic Vision®), Refractive Surgery Centre, 41018 Seville, Spain
- Correspondence:
| | - Davide Borroni
- Department of Doctoral Studies, Riga Stradins University, LV-1007 Riga, Latvia; (D.B.); (V.R.)
- Department of Ophthalmology, Royal Liverpool University Hospital, Liverpool L7 8XP, UK
| | - Víctor Llorens-Bellés
- Department of Ophthalmology, Hospital Clinic de Barcelona Institut Clinic d’Oftalmologia, 08036 Barcelona, Spain; (C.R.-d.-L.); (V.L.-B.); (J.T.-S.); (J.P.-N.)
| | | | - Josep Torras-Sanvicens
- Department of Ophthalmology, Hospital Clinic de Barcelona Institut Clinic d’Oftalmologia, 08036 Barcelona, Spain; (C.R.-d.-L.); (V.L.-B.); (J.T.-S.); (J.P.-N.)
| | - Vito Romano
- Department of Doctoral Studies, Riga Stradins University, LV-1007 Riga, Latvia; (D.B.); (V.R.)
| | - Jorge Peraza-Nieves
- Department of Ophthalmology, Hospital Clinic de Barcelona Institut Clinic d’Oftalmologia, 08036 Barcelona, Spain; (C.R.-d.-L.); (V.L.-B.); (J.T.-S.); (J.P.-N.)
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Comparison of clinical outcomes of 2 platforms for topography-guided LASIK in primary eyes. J Cataract Refract Surg 2021; 47:1183-1190. [PMID: 34468456 DOI: 10.1097/j.jcrs.0000000000000592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 01/18/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare differences in visual, refractive, and ablating outcomes between corneal topography-guided laser in situ keratomileusis (LASIK) by SCHWIND AMARIS and WaveLight Contoura for myopia and myopic astigmatism correction. SETTING Department of Refractive Surgery, Guangzhou Aier Eye Hospital, Guangzhou, China. DESIGN Prospective nonrandomized study. METHODS Patients treated with LASIK to correct ametropia and corneal higher-order aberrations (HOAs) with 6.5 mm of plan optical zone were recruited. In the AMARIS platform, there were 2 centration strategies: the symmetric (AA) and asymmetric (AS) offset modes. In the WaveLight platform, there was only symmetric offset (ES) mode. HOAs, contrast sensitivity, effective optical zone (EOZ), ablation depth, and ablating center were evaluated 3 months after the operation. RESULTS The study included 138 eyes. At 3 months after operation, the postoperative manifest refractive spherical equivalent was 0.04 ± 0.34 diopters (D), 0.06 ± 0.25 D, and -0.09 ± 0.21 D in AS, AA, and ES groups, respectively (P = .018). The EOZs of the AS and AA groups were 5.01 mm and 4.96 mm, and both were larger than 4.88 mm in the ES group (P = .04 and .03, respectively). The ablation depth of the AS group was 103.6 μm, which were larger than 86.6 μm in the AA group and 91.2 μm in the ES group. CONCLUSIONS The SCHWIND AMARIS and WaveLight EX500 corneal topography-guided LASIK achieved comparable and excellent visual and refractive outcomes. The EX500 Contoura LASIK ablated less corneal tissue because of the smaller EOZ compared with the AMARIS, with a similar plan optical zone.
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Reinstein DZ, Archer TJ, Rowe EL, Gobbe M, Vida RS. Distribution of Pupil Offset and Angle Kappa in a Refractive Surgery Preoperative Population of 750 Myopic, Emmetropic, and Hyperopic Eyes. J Refract Surg 2021; 37:49-58. [PMID: 33432995 DOI: 10.3928/1081597x-20201109-01] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 10/13/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To report the distribution of pupil offset and angle kappa in 750 myopic, emmetropic, and hyperopic eyes presenting for refractive surgery. METHODS A retrospective study included 750 consecutive eyes screened for corneal refractive surgery between January 2006 and February 2013. The eyes were divided into three equal groups based on manifest refraction spherical equivalent (SEQ): emmetropic group between -0.25 and +0.50 diopters (D) and cylinder up to 1.00 D, myopic group greater than -0.50 D, and hyperopic group greater than +0.50 D. Angle kappa was measured with the Orbscan II software (Bausch & Lomb, Inc) and pupil offset defined as the distance at the corneal plane between the corneal vertex and the pupil center. Correlations with SEQ, cylinder, scotopic pupil diameter, average keratometry, and age were performed. RESULTS All results are reported for myopic, emmetropic, and hyperopic groups, respectively. Mean SEQ was -4.84 ± 2.89 D (range: -0.88 to -14.00 D), +0.21 ± 0.23 D (range: -0.25 to +0.50 D), and +2.44 ± 1.58 D (range: +0.63 to +7.75 D). Mean pupil offset magnitude was 0.27 ± 0.14 mm (range: 0.00 to 0.68 mm), 0.34 ± 0.14 mm (range: 0.02 to 0.78 mm), and 0.39 ± 0.13 mm (range: 0.07 to 0.75 mm). Mean pupil offset X-component was -0.18 ± 0.18, -0.28 ± 0.16, and -0.34 ± 0.15 mm (temporally displaced from the corneal vertex). Mean pupil offset Y-component was 0.06 ± 0.15, 0.03 ± 0.16, and 0.01 ± 0.16 mm (superiorly displaced from the corneal vertex). Multivariate linear regression for pupil offset magnitude found statistically significant variables were SEQ, cylinder, scotopic pupil diameter, and average keratometry. For pupil offset X-component, significant variables were SEQ, cylinder, and scotopic pupil diameter. For pupil offset Y-component, significant variables were SEQ and scotopic pupil diameter. Mean angle kappa was 5.28 ± 1.49°, 6.14 ± 1.44°, and 5.77 ± 1.29°. CONCLUSIONS Contrary to common belief, a pupil offset is present in the vast majority of eyes regardless of refractive error, with the mean temporal offset of at least 0.18 mm. Confirming previous studies, the largest pupil offset was found in the hyperopic group. However, there was also a wide range of pupil offset in myopic and emmetropic eyes. Correlations with SEQ and keratometry support the theory that pupil offset is also correlated with axial length. [J Refract Surg. 2021;37(1):49-58.].
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Yuan B, Li J, Song H. Effect of misalignment at different orientations associated with angle κ on optical performance of aspheric intraocular lenses with different surface designs. APPLIED OPTICS 2021; 60:5917-5924. [PMID: 34263818 DOI: 10.1364/ao.423000] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 06/22/2021] [Indexed: 06/13/2023]
Abstract
Intraocular lens (IOL) misalignment and angle κ have had significant negative impact on post-operative quality of vision. ZEMAX software has been used to imitate the optical performance of pseudophakic eyes with different IOL surface designs at different orientations of IOL misalignment (decentration of 0.4 mm and tilt of 7°, and with the existence of 0.5 mm angle κ). We found that an aspheric balanced curve optic surface maintained better optical performance via inducing less coma aberration. Coma aberration played an unexpectedly important role in the optical performance. With angle κ, the impact of IOL misalignment on visual quality was associated with the orientation of decentration and tilt, indicating that the coma compensation also took effect in pseudophakic eyes. Due to the high incidence of post-operative IOL misalignment, our results provide evidence of the importance of considering personalized angle κ before cataract surgery for patients.
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Delbarre M, Le HM, Boucenna W, Froussart-Maille F. [Refractive surgery for hyperopia]. J Fr Ophtalmol 2021; 44:723-729. [PMID: 33836914 DOI: 10.1016/j.jfo.2020.11.008] [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: 10/14/2020] [Accepted: 11/16/2020] [Indexed: 10/21/2022]
Abstract
Hyperopia is a refractive error in which light is focused behind, instead of on, the retina. Clear vision can be obtained by accommodation, but in the long run, this results in eye strain. Hyperopia can be classified as low [≤2.00 diopters (D)], moderate (2.00-4.00 D) and high (>4.00 D). Detailed preoperative evaluation is necessary and essential to obtain good postoperative results. Various surgical techniques can be proposed to correct this ametropia. The main techniques used act either by modifying the corneal curvature with the Excimer laser or by implanting a phakic intraocular lens. The anatomical peculiarities of the hyperopic eye (small corneal diameter, short axial length, narrow anterior chamber or large kappa angle) make refractive surgery for hyperopia a considerable challenge. Large optical ablation zones now allow correction of high hyperopia by reducing the risks of optical aberrations and regression. The patient must be informed and understand the postoperative course, which differs from that of surgery for myopia.
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Affiliation(s)
- M Delbarre
- Service d'ophtalmologie, Hôpital d'instruction des Armées Percy, 101, avenue Henri-Barbusse, BP 406, 92141 Clamart cedex, France.
| | - H M Le
- Département d'ophtalmologie, Centre hospitalier intercommunal de Créteil, 40, avenue de Verdun, 94000 Créteil, France
| | - W Boucenna
- Service d'ophtalmologie, CHU Amiens-Picardie, 1, rond-point du Professeur-Christian-Cabrol, 80054 Amiens, France
| | - F Froussart-Maille
- Service d'ophtalmologie, Hôpital d'instruction des Armées Percy, 101, avenue Henri-Barbusse, BP 406, 92141 Clamart cedex, France; École du Val-de-Grâce, 1, place Alphonse-Laveran, 75230 Paris cedex 05, France
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Luo J, Liu Y, Wang F, Su Y, Xiao X, Du H, Guo Q. Effect of the kappa angle on depth of focus after implantation of the TECNIS Symfony intraocular lens. Int Ophthalmol 2021; 41:2513-2520. [PMID: 33751306 DOI: 10.1007/s10792-021-01809-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/10/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate the clinical effect of TECNIS Symfony intraocular lens (IOL) implantation and identify the effect of kappa angle on the depth of focus (DOF) after implantation. METHODS This prospective clinical study included consecutive patients who underwent cataract surgery and TECNIS Symfony IOL implantation at the Daqing Oilfield General Hospital from January 2019 to September 2019. Patients were divided into three groups according to the preoperative kappa angle (r): A (0 < r ≤ 0.2), B (0.2 < r ≤ 0.4), and C (r > 0.4). Uncorrected visual acuity was performed preoperatively and at 7 days, 1 month, and 3 months postoperatively. Synthetical optometry, higher-order aberrations, and defocus examinations were performed at 3 months postoperatively. Single-factor analysis of variance and Spearman correlation coefficient were used for data analysis. RESULTS The uncorrected visual acuity values of the three groups were significantly improved postoperatively, compared with preoperative values (p < 0.001). Three months postoperatively, the best-corrected visual acuity values of the three groups were 0.11 ± 0.02 logarithm of the minimum angle of resolution (logMAR), 0.09 ± 0.03 logMAR, and 0.11 ± 0.03 logMAR, respectively. Spherical equivalent (SE) values were 0.37 ± 0.08 D, 0.41 ± 0.06 D, and 0.42 ± 0.06 D, respectively. Best-corrected visual acuity and SE did not significantly differ among the three groups (F = 1.254, p = 0.135; F = 0.849, p = 0.228). There was no significant difference in SE between the three groups (F = 1.658, p = 0.312). Moreover, higher-order aberrations did not significantly differ among the three groups (p > 0.05). The kappa angle was negatively correlated with the postoperative DOF (r = -4.341, p = 0.026). Three months postoperatively, 54.55% of patients exhibited DOF ≥ 3 D, while 92.42% of patients exhibited DOF ≥ 2 D. The ranges of DOF in the three groups were 3.18 ± 0.27 D, 2.83 ± 0.80 D, and 2.57 ± 0.89 D, respectively; the difference among the three groups was statistically significant (F = 5.689, p = 0.037). CONCLUSION Most patients achieved full-range vision after TECNIS Symfony IOL implantation, but the DOF narrowed for those with an excessively large kappa angle, which indicates a need for careful selection.
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Affiliation(s)
- Jie Luo
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, 23 Bundesgasse, Harbin, Heilongjiang Province, China.,Department of Ophthalmology, The Daqing Oilfields General Hospital, 19 ZhongKang Roud, Daqing, Heilongjiang Province, China
| | - Yang Liu
- Department of Ophthalmology, The Daqing Oilfields General Hospital, 19 ZhongKang Roud, Daqing, Heilongjiang Province, China
| | - Feng Wang
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, 23 Bundesgasse, Harbin, Heilongjiang Province, China.
| | - Ying Su
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, 23 Bundesgasse, Harbin, Heilongjiang Province, China.
| | - Xuebing Xiao
- Department of Ophthalmology, The Daqing Oilfields General Hospital, 19 ZhongKang Roud, Daqing, Heilongjiang Province, China
| | - Haitao Du
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, 23 Bundesgasse, Harbin, Heilongjiang Province, China
| | - Qiang Guo
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, 23 Bundesgasse, Harbin, Heilongjiang Province, China
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Determination of Optic Axes by Corneal Topography among Italian, Brazilian, and Chinese Populations. PHOTONICS 2021. [DOI: 10.3390/photonics8020061] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aims to describe a new universal method to identify the relative three-dimensional directions of visual, pupillary, and optical axes of the eye and the angles between them using topography elevation data. The method was validated in a large clinical cohort, and ethnical differences were recorded. Topography elevation data were collected from 1992 normal eyes of 966 healthy participants in Italy, Brazil, and China. The three main axes were defined as follows: optical axis (OA) was defined as the optimal path of light that passes through the ocular system without refraction. The pupillary axis (PA) line was defined using X and Y coordinates of the pupil centre with the chamber depth, in addition to the centre of a sphere fitted to the central 3 mm diameter of the cornea. The visual axis (VA) was taken by its best approximation, the coaxially sighted corneal light reflex. The alpha angle was measured between the VA and OA, and the kappa angle between the VA and PA. The average values of kappa and alpha angles were 3.41 ± 2.84 and 6.04 ± 2.43 in the Italian population, 2.6 ± 1.53 and 5.87 ± 2.3 in the Brazilian population, and 2.09 ± 1.22 and 3.85 ± 1.48 in the Chinese population.
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Wang X, Dong J, Deng M. Limbus-centered marking technique-assisted continuous circular capsulorhexis. Medicine (Baltimore) 2021; 100:e24109. [PMID: 33466181 PMCID: PMC7808535 DOI: 10.1097/md.0000000000024109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 12/09/2020] [Indexed: 01/05/2023] Open
Abstract
To introduce a limbus-centered continuous circular capsulorhexis (CCC) marking technique.Compared with traditional capsulotomy diameter mark technique, a self-designed limbus-centered capsulotomy mark (LCM) was used to perform the routine cataract surgery in this observational study. Ten eyes were included in each group. The area outer/inner 5.5-mm CCC ring, the furthest/nearest distance from the capsule margin to the intraocular lens (IOL) margin, the CCC total coverage IOL area were measured and compared between this 2 groups.No significant differences were found for all the comparison parameters between the 2 groups (all P > .05). However, the capsule total coverage area, area inner 5.5-mm ring was lower in the LCM group, which demonstrated advantage of LCM.The limbus-centered capsulotomy diameter mark, as an inexpensive and convenient method, helps to perform limbus-centered capsulorhexis with not only a 360° overlapping capsular edge but also well-centered IOL optics.
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Affiliation(s)
| | - Jing Dong
- The First Hospital of Shanxi Medical University
| | - Minghui Deng
- Linfen Yaodu Eye Hospital, Linfen, Shanxi, P.R. China
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34
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Grzybowski A, Eppig T. Angle alpha as predictor for improving patient satisfaction with multifocal intraocular lenses? Graefes Arch Clin Exp Ophthalmol 2021; 259:563-565. [PMID: 33394164 DOI: 10.1007/s00417-020-05053-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 12/09/2020] [Accepted: 12/15/2020] [Indexed: 11/29/2022] Open
Affiliation(s)
- Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, 30 Warszawska str., 10-082, Olsztyn, Poland. .,Institute for Research in Ophthalmology, Poznan, Poland.
| | - Timo Eppig
- Institute of Experimental Ophthalmology, Saarland University, Homburg, Germany.,AMIPLANT GmbH, Schnaittach, Germany
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35
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Corneal Topography for Intraocular Lens Selection in Refractive Cataract Surgery. Ophthalmology 2020; 128:e142-e152. [PMID: 33221325 DOI: 10.1016/j.ophtha.2020.11.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 10/26/2020] [Accepted: 11/13/2020] [Indexed: 11/22/2022] Open
Abstract
The purpose of this review is to evaluate the usefulness of corneal topography to select premium intraocular lenses (IOLs), including aspherical IOLs, toric IOLs, and multifocal IOLs, in refractive cataract surgery. Corneal topography can detect corneal regular astigmatism, corneal irregular astigmatism (higher-order aberrations [HOAs]) including spherical aberration, and corneal shape abnormalities after corneal refractive surgery. Surgeons can explain to the patients with significant corneal HOAs about its effect on postoperative visual function before surgery. Multifocal IOLs should not be selected for such eyes. For eyes with abnormal corneal shape, appropriate IOL power calculation formulae can be applied. In the case of toric IOLs, regular astigmatism and corneal HOAs should be checked. Before implanting an aspheric IOL, it is ideal to confirm spherical aberration of the cornea is not below the normal range. Because corneal HOAs, abnormal corneal shape after corneal refractive surgery, corneal regular astigmatism, and corneal spherical aberration increase postoperative refractive errors and poor vision quality with premium IOLs, corneal topography before cataract surgery is helpful in screening patients who are not appropriate candidates for premium IOLs.
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Correlation Analysis of Refractive and Visual Quality after Wavefront-Optimized Laser In Situ Keratomileusis for 50% and 100% Angle Kappa Compensation. J Ophthalmol 2020; 2020:9873504. [PMID: 33083053 PMCID: PMC7556047 DOI: 10.1155/2020/9873504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/13/2020] [Accepted: 09/20/2020] [Indexed: 11/30/2022] Open
Abstract
Purpose To analyze the distribution of the offset between the pupil center and the coaxially sighted corneal light reflex (P-Dist), the effects of 50% and 100% angle kappa adjustments on refractive and visual quality in patients with moderate myopia were investigated. Methods A randomly selected 254 patients (254 eyes) with moderate myopia who underwent femtosecond laser-combined LASIK were examined. During the operation, the P-Dist of the patients was recorded by the x- and y-axis eyeball-tracking adjustment program of the WaveLight Eagle Vision EX500 excimer laser system. Preoperatively and 3 months postoperatively, the WaveLight® ALLEGRO Topolyzer was used to measure the pupil size and center position, and the wavefront sensor was used to measure the wavefront aberrations. The visual function tester (OPTEC 6500) measured contrast sensitivity. Results The average P-Dist was 0.220 ± 0.102 mm. When the P-Dist >0.220 mm, the postoperative residual cylinder was 0.29 ± 0.34 D in the group with the 50% adjustment and 0.40 ± 0.32 D in the 100% group, which was significantly higher than the 50% group (P=0.036). The coma was 0.21 ± 0.17 μm in the 50% adjusted group and 0.34 ± 0.25 μm in the 100% group, which was significantly higher than that in the 50% group (P=0.021). At the 1.5 c/d spatial frequency, contrast sensitivity in the adjusted 100% group was significantly lower than that in the 50% group under visual glare conditions (P=0.039). Conclusion The postoperative visual acuity and spherical equivalent were not affected in the two groups. However, when P-Dist >0.220 mm, the residual astigmatism and coma were lower in the 50% group. Individualized operations for those with moderate myopia and large-angle kappa in which 100% adjustment is chosen may not result in a better visual quality effect than 50%.
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Frings A, Druchkiv V, Pose L, Linke SJ, Steinberg J, Katz T. Analysis of excimer laser treatment outcomes and corresponding angle κ in hyperopic astigmatism. J Cataract Refract Surg 2020; 45:952-958. [PMID: 31262484 DOI: 10.1016/j.jcrs.2019.01.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 01/18/2019] [Accepted: 01/29/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE To investigate the prevalence of preoperative, intraoperative, and postoperative angle κ in hyperopic eyes and its effect on the refractive outcomes of excimer laser vision correction. SETTING University Hospital Hamburg and Care Vision Refractive Centers, Germany. DESIGN Retrospective multicenter study. METHODS Hyperopic patients after laser in situ keratomileusis and before retreatment because of hyperopic regression were included. Three treatment groups were defined based on the magnitude of preoperative angle κ defined as low (<0.25 mm), moderate (0.25 to 0.50 mm), or high (>0.50 mm). RESULTS The study analyzed 170 hyperopic eyes of 112 patients (mean age 29.8 years ± 10.04 [SD], range 21 to 62 years). The preoperative angle κ was low, moderate, or high in 23, 49, and 98 cases, respectively. In eyes with a preoperative angle κ of 0.25 mm or more, changes in the x-axes and y-axes of angle κ and its magnitude were statistically significant (P < .05) between preoperative and intraoperative measurements. In these eyes, intraoperative angle κ (offset) was statistically significantly smaller (P < .05), and Purkinje images were statistically significantly more caudal (P < .001). Treatment predictability was independent from using preoperative or intraoperative angle κ, and there were no statistically significant differences in efficacy or safety. CONCLUSIONS A preoperative magnitude of angle κ as high as 0.50 mm or higher was present in more than 50% of regressed hyperopic eyes. Measuring angle κ preoperatively did not reflect its real-time intraoperative magnitude. Using the preoperatively larger angle κ as an intraoperative offset might result in a too nasally centered ablation that causes topographic and optical drawbacks; therefore, centering the ablation based on the intraoperative measured offset is recommended.
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Affiliation(s)
- Andreas Frings
- University College London, Institute of Ophthalmology, England; Heinrich-Heine-University, Department of Ophthalmology, Düsseldorf, Germany; Care Vision Nuremberg, Nuremberg, Germany.
| | - Vasyl Druchkiv
- Medical University Hamburg, Hamburg, Germany; Care Vision Hamburg, Hamburg, Germany
| | - Lumi Pose
- Medical University Hamburg, Hamburg, Germany
| | - Stephan J Linke
- Care Vision Hamburg, Hamburg, Germany; University Hamburg, Department of Ophthalmology, Hamburg, Germany; zentrumsehstärke - Augenarztpraxis am UKE, Hamburg, Germany
| | - Johannes Steinberg
- Care Vision Hamburg, Hamburg, Germany; University Hamburg, Department of Ophthalmology, Hamburg, Germany; zentrumsehstärke - Augenarztpraxis am UKE, Hamburg, Germany
| | - Toam Katz
- Care Vision Nuremberg, Nuremberg, Germany; Care Vision Hamburg, Hamburg, Germany; University Hamburg, Department of Ophthalmology, Hamburg, Germany
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Jiang JY, Hodge C, Lawless M. Understanding chord mu through a large population‐based study. Clin Exp Ophthalmol 2020; 48:998-1001. [DOI: 10.1111/ceo.13800] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/09/2020] [Indexed: 11/28/2022]
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He X, Niu L, Miao H, Zhao F, Zhou X. Relative position of the central hole after EVO-ICL implantation for moderate to high myopia. BMC Ophthalmol 2020; 20:305. [PMID: 32723334 PMCID: PMC7385873 DOI: 10.1186/s12886-020-01569-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 07/14/2020] [Indexed: 11/25/2022] Open
Abstract
Background This study aimed to evaluate the relative position of the central hole (CH) of EVO Implantable Collamer Lens (EVO-ICL), the pupil center (CP), and the corneal center (CC) after implantation of EVO-ICLs for moderate to high myopia. Methods Eighty-nine eyes of forty-seven patients with moderate to high myopia were evaluated. The mean preoperative spherical equivalent (SE) was − 12.58 ± 4.13D. A routine postoperative follow-up was performed within 1 ~ 12 months. Positions of the CH of EVO-ICLs, the CP and the CC were recorded using a slit lamp anterior segment photography system, and their relative distances were calculated with the Visio image analysis software. Results All surgeries were performed safely, and no complications were observed in follow-ups 4.3 ± 4.82 months after surgery. At the last follow-up, the safety index (postoperative CDVA/preoperative CDVA) was 1.23 ± 0.48, and the efficacy index (postoperative UDVA/preoperative CDVA) was 1.08 ± 0.31. The CH in 85 eyes (95.51%) was superior to the CC, with 47.19% (42/89) on the temporal side and 48.31% (43/89) on the nasal side. The CH in 84 eyes (94.38%) was located on the temporal side of the CP, with 56.18% (50/89) superior and 38.2% (34/89) inferior to the CP. The CP of 85 eyes (95.51%) was superior on the nasal side of the CC. On the defined x-axis, the average distance from the CH to CC was significantly shorter than the average distance from the CP to CC (p < 0.001). Conclusions An imperfect match between the central hole of EVO-ICLs and the pupil center does not necessarily indicate ICL dislocation. Compared to the pupil center, the position of the central hole of EVO-ICL is closer to the corneal center.
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Affiliation(s)
- Xiaojian He
- Department of Ophthalmology, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lingling Niu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Huamao Miao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Feng Zhao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.,Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China. .,NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China. .,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.
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40
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Clinical outcomes of corneal refractive surgery comparing centration on the corneal vertex with the pupil center: a meta-analysis. Int Ophthalmol 2020; 40:3555-3563. [PMID: 32671600 DOI: 10.1007/s10792-020-01506-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 07/06/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To compare the visual and refractive outcomes between centration on the corneal vertex and the pupil center in corneal refractive surgery. METHODS A comprehensive literature search was conducted using PubMed, MEDLINE, EMBASE, and the Cochrane Library to identify relevant studies. The primary outcomes were the postoperative spherical equivalent (SE), effectiveness [uncorrected distance visual acuity (UDVA) ≥ 20/20, eyes within ± 0.50 diopter (D) of target refraction], and safety [loss ≥ 2 lines of corrected distance visual acuity (CDVA)]. Higher-order aberrations were considered secondary outcomes. RESULTS Seven studies describing a total of 1964 eyes were included in this meta-analysis. A statistical significance in postoperative SE was found between the two centration methods for the correction of myopia that favor the CV-centered method (p < 0.001). No significant differences were observed in the proportion of eyes with UDVA ≥ 20/20 or loss ≥ 2 lines of CDVA postoperatively. However, the proportion of eyes within ± 0.50 D was slightly higher (p = 0.02) and the coma aberration was much lower in the corneal vertex-centered method (p < 0.001). CONCLUSION Preferable visual and refractive outcomes could be achieved with either centering on the corneal vertex or pupil center in corneal refractive surgery; however, the corneal vertex-centered method has shown partial benefits in some clinical indices. In order to obtain higher quality of clinical evidences, more randomized controlled trials (RCTs) are required in further investigations.
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Qin B, Li M, Shen Y, Zeng L, Wang X, Sekundo W, Chang J, Zhou X. Management of Suction Loss During SMILE in 12,057 Eyes: Incidence, Outcomes, Risk Factors, and a Novel Method of Same-Day Recutting of Refractive Lenticules. J Refract Surg 2020; 36:308-316. [DOI: 10.3928/1081597x-20200323-01] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/18/2020] [Indexed: 11/20/2022]
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Zhang F, Zhang J, Li W, Zhou L, Feng D, Zhang H, Fang W, Sun R, Liu Z. Correlative Comparison of Three Ocular Axes to Tilt and Decentration of Intraocular Lens and Their Effects on Visual Acuity. Ophthalmic Res 2019; 63:165-173. [PMID: 31846979 DOI: 10.1159/000504716] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 11/10/2019] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate which ocular axis, the corneal topographic axis (CTA), pupillary axis (PA) or line of sight (LOS), for measuring the tilt and decentration of intraocular lens (IOL) is most relevant to correct distance visual acuity (CDVA). METHODS A Scheimpflug device (Pentacam HR) was prospectively used to determine the tilt and decentration of IOLs in vivo 3 months after cataract surgery. A new method was developed to reliably measure PA and LOS. We further evaluated CTA and then used Spearman correlation coefficient and linear regression to assess the correlation between CDVA and IOL displacement based on the data of three different ocular axes. RESULTS Forty-six eyes from 46 patients were evaluated. The majority of decentration and tilt of IOL with reference to CTA, PA and LOS were towards the subtemporal direction. We found that the horizontal meridian data measured using CTA and PA were statistically significantly different (p = 0.011 for tilt; p = 0.005 for decentration). The correlation between CDVA and the distance of decentration temporally (r = -0.344, p = 0.035) and inferiorly (r = -0.336, p = 0.042) of the IOL with regard to CTA was significant. PA and LOS measurements had no correlation with any indices. CONCLUSION Assessment of tilt and decentration of the IOL with reference to different ocular axes was markedly different. IOL tilt and decentration measured by CTA were significantly correlated with CDVA.
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Affiliation(s)
- Fan Zhang
- Department of Ophthalmology, Qingdao Women and Children Hospital, Qingdao University, Qingdao, China.,Department of Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jian Zhang
- Department of Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China,
| | - Wei Li
- Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida, USA
| | - Lin Zhou
- Department of Ophthalmology, First Hospital of Tsinghua University, Beijing, China
| | - Di Feng
- School of Instrumentation Science and Optoelectronics Engineering, Beihang University, Beijing, China
| | - Haixia Zhang
- Biomechanics, School of Biomedical Engineering, Capital Medical University, Beijing, China.,Biomechanics, Beijing Key Laboratory of Basic Research on Biomechanics in Clinical University, Beijing, China
| | - Wei Fang
- Department of Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ran Sun
- Department of Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zhicheng Liu
- Biomechanics, School of Biomedical Engineering, Capital Medical University, Beijing, China.,Biomechanics, Beijing Key Laboratory of Basic Research on Biomechanics in Clinical University, Beijing, China
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Influence of Angle κ and Higher-Order Aberrations on Visual Quality Employing Two Diffractive Trifocal IOLs. J Ophthalmol 2019; 2019:7018937. [PMID: 31885892 PMCID: PMC6900936 DOI: 10.1155/2019/7018937] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 09/21/2019] [Accepted: 10/25/2019] [Indexed: 01/19/2023] Open
Abstract
Prospective, randomized, comparative, and controlled study to estimate the association between angle κ distance and higher-order aberrations (HOAs) with postoperative visual acuity after presbyopia-correcting IOL implantation. Forty-three eyes from 43 patients were included and randomly assigned in two groups for either AT LISA tri 839MP or Acrysof IQ PanOptix IOL implantation. The OPD-Scan III analyzer was utilized to assess the angle κ distance and higher-order aberration (HOAs). Twenty-three eyes were in the Acrysof IQ PanOptix group and 20 patients in the AT LISA tri 839MP group. The uncorrected distance visual acuity (UDVA) for the PanOptix group was 0.092 ± 0.10, whereas for AT LISA tri was 0.050 ± 0.06 (P=0.229). The uncorrected intermediate visual acuity (UIVA) for the PanOptix group was 0.173 ± 0.18, whereas for AT LISA tri, it was 0.182 ± 0.11 (P=0.669). Uncorrected near visual acuity (UNVA) was 0.068 ± 0.04 and 0.085 ± 0.07, respectively (P=0.221). Also, correlation coefficient between HOAs and the Strehl ratio for each group were −0.768 (P < 0.0001) and −0.863 (P=0.0001). Patients implanted with both trifocal IOLs showed excellent postoperative visual performance at all distances at the six-month follow-up visit. No association was found between angle κ distance and postoperative visual acuity regardless of the angle κ magnitude or the two trifocal IOLs inner optical diameter. Also, internal aberrations demonstrated a significant inverse correlation with the Strehl ratio for both trifocal IOLs.
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Chow SS, Chow LL, Lee CZ, Chan TC. Astigmatism Correction Using SMILE. Asia Pac J Ophthalmol (Phila) 2019; 8:391-396. [PMID: 31490198 PMCID: PMC6784860 DOI: 10.1097/01.apo.0000580140.74826.f5] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 06/17/2019] [Indexed: 11/26/2022] Open
Abstract
Small incision lenticule extraction (SMILE) was introduced in the recent decade for the treatment of myopia and myopic astigmatism. This flap-free technique has a high efficacy and safety profile and also carries potential advantages over laser in situ keratomileusis such as a better corneal biomechanical stability, reduction in dry eyes rate, and the avoidance of flap complications. However, there have been concerns regarding the precision of astigmatism correction that undercorrection has been reported to be apparent. Various factors that affect astigmatism correction have been identified in the literature. The purpose of this review is to discuss the factors that affect astigmatism correction in SMILE and several techniques to improve the refractive outcomes.
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Affiliation(s)
- Sharon S.W. Chow
- Department of Ophthalmology, Grantham Hospital, Hong Kong, China
| | | | - Chester Z. Lee
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Tommy C.Y. Chan
- Department of Ophthalmology, Hong Kong Sanatorium & Hospital, Hong Kong, China
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
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45
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Fu Y, Kou J, Chen D, Wang D, Zhao Y, Hu M, Lin X, Dai Q, Li J, Zhao YE. Influence of angle kappa and angle alpha on visual quality after implantation of multifocal intraocular lenses. J Cataract Refract Surg 2019; 45:1258-1264. [DOI: 10.1016/j.jcrs.2019.04.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/27/2019] [Accepted: 04/01/2019] [Indexed: 11/30/2022]
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46
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Reinstein DZ, Vida RS, Archer TJ. Small-incision lenticule extraction in a patient with high astigmatism and nystagmus. J Cataract Refract Surg 2019; 45:515-518. [DOI: 10.1016/j.jcrs.2018.11.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/20/2018] [Accepted: 11/21/2018] [Indexed: 11/30/2022]
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47
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Rodríguez-Vallejo M, Piñero DP, Fernández J. Avoiding misinterpretations of Kappa angle for clinical research studies with Pentacam. JOURNAL OF OPTOMETRY 2019; 12:71-73. [PMID: 29627299 PMCID: PMC6450808 DOI: 10.1016/j.optom.2018.03.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 12/20/2017] [Accepted: 03/01/2018] [Indexed: 06/02/2023]
Affiliation(s)
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain; Department of Ophthalmology (OFTALMAR), Vithas Medimar International Hospital, Alicante, Spain
| | - Joaquín Fernández
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, 04120 Almería, Spain; Department of Ophthalmology, Torrecárdenas Hospital Complex, 04009 Almería, Spain
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48
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Cankaya C, Ozsoy E, Demirel EE, Polat N, Gunduz A. Estimation of angle kappa and pupil barycentre configuration in myopic tilted disc syndrome. Clin Exp Optom 2019; 103:192-196. [PMID: 30924211 DOI: 10.1111/cxo.12897] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 02/11/2019] [Accepted: 02/13/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND To evaluate the angle kappa and pupil barycentre configuration in patients with myopic tilted disc syndrome (TDS). METHODS Thirty-five eyes of 35 patients with TDS were included in the study. Thirty-five eyes of 35 age- and sex-matched healthy subjects were enrolled in the control group. All measurements were performed with the Lenstar LS 900. Angle kappa was calculated according to Pythagorean theorem using the x and y co-ordinates of the pupil centre. Pupil dx and pupil dy values (pupil dx: x co-ordinate of pupil centre relative to corneal apex, pupil dy: y co-ordinate of pupil centre relative to corneal apex) were used to evaluate the pupil barycentre configuration. Central corneal thickness, white to white (cornea diameter), pupil diameter, anterior chamber depth, lens thickness, and axial length were also measured. RESULTS The calculated mean angle kappa distance was 0.27 ± 0.15 mm in the TDS group and 0.29 ± 0.23 mm in the control group (p = 0.42). The mean pupil dx was -0.01 ± 0.24 mm in the TDS group and -0.17 ± 0.14 mm in the control group (p = 0.006). The mean pupil dy was -0.02 ± 0.13 mm in the TDS group and -0.05 ± 0.22 mm in the control group (p = 0.65). CONCLUSIONS The pupil barycentre in TDS cases was statistically significantly closer to the corneal vertex on the horizontal plane compared to the control group. However, there was no statistically significant differences in terms of angle kappa and pupil dy values between the groups. According to our results, refractive surgery can be performed safely with respect to complications related to decentration of ablation zone and decentration of multifocal intraocular lenses in these groups of patients.
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Affiliation(s)
- Cem Cankaya
- Department of Ophthalmology, Inonu University School of Medicine, Malatya, Turkey
| | - Ercan Ozsoy
- Department of Ophthalmology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Ersin Ersan Demirel
- Department of Ophthalmology, Inonu University School of Medicine, Malatya, Turkey
| | - Nihat Polat
- Department of Ophthalmology, Inonu University School of Medicine, Malatya, Turkey
| | - Abuzer Gunduz
- Department of Ophthalmology, Inonu University School of Medicine, Malatya, Turkey
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Analysis of planning strategies in primary eyes gaining a line or more of visual acuity after topography-guided laser in situ keratomileusis. J Cataract Refract Surg 2019; 45:321-327. [PMID: 30733106 DOI: 10.1016/j.jcrs.2018.10.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 09/17/2018] [Accepted: 10/10/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To analyze planning strategies for eyes that gained 1 or more lines of corrected distance visual acuity (CDVA) after topography-guided custom treatment (TCAT). SETTING Refractive Surgery Clinic, Cleveland Clinic, Ohio, USA. DESIGN Retrospective case series. METHODS Eyes having TCAT by the same surgeon between February 2016 and June 2017 were enrolled. The corneal shape was captured with the Wavelight Allegretto Topolyzer diagnostic device coupled with refraction, generating an ablation profile. The cylinder magnitude and axis of laser entry were decided by the surgeon based on the manifest and measured values, assisted by additional data from the Pentacam Scheimpflug tomographer and Ladarwave ocular wavefront aberrometer. RESULTS The study comprised 256 eyes. At 3 months, uncorrected distance visual acuity was 20/20 or better in 95.7% and 20/15 or better in 81.4%; 25.6% gained 1 or more lines of CDVA. The measured and manifest axes differed by less than 15 degrees in 59%, between 15 degrees and 30 degrees in 18%, and by more than 30 degrees in 23%. When it differed by at least 5 degrees, the measured axis was treated in 79%, 75%, and 73% of eyes, respectively. In eyes with higher measured cylinder, 75% were treated between the manifest and measured values, with 7% at full measured value. When the manifest value was greater, 60% were treated at the total measured value and 40% in between. Whole-eye aberrometry showed a small increase in coma, spherical aberration and the total root mean square (all P < .001). CONCLUSIONS The TCAT procedure achieved visual acuity better than the preoperative CDVA in more than 25.0% of eyes. Tomography and wavefront aberrometry assisted in the selection process to achieve optimum visual outcomes.
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Reinstein DZ, Carp GI, Archer TJ, Day AC, Vida RS. Outcomes for Hyperopic LASIK With the MEL 90 ® Excimer Laser. J Refract Surg 2019; 34:799-808. [PMID: 30540362 DOI: 10.3928/1081597x-20181019-01] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 10/10/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To report the outcomes of laser in situ keratomileusis (LASIK) for hyperopia using the Triple-A ablation profile with the MEL 90 excimer laser (Carl Zeiss Meditec, Jena, Germany). METHODS This retrospective analysis included 1,383 eyes treated by LASIK for hyperopia using the Triple-A ablation profile with the MEL 90 at London Vision Clinic, London, United Kingdom, between September 2013 and December 2016. Inclusion criteria were attempted hyperopic correction of +0.25 diopters (D) or higher and corrected distance visual acuity (CDVA) of 20/40 or better. Patients were observed for 1 year after surgery. Standard outcomes analysis was performed. RESULTS One-year data were available for 1,350 (97%) eyes. Mean attempted spherical equivalent refraction (SEQ) was +2.77 ± 1.34 D (range: +0.13 to +6.50 D) and mean cylinder was -0.67 ± 0.66 D (range: 0.00 to -5.00 D). Mean age was 54 ± 11 years (range: 21 to 75 years), and 57% were female. Postoperative spherical equivalent was ±0.50 D in 73% and ±1.00 D in 93% of eyes. Uncorrected distance visual acuity was 20/20 or better in 75% of eyes, relative to 93% with preoperative CDVA of 20/20 or better. One line of CDVA was lost in 17% of eyes and two lines were lost in 0.6% of eyes. There was a clinically insignificant but statistically significant increase (P < .01) in contrast sensitivity at 3 and 6 cycles per degree (cpd) and no change for 12 and 18 cpd. CONCLUSIONS LASIK for hyperopia with the MEL 90 excimer laser was found to satisfy accepted criteria for safety, efficacy, and stability. [J Refract Surg. 2018;34(12):799-808.].
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