1
|
Niazi S, Dhubhghaill SN, Doroodgar F, Gatzioufas Z, Dehghan MH. Insight into small eyes: a practical description from phenotypes presentations to the management. Int J Ophthalmol 2024; 17:380-391. [PMID: 38371260 PMCID: PMC10827624 DOI: 10.18240/ijo.2024.02.23] [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: 02/09/2023] [Accepted: 11/29/2023] [Indexed: 02/20/2024] Open
Abstract
This narrative review aimed to have an algorithmic approach to microphthalmos by a systematic search. The definition can be related to a number of special phenotypes. In the more challenging cases of complex microphthalmos, relative anterior microphthalmos, and nanophthalmos, the surgeon can approach these cases more safely if they have a deep understanding of the anatomical variations and ideal formulae for intraocular lens computation and knows how to avoid intra- and post-operative complications. In this article, we review the criteria by which we recognize and describe pre-, intra-, and post-operative considerations, as well as discuss the ideal intraocular lenses for microphthalmos, given the intricate varieties of small eye phenotypes.
Collapse
Affiliation(s)
- Sana Niazi
- Translational Ophthalmology Research Center, Tehran University of Medical Sciences, Tehran 1416753955, Iran
| | - Sorcha Ní Dhubhghaill
- Antwerp University Hospital, Edegem 2650, Belgium
- Faculty of Health Sciences, Antwerp University, Antwerpen 2000, Edegem, Belgium
| | - Farideh Doroodgar
- Translational Ophthalmology Research Center, Tehran University of Medical Sciences, Tehran 1416753955, Iran
- Negah Aref Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran 16666, Iran
| | | | - Mohammad Hossein Dehghan
- Negah Aref Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran 16666, Iran
| |
Collapse
|
2
|
Lee Y, Kim MK, Oh JY, Choi HJ, Yoon CH. Intraocular lens power calculation in eyes with a shallow anterior chamber depth and normal axial length. PLoS One 2023; 18:e0288554. [PMID: 37498877 PMCID: PMC10374127 DOI: 10.1371/journal.pone.0288554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 06/29/2023] [Indexed: 07/29/2023] Open
Abstract
We compared the accuracy of three intraocular lens (IOL) calculation formulas in eyes with a shallow anterior chamber depth (ACD) and normal axial length (AXL) and control eyes. We retrospectively reviewed eyes with a shallow ACD (<2.5 mm from the corneal epithelium) with normal AXL (22.5≤AXL<24.0 mm) and controls (3.0≤ACD<3.5 mm and normal AXL). Prediction error (PE) and median absolute error (MedAE) were evaluated with SRK/T, Barrett Universal II (BUII), and Kane formulas after adjusting the mean PE to zero for all patients. Percentages of eyes achieving a PE within 0.25 to 1.00 D, and correlations between ACD, lens thickness (LT), and PE were analyzed. Thirty-five shallow ACD and 63 control eyes were included. PE in the shallow ACD group showed more hyperopic results with BUII and Kane but not with SRK/T compared to controls. Within the shallow ACD group, PE showed more hyperopic results in BUII and Kane compared to SRK/T. However, the standard deviation (SD) of PE among formulas was not different. In the shallow ACD group, SRK/T showed a higher percentage of PE within 0.25 D than BUII and Kane, but the percentages within 0.50 to 1.00 D were similar. PE was negatively correlated with ACD in BUII and Kane, and positively correlated with LT in all formulas. BUII and Kane may induce slight hyperopic shift in eyes with a shallow ACD and normal AXL. However, the performance of the three formulas was comparable in the shallow ACD group in terms of MedAE, the SD of PE, and the percentage of eyes achieving PE within 0.50 D.
Collapse
Affiliation(s)
- Yunjin Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
- Department of Ophthalmology, Gachon University Gil Hospital, Incheon, Korea
| | - Mee Kum Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Ocular Regenerative Medicine and Immunology (LORMI), Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea
| | - Joo Youn Oh
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Ocular Regenerative Medicine and Immunology (LORMI), Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea
| | - Hyuk Jin Choi
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Ocular Regenerative Medicine and Immunology (LORMI), Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea
- Department of Ophthalmology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea
| | - Chang Ho Yoon
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Ocular Regenerative Medicine and Immunology (LORMI), Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea
| |
Collapse
|
3
|
Ding Y, Hou M, Liu L, Mao Y, Liu X, Wu M. Prediction of postoperative effective lens position using iris root depth in primary angle-closure diseases. J Cataract Refract Surg 2023; 49:691-696. [PMID: 36853845 DOI: 10.1097/j.jcrs.0000000000001174] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/16/2023] [Indexed: 03/01/2023]
Abstract
PURPOSE To evaluate the role of a new parameter, iris root depth (IRD), in intraocular lens power calculation using ultrasound biomicroscopy (UBM) in primary angle-closure diseases (PACDs), and to compare the accuracy of 6 formulas in PACDs: Barrett Universal II (BUII), Haigis, Hill-Radial Basis Function (RBF) v. 3.0, Hoffer Q, Kane and Sanders Retzlaff Kraff/Theoretical (SRK)/T. SETTING Zhongshan Ophthalmic Center, Guangzhou, China. DESIGN Retrospective consecutive case series. METHODS Patients diagnosed with PACDs who had undergone cataract surgery were reviewed to first evaluate the performance of 6 formulas. Then preoperative UBM examinations of 58 eyes were used to measure IRD and predict effective lens position (ELP) to generate the Haigis IRD formula. The accuracy of Haigis IRD was compared with BUII, Haigis and Kane formulas. The SD of predicted error was the main indicator evaluating formula performance, according to heteroscedastic analysis. RESULTS 103 eyes (103 patients) were included. The SDs of Kane (0.59, P = .01), RBF 3.0 (0.61, P = .02) and SRK/T formula (0.62, P = .04) were significantly lower than Hoffer Q. Modified with IRD, Haigis IRD generated the lowest SD (0.41), which was significantly lower than Haigis formula (0.54, P = .03) and was equal to Kane formula (0.45, P = .37). CONCLUSIONS Kane, RBF 3.0 and SRK/T were more accurate in PACD eyes. Optimized with IRD, Haigis IRD formula achieved the lowest SD and had comparable accuracy with Kane formula. IRD could be a promising parameter to improve accuracy of IOL power calculation for PACDs.
Collapse
Affiliation(s)
- Yujie Ding
- From the State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | | | | | | | | | | |
Collapse
|
4
|
Changes in Macular Thickness after Cataract Surgery in Patients with Open Angle Glaucoma. Diagnostics (Basel) 2023; 13:diagnostics13020244. [PMID: 36673054 PMCID: PMC9857709 DOI: 10.3390/diagnostics13020244] [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: 10/28/2022] [Revised: 12/13/2022] [Accepted: 12/23/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The purpose of this study was to examine the changes in IOP, total macular and RNFL, ganglion cell layer (GCL) thickness, and aqueous humour flare in open angle glaucoma (OAG) patients before and 6 months after cataract surgery. METHODS This was a prospective observational case-control age- and gender-matched study. Groups: 40 subjects in a controlled OAG (OAGc) group, 20 subjects in an uncontrolled OAG (OAGu) group, and 60 control group subjects. EXAMINATION complete ophthalmic evaluation, IOP measurement, anterior and posterior segment Optical Coherence Tomography (OCT), and laser flare photometry before and 6 months postoperatively. RESULTS Six months postoperatively IOP decreased in all groups. An increase in macular thickness was found postoperatively in all groups. Preoperative aqueous humour flare was higher in the OAGc group than in the control group. After cataract surgery, aqueous humour flare was higher in the control group compared to the preoperative result. CONCLUSIONS Changes in IOP following cataract surgery were strongly negatively correlated with preoperative IOP. An increase in macular thickness was observed 6 months postoperatively in all groups. Aqueous humour flare did not differ in OAGc and OAGu groups pre- and postoperatively but significantly increased in the control group postoperatively.
Collapse
|
5
|
Lu W, Hou Y, Yang H, Sun X. A systemic review and network meta-analysis of accuracy of intraocular lens power calculation formulas in primary angle-closure conditions. PLoS One 2022; 17:e0276286. [PMID: 36240196 PMCID: PMC9565378 DOI: 10.1371/journal.pone.0276286] [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: 08/31/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND For primary angle-closure and angle-closure glaucoma, the fact that refractive error sometimes deviates from predictions after intraocular lens (IOL) implantation is familiar to cataract surgeons. Since controversy remains in the accuracy of IOL power calculation formulas, both traditional and network meta-analysis on formula accuracy were conducted in patients with primary angle-closure conditions. METHODS A comprehensive literature search was conducted through Aug 2022, focusing on studies on intraocular lens power calculation in primary angle-closure (PAC) and primary angle-closure glaucoma (PACG). A systemic review and network meta-analysis was performed. Quality of studies were assessed. Primary outcomes were the mean absolute errors (MAE) and the percentages of eyes with a prediction error within ±0.50 diopiters (D) or ±1.00 D (% ±0.50/1.00 D) by different formulas. RESULTS Six retrospective studies involving 419 eyes and 8 formulas (Barrett Universal II, Kane, SRK/T, Hoffer Q, Haigis, Holladay I, RBF 3.0 and LSF) were included. SRK/T was used as a reference as it had been investigated in all the studies included. Direct comparison showed that none of the involved formula outperformed or was defeated by SRK/T significantly in terms of either MAE or % ±0.50/1.00 D (all P>0.05). Network comparison and ranking possibilities disclosed BUII, Kane, RBF 3.0 with statistically insignificant advantage. No significant publication bias was detected by network funnel plot. CONCLUSIONS No absolute advantage was disclosed among the formulas involved in this study for PAC/PACG eyes. Further carefully designed studies are warranted to evaluate IOL calculation formulae in this target population. TRAIL REGISTRATION Registration: PROSEPRO ID: CRD42022326541.
Collapse
Affiliation(s)
- Wenhan Lu
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Chinese Academy of Medical Sciences and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China
| | - Yu Hou
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Chinese Academy of Medical Sciences and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China
| | - Hongfang Yang
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Chinese Academy of Medical Sciences and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China
| | - Xinghuai Sun
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Chinese Academy of Medical Sciences and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
| |
Collapse
|
6
|
Karabulut M, Karabulut S, Simsek HC, Karalezli A. The iridocorneal angle and related anterior segment structures in pediatric anisohyperopic amblyopic eyes. SAGE Open Med 2022; 10:20503121221107474. [PMID: 35795866 PMCID: PMC9252018 DOI: 10.1177/20503121221107474] [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: 07/28/2021] [Accepted: 05/26/2022] [Indexed: 11/18/2022] Open
Abstract
Objectives: We aimed at investigating the iridocorneal angle, anterior segment structural differences, and their relationship in pediatric anisohyperopic amblyopic eyes. Methods: This study was designed as an observational case-control study. We prospectively evaluated the pediatric patients who were newly diagnosed with hyperopic anisometropic amblyopia. Iridocorrneal angle in four sectors, axial length, and anterior segment structures were compared to emmetropic fellow and control eyes using Pentacam and IOLMaster 700 devices. The anisohyperopia and iridocorneal angle related factors were determined in hyperopic anisometropic amblyopic eyes. Results: Forty-three hyperopic anisometropic amblyopic eyes, 43 fellow eyes, and 44 control eyes were included. The mean axial length, anterior chamber volume, and anterior chamber depth were significantly reduced in the study eyes compared to the fellow (p < 0.001, p = 0.021, and p = 0.045, respectively) and control eyes (p < 0.001, p = 0.001, and p = 0.009, respectively). The average iridocorneal angle was significantly lower in the study eyes than in the fellow and control eyes (p < 0.001 and p = 0.018, respectively). The iridocorneal angle correlated with anterior chamber depth (r = 0.49, p = 0.013), anterior chamber volume (r = 0.42, p = 0.038), the anterior radius of curvature (r =−0.54, p = 0.005), the posterior radius of curvature (r =−0.58, p = 0.002), and lens thickness (Rho =−0.41, p = 0.033) in the study eyes. Anisohyperopia was related to the interocular difference in axial length (Rho = 0.53, p = 0.005), anterior chamber depth (Rho = 0.53, p = 0.005), and anterior chamber volume (Rho = 0.42, p = 0.031). Conclusion: Pentacam and IOLMaster 700 are suitable for non-contact imaging of iridocorneal angle and anterior segment structures in the pediatric age. These biometric differences and their relationship should be kept in mind whenever anterior or posterior segment surgery is planned for pediatric anisohyperopic amblyopic eyes.
Collapse
Affiliation(s)
- Müjdat Karabulut
- Department of Ophthalmology, Mugla Sıtkı Koçman University Medical School, Mugla, Turkey
| | - Sinem Karabulut
- Department of Ophthalmology, Mugla Sıtkı Koçman University Medical School, Mugla, Turkey
| | - Hüseyin Cem Simsek
- Department of Ophthalmology, Mugla Sıtkı Koçman University Medical School, Mugla, Turkey
| | - Aylin Karalezli
- Department of Ophthalmology, Mugla Sıtkı Koçman University Medical School, Mugla, Turkey
| |
Collapse
|
7
|
Yan C, Yao K. Effect of Lens Vault on the Accuracy of Intraocular Lens Calculation Formulas in Shallow Anterior Chamber Eyes. Am J Ophthalmol 2022; 233:57-67. [PMID: 34293335 DOI: 10.1016/j.ajo.2021.07.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 07/11/2021] [Accepted: 07/12/2021] [Indexed: 11/15/2022]
Abstract
PURPOSE To explore the impact of preoperative lens vault (LV) on the accuracy of the Barrett Universal Ⅱ, Haigis, Hoffer Q, Hoffer QST, Holladay 1, Kane, and SRK/T formulas in eyes with a shallow anterior chamber. DESIGN Retrospective case series. METHODS Included were 409 eyes with anterior chamber depth (ACD) shallower than 3.0 mm that underwent phacoemulsification. Eyes were divided into a short axial length (AL) group (<22.00 mm) and a normal AL group (22.00 ≤ AL < 24.50 mm). Each group was further divided into a small LV subgroup (LV <0.95 mm) and a large LV subgroup (LV ≥0.95 mm) according to the median of the preoperative LV. Postoperative refraction was measured 3 months after surgery. Mean absolute error (MAE) was calculated and compared for each formula. The correlation between LV and the mean numeric error predicted by each formula was analyzed. RESULTS Overall, the Barrett and Kane formulas generated the smallest MAE in both short AL and normal AL groups (P < .05 for both). In short AL eyes with small LV, the Haigis formula performed better than other traditional formulas (P < .05 for all). In normal AL eyes with a small LV, the Barrett and Kane formulas showed higher accuracy (P < .05 for all), and other formulas were comparable. In either subgroup with a large LV, the Haigis formula created a significant higher MAE (P < .001 for all), followed by Hoffer QST. Positive correlations were found between LV and mean numeric errors predicted by all formulas, except for Barrett and Kane formulas (P < .001 for all), indicating a postoperative hyperopic shift with an increased LV. CONCLUSIONS In shallow anterior chamber eyes with a large LV, the Haigis and Hoffer QST formulas taking preoperative ACD into calculation surprisingly showed a larger prediction error. However, the Barrett and the Kane formulas, which include both ACD and lens thickness as predictive parameters, showed good accuracy in both small and large LV subgroups. Therefore, although formulas referring to preoperative ACD are generally believed to achieve better refractive results in patients with a shallow anterior chamber, LV may be valuable to consider when choosing an IOL power calculation formula.
Collapse
Affiliation(s)
- Chenxi Yan
- From the Eye Center (C.Y., K.Y.) of the 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Ke Yao
- From the Eye Center (C.Y., K.Y.) of the 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
| |
Collapse
|
8
|
Choi JH, Kim SJ, Thomas MG, Jung JH, Oh EH, Shin JH, Cho JW, Kim HS, Park JY, Choi SY, Choi HY, Choi KD. Diagnostic yield of targeted next-generation sequencing in infantile nystagmus syndrome. Ophthalmic Genet 2021; 42:561-569. [PMID: 34132631 DOI: 10.1080/13816810.2021.1938138] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Infantile nystagmus syndrome (INS) is a genetically heterogeneous disorder. Identifying genetic causes of INS would help clinicians to facilitate clinical diagnosis and provide appropriate treatment. The aim of this study was to determine the diagnostic utility of targeted next-generation sequencing (NGS) for INS.Materials and methods: We recruited 37 patients who were referred to the Neuro-ophthalmology clinics for evaluations of INS. NGS was performed using a targeted panel that included 98 candidate genes associated with INS. We identified pathogenic variants according to guidelines of the American College of Medical Genetics and Genomics. We also calculated the sensitivity and specificity of each clinical sign to assess the diagnostic yield of our gene panel.Results: After variant filtering, annotation, and interpretation, the potential pathogenic variants were detected in 13 of the 37 patients, achieving a molecular diagnostic rate of 35%. The identified genes were PAX6 (n = 4), FRMD7 (n = 4), GPR143 (n = 2), CACNA1F (n = 1), CNGA3 (n = 1) and GUCY2D (n = 1). In approximately 30% (n = 4) of the patients, the initial clinical diagnosis was revised after a molecular diagnosis was performed. The presence of a family history had the highest predictive power for a molecular diagnosis (sensitivity = 61.5%, specificity = 91.7%), and the sensitivity increased when the family history was considered together with one of two clinical signs such as pendular nystagmus waveforms or anterior segment dysgenesis.Conclusions: Our study shows that targeted NGS can be useful to determine a molecular diagnosis for patients with INS. Targeted NGS also helps to confirm a clinical diagnosis in atypical phenotypes or unresolved cases.
Collapse
Affiliation(s)
- Jae-Hwan Choi
- Department of Neurology, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Su-Jin Kim
- Department of Ophthalmology, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Mervyn G Thomas
- Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Jae-Ho Jung
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
| | - Eun Hye Oh
- Department of Neurology, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jin-Hong Shin
- Department of Neurology, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jae Wook Cho
- Department of Neurology, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hyang-Sook Kim
- Department of Neurology, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ji-Yun Park
- Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Seo Young Choi
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, Korea
| | - Hee Young Choi
- Department of Ophthalmology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, Korea
| | - Kwang-Dong Choi
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, Korea
| |
Collapse
|
9
|
Pakuliene G, Kuzmiene L, Siesky B, Harris A, Januleviciene I. Changes in ocular morphology after cataract surgery in open angle glaucoma patients. Sci Rep 2021; 11:12203. [PMID: 34108591 PMCID: PMC8190274 DOI: 10.1038/s41598-021-91740-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 05/28/2021] [Indexed: 02/05/2023] Open
Abstract
The purpose of this study was to evaluate intraocular pressure (IOP) pre- and postoperatively, together with anterior chamber angle (ACA) parameters and biometrical results in cataract patients with or without open angle glaucoma (OAG). The prospective observational case-control study included 15 eyes with cataract and OAG in the glaucoma group and 25 eyes with only cataract in control group. Examination included full ophthalmic evaluation, IOP, ocular biometry and anterior segment optical coherence tomography measuring ACA pre- and 6 months postoperatively. OAG patients had a larger absolute IOP reduction compared to control group. Anterior chamber depth (ACD) and ACA width significantly increased in both groups. The OAG group had a tendency of narrower ACA preoperatively, but overall ACA parameters did not differ in either group pre- and postoperatively. The ACD change after surgery correlated with ACA parameters in the control group, but not in OAG group. Axial length was shorter postoperatively in the control group, but remained similar in the OAG group. Absolute IOP reduction was more pronounced in cataract patients with OAG than in cataract patients without glaucoma. ACD and ACA postoperatively increased in both groups and AL shortening was observed in non-OAG in cataract group.
Collapse
Affiliation(s)
- Giedre Pakuliene
- Department of Ophthalmology, Lithuanian University of Health Sciences, Eiveniu g. 2, 50161, Kaunas, Lithuania.
| | - Loreta Kuzmiene
- Department of Ophthalmology, Lithuanian University of Health Sciences, Eiveniu g. 2, 50161, Kaunas, Lithuania
| | - Brent Siesky
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alon Harris
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ingrida Januleviciene
- Department of Ophthalmology, Lithuanian University of Health Sciences, Eiveniu g. 2, 50161, Kaunas, Lithuania
| |
Collapse
|
10
|
Kang YS, Sung MS, Heo H, Ji YS, Park SW. Long-term outcomes of prediction error after combined phacoemulsification and trabeculectomy in glaucoma patients. BMC Ophthalmol 2021; 21:60. [PMID: 33499825 PMCID: PMC7839202 DOI: 10.1186/s12886-021-01824-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 01/20/2021] [Indexed: 11/10/2022] Open
Abstract
Background To investigate long-term outcomes of prediction error after phacotrabeculectomy and to determine risk factors that may cause unstable prediction error after phacotrabeculectomy in glaucoma patients. Methods A total 120 eyes of 120 patients who had underwent uncomplicated phacotrabeculectomy (combined group) or phacoemulsification (phaco-only group) were included. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) were measured before and after surgery, and anterior segment parameters including anterior chamber depth (ACD), lens vault (LV), and anterior vault (AV) measured using anterior-segment optical coherence tomography were compared between the two groups. The mean absolute error (MAE) at 3, 6, 12, and 24 months postoperatively were compared. Risk factors associated with unstable prediction error (MAE ≥ 0.5) were investigated in the combined group. Results In both groups, BCVA was improved and IOP was decreased significantly. MAE at 3, 6, 12, 24 months postoperatively were not significantly different between two groups. The risk factors for unstable prediction error after 12 months of phacotrabeculectomy were old age and LV. Whereas, the only factor predicting unstable prediction error after 24 months of phacotrabeculectomy was LV. The cut-off value of LV for predicting unstable refractive error analyzed by the ROC curve was 0.855 mm. Conclusions Phacotrabeculectomy may be an effective treatment with stable long-term outcomes of prediction error similar to phacoemulsification in patients with glaucoma. However, elderly patients or patients with large LV may be predisposed to unstable prediction error after phacotrabeculectomy.
Collapse
Affiliation(s)
- Yeon Soo Kang
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea
| | - Mi Sun Sung
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea
| | - Hwan Heo
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea
| | - Yong Sok Ji
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea
| | - Sang Woo Park
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea.
| |
Collapse
|
11
|
Fernández-Vega Cueto A, Rodríguez-Una I, Rodríguez-Calvo PP, Alfonso JF. Femtosecond laser-assisted cataract surgery in shallow anterior chamber cases. Int Ophthalmol 2020; 41:707-717. [PMID: 33099746 DOI: 10.1007/s10792-020-01628-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 10/17/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE To assess the effectiveness, safety and predictability of femtosecond laser-assisted cataract surgery (FLACS) in eyes with shallow anterior chamber (AC). METHODS This is a prospective consecutive clinical study. All eyes presented an anterior chamber depth (ACD) ≤ 2.1 mm and were submitted to FLACS with monofocal intraocular lens (mIOL) or trifocal intraocular lens (tIOL) implantation. Uncorrected distance visual acuity (VA) and corrected distance VA values were used to assess efficacy and safety of the surgery. Refraction, intraocular pressure (IOP), endothelial cell density (ECD) and ACD were evaluated before and 6 months post-surgery. RESULTS Phacoemulsification was carried out successfully in all eyes, without intra- or postoperative complications. Efficacy and safety indexes were 0.96 and 1.26 for the mIOL group, and 0.87 and 1.01 for the tIOL group, respectively. The mean postoperative spherical equivalent was - 0.06 ± 0.28D and - 0.14 ± 0.38D for the mIOL and tIOL groups, respectively. The ECD varied from 2470 ± 483 to 2009 ± 538 cells/mm2 (p < 0.05) and from 2443 ± 319 to 2245 ± 628 cells/mm2 (p = 0.06) for the mIOL and tIOL groups, respectively. IOP significantly decreased (p < 0.05) after the surgery from 14.34 to 12.85 mmHg for the mIOL group and from 14.37 to 11.91 mmHg for the tIOL group, with a general reduction of medical hypotensive treatment in both groups (85% of cases required ≤ number of medications). ACD changed significantly (p < 0.05) from 1.96 ± 0.15 mm to 3.75 ± 0.30 mm after the surgery in the mIOL group and from 1.94 ± 0.15 mm to 3.23 ± 0.21 mm for the tIOL group. CONCLUSION FLACS with implantation of either mIOL or tIOL may provide good efficacy, safety and predictability in eyes with shallow AC.
Collapse
Affiliation(s)
- Andrés Fernández-Vega Cueto
- Fernández-Vega Ophthalmological Institute, University of Oviedo, Avda. Dres. Fernández-Vega, 34, 33012, Oviedo, Spain
| | - Ignacio Rodríguez-Una
- Fernández-Vega Ophthalmological Institute, University of Oviedo, Avda. Dres. Fernández-Vega, 34, 33012, Oviedo, Spain.
| | - Pedro P Rodríguez-Calvo
- Fernández-Vega Ophthalmological Institute, University of Oviedo, Avda. Dres. Fernández-Vega, 34, 33012, Oviedo, Spain
| | - José F Alfonso
- Fernández-Vega Ophthalmological Institute, University of Oviedo, Avda. Dres. Fernández-Vega, 34, 33012, Oviedo, Spain
| |
Collapse
|
12
|
Abstract
Mutations in human PAX6 gene are associated with various congenital eye malformations including aniridia, foveal hypoplasia, and congenital nystagmus. These various phenotypes may depend on the mutation spectrums that can affect DNA-binding affinity, although this hypothesis is debatable. We screened PAX6 mutations in two unrelated patients with congenital nystagmus, and measured DNA-binding affinity through isothermal titration calorimetry (ITC). To elucidate phenotypic differences according to DNA-binding affinity, we also compared DNA-binding affinity among the previously reported PAX6 missense mutations within the linker region between two subdomains of the paired domain (PD). We identified two novel mutations of PAX6 gene: c.214 G > T (p.Gly72Cys) and c.249_250delinsCGC (p.Val84Alafs*8). Both were located within the linker region between the two subdomains of the PD. ITC measurement revealed that the mutation p.Val84Alafs*8 had no DNA-binding affinity, while the p.Gly72Cys mutation showed a decreased binding affinity (Kd = 0.58 μM) by approximately 1.4 times compared to the wild type-PAX6 (Kd = 0.41 μM). We also found that there was no close relationship between DNA-binding affinity and phenotypic differences. Our results suggest that the DNA-binding affinity alone might be insufficient to determine PAX6-related phenotypes, and that other modifier genes or environmental factors might affect phenotypes of the PAX6 gene.
Collapse
|
13
|
Sieck EG, Capitena Young CE, Epstein RS, SooHoo JR, Pantcheva MB, Patnaik JL, Lynch AM, Kahook MY, Seibold LK. Refractive outcomes among glaucoma patients undergoing phacoemulsification cataract extraction with and without Kahook Dual Blade goniotomy. EYE AND VISION (LONDON, ENGLAND) 2019; 6:28. [PMID: 31548974 PMCID: PMC6751845 DOI: 10.1186/s40662-019-0153-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 08/29/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Glaucoma patients undergoing phacoemulsification alone have a higher rate of refractive surprise compared to patients without glaucoma. This risk is further increased with combined filtering procedures. Indeed, there are few and conflicting reports on the effect of combined phacoemulsification and micro-invasive glaucoma surgery (MIGS). Here, we look at refractive outcomes of glaucoma patients undergoing phacoemulsification with and without Kahook Dual Blade (KDB) goniotomy. METHODS Retrospective chart review of 385 glaucomatous eyes of 281 patients, which underwent either phacoemulsification alone (n = 309) or phacoemulsification with KDB goniotomy (n = 76, phaco-KDB) at the University of Colorado. The main outcome was refractive surprise defined as the difference in target and postoperative refraction spherical equivalent greater than ±0.5 Diopter (D). RESULTS Refractive surprise greater than ±0.5 D occurred in 26.3% of eyes in the phaco-KDB group and 36.2% in the phacoemulsification group (p = 0.11). Refractive surprise greater than ±1.0 D occurred in 6.6% for the phaco-KDB group and 9.7% for the phacoemulsification group (p = 0.08). There was no significant difference in risk of refractive surprise when pre-operative IOP, axial length, keratometry or performance of KDB goniotomy were assessed in univariate analyses. CONCLUSION There was no difference between refractive outcomes of glaucomatous patients undergoing phacoemulsification with or without KDB goniotomy.
Collapse
Affiliation(s)
- Erin G. Sieck
- Department of Ophthalmology, University of Colorado School of Medicine, 1675 Aurora Court F731, Aurora, CO 80045 USA
| | - Cara E. Capitena Young
- Department of Ophthalmology, University of Colorado School of Medicine, 1675 Aurora Court F731, Aurora, CO 80045 USA
| | - Rebecca S. Epstein
- Department of Ophthalmology, University of Colorado School of Medicine, 1675 Aurora Court F731, Aurora, CO 80045 USA
| | - Jeffrey R. SooHoo
- Department of Ophthalmology, University of Colorado School of Medicine, 1675 Aurora Court F731, Aurora, CO 80045 USA
| | - Mina B. Pantcheva
- Department of Ophthalmology, University of Colorado School of Medicine, 1675 Aurora Court F731, Aurora, CO 80045 USA
| | - Jennifer L. Patnaik
- Department of Ophthalmology, University of Colorado School of Medicine, 1675 Aurora Court F731, Aurora, CO 80045 USA
| | - Anne M. Lynch
- Department of Ophthalmology, University of Colorado School of Medicine, 1675 Aurora Court F731, Aurora, CO 80045 USA
| | - Malik Y. Kahook
- Department of Ophthalmology, University of Colorado School of Medicine, 1675 Aurora Court F731, Aurora, CO 80045 USA
| | - Leonard K. Seibold
- Department of Ophthalmology, University of Colorado School of Medicine, 1675 Aurora Court F731, Aurora, CO 80045 USA
| |
Collapse
|
14
|
Day AC, Cooper D, Burr J, Foster PJ, Friedman DS, Gazzard G, Che-Hamzah J, Aung T, Ramsay CR, Azuara-Blanco A. Clear lens extraction for the management of primary angle closure glaucoma: surgical technique and refractive outcomes in the EAGLE cohort. Br J Ophthalmol 2018; 102:1658-1662. [PMID: 29453222 DOI: 10.1136/bjophthalmol-2017-311447] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 01/04/2018] [Accepted: 01/31/2018] [Indexed: 11/03/2022]
Abstract
BACKGROUND To describe the surgical technique and refractive outcomes following clear lens extraction (CLE) in the Effectiveness, in Angle-closure Glaucoma, of Lens Extraction trial. METHODS Review of prospectively collected data from a multicentre, randomised controlled trial comparing CLE and laser peripheral iridotomy. Eligible participants were ≥50 years old and newly diagnosed with (1) primary angle closure (PAC) with intraocular pressure above 30 mm Hg or (2) PAC glaucoma. We report the postoperative corrected distance visual acuity (CDVA) and refractive outcomes at 12 and 36 months postoperatively for those who underwent CLE. RESULTS Of the 419 participants, 208 were randomised to CLE. Mean baseline CDVA was 77.9 (SD 12.4) letters and did not change significantly at 36 months when mean CDVA was 79.9 (SD 10.9) letters. Mean preoperative spherical equivalents were +1.7 (SD 2.3) and +0.08 (SD 0.95) diopters (D) at 36 months. Fifty-nine per cent and 85% eyes were within ±0.5D and ±1.0D of predicted refraction, respectively, at 36 months. CONCLUSIONS Mean CDVA in patients undergoing CLE for angle-closure glaucoma appeared stable over the 3-year study period. Refractive error was significantly reduced with surgery but refractive predictability was suboptimal. TRIAL REGISTRATION NUMBER
Collapse
Affiliation(s)
- Alexander C Day
- NIHR Biomedical Research Centre, Moorfields Eye Hospital and University College London, London, UK
| | - David Cooper
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Jennifer Burr
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Paul J Foster
- NIHR Biomedical Research Centre, Moorfields Eye Hospital and University College London, London, UK
| | | | - Gus Gazzard
- NIHR Biomedical Research Centre, Moorfields Eye Hospital and University College London, London, UK
| | | | - Tin Aung
- Singapore Eye Research Institute, Singapore
| | - Craig R Ramsay
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | | |
Collapse
|