[Spatial contrast sensitivity in patients with primary open-angle glaucoma and ocular hypertension]

Clinical outcomes after implantation of a new monofocal intraocular lens with enhanced intermediate function in patients with preperimetric glaucoma

Purpose

We evaluated the clinical outcomes after implantation of a new monofocal intraocular lens (IOL) with enhanced intermediate function in patients with preperimetric glaucoma and compared those with patients without retinal nerve fiber layer (RNFL) defects.

Methods

All patients were implanted bilaterally a new monofocal IOL with enhanced intermediate function. Patients with bilateral RNFL defects and no glaucomatous visual field defects were classified as the preperimetric glaucoma group. A total of 60 eyes of 30 patients with preperimetric glaucoma were compared with 60 eyes of 30 patients without RNFL defects. Uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), defocus curve, contrast sensitivity, and questionnaire were evaluated 1 month and 3 months after surgery.

Results

No difference in binocular UDVA, UIVA, and UNVA was evident between the two groups at 1 and 3 months postoperatively. Additionally, there were no significant differences between the two groups regarding the proportion of severe or very severe photic phenomena, such as glare and halos, or the overall satisfaction.

Conclusion

Bilateral implantation of a new monofocal IOL with enhanced intermediate function in patients with preperimetric glaucoma demonstrated commensurate clinical outcomes and could be considered a feasible alternative.

[First experience of implantation of extended depth of focus intraocular lenses in patients with glaucoma]

PURPOSE

This study evaluates the effectiveness of implantation of extended depth of focus (EDOF) intraocular lenses (IOL) in patients with cataract and glaucoma.

MATERIAL AND METHODS

The study included 13 patients (16 eyes) who underwent implantation of the Lentis Comfort EDOF IOL (Teleon Surgical BV, Netherlands). Standard phacoemulsification cataract surgery with IOL implantation was performed in a planned manner after the hypotensive surgery stage in two eyes; a combined procedure was performed in 14 cases. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), near visual acuity, and intraocular pressure (IOP) measured with a Maklakov tonometer were assessed preoperatively, on the first day, and 3-6 months after surgery. Computer perimetry using the 30-2 program and spatial contrast sensitivity (SCS) assessment were also performed preoperatively and at the same follow-up time points.

RESULTS

On the first day after surgery, UCVA was 0.53±0.65, BCVA was 0.85±0.45. Near UCVA (at 40 cm) was 0.5±0.14 on the first day after surgery and 0.56±0.18 at 3-6 months. According to computer perimetry data, retinal light sensitivity values increased in all patients in the long-term (-3.1±2.9 dB). SCS values increased for objects of all sizes compared to preoperative values.

CONCLUSION

Implantation of EDOF IOL contributes to improved vision without reducing contrast sensitivity and retinal light sensitivity in patients with concomitant cataract and glaucoma.

Perimetry Criteria For Assessing The Effectiveness Of Retinoprotective Therapy

Objective — To evaluate the effect of the frequency of retinoprotective therapy courses on perimetry parameters, to compare Octopus 900 perimeter with Octopus 600 perimeter, and to assess threshold perimetry results of G-dynamic versus 24-2 programs. Material and Methods — The study involved 17 patients (34 eyes) diagnosed with primary open-angle glaucoma of advanced stage. Group 1 included subjects receiving a course of Retinalamin every 3 months. Group 2 comprised patients undergoing Retinalamin therapeutics every 6 months. Results — At the onset of the study via G-dynamic and 24-2 programs, we did not observe any statistically significant differences between the groups in mean deviation of retinal photosensitivity (MD) and pattern standard deviation of mean retinal photosensitivity (PSD). However, the absolute values differed between groups and between programs. On average, the differences in MD and PSD values obtained in the photosensitivity study with G-dynamic vs. 24-2 programs were -0.36 dB (CI 95%: -4.27; 3.54) and 0.63 dB (CI 95%: 2.37; -1.11), respectively. Hence, studies performed via 24-2 and G-dynamic programs yielded comparable results (no statistically significant differences). However, they could not be identical due to different spatial arrangement of points in different programs. Conclusion — As a result of conducted treatment, retinal photosensitivity did not exhibit statistically significant changes; however, we observed positive dynamics in both groups in MD and PSD parameters of mean retinal photosensitivity. Different devices (Octopus 600 and Octopus 900 perimeters) and different programs (24-2, G-dynamic) yielded different outcomes due to their technical features and capabilities of reproducibility; however, these differences were not statistically significant.

[Static automated perimetry in the diagnosis of glaucoma. Part 2: Research protocol, glaucoma classifications, perimetric defects through the prism of structural-functional correlation]

Examination of the central visual field is currently required for glaucoma diagnosis. Modern computer perimeters make it possible to qualitatively and quantitatively evaluate defects of light sensitivity. Perimetric indices are calculated showing the severity of the defects. This allows the use of perimetric results to create universal classifications of glaucoma. Recently, new perimeter programs based on optical coherence tomography data have appeared. The possibility of personalizing perimeter programs are being tested. This review attempts to systematize data on the capabilities of computer perimeters in assessing functional defects, presents the widely used glaucoma classifications, and describes ways of developing static perimetry programs for earlier diagnosis of glaucoma with respect to structural and functional correlations.