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Han T, Chen X, Xu Y, Niu L, Wang X, Zhou X. Refractive outcomes of implantable collamer lens implantation in 1212 eyes with suboptimal corrected distance vision acuity. Curr Eye Res 2022; 47:1419-1423. [PMID: 35757851 DOI: 10.1080/02713683.2022.2094418] [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: 11/03/2022]
Abstract
Purpose: To analyze the factors related to corrected distance vision acuity (CDVA) after implantable collamer lens (ICL) implantation in patients with preoperative suboptimal CDVA.Methods: This retrospective study included patients with suboptimal preoperative CDVA (CDVA ≤20/25) who underwent ICL implantation (V4 or V4c). Preoperative and postoperative clinical evaluations included CDVA, uncorrected distance visual acuity (UDVA), and refraction.Results: A total of 1,212 eyes from 731 patients were identified. CDVA increased in 90.8% of the eyes after surgery. Among them, 57.5% of the eyes (697 eyes) gained more than one line. The preoperative LogMAR CDVA was 0.32 ± 0.23, which significantly improved to 0.13 ± 0.17 postoperatively (p < 0.001). There was no significant difference between ICL V4c and ICL V4 in the LogMAR UDVA, sphere, cylinder, SE, LogMAR CDVA, efficacy index, and safety index after surgery (p > 0.05). For eyes with full correction, the postoperative LogMAR CDVA =0.575 * preoperative LogMAR CDVA -0.061 (p < 0.001, R2 = 0.53). For eyes with partial correction, the postoperative LogMAR CDVA =0.536 * preoperative LogMAR CDVA - 0.007 * SE - 0.196 (P < 0.001, R2 = 0.55).Conclusion: ICL implantation can improve CDVA in eyes with suboptimal CDVA. This study provides the postoperative outcomes of eyes with different preoperative CDVA, which makes it convenient for surgeons to communicate with such patients before surgery.
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Affiliation(s)
- Tian Han
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Research Center of Ophthalmology and Optometry Shanghai, Shanghai, China
| | - Xun Chen
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Research Center of Ophthalmology and Optometry Shanghai, Shanghai, China
| | - Ye Xu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Research Center of Ophthalmology and Optometry Shanghai, Shanghai, China
| | - Lingling Niu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Research Center of Ophthalmology and Optometry Shanghai, Shanghai, China
| | - Xiaoying Wang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Research Center of Ophthalmology and Optometry Shanghai, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Research Center of Ophthalmology and Optometry Shanghai, Shanghai, China
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Halicka J, Bittsansky M, Sivak S, Piñero DP, Ziak P. Virtual Reality Visual Training in an Adult Patient with Anisometropic Amblyopia: Visual and Functional Magnetic Resonance Outcomes. Vision (Basel) 2021; 5:vision5020022. [PMID: 34064788 PMCID: PMC8163189 DOI: 10.3390/vision5020022] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/25/2021] [Accepted: 05/10/2021] [Indexed: 11/16/2022] Open
Abstract
A case of an adult with anisometropic amblyopia who underwent a successful vision therapy program playing videogames in a virtual reality environment is described, reporting changes in conventional visual clinical data, as well as in brain activity. The patient was a 22 year old man on baseline examination that never previously wore correction for his anisometropia. After prescribing contact lens correction for the anisometropia and after 44 h of virtual reality-based vision therapy over a period of 1.5 years, the best corrected distance visual acuity (BCDVA) in the amblyopic eye improved from 0.05 to 0.5 (Sloan chart). One year after finishing the visual training, the BCDVA experienced a slight decrease to 0.4 (Sloan chart). Through the visual training, the patient gradually developed stereopsis. Likewise, changes were also detected after visual therapy on functional magnetic resonance imaging while the patient was viewing 2D and 3D stimuli. The preliminary results of this case show the potential of using virtual reality-based visual training as a treatment for adult amblyopia.
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Affiliation(s)
- Juraj Halicka
- Eye Clinic, Jessenius Faculty of Medicine, Commenius University in Bratislava, Kollárova 2, 036 59 Martin, Slovakia;
- UVEA Mediklinik, Zelená 3739/1, 036 01 Martin-Priekopa, Slovakia
| | - Michal Bittsansky
- Department of Biochemistry, Jessenius Faculty of Medicine, Commenius University in Bratislava, Mlynská dolina Ilkovičova 6, 842 15 Bratislava, Slovakia;
| | - Stefan Sivak
- Neurology Clinic, Jessenius Faculty of Medicine, Commenius University in Bratislava, Kollárova 2, 036 59 Martin, Slovakia;
| | - David P. Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig s/n, 03690 Alicante, Spain
- Correspondence: (D.P.P.); (P.Z.); Tel.: +34-965903500 (D.P.P.); +421-43401-2604 (P.Z.)
| | - Peter Ziak
- Eye Clinic, Jessenius Faculty of Medicine, Commenius University in Bratislava, Kollárova 2, 036 59 Martin, Slovakia;
- UVEA Mediklinik, Zelená 3739/1, 036 01 Martin-Priekopa, Slovakia
- Correspondence: (D.P.P.); (P.Z.); Tel.: +34-965903500 (D.P.P.); +421-43401-2604 (P.Z.)
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Zhang J, Zhuang J, Yu KM. Posterior chamber phakic intraocular lens for the correction of high myopic anisometropic amblyopia in adults. Int J Ophthalmol 2018; 11:1870-1874. [PMID: 30450321 DOI: 10.18240/ijo.2018.11.21] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 08/23/2018] [Indexed: 11/23/2022] Open
Abstract
This study aims to evaluate the clinical results of posterior chamber implantable collamer lens (ICL) implantation in adults with high myopic anisometropic amblyopia. Thirteen patients aged 27.04±7.24y (range 19.2 to 42.5) were studied. ICL implantation was performed in 13 amblyopic eyes. The mean myopic anisometropia was significantly dropped from -10.70±3.02 D preoperatively to +0.09±1.67 D at 1mo postoperatively. The logMAR CDVA at 3d, 1, 3 and mean 9mo postoperatively improved by a mean of 1.69, 2.50, 3.01 and 3.00 lines and gained more than 2 lines accounted for 23.08% (3 eyes), 41.67% (5 eyes), 63.63% (7 eyes) and 55.56% (5 eyes), respectively. The contrast sensitivity of amblyopic eyes was significantly increased after surgery. Four patients partially recovered near stereopsis (400″ to 100″). There was no severe complications were observed. ICL implantation alone can improve vision, contrast sensitivity, and partial restoration of binocular vision in adult patients with high myopic anisometropia.
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Affiliation(s)
- Jing Zhang
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Affiliated Shenzhen Eye Hospital of Jinan University, Shenzhen 518040, Guangdong Province, China
| | - Jing Zhuang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Ke-Ming Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
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Sorkin N, Varssano D, Smadja D, Klein A, Mimouni M, Rosenblatt A. Visual outcomes of laser vision correction in eyes with preoperative amblyopia. J Cataract Refract Surg 2017; 43:383-388. [PMID: 28410722 DOI: 10.1016/j.jcrs.2016.12.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 12/06/2016] [Accepted: 12/30/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the visual outcomes of photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) in amblyopic eyes. SETTING Care Vision Refractive Clinic, Tel Aviv, Israel. DESIGN Retrospective case series. METHODS Amblyopic eyes of patients with a preoperative corrected distance visual acuity (CDVA) of 20/33 or worse had PRK or LASIK. Postoperative visual outcomes (uncorrected distance visual acuity, CDVA) and correlations with age, preoperative CDVA, refractive error type, astigmatism grade, procedure type, laser suite model, amblyopia grade, and amblyopia type were analyzed. RESULTS This study evaluated 327 eyes (327 patients). The CDVA improved more than 1, 2, and 3 Snellen lines in 147 eyes (45.0%), 75 eyes (22.9%), and 32 eyes (9.8%), respectively. Age (P = .007, B = 0.002), and preoperative CDVA (P < .001, B = -0.405) were significantly associated with CDVA improvement. The outcome in eyes with lower myopia was significantly better than in eyes with hyperopia (0.054 logMAR difference; P = .016) or high myopia (0.036 logMAR difference; P = .002). Moderately amblyopic eyes had significantly better visual outcomes than mildly amblyopic eyes (0.038 logMAR difference; P = .001). No significant difference was found between PRK and LASIK (P = .262). CONCLUSIONS Laser vision correction, regardless of the type of procedure (LASIK or PRK) might improve CDVA in a large portion of amblyopic patients. Improvement was greater in younger patients, eyes with lower initial CDVA, and eyes with lower myopia.
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Affiliation(s)
- Nir Sorkin
- From the Department of Ophthalmology (Sorkin, Varssano, Smadja, Klein, Rosenblatt), Tel Aviv Sourasky Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Care Vision Refractive Surgery Facility (Sorkin), Tel Aviv, and the Department of Ophthalmology (Mimouni), Rambam Health Care Campus, Haifa, Israel.
| | - David Varssano
- From the Department of Ophthalmology (Sorkin, Varssano, Smadja, Klein, Rosenblatt), Tel Aviv Sourasky Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Care Vision Refractive Surgery Facility (Sorkin), Tel Aviv, and the Department of Ophthalmology (Mimouni), Rambam Health Care Campus, Haifa, Israel
| | - David Smadja
- From the Department of Ophthalmology (Sorkin, Varssano, Smadja, Klein, Rosenblatt), Tel Aviv Sourasky Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Care Vision Refractive Surgery Facility (Sorkin), Tel Aviv, and the Department of Ophthalmology (Mimouni), Rambam Health Care Campus, Haifa, Israel
| | - Ainat Klein
- From the Department of Ophthalmology (Sorkin, Varssano, Smadja, Klein, Rosenblatt), Tel Aviv Sourasky Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Care Vision Refractive Surgery Facility (Sorkin), Tel Aviv, and the Department of Ophthalmology (Mimouni), Rambam Health Care Campus, Haifa, Israel
| | - Michael Mimouni
- From the Department of Ophthalmology (Sorkin, Varssano, Smadja, Klein, Rosenblatt), Tel Aviv Sourasky Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Care Vision Refractive Surgery Facility (Sorkin), Tel Aviv, and the Department of Ophthalmology (Mimouni), Rambam Health Care Campus, Haifa, Israel
| | - Amir Rosenblatt
- From the Department of Ophthalmology (Sorkin, Varssano, Smadja, Klein, Rosenblatt), Tel Aviv Sourasky Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Care Vision Refractive Surgery Facility (Sorkin), Tel Aviv, and the Department of Ophthalmology (Mimouni), Rambam Health Care Campus, Haifa, Israel
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Gonzalez-Lopez F, Alonso-Santander N, Mompean B, Bilbao-Calabuig R, Calvache JA, Beltran J. Visual outcomes in adult amblyopic eyes with moderate myopia after corneal laser surgery versus copolymer phakic intraocular lens implant. J Cataract Refract Surg 2015; 41:2513-23. [PMID: 26703502 DOI: 10.1016/j.jcrs.2015.05.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 05/25/2015] [Accepted: 05/27/2015] [Indexed: 11/17/2022]
Abstract
PURPOSE To assess visual acuity and refractive correction in moderately myopic adult eyes with suboptimal preoperative corrected distance visual acuity (CDVA) after laser in situ keratomileusis (LASIK) or insertion of a posterior chamber Implantable Collamer Lens phakic intraocular lens (pIOL). SETTING Clínica Baviera, Instituto Oftalmológico Europeo, Torrevieja Hospital, Madrid, Spain. DESIGN Retrospective study. METHODS The study sample included 1310 eyes that had LASIK and 94 that had insertion of a pIOL from July 2002 to September 2013. Suboptimal preoperative CDVA was defined as equal to logMAR 0.15 or below and moderate myopia as a spherical equivalent of -5.0 to -10.0 diopters (D). RESULTS The preoperative mean CDVA was 0.22 logMAR ± 0.09 (SD) in the LASIK group and 0.23 ± 0.09 logMAR in the pIOL group. Postoperative uncorrected distance visual acuity (UDVA) was 0.13 ± 0.12 logMAR in the laser group and 0.12 ± 0.09 logMAR in the pIOL group, with a postoperative CDVA of 0.11 ± 0.10 logMAR and 0.08 ± 0.07 logMAR, respectively. CONCLUSIONS Compared with preoperative values, amblyopic eyes with moderate myopia having LASIK or implantation of a pIOL demonstrated a statistically significant improvement in UDVA and CDVA (P < .001). The pIOL group performed significantly better than the LASIK group in terms of safety and efficiency. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Felix Gonzalez-Lopez
- From the Clínica Baviera (Gonzalez-Lopez, Alonso-Santander, Mompean, Bilbao-Calabuig, Calvache, Beltran), Instituto Oftalmológico Europeo and the Department of Ophthalmology (Mompean), Torrevieja Hospital, Alicante, Spain.
| | - Nuria Alonso-Santander
- From the Clínica Baviera (Gonzalez-Lopez, Alonso-Santander, Mompean, Bilbao-Calabuig, Calvache, Beltran), Instituto Oftalmológico Europeo and the Department of Ophthalmology (Mompean), Torrevieja Hospital, Alicante, Spain
| | - Blas Mompean
- From the Clínica Baviera (Gonzalez-Lopez, Alonso-Santander, Mompean, Bilbao-Calabuig, Calvache, Beltran), Instituto Oftalmológico Europeo and the Department of Ophthalmology (Mompean), Torrevieja Hospital, Alicante, Spain
| | - Rafael Bilbao-Calabuig
- From the Clínica Baviera (Gonzalez-Lopez, Alonso-Santander, Mompean, Bilbao-Calabuig, Calvache, Beltran), Instituto Oftalmológico Europeo and the Department of Ophthalmology (Mompean), Torrevieja Hospital, Alicante, Spain
| | - Jose A Calvache
- From the Clínica Baviera (Gonzalez-Lopez, Alonso-Santander, Mompean, Bilbao-Calabuig, Calvache, Beltran), Instituto Oftalmológico Europeo and the Department of Ophthalmology (Mompean), Torrevieja Hospital, Alicante, Spain
| | - Jaime Beltran
- From the Clínica Baviera (Gonzalez-Lopez, Alonso-Santander, Mompean, Bilbao-Calabuig, Calvache, Beltran), Instituto Oftalmológico Europeo and the Department of Ophthalmology (Mompean), Torrevieja Hospital, Alicante, Spain
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Venter JA, Pelouskova M, Schallhorn SC, Collins BM. Visual acuity improvement in adult amblyopic eyes with an iris-fixated phakic intraocular lens: long-term results. J Cataract Refract Surg 2015; 41:541-7. [PMID: 25804581 DOI: 10.1016/j.jcrs.2014.06.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 06/01/2014] [Accepted: 06/04/2014] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the effect of implantation of iris-fixated phakic intraocular lenses (pIOLs) (Artisan) in adult amblyopic eyes. SETTING Optical Express, London, United Kingdom. DESIGN Retrospective case series. METHODS The study analyzed data from 5 years of follow-up of amblyopic eyes that were implanted with iris-fixated pIOLs and had a preoperative corrected distance visual acuity (CDVA) of 6/15 or worse. Visual acuity, refraction, endothelial cell count, and complications were assessed. RESULTS Data for 103 eyes were analyzed as 2 groups. Group 1 comprised 82 eyes with myopia or myopic astigmatism, and Group 2 contained 21 eyes with hyperopia or hyperopic astigmatism. The mean preoperative sphere in Group 1 was -13.42 diopters (D) ± 5.62 (SD) with a mean cylinder of -2.35 ± 1.75 D. In Group 2, the mean sphere and cylinder were +6.77 ± 1.91 D and -2.63 ± 2.43 D, respectively. The mean CDVA improved from 0.51 ± 0.15 logMAR to 0.34 ± 0.16 logMAR (P<.001) in Group 1 and from 0.54 ± 0.17 logMAR to 0.46 ± 0.14 logMAR in Group 2 (P<.005). The safety index was 1.48 in Group 1 and 1.19 in Group 2. The efficacy index was 1.21 in Group 1 and 1.00 in Group 2. The mean gain in CDVA was statistically significantly greater in Group 1 (0.17 ± 0.14 logMAR) than in Group 2 (0.08 ± 0.11 logMAR). Two or more lines of CDVA were gained by 48.8% of eyes in Group 1 and by 19.0% of eyes in Group 2. CONCLUSION The iris-fixated pIOL was a safe and effective option for improving visual acuity in adult amblyopic eyes. FINANCIAL DISCLOSURE Dr. Schallhorn is a consultant to Abbott Medical Optics, Inc. No other author has a financial or proprietary interest in any material or method mentioned.
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Rosa AM, Silva MF, Ferreira S, Murta J, Castelo-Branco M. Plasticity in the human visual cortex: an ophthalmology-based perspective. BIOMED RESEARCH INTERNATIONAL 2013; 2013:568354. [PMID: 24205505 PMCID: PMC3800612 DOI: 10.1155/2013/568354] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 08/05/2013] [Accepted: 08/19/2013] [Indexed: 11/17/2022]
Abstract
Neuroplasticity refers to the ability of the brain to reorganize the function and structure of its connections in response to changes in the environment. Adult human visual cortex shows several manifestations of plasticity, such as perceptual learning and adaptation, working under the top-down influence of attention. Plasticity results from the interplay of several mechanisms, including the GABAergic system, epigenetic factors, mitochondrial activity, and structural remodeling of synaptic connectivity. There is also a downside of plasticity, that is, maladaptive plasticity, in which there are behavioral losses resulting from plasticity changes in the human brain. Understanding plasticity mechanisms could have major implications in the diagnosis and treatment of ocular diseases, such as retinal disorders, cataract and refractive surgery, amblyopia, and in the evaluation of surgical materials and techniques. Furthermore, eliciting plasticity could open new perspectives in the development of strategies that trigger plasticity for better medical and surgical outcomes.
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Affiliation(s)
- Andreia Martins Rosa
- Departamento de Oftalmologia, Centro Hospitalar e Universitário de Coimbra, 3000 Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
| | - Maria Fátima Silva
- Visual Neuroscience Laboratory, IBILI, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
| | - Sónia Ferreira
- Visual Neuroscience Laboratory, IBILI, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
| | - Joaquim Murta
- Departamento de Oftalmologia, Centro Hospitalar e Universitário de Coimbra, 3000 Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
- Visual Neuroscience Laboratory, IBILI, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
| | - Miguel Castelo-Branco
- Visual Neuroscience Laboratory, IBILI, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
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Visual acuity after laser in situ keratomileusis to correct high astigmatism in adults with meridional amblyopia. Am J Ophthalmol 2011; 152:964-968.e1. [PMID: 21851919 DOI: 10.1016/j.ajo.2011.05.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2010] [Revised: 04/30/2011] [Accepted: 05/04/2011] [Indexed: 11/24/2022]
Abstract
PURPOSE To analyze the effect of laser in situ keratomileusis to correct high myopic astigmatism in patients with suboptimal best spectacle-corrected visual acuity (BSCVA). DESIGN Retrospective, interventional series of consecutive cases. METHODS SETTING Vissum Madrid, Madrid, Spain. PATIENTS Two hundred five eyes of consecutive patients with suboptimal BSCVA and high myopic astigmatism of -3 diopters or more. INTERVENTION Laser in situ keratomileusis surgery. MAIN OUTCOME MEASURES BSCVA. RESULTS The BSCVA (decimal Snellen fraction notation) improved significantly (P = .0001) from a mean preoperative 0.77 ± 0.18 (range, 0.05 to 0.90) to 0.81 ± 0.19 (range, 0.05 to 1.25) 3 months after surgery. The mean change in lines of BSCVA (decimal Snellen fraction notation) was 0.04 ± 0.11 (range, -0.25 to 0.4). A significant inverse relationship (P = .001) was found between the preoperative BSCVA and the improvement in BSCVA. CONCLUSIONS In eyes with high myopic astigmatism and suboptimal preoperative BSCVA, laser in situ keratomileusis may result in a significant improvement in BSCVA.
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