AIM: To evaluate the accuracy of three commonly used biometric formulae across different axial lengths(ALs) at one United States Veterans Affairs teaching hospital.METHODS: A retrospective chart review was conducted f...AIM: To evaluate the accuracy of three commonly used biometric formulae across different axial lengths(ALs) at one United States Veterans Affairs teaching hospital.METHODS: A retrospective chart review was conducted from November 2013 to May 2018. One eye of each patient who underwent cataract surgery with a monofocal intraocular lens(IOL) was included. The range of postoperative follow-up period was from 3 wk to 4 mo. The Holladay 2, Barrett Universal II, and Hill-Radial Basis Function(Hill-RBF) formulae were used to predict the postoperative refraction for all cataract surgeries. For each formula, we calculated the prediction errors [including mean absolute prediction error(MAE)] and the percentage of eyes within ±0.25 diopter(D) and ±0.5 D of predicted refraction. We performed subgroup analyses for short(AL<22.0 mm), medium(AL 22.0-25.0 mm), and long eyes(AL>25.0 mm).RESULTS: A total of 1131 patients were screened, and 909 met the inclusion criteria. Resident ophthalmologists were the primary surgeons in 710(78.1%) cases. We found no statistically significant difference in predictive accuracy among the three formulae over the entire AL range or in the short, medium, and long eye subgroups. Across the entire AL range, the Hill-RBF formula resulted in the lowest MAE(0.384 D) and the highest percentage of eyes with postoperative refraction within ±0.25 D(42.7%) and ±0.5 D(75.5%) of predicted. All three formulae had the highest MAEs(>0.5 D) and lowest percentage within ±0.5 D of predicted refraction(<55%) in short eyes.CONCLUSION: In cataract surgery patients at our teaching hospital, three commonly used biometric formulae demonstrate similar refractive accuracy across all ALs. Short eyes pose the greatest challenge to predicting postoperative refractive error.展开更多
AIM：To analyze the visual outcomes and the posterior capsule opacification（PCO）with the new Incise？MJ14intraocular lens（IOL）implanted through a 1.4 mm clear corneal incision（CCI）in patients who underwent biman...AIM：To analyze the visual outcomes and the posterior capsule opacification（PCO）with the new Incise？MJ14intraocular lens（IOL）implanted through a 1.4 mm clear corneal incision（CCI）in patients who underwent bimanual microincision cataract surgery（B-MICS）.METHODS：Eighty eyes which underwent cataract surgery using B-MICS technique performed by the same experienced surgeon were included in the study：40 eyes were implanted with an Incise？MJ14 IOL through a 1.4 mm CCI（group A）without enlargement of the main CCI,while 40 eyes were implanted with an Akreos？MI60 IOL with enlargement of the main CCI to 1.8 mm（group B）.Best corrected visual acuity（BCVA）,astigmatism and endothelial cell loss were evaluated before and after surgery at 7,30d and 6mo.Anterior segment-optical coherence tomography（AS-OCT）of CCI was performed at 1,3,7,30d,6 and 18mo.PCO incidence was evaluated at 18mo using EPCO 2000 Software.RESULTS：Mean BCVA improvement and endothelial cell loss were statistically significant at 18mo in both groups with no difference between the two groups;no statistically significant difference in surgically induced astigmatism（SIA）was noticed in the two groups.At AS-OCT the only significant alterations in the CCI were endothelial gaping and local detachment of Descemet’s membrane at 1 and 7d after surgery;no statistically significant alterations were found at 1,6 and 18mo.PCO score at 18mo was 0.03±0.07for group A and 0.08±0.18 for group B（P=0.11）with no sign of central optic plate invasion in both groups.CONCLUSION：The implant of the new Incise？MJ14 IOL through a 1.4 mm CCI and B-MICS technique appeared to be a safe and effective procedure with rapid visual recovery.PCO rate resulted very low and the CCI presented few morphological alterations which were only detectable in the first days postoperatively and achieved fast corneal healing during the long-term follow-up.展开更多
The aetiology of OAL is undefined, although much attention has been recently focused on determining whether OAL is caused by an autoimmune disorder, chronic antigenic stimulation or both. It is becoming evident that i...The aetiology of OAL is undefined, although much attention has been recently focused on determining whether OAL is caused by an autoimmune disorder, chronic antigenic stimulation or both. It is becoming evident that infectious agents underlying chronic eye infection, as Chlamydia, may play a role in ocular lymphomagenesis. The high prevalence of Chlamydophila psittaci in patients with OAL has suggested a potential oncogenic role for its tendency to cause chronic and persistent infections, although it has been documented an evident geographical variability and response to antibiotic treatment. For C. pneumoniae, the findings so far obtained are very limited not only for identification in OAL but also for the specific treatment with antibiotics. The recent molecular and cultural evidence of C. trachomatis in patients with OAL, seems to suggest that also this pathogen may contribute to pathogenesis of such lymphoma. The potential application of bacteria-eradicating therapy at local and systemic level may ultimately result in safer and more efficient therapeutic option for patients affected by these malignancies. Moreover, a close collaboration between experts in ophthalmology, infectious diseases and hematology will help, in the future, to effectively manage this disease. This review attempts to weigh the currently available evidence regarding the role that Chlamydia play in development of OAL and focuses on patients with OAL observed at our Institution.展开更多
Background: Anterior chamber angle (ACA) can be measured by many different techniques. In order for a technique to be a part of the routine eye examination, it has to be quick and easy in good agreement with gonioscop...Background: Anterior chamber angle (ACA) can be measured by many different techniques. In order for a technique to be a part of the routine eye examination, it has to be quick and easy in good agreement with gonioscopy both nasally and temporally. Aim: To investigate variation in ACA measurement between gonioscopy, van Herick technique, anterior segment optical coherence tomography (AS-OCT) and Sirius Scheimpflug-Camera both nasally and temporally. Method: The ACA of 50 eyes of 25 healthy subjects was measured with gonioscopy, van Herick technique, AS-OCT and Sirius Scheimpflug-Camera. The angle was measured both nasally and temporally. Results: No statistically significant difference could be found between gonioscopy, van Herick technique and AS-OCT either nasally or temporally. The Sirius Scheimpflug-Camera on the other hand showed statistically significant difference to gonioscopy (p < 0.0001) both nasally (p = 0.03, p = 0.001, p < 0.0001) and temporally (p = 0.0002, p = 0.001, p Conclusion: This study showed good agreement between three of the four techniques. ACA measurements obtained by the Sirius Scheimpflug-Camera should therefore not be considered interchangeable with those obtained by the remaining three methods.展开更多
Background:The Akreos®AO60 intraocular lens(IOL)has been employed for scleral fixation in eyes without capsular support,although surgical complications,including IOL opacification,have been reported.This study ai...Background:The Akreos®AO60 intraocular lens(IOL)has been employed for scleral fixation in eyes without capsular support,although surgical complications,including IOL opacification,have been reported.This study aims to evaluate the outcomes and complications associated with scleral fixation of the Akreos®AO60 IOL in vitrectomized eyes,with a particular focus on IOL opacification.Methods:Electronic medical records of consecutive eyes that underwent scleral-fixation of the Akreos®AO60 lens using Gore-tex®sutures from 2017 to 2022 were reviewed.The following parameters were collected:age,sex,laterality,past ocular/medical history,surgical indication,pre-operative visual acuity(VA)and intraocular pressure(IOP),surgical procedure,and post-operative VA and IOP.The types of complications,onset,management,and outcomes were also documented.Descriptive statistics,Wilcoxon signed-rank test,and Fisher’s exact test were employed for statistical analysis.Results:Eighty-nine eyes of 86 patients aged 31-100 years were included.The most common surgical indication was non-traumatic IOL displacement.Retinal tears and localized choroidal hemorrhage were found intraoperatively in 7.9%and 1.1%,respectively.The most common post-operative complications were vitreous hemorrhage(13.5%),corneal edema(12.4%),ocular hypotony(11.2%),and IOL opacification(11.2%).IOL opacification was associated with intra-/post-operative exposure to air/gas[odds ratio(OR):12.24;95%confidence interval(CI),1.46-103.0;P=0.006].Mean logarithm of the minimum angle of resolution(logMAR)best-reported VA(BRVA)improved from 1.22±0.77 pre-operatively to 0.56±0.67 on latest follow-up(P<0.001).Conclusions:The majority of the complications from scleral-fixation of the Akreos®AO60 lens in vitrectomized eyes were mild and transient;however,a proportion required surgical intervention.A significant risk for opacification was found in IOLs exposed to air/gas,although VA was often maintained.展开更多
Objective:To describe the long-term outcomes of cases of neovascular glaucoma drained by Molteno implants.Methods:A prospective study of 145 eyes(130 patients)followed up for a mean of 3.3 years(range,0.02 year 5 days...Objective:To describe the long-term outcomes of cases of neovascular glaucoma drained by Molteno implants.Methods:A prospective study of 145 eyes(130 patients)followed up for a mean of 3.3 years(range,0.02 year 5 days to 18.1 years)in the province of Otago,New Zealand,from 1979 to 2002.Results:Insertion of a Molteno implant controlled the intraocular pressure at 21 mmHg or less with a probability(95% confidence interval)of 0.72(0.64-0.80),0.60(0.51-0.69),and 0.40(0.29-0.50)at 1,2,and 5 years,respectively.Failure to control intraocular pressure at 1,2,and 5 years was significantly correlated with persistent iris neovascularization(P<.001,P<.001,and P=.01,respectively).Visual acuity at final follow-up in non-enucleated eyes was maintained or improved in 56 eyes(39%)and deteriorated to light perception or better in 25(17%)or no light perception in 47(32%).Seventeen eyes(12%)were enucleated.Conclusions:The insertion of Molteno implants for neovascular glaucoma maintained or improved vision in 39% of eyes,whereas 12% were eventually enucleated(all of which initially had visual acuity < 20/1200).The outcome depended mainly on progression of the underlying vascular disease.展开更多
Aim: To evaluate the effect of oral pilocarpine treatment on conjunctival epithelium of patients with Sjgren’s syndrome (SS). Methods: 15 primary SS patients were included in this prospective, single masked, compar...Aim: To evaluate the effect of oral pilocarpine treatment on conjunctival epithelium of patients with Sjgren’s syndrome (SS). Methods: 15 primary SS patients were included in this prospective, single masked, comparative study. Patients underwent oral pilocarpine treatment for 2 months and were studied before (TO) and after 1 month (T1), 2 months (T2), and 15 days after treatment suspension (T3). Systemic and ocular symptoms, tear film break up time (BUT), corneal fluorescein vital staining, Schirmer I test, tear basal secretion test, and conjunctival imprinting were performed. Student’s t test and Mann-Whitney U test were used for statistics. Results: The conjunctival imprinting showed an increase of goblet cells number at T1 (1.6 (1.2) v 0.6 (0.7) at T0, p=0.025) improving at T2 (5.1 (1.7); p< 0.001 v T0 and T1). At T3 the number of goblet cells significantly decreased (1.9 (1.1); p< 0.001 v T2). An improvement of dry mouth started at T1 and returned towards baseline values at T3. For ocular symptoms, burning and foreign body sensation were improved at T1 while ocular dryness improved at T2. BUT showed a statistically significant improvement at T2. Conclusions: Oral pilocarpine induced an increase in goblet cells number and an amelioration of conjunctival epithelium not dependent on tear secretion.展开更多
Background:The Heidelberg Retina Tomograph(HRT)is a commercially available instrument for the detection of glaucomatous damage by analysis of optic nerve head topography.The main purpose of the study was to investigat...Background:The Heidelberg Retina Tomograph(HRT)is a commercially available instrument for the detection of glaucomatous damage by analysis of optic nerve head topography.The main purpose of the study was to investigate the ability of HRT to detect changes in optic disc topography indicating progression of optic neuropathy in eyes with open-angle glaucoma or,in eyes with ocular hypertension,conversion to open-angle glaucoma.Methods:Fifty-nine subjects(34 with ocular hypertension,25 with glaucoma)from the glaucoma service at Sahlgrenska University Hospital were included in this study.One eye of each patient was selected.All participants underwent thorough clinical examination,including HRT,high-pass resolution perimetry(HRP),and optic disk photography.After a mean follow-up time of 50 months,patients were re-examined.Based on analyses of optic disc photographs and HRP,eyes were classified into one of two groups:progressive or stable.Methods:The differences between baseline and follow-up HRT parameters in the two groups were analysed.The topographic HRT change images were also compared after digital image processing.A pixel ratio was calculated defined as the ratio between the area of pixels representing deepening of the disc surface and the total disc area.Receiver operating characteristic(ROC)curves for HRT parameters and pixel ratio were compared.Results:In the group judged to have progressive optic neuropathy,a statistically significant change between baseline and follow-up examination was found for the following HRT parameters:cup shape measurement,classification index,the third moment in contour,cup/disc ratio,cup area,rim area,and area below reference.In the stable group no HRT parameters had changed significantly.A well-defined distinction between the two groups was found by comparing digitally processed HRT change images.The area under the ROC curve was larger for pixel ratio than for any of the HRT parameters.Conclusions:The HRT is a useful tool for long-term follow-up of glaucomatous optic neuropathy.Digital image processing of HRT change images could facilitate the detection of progressive change.展开更多
Purpose: The aim of this study is to investigate whether there are any abnormalities in the in vivo expression of retinoid acid receptors (RAR-α , RAR-β and RAR-γ ) and retinoid X receptors (RXR-α , RXR-β and RXR...Purpose: The aim of this study is to investigate whether there are any abnormalities in the in vivo expression of retinoid acid receptors (RAR-α , RAR-β and RAR-γ ) and retinoid X receptors (RXR-α , RXR-β and RXR-γ ) in sebaceous cell carcinoma. Methods: Expression of retinoid receptors in paired specimens of cancerous tissues (n = 10) and adjacent normal tissues (n = 10) from 10 patients with sebaceous cell carcinoma was studied immunohistochemically by using anti-retinoid receptor antibodies. Results: In eight of the 10 normal tissue samples, all six receptors were expressed. In the other two samples, all receptors were expressed except RAR-γ (one sample) or RXR-γ (two samples). Five tumours (50% ) lacked RAR-α ; RAR-α expression was lower in tumours than in normal tissues in eight of 10 cases. RAR-β was expressed in the cytoplasm of nine of 10 tumours; RAR-β expression was at least as high in tumours as in normal tissue in eight of 10 cases. Two tumours lacked RAR-γ ; three tumours had lower RAR-γ expression than paired normal epithelium; four had the same RAR-γ expression, and one had higher RAR-γ expression. RXR-α expression was strong in all normal tissues and tumour samples. Ten tumours lacked RXR-β and all 10 tumours lacked RXR-γ expression. Conclusions: Diminished RXR-β and RXR-γ expression might be related to the development of sebaceous cell carcinoma. Additional studies are required to establish whether the defects in RAR expression in sebaceous cell carcinoma might affect the potential response of this tumour to treatment with retinoids.展开更多
Reading ability in the elderly means independence, and quality of life. In age-related macular degeneration (AMD), the main deficit is the loss of reading ability. The neovascular form is the leading cause of vision l...Reading ability in the elderly means independence, and quality of life. In age-related macular degeneration (AMD), the main deficit is the loss of reading ability. The neovascular form is the leading cause of vision loss in the developed world among people over 50 years of age. With ranibizumab (Lucentis) a drug treatment has become available, but, despite good outcome of visual acuity, patients often report that their reading ability has been affected. We aimed therefor to study reading performance with Tobii Eye Tracker in patients, treated with intravitrial Lucentis. Twenty patients, 15 female and 5 male (range 74 - 98 year), were recruited from St. Erik Eye Hospital. All had, before and after treatment, their reading speed, comprehension, fixations, saccadic eye movements measured while reading two texts with an equal readability rating. For all eye movement parameters, except the number of regressions per word, there was no statistically significant difference when comparing the results from before and after treatment. However, a statistically significant increase in the number of regressions per word after treatment as well as increased visual acuity and comprehension, were found. Reading is fundamental in our society and should be tested in order to fully understand a patient’s complaints;however, an increased VA will not necessarily equal an increased reading ability. The results also show that the Tobii system is suitable for evaluation of reading performance in a clinical setting, and can together with other tests, give valuable information about the patients complains and the outcome of a treatment.展开更多
Background:To study and compare the clinical optical image quality following implantation with different premium IOLs by analysing the point spread function(PSF)Strehl ratio using a pyramidal wavefront sensor(PWS)-bas...Background:To study and compare the clinical optical image quality following implantation with different premium IOLs by analysing the point spread function(PSF)Strehl ratio using a pyramidal wavefront sensor(PWS)-based aberrometer.Methods:This study included 194 eyes implanted with:(a)19 AcrySof SA60AT(control group);(b)19 Miniwell;(c)24 LENTIS Mplus LS-313 MF30;(d)33 LENTIS Mplus LS-313 MF15;(e)17 AkkoLens Lumina;(f)31 AT LISA Tri 839MP;(g)20 Precizon Presbyopic;(h)20 AcrySof IQ PanOptix;(i)11 Tecnis Eyhance.Main outcome measures were PSF Strehl ratio,PSF Strehl ratio excluding second-order aberrations(PSFw2),total root mean square(RMS),low-order aberration(LOA)and high-order aberration(HOA)RMS measured by PWS aberrometer.Results:AT LISA Tri had the highest PSFw2 Strehl ratio at both 3.0-and 4.0-mm pupil size(0.52±0.14 and 0.31±0.10;P<0.05),followed by SA60AT(0.41±0.11 and 0.28±0.07)and PanOptix(0.4±0.07 and 0.26±0.04).AT LISA Tri was found to provide a significantly better retinal image quality than PanOptix at both 3.0 mm(P<0.0001)and 4.0 mm(P=0.004).Mplus MF15 was found to be significantly better than Mplus MF30 at both 3.0 mm(P<0.0001)and 4.0 mm(P=0.002).Total RMS,LOA RMS,HOA RMS,PSF Strehl ratio and PSFw2 varied significantly between the studied groups(P<0.001).Conclusions:Far distance clinical image quality parameters measured by PWS aberrometer differed significantly according to the technology of the implanted lens.AT LISA Tri,SA60AT and PanOptix showed the highest values of far distance retinal image quality,while the lowest PSFw2 Strehl ratios were displayed by Miniwell,Mplus MF30 and Precizon Presbyopic.展开更多
Background:The purpose of the study was to determine the advantages and disadvantages of epi-on corneal crosslinking(CXL)techniques compared with standard epi-off CXL.Methods:We searched MEDLINE and EMBASE for randomi...Background:The purpose of the study was to determine the advantages and disadvantages of epi-on corneal crosslinking(CXL)techniques compared with standard epi-off CXL.Methods:We searched MEDLINE and EMBASE for randomized controlled trials(RCTs)and non-randomized studies of interventions(NRSIs)and we evaluated the selected papers according to the Cochrane risk of bias tool.We considered,as primary outcomes,average Kmax flattening,changes in uncorrected and corrected distance visual acuity(UDVA and CDVA);as secondary outcomes,we considered changes in pachymetry values and endothelial cell density(ECD).We also investigated adverse events related to the treatments and treatment failure.Meta-analysis was conducted with a fixed or random-effects model using weighted mean difference(MD)with 95%confidence interval(CI)as the effect size.Results:A total of 15 studies were included and among these 15 trials,9 were RCTs and 6 were NRSIs,but only 4 studies showed no high risk of bias and were included in this meta-analysis.Our analysis revealed significant postoperative differences in CDVA(MD=0.07;95%CI 0.04 to 0.10;P<0.001),and no significative differences in UDVA,Kmax,central corneal thickness(CCT)and ECD(P>0.05).Epi-on CXL protocol was found to be significantly less prompt to have risks of delay in epithelial healing(P=0.035)and persistent stromal haze(P=0.026).Conclusion:Epi-on CXL is as effective as epi-off CXL.Except for a higher significant improvement in CDVA with current epi-on protocols,our meta-analysis demonstrates that epi-on and epi-off CXL have comparable effects on visual,topographic,pachymetric,and endothelial parameters.Epi-on CXL has clinical advantages in terms of comfort and avoidance of complications as it reduces the risk of developing delay in epithelial healing and persistent stromal haze.展开更多
Background The purpose of the study was to determine the advantages and disadvantages of epi-on corneal cross-linking(CXL)techniques compared with standard epi-off CXL.Methods We searched MEDLINE and EMBASE for random...Background The purpose of the study was to determine the advantages and disadvantages of epi-on corneal cross-linking(CXL)techniques compared with standard epi-off CXL.Methods We searched MEDLINE and EMBASE for randomized controlled trials(RCTs)and non-randomized studies of interventions(NRSIs)and we evaluated the selected papers according to the Cochrane risk of bias tool.We considered,as primary outcomes,average Kmax flattening,changes in uncorrected and corrected distance visual acuity(UDVA and CDVA);as secondary outcomes,we considered changes in pachymetry values and endothelial cell density(ECD).We also investigated adverse events related to the treatments and treatment failure.Meta-analysis was conducted with a fixed or random-effects model using weighted mean difference(MD)with 95%confidence interval(CI)as the effect size.Results A total of 15 studies were included and among these 15 trials,9 were RCTs and 6 were NRSIs,but only 4 studies showed no high risk of bias and were included in this meta-analysis.Our analysis revealed significant postoperative differences in CDVA(MD=0.07;95%CI 0.04 to 0.10;P<0.001),and no significative differences in UDVA,Kmax,central corneal thickness(CCT)and ECD(P>0.05).Epi-on CXL protocol was found to be significantly less prompt to have risks of delay in epithelial healing(P=0.035)and persistent stromal haze(P=0.026).Conclusion Epi-on CXL is as effective as epi-off CXL.Except for a higher significant improvement in CDVA with current epi-on protocols,our meta-analysis demonstrates that epi-on and epi-off CXL have comparable effects on visual,topographic,pachymetric,and endothelial parameters.Epi-on CXL has clinical advantages in terms of comfort and avoidance of complications as it reduces the risk of developing delay in epithelial healing and persistent stromal haze.展开更多
BackgroundTo study and compare the clinical optical image quality following implantation with different premium IOLs by analysing the point spread function (PSF) Strehl ratio using a pyramidal wavefront sensor (PWS)-b...BackgroundTo study and compare the clinical optical image quality following implantation with different premium IOLs by analysing the point spread function (PSF) Strehl ratio using a pyramidal wavefront sensor (PWS)-based aberrometer.MethodsThis study included 194 eyes implanted with: (a) 19 AcrySof SA60AT (control group);(b) 19 Miniwell;(c) 24 LENTIS Mplus LS-313 MF30;(d) 33 LENTIS Mplus LS-313 MF15;(e) 17 AkkoLens Lumina;(f) 31 AT LISA Tri 839MP;(g) 20 Precizon Presbyopic;(h) 20 AcrySof IQ PanOptix;(i) 11 Tecnis Eyhance. Main outcome measures were PSF Strehl ratio, PSF Strehl ratio excluding second-order aberrations (PSFw2), total root mean square (RMS), low-order aberration (LOA) and high-order aberration (HOA) RMS measured by PWS aberrometer.ResultsAT LISA Tri had the highest PSFw2 Strehl ratio at both 3.0- and 4.0-mm pupil size (0.52 ± 0.14 and 0.31 ± 0.10;P < 0.05), followed by SA60AT (0.41 ± 0.11 and 0.28 ± 0.07) and PanOptix (0.4 ± 0.07 and 0.26 ± 0.04). AT LISA Tri was found to provide a significantly better retinal image quality than PanOptix at both 3.0 mm (P < 0.0001) and 4.0 mm (P = 0.004). Mplus MF15 was found to be significantly better than Mplus MF30 at both 3.0 mm (P < 0.0001) and 4.0 mm (P = 0.002). Total RMS, LOA RMS, HOA RMS, PSF Strehl ratio and PSFw2 varied significantly between the studied groups (P < 0.001).ConclusionsFar distance clinical image quality parameters measured by PWS aberrometer differed significantly according to the technology of the implanted lens. AT LISA Tri, SA60AT and PanOptix showed the highest values of far distance retinal image quality, while the lowest PSFw2 Strehl ratios were displayed by Miniwell, Mplus MF30 and Precizon Presbyopic.展开更多
We appreciate the interest of Miguel Faria Ribeiro in our paper[1],as well as the comments made to it.The interest of the topic is sound,as nowadays an enormous amount of new so-called“premium lenses”are appearing i...We appreciate the interest of Miguel Faria Ribeiro in our paper[1],as well as the comments made to it.The interest of the topic is sound,as nowadays an enormous amount of new so-called“premium lenses”are appearing in the market,with different optical profiles which obviously lead to different light distributions and different quality of retinal image.This is why our interest in this topic is longstanding and we have published extensive summaries about the outcomes and complications of multifocal lenses over the last years[2,3].展开更多
文摘AIM: To evaluate the accuracy of three commonly used biometric formulae across different axial lengths(ALs) at one United States Veterans Affairs teaching hospital.METHODS: A retrospective chart review was conducted from November 2013 to May 2018. One eye of each patient who underwent cataract surgery with a monofocal intraocular lens(IOL) was included. The range of postoperative follow-up period was from 3 wk to 4 mo. The Holladay 2, Barrett Universal II, and Hill-Radial Basis Function(Hill-RBF) formulae were used to predict the postoperative refraction for all cataract surgeries. For each formula, we calculated the prediction errors [including mean absolute prediction error(MAE)] and the percentage of eyes within ±0.25 diopter(D) and ±0.5 D of predicted refraction. We performed subgroup analyses for short(AL<22.0 mm), medium(AL 22.0-25.0 mm), and long eyes(AL>25.0 mm).RESULTS: A total of 1131 patients were screened, and 909 met the inclusion criteria. Resident ophthalmologists were the primary surgeons in 710(78.1%) cases. We found no statistically significant difference in predictive accuracy among the three formulae over the entire AL range or in the short, medium, and long eye subgroups. Across the entire AL range, the Hill-RBF formula resulted in the lowest MAE(0.384 D) and the highest percentage of eyes with postoperative refraction within ±0.25 D(42.7%) and ±0.5 D(75.5%) of predicted. All three formulae had the highest MAEs(>0.5 D) and lowest percentage within ±0.5 D of predicted refraction(<55%) in short eyes.CONCLUSION: In cataract surgery patients at our teaching hospital, three commonly used biometric formulae demonstrate similar refractive accuracy across all ALs. Short eyes pose the greatest challenge to predicting postoperative refractive error.
文摘AIM：To analyze the visual outcomes and the posterior capsule opacification（PCO）with the new Incise？MJ14intraocular lens（IOL）implanted through a 1.4 mm clear corneal incision（CCI）in patients who underwent bimanual microincision cataract surgery（B-MICS）.METHODS：Eighty eyes which underwent cataract surgery using B-MICS technique performed by the same experienced surgeon were included in the study：40 eyes were implanted with an Incise？MJ14 IOL through a 1.4 mm CCI（group A）without enlargement of the main CCI,while 40 eyes were implanted with an Akreos？MI60 IOL with enlargement of the main CCI to 1.8 mm（group B）.Best corrected visual acuity（BCVA）,astigmatism and endothelial cell loss were evaluated before and after surgery at 7,30d and 6mo.Anterior segment-optical coherence tomography（AS-OCT）of CCI was performed at 1,3,7,30d,6 and 18mo.PCO incidence was evaluated at 18mo using EPCO 2000 Software.RESULTS：Mean BCVA improvement and endothelial cell loss were statistically significant at 18mo in both groups with no difference between the two groups;no statistically significant difference in surgically induced astigmatism（SIA）was noticed in the two groups.At AS-OCT the only significant alterations in the CCI were endothelial gaping and local detachment of Descemet’s membrane at 1 and 7d after surgery;no statistically significant alterations were found at 1,6 and 18mo.PCO score at 18mo was 0.03±0.07for group A and 0.08±0.18 for group B（P=0.11）with no sign of central optic plate invasion in both groups.CONCLUSION：The implant of the new Incise？MJ14 IOL through a 1.4 mm CCI and B-MICS technique appeared to be a safe and effective procedure with rapid visual recovery.PCO rate resulted very low and the CCI presented few morphological alterations which were only detectable in the first days postoperatively and achieved fast corneal healing during the long-term follow-up.
文摘The aetiology of OAL is undefined, although much attention has been recently focused on determining whether OAL is caused by an autoimmune disorder, chronic antigenic stimulation or both. It is becoming evident that infectious agents underlying chronic eye infection, as Chlamydia, may play a role in ocular lymphomagenesis. The high prevalence of Chlamydophila psittaci in patients with OAL has suggested a potential oncogenic role for its tendency to cause chronic and persistent infections, although it has been documented an evident geographical variability and response to antibiotic treatment. For C. pneumoniae, the findings so far obtained are very limited not only for identification in OAL but also for the specific treatment with antibiotics. The recent molecular and cultural evidence of C. trachomatis in patients with OAL, seems to suggest that also this pathogen may contribute to pathogenesis of such lymphoma. The potential application of bacteria-eradicating therapy at local and systemic level may ultimately result in safer and more efficient therapeutic option for patients affected by these malignancies. Moreover, a close collaboration between experts in ophthalmology, infectious diseases and hematology will help, in the future, to effectively manage this disease. This review attempts to weigh the currently available evidence regarding the role that Chlamydia play in development of OAL and focuses on patients with OAL observed at our Institution.
文摘Background: Anterior chamber angle (ACA) can be measured by many different techniques. In order for a technique to be a part of the routine eye examination, it has to be quick and easy in good agreement with gonioscopy both nasally and temporally. Aim: To investigate variation in ACA measurement between gonioscopy, van Herick technique, anterior segment optical coherence tomography (AS-OCT) and Sirius Scheimpflug-Camera both nasally and temporally. Method: The ACA of 50 eyes of 25 healthy subjects was measured with gonioscopy, van Herick technique, AS-OCT and Sirius Scheimpflug-Camera. The angle was measured both nasally and temporally. Results: No statistically significant difference could be found between gonioscopy, van Herick technique and AS-OCT either nasally or temporally. The Sirius Scheimpflug-Camera on the other hand showed statistically significant difference to gonioscopy (p < 0.0001) both nasally (p = 0.03, p = 0.001, p < 0.0001) and temporally (p = 0.0002, p = 0.001, p Conclusion: This study showed good agreement between three of the four techniques. ACA measurements obtained by the Sirius Scheimpflug-Camera should therefore not be considered interchangeable with those obtained by the remaining three methods.
文摘Background:The Akreos®AO60 intraocular lens(IOL)has been employed for scleral fixation in eyes without capsular support,although surgical complications,including IOL opacification,have been reported.This study aims to evaluate the outcomes and complications associated with scleral fixation of the Akreos®AO60 IOL in vitrectomized eyes,with a particular focus on IOL opacification.Methods:Electronic medical records of consecutive eyes that underwent scleral-fixation of the Akreos®AO60 lens using Gore-tex®sutures from 2017 to 2022 were reviewed.The following parameters were collected:age,sex,laterality,past ocular/medical history,surgical indication,pre-operative visual acuity(VA)and intraocular pressure(IOP),surgical procedure,and post-operative VA and IOP.The types of complications,onset,management,and outcomes were also documented.Descriptive statistics,Wilcoxon signed-rank test,and Fisher’s exact test were employed for statistical analysis.Results:Eighty-nine eyes of 86 patients aged 31-100 years were included.The most common surgical indication was non-traumatic IOL displacement.Retinal tears and localized choroidal hemorrhage were found intraoperatively in 7.9%and 1.1%,respectively.The most common post-operative complications were vitreous hemorrhage(13.5%),corneal edema(12.4%),ocular hypotony(11.2%),and IOL opacification(11.2%).IOL opacification was associated with intra-/post-operative exposure to air/gas[odds ratio(OR):12.24;95%confidence interval(CI),1.46-103.0;P=0.006].Mean logarithm of the minimum angle of resolution(logMAR)best-reported VA(BRVA)improved from 1.22±0.77 pre-operatively to 0.56±0.67 on latest follow-up(P<0.001).Conclusions:The majority of the complications from scleral-fixation of the Akreos®AO60 lens in vitrectomized eyes were mild and transient;however,a proportion required surgical intervention.A significant risk for opacification was found in IOLs exposed to air/gas,although VA was often maintained.
文摘Objective:To describe the long-term outcomes of cases of neovascular glaucoma drained by Molteno implants.Methods:A prospective study of 145 eyes(130 patients)followed up for a mean of 3.3 years(range,0.02 year 5 days to 18.1 years)in the province of Otago,New Zealand,from 1979 to 2002.Results:Insertion of a Molteno implant controlled the intraocular pressure at 21 mmHg or less with a probability(95% confidence interval)of 0.72(0.64-0.80),0.60(0.51-0.69),and 0.40(0.29-0.50)at 1,2,and 5 years,respectively.Failure to control intraocular pressure at 1,2,and 5 years was significantly correlated with persistent iris neovascularization(P<.001,P<.001,and P=.01,respectively).Visual acuity at final follow-up in non-enucleated eyes was maintained or improved in 56 eyes(39%)and deteriorated to light perception or better in 25(17%)or no light perception in 47(32%).Seventeen eyes(12%)were enucleated.Conclusions:The insertion of Molteno implants for neovascular glaucoma maintained or improved vision in 39% of eyes,whereas 12% were eventually enucleated(all of which initially had visual acuity < 20/1200).The outcome depended mainly on progression of the underlying vascular disease.
文摘Aim: To evaluate the effect of oral pilocarpine treatment on conjunctival epithelium of patients with Sjgren’s syndrome (SS). Methods: 15 primary SS patients were included in this prospective, single masked, comparative study. Patients underwent oral pilocarpine treatment for 2 months and were studied before (TO) and after 1 month (T1), 2 months (T2), and 15 days after treatment suspension (T3). Systemic and ocular symptoms, tear film break up time (BUT), corneal fluorescein vital staining, Schirmer I test, tear basal secretion test, and conjunctival imprinting were performed. Student’s t test and Mann-Whitney U test were used for statistics. Results: The conjunctival imprinting showed an increase of goblet cells number at T1 (1.6 (1.2) v 0.6 (0.7) at T0, p=0.025) improving at T2 (5.1 (1.7); p< 0.001 v T0 and T1). At T3 the number of goblet cells significantly decreased (1.9 (1.1); p< 0.001 v T2). An improvement of dry mouth started at T1 and returned towards baseline values at T3. For ocular symptoms, burning and foreign body sensation were improved at T1 while ocular dryness improved at T2. BUT showed a statistically significant improvement at T2. Conclusions: Oral pilocarpine induced an increase in goblet cells number and an amelioration of conjunctival epithelium not dependent on tear secretion.
文摘Background:The Heidelberg Retina Tomograph(HRT)is a commercially available instrument for the detection of glaucomatous damage by analysis of optic nerve head topography.The main purpose of the study was to investigate the ability of HRT to detect changes in optic disc topography indicating progression of optic neuropathy in eyes with open-angle glaucoma or,in eyes with ocular hypertension,conversion to open-angle glaucoma.Methods:Fifty-nine subjects(34 with ocular hypertension,25 with glaucoma)from the glaucoma service at Sahlgrenska University Hospital were included in this study.One eye of each patient was selected.All participants underwent thorough clinical examination,including HRT,high-pass resolution perimetry(HRP),and optic disk photography.After a mean follow-up time of 50 months,patients were re-examined.Based on analyses of optic disc photographs and HRP,eyes were classified into one of two groups:progressive or stable.Methods:The differences between baseline and follow-up HRT parameters in the two groups were analysed.The topographic HRT change images were also compared after digital image processing.A pixel ratio was calculated defined as the ratio between the area of pixels representing deepening of the disc surface and the total disc area.Receiver operating characteristic(ROC)curves for HRT parameters and pixel ratio were compared.Results:In the group judged to have progressive optic neuropathy,a statistically significant change between baseline and follow-up examination was found for the following HRT parameters:cup shape measurement,classification index,the third moment in contour,cup/disc ratio,cup area,rim area,and area below reference.In the stable group no HRT parameters had changed significantly.A well-defined distinction between the two groups was found by comparing digitally processed HRT change images.The area under the ROC curve was larger for pixel ratio than for any of the HRT parameters.Conclusions:The HRT is a useful tool for long-term follow-up of glaucomatous optic neuropathy.Digital image processing of HRT change images could facilitate the detection of progressive change.
文摘Purpose: The aim of this study is to investigate whether there are any abnormalities in the in vivo expression of retinoid acid receptors (RAR-α , RAR-β and RAR-γ ) and retinoid X receptors (RXR-α , RXR-β and RXR-γ ) in sebaceous cell carcinoma. Methods: Expression of retinoid receptors in paired specimens of cancerous tissues (n = 10) and adjacent normal tissues (n = 10) from 10 patients with sebaceous cell carcinoma was studied immunohistochemically by using anti-retinoid receptor antibodies. Results: In eight of the 10 normal tissue samples, all six receptors were expressed. In the other two samples, all receptors were expressed except RAR-γ (one sample) or RXR-γ (two samples). Five tumours (50% ) lacked RAR-α ; RAR-α expression was lower in tumours than in normal tissues in eight of 10 cases. RAR-β was expressed in the cytoplasm of nine of 10 tumours; RAR-β expression was at least as high in tumours as in normal tissue in eight of 10 cases. Two tumours lacked RAR-γ ; three tumours had lower RAR-γ expression than paired normal epithelium; four had the same RAR-γ expression, and one had higher RAR-γ expression. RXR-α expression was strong in all normal tissues and tumour samples. Ten tumours lacked RXR-β and all 10 tumours lacked RXR-γ expression. Conclusions: Diminished RXR-β and RXR-γ expression might be related to the development of sebaceous cell carcinoma. Additional studies are required to establish whether the defects in RAR expression in sebaceous cell carcinoma might affect the potential response of this tumour to treatment with retinoids.
文摘Reading ability in the elderly means independence, and quality of life. In age-related macular degeneration (AMD), the main deficit is the loss of reading ability. The neovascular form is the leading cause of vision loss in the developed world among people over 50 years of age. With ranibizumab (Lucentis) a drug treatment has become available, but, despite good outcome of visual acuity, patients often report that their reading ability has been affected. We aimed therefor to study reading performance with Tobii Eye Tracker in patients, treated with intravitrial Lucentis. Twenty patients, 15 female and 5 male (range 74 - 98 year), were recruited from St. Erik Eye Hospital. All had, before and after treatment, their reading speed, comprehension, fixations, saccadic eye movements measured while reading two texts with an equal readability rating. For all eye movement parameters, except the number of regressions per word, there was no statistically significant difference when comparing the results from before and after treatment. However, a statistically significant increase in the number of regressions per word after treatment as well as increased visual acuity and comprehension, were found. Reading is fundamental in our society and should be tested in order to fully understand a patient’s complaints;however, an increased VA will not necessarily equal an increased reading ability. The results also show that the Tobii system is suitable for evaluation of reading performance in a clinical setting, and can together with other tests, give valuable information about the patients complains and the outcome of a treatment.
基金financed in part by the Network for Cooperative Research in Health“OFTARED”—Reference:RD16/0008/0012Funded by Instituto de Salud Carlos IIIco-funded by European Regional Development Fund(ERDF),Project"A way to make Europe".
文摘Background:To study and compare the clinical optical image quality following implantation with different premium IOLs by analysing the point spread function(PSF)Strehl ratio using a pyramidal wavefront sensor(PWS)-based aberrometer.Methods:This study included 194 eyes implanted with:(a)19 AcrySof SA60AT(control group);(b)19 Miniwell;(c)24 LENTIS Mplus LS-313 MF30;(d)33 LENTIS Mplus LS-313 MF15;(e)17 AkkoLens Lumina;(f)31 AT LISA Tri 839MP;(g)20 Precizon Presbyopic;(h)20 AcrySof IQ PanOptix;(i)11 Tecnis Eyhance.Main outcome measures were PSF Strehl ratio,PSF Strehl ratio excluding second-order aberrations(PSFw2),total root mean square(RMS),low-order aberration(LOA)and high-order aberration(HOA)RMS measured by PWS aberrometer.Results:AT LISA Tri had the highest PSFw2 Strehl ratio at both 3.0-and 4.0-mm pupil size(0.52±0.14 and 0.31±0.10;P<0.05),followed by SA60AT(0.41±0.11 and 0.28±0.07)and PanOptix(0.4±0.07 and 0.26±0.04).AT LISA Tri was found to provide a significantly better retinal image quality than PanOptix at both 3.0 mm(P<0.0001)and 4.0 mm(P=0.004).Mplus MF15 was found to be significantly better than Mplus MF30 at both 3.0 mm(P<0.0001)and 4.0 mm(P=0.002).Total RMS,LOA RMS,HOA RMS,PSF Strehl ratio and PSFw2 varied significantly between the studied groups(P<0.001).Conclusions:Far distance clinical image quality parameters measured by PWS aberrometer differed significantly according to the technology of the implanted lens.AT LISA Tri,SA60AT and PanOptix showed the highest values of far distance retinal image quality,while the lowest PSFw2 Strehl ratios were displayed by Miniwell,Mplus MF30 and Precizon Presbyopic.
基金financed in part by the Network for Cooperative Research in Health“OFTARED”—Reference:RD16/0008/0012Funded by Instituto de Salud Carlos IIIco-funded by the European Regional Development Fund(ERDF),Project"A way to make Europe".
文摘Background:The purpose of the study was to determine the advantages and disadvantages of epi-on corneal crosslinking(CXL)techniques compared with standard epi-off CXL.Methods:We searched MEDLINE and EMBASE for randomized controlled trials(RCTs)and non-randomized studies of interventions(NRSIs)and we evaluated the selected papers according to the Cochrane risk of bias tool.We considered,as primary outcomes,average Kmax flattening,changes in uncorrected and corrected distance visual acuity(UDVA and CDVA);as secondary outcomes,we considered changes in pachymetry values and endothelial cell density(ECD).We also investigated adverse events related to the treatments and treatment failure.Meta-analysis was conducted with a fixed or random-effects model using weighted mean difference(MD)with 95%confidence interval(CI)as the effect size.Results:A total of 15 studies were included and among these 15 trials,9 were RCTs and 6 were NRSIs,but only 4 studies showed no high risk of bias and were included in this meta-analysis.Our analysis revealed significant postoperative differences in CDVA(MD=0.07;95%CI 0.04 to 0.10;P<0.001),and no significative differences in UDVA,Kmax,central corneal thickness(CCT)and ECD(P>0.05).Epi-on CXL protocol was found to be significantly less prompt to have risks of delay in epithelial healing(P=0.035)and persistent stromal haze(P=0.026).Conclusion:Epi-on CXL is as effective as epi-off CXL.Except for a higher significant improvement in CDVA with current epi-on protocols,our meta-analysis demonstrates that epi-on and epi-off CXL have comparable effects on visual,topographic,pachymetric,and endothelial parameters.Epi-on CXL has clinical advantages in terms of comfort and avoidance of complications as it reduces the risk of developing delay in epithelial healing and persistent stromal haze.
基金This study has been financed in part by the Network for Cooperative Research in Health“OFTARED”—Reference:RD16/0008/0012.Funded by Instituto de Salud Carlos III and co-funded by the European Regional Development Fund(ERDF),Project“A way to make Europe”.
文摘Background The purpose of the study was to determine the advantages and disadvantages of epi-on corneal cross-linking(CXL)techniques compared with standard epi-off CXL.Methods We searched MEDLINE and EMBASE for randomized controlled trials(RCTs)and non-randomized studies of interventions(NRSIs)and we evaluated the selected papers according to the Cochrane risk of bias tool.We considered,as primary outcomes,average Kmax flattening,changes in uncorrected and corrected distance visual acuity(UDVA and CDVA);as secondary outcomes,we considered changes in pachymetry values and endothelial cell density(ECD).We also investigated adverse events related to the treatments and treatment failure.Meta-analysis was conducted with a fixed or random-effects model using weighted mean difference(MD)with 95%confidence interval(CI)as the effect size.Results A total of 15 studies were included and among these 15 trials,9 were RCTs and 6 were NRSIs,but only 4 studies showed no high risk of bias and were included in this meta-analysis.Our analysis revealed significant postoperative differences in CDVA(MD=0.07;95%CI 0.04 to 0.10;P<0.001),and no significative differences in UDVA,Kmax,central corneal thickness(CCT)and ECD(P>0.05).Epi-on CXL protocol was found to be significantly less prompt to have risks of delay in epithelial healing(P=0.035)and persistent stromal haze(P=0.026).Conclusion Epi-on CXL is as effective as epi-off CXL.Except for a higher significant improvement in CDVA with current epi-on protocols,our meta-analysis demonstrates that epi-on and epi-off CXL have comparable effects on visual,topographic,pachymetric,and endothelial parameters.Epi-on CXL has clinical advantages in terms of comfort and avoidance of complications as it reduces the risk of developing delay in epithelial healing and persistent stromal haze.
基金This study has been financed in part by the Network for Cooperative Research in Health“OFTARED”—Reference:RD16/0008/0012.Funded by Instituto de Salud Carlos III and co-funded by European Regional Development Fund(ERDF),Project“A way to make Europe”.
文摘BackgroundTo study and compare the clinical optical image quality following implantation with different premium IOLs by analysing the point spread function (PSF) Strehl ratio using a pyramidal wavefront sensor (PWS)-based aberrometer.MethodsThis study included 194 eyes implanted with: (a) 19 AcrySof SA60AT (control group);(b) 19 Miniwell;(c) 24 LENTIS Mplus LS-313 MF30;(d) 33 LENTIS Mplus LS-313 MF15;(e) 17 AkkoLens Lumina;(f) 31 AT LISA Tri 839MP;(g) 20 Precizon Presbyopic;(h) 20 AcrySof IQ PanOptix;(i) 11 Tecnis Eyhance. Main outcome measures were PSF Strehl ratio, PSF Strehl ratio excluding second-order aberrations (PSFw2), total root mean square (RMS), low-order aberration (LOA) and high-order aberration (HOA) RMS measured by PWS aberrometer.ResultsAT LISA Tri had the highest PSFw2 Strehl ratio at both 3.0- and 4.0-mm pupil size (0.52 ± 0.14 and 0.31 ± 0.10;P < 0.05), followed by SA60AT (0.41 ± 0.11 and 0.28 ± 0.07) and PanOptix (0.4 ± 0.07 and 0.26 ± 0.04). AT LISA Tri was found to provide a significantly better retinal image quality than PanOptix at both 3.0 mm (P < 0.0001) and 4.0 mm (P = 0.004). Mplus MF15 was found to be significantly better than Mplus MF30 at both 3.0 mm (P < 0.0001) and 4.0 mm (P = 0.002). Total RMS, LOA RMS, HOA RMS, PSF Strehl ratio and PSFw2 varied significantly between the studied groups (P < 0.001).ConclusionsFar distance clinical image quality parameters measured by PWS aberrometer differed significantly according to the technology of the implanted lens. AT LISA Tri, SA60AT and PanOptix showed the highest values of far distance retinal image quality, while the lowest PSFw2 Strehl ratios were displayed by Miniwell, Mplus MF30 and Precizon Presbyopic.
文摘We appreciate the interest of Miguel Faria Ribeiro in our paper[1],as well as the comments made to it.The interest of the topic is sound,as nowadays an enormous amount of new so-called“premium lenses”are appearing in the market,with different optical profiles which obviously lead to different light distributions and different quality of retinal image.This is why our interest in this topic is longstanding and we have published extensive summaries about the outcomes and complications of multifocal lenses over the last years[2,3].
