Our prospective study was conducted to compare axial length elongation in myopic children receiving long-term overnight orthokeratology (OK) treatment to those wearing spectacles as controls.
There ...were 59 subjects enrolled in this study. The OK group comprised 29 subjects who matched the inclusion criteria for OK. The control group comprised 30 subjects who also matched the inclusion criteria for OK, but preferred spectacles for myopia correction. Axial length was measured periodically for 5 years using an IOLMaster device, and the time course of changes was evaluated and compared between the groups.
A total of 43 subjects (22 and 21 in the OK and control groups, respectively) completed the 5-year follow-up examinations. At baseline, the mean age ± SD was 10.04 ± 1.43 and 9.95 ± 1.59 years, the spherical equivalent refractive error was -1.89 ± 0.82 and -1.83 ± 1.06 diopters (D), and the axial length was 24.09 ± 0.77 and 24.22 ± 0.71 mm in the OK and control groups, respectively, with no significant differences between the groups. The increase in axial length during the 5-year study period was 0.99 ± 0.47 and 1.41 ± 0.68 mm for the OK and control groups, respectively, and the difference was statistically significant (P = 0.0236, unpaired t-test). The annual increases in axial length were significantly different between the groups for the first (P = 0.0002), second (P = 0.0476), and third years (P = 0.0385), but not for the fourth (P = 0.0938) and fifth (P = 0.8633) years. There were no severe complications throughout the study period.
The current 5-year follow-up study indicated that OK can suppress axial length elongation in childhood myopia.
This prospective study was conducted to assess the influence of overnight orthokeratology (OK) on axial elongation in children, with those wearing spectacles as controls.
One hundred five subjects ...(210 eyes) were enrolled in the study. The OK group comprised 45 patients (90 eyes, age 12.1 ± 2.5 years, mean ± SD; OK group) who matched the inclusion criteria for OK. The control group comprised 60 patients (120 eyes, 11.9 ± 2.0 years) who also matched the inclusion criteria for OK but preferred spectacles for myopia correction. Axial length was measured at baseline and after 2 years using ocular biometry, and the changes were evaluated and compared between the groups.
Ninety-two subjects (42 and 50 in the OK and control groups, respectively) completed the 2-year follow-up examinations. At baseline, the spherical equivalent refractive error was -2.55 ± 1.82 and -2.59 ± 1.66 D, and the axial length was 24.66 ± 1.11 and 24.79 ± 0.80 mm in the OK and control groups, respectively, with no significant differences between the groups. The increase in axial length during the 2-year study period was 0.39 ± 0.27 and 0.61 ± 0.24 mm, respectively, and the difference was significant (P < 0.0001, unpaired t-test).
OK suppressed axial elongation in myopic children, suggesting that this treatment can slow the progression of myopia to a certain extent.
Purpose
To assess the general health-related quality of life (QOL) in children with intermittent exotropia (IXT) before and 3 months after surgery, by interviewing individual patients and their ...parents.
Study design
Prospective, interventional case series.
Methods
Twenty-one patients undergoing IXT surgery and their parents were included. Using the Pediatric Quality of Life Inventory (PedsQL), children and parents were separately questioned about QOL of patients.
Results
The mean patients’ age was 8.6 ± 3.2 years (SD), with range of 5–16 years. The children responded that all PedsQL scores were significantly improved by surgery, and the highest improvement was observed in the school subscale score. When the parents rated the children’s QOL, significant improvements were limited to 3 out of 7 subscales, including the emotional, psychosocial health summary, and total scores. The improvements in the PedsQL score were not correlated with age, size of deviation changes following surgery, nor the improvement in binocular vision.
Conclusions
The general health-related QOL significantly improved by surgery in pediatric patients with IXT, while the improvement was considerably underestimated by the parents. The children reported the greatest improvement in the school functioning subscale, whereas parents failed to discern this improvement. The discrepancy in children’ and parents’ views can be an important factor when considering indication of corrective surgery and evaluating surgical outcomes.
Purpose
This study evaluated the efficacy and safety of YOUSOFT
®
soft contact lens (CL) (TOMEY-CL) in patients with keratoconus and intolerance to rigid CLs.
Study design
Retrospective observational ...study.
Methods
Thirty-six eyes of 20 patients (14 men and 6 women) with keratoconus and rigid CL intolerance were included in the study. Four patients were unilateral. The mean age was 33.1 ± 11.7 (± standard deviation) years, the mean spherical refractive error was − 4.99
± 3.97 D, and the mean cylindrical refractive error was − 3.39 ± 2.13 D. The following examinations were performed at baseline and were repeated at every visit; refractometry, visual acuity, corneal topography and pachymetry with an anterior OCT system. Corneal endothelial cell density was evaluated at baseline and every 6 months. Slit-lamp examination was also performed to confirm the CL condition and ocular health at every visit.
Results
Seventeen patients (85%) were able to continue using the Yousoft. Among 3 patients (15%) who dropped out, 2 were dissatisfied with their visual outcomes and one had trouble with lens handling. Uncorrected visual acuity was 1.08 ± 0.43 (range: 0.22 to 2.00) logMAR at baseline, and best CL-corrected visual acuity was 0.01 ± 0.15 (range: − 0.18 to 0.40) logMAR, showing a significant improvement after wearing Yousoft (P < 0.0001). The endothelial cell density did not change significantly, with 2373 ± 482 at baseline and 2402 ± 464 cells/mm
2
at the latest visit after lens prescription (P = 0.351). There were no severe complications such as corneal infiltrates or infectious keratitis throughout the study period.
Conclusions
This study showed the efficacy and acceptable safety of Yousoft for patients with keratoconus and intolerance to rigid CLs.
To determine ocular optical parameters that affect axial length elongation in myopic children undergoing overnight orthokeratology.
Prospective, noncomparative study.
Fifty-nine subjects who met the ...inclusion criteria were enrolled in this study.
Axial length and ocular wavefront aberration were assessed before and 1 year after the start of orthokeratology. Corneal topography was performed, and then corneal multifocality was calculated for a 4-mm pupil. After evaluating simple correlations between axial elongation and optical parameters, multiple linear regression analysis was performed to identify explanatory variables with a statistically significant contribution to axial elongation.
Axial length and ocular wavefront aberration before and 1 year after the start of orthokeratology.
Fifty-five subjects completed the 1-year follow-up examinations. At baseline, their age ranged from 7.2 to 12.0 years. The manifest spherical equivalent refractive error ranged from -3.50 to -0.75 diopters. The mean axial length significantly increased from 24.20 mm at baseline to 24.43 mm 1 year after treatment. The axial elongation showed significant simple correlations with the change in C2(0), change in second-order aberration, change in coma-like aberration, change in spherical-like aberration, change in total higher-order aberrations, change in corneal multifocality, baseline age, and baseline spherical equivalent refractive error, but not C4(0). Multiple linear regression analysis showed that the change in coma-like aberration was the most relevant variable.
Asymmetric corneal shapes, rather than concentric and radially symmetric shapes, have a considerable effect on retardation of axial elongation, suggesting that the inhibitory effect of orthokeratology on myopia progression is caused by mechanisms other than the reduction in peripheral hyperopic defocus.
Purpose
To assess the visual performance of extended depth of focus (EDF) contact lenses (CL) in eyes that had undergone monofocal intraocular lens (IOL) implantation, and compare that between EDF ...and single-vision (SV) contact lenses.
Study design
Prospective, randomized, crossover study
Methods
Seventeen patients implanted with monofocal IOLs were enrolled. The study was conducted using 1dayPure EDOF as a test CL and 1dayPure moisture (both SEED Co., Ltd.) as a control CL. Binocular visual acuity from far to near distances, photopic and mesopic contrast sensitivity (with and without glare), and stereopsis were evaluated after wearing the two kinds of CLs in random order. The obtained results were compared between the EDF and SV CLs.
Results
Binocular visual acuity at 0.3, 0.4, 0.7, 1, and 5 m was 0.24 ± 0.12, 0.07 ± 0.09, − 0.02 ± 0.08, − 0.02 ± 0.08, and − 0.06 ± 0.07 logMAR during the EDF CL wear, respectively, and 0.39 ± 0.17, 0.26 ± 0.15, 0.04 ± 0.12, − 0.02 ± 0.08, and − 0.09 ± 0.09 during the SV CL wear, respectively. The EDF CL showed better results than the SV CL at 0.3, 0.4, and 0.7 m (p < 0.05). There were no significant differences in contrast sensitivity between the EDF and SV CLs at 1.5 cycles per degree under all conditions; however, the sensitivity of the EDF CL was generally worse than that of the SV CL from the middle to high spatial frequencies. Stereopsis at 40 cm was significantly better in the EDF CL wear than in the SV CL wear (p < 0.05).
Conclusions
The EDF CL substantially improved visual acuity at near to intermediate distances in IOL-implanted eyes. However, far visual acuity decreased under low-contrast conditions, and contrast sensitivity slightly declined at the middle to high spatial frequencies.
Abstract
We investigated the relation between corneal regular and irregular astigmatism in normal human eyes. In 951 eyes of 951 patients, corneal irregular astigmatism, such as asymmetry and ...higher-order irregularity components, was calculated using the Fourier harmonic analysis of corneal topography data within the central 3-mm zone of the anterior corneal surface. The eyes were classified by the type of corneal regular astigmatism into four groups; minimum (< 0.75 diopters), with-the-rule (WTR), against-the-rule (ATR), and oblique astigmatism. The mean age was significantly different among the four groups (
P
< 0.001); patients with WTR astigmatism were the youngest, followed by those with minimum, oblique, and ATR astigmatism. Significant inter-group differences were found among the four groups in asymmetry (
P
= 0.005) and higher-order irregularity components (
P
< 0.001); the largest was in eyes with oblique astigmatism, followed by ATR, WTR, and minimum astigmatism. The stepwise multiple regression analysis revealed that corneal regular astigmatism pattern significantly influenced the amount of corneal irregular astigmatism after controlling for confounding factors (
P
< 0.001). Corneal irregular astigmatism, such as asymmetry and higher order irregularity components, was the largest in eyes with oblique astigmatism, followed by those with ATR, WTR, and minimum astigmatism, even after adjustment for age of subjects.
•We have evaluated corneal HOAs in normal eyes by using AS-OCT.•Age and amount of corneal astigmatism increase corneal higher-order aberration.•Refractive status (myopia, emmetropia and hyperopia) is ...not associated with corneal higher-order aberration.
This study aimed to investigate the influence of refractive status and age of patients on corneal higher-order aberrations (HOAs). Four hundred and twenty-six right eyes of 426 patients were enrolled in this study. The mean and standard deviation of patient age was 47.7 ± 22.1 years. Total HOAs, spherical-like aberration, coma-like aberration, Z−13, Z13, Z−33, Z−33 and spherical aberration (Z04) for 6-mm pupil were measured using anterior segment optical coherence tomography (AS-OCT). Subjects were classified into three groups according to the amount of spherical equivalent refractive error (SE): myopia (<−0.5 D), emmetropia (−0.5 to 0.5 D), and hyperopia (>0.5 D). The amount of corneal astigmatism was recorded. Relationship between corneal aberrations, refractive status, astigmatism, and age was analyzed. In total, total HOAs, spherical-like aberration and amount of Z−33 and Z04 were significantly larger in the hyperopia group than in the myopia group. After adjustment for age, however, aberration components did not differ among the three refractive groups. In multiple regression analysis, age and corneal astigmatism showed significant correlation with aberrations, whereas amount of SE and refractive status did not. The current study indicated that age and amount of corneal astigmatism have significant influence on corneal HOAs, but refractive status (myopia, emmetropia, or hyperopia) is not associated with corneal HOAs.
Purpose
Atropine eye drops prevent the progression of myopia, but their use has not been tested in the Japanese schoolchildren population. Here, we evaluate the efficacy and safety of 0.01% atropine ...eye drops for myopia control in Japanese children.
Study design
Multicenter (7 university hospitals), randomized, double-masked, placebo-controlled trial.
Methods
Participants were 171 Japanese schoolchildren aged 6 to 12 years, with progressive myopia, spherical equivalence (SE) of −1.00 to −6.00 diopters (D), and astigmatism of ≤1.5 D. They were randomized to receive either 0.01% atropine (
n
=85) or placebo (
n
=86) eye drops once nightly OU for 24 months. Primary and secondary efficacy endpoints were changes in SE and axial length (AL), respectively, from baseline to month 24.
Results
Data from 168 subjects were analyzed. At month 24, compliance was similar in both groups (atropine: 83.3%; placebo: 85.7%). The least squares mean change in SE and AL from baseline were, respectively, −1.26 D (95% confidence interval CI: −1.35, −1.17) and 0.63 mm (0.59, 0.67) for atropine and −1.48 D (− 1.57, −1.39) and 0.77 mm (0.73, 0.81) for placebo. Inter-group differences were 0.22 D (95% CI: 0.09, 0.35;
P
< 0.001) for SE and − 0.14 mm (−0.20, −0.08;
P
< 0.001) for AL. Three patients experienced mild allergic conjunctivitis side effects, with no inter-group difference in incidence (atropine: 2.4%; 2/84 patients; placebo: 1.4%; 1/84 patients).
Conclusion
With good compliance, 0.01% atropine is effective and safe for preventing the progression of childhood myopia.
Purpose
To assess whether the outcomes of toric intraocular lens (IOL) implantation in eyes with oblique astigmatism can be improved by direct measurements of posterior corneal astigmatism using ...anterior segment optical coherence tomography (AS-OCT) instead of by using anterior corneal measurements alone.
Study design
Retrospective case series.
Methods
Two toric IOL power calculation methods were compared: anterior corneal astigmatism was used in the keratometry group, whilst total corneal astigmatism determined by ray tracing through the measured anterior and posterior corneal surfaces was used in the AS-OCT group. In a total of 279 eyes of 232 patients, subgroup analysis was conducted for with-the-rule (WTR) (85 eyes in the keratometry group and 34 eyes in the AS-OCT group), against-the-rule (ATR) (73/29 eyes), and oblique (26/32 eyes) astigmatism.
Results
In the WTR and ATR astigmatism groups, the uncorrected distance visual acuity (UDVA) was significantly better in the AS-OCT group than in the keratometry group (
P
= 0.012 and
P
< 0.001, Mann–Whitney test), and the residual astigmatism was significantly smaller in the AS-OCT group than in the keratometry group (
P
= 0.037 and
P
< 0.001). In eyes with oblique astigmatism, the UDVA (
P
= 0.299) and residual astigmatism (
P
= 0.373) of the keratometry and AS-OCT groups did not differ.
Conclusion
Incorporation of posterior corneal astigmatism measured with AS-OCT can significantly improve the outcomes of toric IOL implantation in eyes with WTR and ATR astigmatism, but not in eyes with oblique astigmatism.
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