Purpose To assess the repeatability of a new swept-source optical coherence tomography (SS-OCT) biometer (IOLMaster 700) and evaluate the agreement with an optical low-coherence reflectometry (OLCR) ...biometer (Lenstar 900) in cataractous eyes. Setting Tertiary eyecare facility. Design Prospective evaluation of a diagnostic test. Methods Eyes of patients had 3 consecutive scans acquired by the same operator. The repeatability of measurements was assessed using the within-subject standard deviation and coefficient of variation (CoV). Agreement between the mean measurements of each machine was evaluated. Results The study comprised 100 eyes of 100 patients. The median lens thickness and axial length (AL) measurements were significantly greater ( P < .001) with SS-OCT (4.29 mm and 23.5 mm, respectively, versus 4.25 mm and 23.4 mm, respectively); anterior chamber depth (ACD) was greater with OLCR (2.72 mm versus 2.70 mm, respectively) ( P < .001). The within-subject standard deviation and CoV of the AL (0.01 and 0.05, respectively) and the ACD (0.04 and 1.22, respectively) measurements showed lower variability with SS-OCT (0.05 and 0.21, respectively, for AL; 0.06 and 1.99, respectively, for ACD) than with OLCR. Good agreement was seen for anterior segment measurements between the 2 devices. The 95% limits of agreement of most parameters fell within the test–retest variability of the parameters. The SS-OCT biometer also showed better penetration in dense posterior subcapsular cataracts, measuring AL successfully in 96% of cases. Conclusions The new SS-OCT biometer showed good repeatability and agreement with the OLCR biometer. The SS-OCT biometer measured the AL with fewer dropouts compared with the OLCR even in dense cataracts. Financial Disclosure None of the authors has a financial or proprietary interest in any material or method mentioned.
To quantify image-quality characteristics after correction of refractive error with a posterior chamber phakic intraocular lens (PC pIOL) in eyes with stable or stabilized keratoconus.
Narayana ...Nethralaya Postgraduate Institute of Ophthalmology, Bangalore, India.
Case series.
Eyes with stable or stabilized keratoconus that had V4 Visian PC pIOL implantation for correction of refractive error were evaluated postoperatively for visual-quality metrics.
Ten eyes of 7 patients had PC pIOL implantation. The preoperative mean refractive spherical equivalent of -7.21 diopters (D) ± 2.25 (SD) decreased to -0.55 ± 1.53 D at 6 weeks and -0.44 ± 1.21 D at 6 months. The efficacy index was 0.72 and the safety index, 1.13. The mean modulation transfer function (MTF) was 18.96 ± 14.16 (≥ 30 cycles per degree = good), the Strehl ratio was 0.11 ± 0.07 (1 = perfect), and the objective scatter index (OSI) was 4.45 ± 3.29 (≥ 1.5 = significant scatter). The MTF correlated inversely with secondary coma (P=.026), negative vertical coma (P=.014), and the root mean square (RMS) of total aberrations (P=.010) and higher-order aberrations (HOAs) (P=.015). The OSI was directly correlated with secondary coma (P=.021), secondary trefoil (P=.016), the RMS of total aberrations (P=.032), and HOAs (P=.050).
In keratoconus, the refractive error could be corrected with the PC pIOL; however, the associated aberrations had an adverse impact on the ultimate visual quality and have to be addressed.
Scleral fixation of intraocular lenses (IOLs) is traditionally performed after conjunctival dissection and preparation of scleral flaps. The Hoffman pocket technique creates scleral pockets without ...conjunctival dissection. We describe a technique that uses a Hoffman pocket and 7-0 polytetrafluoroethylene (Gore-Tex) sutures for scleral fixation of a foldable posterior chamber IOL in patients with insufficient capsule support. The technique eliminates the need for conjunctival dissection, scleral cauterization, knot rotation, and sutured wound closure. The favorable properties of the suture material and the use of a small incision to insert a foldable IOL are additional advantages. Financial Disclosure None of the authors has a financial or proprietary interest in any material or method mentioned.
Phacoemulsification is challenging in soft cataracts due to the difficulty in cracking the nucleus by a divide-and-conquer technique or by chopping. We describe another technique, the Y sign for ...trenching endpoint: a clinical sign that indicates the surgeon should stop trenching and start cracking during classical divide-and-conquer nucleofractis emulsification using proximal downslope trenching. This technique exploits the morphological structure of the lens to precisely gauge the depth of the trench at which the surgeon can split even a soft nucleus into small wedges without instrument cheese-wiring and thus perform safer phacoemulsification while reducing the risk for posterior capsule rupture.
Phaco chop is the preferred technique for many phaco surgeons. A critical step in chopping is the surgeon's ability to impale the nucleus in the middle of the core endonucleus, which can be ...challenging. We describe a clinical sign in the phaco chop technique to help surgeons identify the center of the endonucleus without estimating the nucleus thickness. This technique uses the morphological structure of the lens and the lens fiber orientation to precisely gauge the depth at which the surgeon should impale and hold the nucleus for effective chopping.
No author has a financial or proprietary interest in any material or method mentioned.
Goldenhar syndrome is a rare disorder that normally affects just one side and is distinguished by a variety of anomalies in internal organs, vertebrae, and craniofacial tissues. Although this ...sickness varies genetically and has been linked to a variety of factors, its etiology is unknown. We describe a case of hemifacial microsomia linked with Goldenhar syndrome that was clinically and radiographically investigated using cone-beam computed tomography. Several classical indications of the condition were present in the patient along with few uncommon ones. The many facets of this uncommon disease have been covered, with a focus on early detection and a multidisciplinary approach to treatment.
Keratoconus is a progressive non-inflammatory thinning of the cornea that induces myopia and irregular astigmatism and decreases the quality of vision due to monocular diplopia, halos, or ghost ...images. Keratoconus patients unfit for corneal procedures and intolerant to refractive correction by spectacles or contact lenses have been implanted toric posterior chamber phakic intraocular lenses (PC pIOLs) alone or combined with other surgical procedures to correct the refractive errors associated with keratoconus as an off label procedure with special informed consent from the patients. Several reports attest to the safety and efficacy of the procedure, though the associated corneal higher order aberrations would have an impact on the final visual quality.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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