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Ahmed Galal

Publications and source records attributed to Ahmed Galal.

At least 19 recordsLinked to original sources
PubMed2006

Contrast sensitivity: determining the visual quality and function of cataract, intraocular lenses and refractive surgery.

PURPOSE OF REVIEW: This review provides an update of recent advances in understanding the quality and functional significance of contrast sensitivity for the clinician regarding cataract, intraocular lenses and refractive surgery that goes beyond the measurement of visual acuity. RECENT FINDINGS: New American National Standards Institute standards for contrast sensitivity based on linear sine-wave gratings are discussed that promise rapid advances of understanding and quantifying visual quality and function by unifying clinical results reported using contrast sensitivity. Increased sensitivity of linear sine-wave gratings over proposed bull's-eye radial gratings is discussed. Digital-image-processing software uses contrast sensitivity data to process images to help understand the quality of what the patient sees. Contrast sensitivity measurement is compared with wavefront aberrometry. Contrast sensitivity measures the total visual system quality in terms of contrast, whereas wavefront aberrometry measures the optical quality in terms of spatial distortion. Both measurements are needed to more fully understand the quality of vision. SUMMARY: Recent advances provide the clinician with an awareness of why the new contrast-sensitivity standards are based on linear sine-wave gratings and how image-processing software can be used to better understand the quality of functional vision of the patient.

Cataract↗
PubMed2006

Interface corneal edema secondary to steroid-induced elevation of intraocular pressure simulating diffuse lamellar keratitis.

PURPOSE: To describe interface corneal edema secondary to steroid-induced elevation of intraocular pressure (IOP) following LASIK. METHODS: Retrospective observational case series. Diffuse interface edema secondary to steroid-induced elevation of IOP was observed after LASIK simulating diffuse lamellar keratitis (DLK) in 13 eyes. Mean patient age was 31.4 +/- 5.3 years. Patients were divided into two groups according to provisional misdiagnosis: DLK group (group 1) comprised 11 eyes and infection group (group 2) comprised 2 eyes (microbial keratitis). Mean follow-up was 8.1 +/- 0.5 weeks. RESULTS: In the DLK group, typical diffuse haze was confined to the interface and extended to the visual axis, impairing vision in all eyes. Provisional diagnosis was late-onset DLK and topical steroids were started. Repeat examination showed elevated IOP as measured at the corneal center and periphery using applanation tonometry (mean 19.1 mmHg and 39.5 mmHg, respectively), causing interface edema with evident interface fluid pockets. Steroids were stopped and topical anti-glaucoma therapy was started. The interface edema decreased and at the end of follow-up the corneal transparency was restored and IOP dropped to normal values. The infection group demonstrated a microbial keratitis-like reaction and underwent flap lifting and interface wound debridement and biopsy with administration of fortified antibiotics and steroids. After elevated IOP was detected, steroids and antibiotics were stopped and topical anti-glaucoma therapy was started, resulting in the resolution of the interface edema. CONCLUSIONS: Interface fluid syndrome secondary to steroid-induced elevation of IOP might develop in steroid responders after LASIK with a misleading clinical picture simulating DLK or infectious keratitis. Management includes stopping topical steroids and starting topical antiglaucoma therapy.

Adult↗
PubMed2006

Hyperopic LASIK retreatments with the Technolas laser.

PURPOSE: To evaluate the safety, efficacy, and predictability of hyperopic LASIK retreatments. METHODS: This retrospective, consecutive, non-comparative, observational study included 85 eyes that underwent hyperopic LASIK retreatment with 1-year follow-up. Complete ophthalmic examination included distance uncorrected (UCVA) and best spectacle-corrected visual acuity (BSCVA), cycloplegic refraction, and pachymetry. Patients were divided into two groups according to the preoperative spherical equivalent refraction: group 1, < or = +3.9 diopters (D) and group 2, > or = +4.0 D. RESULTS: The UCVA improved from 0.31 +/- 0.2 to 0.7 +/- 0.2 in group 1 and from 0.2 +/- 0.2 to 0.6 +/- 0.2 in group 2 following retreatment. Mean spherical equivalent refraction improved from +2.8 +/- 0.85 to +0.2 +/- 0.9 in group 1 and from +5.3 +/- 0.9 to +0.3 +/- 1.3 in group 2 after retreatment. In group 1, 32 (72.7%) of 44 eyes had BSCVA > or = 20/25, and in group 2, 24 (58.5%) of 41 eyes had BSCVA > or = 20/25. After primary hyperopic LASIK, 25 (56.8%) of 44 eyes in group 1 and 19 (46.3%) of 41 eyes in group 2 maintained BSCVA or gained > or = 1 lines postoperatively in contrast to 21 (47.7%) of 44 eyes in group 1 and 22 (53.9%) of 41 eyes in group 2 after retreatment. In group 1, 11 (25%) of 44 eyes lost > or = 2 lines of BSCVA after initial hyperopic LASIK compared to 14 (31.8%) of 44 eyes after retreatment. In group 2, 10 (24.4%) of 41 eyes lost > or = 2 lines of BSCVA after initial hyperopic LASIK compared to 12 (29.2%) of 41 eyes after retreatment. After hyperopic LASIK retreatment, 31 (70.5%) of 44 eyes in group 1 and 19 (46.4%) of 41 eyes in group 2 were within +/- 0.5 D of emmetropia. Safety was 0.9 in both groups and efficacy was 0.8 and 0.7 in groups 1 and 2, respectively. Complications included epithelial ingrowth of 1 to 3 mm (30%) and flap edge melting (2%). CONCLUSIONS: Hyperopic LASIK retreatment improved the refractive results of initial hyperopic LASIK surgery with 20% to 30% of eyes gaining > or = 1 lines of BSCVA. The loss of BSCVA was greater after primary hyperopic LASIK than after retreatment.

Adult↗
PubMed2006

Hyperopic LASIK with Esiris/Schwind technology.

PURPOSE: To investigate the refractive and visual outcomes of hyperopic LASIK using Esiris/Schwind technology. METHODS: This retrospective non-comparative observational study included 106 eyes (65 patients) operated with the Esiris/Schwind laser for hyperopia. Eyes were divided into two groups: group 1, < or = +3.99 diopters (D) and group 2, > or = +4.0 D (up to +7.0 D). Visual outcome for distance and near uncorrected (UCVA) and best spectacle-corrected visual acuities (BSCVA) (decimal values), cycloplegic refraction, keratometry (K), pachymetry, and complications were evaluated. RESULTS: In group 1, mean UCVA was 0.4 +/- 0.1 preoperatively and 0.8 +/- 0.2 6 months postoperatively. Mean BSCVA was 0.9 +/- 0.1 preoperatively and 0.9 +/- 0.1 6 months postoperatively. Safety index was 1.1 and efficacy index was 0.97. Mean spherical equivalent refraction was +2.33 +/- 0.9 D preoperatively and +0.3 +/- 0.3 D 6 months postoperatively. Mean K reading was 43.7 +/- 1.1 D preoperatively and 45.0 +/- 1.6 D 6 months postoperatively. In group 2, mean UCVA was 0.3 +/- 0.1 preoperatively and 0.8 +/- 0.2 6 months postoperatively. Mean BSCVA was 0.9 +/- 0.1 preoperatively and 0.9 +/- 0.1 6 months postoperatively. Safety index was 0.98 and efficacy index was 0.92. Mean spherical equivalent refraction was +5.1 +/- 0.9 D preoperatively and +0.4 +/- 0.5 D 6 months postoperatively. Mean K reading was 43.1 +/- 1.6 D preoperatively and 46.0 +/- 1.4 D 6 months postoperatively. Forty-six (90.2%) of 51 eyes in group 1 and 47 (85.5%) of 55 eyes in group 2 were within +/- 0.5 D of emmetropia. At 6-month follow-up, 40 (78%) of 51 eyes in group 1 had UCVA of 20/20 compared to 41 (75%) of 51 eyes in group 2. One (2%) of 51 eyes in group 1 and 4 (7.3%) of 55 eyes in group 2 lost < or = 2 lines of BSCVA. No eye lost >2 lines of BSCVA. CONCLUSIONS: Hyperopic LASIK with Esiris/Schwind technology is effective and safe in the correction of hyperopia up to + 7.0 D. Although a slight statistical significance was found for low hyperopia, visual and refractive results obtained in high hyperopia were encouraging.

Adult↗
PubMed2005

Outcomes of microincision cataract surgery versus coaxial phacoemulsification.

PURPOSE: To compare outcomes of microincision cataract surgery (MICS) with coaxial phacoemulsification. DESIGN: Prospective randomized consecutive case series. PARTICIPANTS: One hundred eyes of 50 patients with nuclear or corticonuclear cataract (grades 2+ to 4) with Lens Opacities Classification System III. METHODS: One hundred eyes (50 patients) were randomly operated through clear corneal incisions using 2 techniques: coaxial phacoemulsification (50 eyes) and microincision cataract surgery (50 eyes). MAIN OUTCOME MEASURES: Mean phacoemulsification time, total phacoemulsification percent, effective phacoemulsification time (EPT) (calculated by multiplying total phacoemulsification time in seconds by the average power percent used), intraoperative total balanced salt solution (BSS) volume, visual outcome, vectorial astigmatic changes, corneal thickness, endothelial cell count, and anterior chamber flare and cells preoperatively and at 1 day, 1 month, and 3 months. RESULTS: Statistically significant differences were found between MICS and coaxial phacoemulsification regarding mean incision size, mean total phacoemulsification percent, and EPT. There were no significant differences between the techniques regarding the mean percent of endothelial cell loss, anterior chamber cell count and flare, mean phacoemulsification time, pachymetric measures or total BSS volume utilized, or visual outcome. The vectorial astigmatic changes in the MICS group showed a change of < or =0.25 diopters (D) in 35% of the eyes, 0.25 to 0.5 D in 50% of the eyes, and 0.5 to 1.0 D in 15% of the eyes. These changes were induced by the surgery. Vectorial astigmatic changes of >1 D were not observed. In the coaxial phacoemulsification group, vectorial astigmatic changes of <0.25 D were not observed either. Changes of 0.25 to 0.5 D were seen in 20% of the eyes, and changes of 0.5 to 1.0 D were seen in 30%. Fifty percent of the eyes showed changes of >1.0 D. Mean vectorial astigmatic changes were 0.36+/-0.23 D in the MICS group and 1.2+/-0.74 D in the coaxial phacoemulsification group (P<0.001). CONCLUSIONS: Microincision cataract surgery significantly lowered mean phacoemulsification time, mean total phacoemulsification percent, mean EPT, and surgically induced astigmatism when compared with coaxial phacoemulsification.

Cataract Extraction↗
PubMed2005

LASIK in patients with rheumatic diseases: a pilot study.

PURPOSE: To investigate the safety of LASIK in patients with a known history of controlled rheumatic diseases. DESIGN: Retrospective consecutive observational clinical study. PARTICIPANTS: Forty-two eyes (22 patients) known to have had a history of rheumatic diseases underwent LASIK. All patients had a history of controlled rheumatic diseases, including rheumatoid arthritis, systemic lupus erythematosus, dermatomyositis, scleroderma, ankylosing spondylitis, psoriatic arthritis, inflammatory bowel disease, arthritis, or Behçet's disease. METHODS: Assessments were made preoperatively and at 1, 3, and 6 months postoperatively and included visual acuity (VA), refraction, keratometric readings, slit-lamp biomicroscopy, and corneal topography. All the patients underwent LASIK. Postoperative treatment included a topical steroid-antibiotic combination. MAIN OUTCOME MEASURES: Visual acuity, refraction, keratometric readings, and slit-lamp biomicroscopy findings at 1, 3, and 6 months postoperatively. RESULTS: LASIK was performed uneventfully on all patients. The mean pre-LASIK spherical equivalent (SE) was -5.39+/-2.25, and the sixth month postoperative SE was -0.15+/-0.38 diopters (D) (P<0.001). Uncorrected VA 6 months after the LASIK procedure was 20/25. Enhancement procedures were performed in 6 of 42 eyes (14.3%) at variable times after the primary procedure. Postoperative follow-up showed development of a moderate degree of dry eye syndrome in 4 eyes (9.5%). Corneal haze, melting, flap, or interface complications were not observed in any of the study eyes. CONCLUSIONS: In this small series, we found good outcomes when correcting refractive errors using LASIK in selected patients with controlled rheumatic diseases. In this series, a favorable postoperative visual outcome was obtained with no operative or postoperative vision-threatening complications.

Adult↗
PubMed2005

One or 2 Intacs segments for the correction of keratoconus.

PURPOSE: To evaluate the effect of implanting 1 or 2 intracorneal rings (Intacs, KeraVision) as a device to correct, stabilize, and/or improve the best corrected visual acuity in patients with clear cornea keratoconus oriented by the preoperative corneal topography pattern. SETTING: Vissum/Instituto Oftalmológico de Alicante, Miguel Hernandez University, Alicante, Spain. METHODS: In this prospective comparative consecutive study, Intacs segments were implanted in 26 keratoconic eyes with clear central corneas of 19 consecutive patients (9 women and 10 men). Corneas were divided into 2 groups according to the topographic pattern of the cone. Group I included keratoconus not crossing the 180 degrees meridian and Group II included keratoconus crossing the 180 degrees meridian. The Intacs were horizontally placed through a lateral clear corneal incision. According to the corneal topography 1 segment was implanted 0.45 mm inferior in Group I, and 2 segments were implanted, 1 0.25 mm superior and the other 0.45 mm inferior, in Group II. All cases completed a minimum follow-up of 1 year. Differences between preoperative and postoperative uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, and keratometry were clinically and statistically evaluated. RESULTS: Spherical equivalent error and refractive astigmatism were significantly reduced. The mean keratometric values were reduced following Intacs insertion in both groups. At the end of the first year of the postoperative follow-up, Group I (1 segment) had an improvement in mean UCVA to 20/50 (0.4 +/- 0.22 decimal value), which was statistically significant when compared to the preoperative UCVA of 20/100 (0.2 +/- 0.13 decimal value) (P=.011). Mean BSCVA was 20/32 (0.62 +/- 0.24 decimal value), which was also statistically significant when compared to the preoperative BSCVA, which was 20/50 (0.4 +/- 0.21 decimal value) (P=.002). In Group II (2 segments), UCVA after 1 year was 20/63 (0.34 +/- 0.17 decimal value), which was statistically significant when compared to the preoperative UCVA of 20/400 (0.06 +/- 0.02 decimal value) (P=.001). Mean BSCVA was 20/32 (0.62 +/- 0.27 decimal value), which was significantly better than the preoperative UCVA of 20/50 (0.38 +/- 0.22 decimal value) (P=.001). In 4 eyes, the inferior segment was removed because of partial extrusion during the postoperative follow-up. CONCLUSIONS: Treatment of keratoconus with 1 or 2 Intacs segments oriented by the preoperative corneal topography used in this study proved to be effective in decreasing the corneal steepening and astigmatism and improving BSCVA. Further follow-up is needed to determine the final effect of Intacs on the progression of the corneal disease.

Adult↗
PubMed2005

Retinal image quality after microincision intraocular lens implantation.

PURPOSE: To evaluate the modulation-transfer function (MTF) in eyes implanted with a conventional intraocular lens (IOL) and 2 IOLs designed for microincision cataract surgery (MICS). SETTING: Research, Development, and Innovation Department, Instituto Oftalmológico de Alicante, Alicante, Spain. METHODS: This prospective nonrandomized consecutive series comprised 30 eyes implanted with 1 of the following IOLs: conventional acrylic foldable (AcrySof MA60BM, Alcon Laboratories) or the UltraChoice 1.0 ThinOptX (ThinOptX Inc.) or the Acri. Smart 48S (Acri.Tech) MICS IOL. The 0.5 MTF and 0.1 MTF following MICS were calculated 3 months after implantation with the Optical Quality Analysis System (OQAS) for a 5 mm pupil. The differences were statistically analyzed with the Mann-Whitney U test. RESULTS: The values of 0.5 MTF for AcrySof, UltraChoice, ThinOptX, and Acri. Smart IOLs were, respectively, 2.647 cycles per degree (cpd) +/- 0.833 (SD), 2.601 +/- 0.986 cpd, and 3.453 +/- 0.778 cpd. The mean 0.1 MTF values for the same IOLs were 8.720 +/- 3.074 cpd, 8.814 +/- 4.380 cpd, and 11.418 +/- 2.574 cpd, respectively. Statistical analysis did not show significant differences in 0.5 MTF and 0.1 MTF between the conventional IOL and MICS IOLs. CONCLUSIONS: Microincision cataract surgery IOLs showed excellent MTF performance when implanted after cataract surgery, equal to that of conventional IOLs. An in vivo MTF study may be an excellent option to evaluate IOL performance in the eye.

Acrylic Resins↗
PubMed2005

Visual outcome of microincision cataract surgery with implantation of an Acri. Smart lens.

PURPOSE: To evaluate visual and refractive outcome of microincision cataract surgery (MICS) with implantation of an Acri. Smart 48S intraocular lens (IOL) (Acri.Tech) through a sub-1.9 mm incision. SETTING: Vissum/Instituto Oftalmologico de Alicante and Ophthalmology Department, Miguel Hernandez University, Alicante, Spain. METHODS: In this consecutive prospective observational noncomparative clinical trial, 45 eyes were included. Microincision cataract surgery was performed through a 1.9 mm or smaller clear corneal incision using low ultrasound power MICS. The IOL was injected using a hydraulic cartridge and injector. The final size of the clear corneal incision, postoperative uncorrected and best corrected near and distance acuities, lens stability, ease of implantation, rate of posterior capsule opacification (PCO), and complications were reported up to 6 months. RESULTS: The Acri. Smart lens was inserted through mean incision of 1.5 mm +/- 0.3 (SD). The mean uncorrected distance visual acuity improved significantly from 20/100 (0.2 +/- 0.2 decimal value) preoperatively to 20/32 (0.7 +/- 0.3) by the end of 6 months postoperatively (P<.000). The best corrected distance visual acuity improved significantly from 20/50 (0.4 +/- 0.2) preoperatively to 20/25 (0.9 +/- 0.2) after 6 months (P<0.000). The uncorrected near visual acuity at the end of 6 months was 20/32 (0.6 +/- 0.2, P<.000). The mean postoperative spherical equivalent was -1.1 +/- 0.9 diopters (P<.947). The safety index was 2.5 for distance and 1.4 for near. There were no intraoperative or postoperative complications. No eye had a neodymium:YAG laser capsulotomy for PCO or reported undesirable complications at the end of 6 months. CONCLUSIONS: Results show that the Acri. Smart 48S IOL is a safe, effective, and stable lens that could be inserted through sub-1.9 mm incisions. It provided excellent surgical performance, predictability, and some degree of pseudoaccommodation.

Acrylic Resins↗
PubMed2005

Severe corneal epithelial sloughing during laser in situ keratomileusis as a presenting sign for silent epithelial basement membrane dystrophy.

PURPOSE: To report the occurrence of large intraoperative epithelial sloughing during laser in situ keratomileusis (LASIK) as a first diagnostic sign for silent epithelial basement membrane dystrophy (EBMD). SETTING: Refractive Surgery and Cornea Unit, Alicante Institute of Ophthalmology, Alicante, Spain. METHODS: In this retrospective case series, the medical records of all patients with large corneal epithelial sloughing/defects during LASIK from January 1995 to December 2004 were reviewed. All patients who presented normal corneas before LASIK and EBMD changes after LASIK were included in this study. The surgical procedures and postoperative course were recorded. The follow-up period was 12 months for all patients. RESULTS: Eleven eyes of 6 patients were included. The mean age was 35 years +/- 6.1 (SD). Mean preoperative uncorrected visual acuity (UCVA) was 20/500 (0.04 +/- 0.02); 12 months after surgery, mean UCVA increased to 20/27 (0.74 +/- 0.21). There was a significant decrease in best spectacle-corrected visual acuity 1 month after surgery. One year postoperatively, 10 of 11 eyes (91%) were within +/-1.00 diopter of emmetropia. Postoperatively, clinical manifestations of EBMD were observed in all eyes and complications were common. In the early postoperative period, diffuse lamellar keratitis was observed in 6 of 11 eyes (54.5%) and flap microfolds were noted in 2 of 11 (18.2%). One year after surgery, epithelial ingrowth was present in 8 of 11 eyes (72.7%) and flap melting was noted in 4 of 11 (36.4%). CONCLUSION: Occurrence of large intraoperative epithelium sloughing/defects during LASIK might be a diagnostic sign for subclinical EBMD. These patients are predisposed to multiple postoperative complications. Because of the high risk for epithelial sloughing in the second eye, LASIK should not be performed.

Adult↗
PubMed2004

Intraocular telescopic lens evaluation in patients with age-related macular degeneration.

PURPOSE: To evaluate the improvement of distance and near visual acuity after removal of cataract and implantation of an 3.0x intraocular miniaturized telescope (IMT) in patients with stable atrophic type age-related macular degeneration (ARMD). SETTINGS: Instituto Oftalmológico de Alicante and a multicenter group. METHODS: In this prospective noncomparative multinational consecutive study, 40 eyes of 40 patients with dry-type ARMD were implanted with IMTs at multiple centers. Standard phacoemulsification procedure followed by enlargement of the incision to 10 mm and implantation in the capsular bag of an 3.0x IMT was carried out in all the cases. Patients were followed for 12 months. Evaluation included the differences between preoperative and postoperative uncorrected and best corrected visual acuity for far and near, position of the IMT, intraocular pressure, and occurrence of any postoperative complications. RESULTS: Mean preoperative uncorrected distance visual acuity (UCDVA) in the operated eye was 0.9 logMAR (0.125 +/- 0.01, range 0.1 to 0.3 in decimal values); at 1 year postoperatively, mean UCDVA in the operated eye was 0.6 logMAR (0.25 +/- 0.14, range 0.1 to 0.5 in decimal values). Mean preoperative uncorrected near visual acuity (UCNVA) in the operated eye was 0.8 logMAR (0.16 +/- 0.13, range 0.1 to 0.5 in decimal values); at 1 year postoperatively, mean UCNVA in the operated eye was 0.4 logMAR (0.4 +/- 0.26, range 0.1 to 1.0 in decimal values). The differences between pre- and postoperative distance and near visual acuities were statistically significant. Six cases were explanted, and 14 developed adverse effects, 7 of which were persistent. The corneal endothelium tolerated the procedure well. CONCLUSION: Implantation of IMT is feasible and plays an effective role in improving far and near visual acuity in patients with stable dry-type ARMD.

Aged↗
PubMed2004

Milling trabeculoplasty for nonpenetrating glaucoma surgery.

PURPOSE: To describe the use of a motorized milling drill to perform nonpenetrating glaucoma surgery and to assess its safety. SETTING: Instituto Oftalmológico de Alicante, Miguel Hernandez University, School of Medicine, Alicante, Spain. METHODS: This prospective noncomparative study included 16 eyes (13 patients) diagnosed with primary open-angle glaucoma. The eyes were divided into 2 groups. Group 1 (8 eyes) had a milling procedure, and Group 2 (8 eyes) had combined phacoemulsification and milling. A fornix-based conjunctival flap was created, and then the milling procedure was performed using a notched hemispherical metallic tip. Evolution of intraocular pressure (IOP), visual outcomes, and the development of intraoperative and postoperative complications were evaluated. RESULTS: The mean age of the patients was 67.9 years +/- 10.9 (SD) (range 50 to 80 years). In Group 1, the mean IOP preoperatively was 27.6 +/- 10.1 mm Hg (range 18 to 50 mm Hg) and after 6 months, 15.8 +/- 5.2 mm Hg (range 12 to 24 mm Hg). The mean IOP reduction 6 months postoperatively was 15.4 +/- 10.6 mm Hg, a 55.7% decrease from preoperatively. In Group 2, the mean IOP preoperatively was 21.7 +/- 4.6 mm Hg (range 13 to 30 mm Hg), and after 6 months, 16.2 +/- 3.4 mm Hg (range 13 to 23 mm Hg). The mean reduction in IOP at 6 months was 5.5 +/- 2.8 mm Hg, a decrease of 25.3% from the preoperative value. In Group 1 at 6 months, 5 eyes (62.5%) had a diffuse filtering bleb and 3 (37.5%), localized filtration. In Group 2, 7 eyes (87.5%) had a diffuse filtering bleb and 1 (12.5%) had fibrosis of the bleb and reduction of filtration. CONCLUSION: The motorized milling drill can be safely used to mill and refine the remaining scleral thickness, eliminating the rupture of trabeculo-Descemet's membrane.

Aged↗
PubMed2004

Near vision restoration with refractive lens exchange and pseudoaccommodating and multifocal refractive and diffractive intraocular lenses: comparative clinical study.

PURPOSE: To evaluate near visual performance after implantation of a pseudoaccommodating intraocular lens (IOL) (Crystalens AT-45, eyeonics) or a multifocal IOL (refractive model, AMO Array; diffractive model, AcriTec TwinSet) after lens surgery. SETTINGS: Instituto Oftalmologico de Alicante, Miguel Hernandez University, Alicante, Spain. METHODS: Forty patients were included in this prospective clinical comparative study. The patients were divided into 3 groups according to the type of IOL implanted. Group 1 included 24 eyes (12 patients) implanted with the Crystalens IOL; Group 2, 32 eyes (16 patients) with the Array IOL, and Group 3, 24 eyes (12 patients) with the TwinSet IOL. Bilateral phacoemulsification and IOL implantation were performed in all patients, and the follow-up was 1 year. The postoperative main visual outcome evaluations were uncorrected and best corrected distance and near visual acuities, mean add for near, and best distance-corrected near acuity. RESULTS: In Group 1, the mean uncorrected near acuity was 20/40 preoperatively and 20/25 after 1 year. The mean preoperative best distance-corrected near acuity was 20/32 and 20/25 after 1 year. In Group 2, the mean uncorrected near acuity was 20/40 and 20/25, respectively. The mean preoperative best distance-corrected near acuity was 20/32 and 20/25 after 1 year. In Group 3, the mean uncorrected near acuity was 20/63 preoperatively; after 1 year, it was approximately 20/25. The mean best distance-corrected near acuity was 20/50 and 20/25, respectively. A neodymium:YAG laser capsulotomy was performed for posterior capsule opacification when required, with no change in the refractive outcome. CONCLUSIONS: Implantation of multifocal and pseudoaccommodating IOLs provides adequate near vision restoration. The TwinSet IOL provided faster recovery of near vision than the other 2 IOLs. The Crystalens IOL provided less postoperative visual phenomena with favorable near vision. The Array IOL achieved the most comfortable distance and near vision.

Accommodation, Ocular↗
PubMed2004

Changes in keratoconic corneas after intracorneal ring segment explantation and reimplantation.

PURPOSE: To evaluate the outcome and potential reversibility of the changes induced in keratoconic eyes after intracorneal ring segment explantation. DESIGN: Retrospective, interventional case series. PARTICIPANTS: Five eyes of 4 patients who underwent uneventful implantation of one or two intracorneal ring segment segments for the correction of clear corneal keratoconus and who required explantation of one segment due to complications. MAIN OUTCOME MEASURES: Visual acuity, refraction, keratometric readings, and corneal topography. The follow-up was up to 1 year from the primary implantation procedure in all cases. RESULTS: Explantation was performed easily in all cases without intraoperative or postoperative complications. The segments were extracted due to migration and local melting. The visual, refractive, and topographic map findings regressed to approximate the original clinical situation before segment implantation. CONCLUSIONS: Intracorneal ring segments are safely and easily explanted from keratoconic eyes. Most of the visual, refractive, and topographic findings return to near the preimplantation levels.

Adult↗
PubMed2003

Intracorneal rings for the correction of pellucid marginal degeneration.

We report a case of Intacs(R) (KeraVision) implantation for the correction of pellucid marginal degeneration (PMD). Preoperatively, the patient's uncorrected visual acuity (UCVA) was 0.05, the best spectacle-corrected visual acuity (BSCVA) was 0.1, and the refraction was -2.00 -7.00 x 90 in the right eye. The flattest meridian (K1) measured 43.8@104 and the steepest meridian (K2), 51.3@14. Ultrasound pachymetry revealed a thin cornea of 420 micrometers. One month postoperatively, the UCVA was 0.2, the BSCVA was 0.5, and the refraction was -8.00 -7.00 x 50. Contact lens best corrected visual acuity was 0.9; 6 months postoperatively, it improved to 1.0. The use of Intacs to treat PMD seems to be viable and improves visual acuity. The residual error can be corrected with contact lenses.

Adult↗
PubMedDate not supplied

Artisan toric phakic intraocular lens for correction of astigmatism.

PURPOSE: To assess the safety and efficacy of implanting Artisan toric phakic intraocular lenses (PIOLs) (Ophtec BV, Groningen, The Netherlands) in eyes with high degrees of compound myopic, hyperopic, and mixed astigmatism. METHODS: Twenty-five eyes (20 patients) presenting with high astigmatism were implanted with Artisan toric PIOLs and followed for 1 year. Group 1 included 8 eyes (myopic astigmatism), group 2 included 9 eyes (hyperopic astigmatism), and group 3 included 8 eyes (mixed astigmatism). RESULTS: In the myopic astigmatism group, 8 (100%) of 8 eyes had preoperative uncorrected visual acuity (UCVA) of < or = 20/50, and at 6-month follow-up, 5 (62.5%) of 8 eyes had UCVA of > or = 20/40 (P = .005). In this group, 75% of eyes were within +/- 1.00 diopter (D) of the intended correction. In the hyperopic astigmatism group, 8 (88.9%) of 9 eyes had preoperative UCVA of < or = 20/40, and at 6-month follow-up, 6 (66.6%) of 9 eyes had UCVA of > or = 20/32 (P = .199). Approximately 77.8% of eyes were within +/- 1.00 D of the intended correction. In the mixed astigmatism group, 8 (100%) of 8 eyes had preoperative UCVA of < or = 20/50, and at 6-month follow-up, 6 (87.5%) of 8 eyes had UCVA of > or = 20/40 (P = .007). In this group, 87.5% of eyes were within +/- 1.00 D of the intended correction. The safety index of the procedure was 1.6, 1.3, and 1.3 in the myopic, hyperopic, and mixed astigmatism groups, respectively. The efficacy index of the procedure was 1.2, 1.0, and 1.0 in the myopic, hyperopic, and mixed astigmatism groups, respectively. CONCLUSIONS: Artisan toric PIOLs are safe for the correction of high degrees of astigmatism associated with myopic or hyperopic spherical refractive defect.

Adult↗