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Biomedical subjects

Robert A Latkany

Publications and source records attributed to Robert A Latkany.

5 recordsLinked to original sources

Effect of artificial tears on visual acuity.

PURPOSE: To study the effect of commonly used preservative free artificial tear, carboxymethylcellulose (CMC) 0.5% (Refresh Plus, Allergan, Irvine, California) on visual acuity in symptomatic dry eye (SDE) and asymptomatic dry eye (ADE) patients. DESIGN: Nonrandomized prospective clinical trial. METHODS: Prospective study involving 20 patients (40 eyes) with SDE and 20 patients (40 eyes) with ADE, all 40 years and older, were recruited from a clinic setting over a 1-month period. Distance visual acuity was measured by the Early Treatment of Diabetic Retinopathy Study (ETDRS) vision chart and near visual acuity was measured by the Lighthouse Near Vision chart before and 30 seconds after instillation of one drop of CMC. Distance and near visual acuity was measured both with and without correction. The duration of action of CMC was measured at 1-minute intervals until the patient's visual acuity returned to pretear level. RESULTS: In both SDE and ADE groups, uncorrected and corrected near and distance vision showed a statistically significant improvement after the use of CMC (P < .05). There was no statistically significant difference in improvement between the SDE and ADE groups in all categories (P values > .05). The mean duration of improvement of vision was 2.93 minutes in the SDE group and 3.70 minutes in the ADE group (P = .036). CONCLUSIONS: CMC 0.5% provides a temporary yet significant improvement in the visual acuity of SDE and ADE patients. The effect of artificial tears on visual acuity may be of diagnostic value in detecting ocular surface abnormality in symptomatic and asymptomatic patients.

Aged↗

Intraocular lens calculations after refractive surgery.

PURPOSE: To evaluate the effect of refractive surgery on intraocular lens (IOL) power calculation, compare methods of IOL power calculation after refractive surgery, evaluate the effect of pre-refractive surgery refractive error on IOL deviation, review the literature on determining IOL power after refractive surgery, and introduce a formula for IOL calculation for use after refractive surgery for myopia. SETTING: Laser & Corneal Surgery Associates and Center for Ocular Tear Film Disorders, New York, New York, USA. METHODS: This retrospective noncomparative case series comprised 21 patients who had uneventful cataract extraction and IOL implantation after previous uneventful myopic refractive surgery. Six methods of IOL calculation were used: clinical history (IOL(HisK)), clinical history at the spectacle plane (IOL(HisKs)), vertex (IOL(vertex)), back-calculated (IOL(BC)), calculation based on average keratometry (IOL(avgK)), and calculation based on flattest keratometry (IOL(flatK)). Each method result was compared to an "exact" IOL (IOL(exact)) that would have resulted in emmetropia and then compared to the pre-refractive surgery manifest refraction using linear regression. The paired t test was used to determine statistical significance. RESULTS: The IOL(HisKs) was the most accurate method for IOL calculations, with a mean deviation from emmetropia of -0.56 diopter +/-1.59 (D), followed by the IOL(BC) (+1.06 +/- 1.51 D), IOL(vertex) (+1.51 +/- 1.95 D), IOL(flatK) (-1.72 +/- 2.19 D), IOL(HisK) (-1.76 +/- 1.76 D), and IOL(avgK) (-2.32 +/- 2.36 D). There was no statistical difference between IOL(HisKs) and IOL(exact) in myopic eyes. The power of IOL(flatK) would be inaccurate by -(0.47x+0.85), where x is the pre-refractive surgery myopic SE (SEQ(m)). Thus, without adjusting IOL(flatK), most patients would be left hyperopic. However, when IOL(flatK) is adjusted with this formula, it would not be statistically different from IOL(exact). CONCLUSIONS: For IOL power selection in previously myopic patients, a predictive formula to calculate IOL power based only on the pre-refractive surgery SEQ(m) and current flattest keratometry readings was not statistically different from IOL(exact). The IOL(HisKs), which was also not statistically different from IOL(exact), requires pre-refractive surgery keratometry readings that are often not available to the cataract surgeon.

Adult↗

Advanced epithelial ingrowth 6 months after laser in situ keratomileusis.

Epithelial ingrowth is a common complication of laser in situ keratomileusis (LASIK). The cause is thought to be postoperative invasion of surface epithelial cells under the flap. We present a case of advanced epithelial cystic ingrowth that caused a profound reduction in visual acuity 6 months after a second LASIK enhancement.

Corneal Diseases↗