1/25. Piggyback posterior chamber multifocal intraocular lenses in anisometropia.A 63-year-old white man with anisometropic hyperopia presented with cataract in both eyes. He had uneventful temporal limbal phacoemulsification with intracapsular placement of a multifocal 3-piece silicone intraocular lens (IOL) in his right eye (model SA-40N, Allergan, Inc.). One week later, 2 intracapsular 3-piece silicone IOLs (1 monofocal backward, Allergan model SI-40NB; 1 multifocal in front, Allergan model SA-40N) were implanted in his left eye. At 8 days postoperatively, uncorrected visual acuity was 20/20 for distance and J1 for near vision in the right eye and 20/30 and J2, respectively, in the left. These values remained constant until the patient was seen 7 months postoperatively. Power calculation and insertion order of the piggyback IOLs were considered.- - - - - - - - - - ranking = 1keywords = eye (Clic here for more details about this article) |
2/25. A new technique for rigid gas permeable contact lens fitting following penetrating keratoplasty.PURPOSE: To evaluate a new, rigid gas permeable contact lens fitting technique following penetrating keratoplasty. methods: For the correction of postoperative anisometropia or astigmatism, a rigid gas permeable, tetra-curve contact lens with an overall diameter of 12.0 mm and a back optic zone diameter of 8.5 mm was fitted in 36 eyes of 33 patients, 7 months after penetrating keratoplasty. The contact lens back optic zone radius was selected using the videokeratography values over the elevated edges of the transplant wound (with the sutures in place). Graft clarity, visual outcome, and corneal topography were evaluated up to 3 years after surgery at intervals of 6 months. RESULTS: Throughout the follow-up period (range 6-36, mean 19.3 /-sd 11.8 months), all grafts remained clear. Mean contact lens daily wearing time averaged 13.6 ( /- sd 4.7) hours. Mean best-corrected visual acuity improved from 0.36 ( /- sd 0.18) LogMAR with spectacles to 0.11 ( /- sd 0.11) LogMAR with contact lenses (p < 0.0001). One patient was excluded from the study due to a lack of motivation and one had an adverse reaction to the stitches. CONCLUSIONS: To improve the visual performance following penetrating keratoplasty, the described fitting technique, guided by videokeratography, eased selection of the back optic zone radius of the initial trial lens. The large diameter contact lenses with a tetra-curve design were well tolerated in all patients for more than 13 hours daily.- - - - - - - - - - ranking = 0.25keywords = eye (Clic here for more details about this article) |
3/25. Reversal of myopic anisometropic amblyopia with phakic intraocular lens implantation.PURPOSE: To report a case of reversal of myopic anisometropic amblyopia with phakic intraocular lens implantation. methods: A 6-year-old boy with anisometropic amblyopia with spherical equivalent refraction of right eye: -14.00 -3.00 x 100 degrees, left eye: -0.50 -3.25 x 90 degrees, was treated for 2 years with occlusion to the left eye, with poor results. Refractive surgery was planned because of contact lens intolerance at age 8 years. A -15.00-D iris claw Artisan intraocular lens (IOL) was implanted. RESULTS: Following surgery, treatment of the amblyopia and spectacle correction of -4.00 D cylinder at 85 degrees in the right eye and -3.50 D cylinder at 90 degrees in the left eye was necessary. visual acuity 6 months after surgery was 20/25 in the right eye and 20/20 in the left eye, and has remained stable 18 months after surgery. CONCLUSION: Myopic anisometropic amblyopia in an 8-year-old boy was treated successfully with implantation of an Artisan iris claw phakic anterior chamber IOL, combined with occlusion therapy, and resulted in reversal of amblyopia.- - - - - - - - - - ranking = 1.75keywords = eye (Clic here for more details about this article) |
4/25. Mirror image myopic anisometropia in two pairs of monozygotic twins.Two sets of monozygotic twins with mirror image myopic anisometropia are reported. The first set were two boys aged 1 year 8 months. There was a right eye myopic anisometropia in one twin, and a left eye myopic anisometropia in the other. The differences in refractive power between both eyes were 11.6 and 7.6 dpt, respectively (spherical equivalent). The second set were two 6-year-old boys. The right eye had myopic anisometropia in one twin, while the left eye was affected in the other. The differences in refractive power between both eyes were 6.5 and 3.7 dpt, respectively (spherical equivalent). exotropia was recognized in 3 cases. Previously only two sets of monozygotic twins with mirror image myopic anisometropia have been reported. Monozygotic twins with mirror image myopic anisometropia are extremely rare.- - - - - - - - - - ranking = 1.5keywords = eye (Clic here for more details about this article) |
5/25. Electronically measured compliance with occlusion therapy for amblyopia is related to visual acuity increase.PURPOSE: We set out to determine whether the children who have low compliance (measured electronically) with occlusion therapy for amblyopia are those with insufficient increase of visual acuity. methods: In 14 newly identified amblyopic children (mean age 4.3 /-1.9 years), compliance was measured electronically over a period of 1 week, 6 months after the start of occlusion therapy. compliance was measured with an Occlusion Dose Monitor (ODM). The measurements took place during planned domiciliary visits. The children were diagnosed with anisometropia (n=5), strabismus (n=4) and anisometropia and strabismus (n=5). compliance was expressed in percentages of the electronically registered time compared with the prescribed occlusion time. Satisfactory acuity increase following 6 months of occlusion therapy was defined on reaching any of the following criteria: acuity increase expressed as a ratio between acuity of the amblyopic eye and acuity of the good eye of more than 0.75, acuity of the amblyopic eye exceeding 0.5 as measured on the E-Chart or Landolt-C, or three LogMAR lines of increase in acuity. RESULTS: Measured compliance averaged 80% in the eight children who had a satisfactory acuity increase and 34% in the six children who had an unsatisfactory visual acuity increase. Children with low acuity increase had statistically significantly lower compliance (P=0.038). CONCLUSION: The general assumption among orthoptists, that compliance with occlusion therapy for amblyopia is low in children with insufficient acuity increase, has been validated by electronic, objective means.- - - - - - - - - - ranking = 0.75keywords = eye (Clic here for more details about this article) |
6/25. anterior chamber iris-fixated phakic intraocular lens for anisometropic amblyopia.We report a child who had implantation of an iris-fixated Artisan phakic intraocular lens (IOL) to correct high unilateral myopia to support the therapy of anisometropic amblyopia. After IOL implantation, the patient continued occlusion therapy to further treat the amblyopic eye. One year postoperatively, the best corrected visual acuity in the amblyopic eye was 1.00 and binocular stereovision had developed. The visual acuity remained stable through 3 years of follow-up. There were no complications, although postoperative endothelial cell loss was significant.- - - - - - - - - - ranking = 0.5keywords = eye (Clic here for more details about this article) |
7/25. Exodeviation following monocular myopic regression after laser in situ keratomileusis.We report a 44-year-old woman with intermittent left exotropia of 35 prism diopters at distance who initially exhibited alignment of both eyes after bilateral laser in situ keratomileusis (LASIK). The exophoria was not preserved due to myopic regression in the dominant eye. An uneventful LASIK treatment was performed to correct -11.00 -0.50 x 130 in the right eye and -13.50 -1.50 x 145 in the left eye. The aim was to achieve emmetropia in both eyes. Although an examination revealed exophoria at near and distance during the 6 months following refractive surgery, the tropic aspect of the divergent deviation appeared in the right eye following the myopic regression. Laser in situ keratomileusis is an effective option to achieve binocular visual quality in myopic anisometropic patients. However, myopic regression after LASIK may disrupt the binocular visual quality.- - - - - - - - - - ranking = 1.5keywords = eye (Clic here for more details about this article) |
8/25. choroidal neovascularization after laser-assisted in situ keratomileusis following penetrating keratoplasty.PURPOSE: To describe a case of choroidal neovascularization (CNV) after laser in situ keratomileusis (LASIK) following penetrating keratoplasty (PK). methods: Case report. RESULTS: A 30-year-old man underwent PK in both eyes for bilateral keratoconus in 1997. Two years later, best-corrected visual acuity (BCVA) was 20/40 (-6=-4.50 x 170 degrees ) in RE and 20/20 (-1.50=-0.50 x 90 degrees ) in LE. To reduce the anisometropic defect, LASIK was performed in RE. After surgery, the refractive defect in RE reduced to -1.75 x 125 degrees and BCVA improved to 20/25. Six months after LASIK the patient presented loss of vision and metamorphopsia in RE due to choroidal neovascularization. BCVA was reduced to 20/200. Photodynamic therapy was performed in RE; 1 year later BCVA was stable at 20/200. CONCLUSION: Vitreoretinal complications after LASIK occur rarely. The potential relationship between CNV and LASIK is discussed.- - - - - - - - - - ranking = 0.25keywords = eye (Clic here for more details about this article) |
9/25. Decreased activation of the lateral geniculate nucleus in a patient with anisometropic amblyopia demonstrated by functional magnetic resonance imaging.Although postmortem morphological changes in the lateral geniculate nucleus (LGN) have been reported in human amblyopia, LGN function during monocular viewing by amblyopic eyes has not been documented in humans. We used functional magnetic resonance imaging (fMRI) to study monocular visual activation of the LGN in a patient with anisometropic amblyopia. Four normal subjects, a patient with optic neuritis and a patient with anisometropic amblyopia were studied with fMRI at 1.5 T during monocular checkerboard stimulation. Activated areas in the LGN and visual cortex were identified after data processing (motion correction and spatial normalization) with SPM99. In the 4 normal subjects, comparable activation of the LGN and visual cortex was obtained by stimulation of either the right or left eye. In the patient with unilateral optic neuritis, activation of the LGN and visual cortex was markedly decreased when the affected eye was stimulated. Similarly, decreased activation of the LGN as well as the visual cortex by the affected eye was demonstrated in the patient with anisometropic amblyopia. Our preliminary results suggest that activation of the LGN is diminished during monocular viewing by affected eyes in anisometropic amblyopia. fMRI appears to be a feasible method to study LGN activity in human amblyopia.- - - - - - - - - - ranking = 1.25keywords = eye (Clic here for more details about this article) |
10/25. hyperopia, anisometropia, and irregular astigmatism in a patient following revisional radial keratotomy.We present a patient who underwent bilateral radial keratotomy (RK) followed by a bilateral revisional RK for undercorrection. After the second procedure, the patient had a severely flattened left cornea, with marked hyperopia and irregular astigmatism. The right eye, however, remained myopic, causing extreme anisometropia. We hypothesize that the different results in these two eyes may have been due to a critical number of damaged left corneal stromal fibers. patients undergoing revisional RK or requiring additional incisions may be at increased risk for such a complication.- - - - - - - - - - ranking = 0.5keywords = eye (Clic here for more details about this article) |
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