Cases reported "Hyperopia"

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1/70. Very high-frequency ultrasound corneal analysis identifies anatomic correlates of optical complications of lamellar refractive surgery: anatomic diagnosis in lamellar surgery.

    OBJECTIVE: To examine the utility of very high-frequency (VHF) ultrasound scanning in determining the anatomic changes and correlates of optical complications in lamellar refractive surgery. STUDY DESIGN: Case series. PARTICIPANTS: Cases analyzed included marked asymmetric astigmatism postautomated lamellar keratoplasty (ALK), image ghosting despite normal videokeratography post-ALK, uncomplicated myopic laser in situ keratomileusis (LASIK), and hyperopic LASIK with regression. methods: A prototype VHF ultrasound scanner (50 MHz) was used to obtain sequences of parallel B-scans of the cornea. Digital signal processing techniques were used to measure epithelial, stromal, and flap thickness values in a grid encompassing the central 4 to 5 mm of the cornea, enabling pachymetric mapping of each layer with 2-micron precision. MAIN OUTCOME MEASURE: The appearance of the corneas in VHF ultrasound images and thickness values of individual corneal layers determined from VHF ultrasound data. RESULTS: VHF ultrasound resolved the epithelial, stromal cap, or flap and residual stromal layers 1 year after lamellar surgery. Asymmetric stromal tissue removal was differentiated from stromal cap irregularity. epithelium acted to compensate for asymmetry of the stromal surface about the visual axis and for localized surface irregularities. Irregularities in the epithelial-stromal interface accounted for image ghosting present despite apparently normal videokeratography. Epithelial thickening was shown after uncomplicated myopic LASIK. Hyperopic LASIK demonstrated relative epithelial thickening localized to the region of ablation accounting for refractive regression. CONCLUSIONS: VHF ultrasound shows promise as a sensitive method of determining the anatomic correlates of optical complications in lamellar refractive surgery.
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ranking = 1
keywords = visual
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2/70. Bacterial keratitis following laser in situ keratomileusis for hyperopia.

    A 42-year-old Bahraini man had uneventful laser in situ keratomileusis for hyperopia (OD: 3.00 0.75 x 155 degrees; OS: 2.00 0.50 x 155 degrees). Three weeks later, he presented with localized keratitis in his right eye, with localized keratitis at the flap margin with stromal edema. Uncorrected visual acuity was 20/80 OD with no improvement with pinhole, and was 20/20 OS. Corneal smear culture showed a positive growth of staphylococcus aureus. The patient was immediately treated with subconjunctival gentamicin and intensive topical ofloxacin 0.3% with systemic cephalosporin. The patient recovered from keratitis within 2 weeks and his uncorrected visual acuity OD improved to 20/20. keratitis following LASIK should be treated promptly so that it does not lead to permanent reduction in visual acuity.
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ranking = 3
keywords = visual
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3/70. Clear lens extraction with intraocular lens implantation for hyperopia.

    PURPOSE: Current surgical options for the correction of moderate to severe hyperopia include hyperopic laser in situ keratomileusis (LASIK), phakic intraocular lens implantation and clear lens extraction with intraocular lens (IOL) implantation. We investigate the safety and efficacy of clear lens extraction with IOL implantation to correct hyperopia. methods: phacoemulsification and IOL implantation was performed on 18 eyes of 10 patients. In 16 eyes, the Hoffer-Q formula was used for IOL power calculation and a single IOL was inserted; in the remaining 2 nanophthalmic eyes, the Holladay-II formula was used and two piggy-back IOLs were inserted. RESULTS: Mean preoperative spherical equivalent for distance was 6.17 D (range, 4.25 to 9.62 D). patients were followed postoperatively for a mean of 10.5 months (range, 4 to 27 mo). Uncorrected visual acuity in all eyes was 20/50 or better with a median uncorrected visual acuity of 20/40 (range, 20/30 to 20/50). Two patients lost 2 lines of spectacle-corrected visual acuity; both of these patients achieved spectacle-corrected visual acuity of 20/30. CONCLUSIONS: Clear lens extraction with IOL implantation is a safe and effective procedure for the correction of moderate to severe hyperopia in the presbyopic age range.
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ranking = 4
keywords = visual
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4/70. Abnormal head posture associated with high hyperopia.

    BACKGROUND: An abnormal head posture may be adopted for ocular or nonocular reasons. The most common ocular reasons are to maintain binocularity and to obtain the best possible visual acuity. patients with undercorrected or overcorrected refractive errors have been reported to adopt a variety of head positions, thought to be an attempt to obtain the best possible visual acuity. methods: Five patients with symmetric high hyperopia (at least 5.00 D) and an abnormal head posture are presented. RESULTS: All five patients demonstrated an abnormal head posture of chin down for fixation without the spectacle correction in place. This abnormal head posture was eliminated by occlusion of either eye and also by wearing of the refractive correction. No patient demonstrated significant strabismus. CONCLUSION: An abnormal head posture when not wearing spectacle correction can occur in children who have high hyperopia and insignificant strabismus. This may be a mechanism by which the best visual acuity is obtained (indicated by the disappearance of the abnormal head posture on wearing of the glasses) and also to maintain binocularity (indicated by the disappearance of the abnormal head posture under monocular testing conditions). The presence of a chin-down abnormal head posture should alert the examiner to the possible presence of high hyperopia and therefore the necessity for a cycloplegic refraction.
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ranking = 3
keywords = visual
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5/70. Central bump-like opacity as a complication of high hyperopic photorefractive keratectomy.

    PURPOSE: A new complication is reported in association with high hyperopic excimer laser photorefractive keratectomy. methods: One thousand consecutive eyes were treated with a Meditec MEL-60 excimer laser (Meditec Inc, Heroldsberg, germany) for hyperopic refractive error between 1 diopters and 7 diopters. RESULTS: Three eyes with high hyperopic corrections between 5 and 6 diopters had a central, round bump-like subepithelial scar develop 1 month after hyperopic photorefractive keratectomy, which reduced the uncorrected and spectacle-corrected visual acuity. CONCLUSION: Central bump-like opacity is a new, visually significant complication of unknown origin associated with high hyperopic photorefractive keratectomy. Possible causes of this complication include drying and edema of the cornea as a result of prolonged exposure, interruption of the peripheral superficial nerve plexus affecting the central anterior stroma, and abnormal epithelial or tear film function resulting from excessive central steeping.
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ranking = 2
keywords = visual
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6/70. 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.
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ranking = 1
keywords = visual
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7/70. Topography-controlled excimer laser photorefractive keratectomy.

    PURPOSE: To assess whether photorefractive keratectomy (PRK) controlled by videokeratography can successfully treat refractive errors in eyes with corneal irregularities and improve spectacle-corrected visual acuity. methods: In a prospective clinical study, PRK was performed in 10 eyes of 10 patients. Reason for surgery was irregular astigmatism after penetrating keratoplasty, corneal irregularity after corneal scarring, corneal astigmatism in keratoconus, and decentration after myopic and hyperopic PRK. Excimer ablation was controlled by preoperative videokeratography (Orbscan II, Orbtek) using the MEL-70 system from Aesculap Meditec. Follow-up was 6 months. RESULTS: Concerning manifest refraction, the sphere was reduced on average from 1.92 to 0.57 D, 6 months postoperatively. Cylinder changed from -1.95 D on average to -0.30 D at 6 months postoperatively. There was improvement of uncorrected visual acuity of 2 or more lines in 5 eyes and no change in 5 eyes 6 months postoperatively. Spectacle-corrected visual acuity improved in 2 eyes by 2 to 3 lines, in 9 eyes by 1 to 3 lines, and showed no change in 1 eye. CONCLUSION: Videokeratography-controlled PRK improved refractive errors in irregular corneas with improvement of spectacle-corrected visual acuity.
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ranking = 4
keywords = visual
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8/70. Topography-driven photorefractive keratectomy: results of corneal interactive programmed topographic ablation software.

    OBJECTIVE: This study evaluated the efficacy, predictability, stability, and safety of a software program (Corneal Interactive Programmed Topographic Ablation (CIPTA) LIGI, Taranto, italy) which, by transferring programmed ablation from the corneal topography to a flying-spot excimer laser, provides customized laser ablation. DESIGN: Noncomparative consecutive case series. PARTICIPANTS: Forty-two eyes of 34 subjects with a mean age of 33.9 (range, 20-54) had CIPTA at the Cattedra di Ottica Fisiopatologica of Bari (italy). Twenty-eight eyes were treated for hyperopic astigmatism and 14 for myopic astigmatism. All the subjects had irregular astigmatism. OPERATION: Topography was acquired by a corneal topography mapping system (Orbscan, Orbtek, Inc., Salt Lake City, UT). These data were processed to obtain a customized altimetric ablation profile, which was transferred to a flying-spot laser (Laserscan 2000, Lasersight, Orlando, FL). MAIN OUTCOME MEASURES: Data on uncorrected (UCVA) and best-corrected visual acuity (BCVA), predictability, and stability of refraction and any complications were analyzed. RESULTS: Mean follow-up was 13.2 months. At the last postoperative examination, 26 eyes (92.8%) in the hyperopic group and 12 eyes (85.7%) in the myopic group had an UCVA superior to 20/40. Twelve hyperopic eyes (42.8%) and five myopic eyes (35.7%) had a UCVA of 20/20. All patients fell between 1 diopter of attempted correction in the spherical equivalent. Only 1 (2.4%) of the 42 eyes, belonging to the hyperopic group, lost 1 Snellen line of BCVA. We did not observe any decentration and/or haze after photorefractive keratectomy treatment or any irregularity in the flap-stroma interface in the three laser in situ keratomileusis operations performed in this study. CONCLUSIONS: The combination of topographic data with computer-controlled flying-spot excimer laser ablation is a suitable solution for correcting irregular astigmatism due to different causes.
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ranking = 1
keywords = visual
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9/70. Good visual function in posterior microphthalmos.

    Posterior microphthalmos is a rare condition in which the anterior segment is normal in size and configuration, but the posterior segment is reduced in size; this results in axial hyperopia and retinal folding. patients have decreased vision that is caused by posterior segment abnormalities, high refractive error, and amblyopia. We present a case of posterior microphthalmos in which retinal function was relatively intact and visual loss was believed to be primarily caused by refractive error and amblyopia. After treatment, the child's visual acuity and school performance improved. This case emphasizes the need for careful examination, refraction, and follow-up for these children because their visual potential may be reasonably good.
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ranking = 7
keywords = visual
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10/70. SHORT syndrome: a case with high hyperopia and astigmatism.

    We describe a case of the SHORT syndrome and compare it with previously published cases. This six-year-old girl shows nearly all the typical manifestations reported in patients with the SHORT syndrome, including lipoatrophy, minor facial anomalies, Rieger anomaly, and short stature. However, she also suffers from high hyperopia and astigmatism associated with poor visual acuity.
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ranking = 1
keywords = visual
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