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BCVA
Selected AbstractsThe effect of treatment zone diameter in hyperopic orthokeratologyOPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 6 2009Paul Gifford Abstract Purpose:, To investigate the time course of treatment zone (TZ) diameter changes in hyperopic orthokeratology (OK) lens wear from 1 h in the open eye through to seven nights in the closed eye. Methods:, Twelve subjects were fitted with rigid hyperopic OK lenses. Lenses were worn in the open eye for 1 h then one night in the closed eye, separated by a washout period of 4 days. Changes in best corrected visual acuity (BCVA) and corneal topography (Medmont E-300) were measured on lens removal. The TZ, comprising the central steepened zone (CSZ) and surrounding annular flattened zone (AFZ), was measured from corneal topography. Subsequently, ten subjects wore the same lens design overnight for seven nights, and measurements were taken on lens removal and 8 h later on Days 1 and 7. Results:, Both CSZ and AFZ were apparent after 1 h of hyperopic OK lens wear. CSZ decreased while AFZ increased with longer periods of lens wear. BCVA reduced with longer periods of lens wear and was associated with decreasing CSZ (r = ,0.866, p < 0.001) and increasing AFZ (r = 0.447, p < 0.05). Conclusions:, The association of changes of treatment zone size with reductions in BCVA suggests that increasing CSZ may lead to better visual outcomes in hyperopic OK. [source] Clinical features and follow-up results of pulsating polypoidal choroidal vasculopathy treated with photodynamic therapyACTA OPHTHALMOLOGICA, Issue 6 2010Suk Ho Byeon Acta Ophthalmol. 2010: 88: 660,668 Abstract. Purpose:, To report on the clinical course of pulsating polypoidal choroidal vasculopathy (PCV) treated with photodynamic therapy (PDT). Methods:, A total of 63 eyes of 58 consecutive patients diagnosed with PCV, treated with PDT and followed up for at least 6 months were enrolled. Best-corrected visual acuity (BCVA), fluorescein angiography and high-speed indocyanine green angiography (ICGA) using confocal scanning laser ophthalmoscopy (HRA) were performed. Results:, Of the 63 PCV eyes, 14 eyes (22.2%) of 14 patients were classified as having pulsating PCV. The mean age of pulsating PCV patients was 60.6 ± 7.0 years (48,69 years), which was younger than non-pulsating PCV patients (65.7 years, p = 0.035). The mean follow-up period was 23.9 ± 10.7 months, and PDT was administered 1.6 ± 0.9 times to pulsating PCV patients. The mean logMAR BCVAs were 0.85 ± 0.47 at presentation and 0.71 ± 0.52 at final examination. Extensive haemorrhagic events were more common in pulsating than in non-pulsating PCV patients (57.1% versus 26.5%, p = 0.032). However, the risk of haemorrhage within 3 months of PDT was similar for both pulsating PCV and the remaining patients (14.3% versus 20%, p = 0.723). Conclusion:, Pulsating PCV showed distinctive features including a relatively younger patient age at presentation, and a haemorrhagic tendency (especially extensive). However, the use of PDT did not directly increase the risk of haemorrhage in pulsating PCV patients. [source] Prevalence and causes of visual impairment in a rural North-east China adult population: a population-based survey in Bin County, HarbinACTA OPHTHALMOLOGICA, Issue 6 2010Wulian Song Acta Ophthalmol. 2010: 88: 669,674 Abstract. Purpose:, To investigate the prevalence and causes of visual impairment in a rural population in north-east China. Methods:, A population-based study was conducted within Bin County, Harbin of north-east China. Low vision and blindness were defined using the World Health Organization categories of visual impairment. The prevalence of visual impairment was estimated, and causes were identified based on best-corrected visual acuity (BCVA) as well as presenting visual acuity (VA). Results:, Out of 5764 people, 4956 (86.01%) aged older than 40 participated in the study. The prevalence of visual impairment, low vision and blindness based on presenting VA was 9.6% (BCVA, 6.6%), 7.7% (BCVA, 4.9%) and 1.9% (BCVA, 1.7%), respectively. Taking the presenting VA, cataract (44%) was the most common cause for visual impairment followed by uncorrected refractive error (24%), treatable causes of visual impairment accounted for 68% of the total cases. Cataract (59%) and glaucoma (15%) were leading causes for blindness based on presenting VA. According to BCVA, cataract was the leading cause of visual impairment and blindness (58% and 60%, respectively), followed by glaucoma (17% and 15%, respectively). The prevalence of visual impairment was higher among women than men (p < 0.0001) and increasing with age (p < 0.0001) and decreasing with increasing education level (p = 0.0075). Conclusion:, Visual impairment was a serious public health problem in this rural population, with most of it easily remedied. Results highlighted the need for visual impairment prevention programs to an increasing number of elderly people, with a special emphasis on female and those with little or no education. [source] Retinal sensitivity and fixation changes 1 year after triamcinolone acetonide assisted internal limiting membrane peeling for macular hole surgery , a MP-1 microperimetric studyACTA OPHTHALMOLOGICA, Issue 6 2010Hakan Ozdemir Acta Ophthalmol. 2010: 88: e222,e227 Abstract. Purpose:, To evaluate microperimetric changes 1 year after macular hole surgery with triamcinolone acetonide assisted internal limiting membrane (ILM) peeling. Methods:, Twenty-two eyes of 22 patients with stage 3 and 4 idiopathic macular holes of <6 months' duration underwent vitrectomy with triamcinolone acetonide assisted ILM peeling. Best corrected visual acuity (BCVA) (logarithm of the minimum angle of resolution), and central retinal sensitivity were documented before and 1, 3, 6, and 12 months after surgery. Macular sensitivity (mean sensitivity in decibels -dB), and stability and location of fixation (preferred retinal locus) were determined using MP-1 microperimetry (Nidek). The MP-1 microperimetry sensitivity map was overlaid onto infrared images recorded on a Heidelberg scanning laser ophthalmoscope using dedicated MP-1 software to evaluate the fixation location before surgery. Anatomical success was evaluated with optical coherence tomography (OCT). Optical coherence tomography scans were recorded on an OCT 3000 scanner. Results:, Anatomical success was achieved in all 22 eyes. All patients completed 1 year follow-up. No recurrence of macular hole was seen in any patients in the follow-up period. The mean BCVA improved from 0.75 ± 0.2 before surgery to 0.31 ± 0.1 logMAR at the last visit (p < 0.001). Mean sensitivity improved from 3.7 ± 0.6 to 5.3 ± 1.0 dB at the last visit (p < 0.001). Before surgery, the preferred retinal locus was located on the margin of the hole in all, in 18 eyes on its upper part and in four eyes to the side or on its lower part. Preoperatively, 12 eyes were stable and 10 were relatively unstable, but 12 month after surgery, fixation stability had improved, and 20 eyes were stable and two were relatively unstable. Conclusions:, MP-1 microperimetry sensitivity map overlaid onto an infrared image using dedicated MP-1 software can be used successfully to evaluate fixation location in patients with a macular hole before surgery. With microperimetry findings, we can also measure functional macular changes more precisely than using BCVA alone after macular hole surgery. Our results also showed that retinal sensitivity and fixation properties were improved after vitrectomy with triamcinolone acetonide assisted ILM peeling in patients with idiopathic macular hole. [source] 1233: How to choose the best surgical procedure?ACTA OPHTHALMOLOGICA, Issue 2010CJ POURNARAS Purpose Dealing to the localization and sealing retinal breaks, the surgical success rate for the cure of rhegmatogenous retinal detachment greatly changed with the introduction of scleral buckling (SB), intraocular gas injection, and pars plana vitrectomy (PPV). Methods In localized cases, pneumatic retinopexy and scleral buckling surgery (SB) remains the most popular surgical methods. Complicated cases with PVR grade B or C, giant tears, or macular holes are most commonly treated with primary pars plana vitrectomy. A large group of rhegmatogenous RDs with medium severity that comprise about 30% of all primary rhegmatogenous RDs in the Scleral Buckling versus Primary Vitrectomy in Rhegmatogenous Retinal Detachment recruitment study, were treated by SB and PPV. Advances in vitrectomy instrumentation and wideangle imaging systems have increased the popularity of PPV. Results The decision by the surgeon to use scleral buckling rather than PPV depends on a number of factors, including the lens status, size and location of breaks, patient compliance, and individual experience. Initial PPV may be successful for phakic patients. However, the SPR study shows a benefit of SB in phakic eyes with respect to BCVA improvement. Although no difference in BCVA was demonstrated in the pseudophakic trial, PPV was recommend for pseudophakic RD based on a better anatomical outcome. Conclusion There was a significant trend towards more frequently employing primary PPV (with or without SB) for the management of primary RRD. A significant improvement in the primary success rates for RD, were shown for all retinal surgical modalities applied for the treatment of rhegmatogenous retinal detachment. [source] 3425: Influence of cataract morphology on retinal straylight and straylight changes due to cataract surgery using the Morcher 89A Bag in the LensTMACTA OPHTHALMOLOGICA, Issue 2010MJ TASSIGNON Purpose To evaluate straylight and contrast sensitivity (CS) in eyes with various cataract morphologies, to determine which type of cataract presents a higher impairment of visual function with respect to proposed norms car driver safety and to compare retinal straylight and CS before and after implantation of a Morcher 89A IOL. Methods BCVA, CS and straylight were measured in 97 cataractous eyes using respectively a Snellen chart, a Pelli-Robson chart and the C-Quant. Cataracts were graded using the LOCS III scale and divided into four groups: nuclear, cortical, nuclear-cortical and posterior subcapsular cataract. These results were compared to data from 38 cataract-free control subjects. A separate group of 71 eyes had their straylight measured before and after cataract surgery. Results CS was reduced and straylight increased in all cataract patients, most notably in posterior subcapsular and nuclear-cortical cataract. CS and BCVA were correlated (r=0.44), whereas straylight and BCVA were not. Applying cut-off values as proposed by European drivers studies of l.25 log CS and 1.4 log straylight as safe margins for driving, 31% would be considered unfit to drive on the basis of CS and 78% on the basis of straylight although their visual acuity was still above the current European visual acuity requirement for driving. Retinal straylight reduced significantly from 1.560.26 to 1.250.22logunits (P<0.001) after IOL implantation . Conclusion Straylight and, to a lesser extent, CS are complementary to BCVA and should be taken into account when considering driving eligibility. After IOL implantation straylight reduces significantly, resulting in a significant increase in driving eligibility. [source] 3412: Anti-VEGF and corticosteroids therapy in macular edema secondary to venous occlusionsACTA OPHTHALMOLOGICA, Issue 2010JAC POURNARAS Purpose To assess the evidence on interventions to improve visual acuity (VA) and to treat macular edema (ME) secondary to central (CRVO) and branch retinal vein occlusion (BRVO) Methods Recent randomized studies have evaluated the safety and efficacy of corticosteroids (triamcinolone, dexamethasone) and anti-VEGF therapies (ranibizumab). Score study evaluates preservative-free intravitreal triamcinolone with standard care in BRVO and CRVO. In Geneva study, dexamethasone (DEX) intravitreal implant is compared with sham in BRVO and CRVO. BRAVO and Cruise studies evaluate intraocular injections of ranibizumab in patients with ME following BRVO and CRVO, respectively. Results In SCORE study, there was no difference identified in visual acuity at 12 months for the standard care group compared with the triamcinolone groups in BRVO patients. Intravitreal triamcinolone is superior to observation for treating vision loss associated with ME secondary to CRVO. Improvements in BCVA with DEX implant were seen in patients with BRVO and CRVO, although the patterns of response differed. Intraocular injections of 0.3 mg or 0.5 mg ranibizumab provided rapid, effective treatment for ME following BRVO and CRVO Conclusion Grid photocoagulation remains the standard care for patients with vision loss associated with ME secondary to BRVO. Intravitreal triamcinolone is superior to observation for treating vision loss associated with ME secondary to CRVO. Dexamethasone intravitreal implant can both reduce the risk of vision loss and improve the speed and incidence of visual improvement in eyes with ME secondary to BRVO or CRVO. Anti-VEGF therapies represent new therapeutical option in the treatment of ME secondary to BRVO and CRVO. Further randomized studies are needed [source] 2113: AO imaging in AMDACTA OPHTHALMOLOGICA, Issue 2010N MASSAMBA Purpose Two different systems, adaptive optics scanning laser ophthalmoscope (AOSLO), and Spectral Domain Ophtalmoloscopy (SD-OCT) were used to visualize cones in the outer neurosensory retina overlying soft macular drusen and the surrounding retinal areas. Methods High resolution images were obtained with Adaptive Optics (AO) in addition to complete ophthalmic examination including BCVA on ETDRS chart, biomicroscopic examination, autofluorescence imaging, fluorescein and indocyanine angiographies (HRA2 Heidelberg ,Germany) and SD-OCT. The AO image are then compared with conventional infrared and SD-OCT. Soft macular drusen from 50 patients (age between 65 and 85) visible on the scanning laser ophthalmoscope(SLO) examination were evaluated included in the study Results The soft drusen were visible in AO images as generally round areas delimited by a peripheral low-reflectance line. The highly reflective photoreceptor inner/outer segment junction (IS/OS) can be used as a pattern of photoreceptors integrity in SD-OCT images. In areas where the IS/OS junction is absent on SD-OCT, no cones are visualized in registered AOSLO images. In the inner area of many drusen, hyper reflective spots of a size between 2 and 15 µm were sometimes isolated, sometimes grouped into tight aggregates of 2 to 40 components. Cone photoreceptors were visible in areas between drusen in most AO images, however the mosaic image sharpness was significantly less uniform in these elderly patients than previously observed in younger, healthy retinas. Conclusion This study shows the synergistic nature of these two high-resolution retinal imaging systems The microscopic characteristics of soft drusen on AO imaging suggest some analogy with the anatomopathologic characteristics. AO technology will be a powerful tool to refine their clinical classification [source] 2145: Descemet´s membrane detachment 16 years after PK and 10 months after phacoACTA OPHTHALMOLOGICA, Issue 2010JO FERNANDEZ MENDY Purpose The purpose of this paper is to present an unusual case of DMD and analyze this complication Methods A 57-year-old woman, who had bilateral keratoconus, underwent three penetrating keratoplasties (PK) on her RE in 1981, 1993 and 1995 resulting in ptisis bulbi. In her LE she underwent two PK (1981, 1994) follow by arcuate incisions (1995) and an uneventful phacoemulsification in 2007. 10 months after cataract surgery, she begun with blurred vision, the BCVA was 20/400 and was seen by 3 ophthalmologists who made the diagnosis of endothelial failure and suggested a new PK or a DSAEK. We performed an Optical Coherence Tomography, diagnosing a complete Descemet´s membrane detachment (DMD). An intracameral gas injection of C3F8 at 16% was performed in the operating room, and the patient was instructed to maintain a supine position. After 24 hours VA improved to 20/80 and after 72 hours 20/30 UCVA. A small bubble was present in the anterior chamber for more than 3 weeks. One month later she achieved 20/20 with Contact Lens. During the first year after reattachment it was necessary to change the CL due to an increasing with the rule astigmatism from 3D to 5D. Results Two years after gas injection BSVA is 20/25 because she is no longer using CL, Descemet´s membrane still remains well attached, even thought we realized that there was a trend to steepen the vertical meridian due to the widening of a nasal arcuate incision, that we think was the origin of the DMD. Conclusion DMD is a rare complication of Phacoemulsification, seen immediately after the surgery. So far there has not reported any complete DMD after phaco after PK. We think that it is mandatory to perform a corneal OCT in all cases of PK and stromal edema; it could probably be a DMD. [source] 3234: Stability of corneal shape and morphology in patients with Fuchs' dystrophy after phacoemulsification with soft shell technique.ACTA OPHTHALMOLOGICA, Issue 2010M MILKA Purpose To evaluate effectiveness of soft shell cataract surgery technique on the corneal structure in group of Fuchs' dystrophy patients. Methods 24 patients (mean age 52,7±13,8), 31 eyes after phacoemulsification were examined before and 10 months after surgery. BCVA, mean central corneal thickness (CCT) and corneal endothelial cell density (CD) were evaluated. Corneal aberrations root-mean-square (RMS) was calculated 1 and 10 months after surgery for 4.0mm pupil. Results Corneal higher-order aberrations (RMS) 1 month after surgery was 0,372±0,058 and 10 months after surgery was 0,345±0,076, BCVA 10 months after surgery was 0,75±0,27 (before surgery 0,32±0,28), the mean CCT was 563,37±21,42µm (before surgery 559,62±45,29µm), CD 1786,341±493,127 (before surgery 1912,783±381,963). Conclusion All patients revealed good stability and protection of the cornea confirming safety of the soft shell technique. [source] Effect of intravitreal bevacizumab (Avastin®) in neovascular age-related macular degeneration using a treatment regimen based on optical coherence tomography: 6- and 12-month resultsACTA OPHTHALMOLOGICA, Issue 5 2010Christina Leydolt Abstract. Purpose:, To study the effect of intravitreal bevacizumab therapy on visual and anatomical outcomes in patients with neovascular age-related macular degeneration (AMD) within a follow-up period of 6 and 12 months. Methods:, A retrospective analysis of 102 eyes of 102 consecutive patients with neovascular AMD evaluated repeated intravitreal bevacizumab (1 or 2.5 mg) injections. Retreatment was performed following an optical coherence tomography (OCT)-based regimen. Ophthalmic examination included best-corrected visual acuity (BCVA), dilated fundus examination and OCT imaging. Data were analysed at baseline, 6 months (24 weeks) and 12 months (48 weeks) after treatment initiation. Results:, BCVA remained stable at 6 months (mean: 0.00 ± 0.41 logMAR; p = 0.95) and 12 months (mean: +0.02 ± 0.43 logMAR; loss of , 1 letter; p = 0.70) after the first treatment. OCT retinal thickness decreased by a mean of ,37.8 ± 101.6 ,m (p < 0.05) compared to baseline at month 6 and ,38.6 ± 93.3 ,m (p < 0.05) at month 12. A mean of 2.6 ± 1.2 injections were needed to obtain absence of fluid by OCT, and the time to recurrence was 23 ± 11 weeks thereafter. There was no difference in BCVA and OCT outcomes between treatment-naive eyes and eyes that had undergone prior treatment. Conclusion:, The 6- and 12-month follow-up of repeated intravitreal bevacizumab therapy in eyes with neovascular AMD demonstrated stabilization of vision and no safety concerns. An OCT-based retreatment strategy appears appropriate in the management of patients treated with intravitreal bevacizumab. [source] Significant improvements in near vision, reading speed, central visual field and related quality of life after ranibizumab treatment of wet age-related macular degenerationACTA OPHTHALMOLOGICA, Issue 4 2010Christina Frennesson Abstract. Purpose:, To investigate the effects on near visual acuity, reading speed, central visual field and related quality of life of ranibizumab treatment of wet age-related macular degeneration (AMD). Methods:, The study was a prospective, non-comparative consecutive case series, followed for 3 months and investigator-driven. Thirty eyes of 30 patients with wet AMD were included, mean age 75 years (range 69,95 years). In addition to a full ophthalmological examination , including best-corrected visual acuity (BCVA; Early Treatment Diabetic Research Study chart), fundus biomicroscopy, fundus photography, fluorescein angiography, indocyanine green angiography (occult cases) and ocular coherence tomography , near visual acuity, reading speed, central visual field and quality of life for related activities were also investigated at baseline and at 3 months after ranibizumab treatment. Results:, Mean BCVA increased from 62 ± 11 to 66 ± 14 letters at 3 months (7%; p = 0.018). Near vision improved from 9 ± 5 to 6 ± 3 points (33%; p = 0.0006) and reading speed increased from 59 ± 40 to 85 ± 50 words/min (44%; p < 0.0001). The mean deviation from normal of the visual field improved from ,9 ± 7 to ,6 ± 5 dB (33%; p < 0.0001). Quality of life improved for distance activities from 54 ± 28 to 63 ± 28 points (17%; p < 0.0001) but significantly (p = 0.024) more for near activities, from 49 ± 26 to 63 ± 26 points (29%; p < 0.0001). Reading newspaper text in the group in which the better eye was treated showed the highest increase in quality of life score of all: 116%. Conclusion:, The increase in BCVA after ranibizumab treatment is well established. The present study also showed significant improvements in other important visual qualities, such as near visual acuity, reading speed, central visual field and several activities influencing quality of life. The improvement was greater for near activities than for distance activities. Therefore, the beneficial effects of ranibizumab treatment shown here are more extensive than those reported previously. [source] Rarebit perimetry and fovea test before and after cataract surgeryACTA OPHTHALMOLOGICA, Issue 4 2010Maria Nilsson ABSTRACT. Purpose:, To evaluate the effect of cataract on rarebit perimetry and the fovea test. Methods:, Twenty-five consecutive patients scheduled for cataract surgery (mean age 63.0 ± 7.9 years) were examined prior to and after cataract surgery with a complete ophthalmological examination. In addition, the rarebit perimetry (RBP) and the rarebit fovea test (RFT) were performed. Results:, Best-corrected visual acuity [BCVA, expressed in minimum angle of resolution (MAR)], RBP and RFT mean hit rate (MHR) improved significantly after cataract surgery. The relative pre,postsurgery difference was larger in the RFT [2.1 standard deviations (SDs)] compared to in BCVA (0.78 SDs). Seven patients had good BCVA (, 1.25) and RBP (83,99%) but low RFT (0,66%) before surgery. One patient with low preoperative BCVA (2.5) had a normal RFT (94%). Conclusion:, Cataract influenced both the RFT and RBP test, albeit the former more than the latter. The influence of cataract on RFT results, even when visual acuity is decreased only moderately, has to be taken into account when evaluating foveal function in patients with cataract. The larger relative change in RFT compared to BCVA values is thought to indicate that RFT is more sensitive for the effect of cataract. Therefore, RFT appears to be a sensitive test for visual disturbance and can presumably provide additional information at the preoperative evaluation of the patient. [source] Predictable signs of benign course of polypoidal choroidal vasculopathy: based upon the long-term observation of non-treated eyesACTA OPHTHALMOLOGICA, Issue 4 2010Akiko Okubo Abstract. Purpose:, To find predictable signs of benign polypoidal choroidal vasculopathy (PCV). Methods:, Medical records of 13 eyes from 12 patients who were followed up for 5 years or longer without treatment among 258 consecutive patients with PCV were reviewed retrospectively. The main outcomes measured were best corrected visual acuity (BCVA) and fundus findings during the follow-up period. Results:, The average age at presentation was 68 years, and the average follow-up period after diagnosis was 80 months (range, 62,119 months). The initial mean logarithmic value of the minimal angle of resolution (logMAR) BCVA was 0.28 ± 0.26, and the final mean logMAR BCVA was 0.62 ± 0.72. The difference in the logMAR BCVA values between the two points was not statistically significant (p > 0.05). The trend of change from baseline at 2-year follow-up was consistent with those at 5-year follow-up in nine eyes. Fundus findings at the initial examination were classified into two patterns: (i) reddish-orange nodules and detachment of the retinal pigment epithelium with/without detachment of the neurosensory retina (nine eyes); (ii) reddish-orange nodules alone, or nodules and small subretinal haemorrhage (four eyes). In the eyes with the first pattern, clinical course and visual prognosis were variable. An absence of hard exudates could be a sign to maintain a benign clinical course or stable vision with this pattern. The eyes with the second pattern took a benign clinical course with stable vision. Conclusions:, There is certainly a group of PCV eyes with a benign prognosis. Considering the huge cost and risk of current therapies, the initial ocular findings could be deciding factors that determine the necessity for further treatment. [source] EXTEND-I: safety and efficacy of ranibizumab in Japanese patients with subfoveal choroidal neovascularization secondary to age-related macular degenerationACTA OPHTHALMOLOGICA, Issue 3 2010Yasuo Tano Abstract. Purpose:, To evaluate the efficacy and safety of intravitreal ranibizumab for subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) in Japanese patients. Methods:, This open-label, multicentre, Phase I/II study enroled patients into Group A (single injection of ranibizumab nonrandomized doses of 0.3 or 0.5 mg followed by 11 monthly injections of the same dose) and Group B (12 monthly injections of ranibizumab randomized to 0.3 or 0.5 mg). The primary efficacy endpoint was the mean change from baseline in best-corrected visual acuity (BCVA) score at Month 6. Safety was evaluated in all patients who received ranibizumab. Results:, Of 88 patients enroled, 12 entered Group A (six per dose) and 76 entered Group B (0.3 mg: n = 35; 0.5 mg: n = 41). Mean change from baseline in BCVA was significantly increased for both doses (Group B) at Month 6 (0.3 mg: +8.1 letters, p = 0.0006; 0.5 mg: +9.0 letters, p < 0.0001) and Month 12 (0.3 mg: +9.5 letters, p = 0.0001; 0.5 mg: +10.5 letters, p < 0.0001). At Month 12, one patient (0.3 mg) and 0 patients (0.5 mg) lost ,15 letters, while 37.1% (0.3 mg) and 31.7% (0.5 mg) of patients gained ,15 letters. Ocular serious adverse events (SAEs) of the study eye were reported in 1 and 2 patients in the 0.3- and 0.5-mg groups, respectively. Nonocular SAEs were experienced by 2 and 5 patients in the 0.3- and 0.5-mg groups, respectively. No cases of endophthalmitis were reported. Conclusion:, Ranibizumab was effective and well tolerated in Japanese patients with subfoveal CNV secondary to AMD. [source] Axonal loss occurs early in dominant optic atrophyACTA OPHTHALMOLOGICA, Issue 3 2010Dan Milea Abstract. Purpose:, This study set out to investigate retinal nerve fibre layer (RNFL) thickness and best corrected visual acuity (BCVA) in relation to age in healthy subjects and patients with OPA1 autosomal dominant optic atrophy (DOA). Methods:, We carried out a cross-sectional investigation of RNFL thickness and ganglion cell layer density in 30 healthy subjects and 10 patients with OPA1 DOA using optical coherence tomography (OCT). We then performed a regression analysis of RNFL thickness and BCVA versus age. Results:, Both healthy subjects and DOA patients demonstrated a gradual reduction in RNFL thickness with age; the relationship was best described statistically by a model that assumed a constant offset between the two groups. Best corrected VA decreased significantly with age in DOA patients, in whom BCVA was correlated with peripapillary RNFL thickness in the inferior and superior peripapillary quadrants and with total macular thickness at eccentricities of 500,3000 ,m. The observations were best described by a constant offset of 41.9 ,m separating the two groups and an annual decrease in RNFL thickness of 0.48 ,m (p < 0.0001). In patients with DOA, increasing age was associated with decreasing BCVA (p = 0.046). Conclusions:, This cross-sectional study found evidence of comparable age-related decreases in RNFL thickness in healthy subjects and in DOA patients, where the deficit in DOA patients is best described using a model that assumes the deficit between the groups does not vary with age. The gradual reduction of BCVA with age may be a consequence of a relative deficit in RNFL thickness that is established before the second decade of life. [source] Five-year incidence of visual impairment and blindness in older Icelanders: the Reykjavik Eye StudyACTA OPHTHALMOLOGICA, Issue 3 2010Elin Gunnlaugsdottir Abstract. Purpose:, This study examined age, sex and cause-specific 5-year incidence of visual impairment and blindness in a middle-aged and elderly Icelandic population. Methods:, The study cohort consisted of a population-based, random sample of citizens aged , 50 years. Of 1379 eligible subjects, 1045 underwent a baseline examination in 1996; 846 of the 958 survivors (88.2%) underwent a 5-year follow-up examination in 2001. All participants underwent an extensive ophthalmological examination including best corrected visual acuity (BCVA) using a Snellen chart. We used World Health Organization (WHO) criteria, which define visual impairment as BCVA in the better eye of < 6/18 and , 3/60 and blindness as BCVA in the better eye of < 3/60. We also used US criteria, which consider BCVA of < 6/12 and > 6/60 in the better eye to represent visual impairment and BCVA of , 6/60 in the better eye to represent blindness. The causes of incident visual loss in either eye were determined. Deterioration or improvement in vision were defined as a loss or gain of , 2 Snellen lines. Results:, According to WHO criteria, 5-year incidence of bilateral visual impairment and blindness were 1.07% (95% confidence interval [CI] 0.37,1.76) and 0.35% (95% CI 0.00,0.76), respectively. Using US criteria, equivalent incidence of bilateral visual impairment and blindness were 3.49% (95% CI 2.24,4.74) and 0.95% (95% CI 0.29,1.60), respectively. Age-related macular degeneration and cataract were the major causes of incident visual impairment and blindness. Conclusions:, Incidences of visual impairment and blindness increased significantly with age. Age-related macular degeneration, present in 75% of affected persons, was the most common cause of 5-year incident legal blindness in this middle-aged and elderly Icelandic population. [source] Photodynamic therapy for chronic central serous chorioretinopathyACTA OPHTHALMOLOGICA, Issue 3 2010José M. Ruiz-Moreno Abstract. Purpose:, This study aimed to evaluate the efficacy of photodynamic therapy (PDT) in treating chronic central serous chorioretinopathy (CSC). Methods:, We describe a non-randomized, multicentre, interventional case series. A total of 82 eyes of 72 patients with chronic CSC were treated by conventional PDT. LogMAR best corrected visual acuity (BCVA) (ETDRS charts) and central foveal thickness (CFT) measured by optical coherence tomography before and after PDT, number of PDT treatments and complications were used as outcome indicators. Results:, Mean follow-up was 12 ± 10 months and mean age was 46 ± 10 years. Mean logMAR BCVA changed from 0.53 (standard deviation [SD] 0.43) before PDT to 0.38 (SD 0.41) at 3 months and 0.48 (SD 0.50) at 6 months (p < 0.0001 and p = 0.007, respectively, Student's t- test for paired data). Mean BCVA at the end of follow-up was 0.37 (SD 0.45; p < 0.0001 from baseline). Macular detachment was resolved and subretinal fluid (SRF) disappeared in all cases. Central foveal thickness decreased from 325 ,m (SD 95), to 229 ,m (SD 70) at 1 month after PDT, 206 ,m (SD 68) at 3 months, and 202 ,m (SD 76) at 6 months (all p < 0.0001, Student's t- test for paired data). No cases developed severe visual loss or complications derived from PDT. Reactive retinal pigment epithelium hypertrophy appeared in nine cases after PDT. Conclusions:, Photodynamic therapy with verteporfin may be useful in chronic CSC for improving BCVA and reducing SRF and CFT. Randomized studies with longer follow-up are needed to assess the real role of this treatment in chronic CSC. [source] Time-course and characteristic morphology of retinal changes following combination of verteporfin therapy and intravitreal triamcinolone in neovascular age-related macular degenerationACTA OPHTHALMOLOGICA, Issue 2 2010Shilla Lie Abstract. Purpose:, To identify characteristic morphological changes of the retina over time and the association with visual function after combined photodynamic therapy (PDT) and intravitreal triamcinolone (IVTA). Methods:, In this retrospective study, 40 patients (40 eyes) were treated with PDT and same-day IVTA. Optical coherence tomography (OCT), fluorescein angiography (FA) and evaluation of distance visual acuity (VA) were performed. The anatomical changes within intra- and subretinal compartments and their detailed analysis and grading were the main outcome measures. Results:, Intraretinal fluid (IRF) and subretinal fluid (SRF) by OCT decreased until 3 months (p < 0.01). At month 3, intraretinal cystoid spaces (ICS) had resolved or decreased in 84% of eyes, SRF in 58% and pigment epithelial detachment (PED) in 50%. Mean best-corrected VA (BCVA) improved significantly at month 1 (p < 0.01). Mean central retinal thickness (CRT) increased from 334 ,m at baseline to 439 ,m at day 1 (p = 0.03) before decreasing to 286 ,m at day 7 (p = 0.06), 233 ,m at month 1 (p = 0.001) and 255 ,m at month 3 (p = 0.001). Conclusion:, Combined verteporfin/IVTA therapy induces distinct time-related effects on the retina within the different intra- and subretinal compartments. [source] Foveal function in children treated for amblyopiaACTA OPHTHALMOLOGICA, Issue 2 2010Pia Agervi Abstract. Purpose:, This study aimed to evaluate foveal function, using three different methods, in children treated for monocular amblyopia. Methods:, A sample of 24 otherwise healthy children with treated amblyopia and an age-matched control group of 25 healthy children were examined for best corrected visual acuity (BCVA) using a standard decimal (KM) chart and the computerized TriVA method at 50% and 10% contrasts. Foveal function was also measured with the rarebit fovea test (RFT), which is included in the rarebit perimetry program package. This test uses very small and bright dots against a dark background. The result is expressed as mean hit rate (MHR). Results:, Amblyopic eyes showed significantly lower BCVA when evaluated with the KM chart and with the TriVA test at different contrast levels, compared with both fellow eyes and control eyes. No statistically significant difference between amblyopic and fellow eyes was found when foveal function was evaluated with the RFT (median MHRs 91.5% and 94.5%, respectively), although results for both amblyopic and fellow eyes were statistically lower than those of the control group (median MHR 97%) (p = 0.001 and p = 0.046, respectively). This might indicate that the RFT provides different information about foveal function than conventional VA tests. Conclusions:, The findings in the current study accord with those of other studies reporting abnormalities in the fellow eyes of previously treated amblyopic patients. These findings may reflect a general disturbance in the visual system rather than a monocular adaptation to refractive error or ocular motor disturbance. [source] Functional and morphological changes in the eyes of Behçet's patients with uveitisACTA OPHTHALMOLOGICA, Issue 2 2010Masaru Takeuchi Abstract. Purpose:, Behçet's disease (BD) is a chronic, recurrent, multisystem disorder, and serious ocular involvement may lead to blindness. In some BD patients, latent tissue damage caused by recurrent ocular inflammation is not reflected by visual acuity or ophthalmoscopic findings. In this study, we evaluated the morphological and functional changes of ocular features related to duration of uveitis from onset in BD patients, and analysed their association with visual acuity. Methods:, Thirty-eight eyes of 20 patients with ocular BD were enrolled. Eyes with marked complications such as cataract, glaucoma, cystoid macular oedema, macular degeneration and optic atrophy were excluded from the study. During clinical remission of ocular inflammation, perimetric sensitivity and retinal thickness were measured by Micro Perimeter 1 (MP-1) and optical coherence tomography (OCT), respectively. The relationship between MP-1 and OCT findings, best-corrected visual acuity (BCVA) converted to logarithm of the minimum angle of resolution (logMAR) and duration from initial onset of uveitis were analysed statistically. Results:, logMAR correlated with perimetric sensitivity measured with MP-1 at the fovea, inner macula and outer macula, but not with retinal thickness based on OCT. The duration of uveitis correlated significantly with logMAR and with OCT-based retinal thickness at the fovea, inner macular and outer macula, but not with MP-1-derived retinal perimetric sensitivity. No correlation was found between OCT-based retinal thickness and the corresponding MP-1-derived retinal sensitivity at the fovea, inner macula or outer macula. Conclusion:, These results demonstrate that visual acuity, retinal perimetric sensitivity and retinal thickness decrease with an increase in the duration of uveitis in BD patients, but that retinal perimetric sensitivity is relatively preserved among these factors. [source] Bevacizumab as adjuvant for neovascular glaucomaACTA OPHTHALMOLOGICA, Issue 1 2010Julia Beutel Abstract. Purpose:, We aimed to evaluate the longterm effects of intraocular bevacizumab (Avastin®) injections as adjuvant treatment in patients with neovascular glaucoma. Methods:, Twenty eyes of 18 consecutive patients with secondary neovascular glaucoma caused by proliferative diabetic retinopathy (n = 7), ischaemic central retinal vein occlusion (n = 7), ischaemic ophthalmopathy (n = 2) and retinal ischaemia resulting from persistent detachment (n = 2) were treated with intraocular bevacizumab injections (1.25 mg/0.05 ml) in addition to other treatments. The main outcome measure was the change in degree of iris rubeosis. Secondary outcomes included intraocular pressure (IOP), best corrected visual acuity (BCVA) and numbers of additional interventions or antiglaucoma medications administered after injection. Results:, Mean (± standard deviation) follow-up was 67.7 ± 13.8 weeks (range 50,93 weeks). At the last follow-up, complete regression of rubeosis was detectable in five (20%) eyes, incomplete regression in seven (35%), stabilization in six (30%), and an increase in two (10%) eyes. Mean IOP was 26.0 ± 8.9 mmHg at baseline and significantly decreased to 14.75 ± 5.3 mmHg at the last follow-up visit (p = 0.000005). Mean baseline BCVA (logMAR [logarithm of the minimum angle of resolution] 1.43 ± 0.89) was stabilized during the follow-up period (logMAR 1.5 ± 0.98). Patients received an average of 2.75 injections. Additional treatments were laser photocoagulation in 13 (65%) eyes, cyclodestructive procedure in 14 (70%), cryopexy in six (30%), drainage procedures in two (10%), and vitrectomy in five (25%) eyes. Conclusions:, Bevacizumab may be beneficial as adjuvant treatment in neovascular glaucoma because of its anti-angiogenic properties and its ability to prevent establishment or progression of angular obstruction. The causative disease inducing the angiogenic process requires treatment in all cases. Antiglaucoma treatment is needed in cases of persistent elevated IOP. [source] Intravitreal pegaptanib sodium (Macugen®) for diabetic macular oedemaACTA OPHTHALMOLOGICA, Issue 6 2009Giuseppe Querques Abstract. Purpose:, To report the functional and anatomical outcomes resulting from the use of intravitreal pegaptanib sodium (Macugen®) in patients with diabetic macular oedema (DMO). Methods:, We conducted a retrospective outcome analysis, by optical coherence tomography (OCT) and best-corrected visual acuity (BCVA), of eyes with DMO treated with intravitreal pegaptanib sodium. Moreover, we evaluated the foveal transverse photoreceptor (PR) band integrity in the OCT images at the time of the last follow-up visit. Results:, Sixty-three eyes of 48 patients with a minimum of 6 months of follow-up were included for analysis. Intravitreal pegaptanib was found to produce significant improvements in mean BCVA (p = 0.019) and reductions in mean central macular thickness (CMT) (p < 0.001) as soon as the 6-week follow-up. Most eyes (60/63) required a mean of 3.03 ± 0.9 repeated treatments, over a mean follow-up period of 6.7 ± 1.2 months, to achieve significant improvements in mean BCVA (p < 0.001) and mean CMT (p < 0.001). In our series, the lower visual acuities tended to congregate in the group with the less-defined PR band (p < 0.001) and the lower CMT tended to congregate in the group with the best-defined PR band (p = 0.04), even though the higher CMT did not tend to congregate in the group with the less-defined PR band. Conclusion:, Our findings demonstrate that selective inhibition by intravitreal pegaptanib sodium of vascular endothelial growth factor (VEGF)-165 may produce a clinically meaningful and statistically significant benefit in the treatment of DMO. [source] How should we quantify the performance of KPro's?ACTA OPHTHALMOLOGICA, Issue 2009Purpose To report a method of standardized data collection and reporting and statistical assessment that can be used for all KPro´s available on the market. The database (will be presented) should be , Usable for different types of KPro´s , Easily adaptable to changes in technique , Allow for complete entry of relevant data Methods Visual Acuity data should be reported in different international surgical centres in a standardized manner: Best spectacle corrected VA, unless BCVA only possible with CL (> useful time of wear). A complete entry of all relevant data is possible in this database. The statistical analysis should be agreed upon by all centres. For Survival Time = Retention of KPro > the Kaplan-Meier method For Visual Acuity over the Course of Time > the Monte-Carlo method Results A database will be demonstrated that can be used free of charge by all KPro centres interested. The VISUAL ACUITY BY TIME- INDEX (VAT- Index) will also be presented, whose theoretical basis published in: Journal of Theoretical Medicine, 2002 / 4, 183-190, W. Hitzl and G. Grabner [bdquo]Application of the Monte Carlo Method for the Assessment of Long-term Success in Keratoprosthesis Surgery". Example of its use will be give, based in data, courtesy Barraquer Eye Clinic, Barcelona. Conclusion With the Kaplan-Meier method: + analysis is done quickly, uses all data available, hypotheses tests are available for comparisons and mean and median survival time can be computed - no information about relation between time and best corrected visual acuity and the definition of terminal event is arbitrary to a certain extent. Monte-Carlo method (VAT-index): + Method is based on a so-called non-parametric longitudinal model + Reliabel estimation of relation between time and best corrected visual acuity at any given time point (patient as well as surgeon is basically interested in this relation). + statistically valid analysis and better comparison of different KPro techniques + easy comparison of defined postoperative periods + comparison of different initial clinical findings and diseases possible + long-time follow-up of BCVA - shorter follow-up time as compared with Kaplan-Meier method (e.g. with strict [bdquo]80%data complete" criteria) [source] Subconjunctival injection of bevacizumab (Avastin®) for corneal neovascularizationACTA OPHTHALMOLOGICA, Issue 2009MF DE LA PAZ Purpose to study the effects of subconjunctival injection of Bevacizumab on corneal neovascularization. Methods Prospective interventional case series on 7 eyes of 7 patients who underwent subconjunctival injection with Bevacizumab. The following parameters were studied pre-op, at 1 week, 30, 60 and 90 days post-op: UCVA, BCVA, pachymetry with OCT, slit lamp examination and photographic imaging. Conjunctival impression cytology pre-op at 1 week and 9o days was done and complications were also noted. Results Pre-op diagnoses were: herpetic leucoma (4 eyes), chemical burn (2 eyes), neurotrofic keratopathy (1 eye). An informed off-label consent form prior to procedure was signed. 1.25 mg of subconjunctival Bevacizumab was injected nearest the area affected. Mean preoperative UCVA and BCVA were 0.86 and 0.44 LogMar units, improved to 0.61 and 0.26 LogMar units at 90 days post-op, respectively. Central and peripheral pachymetry improved from 532 and 623 microns pre-op, to 529 and 619 microns at 90 days post-op, respectively. All slit lamp findings and photographic imaging showed a clear regression of superficial and deep stromal corneal vascularization, with clearing of lipid deposits around the affected areas. No toxic effects were noted on conjunctival impression cytology. Conclusion Subconjunctival injection of Bevacizumab is a safe and effective procedure for the regression of superficial and deep corneal neovascularization. It may be a good alternative for patients prior to performing an optical keratoplasty or for those who are poor candidates for the same. [source] Intravitreal bevacizumab for treatment-naïve subfoveal occult choroidal neovascularization in age-related macular degenerationACTA OPHTHALMOLOGICA, Issue 4 2009Claudio Furino Abstract. Purpose:, This study aimed to evaluate the efficacy of multiple injections of intravitreal bevacizumab for treatment-naïve subfoveal occult choroidal neovascularization (CNV) in age-related macular degeneration (AMD). Methods:, Twelve eyes of 12 patients (mean age 76 ± 6 years) with mean best corrected visual acuity (BCVA) of 20/100 and occult subfoveal CNV at fluorescein angiography (FA), indocyanine-green (ICG) angiography and optical coherence tomography (OCT), showing intra- or subretinal fluid with or without retinal pigment epithelial detachment (PED), underwent multiple intravitreal injections (mean 2.4 ± 0.7) of 1.25 mg (0.05 ml) bevacizumab. Visual acuity and OCT findings were assessed at the end of follow-up. Results:, After a mean follow-up of 5.7 ± 2 months, BCVA improved from 20/100 (range 20/50,20/303) to 20/60 (range 20/28,20/200) (p = 0.038). Five eyes (42%) increased BCVA by , 3 lines, six eyes (50%) increased BCVA by < 3 lines and one eye (8%) remained stable. Macular thickness decreased from 298 ± 71 ,m to 223 ± 72 ,m (p = 0.017). No ocular or systemic side-effects were observed. Conclusions:, Short-term results suggest that multiple intravitreal injections of 1.25 mg bevacizumab are well tolerated and associated with significant improvements in BCVA and decreased retinal thickness by OCT in most patients with treatment-naïve occult CNV. Further evaluation of intravitreal bevacizumab for the treatment of occult CNV is warranted. [source] Effects of repeated injection of intravitreal triamcinolone on macular oedema in central retinal vein occlusionACTA OPHTHALMOLOGICA, Issue 3 2009Lili Wang Abstract. Purpose:, To investigate the effectiveness of repeated injections of intravitreal triamcinolone acetonide (IVTA) in the treatment of macular oedema caused by central retinal vein occlusion (CRVO). Methods:, Seventeen pseudophakic or aphakic eyes of 17 patients (10 male, seven female) with macular oedema caused by CRVO received a repeat injection of 4 mg IVTA, 16 weeks after the first injection of the same dose. The examination included measurements of best-corrected visual acuity (BCVA) for distance and central foveal thickness (CFT) by optical coherence tomography (OCT), preoperatively and 1, 2, 3 and 4 months postoperatively. The values were compared by paired- t test. Side-effects were monitored. Results:, BCVA and CFT were not significantly different before initial and repeat injections. Transient improvements of BCVA and CFT were achieved after both injections. At the end of follow-up, BCVA and CFT were significantly different compared to pre-injection values in the same group (P = 0.032, 0.049 in the initial-injection group and P = 0.001, 0.008 in the repeat-injection group, respectively). However, compared to the initial injection, BCVA measurements were significantly worse at each time-point (P = 0.043, 0.011, 0.010 and 0.012, respectively) after the repeat injection, as were CFT at 1, 2 and 3 months post-injection (P = 0.040, 0.015 and 0.025, respectively). The achieved maximum mean intraocular pressures were 20.00 [standard deviation (SD) 2.06] mmHg and 18.56 (SD 3.65) mmHg after the first and repeat injections, respectively. These values were not significantly different (P = 0.467). No other significant adverse events were noted during the study. Conclusion:, A repeat injection of 4 mg IVTA may not be as effective as an initial injection for the treatment of macular oedema caused by CRVO. [source] Effect of bromfenac ophthalmic solution on ocular inflammation following cataract surgeryACTA OPHTHALMOLOGICA, Issue 3 2009Masaru Miyanaga Abstract. Purpose:, This study compared the post-cataract surgery anti-inflammatory effects of topical treatment with 0.1% bromfenac, 0.1% betamethasone or both on postoperative anterior chamber inflammation and corneal swelling. Methods:, Seventy-two patients with no eye disease other than cataract were enrolled in a prospective, randomized study to undergo phacoemulsification combined with intraocular lens implantation. After cataract surgery, patients were randomized to treatment with bromfenac, betamethasone or both agents. Twenty-five eyes were assigned to bromfenac, 23 to betamethasone and 24 to the combined treatment group. Inflammatory reactions in the anterior chamber were measured with laser flare photometry preoperatively and at 1 and 3 days, 1 and 2 weeks, and 1 and 2 months postoperatively. Intraocular pressure (IOP) and corneal thickness were measured at the same time-points. Best corrected visual acuity (BCVA) was measured preoperatively and at 2 days, 1 and 2 weeks, and 1 and 2 months postoperatively. Specular microscope endothelial photography of the central region of the cornea was performed preoperatively and at 3 months after surgery. Results:, There were no significant differences among the bromfenac, betamethasone and combined treatment groups in BCVA, IOP, aqueous flare or corneal thickness. Cystoid macular oedema was present in one eye treated with betamethasone. Conclusions:, There were no significant differences in anti-inflammatory effects among the three treatments. These findings suggest that bromfenac is as effective as betamethasone in minimizing inflammatory reactions after cataract surgery. [source] Outcome indicators for vitrectomy in Terson syndromeACTA OPHTHALMOLOGICA, Issue 2 2009Justus G. Garweg Abstract. Purpose:, There is no general agreement on the best indication and timing of vitrectomy in patients suffering from Terson syndrome. Therefore, we reviewed our cases in order to assess factors interfering with the functional outcome and complication rates after vitrectomy. Methods:, In this retrospective consecutive case series, the records from all patients undergoing vitrectomy for Terson syndrome between 1975 and 2005 were evaluated. Results:, Thirty-seven patients (45 eyes) were identified, 36 of whom (44 corresponding eyes) were eligible. The best-corrected visual acuity (BCVA) at first and last presentation was 0.07 ± 0.12 and 0.72 ± 0.31, respectively. Thirty-five eyes (79.5%) achieved a postoperative BCVA of , 0.5; 26 (59.1%) eyes achieved a postoperative BCVA of , 0.8. Patients operated on within 90 days of vitreous haemorrhage achieved a better final BCVA than those with a longer latency (BCVA of 0.87 ± 0.27 compared to 0.66 ± 0.31; P = 0.03). Patients younger than 45 years of age achieved a better final BCVA than older patients (0.85 ± 0.24 compared to 0.60 ± 0.33; P = 0.006). Retinal detachment developed in four patients between 6 and 27 months after surgery. Seven patients (16%) required epiretinal membrane peeling and seven cataract surgery. Conclusion:, Ninety-eight per cent of our patients experienced a rapid and persisting visual recovery after removal of a vitreous haemorrhage caused by Terson syndrome. A shorter time between occurrence of vitreous haemorrhage and surgery as well as a younger patient age are predictive of a better outcome. Generally, the surgical risk is low, but complications (namely retinal detachment) may occur late after surgery. [source] Visual outcome and corneal aberrometry after implantation of intracorneal ring segments (INTACS) for keratoconusACTA OPHTHALMOLOGICA, Issue 2007J HERNANDEZ VERDEJO Purpose: To analyze corneal aberrometry and visual outcome after implantation of intracorneal ring segments (INTACS) in keratoconus patients. Methods: Corneal aberration was measured in 15 keratoconus eyes pre and post implantation of INTACS. Root Mean Square values (RMS), (Total, RMS for corneal astigmatism and RMS for coma) where recorded for 5, 6 and 7 pupil diameters, and where divided into two groups due to their previous levels of coma and total RMS. Comatic aberration was divided in vertical (Z3-1) an horizontal (Z3+1) Zernicke Coeficcients. All data was recorded pre-op and three months after surgery. Best corrected visual acuity (BCVA), uncorrected visual acuity (UCVA), spherical equivalent and astigmatism where also analyzed. Results: We found statistically significant decrease in spherical equivalent (p<0,01) and increase of UCVA (p<0,01). Significant increase (p=0,04) in coma and total RMS in patients with lower previous values for 5 and 6mm and significant decrease in patients with higher previous values for 7mm (p=0,03) Conclusions: INTACS implantation for keratoconus reduces the mean spherical refractive error, increases UCVA and improves keratoconus aberrations for 7mm pupil diameter in patients with previous high levels of coma and total RMS. [source] | ||||||||||