Clinical outcomes of a new diffractive multifocal intraocular lens

AIM: To evaluate clinical outcomes after implantation of a new diffractive aspheric multifocal intraocular lens (IOL) with +3.00 addition power. METHODS: This is a retrospective, consecutive case series of cataract patients who underwent bilateral implantation of the Optiflex MO/HF D012 (Moss Vision Inc. Ltd, London, UK) multifocal IOL. Patients followed for 6mo were included in the study. Data on distance, intermediate and near visual acuity, refractive error [manifest spherical equivalent (MSE)], contrast sensitivity, adverse events, subjective symptoms, spectacle independence and patient satisfaction [visual function questionnaire (VFQ)-25 questionnaire] were retrieved from electronic medical records and analyzed. RESULTS: Forty eyes of 20 patients with a mean age of 66.7±8.5y (range: 53-82) were included in the study. Mean uncorrected distance, near and intermediate visual acuity remained stable through postoperative visits and was 0.19±0.19 logMAR, Jaeger 4 and Jaeger 3 respectively at the 6mo visit. At the end of postoperative 6mo, MSE was -0.14±0.42 diopters (D) and 98% of the eyes were within 1.00 D of target refraction. Postoperative low contrast (10%) visual acuity remained stable (P=0.54) through follow up visits with a mean of 0.35±0.17 logMAR at the 6mo visit. There were no reported adverse events. None of the patients reported subjective symptoms of halo or glare. Spectacle independence rate was 90%. Mean VFQ-25 questionnaire score was 93.5±6.12. CONCLUSION: The Optiflex MO/HF-DO12 IOL was safely implanted and successfully restored distance, intermediate and near visual acuity without impairing contrast sensitivity. High levels of spectacle independence were achieved at all distances including intermediate distance

Full-Thickness Macular Hole Formation after Internal Limiting Membrane Peeling: Beware the “Omega Sign”

Purpose. To introduce a clinical sign on spectral domain optical coherence tomography (SDOCT), which may indicate high risk for full-thickness macular hole formation after internal limiting membrane (ILM) peeling. Methods. The preoperative SDOCT images of two patients—one with multilaminar hemorrhage from ruptured retinal artery macroaneurysm and one with serous retinal detachment and severe macular schisis from optic pit maculopathy—who developed full-thickness macular hole (FTMH) after ILM peeling were evaluated retrospectively. Results. On the preoperative SDOCT images of both patients there was a thin bridge of tissue on either side of the foveal center with an outer retinal defect. The photoreceptors were displaced laterally away from the foveal center to create an “omega-” shaped configuration of the remaining tissue. Conclusion. “Omega-” shaped configuration on SDOCT may represent a higher risk of FTMH following ILM peeling. Vitreoretinal surgeons may wish to consider this sign in the process of their surgical decision making

Central corneal thickness in type II diabetes mellitus: is it related to the severity of diabetic retinopathy?

Background/aim: To compare the central corneal thickness (CCT) of type II diabetes mellitus patients with age- and sex-matched healthy subjects and to determine the association of the severity of diabetic retinopathy and CCT. Materials and methods: Type II diabetes mellitus patients without retinopathy, with nonproliferative retinopathy, and with proliferative retinopathy were organized as the three subgroups of the study group, and an age-and sex-matched control group was formed. All subjects underwent full ophthalmological examination and CCT measurement with ultrasonographic pachymetry. CCT values were compared between diabetic and healthy subjects and between the three diabetic subgroups. Correlation analysis was performed to determine any relationship between CCT and intraocular pressure. Results: The average CCT was significantly higher in diabetic patients than in the control group (P = 0.04). CCT in diabetic patients without retinopathy did not significantly differ from that of patients with retinopathy (P = 0.64). Similarly, there was no significant difference in CCT between nonproliferative and proliferative diabetic retinopathy patients (P = 0.47). In the whole study population, CCT was significantly correlated with intraocular pressure (P < 0.01). Conclusion: CCT is significantly increased in type II diabetes mellitus patients with respect to controls. Retinal disease severity does not seem to have an effect on corneal thickness

Evaluatıon Of Lower Lıp Profıle In Cleft Lıp And Palate Patıents

The aim of this study was to evaluate the lower lip morphology and posture of pre-peak cleft lip and palate (CLP) patients comparatively with skeletodental Class I normals and post-peak unilateral CLP subjects. The study material consisted of lateral cephalometric and hand-wrist radiographs obtained from a total of 38 CLP patients, 24 pre-peak unilateral (Mean age: 12.86± 0.85 years), 14 post-peak unilateral (Mean age: 16.53±0.77 years) and 20 control individuals (Mean age:12.33±0.85 years) with Class I occlusion and a harmonious profile. Cephalometric landmarks were double-digitized and the measurements were calculated by a computer program. Besides conventional dentofacial variables, the lower lip area was also measured by using a digital planimeter on the cephalometric tracings. Bonferroni test was performed to evaluate the differences between the pre-peak CLP and the control group while t-test was used to evaluate the defferences between pre and post peak unilateral CLP groups. The lower lip area was 3.46±0.27cm2 in the pre-peak CLP group and no statistically significant difference was found in comparison with the control (4.42±0.24 cm2). The lower lip area was found as 4.38+0.19cm2 in the post-peak unilateral group and was significantly different from the pre-peak group (p<0.001). The results of this study imply that the lower lip thickness of CLP patients increases after puberty. The reason of this increase may be a compensatory mechanism to reduce the increased inter-labial gap due to the short upper lip seen in CLP subjects

Tc-99m(V)-DMSA SPECT for the assessment of disease activity in Graves' ophthalmopathy

WOS: 000249773700004PubMed ID: 17728607Objective The aim of this study was to evaluate the use of Tc-99m(V)-dimercaptosuccinic acid (Tc-99m(V)-DMSA) scintigraphy for the assessment of disease activity in patients with Graves' ophthalmopathy (GO) and compare their clinical parameters. Methods The study involved 20 patients who were clinically inactive and eight patients who were clinically active, a total 28 GO patients (18 female, 10 male; mean age: 39.2 +/- 13.4 years) and 12 control subjects (six female, six male; mean age: 57.12 12 years). Planar and SPECT orbital images were obtained 4 h after the intravenous injection of 555-740MBq Tc-99m(V)-DMSA, using low-energy, high-resolution, parallel-hole collimators with dual-head detectors. All SPECT data were reconstructed on conventional axial, sagittal and coronal projections using an iterative reconstruction. Semi-quantitative evaluation was performed comparing the orbital activity with nasal activity based on four grades. GO was classified according to the NOSPECS classification of the American Thyroid Association. Disease was considered clinically active if symptoms and signs deteriorated over 3 months. Results No significant correlation was detected between clinical activity and classification (P=0.192). However, clinical activity and Tc-99m(V)-DMSA uptake were significantly correlated (P=0.0001). There was no correlation between the clinical classification and scintigraphic grading. Bilateral orbital index of the active group was significantly higher than that of the inactive group (P=0.0001). Conclusion Tc-99m(V)-DMSA imaging discriminates the active from inactive GO as well as showing an ongoing subclinical inflammation in the orbits of the patients with GO, regardless of the disease activity clinically. Our results revealed that Tc-99m(V)-DMSA is a promising agent for the diagnosis of active Graves' ophthalmopathy

BİLATERAL OPTİK DİSK DRUZENİ VE PAPİLÖDEM AYIRICI TANISINDA OPTİK KOHERENS TOMOGRAFİNİN YERİ: ÜÇ OLGU NEDENİYLE

Optic disc drusen is composed of hyaline-like calcific material within the substance of the optic nerve head. If it occurs in both eyes it is generally misdiagnosed as papiledema. In this report, we evaluated the clinical features and the results of optical coherence tomography of three cases with bilateral optic disc drusen. By these three cases we also discuss the efficiency of optical coherence tomography in the differential diagnosis of optic disc drusen and papiledem

SUBRETINAL CANNULATION AS A COMPLICATION OF SUTURE TRABECULOTOMY SURGERY IN A PEDIATRIC PATIENT

PURPOSETo report a case of inadvertent subretinal cannulation of ab externo suture trabeculotomy surgery associated with serous macular detachment.METHODSRetrospective case report. Ophthalmic examination and portable spectral domain optical coherence tomography (Envisu C2300; Bioptogen, Morrisville, NC) were performed under general anesthesia.RESULTSA 5-year-old girl with uveitis secondary to oligoarticular juvenile idiopathic arthritis underwent trabeculotomy surgery of the left eye for steroid-induced glaucoma refractory to medical management. The surgery was complicated by inadvertent subretinal cannulation with the prolene suture. Multiple, arcuate, hypopigmented subretinal tracks, originating from the ora serrata, were observed. Spectral domain optical coherence tomography images through the macula revealed subretinal fluid overlying funduscopically visible tracks, defects in photoreceptor outer segments overlying the tracks, and normal choroidal anatomy. The serous macular detachment resolved spontaneously after 4 months and visual acuity returned to baseline 20/25 in the left eye, consistent with reversible localized damage to the outer retina and retinal pigment epithelium.CONCLUSIONWe report a case of inadvertent subretinal cannulation during suture trabeculotomy surgery that resulted in serous macular detachment which resolved spontaneously. The inadvertent complication demonstrated a pathway for administration of therapeutics to the subretinal space