Stereoacuity After Refractive Lens Exchange With AcrySof ReSTOR Intraocular Lens Implantation

Journal of Refractive Surgery Vol. 25 No. 11

Stereoacuity was measured using the Titmus stereotest at 40 cm under photopic conditions (85 cd/m²) before and after RLE with bilateral AcrySof ReSTOR Natural (SN60D3 model) implantation in 30 hyperopic eyes of presbyopes with low astigmatism (<1.00 diopter [D]). Stereoacuity measurements after implantation were compared with those found before surgery.Stereoacuity was unchanged after RLE with pseudoaccommodative IOL implantation. In this population of non-cataractous hyperopes with excellent preoperative stereoacuity (46.42±1.36 sec arc), 95% maintained the same level of stereoacuity (48.67±1.13 sec arc) after surgery (P=.223). Further calculations predict that this ability to discriminate objects in depth extends to approximately 2 m. Beyond this distance, depth discrimination does not help the visual system.....CONCLUSIONS Refractive lens exchange with AcrySof ReSTOR IOL implantation does not affect the binocular ability of the human eye regarding depth perception, the best evidence of binocular function in hyperopic individuals.

Progression of Age-Related Macular Degeneration After Cataract Surgery

Surgeons prospectively enrolled patients with nonneovascular AMD who were awaiting cataract surgery. Fluorescein angiography was performed preoperatively and at the postoperative week 1, month 3, and month 12 visits. Incidence of neovascular AMD development within 12 months after operation was the primary outcome measure.Results A total of 108 subjects were enrolled. Of 86 eyes with preoperatively photographically confirmed nonneovascular AMD, 71 had gradable images by month 12. Neovascular AMD was observed in 9 of 71 eyes (12.7%; 95% confidence interval, 6.0%-22.7%). The progression rate between week 1 and month 12 decreased to 3 of 65 eyes (4.6%; 95% confidence interval, 1.0%-12.9%) after excluding 5 neovascular events identified on the postoperative week 1 visit and 1 case with missing photographs at this visitConclusion The low incidence rate of neovascular AMD development between 1 week and 1 year after cataract surgery did not support the hypothesis that cataract surgery increases the risk of AMD progression. Several eyes appeared to have disease progression on postsurgery week 1 fluorescein angiograms, suggesting that many cases of presumed progression to neovascular AMD following cataract surgery may have been present prior to cataract surgery, but not recognized owing to lens opacity.

Intraocular pressure in keratoconus

Intraocular pressure was measured in 20 keratoconus subjects and 20 age-matched control subjects using the DCT and NCT instruments. Central and off-centre measures were taken with the DCT in order to highlight any systematic errors associated with corneal biomechanical factors. Measures of anterior and posterior corneal topography and thickness were also taken in each subject.Results: No significant difference was found between the central and off-centre DCT IOP readings for the keratoconus subjects and age-matched controls (p > 0.05). The average DCT IOP was 14.2 ± 1.4 mmHg in the keratoconus subjects and 14.2 ± 1.6 mmHg in the controls. However, the average NCT readings differed significantly (p <> 0.05) correlation with the severity of keratoconus as determined through measures of corneal topography and thickness. Equivalent IOP measurements taken with the NCT correlated significantly with certain measures of corneal curvature and thickness in the keratoconus population. The difference between DCT and NCT IOP was strongly correlated with measures of corneal topography and thickness, with differences increasing in more advanced keratoconus.Conclusions: The measurements obtained with the DCT do not appear to be dependent upon corneal factors, unlike those taken with the NCT. The presence or severity of keratoconus was not correlated with DCT IOP values.

Natural History of Open-Angle Glaucoma

The median and interquartile rates of visual function loss were −0.40 (1.05) dB/year overall and −0.46 (1.61) in HTG, −0.22 (0.65) in NTG, and −1.13 (6.13) in PEXG. Thus, interpatient variability was large. Mean rates were considerably higher than medians: −1.08 dB/year overall, −1.31 in HTG, −0.36 in NTG, and −3.13 in PEXG. Differences in median visual function progression rates among groups were statistically significant (NTG vs. HTG, P = 0.003; PEXG vs. non-PEXG, P<0.001). Progression was considerably and significantly faster in older than in younger patients (P = 0.002). By 6 years, 68% of patients had progressed overall, 74% of those with HTG, 56% of those with NTG, and 93% of those with PEXG (P = 0.012). Median time to progression also differed considerably among groups: 19.5 months in PEXG, 44.8 months in HTG, and particularly 61.1 months in NTG (P<0.0001).
ConclusionsIn this 6-year follow-up study, the median untreated rate of progression corresponded to advancing from normal visual function to blindness in approximately 70 years, whereas on the basis of the mean rate, visual function would show the same deterioration in approximately 25 years. Large differences existed among patients and different glaucoma types, with PEXG progressing considerably faster than HTG, and NTG progressing at the lowest rate.

Intravitreal bevacizumab combined with panretinal photocoagulation in the treatment of open angle neovascular glaucoma

Eur J Ophthalmol 2009; 19: 1029 - 1034

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In NVG, IVB treatment can reduce iris and angle neovascularization and inhibits further PAS formation temporarily. Panretinal photocoagulation inhibits neovascularization constantly. Therefore, management of open angle NVG is more feasible with bevacizumab combined with panretinal photocoagulation.

Central Corneal Thickness During Treatment With Travoprost 0.004% in Glaucoma Patients

Journal of Ocular Pharmacology and Therapeutics

Experimental studies demonstrated an alteration of corneal collagen structure by prostaglandin analogues. The possible effect of the prostaglandin F_2α analogue travoprost 0.004% on the central corneal thickness (CCT) in newly diagnosed glaucoma patients was evaluated.Results: Mean CCT of all treated eyes (n = 136) was 546.71 ± 34.63 μm at baseline, 535.14 ± 34.78 μm after 6 months, and 532.38 ± 34.18 μm after 12 months (ANOVA, P <>30 μm occurred in 5.1% of all treated eyes. There was a significant correlation between the magnitude of corneal thinning and the initial CCT but not between corneal thinning and IOP reductions.

Conclusions: Topical therapy with the prostaglandin derivate travoprost is accompanied by a significant reduction of CCT within one year of treatment. Further clinical studies are needed to evaluate the possible long-term effects of prostaglandins on the CCT of glaucoma patients.

Efficacy and safety of travoprost/timolol vs dorzolamide/timolol in patients with open-angle glaucoma or ocular hypertension

The fixed combination travoprost 0.004%/timolol 0.5% dosed once daily in the morning demonstrated superior mean diurnal IOP-lowering efficacy compared to dorzolamide 2%/timolol 0.5% dosed twice daily in patients with ocular hypertension or open-angle glaucoma.