RESUMEN

INTRODUCTION: In recent years, fedratinib, a selective JAK2 inhibitor, has emerged as a potential therapeutic option for patients who have failed or are intolerant to ruxolitinib. Despite the promising results observed in clinical studies, real-world evidence from the United States and Europe suggests that the efficacy of fedratinib may be less conclusive. We report the characteristics, treatment patterns, and clinical outcomes of patients with myelofibrosis (MF) treated with fedratinib following ruxolitinib failure in Israel's clinical practice. METHODS: This retrospective patient chart review included adults with a physician-reported diagnosis of MF, who initiated fedratinib after discontinuing ruxolitinib. Descriptive analyses characterized patient characteristics, clinical outcomes, and treatment patterns from MF diagnosis through ruxolitinib and fedratinib treatment. RESULTS: We extracted data for 16 eligible patients. Approximately 62.5 % of the patients were female, and the median age was 77 (range, 63-85) years. The median duration of ruxolitinib therapy was 17 months (range 3-84 ) months. Before the initiation of fedratinib, the median spleen size by palpation was 15.5cm below the costal margin (range 4-22cm). After three months the median spleen size was 13cm below the costal margin (range 2-21 cm). Only two patients showed minimal improvement after six months, while three patients progressed, and two patients showed no change in the spleen size. The spleen response did not improve after 12 months of treatment. At this point, the median spleen size was 19 cm below the costal margin (range 2-30 cm). Regarding the MF-related symptoms, 43.75% (n =7) of patients reported some improvement, 37.5% (n =6) showed no changes, whereas 18.75% (n =3) of the population complained of worsening. Gastrointestinal toxicity was the most frequent adverse effect of the drug, while 31% of patients died. CONCLUSION: Our observations showed that in MF patients who have failed to ruxolitinib, the therapeutic value from fedratinib may be modest especially when exposure time to ruxolitinib was more than 12 months. We may hypothesize that earlier switching from ruxolitinib to fedratinib may yield a better result.

RESUMEN

PURPOSE: The current study aimed to describe the distribution of angle alpha and angle kappa offsets as well as their associated ocular biometric parameters in a large population of candidates for cataract surgery. METHODS: This cross-sectional retrospective study included 8,119 eyes of 4,781 candidates for cataract surgery (mean age 70.7 ± 12.9 years). There were 49.9% right eyes, and 53.0% patients were females. The angles offset and ocular biometric parameters were measured by the IOLMaster 700 (Carl Zeiss Meditec, AG, Germany). RESULTS: Patient's age and gender, and most of their ocular biometric measurements were similar for the right and left eyes except for pupil diameter (4.01 ± 1.18 vs. 3.92 ± 1.14 mm, respectively, P < 0.001). The angle alpha offset magnitude was similar for the right and left eyes (0.50 ± 0.20 and 0.51 ± 0.21 mm, P = 0.08), whereas the angle kappa offset magnitude was greater in the right eyes (0.37 ± 0.21 vs. 0.33 ± 0.20 mm, P < 0.001). The angle kappa offset magnitudes were greater in the right eyes compared to the left eyes for both males (0.36 ± 0.21 vs. 0.33 ± 0.21 mm, respectively, P < 0.001) and females (0.37 ± 0.20 vs. 0.34 ± 0.20 mm, respectively, P < 0.001). The offset magnitudes of both angles varied significantly according to gender, eye laterality, angle location, and biometric parameters (e.g., axial length). The offset magnitudes of both angles were positively correlated in both right and left eyes. CONCLUSIONS: The offset magnitudes of both the angle alpha and angle kappa present significant variations according to gender, eye laterality, angle location, and biometric parameters, such as AL. These values are also population-specific.

RESUMEN

PURPOSE: To investigate whether standard keratometry (K) or total corneal power (TCP) lead to more accurate refractive outcomes for intraocular lens (IOL) power calculation. SETTING: Public hospital. DESIGN: Retrospective evaluation of a diagnostic test instrument. METHODS: Preoperatively all patients underwent optical biometry with the Anterion (Heidelberg), a swept-source optical coherence tomographer providing both K and TCP. The same IOL model was implanted in all cases. The whole sample was divided into a training dataset, used to optimize the formula constants, and a testing dataset, used to investigate the spherical equivalent prediction error (SEQ-PE) of 8 IOL power formulas. Trueness, precision and accuracy were evaluated by means of the robust two-sample t-test. Cochran's Q test was performed to assess whether the percentage of eyes with an SEQ-PE within each threshold was significantly different; in such an event, the McNemar test was then applied. RESULTS: Both the training and testing datasets included 317 eyes. No significant differences were detected for trueness, due to constant optimization. Precision and accuracy were better when K was entered, although a statistically significant difference was observed only with the EVO (precision: p = 0.02 and accuracy: p = 0.03) and Haigis formula (p <0.01 for both precision and accuracy). No significant differences were observed for the percentage of eyes with an absolute SEQ-PE within any threshold. CONCLUSIONS: With most formulas, IOL power calculation is not more accurate when TCP is used instead of K.

RESUMEN

PURPOSE: To compare two different datasets, using Eyetemis, an online analytical tool designed for assessing the spherical equivalent prediction errors (SEQ-PE) of intraocular lens (IOL) power calculation formulas following cataract surgery. SETTING: Institutional. DESIGN: Retrospective case series. METHODS: The study was comprised of two distinct datasets of patients who had undergone successful cataract surgery. Dataset-1 includes standard eyes whereas Dataset-2 includes eyes with keratoconus. An online tool was used for SEQ-PE analysis across the 2 datasets, adhering to ISO standards for evaluating accuracy based upon trueness and precision. The tool incorporates robust t-tests for comparing the trimmed-mean of the data, adjusting for heteroscedasticity. IOL constants in Dataset-1 were optimized for the comparison of Hoffer Q, Holladay1, SRK/T, Haigis and Barrett Universal II (BUII) formulas. In Dataset-2, IOL constants from the IOLCon website, were used for the comparison of the BUII and its designated KCN-version: Barrett TrueK Keratoconus (TrueK [KCN]). RESULTS: For Dataset-1: the trimmed-mean SEQ-PE values of all formulas were not significantly different from zero. BUII had superior precision and accuracy compared to all other formulas except from Haigis (P≤ 0.04). For Dataset-2: BUII's trimmed-mean SEQ-PE was significantly different from zero (0.59D, P< 0.01), unlike the TrueK [KCN] (0.12D, P= 0.10). Additionally, TrueK [KCN] exhibited enhanced precision and accuracy relative to BUII (P< 0.01). CONCLUSIONS: The online analysis tool provides a streamlined approach for assessing the prediction accuracy of SEQ refraction following cataract surgery, effectively evaluating trueness, precision, and overall accuracy through the use of advanced statistical methods.

RESUMEN

Tyrosine kinase inhibitors (TKIs) have greatly improved chronic myeloid leukemia (CML) treatments, with survival rates close to the general population. Yet, for the very elderly, robust data remains limited. This study focused on assessing comorbidities, treatment approaches, responses, and survival for elderly CML patients. Our study was conducted on 123 elderly (≥ 75 years) CML patients across four centers in Israel and Moffitt Cancer Center, USA. The median age at diagnosis was 79.1 years, with 44.7% being octogenarians. Comorbidities were very common; cardiovascular risk factors (60%), cardiovascular diseases (42%), with a median age-adjusted Charlson Comorbidity Index (aaCCI) of 5. Imatinib was the leading first-line therapy (69%), while the use of second-generation TKIs increased post-2010. Most patients achieved a major molecular response (MMR, 66.7%), and half achieved a deep molecular response (DMR, 50.4%). Over half (52.8%) of patients moved to second-line, and nearly a quarter (23.5%) to third-line treatments, primarily due to intolerance. Overall survival (OS) was notably longer in patients with an aaCCI score below 5, and in patients who attained DMR. Contrary to expectations, the Israeli cohort showed a shorter actual life expectancy than projected, suggesting a larger impact of CML on elderly survival. In summary, imatinib remains the main initial treatment, but second-generation TKIs are on the rise among elderly CML patients. Outcomes in elderly CML patients depend on comorbidities, TKI type, response, and age, underscoring the need for personalized therapy and additional research on TKI effectiveness and safety.

Asunto(s)

RESUMEN

PURPOSE: To evaluate prediction accuracy of formulas included in the ESCRS-Online-IOL-Calculator using standard keratometry (K) or total keratometry (TK). SETTING: Hospital-based academic practice. DESIGN: Retrospective case-series. METHODS: Participants: 523 cataract patients (523 eyes). Outcome Measures: trimmed-means of the spherical equivalent prediction error (SEQ-PE, trueness), precision and absolute SEQ-PE (accuracy) of all seven formulas available on the ESCRS-Online-IOL-Calculator as well as the mean (Mean-All) and median (Median-All) of the predicted SEQ refraction of all formulas. Sub-group analyses evaluated the effect of axial length on formula accuracy. RESULTS: Trimmed-mean SEQ-PE range of all formulas varied from -0.075 to +0.071D for K-based and from -0.003 to +0.147D for TK-based calculations, with TK-based being more hyperopic in all formulas (p<0.001). Precision ranged from 0.210 to 0.244D for both K-based and TK-based calculations. Absolute SEQ-PE ranged from 0.211 to 0.239D for K-based and from 0.218 to 0.255D for TK-based calculations. All formulas, including Mean-All and Median-All, showed high accuracy with 84-90% of eyes having SEQ-PEs within 0.50D.Myopic trimmed-mean SEQ-PEs significantly different from zero were observed in long eyes for Pearl DGS (-0.110D, p=0.005), Hill RBF (-0.120D, p<0.001) and Hoffer QST (-0.143D, p=0.001), and in short eyes for EVO 2.0 (-0.252D, p=0.001), Kane (-0.264D, p=0.001), Hoffer QST (-0.302D, p<0.001), Mean-All (-0.122D, p=0.038) and Median-All (-0.125D, p=0.043). CONCLUSION: Prediction accuracy of all ESCRS IOL Calculator formulas was high and globally comparable. TK-based calculations did not increase prediction accuracy and tended towards hyperopia. Observations indicating formula superiority in long and short eyes merit further evaluation.

RESUMEN

PURPOSE: To compare intraocular lens (IOL) power prediction accuracy of the Eyestar 900 (EyeS900) and the IOLMaster 700 (IOLM700) based on estimated and measured posterior corneal power. DESIGN: Retrospective, interinstrument reliability study. METHODS: Setting: Institutional. PARTICIPANTS: Two hundred twenty-five eyes of 225 cataract surgery patients. MEASUREMENTS: Patients underwent measurements by both devices preoperatively. MAIN OUTCOME MEASURES: Spherical Equivalent Prediction Error (SEQ-PE), spread of the SEQ-PE (precision) and the absolute SEQ-PE (accuracy) of each device using Barrett Universal II (BUII) formula with either estimated posterior keratometry (E-PK) or measured posterior keratometry (M-PK). RESULTS: Trimmed mean SEQ-PEs of EyeS900 E-PK, EyeS900 M-PK, IOLM700 E-PK, and IOLM700 M-PK were 0.03, 0.08, 0.02, and 0.09 D, respectively with no significant differences between EyeS900 E-PK and IOLM700 E-PK (P = 0.31) as well as between EyeS900 M-PK and IOLM700 M-PK (P = 0.31). Statistically significant SEQ-PE differences were found when E-PK and M-PK were compared, regardless of the device used, showing hyperopic SEQ-PE in M-PK calculations. Excellent correlation and agreement in SEQ-PE were found between the devices for both E-PK (P < 0.001, r = 0.848, mean bias: +0.01 D, 95% LOA of -0.32 to +0.34 D) and M-PK (P < 0.001, r = 0.776, mean bias: -0.01 D, 95% LOA of -0.42 to +0.39 D). No significant differences were found comparing absolute SEQ-PE and precision of the devices. CONCLUSION: The Eyestar 900 and the IOLMaster 700 show comparable IOL power prediction accuracy by the BUII formula using either estimated or measured posterior keratometry. An adjusted lens factor may be required for BUII when utilizing measured posterior keratometry in both devices.

Asunto(s)

RESUMEN

PURPOSE: To evaluate the clinical significance of preoperative spectral domain optical coherence tomography (OCT) of the retinal nerve fiber layer (RNFL) thickness in identifying glaucoma and better managing patients scheduled for routine cataract surgery. SETTING: Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel. DESIGN: Retrospective cohort study. METHODS: Consecutive patients scheduled for cataract surgery were enrolled from February 2022 to August 2022. Participants underwent routine OCT RNFL studies which were evaluated by a glaucoma specialist. Findings were compared with those of preoperative fundus biomicroscopic examinations conducted by the referring ophthalmologist. The main outcomes were the incidence of newly detected glaucoma based on OCT RNFL findings and the consequent changes in patient management. RESULTS: In total, 486 patients met the inclusion criteria of whom 112 (23%) had abnormal RNFL. 31 patients (6.4%) had abnormal OCT RNFL findings attributed to comorbidities other than glaucoma, and 81 patients (16.7%) were suspected to have glaucoma based on their OCT RNFL findings, from which 44 patients (9%) were newly diagnosed with glaucoma or as glaucoma suspects, resulting in management modifications that included routine glaucoma follow-up (25 patients, 5.1%), initiation of intraocular pressure-lowering treatment (12 patients, 2.5%), and conversion to combined cataract-glaucoma surgery (7 patients, 1.4%). CONCLUSIONS: OCT RNFL for cataract surgery candidates proved valuable in detecting glaucoma that had not been revealed by standard fundus biomicroscopic examination. The additional information provided by OCT RNFL can potentially enhance patient management and optimize outcomes.

Asunto(s)

RESUMEN

BACKGROUND: A focused bibliographic analysis of Israel's ophthalmology research productivity has never been performed. OBJECTIVES: To assess the research output of Israeli ophthalmology departments between the years 2011-2021 and compare to leading countries in the discipline. METHODS: The PubMed search engine was used to detect all medical articles published between the years 2011 and 2021, with at least one author from an Israeli ophthalmology department. Each entry was reviewed for: year of publication, journal, department, sub-specialty, and study design. Journals were ranked according to Scopus Cite Score. Research output and population data of 7 top-ranked countries in ophthalmology (USA, UK, Japan, Germany, Australia, Canada, China) were documented for comparisons. RESULTS: Overall, 1,919 publications were included. Total research output of Israeli ophthalmology departments significantly increased throughout the study period (R2=0.85, P<0.0001). Medical retina publications were the most prevalent (493 articles, 25.6%), and the most commonly utilized design was cohort (536 articles, 28%). Over a third of all articles (669) were published in Q1 ophthalmology journals, and 16% were published in the top-10 journals. Israel was ranked (1/8) and (3/8) in publications per population and physician, respectively, compared to the other assessed countries. CONCLUSIONS: Between 2011-2021, the research productivity of the Israeli ophthalmological community has constantly increased across all sub-specialties and in high-impact journals. Israel's relative contribution to the ophthalmic medical literature is noteworthy internationally.

Asunto(s)

RESUMEN

PURPOSE: To demonstrate the noninferiority in antimicrobial effectiveness of thrice-repeated applications of 1% povidone-iodine (PI) compared with a single application of 5% PI on the ocular surface in vivo and to evaluate potential toxicity of PI to the corneal epithelium. SETTING: Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel. DESIGN: Prospective, randomized, double-blind study. METHODS: Patients randomly received either a single application of 5% PI or repeated irrigations of 1% PI on the ocular surface preoperatively. Bacterial colony counts were quantitatively analyzed by taking standardized conjunctival swabs before and after irrigation, and differences in bacterial colony counts were compared between the 2 groups. The presence of superficial punctate keratopathy was evaluated in all patients by the National Eye Institute grading system. RESULTS: The study comprised 102 eyes of 102 patients. Both 1% and 5% PI yielded a marked decrease in bacterial colonies compared with before application ( P < .001). The repeated application of 1% PI showed a significantly lower bacterial count compared with the single application of 5% PI ( P < .05) and resulted in significantly less damage to the corneal epithelium compared with a single 5% PI application ( P < .001). CONCLUSIONS: Preoperative repeated applications of 1% PI effectively eradicated ocular surface bacteria equal to that of 5% PI with a less deleterious effect on the corneal epithelium. Our findings suggest that 1% PI may be a promising alternative to 5% PI.

Asunto(s)

RESUMEN

The management of chronic myeloid leukemia (CML) diagnosed during pregnancy is a rare and challenging situation. We report the treatment and outcome of 87 cases diagnosed in chronic phase from 2001-2022 derived from the largest international observational registry, supported by the European LeukemiaNet (ELN), of 400 pregnancies in 299 CML women. Normal childbirth occurred in 76% without an increased rate of birth abnormalities or life-threatening events, including in patients untreated or treated with interferon-α and/or imatinib in 2nd-3rd trimester. The low birth weight rate of 12% was comparable to that seen in the normal population. Elective and spontaneous abortions occurred in 21% and 3%, respectively. The complete hematologic response rate before labor was 95% with imatinib and 47% with interferon only. No disease progression during pregnancy was observed, 28% of the patients switched their therapy at varying times after delivery. Treatment options balance the efficacy and safety for mother and infant: interferon-α can commence in the 1st trimester and continued throughout in cases of good disease control and tolerability. Because of limited placental crossing, selected tyrosine kinase inhibitors (imatinib and nilotinib) seem to be safe and effective options in 2nd and 3rd trimester while hydroxycarbamide offers few benefits.

Asunto(s)

RESUMEN

PURPOSE: To compare the prediction accuracy of toric intraocular lens calculations using estimated vs measured posterior corneal astigmatism (PCA). DESIGN: Retrospective case series. METHODS: A total of 110 eyes of 110 patients with uncomplicated toric intraocular lens implantation were included in this study. Predicted postoperative refractive astigmatism was calculated with the Barrett Toric Calculator using the estimated PCA (E-PCA), the measured IOLMaster 700 PCA (I-PCA), and the measured Pentacam PCA (P-PCA). Refractive astigmatism prediction errors (RA-PEs), including their trimmed (tr-) centroid (mean vector), spread (precision), tr-mean absolute RA-PE (accuracy), and percentage within a certain threshold, were determined using vector analysis and compared between groups. SETTING: University Eye Clinic, Maastricht University Medical Center+, the Netherlands. RESULTS: The tr-centroid RA-PEs of the E-PCA (0.02 diopter [D] at 82.2°), the I-PCA (0.08 D at 35.5°), and the P-PCA (0.09 D at 69.1°) were significantly different from each other (P < .01), but not significantly different from zero (P = .75, P = .05, and P = .05, respectively). The E-PCA had the best precision (tr-mean 0.40 D), which was not significantly lower than the I-PCA (0.42 D, P = .53) and P-PCA (0.43 D, P = .06). The E-PCA also had the best accuracy (0.40 D), which was not significantly different from the I-PCA (0.42 D, P = .26) and significantly better than the P-PCA (0.44 D, P < .01). The precision and accuracy of the I-PCA did not significantly differ from those of the P-PCA. There were no statistically significant differences in the percentage of eyes within a certain absolute RA-PE threshold. CONCLUSIONS: The Barrett Toric Calculator using the E-PCA, I-PCA, or P-PCA showed a comparable prediction of postoperative refractive astigmatism in standard clinical practice.

RESUMEN

PURPOSE: To report the intraoperative performance and postoperative outcomes of crystalline lens removal and in-the-bag intraocular lens (IOL) implantation with scleral-bag fixation by means of capsular tension segments (CTSs) and a capsular tension ring (CTR) in patients with a subluxated lens. SETTING: Department of Ophthalmology, Shaare-Zedek Medical Center, Jerusalem, Israel. DESIGN: Retrospective, consecutive case series. METHODS: This study included patients with subluxated crystalline lens who underwent lensectomy or cataract extraction using an anterior chamber maintainer (ACM), a CTR, transscleral capsular-bag fixation by polytetrafluoroethylene suture with 2 CTSs, and in-the-bag IOL implantation. Outcome measures included intra- and postoperative complications, corrected distance visual acuity (CDVA), target and postoperative refraction, and IOL tilt. RESULTS: 17 eyes (9 patients) were included, with a mean follow-up of 22.06 ± 14.88 months. There was a significant improvement in mean logMAR CDVA ( P < .001), with 15 eyes (88.24%) achieving a Snellen CDVA of 20/30 or better and all eyes achieving 20/40 or better. The mean refractive spherical-equivalent prediction error was 0.07 ± 1.10 diopters (D), with 10 (58.82%) and 15 (88.24%) of eyes within ±0.50 D and 1.00 D, respectively, from the intended refraction. The mean horizontal and vertical tilts were 1.9 ± 2.6 degrees and 2.6 ± 2.1 degrees, respectively. No complications were observed except for 1 case of an intraoperative posterior-capsular tear. CONCLUSIONS: A comprehensive surgical approach for scleral-bag fixation that combines the use of an ACM, CTR, polytetrafluoroethylene sutures, 2 CTSs with in-the-bag IOL implantation, offers an effective strategy for achieving favorable visual outcomes and a low incidence of complications in patients with subluxated crystalline lenses.

Asunto(s)

RESUMEN

Purpose: To obtain consensus on the key areas of burden associated with existing devices and to understand the requirements for a comprehensive next-generation diagnostic device to be able to solve current challenges and provide more accurate prediction of intraocular lens (IOL) power and presbyopia correction IOL success. Patients and Methods: Thirteen expert refractive cataract surgeons including three steering committee (SC) members constituted the voting panel. Three rounds of voting included a Round 1 structured electronic questionnaire, Round 2 virtual face-to-face meeting, and Round 3 electronic questionnaire to obtain consensus on topics related to current limitations and future solutions for preoperative cataract-refractive diagnostic devices. Results: Forty statements reached consensus including current limitations (n = 17) and potential solutions (n = 23) associated with preoperative diagnostic devices. Consistent with existing evidence, the panel reported unmet needs in measurement accuracy and validation, IOL power prediction, workflow, training, and surgical planning. A device that facilitates more accurate corneal measurement, effective IOL power prediction formulas for atypical eyes, simplified staff training, and improved decision-making process for surgeons regarding IOL selection is expected to help alleviate current burdens. Conclusion: Using a modified Delphi process, consensus was achieved on key unmet needs of existing preoperative diagnostic devices and requirements for a comprehensive next-generation device to provide better objective and subjective outcomes for surgeons, technicians, and patients.

RESUMEN

PURPOSE: To evaluate the differences in corneal wavefront measurements in myopic and hyperopic eyes when calculated using three different reference centers and explore possible influencing factors for such differences. METHODS: Corneal wavefront measurements were performed in myopic and hyperopic eyes using a GALILEI Placido Dual Scheimpflug Analyzer (Ziemer Ophthalmic Systems AG). Corneal higher order aberrations (HOAs), including total, vertical, and horizontal coma-like aberrations, spherical aberrations, and total corneal HOAs through a 6-mm pupil size, were calculated over three different reference center positions: pupil center, corneal vertex, and limbus to limbus. Values were then compared between the myopic and hyper-opic eyes, and correlations with kappa distance and spherical equivalent were tested. RESULTS: A significant decrease in the level of total corneal HOAs (-0.04 ± 0.05 and -0.12 ± 0.09), total corneal coma (-0.07 ± 0.09 and -0.18 ± 0.12), and horizontal coma (-0.07 ± 0.11 and -0.22 ± 0.11) in myopic and hyperopic eyes, respectively, was found when recalculating from pupil center to corneal vertex centration, whereas a significant increase in the same aberrations was observed from pupil center or corneal vertex to limbus to limbus. Significant correlations were found between the kappa distance and changes in total corneal HOAs, total corneal coma, and horizontal coma from the pupil center to the corneal vertex in both groups. CONCLUSIONS: Corneal vertex centration generated the lowest level of corneal wavefront error in both groups. The differences in corneal aberrations between the reference centers for calculation were highly correlated with the kappa distance in hyperopic eyes. [J Refract Surg. 2023;39(5):340-346.].

Asunto(s)

Asunto(s)

RESUMEN

PURPOSE: To compare retinal image quality in subclinical keratoconus and normal eyes using a double-pass aberrometer and to correlate it with posterior surface deformation. METHODS: Sixty normal corneas were compared to 20 subclinical keratoconus (SKC) corneas. Retinal image quality was assessed using a double-pass system in all the eyes. The objective scatter index (OSI) modulation transfer function (MTF) cutoff, Strehl ratio (SR), and Predicted Visual Acuity (PVA) values at 100%, 20%, and 9% were calculated and compared between the groups. Posterior corneal asymmetry was measured using a combined Placido Dual Scheimpflug Analyzer, and correlations were tested with all optical quality parameters. RESULTS: Significant decrease in optical quality parameters was observed in SKC eyes compared with that in normal eyes. Subclinical KC eyes expressed greater scattering (OSI = 0.66 ± 0.36 vs 0.47 ± 0.26) and reduced contrast images (MTF and SR) than normal eyes, with 38.82 ± 9.4 and 0.22 ± 0.04, and 44.35 ± 7.1 and 0.24 ± 0.04, respectively. The reduction in the image contrast parameters (MTF and SR) was strongly correlated to the level of posterior corneal asymmetry in SKC. The greater the posterior asymmetry, the more affected was the image contrast, with r = -0.63 and -0.59, respectively for MTF and SR. CONCLUSION: Retinal image quality was significantly more affected in eyes with subclinical keratoconus than in normal eyes. The reduction in optical quality observed in subclinical keratoconus was strongly associated with the increased asymmetry of the posterior cornea.

Asunto(s)

RESUMEN

This retrospective comparative study analyzes the early postoperative impact of laser vision correction for myopia on the optical quality and stability of functional vision using a double-pass aberrometer. Retinal image quality and visual function stability were assessed preoperatively, one and three months after myopic laser in situ keratomileuses (LASIK) and photorefractive keratectomy (PRK) using double-pass aberrometry (HD Analyzer, Visiometrics S.L, Terrassa, Spain). The parameters analyzed included vision break-up time (VBUT), objective scattering index (OSI), modulation transfer function (MTF), and Strehl ratio (SR). The study included 141 eyes of 141 patients, of whom 89 underwent PRK and 52 underwent LASIK. No statistically significant differences were noted between the two techniques in any analyzed parameters at three months postoperatively. However, a significant drop was observed in all parameters one month after PRK. Only the OSI and VBUT remained significantly altered from baseline at the three months follow-up visit, with an increased OSI by 0.14 +/- 0.36 (p < 0.01) and a shortened VBUT by 0.57 +/- 2.3 s (p < 0.01). No correlation was found between the changes in optical and visual quality parameters and age, ablation depth, or postoperative spherical equivalent. The stability and quality of the retinal images were similar between LASIK and PRK at three months postoperatively. However, significant degradation in all parameters was found one month after PRK.

RESUMEN

PURPOSE: To evaluate the agreement in biometry measurements and intraocular lens (IOL) power prediction between the Eyestar 900 and the IOLMaster 700. SETTING: Institutional. DESIGN: Retrospective comparative study. METHODS: Patients were evaluated before cataract surgery using both devices on the same visit. Axial length, anterior and posterior keratometry, anterior chamber depth, corneal diameter (CD), central corneal thickness, and lens thickness were recorded by both devices. The agreement in measurements and in IOL power calculations was evaluated using the Barrett Universal II (BU-II) formula with either predicted or measured posterior keratometry. RESULTS: In total, 402 eyes of 402 consecutive patients were included. The mean age was 72.0 ± 9.2 years. Clinically, mean differences in measured variables were small, albeit slightly larger for posterior flat and steep keratometry (0.43 diopters [D] and 0.42 D, respectively). The measurement correlation and agreement between the devices were good for all variables with slightly lower agreement in CD measurements. Consistent bias was seen in measurements of posterior flat and steep keratometry. Good agreement was also found in anterior and posterior astigmatism measurements. Good IOL power calculation agreement was found using either predicted posterior keratometry (95% limits of agreement [LoA] of -0.40 to +0.30 D) or measured posterior keratometry (95% LoA of -0.45 to +0.40 D). The agreement was within ±0.5 D in 394 eyes (98.0%) using predicted posterior keratometry and in 386 eyes (96.0%) using measured posterior keratometry. CONCLUSIONS: The Eyestar 900 and the IOLMaster 700 show strong agreement in biometry measurements and IOL power prediction by the BU-II formula using either standard or total corneal keratometry and can be used interchangeably.

Asunto(s)