RESUMEN
BACKGROUND: In many countries, access to general health and eye care is related to an individual's socioeconomic status (SES). We aimed to examine the prevalence of oculo-visual disorders in children in Istanbul Turkey, drawn from schools at SES extremes but geographically nearby. METHODS: Three school-based vision screenings (presenting distance visual acuity, cover test, eye assessment history, colour vision, gross stereopsis and non-cycloplegic autorefraction) were conducted on 81% of a potential 1014 primary-school children aged 4-10 years from two private (high SES) schools and a nearby government (low SES) school in central Istanbul. Prevalence of refractive errors and school-based differences were analysed using parametric statistics (ANOVA). The remaining oculo-visual aspects were compared using non-parametric tests. RESULTS: Of the 823 children with mean age 6.7 ± 2.2 years, approximately 10% were referred for a full eye examination (8.2% and 16.3% of private/government schools respectively). Vision had not been previously examined in nearly 22% of private school children and 65% of government school children. Of all children, 94.5% were able to accurately identify the 6/9.5 [LogMAR 0.2] line of letters/shapes with each eye and 86.6% the 6/6 line [LogMAR 0], while 7.9% presented wearing spectacles, 3.8% had impaired colour vision, 1.5% had grossly impaired stereo-vision, 1.5% exhibited strabismus, 1.8% were suspected to have amblyopia and 0.5% had reduced acuity of likely organic origin. Of the 804 without strabismus, amblyopia or organic conditions, 6.0% were myopic ≤ - 0.50DS, 0.6% hyperopic ≥ + 2.00DS, 7.7% astigmatic ≥1.00 DC and 6.2% anisometropic ≥1.00DS. CONCLUSIONS: The results highlight the need for general vision screenings for all children prior to school entry given the varied and different pattern of visual problems associated with lifestyle differences in two populations raised in the same urban locale but drawn from different socioeconomic backgrounds.
Asunto(s)
Necesidades y Demandas de Servicios de Salud/estadística & datos numéricos , Trastornos de la Visión/epidemiología , Selección Visual/normas , Análisis de Varianza , Niño , Preescolar , Anteojos/estadística & datos numéricos , Femenino , Humanos , Masculino , Prevalencia , Turquía/epidemiología , Agudeza VisualRESUMEN
UNLABELLED: To evaluate the results of laser in situ keratomileusis (LASIK) for extremely high myopia with a minimum follow-up of 10 years. Istanbul Surgery Hospital, Istanbul, Turkey. Extremely high myopic patients treated with LASIK between 1995 and 1997 with a minimum follow-up of 10 years are reviewed retrospectively. Cases over 14 diopters (D) of myopia were included in the study. From 143 eyes with high myopia greater than -14 D operated on between 1995 and 1997, 39 eyes (26 patients) were available for 10-year follow-up. RESULTS: The manifest average spherical equivalent refraction was -21.7 ± 5.8 D prior to surgery. This value became -6.0 ± 3.3 D after at least 10 years of follow-up. The regression was -6.1 ± 2.2 D in the period starting from the first month of the follow-up until the last control. The uncorrected visual acuity was 0.07 ± 0.1 at the last follow-up. The mean preoperative best-corrected visual acuity (BCVA) was 0.22 ± 0.12 and 0.30 ± 0.17 postoperatively (p < 0.001). Loss or gain of one line or more at the BCVA in the last control were 10.3 and 53.8 %, respectively. The safety and efficacy indexes are 1.56 ± 0.95 and 0.29 ± 0.4, respectively. No corneal ectasias were noted at follow-up. Although LASIK gives reliable results with high degrees of myopia, significant regression develops in the long term.
Asunto(s)
Córnea/cirugía , Queratomileusis por Láser In Situ/métodos , Miopía/cirugía , Refracción Ocular , Adulto , Córnea/patología , Topografía de la Córnea , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Miopía/patología , Estudios Retrospectivos , Factores de Tiempo , Resultado del Tratamiento , Adulto JovenRESUMEN
To determine the incidence of recurrent epithelial loosening (REL) following laser in situ keratomileusis (LASIK) and evaluate the efficacy of anterior stromal micropuncture (ASP) and the application of bandage contact lenses (BCLs) in the management of REL after LASIK. A retrospective study including all individuals who underwent LASIK with a microkeratome between January 2006 and January 2007. Medical records were reviewed to identify patients who were diagnosed as having epithelial loosening with or without epithelial defects. Data were collected on 5,566 eyes that underwent LASIK with a microkeratome. Eight eyes (0.14 % or one in 696 eyes) of seven patients had REL with or without epithelial defects. Frequent lubrication, BCL application, and ASP were needed for four eyes (50 %) in the management of REL, respectively. All patients remained free of symptoms after completion of ASP. REL following LASIK is uncommon. Follow-up of patients showed that BCL application and ASP were effective in the management of REL following LASIK.
Asunto(s)
Enfermedades de la Córnea/etiología , Enfermedades de la Córnea/cirugía , Sustancia Propia/cirugía , Epitelio Corneal/patología , Queratomileusis por Láser In Situ , Complicaciones Posoperatorias , Punciones , Adulto , Femenino , Humanos , Incidencia , Láseres de Excímeros , Láseres de Estado Sólido/uso terapéutico , Recurrencia , Estudios RetrospectivosRESUMEN
BACKGROUND AND OBJECTIVE: To evaluate an intracuring method by changing the corneal curvature. MATERIALS AND METHODS: An intrastromal tunnel was created by femtosecond laser in five cadaveric sheep eyes. Dental flowable restorative composite was used to fill the tunnel. A light-emitting diode light was applied for polymerization for 20 seconds. Flat plastic material was used for pressure on the cornea during polymerization. Keratometric measurements were obtained in all eyes using a rotating Scheimpflug camera. RESULTS: Remarkable changes on the corneal curvature were observed after the intracuring method. Inferior or inferonasal flattening and opposite steepening was observed in all sheep eyes. The average flattening effect of this method was 10.6 diopters. CONCLUSION: This new application may be a promising technique for the treatment of keratoconus. The application of this technique in humans could offer improved treatment options in the future.
Asunto(s)
Resinas Compuestas/uso terapéutico , Córnea , Queratocono/terapia , Polimetil Metacrilato/uso terapéutico , Prótesis e Implantes , Animales , Cadáver , Sustancia Propia , Topografía de la Córnea , Queratocono/patología , Implantación de Prótesis/métodos , OvinosRESUMEN
PURPOSE: To assess the efficacy and safety of holmium laser thermal keratoplasty (Ho:LTK) for hyperopia in eyes overcorrected after laser in situ keratomileusis (LASIK) for myopia. METHODS: We performed a prospective evaluation of Ho:LTK in eyes with secondary hyperopia from +1.00 to +5.50 D after LASIK. Thirty-seven eyes of 23 patients received one concentric 8-spot application at the 6-mm-diameter zone. Mean patient age was 41.3 +/- 13.0 years (range 20 to 68 yr). Mean corneal thickness was 455.86 +/- 31.20 microm (range 373 to 506 microm). RESULTS: Mean spherical equivalent refraction changed from +2.30 +/- 1.08 D to +0.45 +/- 1.00 D at 12 months after Ho:LTK. Thirty-one eyes (84%) were within +/- 1.00 D of emmetropia and 25 eyes (68%) were within +/- 0.50 D at 1 year. Mean change in refraction was 1.84 +/- 0.92 D. No eye lost 2 lines of best spectacle-corrected visual acuity. CONCLUSIONS: Ho:LTK is a suitable alternative for correcting secondary hyperopia resulting from LASIK for myopia. Parameter adjustments may be necessary for improving the results.