RESUMEN
The aim of this study was to calculate the level of improvement of visual acuity comparing the best corrected visual acuity (VA) achieved with spectacles with the best corrected VA achieved with rigid gas permeable (RGP) contact lenses in patients with high, simple or compound corneal astigmatism (myopic, hypermetropic and mixed). The investigation of patients included auto-kerato-refractometry, manual keratometry, corneal topography and visual acuity with Snellen chart. The best corrected VA obtained with spectacles was compared with the best corrected VA obtained with RGP contact lenses in 72 patients (116 eyes). All patients showed a significant improvement in visual acuity with RGP lenses from one to seven lines compared to spectacles (p = 0.0001). Level of improvement in VA represented as the number of lines obtained was as follows: 74 percent of patients got two to four lines more in VA with RGP lenses compared to spectacles, and almost 10 percent of patients got five to seven lines. RGP contact lenses provide a significant improvement in VA compared to VA reached with spectacles in patients with high corneal astigmatism. The benefit in VA with RGP lenses is higher as the astigmatism is higher.
Asunto(s)
Astigmatismo/diagnóstico , Lentes de Contacto , Anteojos , Agudeza Visual , Adolescente , Adulto , Niño , Preescolar , Córnea , Topografía de la Córnea , Femenino , Humanos , Masculino , Persona de Mediana Edad , Miopía , Refractometría , Visión Ocular , Adulto JovenRESUMEN
BACKGROUND: Open globe injuries are the most serious eye injuries in war as in peace time. The purpose of this study is to analyze wartime open globe eye injuries in 72 patients treated at the Department of Ophthalmology, Clinical Hospital of Split from July 1991 to April 1993, during the intensive war in Croatia and Bosnia and Herzegovina, and to evaluate crucial factors responsible for the functional success of the treatment. METHODS: Wartime open globe eye injuries were retrospectively analyzed in 72 patients (80 eyes) hospitalized at Clinical Hospital of Split, Department of Ophthalmology, between July 1991 and April 1993. The causes and ways of wounding, localization of wounds and presence, nature and localization of the foreign body, as well as admission time, microsurgical management and other factors contributing to poor visual outcome were studied. Standard international classification of ocular traumas (the Birmingham Eye Trauma Terminology and the International Ocular Trauma Classification) was used for the classified and graded injuries. RESULTS: Open globe eye injuries amounted to 52.65% of all war injuries to the eyes. Bilateral injuries were found in eight patients (11.11%). The most frequent cause of the injures were fragments of explosive devices (more than two-thirds). Most of the patients were admitted to the hospital within 24 hours of the injury. Using current microsurgical techniques, the attempt was made to achieve not only anatomical but also functional recovery already in the primary treatment. In 30 eyes (37.50%) final visual acuity amounted to more than 0.1, and in 22 eyes (27.50%) it reached 0.5. There was a statistically significant correlation between admission within the first 12 hours and postoperative improved visual acuity (chi(2) = 4.53; p = 0.033). Statistically significantly better visual acuity was found in patients with lesions limited to the anterior segment of the eye. Primary enucleation or evisceration was performed only exceptionally: one enucleation and six eviscerations (8.75%). CONCLUSION: The most important factors in the prognosis of postoperational visual acuity for wartime open globe eye injuries were: (1) preoperative condition of the eye, (2) localization and extent of the wound, (3) presence, size and nature of foreign bodies, and (4) adequate surgical treatment in specialized institutions.