RESUMO
PURPOSE: To assess the outcome of simultaneous implantable contact lens (ICL) removal and cataract extraction with pseudophakic intraocular lens (IOL) implantation. SETTING: CODET Aris Vision Institute, Tijuana, Mexico. METHODS: This retrospective noncomparative interventional case series evaluated 14 eyes of 12 patients with ICL implantations who developed a cataract and simultaneously had ICL removal and cataract extraction with IOL implantation. The follow-up time was at least 6 months (range 6 to 24 months). Visual acuity (logMAR), manifest refraction, intraocular pressure, and adverse events were recorded. RESULTS: Of the 12 patients (14 eyes), 10 patients (12 eyes) had ICL surgery to correct high myopia and 2 patients (2 eyes), to correct hyperopia. The mean uncorrected visual acuity after ICL implantation (before cataract development), before cataract surgery, and after cataract surgery were 0.48 +/- 0.32, 0.83 +/- 0.34, and 0.40 +/- 0.27, respectively. The mean best corrected visual acuity (BCVA) before ICL implantation, after ICL implantation, and after cataract surgery were 0.31 +/- 0.21, 0.28 +/- 0.19, and 0.27 +/- 0.21, respectively. The mean final manifest spherical equivalent was 0.30 diopters (D) +/- 1.07 (SD) (range +2.38 to 2.0 D). Ten eyes (71.4%) were within +/-1.0 D of the calculated target. One eye had a tear in the posterior capsule with vitreous loss during cataract surgery. No other intraoperative, perioperative, or postoperative complications were observed. No loss of BCVA was recorded at the last postoperative visit. CONCLUSIONS: Lens opacities and cataract formation are a potential complication of ICL surgery. The removal of the ICL and the cataract with IOL implantation was found to be safe, with predictable refractive results.
Assuntos
Catarata/etiologia , Lentes de Contato/efeitos adversos , Remoção de Dispositivo , Implante de Lente Intraocular , Facoemulsificação , Implantação de Prótese/efeitos adversos , Adulto , Humanos , Hiperopia/cirurgia , Pressão Intraocular , Pessoa de Meia-Idade , Miopia/cirurgia , Pseudofacia/etiologia , Estudos Retrospectivos , Resultado do Tratamento , Acuidade VisualRESUMO
PURPOSE: To evaluate the changes in ocular aberrations induced by corneal flap creation. DESIGN: Prospective interventional nonrandomized clinical trial. METHODS: This study included 15 patients who were scheduled for laser in situ keratomileusis. A nasal hinge flap was created, using the Nidek MK-2000 microkeratome and then replaced without performing laser ablation. The ocular aberrations were measured before and after flap creation using the Nidek Optical Path Difference Scanning System ARK-10000. RESULTS: The root mean square wavefront errors of the higher-order optical aberrations (third-, fourth-, fifth-, and sixth-order aberrations) were not significantly altered at 1 week postsurgery compared with the preoperative values (P >.35). CONCLUSIONS: Creating a corneal flap with the Nidek MK-2000 microkeratome did not induce changes in higher-order optical aberrations as measured with the Nidek Optical Path Difference Scanning System ARK-10000 during the early postoperative period.
Assuntos
Substância Própria/cirurgia , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Miopia/cirurgia , Complicações Pós-Operatórias , Retalhos Cirúrgicos , Adulto , Topografia da Córnea , Humanos , Estudos Prospectivos , Refração Ocular , Erros de Refração/etiologia , Retalhos Cirúrgicos/efeitos adversos , Transtornos da Visão/etiologiaRESUMO
PURPOSE: To describe a case series to determine the incidence of lens opacities after posterior chamber phakic intraocular lens (IOL) implantation (STAAR Surgical, Monrovia, CA) for very high ametropias. DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: Fourteen eyes of 170 consecutive eyes with high ametropias in whom lens opacities developed after posterior chamber phakic IOL implant (PCPIOL). INTERVENTION: Posterior chamber phakic intraocular lens implant. MAIN OUTCOME MEASURES: Lens opacity appearance, localization, and clinical course. RESULTS: Fourteen eyes developed lens opacities 125 +/- 116 days after phakic IOL implant. All eyes had anterior subcapsular opacities, and two eyes also developed nuclear sclerosis. The anterior opacities did not extend posteriorly within the lens, and there were no posterior subcapsular cataracts. Seventy-one percent of opacities were first seen
Assuntos
Catarata/etiologia , Implante de Lente Intraocular/efeitos adversos , Cristalino/patologia , Complicações Pós-Operatórias , Adulto , Catarata/epidemiologia , Progressão da Doença , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Esclerose , Acuidade VisualRESUMO
PURPOSE: To compare the early postoperative visual rehabilitation after laser-assisted subepithelial keratectomy (LASEK) and photorefractive keratectomy (PRK) for the correction of myopia. SETTING: CODET Aris Vision Institute, Tijuana, Mexico. METHODS: This prospective study included 50 eyes of 25 patients with myopia who received LASEK in 1 eye and PRK in the contralateral eye. Excimer laser corneal ablation was done using the Nidek EC-5000 excimer laser. Patients were seen at 1 and 3 days, 1 week, and 1 month. Discomfort, subjective uncorrected visual acuity (UCVA), objective UCVA, best corrected visual acuity (BCVA), corneal clarity (haze), and time for corneal reepithelialization were analyzed. RESULTS: Seventy-two percent and 80% of the LASEK eyes had more discomfort at 1 day and 3 days, respectively. Eighty percent and 96% of the PRK eyes had better subjective UCVA at 1 day and 3 days, respectively. Corneas were fully reepithelialized at a mean of 3.3 days +/- 0.5 (SD) and 3.6 +/- 0.5 days in the PRK and LASEK groups, respectively. At 1 month, the UCVA was similar in both groups; no eye had lost lines of BCVA or developed haze. CONCLUSIONS: Both LASEK and PRK were effective and safe procedures in the surgical correction of myopia at the 1-month postoperative visit. Patients reported less discomfort and better visual acuity in their PRK eye during the early postoperative period. Patients should be informed that LASEK, whose acronym is similar to that of laser in situ keratomileusis, has a recovery speed that is similar to that of surface laser refractive procedures such as PRK.
Assuntos
Ceratomileuse Assistida por Excimer Laser In Situ , Miopia/cirurgia , Ceratectomia Fotorrefrativa , Adulto , Epitélio Corneano/fisiopatologia , Feminino , Humanos , Ceratomileuse Assistida por Excimer Laser In Situ/efeitos adversos , Lasers de Excimer , Masculino , Ceratectomia Fotorrefrativa/efeitos adversos , Período Pós-Operatório , Estudos Prospectivos , Fatores de Tempo , Acuidade Visual , CicatrizaçãoRESUMO
La endotropía acomodativa (ETA) no refractiva asociada a una relación de convergencia acomodativa sobre acomodación (CA/A) alta tradicionalmente ha sido tratada con bifocales y/o mióticos tópicos inhibidores de la acetilcolinesterasa, aunque el resultado del tratamiento a largo plazo con éstos ha sido desilusionante. El tratamiento quirúrgico de retroinserción bimedial es controversial y más aún cuánta cirugía debe realizarse para corregir el estrabismo tanto de lejos como de cerca. Se realizó un estudio a 14 pacientes con endotropía acomodativa y CA/A alta que fueron sometidos a una retroinserción bimedial en forma dinámica. Se evaluaron los resultados de lejos, de cerca y CA/A postoperatorio, para lejos, 12 pacientes obtuvieron una buena alineación ocular y los 2 restantes no modificaron su ortoposición. Para cerca 12 pacientes lograron una ET residual < 10 dp y 2 casos una ET residual cosméticamente aceptable de 10 a 20 dp. No se observaron sobrecorrecciones. El índice de CA/A postoperatorio disminuyó en todos los casos. Los resultados obtenidos no se modificaron durante el seguimiento y los pacientes que alcanzaron una ET residual < 10 dp suspendieron el uso de bifocales.