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  1. Lee MW
    Int Ophthalmol, 2024 Jul 24;44(1):334.
    PMID: 39046597 DOI: 10.1007/s10792-024-03247-x
    PURPOSE: To evaluate the clinical outcomes following bilateral implantation of the AcrySof™ IQ Vivity™ toric extended depth of focus (EDOF) intraocular lens (IOL).

    DESIGN: Prospective interventional case series.

    METHODS: Patients with bilateral significant cataracts and pre-existing corneal astigmatism underwent cataract surgery and implantation with the AcrySof™ IQ Vivity™ toric IOL. Dominant eyes were targeted at emmetropia and non-dominant eyes at -0.50D. Primary endpoints were binocular uncorrected distance (UDVA), intermediate (UIVA at 66 cm) and near (UNVA at 40 cm) acuities at 3 months. Secondary outcomes were corrected distance (CDVA), distance corrected intermediate (DCIVA) and distance corrected near (DCNVA), refractive predictability, rotational stability, binocular defocus curve, contrast sensitivity, Questionnaire for Visual Disturbances (QUVID) and Visual Function Index (VF-14) questionnaire scores. All visual acuities were converted to logarithm of minimum angle of resolution (logMAR) for analysis.

    RESULTS: 30 patients underwent uneventful phacoemulsification. The mean binocular UDVA, UIVA and UNVA were 0.06 ± 0.12, 0.11 ± 0.10 and 0.26 ± 0.10 respectively. The mean refractive spherical equivalent (MRSE) for dominant and non-dominant eyes were - 0.07D ± 0.27 and - 0.12D ± 0.54 respectively. 92.4% of dominant eyes and 84.6% of non-dominant eyes within 0.50D of target. The mean IOL rotation was 3.85° ± 5.09 with 86.7% of eyes with less than 5° of rotation. 26.7%, 20% and 36.7% of patients reported starbursts, haloes and glare respectively. The mean VF-14 score was 91.77.

    CONCLUSION: Bilateral implantation of the AcrySof™ IQ Vivity™ Toric IOL resulted in very good unaided visual acuities for far and intermediate distance with functional near vision. Dysphotopsias were reported but despite this, a high level of visual function was achieved.

  2. Lee MW, Lee YC
    PMID: 26107477 DOI: 10.1097/APO.0b013e318260f730
    PURPOSE: The objective of this study was to describe our initial experience with the newest refractive platform, the Wavelight Refractive Suite.

    DESIGN: This was a consecutive case series of first 50 eyes that underwent myopic laser in situ keratomileusis.

    METHODS: A total of 50 myopic eyes (28 patients) were included in this study. Uncorrected distance visual acuity, manifest refraction, and keratometry readings were taken preoperatively and 3 months postoperatively. Emmetropia was targeted with an optical zone of 6.5 mm, and flap dimensions were of 130-μm thickness and 9-mm diameter with a superior hinge in all eyes. Flap thickness was measured with optical coherence tomography postoperatively.

    RESULTS: At 3 months postoperatively, 82% (41/50) of eyes achieved uncorrected distance visual acuity of 6/6 or better, 98% (49/50) achieved 6/9 or better, and all eyes achieved 6/12 or better. Eighty-four percent of eyes were within 0.5 diopter (D) of target of emmetropia, and 98% of eyes were within 1 D. Mean postoperative flap thickness was 124 ± 7.8 μm.

    CONCLUSIONS: The Wavelight Refractive Suite consisting of the femtosecond laser FS200 and Excimer laser EX500 is the newest integrated refractive surgical platform available and can offer good refractive predictability as shown by the results in our initial 50 myopic eyes.

  3. Gan EH, Woo WW, Seng KF, Singh P, Lee MY, Kong VY, et al.
    Clin Ophthalmol, 2024;18:3249-3262.
    PMID: 39559252 DOI: 10.2147/OPTH.S476779
    BACKGROUND: Ocular surface disease (OSD) severity varies among glaucoma patients and is exacerbated by intraocular pressure (IOP)-lowering medications.

    PURPOSE: To determine OSD prevalence and dry eye severity among glaucoma patients at nine private clinics in Malaysia.

    METHODS: This multicentre, cross-sectional observational study recruited glaucoma patients undergoing routine eye examinations, with IOP ≤21mmHg receiving anti-glaucoma eye drops. OSD was assessed through National Eye Institute (NEI) scoring, tear film break-up time (TBUT), hyperaemia grading, Schirmer's tests and questionnaires on symptom evaluation, OSD index and quality of life (QoL).

    RESULTS: Our cohort (n = 406, mostly male, ethnically Chinese, mean 63.5 ± 11.5 years, mean IOP 15.34 ± 2.95mmHg) frequently used prostaglandin analogues or PGA/beta-blockers and had cornea total NEI scores of 3.64 ± 2.76, mostly with minimal (51.2%) or mild (40.4%) epitheliopathy. Mean TBUT was 6.59 ± 3.08s (25.0%) in patients with severe lipid deficiency dry eye (DE). Bulbar conjunctiva hyperemia (70.4%) and palpebral conjunctiva hyperemia (68.0%) were mild. Schirmer's test showed that most had tear deficiency (70.2%) with severe DE (38.9%). Questionnaires reported ocular symptoms in few patients, but 69.2% had DE symptoms (13.1% moderate/severe). While QoL was good, several patients had QoL and OSD index scores suggesting some adaptation to ocular symptoms and discomfort, with most patients being unconcerned (43-60%) by the occurrence of eye drop side effects (75.4%).

    CONCLUSION: Normal-mild DE or OSD can be asymptomatic, and the symptoms are unlikely to bother most patients. However, as OSD severity varies in patients with glaucoma, it should be evaluated using questionnaires and clinical tests to ensure that subjectively asymptomatic individuals are not missed.

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