To evaluate patient satisfaction after implantation of the Tecnis Symfony multifocal intraocular lens (MIOL).
Methods
120 eyes of 60 subjects with senile cataract were bilaterally implanted with the Tecnis Symfony IOL. Follow-up examination was performed 6 months postoperatively. Main outcome measures included uncorrected and corrected distance and near visual acuity, manifest refraction, and visual quality metrics. According to their subjective symptoms patient were divided in two groups: satisfied and unsatisfied.
Results
Uncorrected intermediate (0.15 ± 0.11 vs 0.18 ± 0.01, P = 0.04) and near (0.26 ± 0.12 vs 0.31 ± 0.11, P = 0.04) (UIVA, UNVA) log MAR visual acuity was significantly better, cylindrical error less (0.31 ± 0.36 vs 0.67 ± 0.29, P = 0.05), axial length (AL) smaller (23.68 ± 1.3 vs 24.22 ± 1.6, P = 0.05), Strehl ratio higher (0.08 ± 0.08 vs 0.05 ± 0.04, P = 0.03) and mesopic pupil larger (4.3 ± 1.1 vs 3.7 ± 1.05, P = 0.01) among satisfied patients.Residual cylinder, Strehl ratio, halos, mesopic pupil diameter and UNVA were significant predictors of patient satisfaction. Uncorrected distance visual acuity, higher order Strehl ratio and pupil diameter were significant predictors of halos. Near visual acuity significantly correlated (P = 0.018, R = 0.22) with axial length.
Conclusions
Uncorrected cylindrical error, poor reading quality, larger pupil and halos seem to be the most disturbing factors for patients implanted with the Tecnis Symfony IOL.
It is possible that preservative-free eye drops can be contaminated. The aim of this study was to assess the incidence of microbial contamination of preservative-free hospital-prepared anti-infective eye drops and investigate factors that contribute to contamination. This finding may help to raise awareness of this problem to medical healthcare staff and patients in order to prevent the transmission of microorganisms from eye drops to the patients through treatment of pre-existing eye diseases.
Methods
Two hundred and ninety-five eye drop bottles were collected from patients attending Rajavithi Hospital Ophthalmologic outpatient and inpatient department, including both those used by patients at home and those administered in the hospital by medical staff. Samples were taken from the tips of droppers and bottles, and the residual fluid inside the bottles was then cultivated onto different culture plates. The culture results were identified and analyzed according to various factors related to both individual users and the bottles.
Results
Seven different types of eye drops were collected and 71 (24.06%) of the 295 bottles were contaminated. Vancomycin eye drops were the most contaminated. Twenty-six different types of pathogens were identified, most frequently mold (42.98%), and the amount of contamination was higher in tips than in residual fluid inside the bottle. There was no statistically significant difference in contamination between patients used eye drops collected in outpatient units (32.14%) and medical staff used eye drops collected in inpatient settings (23.22%). The only factor that was statistically significant was the number of eye drops used per person. We found that samples from patients who used only up to 2 eye drops suffered contamination (42.8%) more than those from their counterparts who used at least 3 (22.18%), P = 0.02.
Conclusions
Of these preservative-free hospital preparations anti-infective eye drops, 24.06% were contaminated. The number of eye drops used per person was statistically significant in triggering contamination. There is a possibility of number of eyedrops use person may trigger contamination.
To compare the complications of femtosecond laser-assisted cataract surgery (FLACS) with those of conventional phacoemulsification surgery (CPS) for age-related cataracts.
Methods
PubMed, Cochrane Library, and EMBASE were systematically searched for studies comparing FLACS and CPS. Outcomes were operative complications, including the intraoperative capsule tear, postoperative corneal edema, macular edema, uncontrolled IOP, etc. The effect measures were weighted with odds ratios with 95% CIs.
Results
Nineteen RCTs and 18 cohort studies, including 24,806 eyes (11,375 of the FLACS group and 13,431 of the CPS group), were identified. There were no significant differences between the two groups in anterior capsule tear, corneal edema, macular edema, uncontrolled IOP, vitreous loss, posterior vitreous detachment, etc. Posterior capsule tear rate showed a significantly lower in RCT subgroups (P = 0.04) and without differences in total (P = 0.63). Significant differences were observed in the incidence of descemet membrane tear/trauma (P = 0.02) and IFIS/iris trauma (P = 0.04. Additionally, The FLACS specific complications showed a significantly higher rate of miosis (P < 0.0001), corneal epithelial defect (P = 0.001), corneal haze (P = 0.002), and subconjunctival hemorrhage (P = 0.01).
Conclusions
FLACS maintains the same safety compared with CPS in terms of all intraoperative and postoperative complications. Although FLACS did show a statistically significant difference for several FLACS specific complications, it would not influence the visual outcome and heal itself.
Normal tension glaucoma (NTG) is a multifactorial disease in the pathogenesis of which intraocular pressure (IOP)-independent factors play a key role.
Main text
There is considerable evidence that impairment of the ocular blood flow (OBF) is involved both in the onset and progression of this disease. With the development of the hypothesis of OBF in NTG, various imaging techniques have been developed to evaluate the OBF and blood vessels. Moreover, vascular dysregulation, which is a main factor in Flammer syndrome, was frequently observed in NTG patients. Disturbed OBF leads to increased oxidative stress, which plays an important role in the pathogenesis of glaucomatous optic neuropathy. These results suggested that IOP-independent management may provide alternative treatment options for NTG patients.
Conclusions
In this review, we mainly focus on the mechanisms of the abnormal OBF in NTG.
Presbyopia has become a global disease affecting the world's aging population. Among various treatments, cataract extraction and intraocular lens (IOL) implantation have become the most popular and common methods of presbyopia correction. During the twentieth century, IOLs have underwent significant innovation and advancements to meet the patients' high demands for functional vision at all distances.
Main Text
To meet the increasing needs for excellent near and intermediate vision for daily activities, some premium IOLs with more than one focus have been developed, for example, the refractive MfIOLs, diffractive MfIOLs, extended depth of field (EDOF) IOLs, and accommodating IOLs (AIOLs) were introduced to meet this need. In addition, the add-on MfIOLs have been explored as promising supplementary IOLs for pseudophakic presbyopia. When selecting the MfIOLs, the IOLs' features, patients’ characteristics, preoperative eye conditions, and treatment expectations should be considered.
Conclusions
In this review, we focus on the multifocal IOLs (MfIOLs) commonly used for presbyopia correction and systematically summarized their optical designs and clinical outcomes. More evidence-based studies are required to provide guidelines for MfIOL selection, provide maximum visual benefits, and develop personalized visual solutions in the future.
关键词:Presbyopia;Intraocular lens;Monofocal intraocular lens;Multifocal intraocular lens;Extended depth of field intraocular lens;Accommodating intraocular lens;Clinical outcomes