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Purpose: To compare the clinical outcomes of transscleral fixation of a posterior chamber intraocular lens (PC IOL) in the ciliary sulcus or pars plana. Setting: Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea. Design: Comparative case series. Methods: This retrospective chart review comprised eyes having ciliary sulcus or pars plana fixation of a 3-piece foldable acrylic PC IOL between January 2003 and August 2010. The postoperative corrected distance visual acuity (CDVA), efficacy index, safety index, endothelial cell count (ECC), and complication rates in the 2 groups were compared. Results: The ciliary sulcus group comprised 38 eyes and the pars plana group, 56 eyes. There was no significant between-group difference in the postoperative CDVA, efficacy index, safety index, or ECC. The mean spherical equivalent difference was larger in the ciliary sulcus group. Intraocular lens dislocation and pupillary capture of the IOL optic occurred more frequently in the ciliary sulcus group (P=.001 and P=.041, respectively). However, retinal detachment, IOL decentration or tilt, cystoid macular edema, secondary glaucoma, and vitreous hemorrhage did not differ significantly between the 2 groups. Conclusion: The pars plana location for PC IOL transscleral fixation was as safe and effective as the ciliary sulcus location. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. [Copyright &y& Elsevier]

Purpose: To evaluate the clinical outcomes of contact lens fitting in eyes with keratectasia after laser in situ keratomileusis (LASIK) to optimize the performance of the contact lenses.Setting: Contact Lens Clinic, Seoul National University Hospital, Seoul, Korea.Methods: Six eyes of 4 patients with keratectasia were examined. Keratectasia was diagnosed based on abnormal topographic findings, progressive myopic changes, and uncorrected visual acuity with glasses. A multicurve lens or reverse-geometry lens (RGL) was selected based on the anterior elevation map. The base curve radius and peripheral parameters were determined based on the axial map and the evaluation of the fluorescein pattern of the lens. The contact lens fitting characteristics and visual acuity were evaluated. Patients were interviewed about their level of comfort, daily contact lens wear time, and glare.Results: Multicurve lenses and RGLs were fitted in 4 eyes and 2 eyes, respectively. The base curve radius of the multicurve lenses ranged from 7.2 to 7.5 mm; the alignment curve radius of RGLs was 7.6 mm in both cases. The radii of peripheral curves were customized to enhance tear interchange. Visual acuity improved to 20/30 or better in all eyes. All patients were completely satisfied with the comfort of the fitting. The mean daily wearing time was 12.7 hours. One patient reported tolerable glare in the eye after being fitted with an RGL.Conclusion: Proper contact lens fitting based on topographic data and slitlamp evaluation allowed good visual rehabilitation and comfortable extended daily wear in patients with keratectasia after LASIK. [Copyright &y& Elsevier]

Purpose: To investigate the effect of secondary intraocular lens (IOL) implantation on binocular vision in patients with unilateral aphakia uncorrected consecutively for 3 years or more., Methods: This study included nine patients who underwent secondary IOL implantation, but had remained in a unilateral aphakic state, without being corrected, for at least 3 consecutive years at the time of the secondary IOL implant. They also had a postoperative best-corrected visual acuity of better than 20/40 in both eyes. All patients underwent an ophthalmologic examination including best spectacle-corrected visual acuity and binocular alignment. Stereoacuity was evaluated using the Titmus Stereotest and a stereoacuity of 100 sec of arc or better was designated as "good" stereoacuity. Binocularity was determined using the polarized 4-dot test at distance and at near and the reporting of 4 dots were used to establish fusional ability., Results: Four of the nine patients (44.4%) showed the highest stereoacuity of 40 sec of arc and another four patients (44.4%) showed a stereoacuity of 50 or 60 sec of arc. Only one patient showed "poor" stereoacuity of 200 sec of arc. All the patients could fuse at near and at distance on the polarized 4-dot test. Diplopia and anomalous eye movements were not found in any patient., Conclusions: Secondary IOL implantation can provide good binocular vision even in patients with unilateral aphakia who had not been corrected for 3 years or more.