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PURPOSE: To assess the effect of residual sphere on vision and satisfaction in pseudophakic patients. SETTING: Private clinics, United Kingdom. DESIGN: Retrospective case series. METHODS: A multivariate model evaluated the effect of 1-month residual sphere on outcomes of pseudophakic patients. Odds ratios (ORs) were calculated to assess the relative risk of not achieving ≥20/20 monocular uncorrected distance visual acuity (UDVA), ≥20/50 uncorrected near visual acuity (UNVA), and not being satisfied with vision. ORs were assessed for residual sphere -1.00 to +1.00 diopter (D) in quarter-diopter steps, using 0.00 D as a reference. RESULTS: The analysis included 38 828 multifocal and 11 571 monofocal intraocular lenses (IOLs). The residual myopic sphere ≤-0.25 D and hyperopic sphere ≥+0.50 D had a clinically meaningful effect on UDVA. Although monofocal IOLs had an improvement in UNVA with every additional 0.25 D of myopia, the change in ORs with increasing myopia was not significant for multifocal IOLs. The mean improvement in UNVA comparing eyes with 0.00 D and -1.00 D sphere was 0.26 logMAR for monofocal and 0.03 logMAR for multifocal IOLs. Low near-addition IOLs had a slightly higher gain in UNVA with increasing myopia, but the gain was not as substantial as with monofocal IOLs. The effect of ametropia on satisfaction was more pronounced for multifocal IOLs. For every 0.25 D of residual myopia, there was >25% increase in dissatisfied patients. CONCLUSIONS: Although myopia improved UNVA in eyes with monofocal IOL, multifocal IOLs did not benefit from residual myopia. Multifocal IOL patients desiring distance vision should be targeted closest to emmetropia, even if it means targeting slight hyperopia.

PURPOSE: To assess the accuracy of intraoperative wavefront aberrometry (IWA) versus modern intraocular lens formulas in post-myopic laser vision correction (LVC) patients undergoing cataract surgery with capsular tension ring placement. METHODS: This is a retrospective chart review conducted at an academic outpatient center. All post-myopic LVC eyes undergoing cataract surgery with IWA from a single surgeon from 05/2017 to 12/2019 were included. All patients received a capsular tension ring (CTR). Mean numerical error (MNE), median numerical error (MedNE), and percentages of prediction error within 0.50D, 0.75D, and 1.00D were calculated for the above formulas. RESULTS: Twenty-seven post-myopic LVC eyes from 18 patients were included. In post-myopic LVC, MNE with Optiwave Refractive Analysis (ORA), Barrett True K (BTK), Haigis, Haigis-L, Shammas, SRK/T, Hill-RBF v3.0, and W-K AL-adjusted Holladay 1 were + 0.224, - 0.094, + 0.193, - 0.231, - 0.372, + 1.013, + 0.860, and + 0.630 (F = 8.49, p

A 78-year-old woman with an ocular history of cataract surgery with a diffractive intraocular lens (IOL) in each eye has developed fluctuating vision, greater in the right eye than the left eye, after 4 years. She has a history of inactive central serous retinopathy and a vision potential of 20/25 + 2 in the right eye and 20/25 in the left eye. She has well-controlled diabetes, hypertension, and hypercholesterolemia. She has enjoyed her spectacle independence for some time and wishes to have her vision restored. On examination, her uncorrected distance visual acuity (UDVA) was 20/50 in the right eye and 20/25 in the left eye and her uncorrected near visual acuity (UNVA) was J3 in the right eye and J1 in the left eye. Intraocular pressures (IOPs) measured 22 mm Hg in the right eye and 18 mm Hg in the left eye. Pupils had limited reactivity with irregularity in the right eye but no obvious relative afferent pupillary defect. Motility and confrontation visual fields were unremarkable in both eyes. Retinal acuity meter was 20/20 in both eyes, and manifest refraction was plano -1.25 × 105 20/40, J3 in the right eye and +0.50 × 20/25, J1 in the left eye. Pertinent findings on slitlamp examination included temporal iris atrophy and transillumination defects greater in the right eye than the left eye, peripupillary pseudoexfoliative changes in both eyes, significant inferior subluxation of a diffractive 3-piece posterior chamber IOL in the capsular bag with lens-pitting peripherally and few central, moderate pseudophacodonesis, and an open posterior capsule in the right eye. In the left eye, she had mild inferior subluxation of a single-piece acrylic diffractive IOL in the capsular bag with moderate pseudophacodonesis and an open posterior capsule (Figure 1JOURNAL/jcrs/04.03/02158034-202403000-00019/figure1/v/2024-02-20T193212Z/r/image-tiff). All other anterior segment findings were unremarkable. On dilated posterior examination, she had a cup-to-disc ratio of 0.50 in the right eye and 0.65 in the left eye without edema hemorrhage or pallor. There were attenuated vessels in both eyes, posterior vitreous detachment in both eyes, and a few small drusen peripherally in both eyes. There was retinal pigment epithelium irregularity and dropout parafoveal in the right eye and subfoveal in the left eye (Figure 2). There was no evidence of macular edema, subretinal fluid, choroidal thickening, or neovascular membranes. The periphery was unremarkable in both eyes.JOURNAL/jcrs/04.03/02158034-202403000-00019/figure2/v/2024-02-20T193212Z/r/image-tiff What testing would you obtain preoperatively to help guide your decision-making? How would you counsel the patient regarding comorbid conditions and expectations?

Kepa Balparda,1– 3 Mariana Escobar Giraldo,4 Yeliana M Valencia Gómez,5 Isabela Franco Sánchez,6 Tatiana Herrera Chalarca2 1Department of Cornea and Refractive Surgery, Clínica de Oftalmología Sandiego, Medellín, Colombia; 2Department of Clinical Research, Black Mammoth Surgical, Medellín, Colombia; 3Private Practice, Medellín, Colombia; 4Department of Ophthalmology, Universidad Pontificia Bolivariana, Medellín, Colombia; 5Department of Ophthalmology, Pontificia Universidad Javeriana, Cali, Colombia; 6School of Medicine, Universidad Pontificia Bolivariana, Medellín, ColombiaCorrespondence: Kepa Balparda, Email kb@kepabalparda.comPurpose: To determine clinical and refractive results after the implantation of EyeCryl Phakic Toric intraocular lens in patients with stable keratoconus.Methods: The study included all patients diagnosed with keratoconus who underwent implantation of an EyeCryl Phakic Toric intraocular lens (Biotech Healthcare Holding; Ahmedabad, India) in at least one eye and had a follow-up of at least 12 months. Visual and refractive data were collected for all patients, along with corneal tomography measurements using Pentacam, and vault measurement using optical coherence tomography. This retrospective study was conducted at a high-volume private refractive surgery center in Medellín, Colombia.Results: A total of 83 eyes from 47 patients were included in the study. The majority (71.1%) were female, with a mean age of 31.2 ± 5.1 years. After 12 months of follow-up post-surgery, the spherical equivalent improved significantly from – 8.19 ± 4.04 D to – 0.06 ± 0.48 D (p < 0.001). Furthermore, 77% of eyes had a post-surgical spherical equivalent within ± 0.50 D, while 92% had residual astigmatism ≤ 0.50 D. Twelve months after surgery, mean manifest astigmatism was – 0.28 ± 0.27 D. Uncorrected visual acuity also showed improvement, from 1.11 ± 0.35 LogMAR to 0.14 ± 0.11 LogMAR. Moreover, 52.4% of eyes demonstrated an improvement of at least one line in best-corrected visual acuity. Notably, no intraoperative or postoperative complications were observed in the study population.Conclusion: The implantation of EyeCryl Phakic Toric intraocular lenses represents a highly effective and safe option for correcting refractive errors in patients with a history of keratoconus. Refractive accuracy is excellent, and a significant proportion of patients experienced an improvement in their best-corrected vision by at least one line.Keywords: keratoconus, lens implantation, intraocular, refractive error

Despite significant advancements in ocular drug delivery, challenges persist in treating posterior segment diseases like macular edema (ME) and age-related macular degeneration (AMD). Suprachoroidal (SC) injections are a promising new method for targeted drug delivery to the posterior segment of the eye, providing direct access to the choroid and retina while minimizing systemic exposure and side effects. This review examines the anatomical and physiological foundations of the SC space; evaluates delivery devices such as microcatheters, hypodermic needles, and microneedles; and discusses pharmacokinetic principles. Additionally, advancements in gene delivery through SC injections are explored, emphasizing their potential to transform ocular disease management. This review also highlights clinical applications in treating macular edema, diabetic macular edema, age-related macular degeneration, choroidal melanoma, and glaucoma. Overall, SC injections are emerging as a promising novel route for administering ophthalmic treatments, with high bioavailability, reduced systemic exposure, and favorable safety profiles. Key therapeutic agents such as triamcinolone acetonide, dexamethasone, AAV-based gene therapy, and axitinib have shown promise. The field of suprachoroidal injection is progressing rapidly, and this review article, while attempting to encapsulate most of the published preclinical and clinical studies, mainly focuses on those that are published within 2023 and 2024. [ABSTRACT FROM AUTHOR]

The travoprost intracameral implant was recently approved by the US Food and Drug Administration for sustained release medical treatment of open-angle glaucoma in the USA. The approval represents a substantial and progressive step forward in the area of sustained-release glaucoma therapy. Topical intraocular pressure-lowering medications for the treatment of glaucoma are faced with a host of challenges for long-term and usually lifelong care. A changing paradigm in glaucoma management involves first-line interventions with laser modalities, micro-invasive surgeries, and sustained-release treatment platforms. Future needs in the area of sustained-release therapy include a non-prostaglandin drug delivery platform and longer-term treatments that do not require surgical reintervention. [ABSTRACT FROM AUTHOR]

Retinal ischemia-reperfusion (I/R) is a pathological phenomenon that causes cellular destruction in several ocular disorders, so there is a need for novel possible neuroprotective drugs. Researchers have reported numerous neuroprotective effects of Germacrone (GM). Therefore, this study aimed to elucidate the underlying processes of GM that may contribute to glaucoma development. 40 healthy rats underwent retinal ischemia-reperfusion (I/R) damage. The animals were divided into control, I/R-induced, GM-1d, and GM-7d. After 7 days of I/R, mice were sacrificed and retinal tissue removed. An enzyme-linked immunosorbent assay (ELISA) was used to assess retinal Malondialdehyde (MDA) and 8-OHdG levels after oxidative injury. The Fluro-Gold (FG) labelling assay counted retinal ganglion cells (RGC) before and after labelling. DNA from retinal tissue RNA was amplified. Western blotting and real-time qRT-PCR were utilised to assess Bax, Casapses-3, Bcl-2, retinal NF-kB, and COX-2 expression. Retinal cell apoptotic mediator expression was measured by a TUNEL assay. Retinal I/R damage increases ganglion cell death. Long-term GM treatment (GM-7d) reduced NF-κB activation and raised COX-2 expression, which suggests antioxidant potential. TUNEL-positive apoptotic cells were reduced in long-term GM-treated rats. In GM-treated retinas, the Bax-Bcl-2 ratio was identical to the control group and significantly different from the I/R group. GM reduces I/R-induced retinal cell damage by inhibiting RG cell death. Seven days after GM therapy, histology showed retinal tissue loss. NF-κB signaling and intrinsic mitochondrial apoptosis are possible mechanisms that may be attenuated by GM and are attributed to a retinal protective effect. [ABSTRACT FROM AUTHOR]

Abstract The travoprost intracameral implant was recently approved by the US Food and Drug Administration for sustained release medical treatment of open-angle glaucoma in the USA. The approval represents a substantial and progressive step forward in the area of sustained-release glaucoma therapy. Topical intraocular pressure-lowering medications for the treatment of glaucoma are faced with a host of challenges for long-term and usually lifelong care. A changing paradigm in glaucoma management involves first-line interventions with laser modalities, micro-invasive surgeries, and sustained-release treatment platforms. Future needs in the area of sustained-release therapy include a non-prostaglandin drug delivery platform and longer-term treatments that do not require surgical reintervention.

Introduction: cataract is the most common eye condition worldwide and is considered a cause of decreased visual acuity that can be remedied through a relatively easy and safe surgical intervention. Phacoemulsification is the preferred surgical technique among Anterior Segment Ophthalmic Surgery Specialists worldwide. Objective: to find a viable option to perform cataract surgery using the phacoemulsification technique in the absence of foldable intraocular lenses and to evaluate the induction of astigmatism after this variation. Methods: a quasi-experimental study was carried out, with before/after evaluation, in a group of patients who underwent phacoemulsification and intraocular lens implantation of a polymethylmethacrylate intraocular lens at the Ophthalmological Center of the "Arnaldo Milián Castro" Hospital. Results: the average age of the patients was 62.88 (±8.93) years, with a range between 45 and 76 years of age, 12 of the 23 patients (52.17%) belonged to the female sex and 11 (47.83%) to the male. The time required for the proposed variations and the steps added to the standard phacoemulsification technique to place an intraocular lens do not represent a substantial increase over it of about 20 minutes on average. Conclusions: this option can be used when only rigid polymethylmethacrylate intraocular lenses are available. It is recommended for situations in which the insertion of a folding lens through opercula in the posterior capsule is not recommended. [ABSTRACT FROM AUTHOR]

This narrative review aimed to have an algorithmic approach to microphthalmos by a systematic search. The definition can be related to a number of special phenotypes. In the more challenging cases of complex microphthalmos, relative anterior microphthalmos, and nanophthalmos, the surgeon can approach these cases more safely if they have a deep understanding of the anatomical variations and ideal formulae for intraocular lens computation and knows how to avoid intra- and post-operative complications. In this article, we review the criteria by which we recognize and describe pre-, intra-, and post-operative considerations, as well as discuss the ideal intraocular lenses for microphthalmos, given the intricate varieties of small eye phenotypes.

One of the first prophylaxis applications in the field of eye diseases was made by Dr. Crede in 1880. Dr Crede, an obstetrician and gynecologist, has used 2% silver nitrate in newborns against Neisseria gonorrhoea neonatal conjunctivitis. In surgery, wounds are divided into 4 groups: Clean: Surgical wounds Clean-contaminated: GIS, Urinary System, respiratory system surgical wounds Contaminated: Fresh trauma wounds Dirty: Late trauma wounds, presence of dead tissue, foreign body in the wound area Guidelines recommend antibiotic prophylaxis for clean and contaminated wounds. In case of implant placement, prophylaxis is also recommended for clean wounds. However, most of these approaches are in the form of antibiotic prophylaxis, which starts perioperatively and continues in the postoperative period.

Background: Canine transmissible venereal (TVT) is a transplantable tumor usually transmitted to genital organs during coitus. Tumor cell inoculation is also possible in extragenital sites via licking or sniffing of the vaginal or preputial discharge. Metastases occur predominantly in males involving mainly the regional lymph nodes. On rare occasions, TVT metastases may affect kidney, spleen, tonsils, pancreas, lung, eye, brain, pituitary gland and musculature. Primary ocular involvement of TVT is not commonly reported in dogs, with few cases cited in the literature. The purpose of this study is to describe the ocular manifestations, histological features and immunohistochemical analysis in a canine intraocular TVT. Case: A 8-year-old male dog of mixed breed weighing 14.3 kg, was presented because red protrusion from both eyes. After of clinical examination, the dog was submitted to bilateral enucleation. In the histopathological examination was observed tumor cells uniformly round, arranged in solid sheets by delicate connective-tissue stroma. The cells have centrally located round nuclei that contain 1 or 2 prominent nucleolus. The cytoplasm was scant, sometimes contain brown pigment. Immunohistochemical staining with commercially available antibodies such as lysozyme, CD3, CD45R, PAX5 and PNL2 was performed to obtain a more accurate diagnosis. Immunohistochemical staining revealed strong cytoplasmic reactivity to lysozyme in about 90% cells. Weak cytoplasmic immunoreactivity of CD45R was detected in 80-90% of cells and negative immunoreactivity was observed in the CD3, PAX-5, PNL2 antibodies. Discussion: The use of imunohistochemical markers excluded other types of round cell tumors, such as lymphomas, melanomas, amelanotic melanomas, poorly differentiated carcinomas and mast cell tumors. However, some authors described similar immunostaining in histiocitomas, but the specific staining for Lysozyme, histopathological analisys and immunohistochemical evaluation was fundamental for this diagnosis. As a differential diagnosis for ophthalmic lesions, there are malignant and benign and non-neoplastic neoplastic processes. As malignant neoplasms of intraocular location, there are melanomas, poorly differentiated carcinomas, mast cell tumors. In the case of benign variants, adenomas are highlighted. Round cell neoplasms are also important differential diagnoses, including mast cell tumor, histiocioma, and lymphoma. Non-neoplastic processes, such as granulomatous lesions caused by Leishmaniasis, should also be considered. Linked to this, the performance of immunohistochemistry, due to the range of possible tumor markers, becomes essential for the diagnostic conclusion by excluding other types of round cell tumors, such as lymphoma, melanoma, poorly differentiated carcinomas and mast cell tumors. The prognosis for ocular TVT is good in situations where enucleation occurs, as in this case. That the patient was healthy and in the absence of neoplastic cells due to being affected only in the eye region. Finally, histopathological and imunohistochemistry are examination are confirmatory are the definitive diagnosis. Despite the specific labeling for Lysozyme, it was present in 90% of the cells, and the non-sensitivity of imunoreactivity to CD3 and PAX-5, similar results already described. Thus, and due to the fact that the importance of immunohistochemistry is observed, it suggests - if the use of this technique can validate the confirmation of marking of primary cells of the tumor, in this case reported here. [ABSTRACT FROM AUTHOR]

Introduction: This study investigated patient satisfaction levels in five premium intraocular lenses (IOLs). A secondary aim was to determine whether patient satisfaction was associated with the cataract grade before lens surgery. Methods: In this multicenter prospective comparative study, 164 patients from diverse backgrounds underwent cataract surgery and were assigned for identical bilateral implantation of multifocal IOLs. In addition to visual performance, quality of life was measured using the National Eye Institute Refractive Error Quality Of Life Instrument (NEI-RQL 42) scoring questionnaire. The Sirius Scheimpflug Analyzer was used to evaluate the posterior cornea and aberrations. Finally, the association of patient satisfaction reports with the Pentacam Cataract Grading Scale (PCGS) and Lens Opacities Classification System (LOCS III) was evaluated. Results: A considerable subjective improvement was observed in uncorrected far, near (40 cm), and intermediate (60 cm) visual acuity in the five groups (P values < 0.001). A significant difference was observed in mesopic and photopic contrast sensitivity between Symfony, Trinova, and AT LISA at the spatial frequency of 12 cycles per degree, favoring Symfony (P < 0.001). PanOptix users had considerably lower mean coma values (P < 0.001), while AT LISA users had lower mean spherical aberrations (P = 0.009) compared to the other groups. No additional safety concerns relating to IOLs were recorded. Mean satisfaction had a high correlation with LOCS and Pentacam Nuclear Staging (PNS) in each lens group, e.g., correlation coefficient and P value for AT LISA were respectively r = 0.99, P < 0.001 and r = 0.97, P = 0.004. Conclusion: Despite discrepancies between groups of lenses, most patients who received multifocal IOLs reported satisfaction at more than 3 years after the initial operation. A growing number of patients with cataracts are seeking spectacle-free vision with presbyopia-correcting IOLs. Hence, the high satisfaction rate among patients with cataract could indicate the value of offering a wider range of available lenses. [ABSTRACT FROM AUTHOR]

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Despite significant advancements in ocular drug delivery, challenges persist in treating posterior segment diseases like macular edema (ME) and age-related macular degeneration (AMD). Suprachoroidal (SC) injections are a promising new method for targeted drug delivery to the posterior segment of the eye, providing direct access to the choroid and retina while minimizing systemic exposure and side effects. This review examines the anatomical and physiological foundations of the SC space; evaluates delivery devices such as microcatheters, hypodermic needles, and microneedles; and discusses pharmacokinetic principles. Additionally, advancements in gene delivery through SC injections are explored, emphasizing their potential to transform ocular disease management. This review also highlights clinical applications in treating macular edema, diabetic macular edema, age-related macular degeneration, choroidal melanoma, and glaucoma. Overall, SC injections are emerging as a promising novel route for administering ophthalmic treatments, with high bioavailability, reduced systemic exposure, and favorable safety profiles. Key therapeutic agents such as triamcinolone acetonide, dexamethasone, AAV-based gene therapy, and axitinib have shown promise. The field of suprachoroidal injection is progressing rapidly, and this review article, while attempting to encapsulate most of the published preclinical and clinical studies, mainly focuses on those that are published within 2023 and 2024.

PurposeTo assess safety and efficacy outcomes of sutured custom silicone artificial iris and intraocular lens implantation combined with penetrating keratoplasty (triple procedure).MethodsProspective consecutive surgical case series of patients who underwent the triple procedure between 2010 and 2019 at Stein Eye Institute, UCLA, followed up for 1 year minimum. Safety outcomes were changes from preoperative to last follow-up in corrected distance visual acuity (CDVA), endothelial cell count, intraocular pressure (IOP), and postoperative complications. Efficacy outcomes included changes in subjective glare (none to severe), cosmetic appearance (worse to very much improved), and visual function as assessed by the Visual Function Questionnaire-25 at 1-year follow-up.ResultsAmong 82 eyes implanted with an artificial iris, 14 eyes (17.1%) underwent the triple procedure. The median follow-up was 18.1 months (range 12.0-54.9 months). The median CDVA improved from 2.0 log of minimum angle of resolution (logMAR) (range 0.9-2.3 logMAR) to 0.7 logMAR (range 0.2-2.6 logMAR) (P = 0.02). Average endothelial cell count decreased 57.6% (P < 0.01). Six eyes (42.9%) experienced IOP elevations, 13 eyes (92.3%) developed iritis, and 11 eyes (78.6%) underwent secondary surgery. Graft rejection or secondary graft failure occurred in 7 eyes each (50.0%). Cosmesis improved in 12 eyes (85.7%; P < 0.01). The Visual Function Questionnaire-25 score improved from 72 to 77 (P < 0.01). Glare symptoms did not change significantly.ConclusionsThe triple procedure was effective at improving CDVA, cosmesis, and quality of life; however, it was associated with frequent postoperative complications, of which iritis, IOP elevation, and secondary graft failure were the most common.

Lens subluxation is mainly produced by the interruption, damage or degeneration of the suspension system of the zonules. In the case of felines, the primary etiology responsible for the appearance of this pathology is represented by anterior uveitis preceding the moment of diagnosis, often complicated by secondary glaucoma. [ABSTRACT FROM AUTHOR]

Purpose: Penetrating eye injuries commonly cause permanent loss of vision in patients. Unlike mammals, zebrafish can regenerate both damaged tissue and severed axons in the central nervous system. Here, we present a tractable adult zebrafish model to study intraocular axon regeneration after penetrating eye injury. Methods: To create consistent penetrating intraocular injuries, pins of standardized diameters were inserted into the eye through the cornea and penetrating the retina but not the underlying sclera. Transgenic gap43:GFP reporter fish were used to preferentially label retinal ganglion cells (RGCs) that respond to injury with regenerating axons. Retinas were fixed and flat mounted at various times postinjury to examine injury size, number of green fluorescent protein (GFP)-positive cells and axons, axonal varicosities, and rate of regeneration to the optic nerve head. Intraocular injection of colchicine was used to inhibit axon outgrow as a proof of principle that this method can be used to screen effects of pharmacological agents on intraocular axon regeneration. Results: Penetrating injury to the zebrafish retina results in robust axon regeneration by RGCs around and beyond the site of injury. The gap43:GFP transgene allows visualization of individual or small bundles of axons with varicosities and growth cones easily observable. Regeneration proceeded with most, if not all, axons reaching the optic nerve head by 3-day postinjury. A single intraocular injection of colchicine a day after injury was sufficient to delay axon regeneration at 2-days postinjury. Surprisingly, we identified a stereotypically located population of circumferential projecting neurons within the retina that upregulate gap43:GFP expression after injury. Conclusions: Penetrating injury to the adult gap43:GFP transgenic zebrafish eye is a model of successful intraocular axon regeneration. The pharmacological and genetic tools available for this organism should make it a powerful tool for dissecting the cellular, molecular, and genetic mechanisms of axon regeneration in the intraocular environment. [ABSTRACT FROM AUTHOR]

Copyright of Revista Médica Clínica Las Condes is the property of Editorial Sanchez y Barcelo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Médica Clínica Las Condes is the property of Editorial Sanchez y Barcelo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To improve awareness of delayed onset uveitis in patients with a history of intraocular tattoo ink injection.Results: A 47-year-old man underwent a scleral tattoo procedure during which there was inadvertent intraocular injection of tattoo ink into his right eye. He subsequently developed endophthalmitis, retinal detachment, and retinal necrosis. He was treated with intravitreal and oral antibiotics and underwent vitreoretinal surgical intervention. A vitreous specimen was obtained and demonstrated significantly elevated levels of several heavy metals. One month later, he developed an acute granulomatous anterior uveitis in the same eye that was managed with a combination of topical and perioperative intravitreal, intravenous, and oral corticosteroids.Conclusion: This case highlights the importance of monitoring patients with a history of intraocular tattoo ink injection for delayed onset uveitis in addition to retinal toxicity.

PurposeTo review and compare the results of unpublished premarket approval studies for recent multifocal and extended depth of focus (EDOF) intraocular lenses.MethodsLenses without previously published pre-market approval trials were identified and clinical and patient-reported outcomes were reviewed and compared.ResultsLenses included the DFT/DAT (Acrysof Vivity) EDOF lens, the TFNT/TFAT (PanOptix) trifocal lens, and the SV25T (ReStor ActiveFocus) lens (all from Alcon Laboratories, Inc), as well as the ZXR/ZXT (Tecnis Symfony and Symfony Toric), the ZLB00 (Tecnis Multifocal +3.25), and the ZKB00 (Tecnis Multifocal +2.75, all Tecnis lenses from Johnson & Johnson Vision). All lenses produced equivalent distance vision and superior intermediate and near vision compared to monofocal controls. Patient-reported difficulty with glare, halos, and starbursts was higher in the multifocal and EDOF lens cohort compared to monofocal controls. Spectacle independence was higher in the multifocal and EDOF cohort with the exception of the SV25T (ActiveFocus) lens, which was not significantly different than the control lens.ConclusionsClinical trial data from the U.S. Food and Drug Administration premarket approval studies supports multifocal and EDOF lenses as an effective treatment for aphakia and presbyopia. [J Refract Surg. 2021;37(2):98-104.].

PurposeTo compare the effects of the Ahmed glaucoma valve (AGV; New World Medical, Rancho Cucamonga, CA) with sulcus versus anterior chamber (AC) tube placement on the corneal endothelial density and morphology over time.DesignNonrandomized, interventional study.ParticipantsThis study included 106 eyes from 101 pseudophakic patients who had the AGV tube placed in the AC (acAGV) and 105 eyes from 94 pseudophakic patients who had the AGV tube placed in the ciliary sulcus (sAGV).MethodsAll patients underwent preoperative specular microscopy, which was repeated postoperatively in 2019. The patients' demographic information, glaucoma diagnoses, and basic ocular information were obtained on chart review. Anterior segment OCT was conducted for patients who underwent sAGV to evaluate the sulcus tube position. Gonioscopy was performed to document peripheral anterior synechiae (PAS). Linear mixed-effects models were used to compare the different ocular and endothelial measurements between the 2 groups and to identify risk factors for endothelial cell density (ECD) loss over time.Main outcome measuresMonthly change in corneal endothelial measurements, including ECD and coefficient of variation (CV), calculated as the difference between preoperative and postoperative measurements divided by the number of months from the time of surgery to postoperative specular microscopy.ResultsThe acAGV and sAGV groups were comparable in all baseline characteristics except that the acAGV group had longer follow-up (37.6 vs. 20.1 months, respectively, P < 0.001). Mean monthly loss in central ECD was significantly more in the acAGV group (mean ± standard deviation: 29.3±29.7 cells/mm2) than in the sAGV group (15.3±20.7 cells/mm2, P < 0.0001). Mean monthly change in CV was similar between the 2 groups (P = 0.28). Multivariate analyses revealed that younger age and tube location in the AC were associated with faster central ECD loss (P = 0.02, P < 0.0001, respectively). For patients with sAGV, while PAS was associated with faster central ECD loss (P = 0.002), a more forward tube position tenting the iris was not (P > 0.05).ConclusionsCompared with anterior segment placement, ciliary sulcus tube implantation may be a preferred surgery approach to reduce endothelial cell loss in pseudophakic patients.

Sebaceous carcinoma of the eyelid is a very rare malignant tumour, accounting for 1-1.5% of total eyelid malignancies. It typically arises from the meibomian glands, making it more common in the upper eyelids. It predominantly affects individuals in their sixth to eighth decade, with a higher incidence in females. Histologically, the tumour cells are arranged in well-defined lobules with circumscribed borders. These cells exhibit pleomorphism, eccentric hyperchromatic nuclei, inconspicuous nucleoli, and multivacuolated cytoplasm. The clinical course of sebaceous carcinoma is aggressive, often characterised by recurrences and metastasis to regional lymph nodes. Unfortunately, it is not commonly considered in the differential diagnosis of eyelid tumours, leading to delayed treatment. Thus, it is crucial to raise awareness about this uncommon neoplasm occurring at unusual sites in order to improve patient survival. In the present case report, the authors present two cases: a 54-year-old male patient with intraocular sebaceous carcinoma, which recurred, and an 83-year-old male patient with extraocular sebaceous carcinoma. In both the cases, imaging and other investigations were performed, followed by excision of the mass and confirmation of the diagnosis through histopathological reporting. Subsequent follow-up was conducted for both cases and the postoperative recovery was uneventful.

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Brolucizumab is a next-generation anti-vascular endothelial growth factor (VEGF) agent for the treatment of neovascular age-related macular degeneration. It is highly potent and thus appropriate for those unresponsive to other anti-VEGF agents and those undertreated owing to the low adherence or the heavy burden of repeated injections. An expert panel of 10 retina specialists from Hong Kong and Germany convened in February 2021 to discuss the benefit-risk profile and clinical use of brolucizumab. Evidence suggests that brolucizumab provides comparable visual outcomes to aflibercept at a more relaxed injection schedule. Brolucizumab is superior to aflibercept in resolving intraretinal and subretinal fluids and decreasing disease activity. Brolucizumab is suitable for patients unresponsive to other anti-VEGF agents, especially for those with persistent intraretinal and subretinal fluids or disease activity. Injection intervals of brolucizumab can be extended to 8 to 12 weeks. However, brolucizumab has higher risk of adverse events such as intraocular inflammation, retinal vasculitis, and retinal occlusion, compared with aflibercept. Thus, regular monitoring for signs of intraocular inflammation and prompt management are important before and during treatment. [ABSTRACT FROM AUTHOR]

Purpose: To retrospectively review visual outcomes of patients with myopia who were implanted with the IC-8 intraocular lens in the nondominant eye and a monofocal intraocular lens in the dominant eye at a private ophthalmology clinic in Australia. Methods: We retrospectively reviewed medical records of consecutive patients aged =18 years who had myopia (=-0.25 diopter) in both eyes and astigmatism (=-2.50 diopters) in the nondominant eye and underwent bilateral cataract surgery and implantation of the IC-8 intraocular lens in the nondominant eye and a monofocal intraocular lens in the dominant eye between January 2018 and February 2020 at a private ophthalmology clinic in Australia. At 6 months, uncorrected monocular and binocular distance, intermediate, and near visual acuity was assessed. Dysphotopsia symptoms was evaluated with the Quality of Vision questionnaire. Results: Medical records of 15 men and 10 women aged 28 to 79 (mean, 60.8±11.5) years of Chinese (n=16), Caucasians (n=8), and South Asian (n=1) ethnicity were reviewed. The mean spherical equivalent improved from -2.92 to -1.20 diopters in nondominant eyes and from -2.42 to -0.13 diopters in dominant eyes. Binocularly, 92%, 64%, and 100% of patients achieved uncorrected distance, intermediate, and near visual acuity of logMAR 0 or better, logMAR 0 or better, and logMAR 0.20 (N5) or better, respectively. The mean Quality of Vision questionnaire score was 32.1 for frequency, 25.4 for severity, and 23.9 for bothersomeness of dysphotopsia symptoms. The rate of laser capsulotomy was higher in eyes with the IC-8 intraocular lens than eyes with the monofocal intraocular lens (72% vs 48%, p=0.08). Conclusions: The IC-8 intraocular lens can extend the depth of focus and is a good option for patients with myopia. It provides good binocular uncorrected distance, intermediate, and near visual acuity when used in conjunction with a monofocal intraocular lens in the dominant eye. Some patients may have dysphotopsia symptoms, but the symptoms are not frequent, severe, or bothering. [ABSTRACT FROM AUTHOR]

PURPOSE:To assess the accuracy of the Kane formula for intraocular lens (IOL) power calculation in comparison to established formulas in the elderly population. SETTING:Shiley Eye Institute, University of California San Diego, USA. DESIGN:Retrospective cohort. METHODS:Retrospective data from 90 patients ≥75 years old who underwent uneventful cataract surgery with SN60WF IOL implantation were evaluated. The first operated eyes of patients with final best-corrected visual acuity 20/40 or better and axial length 22-26 mm were included. Prediction errors were calculated for Barrett Universal II (BUII), Haigis, Hoffer Q, Holladay 1, Kane and SRK/T formulas. A subgroup analysis based on age (75-84 and ≥85 years old) was performed. RESULTS:Use of both BUII and Kane formulas resulted in the highest percentage of eyes with prediction errors within ±0.50 D (72% each) and significantly higher than Hoffer Q, Holladay 1 and SRK/T (p=0.001). Rates of predictability within ±0.25 D and ±1.00 D were 31%-38% and 87% -92%, respectively, with no significant differences between formulas. No statistically significant difference was seen between formulas in the median absolute error. These tendencies remained consistent in both age groups when analyzed separately. Subgroup analysis showed better predictability of all formulas in the younger age group. CONCLUSIONS:This is the first study evaluating the Kane formula exclusively in the elderly population. The Kane formula was found to be of equal accuracy to the BUII and superior to the Hoffer Q, Holladay 1 and SRK/T formulas. Very elderly patients may have reduced refractive precision using all formulas.

Background/objectivesTo analyze the refractive predictability and outcomes of cataract surgery in the very elderly (≥85 years old).Subjects/methodsA retrospective case-series performed at the Shiley Eye Institute, University of California San Diego, USA. Electronically pulled data of 2444 surgeries revealed 147 surgeries on 133 very elderly patients. Chart review was conducted for all very elderly and corresponding control patients (75-84 years old). The first operated eyes of patients with final best-corrected visual acuity ≥20/40, axial length (AL) 22-26 mm, and implanted SN60WF IOL were included. Patients with ocular comorbidities and/or intra- or post-operative complications were excluded. Prediction errors of refractive outcome and percentage of eyes within ±0.50D and ±1.00D were compared between the groups for the Holladay 1 and Barrett Universal II (Barrett) formulas. Logistic regression analysis for achievement of ±1.00D was conducted.ResultsFinal analysis included 90 eyes (n = 44, very elderly, n = 46, control patients). Median absolute refractive error (MedAE) with Holladay 1, but not Barrett formula, was significantly higher in the older group (p = 0.02 and p = 0.07, respectively). The MedAE in the older group was lower using the Barrett compared to Holladay 1 (p = 0.02). Fewer older patients than younger patients achieved refraction within ±0.50D and ±1.00D from goal, using the Holladay 1 (p = 0.049 and p = 0.002 respectively). Logistic regression analysis supported the relationship between Holladay 1 predictive refractive error of >1.00D and patient's age (p = 0.046).ConclusionsVery elderly patients undergoing cataract surgery may be prone to reduced refractive precision, particularly with utilization of the Holladay 1 formula.

BackgroundPresbyopia occurs when the lens of the eyes loses its elasticity leading to loss of accommodation. The lens may also progress to develop cataract, affecting visual acuity and contrast sensitivity. One option of care for individuals with presbyopia and cataract is the use of multifocal or extended depth of focus intraocular lens (IOL) after cataract surgery. Although trifocal and bifocal IOLs are designed to restore three and two focal points respectively, trifocal lens may be preferable because it restores near, intermediate, and far vision, and may also provide a greater range of useful vision and allow for greater spectacle independence in individuals with presbyopia.ObjectivesTo assess the effectiveness and safety of implantation with trifocal versus bifocal IOLs during cataract surgery among participants with presbyopia.Search methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2019, Issue 9); Ovid MEDLINE; Embase.com; PubMed; ClinicalTrials.gov; and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We did not use any date or language restrictions in the electronic search for trials. We last searched the electronic databases on 26 September 2019. We searched the reference lists of the retrieved articles and the abstracts from the Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO) for the years 2005 to 2015.Selection criteriaWe included randomized controlled trials that compared trifocal and bifocal IOLs among participants 30 years or older with presbyopia undergoing cataract surgery.Data collection and analysisWe used standard Cochrane methodology.Main resultsWe identified five studies conducted in Europe with a total of 175 participants. All five studies assessed uncorrected distance visual acuity (primary outcome of the review), while some also examined our secondary outcomes including uncorrected near, intermediate, and best-corrected distance visual acuity, as well as contrast sensitivity. Study characteristics All participants had bilateral cataracts with no pre-existing ocular pathologies or ocular surgery. Participants' mean age ranged from 58 to 64 years. Only one study reported on gender of participants, and they were mostly women. We assessed all the included studies as being at unclear risk of bias for most domains. Two studies received financial support from manufacturers of lenses evaluated in this review, and at least one author of another study reported receiving payments for delivering lectures with lens manufacturers. Findings All studies compared trifocal versus bifocal IOL implantation on visual acuity outcomes measured on a LogMAR scale. At one year, trifocal IOL showed no evidence of effect on uncorrected distance visual acuity (mean difference (MD) 0.00, 95% confidence interval (CI) -0.04 to 0.04; I2 = 0%; 2 studies, 107 participants; low-certainty evidence) and uncorrected near visual acuity (MD 0.01, 95% CI -0.04 to 0.06; I2 = 0%; 2 studies, 107 participants; low-certainty evidence). Trifocal IOL implantation may improve uncorrected intermediate visual acuity at one year (MD -0.16, 95% CI -0.22 to -0.10; I2= 0%; 2 studies, 107 participants; low-certainty evidence), but showed no evidence of effect on best-corrected distance visual acuity at one year (MD 0.00, 95% CI -0.03 to 0.04; I2= 0%; 2 studies, 107 participants; low-certainty evidence). No study reported on contrast sensitivity or quality of life at one-year follow-up. Data from one study at three months suggest that contrast sensitivity did not differ between groups under photopic conditions, but may be worse in the trifocal group in one of the four frequencies under mesopic conditions (MD -0.19, 95% CI -0.33 to -0.05; 1 study; I2 = 0%, 25 participants; low-certainty evidence). In two studies, the investigators observed that participants' satisfaction or spectacle independence may be higher in the trifocal group at six months, although another study found no evidence of a difference in participant satisfaction or spectacle independence between groups. Adverse events Adverse events reporting varied among studies. Two studies reported information on adverse events at one year. One study reported that participants showed no intraoperative or postoperative complications, while the other study reported that four eyes (11.4%) in the bifocal and three eyes (7.5%) in the trifocal group developed significant posterior capsular opacification requiring YAG capsulotomy. The certainty of the evidence was low.Authors' conclusionsThere is low-certainty of evidence that compared to bifocal IOL, implantation of trifocal IOL may improve uncorrected intermediate visual acuity at one year. However, there is no evidence of a difference between trifocal and bifocal IOL for uncorrected distance visual acuity, uncorrected near visual acuity, and best-corrected visual acuity at one year. Future research should include the comparison of both trifocal IOL and specific bifocal IOLs that correct intermediate visual acuity to evaluate important outcomes such as contrast sensitivity and quality of life.

Abstract Background To evaluate a new method of implantable collamer lens (ICL) sizing based on ultrasound biomicroscopy (UBM) video clips. Methods This observational study included consecutive patients with myopia and myopic astigmatism scheduled for V4c toric ICL (TICL) implantation (STAAR) at Hangzhou MSK Eye Hospital (October 2020 to November 2020). Sulcus-to-sulcus (STS) distance, lens thickness (LT), and clinical refraction were measured preoperatively. The ZZ ICL formula (provides the predicted vault height and refraction based on TICL size, intraocular meridian, power, and eye parameters, including STS distance and LT) was used to select TICL size and predict vault height and residual refraction, which was also compared with the STAAR software recommended. Vault and residual refraction were measured at 3 months postoperatively. Results The analysis included 168 eyes in 84 patients. Postoperative vault size was comparable to that predicted by the ZZ ICL formula (528 ± 193 vs. 545 ± 156 μm, P = 0.227). Vault prediction error (PE) by the ZZ ICL formula was within 100, 300, and 500 μm in 40.48%, 88.10%, and 100% of eyes, respectively. Spherical equivalent (SE) and absolute cylindrical refractive error were 0.36 ± 0.48 and 0.40 ± 0.31 D at 3 months postoperatively. The SE PE, absolute cylindrical PE, and percentages of eyes with an absolute cylindrical PE within ± 0.50 D and ± 1.00 D were lower for the ZZ ICL formula than for the STAAR software (P

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

PURPOSE:To determine if there is a benefit to adjuvant intrastromal voriconazole (ISV) injections for primary treatment of filamentous fungal keratitis. DESIGN:Outcome-masked, randomized controlled clinical trial. PARTICIPANTS:Patients with moderate vision loss resulting from a smear-positive fungal ulcer. METHODS:Study eyes were randomized to topical natamycin plus ISV injection versus topical natamycin alone. MAIN OUTCOME MEASURES:The primary outcome of the trial was microbiological cure on 3-day repeat culture analysis. Secondary outcomes included microbiological cure on 7-day repeat culture analysis; 3-week and 3-month best spectacle-corrected visual acuity; infiltrate or scar size or both; rate of perforation; therapeutic penetrating keratoplasty (TPK); and other adverse events. RESULTS:A total of 151 patients with smear-positive ulcers were screened and 70 were enrolled at Aravind Eye Hospital, Pondicherry, India. Baseline cultures grew Fusarium in 19 samples (27%), Aspergillus in 17 samples (24%), and other filamentous fungi in 19 samples (27%) and showed negative results in 13 samples (19%). Those randomized to ISV injection had 1.82 times the odds of 3-day culture positivity after controlling for baseline culture status (95% confidence interval [CI], 0.65-5.23; P = 0.26, bias-corrected logistic regression) and 1.98 times the odds of positive 7-day culture results, after controlling for baseline culture status (95% CI, 0.69-5.91; P = 0.20, bias-corrected logistic regression). Those randomized to ISV injection showed 0.5 logMAR lines (approximately 0.5 Snellen lines) of decreased visual acuity (95% CI, -2.6 to 3.6 lines; P = 0.75) and 0.55 mm worse infiltrate or scar size or both at 3 months after controlling for baseline values (95% CI, -0.13 to 1.25; P = 0.11). Intrastromal voriconazole injections showed a 2.85-fold increased hazard of perforation after controlling for baseline infiltrate depth (95% CI, 0.76-10.75; P = 0.12) but no difference in the rate of TPK (hazard ratio, 0.95; 95% CI, 0.44-2.04; P = 0.90). CONCLUSIONS:There seems to be no benefit to adding ISV injections to topical natamycin in the primary treatment of moderate to severe filamentous fungal ulcers. Studies consistently suggest that voriconazole has a limited role in the treatment of filamentous fungal ulcers.

OBJECTIVE:To compare the effectiveness of retrobulbar anesthesia (RBA) and peribulbar anesthesia (PBA) in dogs. ANIMAL STUDIED:Six adult mixed-breed dogs (18-24 kg). PROCEDURES:In a randomized, masked, crossover trial with a 10-day washout period, each dog was sedated with intravenously administered dexmedetomidine and administered 0.5% bupivacaine:iopamidol (4:1) as RBA (2 mL via a ventrolateral site) or PBA (5 mL divided equally between ventrolateral and dorsomedial sites). The contralateral eye acted as control. Injectate distribution was evaluated by computed tomography. Following intramuscularly administered atipamezole, corneal and periocular skin sensation, intraocular pressure (IOP), and ocular reflexes, and appearance were evaluated for 24 hours. Comparisons were performed with mixed-effects linear regression (IOP) or the exact Wilcoxon signed rank test (scores). Significance was set at P ≤ .05. RESULTS:Injectate distribution was intraconal in 2/6 RBA- and 4/6 PBA-injected eyes. Eyes undergoing PBA had significantly reduced lateral, ventral, and dorsal periocular skin sensation for 2-3 hours, and significantly reduced corneal sensitivity for 4 hours, relative to control eyes. Chemosis and exophthalmos occurred in 33%-40% of eyes undergoing RBA and 83%-100% eyes undergoing PBA but resolved within 14 hours. Anterior uveitis developed in 2/6 and 1/6 eyes of RBA and PBA, respectively, of them corneal ulcer developed in one eye of each treatment. Both resolved 1-3 days following medical treatment. CONCLUSIONS:Peribulbar injection produced notable anesthesia more reliably than did retrobulbar injection. Both techniques may produce adverse effects, although the uveitis/ulcer could have resulted from the contrast agent used.

Background: We aim to analyze which tumor location gives more favorable chemotherapy response in intraocular retinoblastoma grade B, C, and D as well as to report the first case series in Indonesia. Methods: Six boys with age ranging from 10 weeks to 47 months old were recruited into the study from April 2019 to January 2020 at National Eye Centre, Cicendo Eye Hospital, and Hasan Sadikin General Hospital, Bandung, West Java, Indonesia. Retinoblastoma (RB) patients underwent examination under anesthesia (EUA). Tumor size and location were evaluated by using RetCam pre and post 2 cycles of chemotherapy. The tumors were classified according to the International Intraocular Retinoblastoma Classification. Results: There were two patients with unilateral RB and four patients with bilateral RB. All patients had leukocoria and sought medical advice within 12 months of onset. There were one tumor in the macular zone, six tumors in the equatorial zone, and two tumors in the ora zone. Two cycles of intravenous vincristine, etoposide, and carboplatin (VEC) were administered and the tumor diameter was re-evaluated afterwards. The tumor size was decreased following 2 cycles of chemotherapy. Conclusions: Ora zone showed a more favorable chemotherapy response.

BackgroundPhacoemulsification and intraocular lens (IOL) implantation during cataract surgery in horses occur with increasing frequency. To reduce the postoperative refractive error it is necessary to determine the proper IOL power. In the present study retinoscopy, keratometry and ultrasonographic biometry were performed on 98 healthy equine eyes from 49 horses. The refractive state, corneal curvature (keratometry) and the axial location of all optical interfaces (biometry) were measured. The influences of breed, height at the withers, gender and age on values obtained and the comparison between the left and right eye were evaluated statistically. Corresponding IOL power were calculated by use of Binkhorst and Retzlaff theoretical formulas.ResultsMean ± SD refractive state of the horses was + 0.32 ± 0.66 D. Averaged corneal curvature for Haflinger, Friesian, Pony, Shetland pony and Warmblood were 21.30 ± 0.56 D, 20.02 ± 0.60 D, 22.61 ± 1.76 D, 23.77 ± 0.94 D and 20.76 ± 0.88 D, respectively. The estimated postoperative anterior chamber depth (C) was calculated by the formula C = anterior chamber depth (ACD)/0.73. This formula was determined by a different research group. C and axial length of the globe averaged for Haflinger 9.30 ± 0.54 mm and 39.43 ± 1.26 mm, for Friesian 10.12 ± 0.33 mm and 42.23 ± 1.00 mm, for Pony 8.68 ± 0.78 mm and 38.85 ± 3.13 mm, for Shetland pony 8.71 ± 0.81 mm and 37.21 ± 1.50 mm and for Warmblood 9.39 ± 0.51 mm and 40.65 ± 1.30 mm. IOL power was calculated with the Binkhorst and Retzlaff theoretical formulas. Calculated IOL power for the several breeds ranged from 18.03 D to 19.55 D. The mean value across all horses was 18.73 D determined with Binkhorst formula and 18.54 D determined with Retzlaff formula.ConclusionsMean result of this study is: an 18.5 D IOL seemed to be the most appropriate to achieve emmetropia after IOL implantation in horses. Cataract surgery without IOL implantation results in hyperopic and visual compromised horses. Retinoscopy, keratometry and ultrasonographic biometry should be performed on every affected horse and postoperative visual outcome should be determined.

Abstract Purpose: To evaluate the ray tracing method's accuracy employing Okulix ray tracing software and thin-lens formulas to calculate intraocular lens (IOL) power using a swept-source optical coherence tomography (SS-OCT) biometer (OA2000). Methods: A total of 188 eyes from 180 patients were included in this study. An OA-2000 optical biometer was used to collect biometric data. The predicted postoperative refraction based on thin-lens formulas including SRK/T, Hoffer Q, Holladay 1, and Haigis formulas and the ray tracing method utilizing the OKULIX software was determined for each patient. To compare the accuracy of approaches, the prediction error and the absolute prediction error were determined. Results: The mean axial length (AL) was 23.66 mm (range: 19–35). In subgroup analysis based on AL, in all ranges of ALs the ray tracing method had the lowest mean absolute error (0.56), the lowest standard deviation (SD; 0.55), and the greatest proportion of patients within 1 diopter of predicted refraction (87.43%) and the lowest absolute prediction error compared to the other formulas (except to SRK/T) in the AL range between 22 and 24 mm (all P < 0.05). In addition, the OKULIX and Haigis formulas had the least variance (variability) in the prediction error in different ranges of AL. Conclusion: The ray tracing method had the lowest mean absolute error, the lowest standard deviation, and the greatest proportion of patients within 1 diopter of predicted refraction. So, the OKULIX software in combination with SS-OCT biometry (OA2000) performed on par with the third-generation and Haigis formulas, notwithstanding the potential for increased accuracy in the normal range and more consistent results in different ranges of AL.

Objective: Intraocular lens (IOL) implants are artificial lenses which helps to clear up the vision after cataract surgery. In this work, we aimed to compare the monofocal and trifocal IOL implantation during phacoemulsification. Methods: 60 eyes of 60 patients were divided into 2 equal groups. Postoperative astigmatism and UCVA were measured and compared during week 1, week 2 and month. Results: The mean preoperative UCVA was 6.83 ± 4.61 in the monofocal IOL group, and 17.5 ± 17.55 in the trifocal IOL group. At the first week: The mean postoperative UCVA at one week was 35.46 ± 19.45 and 58.64 ± 20.77, in each group respectively. The mean postoperative BCVA in the first week was 42.71 ± 20.63 and 65.91 ± 20.85, in each group respectively. The mean postoperative UCVA at 1 month was 46.57 ± 24.37 and 76.36 ± 23.61, in each group, while BCVA was 63.14 ± 24.94 and 89.54 ± 14.63. There was a highly significant statistical difference between the result of UCVA preoperative and the results of UCVA at the early and last postoperative follow up. Conclusion: From our results, it is evident that post-operative near UCVA and BCVA was statistically significant at monofocal and trifocal groups.

Abstract Background Intraocular silicone oil (SiO) tamponade is a popular modality of treatment of rhegmatogenous retinal detachment. It can, however, rarely lead to an incompletely understood phenomenon known as intracranial migration of SiO. Though usually benign, this entity is often misinterpreted as a tumour or haemorrhage. Case presentation We present a case report of a patient with acute progressive encephalopathy and intracranial migration of intravitreal silicone. We also put forward the possibility of toxic effects of intracranial SiO on the central nervous system. Conclusion Clinicians and radiologists should be aware of the rare complication of intravitreal SiO tamponade. Eliciting the history of intraocular SiO tamponade and identifying the key imaging features on ultrasonography of the orbit, CT of the head, and MRI of the brain will help in avoiding unnecessary interventions or delays in the management of the patients from misdiagnosing it as haemorrhage or tumour.

As the need for nasal, ocular, spinal, and articular therapeutic compounds increases, toxicology assessments of drugs administered via these routes play an important role in human safety. This symposium outlined the local and systemic evaluation to support safety during the development of these drugs in nonclinical models with some case studies. Discussions included selection of appropriate species for the intended route; conducting nonclinical studies that closely mimic the intended use with adequate duration; functional assessment, if deemed necessary; evaluation of local tissues with special histological staining procedure; and evaluations of safety margins based on local and systemic toxicity.

Рurpose. Upon obtained information from a questionnaire and trial multifocal contact lenses prior operation, our goal is to present a new methodology to select patients for multifocal intraocular correction with an individual definition of the IOL type. Patients and methods. An analysis of 1000 medical case reports (540 hyperopia, 460 myopia) and questionnaire of patients who have undergone operation because of cataract and refractive anomalies in the section of lens surgery and intraocular correction, department of eye diseases in Samara regional clinical hospital named after V. D. Seredavin. Patients are offered monofocal IOLs from leading global manufacturers, such as Rayner, H.Optics and Alcon, bifocal IOLs such as M-plus, Comfort (Oculentis), Restor (Alcon) and the trifocal IOL PanOptix (Alcon) for implantation. To get our goal, questionnaires were developed with questions allowing to determine the psychological type of the patient before the surgery, the nature of his/her visual stress besides requirements and expectations after surgery. Multifocal contact lenses Acuvue Moist with varying ADD power are selected to patients before operation to create similar conditions of multifocal intraocular correction. Visual acuity, contrast sensitivity are evaluated 2 weeks and 2 months postoperatively. At the same time, another survey is conducted to evaluate their satisfaction of visual outcomes. Results. According to analysis, the percentage of implantations of monofocal IOLs was (450 patients) 45%, while percentage of multifocal IOLs was (550 patients ) 55 % among all ultrasound phacoemulsification surgeries. Of these, in (330) 60 % of cases patients have chosen IOLs with a low degree of ADD power (Lentis Comfort), in (165 patients) 30 % — PanOptix and in (55 patients) 10 % — Lentis M-plus or Restor. Degree of satisfaction and visual results in 2 weeks and 2 months was recorded from (5 points) and obtained (506 patients) 92 % and (528 patients) 96 % respectively. Cases with incomplete patient dissatisfaction don’t exceed (18 patients) 3.2 % and is reported mainly in the group with the implantation of bifocal IOLs and are related with typical complaints of light phenomena, mostly at night.

Copyright of Acta Medica Croatica is the property of Croatian Academy of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)