Journal of refractive and corneal surgery最新文献

Background: There are several advantages to implanting a posterior chamber intraocular lens (IOL) in the ciliary sulcus when the lens capsule is absent. I have developed a simple method of fixating an IOL into the ciliary sulcus which does not require different needles, multiple needle passes, scleral dissection, or awkward surgical maneuvers.

Methods: Thirty eyes were enrolled in this study. All eyes were either aphakic, requiring a secondary lens implantation, or required IOL exchange. The patients were followed for 30 months. Using a single 10-0 double-armed, polypropylene suture, a through-and-through infraciliary scleral pass secured each haptic without tying. The lens was then positioned into the ciliary sulcus and the knots tied outside the eye under direct visualization.

Results: This procedure has been used in 30 eyes without erosion of sutures, dislocation or tilting of the IOL, or induced astigmatism. Twenty-one eyes (70%) had spectacle-corrected visual acuity of 20/40 or better.

Conclusion: The results of this study demonstrate that posterior chamber transscleral fixated IOLs give improved postoperative visual results.

Background: Single and double deepening of the peripheral part of radial keratotomy incisions are used to increase the refractive effect.

Methods: Single peripheral deepening was performed in 52 eyes of 36 patients and double peripheral deepening in 19 eyes of 14 patients who received radial keratotomy.

Results: In the single peripheral deepening group, the mean change in refractive power was 4.01 diopters (D); 53.8% of eyes were within +/- 1.00 D of emmetropia; residual myopia was greater than -1.00 D in 46.2% of eyes; 65.4% of eyes achieved an uncorrected visual acuity greater than or equal to 20/40. In the double peripheral deepening group, the mean change in refractive power was 5.07 D; 52.6% of eyes wee within +/- 1.00 D of emmetropia; residual myopia was greater than -1.00 D in 47.4% of eyes; 89.4% of eyes achieved an uncorrected visual acuity greater than 20/40. The difference in mean dioptric change between the standard radial keratotomy groups and the single and double peripheral deepening groups was 0.53 D and 0.47 D, respectively.

Conclusions: Considering the limited additional dioptric change compared with the standard radial keratotomy surgical technique and the increased rate of complications, we think that peripheral deepening in radial keratotomy should be avoided.

Background: Treatment of corneal abrasions often involves antibiotic ointment and pressure patching. The corneal abrasions following excimer laser photorefractive keratectomy have been managed with disposable soft contact lenses and diclofenac (Voltaren) eye drops.

Methods: We report 13 patients with corneal abrasions from trauma or recurrent corneal erosions treated with application of a disposable soft contact lens and instillation of diclofenac and antibiotic eye drops.

Results: All 13 patients reported significant pain relief and all abrasions healed within 3 days (most within 24 hours). Two of the recurrent erosion patients suffered subsequent spontaneous abrasions and one of the traumatic abrasion patients developed a possible infectious keratitis which cleared without visual loss.

Conclusions: In this small series, the combination of a disposable soft contact lens and the instillation of diclofenac drops provided significant pain relief while the abrasion healed and allowed the patients to function with binocular vision. This treatment regimen offers an alternative to pressure patching in the treatment of corneal abrasions.

Background: A free floating cyst in the anterior chamber was observed 10 days after a 35-year-old woman underwent an eight-incision radial keratotomy and two-incision transverse keratotomy of the left eye.

Methods: A single self-sealing microperforation had occurred on the inferotemporal incision during the initial surgery, which used a two direction incision technique.

Results: A free floating cystic structure was first noted by the surgeon 10 days after surgery, when the patient returned for repeated surgery for residual myopia. After 18 months, there was little change in the size or appearance of the cyst. The patient, who was informed of the complication, remained asymptomatic with uncorrected visual acuity of 20/25 + 2 bilaterally. Because of the lack of growth of the cyst, continued observation was chosen instead of surgical removal. The cause of the cyst is unknown.

Conclusion: A free floating cyst in the anterior chamber may occur after refractive keratotomy.