Efficacy and Safety of Mass Cataract Surgery Campaign in a Developing Country

To determine the visual outcomes achieved in terms of efficacy and safety during a mass eye surgery campaign in a low-income developing country.Three hundred fifteen eyes of 305 patients underwent extracapsular cataract extraction with intraocular lens implantation in a prospective, analytical, experimental, and nonrandomized study on patients who underwent cataract surgery during the campaign that two Spanish nongovernmental organizations conducted in December 2008 in a district hospital in Bobo-Dioulasso (Burkina Faso).Mean age was 61.97 ± 14.39 years. The mean uncorrected distance visual acuity before surgery was 2.17 ± 0.7 (20/3000), which improved to 0.86 ± 0.64 logMAR (20/150) 3 month…

Combined procedure for glaucoma and cataract: A retrospective study

Abstract To ascertain the long-term effects of a triple procedure in the case of coexisting cataract and glaucoma, we did a retrospective study of 93 eyes that had cataract extraction, IOL implantation, and trabeculectomy within a ten-year period. Mean follow-up was 32.4 ± 21.9 months. Mean postoperative intraocular pressure (IOP) was significantly lower than preoperatively, even though fewer medications were being used. One year after surgery, 60% of eyes had a best corrected visual acuity of 20/40 or better with an average improvement of 3.8 Snellen lines. Patients who had had surgery four or more years before the study had the highest percentage of eyes with an IOP exceeding 22 mm Hg. Th…

Prevention of hyperopic surprise after LASIK in patients with refractive multifocal intraocular lenses.

Purpose. Three cases of patients who developed a similar hyperopic defect in refraction following laser in situ keratomileusis (LASIK) after multifocal intraocular lens (IOL) implantation are described. Methods. Ophthalmologic evaluation including refractive status, corrected and uncorrected visual acuity (both at far and near), and corneal topography in patients presenting similar hyperopic refractive surprise in one eye as a result of LASIK refinement of residual ametropia after refractive multifocal IOL implantation. Results. Laser in situ keratomileusis enhancement for residual ametropia of −1.00 to −1.50 D in patients with a prior implantation of refractive multifocal IOL resulted in a…

Contrast sensitivity and color perception with orange and yellow intraocular lenses

To evaluate contrast sensitivity function (CSF) and color vision after implantation of either orange or yellow-tinted intraocular lenses (IOLs).Fifty-six eyes of 28 cataract patients who had bilateral implantation of orange-tinted (PC440Y Orange, Ophtec), yellow-tinted (AcrySof Natural SN60AT, Alcon), or clear (AcrySof SA60AT, Alcon) IOLs were examined. Six months postoperatively, monocular CSF under photopic and mesopic (with and without glare) conditions were measured using the Functional Visual Analyzer. Color discrimination was determined with the Farnsworth-Munsell 100-Hue test.Patients implanted with orange-tinted, yellow-tinted, or clear IOLs displayed similar CSF values, with no sta…

Effects of LASIK on Corneal Endothelium Using the 15-kHz IntraLase Femtosecond Laser

PURPOSE: To assess the effects of LASIK with the 15-kHz IntraLase femtosecond laser on corneal endothelium. METHODS: In a prospective, single-center clinical trial, 138 patients (mean age: 32.0±7.1 years [range: 21 to 42 years]) underwent femtosecond LASIK for the correction of myopia −0.75 to −9.00 diopters (D) and cylinder up to 3.25 D. Patients were divided into two groups: contact lens group (n=76) and non-contact lens group (n=62). Pre- and 12-month postoperative specular microscopy of the central corneal endothelium was performed. The integrity of the central endothelium was assessed in terms of endothelial cell density and percentage of hexagonality. RESULTS: In the contact lens gro…

Long-term comparison of corneal aberration changes after laser in situ keratomileusis: mechanical microkeratome versus femtosecond laser flap creation.

Purpose To compute and compare visual acuity, refractive outcomes, and anterior corneal aberration changes after myopic laser in situ keratomileusis (LASIK) with flap creation by a mechanical microkeratome and by a femtosecond laser. Setting Private practice refractive surgery center, Valencia, Spain. Design Comparative case series. Methods Patients were assigned to have LASIK flap creation with a mechanical microkeratome (Carriazo-Barraquer) or a femtosecond laser (IntraLase). The Visx S2 excimer laser was used for myopic ablation in all cases. Main outcome measures included uncorrected and corrected distance visual acuities and the defocus equivalent. Higher-order aberrations (HOAs) were …

Iris-fixated toric phakic intraocular lens for myopic astigmatism

Purpose To evaluate the efficacy, predictability, safety, stability, and complications of the Artiflex toric iris-fixated phakic intraocular lens (pIOL) for myopic astigmatism. Setting Private practice surgery centers, Valencia and Terrassa, Spain. Design Cohort study. Methods At 12 months, refraction, uncorrected (UDVA) and corrected (CDVA) distance visual acuities, complications, pIOL misalignment, and endothelial cell count (ECC) were evaluated. Indices of success and misalignment were calculated using vector analysis. Results The study enrolled 42 eyes in 25 patients aged 21 to 39 years. The mean spherical equivalent decreased from −8.85 diopters (D) ± 2.71 (SD) to −0.37 ± 0.46 D, with …

Visual function after bilateral implantation of a new zonal refractive aspheric multifocal intraocular lens.

Purpose To evaluate visual function after bilateral implantation of a zonal refractive aspheric multifocal intraocular lens (IOL). Setting Private practice surgery center, Valencia, Spain. Design Cohort study. Methods Consecutive eyes with cataract had bilateral implantation of Lentis Mplus LS-312 multifocal IOLs. Distance, intermediate, and near visual acuities; contrast sensitivity; defocus curves; and a quality-of-vision questionnaire, including presence of halos or dysphotopsia, were evaluated 6 months postoperatively. A control group of age-matched monofocal pseudophakic patients was included to compare contrast sensitivity function. Results In the multifocal group, the mean binocular …

Cataract surgery in West Africa: is couching still a choice?

Lack of effect of intraocular lens asphericity on visual performance with acrylic intraocular lenses.

Purpose. To determine whether implantation of acrylic intraocular lens (IOL) with aspheric design (Tecnis Z9003, AMO) results in improved visual acuity or contrast sensitivity compared with conventional spherical acrylic IOL (AR40e, AMO). Methods. In an intraindividual randomized prospective study of 60 patients with bilateral cataract, the Tecnis Z9003 IOL was compared with the AR40e IOL. Ocular aberrations for a 4.0-mm pupil and 6.0-mm pupil were measured with a Hartmann-Shack aberrometer. Quality of vision was measured using visual acuity and contrast sensitivity under mesopic and photopic conditions. Results. Eyes with the Tecnis Z9003 IOL had significantly less spherical aberration and…

Artiflex Toric Phakic Intraocular Lens Implantation in Congenital Nystagmus

Case: A 44-year-old woman with congenital nystagmus and myopic astigmatism in both eyes who was submitted to phakic intraocular lens (pIOL) implantation. Methods: Full ophthalmologic examination including refractive status, corrected (CDVA) and uncorrected (UCVA) monocular and binocular visual acuities, ocular motility, slit-lamp evaluation, tonometry and fundoscopy before and after implantation of toric pIOLs (Artiflex; Ophtec BV, The Netherlands) in both eyes. Results: Preoperative logMAR CDVA were 0.699 and 0.420 in the right and left eye, respectively. Three months after surgery, logMAR UCVA were 0.398 and 0.182, reaching binocular logMAR UCVA of 0.132. There were no changes in nystagmu…

Visual and optical performance with the ReZoom multifocal intraocular lens

Purpose This study evaluated visual acuity, contrast sensitivity, and wavefront aberrations after refractive multifocal intraocular lens (IOL) implantation. Methods A prospective study comprising 174 eyes of 87 patients who had bilateral implantation of a multifocal IOL was carried out. A control group of 100 eyes of 50 age-matched patients with a monofocal IOL was used for comparison. Uncorrected and corrected distance and near visual acuity, contrast sensitivity (CS), and wavefront analysis (Hartmann-Shack) was performed 6 months after surgery. Contrast sensitivity was tested for distance and near under mesopic (2 cd/m2) and photopic conditions (90 cd/m2). Results Distance photopic CS was…

Single versus double femtosecond laser pass for incomplete laser in situ keratomileusis flap in contralateral eyes: Visual and optical outcomes

Purpose To evaluate visual acuity, refractive outcomes, and anterior corneal higher-order aberrations (HOAs) after myopic laser in situ keratomileusis (LASIK) with uneventful single femtosecond laser pass versus double pass performed for intraoperative suction loss. Setting Private refractive surgery center, Valencia, Spain. Design Cohort study. Methods After the LASIK flap was created with a single pass of an Intralase femtosecond laser in 1 eye and a double pass in the fellow eye, the ablation was performed with a Visx S2 laser. At 12 months, the refraction, uncorrected (UDVA) and corrected (CDVA) distance visual acuities, and anterior corneal HOAs were measured with 4.0 mm and 6.0 mm pup…

Validity of automated refraction after segmented refractive multifocal intraocular lens implantation

Aim To evaluate the clinical utility of automated refraction (AR) and keratometry (KR) compared with subjective or manifest refraction (MR) after cataract or refractive lens exchange surgery with implantation of Lentis Mplus X (Oculentis GmbH) refractive multifocal intraocular lens (IOL). Methods Eighty-six eyes implanted with the Lentis Mplus X multifocal IOL were included. MR was performed in all patients followed by three consecutive AR measurements using the Topcon KR-8000 autorefractor. Assessment of repeatability of consecutive AR before and after dilation with phenylephrine 10%, and comparison of the AR and KR with MR using vector analysis were performed at 3mo follow-up. Results Ana…