Visual outcome and optical quality after bilateral implantation of aspheric diffractive multifocal, aspheric monofocal and spherical monofocal intraocular lenses: a prospective comparison

·AIM: To evaluate the visual function after bilateral implantation of aspheric diffractive multifocal Tecnis ZMA00, aspheric monofocal ZA9003 versus spherical monofocal Akreos Adapt intraocular lenses (IOLs). ·METHODS: Tecnis ZMA00, Tecnis ZA9003 or Akreos Adapt IOLs were bilaterally implanted in 180 eyes from 90 patients. The following parameters were assessed 3 months postoperatively: monocular and binocular uncorrected visual acuity (UCVA) and distance-corrected visual acuity (DCVA) for distance, intermediate and near, spherical aberration (SA), contrast and glare sensitivity, near point refractive power, uncorrected and best corrected near stereoscopic acuity (NSA). Patient satisfaction was assessed by a questionnaire. ·RESULTS:Threemonthspostoperatively,themonocular and binocular UCVA and DCVA at near of Tecnis ZMA00 were significantly better than other two groups. The mean SA for 5.0mm optical zone in Tecnis ZMA00 and Tecnis ZA9003 was significantly lower than that in Akreos Adapt. Mean contrast sensitivity and glare sensitivity were better for Tecnis ZA9003 group than for other two groups. Patients with Tecnis ZMA00 had higher monocular and binocular near point refractive power and uncorrected NSA than monofocal groups. The patients in Tecnis ZMA00 had higher mean values for halo compared with other two groups. ·CONCLUSION: Tecnis ZMA00 provided better near VA and uncorrected NSA and higher near point refractive power than monofocal IOLs and patients were spectacle independent. The IOLs with Tecnis aspheric design improved contrast and glare sensitivity. Patients with Tecnis ZMA00 reported more disturbances on visual phenomena of halo. ·

Conductive keratoplasty: an approach for the correction of residual hyperopia in post-lasik pseudophakia

Although there are many formulae for the calculation of intraocular lens power in the eyes with previous kerato-refractive surgeries, unexpected refractive bias still exists. Hyperopic bias is particularly disliked because it affects both uncorrected distance and near visual acuity. Surgical treatment of the residual hyperopia for the eyes with both laser in situ keratomileusis and cataract surgery remains to be a big problem. Conductive keratoplasty has been shown to be an effective, safe and predictable method for low and moderate hyperopia in the pseudophakic eyes or in the eyes with kerato-refractive surgeries. However, the efficacy and safety of conductive keratoplasty in the correction of residual hyperopia after both corneal and lens refractive surgeries has not been reported. Herein, we reported the surgical correction with conductive keratoplasty for cases of residual hyperopia with/without astigmatism after previous laser in situ keratomileusis for high myopia and following phacoemulsification combined with posterior intraocular lens implantation for complicated cataract.

Retinal pigment epithelial tears following treatment in neovascular age-related macular degeneration

Dear sir,I am Dr Zhi-Qing Chen, from the Department of Ophthalmology of the Second Affiliated Hospital ofZhejiang University in Hangzhou, Zhejiang Province, China. I write to present two cases of neovascular age-related macular degeneration （AMD） occurred retinal pigment epithelium （RPE） tears after different treatment.

Co-existent choroidal neovascular membrane and macular hole in pathologic myopia:a long follow-up clinical outcome and literature review

Choroidal neovascularization(CNV)is an uncommon complication associated with a macular hole.In this case report of a rare condition,we present a pathologic myopia patient with a co-existent macular hole and choroidal neovascular membrane.The patient was treated with photodynamic therapy for CNV,and then vitreous surgery for the retinal detachment and macular hole.At the end of 4 years follow-up,her visual acuity was improved to 0.1 while the macular hole remained open.Optical coherence tomography is a useful inspection method of the diagnosis of CNV and macular hole.

Correction of extreme hyperopia: artisan iris-fixated intraocular lens implantation for pseudophakia after clear lens extraction

A 22-year-old patient suffering from both-side extreme hyperopia with amblyopia was corrected with an Artisan iris-fixated intraocular lens (IOL) implantation followed to clear lens extraction (CLE) with posterior chamber (PC)-IOL implantation. The preoperative refraction values were +17.75DS -1.50DC × 168° for the right eye and +17.25DS -0.75DC × 8° for the left eye. The uncorrected visual acuity (UCVA) was 20/200 bilaterally and the spectacle-corrected visual acuity (BSCVA) was 20/50 bilaterally. One year after Artisan iris-fixated IOL implantation, bilateral BSCVA was 20/50 with a refraction of +1.25DS -0.75DC × 13° for the right eye and +1.50DS -1.00DC × 55° for the left eye. The outcomes of an Artisan iris-fixated IOL implantation followed to CLE with PC-IOL implantation were encouraging for the correction of extreme hyperopia. Long term follow-up examinations were necessary for further determination of the efficacy and safety of this combinational procedure.

Spontaneous resolution of traumatic cataract after removal of a ferrous intravitreal foreign body using external magnetic extraction through a pars plana incision

Dear Editor,I am Dr.Zhi-Tao Su,from the Eye Center,Second Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou,China.I write to present a case of spontaneous resolution of a traumatic cataract resulted in good visual rehabilitation after removal of a ferrous intravitreal foreign body(IVFB).

Resolution of siderotic glaucoma correlated with decreased pigmentation in the anterior chamber angle after removal of a retained ferrous foreign body

Dear Sir,I am Dr.Zhe Xu,from the Eye Center,Second Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou,China.We write to present a case of resolution of siderotic glaucoma after removal of a retained ferrous foreign body.This study has been performed in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of the Second Affiliated Hospital.

The application of ultra-wide-field fundus autofluorescence in early metastatic choroidal tumor screening

I am Dr.Ke Yao,from Eye Center,the Second Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou,China.I write to present three cases with metastatic choroidal tumor using an ultra-wide-field scanning laser ophthalmoscope.