Toric Intraocular Lens vs. Peripheral Corneal Relaxing Incisions to Correct Astigmatism in Eyes Undergoing Cataract Surgery

Purpose:.To compare toric intraocular lens implantation(ToricIOL).with peripheral corneal relaxing incisions(PCRIs) for astigmatism correction in patients undergoing cataract surgery.Methods: 54 patients(54 eyes) with more than 0.75 diopter(D).of preexisting corneal astigmatism were classified as group A(0.75-1.50D) or group B(1.75-2.50D). The patients were randomized to undergo Toric-IOL or PCRIs in the steep axis with spherical IOL implantation..Log MAR uncorrected visual acuity(Log MAR UCVA), Log MAR best corrected vi sual acuity.(Log MAR BCVA),.error of vector(|EV|), surgery induced refraction correction.(|SIRC |),.and correction rates(CR) were measured 1 month and 6 months postoperatively.Results: At 6 months postoperatively, all 54 eyes had LogMAR BCVA≤0.2. Patients who underwent PCRIs and ToricIOL with Log MAR BCVA≤0.1 showed no significant differences in group A(P=1.00) or in group B(P=0.59). Group A showed no significant differences in Log MAR UCVA(P =0.70), |EV|(P=0.13), |SIRC|(P=0.71), and CR(P=0.56)in patients underwent PCRIs and Toric-IOL. However, group B showed significant differences in Log MAR UCVA(P <0.01), |EV|(P<0.01)), |SIRC|(P<0.01), and CR(P<0.01).The Log MAR UCVA and |EV | between 1 and 6 months showed no significant differences in patients in group A. However, in group B, they are significant differences.Conclusion:.The efficacy and stability of Toric-IOL and PCRIs were equal in low astigmatic patients..Toric-IOL achieved an enhanced effect over PCRIs in higher astigmatic patients.PCRIs had the more refractive regression than Toric-IOL in 6months.

Comparison of Anterior Segment Optical Coherence Tomography and Ultrasound Biomicroscopy for Iris Parameter Measurements in Patients with Primary Angle Closure Glaucoma

Purpose: To compare the repeatability and consistency of anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM) in measuring iris parameters in patients with primary angle closure glaucoma. Methods: Twenty-two patients (38 eyes) with primary angle closure glaucoma,including 5 eyes with acute angle closure glaucoma,10 fellow eyes of acute angle closure glaucoma, and 23 eyes with chronic angle closure glaucoma, were recruited consecutively in our hospital. All subjects underwent anterior scanning by AS-OCT and UBM. Peripheral iris thickness (PIT) and iris curvature (IC) in the anterior segment image obtained by AS-OCT and UBM were measured twice. The reproducibility of these two scans was evaluated by the intraclass correlation coefficient (ICC). A paired t-test was used to compare the difference between the two scans and the 95% limits of agreement (LoA) were calculated. Results:The ICCs of PIT and IC measured by UBM were 0.892 and 0.936 respectively, while for AS-OCT these values were 0.629 and 0.859, respectively. UBM had a higher reproducibility in both PIT and IC measurements as compared with AS-OCT.Differences in PIT measurement between AS-OCT and UBM(P=0.331).were not statistically significant, the 95% LoA (-0.178～0.156) mm was 36.1～41.2% of the mean. The IC was 0.053 mm smaller when measured by UBM than by AS-OCT (P=0.017), with the 95% LoA (-0.100～0.206) mm, or 36.2～74.6% of the mean.Conclusion:UBM had a higher reproducibility in measuring iris parameters than AS-OCT. The consistency between AS- OCT and UBM in measuring iris parameters was low in primary angle closure glaucoma patients. (Eye Science 2013; 28:1-6)

Use of Silicone Tubes to Repair Canalicular Lacerations via a Novel Method

Purpose:To develop a novel method to repair canalicular lacerations using silicone tubes.Methods:A total of 47 adult patients(47 eyes)with canalicular lacerations were collected from the outpatient department from November 2010 to December 2012.The age ranged from16 to 53 years.Among the 47 eyes,37 had lower canalicular lacerations,6 had upper canalicular lacerations,and 4 had bicanalicular lacerations..A soft probe was made using a stainless steel acupuncture needle,which was inserted into the lumen of the proximal part of the catheter to increase its rigidity.The probe was then inserted into the lacrimal sac and nasolacrimal duct.After retrieval of the catheters,the two ends of the silicone tube were securely tied.(end to end).to the catheters..The silicon tube outside the nostril formed a Ushape.The catheters were then pulled upward until the silicone tube was completely located in the canalicular system.The catheters were cut off of the silicone tube near the site of the connection.The two ends of the silicone tube were cut short,~2mm out of the lacrimal punctum,and tied securely,end to end.The length of the tube between the upper and lower punctum was adjusted to ensure that no tension was present in the medial cathus,and the suture was removed through the nostril.The silicone tube was removed 3-10 months after this novel canalicular intubation procedure (NCI).Results:.All cases were anatomically rehabilitated after surgery..The silicone tube was removed after implanted in 3-10months (mean 4.5±1.3 months),the average follow-up time was 11.8 months after removal.In total,45 eyes in all 47eyes (95.74%)were free from obstruction.Among them,41eyes (91.11%) achieved complete success(completely disap-pearance of epiphora after tube removal),.4 eyes.(8.89%)achieved partial success.(irritation occurs under stimulation conditions,such as wind or cold conditions),4 eyes showed postoperative tearing,with three eyes having inferior lacrimal duct laceration,and one eye with superior canalicular laceration.Apart from two cases (4.26%) suffering inferior punctum splitting,no other associated issues occurred with the silicone tube or iatrogenic injury and lacrimal complications.Conclusion:For adult patients with canalicular laceration,the NCI was an effective,atraumatic surgery,which has fewer complications than traditional canalicular suture.

Clinical Application of X-ray,B-scan,and CT in the Diagnosis of Ocular Foreign Bodies

Purpose:To analyze the sensitivity and specificity of X-ray, B-ultrasound, and CT scan in diagnosing ocular foreign bodies, and to compare the accuracy of these three imaging tools in locating these foreign bodies. Methods:A retrospective review was conducted of radio graphic and clinical eye examination data from 62 patients (66 eyes),suspected of having ocular foreign bodies at time of first presentation to the Zhongshan Ophthalmic Center (Guangzhou, China) between August 2007 and October 2011. The sensitivity and specificity of X-ray, B-ultrasound and CT scan in the diagnosis of ocular foreign bodies were investigated and their accuracy in locating these foreign bodies was compared. Results: A total of 75.8% (n=47) subjects had ocular foreign bodies; 66% of these were metallic. Patients with intraocular, eye wall,and extraocular foreign bodies accounted for 46, 28, and 26% of the total, respectively. The sensitivities of X-ray,CT scan,and B-ultrasound in the diagnosis of ocular foreign bodies were 58.3%, 61.7%, and 75%, the specificityies were 63.3%, 100%, and 87.5%, and the accuracy in locating foreign bodies was 73.4%, 94.7%, and 86.5%, respectively. The properties of foreign bodies affected the diagnosistic accuracy of X-ray,but exerted little impact upon B-ultrasound and CT scan. Conclusion:A fairly high incidence of ocular foreign bodies was noted in patients suspected with ocular foreign bodies at their first presentations.X-ray combined with CT scan or X-ray in combination with B-ultrasound showed a relatively high sensitivity and specificity in diagnosing ocular foreign bodies. CT scan had the highest accuracy in locating ocular foreignbodies. (Eye Science 2013; 28:11-14)

Recommendation on data collection and annotation of ocular appearance images in ptosis

Ptosis is a common ophthalmologic condition,and the diagnosis is primarily based on ocular appearance.Thediagnosis of such conditions can be improved using emerging technology such as artificial intelligence-basedmethods.However,unified data collection and labeling standards have not yet been established.This directlyimpacts the accuracy of ptosis diagnosis based on appearance alone.Therefore,in the present study,we aimedto establish a procedure to obtain and label images to devise a recommendation system for optimal recognitionof ptosis based on ocular appearances.This would help to standardize and facilitate data sharing and serve as aguideline for the development and improvisation of algorithms in artificial intelligence for ptosis.