To compare the visual outcomes and subjective satisfaction levels of patients who had bilateral mix-and-match implantation or monocular implantation of multifocal intraocular lenses (IOLs).Asan Medical Center, Seoul, South Korea.Retrospective comparative case series.Patients had implantation of a diffractive multifocal IOL (Tecnis ZM900) in 1 eye and a refractive multifocal IOL (Rezoom NXG1) in the other eye via the mix-and-match approach or of a Tecnis ZM900 IOL in 1 eye only. After 1 year, the uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), and contrast sensitivity were evaluated. Patient satisfaction, spectacle dependence, and halo and glare symptoms were also evaluated.Twenty-three patients were evaluated. One year postoperatively, the mean values in the bilateral group and unilateral group were, respectively, binocular UDVA, 0.10 logMAR ± 0.18 (SD) and 0.10 ± 0.13 logMAR (P=.574); UIVA, 0.23 ± 0.12 logMAR and 0.29 ± 0.14 logMAR (P=.127); UNVA, 0.25 ± 0.18 logMAR and 0.27 ± 0.25 logMAR (P=.926). Subjective patient satisfaction was slightly higher in the bilateral implantation group (P=.083). There were no significant differences in contrast sensitivity, spectacle dependency, halos, or glare.There were no significant differences in postoperative visual acuity, subjective patient satisfaction, spectacle independence, or other visual symptoms between patients who had bilateral or unilateral implantation of multifocal IOLs. Unilateral implantation of a multifocal IOL is an option to lower spectacle dependency and increase patient satisfaction.
Purpose: To test the hypothesis that ocular pigment in patients with oculodermal melanocytosis decreases myopia severity.Methods: Refractive and biometric parameters were measured and compared between pigmented eyes and non-pigmented contralateral eyes in oculodermal melanocytosis patients that underwent surgical ocular pigmentation removal. To assess pigmentation, the pigmentation score was measured in each quadrant of the sclera and added together for a cumulative score. For subgroup analyses, patients were categorized into three groups according to the severity of myopia in the non-pigmented eye.Results: Fifty-five patients (110 eyes) were included. Spherical power and spherical equivalent were significantly less myopic in pigmented eyes relative to contralateral non-pigmented eyes. The spherical powers of non-pigmented eyes were positively correlated with the difference in spherical power between contralateral eyes (r = 0.697, p < .001). The pigmentation scores of pigmented eyes were positively correlated with the ratio of myopia inhibition (r = 0.373, p = .005). In subgroup analyses, pigmented eyes exhibited significantly less myopic spherical powers and spherical equivalents than non-pigmented contralateral eyes in the moderate and high myopia groups. Pigmented eyes exhibited significantly shorter axial length than non-pigmented contralateral eyes in the high myopia group only.Conclusions: In patients with oculodermal melanocytosis, pigmented eyes exhibited less severe myopia relative to non-pigmented contralateral eyes. This suggested that ocular pigmentation inhibited myopic changes, potentially by blocking UV transmission. This study will be helpful in elucidating the mechanisms of myopic progression.
각막 지형도를 이용한 각막 구면수차의 산출 박종훈⋅김명준⋅김재용⋅차흥원 울산대학교 의과대학 서울아산병원 안과학교실 목적: 각막지형도 검사에서 제시해 주는 여러 가지 지표들을 이용해서 간단하게 각막 구면수차를 산출할 수 있는 공식을 유도해내고자 하였다.대상과 방법: 백내장 수술을 계획한 76명, 76안을 대상으로 후향적으로 의무기록 검토를 통해 연구를 진행하였다.평균 연령은 57
To investigate the efficacy and safety of cyclophosphamide and other immunosuppressive agents (ISAs) in the treatment of necrotising scleritis.
Methods
We reviewed the medical records of patients with necrotising scleritis at 11 tertiary care centres in South Korea from 2002 to 2012, treated with ISAs within 3 months of follow-up period. We divided patients into two groups: a group treated with cyclophosphamide (CYC group) and a group treated with other ISAs; azathioprine, ciclosporin, methotrexate and mycophenolate mofetil (OISA group). Main outcome measures evaluated were remission rate, relapse rate, rate of visual loss, steroid-sparing rate, adverse effects and discontinuation of medication due to adverse effects.
Results
CYC group had a remission in 95.2% of the patients and OISA group had in 96.3%. Remission rate, relapse rate, visual loss rate and steroid-sparing rate were not significantly different between the two groups (all p>0.05). The median duration of steroid use was longer in CYC group than in other OISA group (55 vs 16 days, p=0.09). The incidence of adverse effects in the CYC group was comparable with that of the OISA group (61.9% vs 41.4%, p=0.15). However, the incidence of leucopenia, haemorrhagic cystitis and discontinuation of medication due to adverse effects were much higher in the CYC group (p<0.001, p<0.001, p=0.05, respectively).
Conclusion
The efficacy of cyclophosphamide in the treatment of necrotising scleritis was comparable with that of other ISAs. However, the rate of discontinuation due to side effects was much higher in the CYC group.
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