International ophthalmology
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The purpose of this study is to present the causes and visual acuity outcomes in patients with elevated intraocular pressure (IOP) following implantable collamer lens (ICL) implantation. A chart review identified patients who developed high IOP at any postoperative examination and a minimum follow-up period of 3 months after ICL implantation. Data are reported out to 6 months postoperatively. ⋯ Two eyes with high vault and elevated IOP underwent ICL explantation. There is a moderate risk of transiently developing elevated IOP after ICL implantation. Thorough removal of viscoelastic and use of anti-glaucoma medications during steroid use will reduce the majority of cases with postoperative IOP elevation.
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Non-traumatic ectopia lentis has been associated with genetic diseases in a European population; however, no data are present in regards to this in a Pakistani demographic. In third world countries such as Pakistan, due to the lack of screening tests, this disease has the potential to remain undiagnosed till a later age, at which point the eye through the finding of ectopia lentis has potential to lead to the right diagnosis. Our purpose was to investigate Pakistani patients presenting with ectopia lentis who have underlying homocystinuria and establish a relationship between the two. ⋯ All 20 (100 %) eyes had ectopia lentis, of which, 15 (75 %) eyes had inferior subluxation, whereas five (25 %) eyes had anterior subluxation of the crystalline lens. Ectopia lentis and homocystinuria appear to have a strong correlation in Pakistani population. Ectopia lentis has the potential to serve as an important clue to its diagnosis, which may in turn lead to decreased morbidity if diagnosed in a timely fashion.
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To assess the intra-observer repeatability and inter-observer reproducibility of central corneal thickness (CCT) measurements of PachPen (Accutome, Inc., Pennsylvania, USA), a hand-held, portable ultrasonic pachymeter when used by an ophthalmic nurse compared to an ophthalmologist. Ophthalmology Clinic, University of Malaya Medical Center In this prospective study, CCT was measured in 184 eyes of 92 healthy subjects, first by a corneal surgeon experienced in ultrasound pachymetry (Observer 1) followed by an ophthalmic nurse new to the procedure (Observer 2). Nine measurements were obtained from each eye by each observer, independently. ⋯ The measurements by both observers showed high correlation (0.96) and good agreement (mean difference -2.4 µm; 95% limits of agreement -21.4, 16.7 µm). Coefficient of reproducibility of measurements between observers was 5.08%. Accutome PachPen hand-held ultrasound pachymeters gives excellent intra-observer repeatability and inter-observer reproducibility by personnel of different training grades.
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To describe lagophthalmos and eyelid closure abnormality after external dacryocystorhinostomy (DCR). A retrospective review of medical records and postoperative photographs of 79 patients who underwent external DCR for nasolacrimal duct obstruction and developed eyelid closure abnormality and lagophthalmos with or without exposure keratopathy was conducted. Collected data included age, sex, indication for surgery, laterality, length and type of incision, length of follow-up duration, presence of punctate epithelial keratopathy, and time for resolution of eyelid closure abnormalities. ⋯ The mean follow-up period was 4.2 months (range 3-6 months). Eyelid closure abnormality and lagophthalmos after external DCR are underestimated problems. Spontaneous resolution is seen in all cases weeks to months after surgery.
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The purpose is to study the ability of an event-based analysis of retinal nerve fibre layer (RNFL) attenuation measured by Stratus(®) optical coherence tomography (OCT) and to detect progression across the spectrum of glaucoma. Adult glaucoma suspects, ocular hypertensives and glaucoma patients who had undergone baseline RNFL thickness measurement on Stratus OCT and reliable automated visual field examination by Humphrey's visual field analyser prior to March 2007 and had 5-year follow-up data were recruited. Progression on OCT was defined by two criteria: decrease in average RNFL thickness from baseline by at least 10 and 20 µ. ⋯ OCT was more useful to detect progression in early glaucoma, but performed poorly in advanced glaucoma. The 10 µ criterion appears to be closer to visual field progression. However, the ability to detect progression varies considerably between functional and structural tools depending upon the severity of the disease.