Over a period of 62 months, a retrospective interventional study was implemented at a tertiary eye care center in southern India. The research study incorporated 256 eyes from 205 patients, following written informed consent. A single, seasoned surgeon handled all instances of DSEK. The donor dissection procedure employed a manual approach in all cases. The temporal corneal incision served as the entry point for the Sheet's glide, which carried the donor button, its endothelial surface oriented downwards. Using a Sinskey's hook, the separated lenticule was advanced into the anterior chamber, the hook pushing it into the anterior chamber's interior. Intraoperative or postoperative problems were documented and dealt with, using either medical remedies or suitable surgical techniques.
Preoperative mean best-corrected visual acuity (BCVA) was CF-1 m, escalating to 6/18 postoperatively. Intraoperative donor graft perforation during the dissection process was observed in 12 instances; three eyes exhibited thin lenticules; and three eyes experienced repeated anterior chamber (AC) collapse. Twenty-one eyes exhibited lenticule dislocation, the most frequently observed complication, which was managed by repositioning the graft and re-bubbling. Eleven patients experienced minimal graft separation, while interface haze was observed in seven cases. The two cases of pupillary block glaucoma showed improvement after a partial bubble release intervention. Surface infiltration was observed in two instances, prompting the use of topical antimicrobial agents for treatment. Primary graft failure was witnessed in the context of two patient cases.
DSEK, while a promising alternative to penetrating keratoplasty for addressing corneal endothelial decompensation, nonetheless possesses intrinsic advantages and disadvantages, yet its advantages frequently outweigh its disadvantages.
DSEK, as a promising alternative to penetrating keratoplasty for cases of corneal endothelial decompensation, although carrying its own set of strengths and weaknesses, often finds its merits exceeding its limitations.
Comparing post-operative pain perception in patients using bandage contact lenses (BCLs) stored at 2-8°C (cold BCLs, CL-BCLs) and 23-25°C (room temperature, RT-BCLs) after photorefractive keratectomy (PRK) or corneal collagen crosslinking (CXL) and evaluating factors related to nociception.
This prospective interventional study enrolled 56 patients who were undergoing PRK for refractive correction, and 100 patients with keratoconus (KC) who were undergoing CXL, in accordance with institutional ethics committee approval and informed consent. In patients undergoing bilateral PRK, the treatment with RT-BCL was given to one eye and treatment with CL-BCL to the other. Pain quantification was performed using the Wong-Baker FACES pain rating scale on the first post-operative day. Measurements of transient receptor potential channels (TRPV1, TRPA1, TRPM8), calcitonin gene-related peptide (CGRP), and interleukin-6 (IL-6) were undertaken in the extracted cellular material from used bone marrow aspirates (BCLs) on postoperative day 1 (PoD1). Post-CXL, a similar count of KC patients were given either RT-BCL or CL-BCL. hepatic cirrhosis Pain assessment was conducted using the Wong-Baker FACES pain rating scale at the commencement of the post-operative period.
On Post-Operative Day 1 (PoD1), pain scores were markedly lower in subjects treated with CL-BCL (mean ± standard deviation 26 ± 21) than in those receiving RT-BCL (60 ± 24) after PRK, with this difference being statistically significant (P < 0.00001). A substantial 804% reduction in reported pain was observed in subjects treated with CL-BCL. 196% of those who received CL-BCL treatment reported either no change in their pain scores or an increase in discomfort. BCL tissue from subjects reporting diminished pain with CL-BCL demonstrated a substantially increased (P < 0.05) TRPM8 expression level relative to those who did not report pain reduction. A substantial reduction (P < 0.00001) in pain scores was observed on PoD1 among subjects treated with CL-BCL (32 21) following CXL, in contrast to those given RT-BCL (72 18).
The simple and direct method of using a cold BCL post-operatively successfully lessened pain perception and could potentially overcome post-operative pain's negative influence on the adoption of PRK/CXL.
Pain perception following PRK/CXL was notably decreased by the straightforward use of a cold BCL post-operatively, which could lead to a better patient acceptance rate.
Two years post-SMILE surgery incorporating angle kappa adjustment, the study compared postoperative visual outcomes, including corneal higher-order aberrations (HOAs) and visual quality, between patients with an angle kappa greater than 0.30 mm and patients with an angle kappa less than 0.30 mm.
The retrospective study involving 12 patients who underwent the SMILE procedure for myopia and myopic astigmatism correction from October 2019 to December 2019 showed that each patient had one eye with a larger kappa angle and the other eye with a smaller kappa angle. A measurement of the modulation transfer function cutoff frequency (MTF) was executed by an optical quality analysis system (OQAS II; Visiometrics, Terrassa, Spain) twenty-four months after the surgical process.
Measurements include the Strehl2D ratio, objective scatter index (OSI), and other parameters. The Tracey iTrace Visual Function Analyzer (Tracey version 61.0; Tracey Technologies, Houston, TX, USA) served to quantify HOAs. RMC-4630 The quality of vision (QOV) questionnaire served as the instrument for evaluating subjective visual quality.
After 24 months of the operation, the mean spherical equivalent (SE) refraction was found to be -0.32 ± 0.040 in the S-kappa group (kappa values below 0.3 mm) and -0.31 ± 0.035 in the L-kappa group (kappa values 0.3 mm or greater), with no statistically significant difference observed (P > 0.05). A mean OSI of 073 032 and 081 047, respectively, was found, with no statistically significant difference (P > 0.005). A lack of meaningful distinction was observed in MTF.
Statistically speaking, there was no notable difference in Strehl2D ratio between the two groups (P > 0.05). Comparative analysis of total HOA, spherical, trefoil, and secondary astigmatism across the two groups revealed no significant difference (P > 0.05).
SMILE procedures incorporating adjustments to kappa angle minimize decentration, leading to a reduction in higher-order aberrations and ultimately boosting visual clarity. medial temporal lobe This dependable method facilitates the optimized concentration of treatments within the SMILE procedure.
In SMILE procedures, modifying the kappa angle successfully reduces decentration, lowering high-order aberrations, and enhancing visual clarity. This method assures a consistent method for achieving the ideal treatment concentration in SMILE.
To ascertain the divergent visual outcomes of early enhancement after small incision lenticule extraction (SMILE) and laser in situ keratomileusis (LASIK).
The records of patients who underwent eye surgery at a tertiary eye care hospital between 2014 and 2020 and required an early enhancement (within the first year) were reviewed retrospectively. Refractive error stability, corneal tomography, and anterior segment Optical Coherence Tomography (AS-OCT) measurements of epithelial thickness were conducted. The eyes underwent post-regression correction using photorefractive keratectomy, including flap lift, building upon the initial procedures of SMILE and LASIK, respectively. The analysis included pre- and post-enhancement data for both corrected and uncorrected distance visual acuity (CDVA and UDVA), mean refractive spherical equivalent (MRSE), and cylinder values. Data manipulation and statistical modeling are facilitated by IBM SPSS software.
A total of 6350 eyes following SMILE procedures and 8176 eyes following LASIK procedures were analyzed. Following SMILE procedures, 32 eyes of 26 patients (5%) and, following LASIK procedures, 36 eyes of 32 patients (4.4%) underwent corrective enhancement surgery. Post-LASIK flap-lift enhancement, and PRK in the SMILE cohort, resulted in UDVA logMAR values of 0.02 to 0.05 and 0.09 to 0.16, respectively (P = 0.009). The refractive sphere and MRSE exhibited no substantial difference (P = 0.033 and P = 0.009, respectively). Analysis reveals 625% of eyes in the SMILE group and 805% in the LASIK group achieved a UDVA of 20/20 or better. This outcome was statistically significant, with a p-value of 0.004.
Post-SMILE PRK procedures yielded outcomes similar to post-LASIK flap-based advancements, signifying a secure and successful approach for early improvements following SMILE.
Early enhancements following SMILE surgery using PRK procedures showed outcomes similar to those achieved with flap-lift LASIK, highlighting its safety and efficacy in this context.
This study investigates the visual acuity produced by two concurrent soft multifocal contact lenses and examines the comparative visual outcomes of multifocal lenses and their monovision modifications within the cohort of newly fitted presbyopic individuals.
A comparative study, using a double-masked design, was conducted on 19 participants, who were randomly assigned to wear either soft PureVision2 multifocal (PVMF) or clariti multifocal (CMF) lenses, in a prospective manner. Distance visual acuity, both at high and low levels of contrast, along with near visual acuity, the ability to perceive depth (stereopsis), contrast sensitivity, and the ability to see in glare conditions, were all measured. Initial measurements were taken using a multifocal and modified monovision design featuring a particular lens brand; these measurements were then duplicated using a different lens brand.
A substantial variation in high-contrast distance visual acuity was detected between CMF (000 [-010-004]) and PureVision2 modified monovision (PVMMV; -010 [-014-000]) correction (P = 0.003), and also between CMF and clariti modified monovision (CMMV; -010 [-020-000]) correction (P = 0.002). Superior performance was observed in the modified monovision lenses when compared to CMF. The contact lens corrections in this study yielded no statistically significant variations in low-contrast visual acuity, near visual acuity, or contrast sensitivity (P > 0.001).