To determine the normal interindividual variability of global visual field indices in normal subjects and investigate the correlations of visual field changes with intraocular pressure and myopic degrees, OCTOPUS 2000R automated perimetry was tested in 70 eyes of 40 normal subjects who had undergone one previous visual field on two separate sessions. The average value of Mean Defect(MD) was 3.83 +/- 1.15dB. Three eyes(4.3%) were within 2dB of the normal. In the statistical analysis of Global indices between the 1st and the 2nd fields. there were no differences(p>0.05). MD and myopic degrees showed a significant positive correlation (r=0.237, p<0.05). These results indicate that visual field indices should be interpreted with caution and used as one adjunctive parameter with other clinical findings.
Intraocular Pressure ; Myopia ; Octopodiformes* ; Visual Field Tests ; Visual Fields

PURPOSE: To evaluate two surgical methods-amniotic membrane transplantation (AMT) and split-conjunctival grafts (SCG)-for double-head pterygium, with regard to the postoperative outcome and recurrence rate. METHODS: In a total of 16 eyes (14 patients), 7 eyes (6 patients) receiving amniotic membrane transplantation and 9 eyes (8 patients) receiving split-conjunctival grafts were compared to evaluate recurrence and complications. RESULTS: Within the amniotic membrane transplantation group, two eyes (29%) had corneal recurrence, and 3 eyes (43%) had conjunctival recurrence. The mean follow-up period was 21.9+/-3.5 months, and all recurrences were on the nasal side. The average period preceding the corneal recurrences was 7.2+/-1.8 months. Within the split-conjunctival grafts group, the mean follow-up was 13.6+/-2.1 months, and neither the corneal nor conjunctival recurrences were observed. In addition, the eyes of this group were more aesthetically stable, with only one eye exhibiting pseudo-pterygium at the donor site. CONCLUSIONS: In cases of double-head pterygium without contraindication of conjunctival autograft, the split-conjunctival grafts produced fewer recurrences and showed enhanced cosmetic results, as compared to the amniotic membrane transplantation, indicating that the split-conjunctival grafts is the superior choice over amniotic membrane transplantation.
Amnion ; Cosmetics ; Eye ; Follow-Up Studies ; Humans ; Membranes ; Pterygium ; Recurrence ; Tissue Donors ; Transplants

PURPOSE: To evaluate the surgical results and complications arising from scleral graft and free conjunctival autograft using tissue adhesive and temporary amniotic membrane transplantation as the surgical treatment for scleromalacia. METHODS: Scleral graft and free conjunctival autograft using tissue adhesive and temporary amniotic membrane transplantation was performed in 20 eyes of 20 patients with scleromalacia caused by pterygium excision. The surgical results and complications arising from the procedure were monitored and analyzed through follow-up. RESULTS: During the follow-up period of 17.6 +/- 5.9 months, the wound injection and edema at the free conjunctival autograft and operation site healed in all the cases except 1 at postoperative 1 month. The stability of the ocular surface for graft transplantation was maintained at postoperative 3 months. Although a partial absorption of the conjunctival autograft induced by careless treatment occurred 2 weeks postoperative in 1 case, the ocular surface stabilized due to suitable treatment after 6 months. Although the edges of the scleral graft in 3 patients were partially absorbed 6 months postoperatively, the ocular surface stability was maintained by covering the conjunctival autografts. CONCLUSIONS: For scleromalacia patients, scleral graft and free conjunctival autograft using tissue adhesive and temporary amniotic membrane transplantation rapidly stabilized the ocular surface and presented excellent aesthetic results.
Absorption ; Amnion ; Edema ; Eye ; Fibrin Tissue Adhesive ; Follow-Up Studies ; Humans ; Pterygium ; Tissue Adhesives ; Transplants

PURPOSE: To evaluate the changes in tearfilm, corneal sensation and ocular surface after advanced surface ablation. METHODS: Tearfilm break-up time (BUT), Schirmer test without local anesthesia, fluorescein staining, corneal sensitivity test, ocular surface disease index (OSDI), and conjunctival impression cytology were evaluated in 50 eyes of 25 patients who underwent advanced surface ablation preoperatively and postoperatively at 2 weeks and at 1, 2, 3, and 6 months. Each value was compared to the preoperative value. RESULTS: OSDI diminished by 2 weeks postoperatively, and corneal sensation diminished by 1 month postoperatively (p < 0.05). There were significant decreases in BUT by 2 weeks to 1 month postoperatively as well as decreases in the Schirmer test by 2 to 3 months postoperatively (p < 0.05). Fluorescein staining increased at 2 weeks postoperatively (p < 0.05). Goblet cells decreased substantially by 1 month postoperatively and conjunctival squamous metaplasia increased significantly by 2 months postoperatively (p < 0.05). CONCLUSIONS: Advanced surface ablation may affect tearfilm, corneal sensation and ocular surface up to 3 months postoperatively. Early treatment of dry eye syndrome following advanced surface ablation should strongly be considered.
Anesthesia, Local ; Dry Eye Syndromes ; Eye ; Fluorescein ; Goblet Cells ; Humans ; Metaplasia ; Sensation ; Tears

PURPOSE: To compare the clinical results of short-term visual acuity and quality of vision after implantation of a yellow-tinted blue light-filtering intraocular lens (IOL) (Acrysof IQ® SN60WF) and an clear ultraviolet (UV) light filtering IOL (enVista™ MX60) in the same patient. METHODS: 44 patients with bilateral cataract received an SN60WF in one eye and an MX60 in the other eye. All eyes were evaluated for refraction power and uncorrected visual acuity (UCVA) at preoperative and 1, 3 months postoperatively. At postoperative 3 months, corrected visual acuity, quality of vision (OQAS II®), contrast sensitivity (CGT 2000®) and visual field (Humphrey Field Analyzer®), and subjective patients' response to the degree of brightness were evaluated. Furthermore, glistening degree, intraocular stability, and posterior capsular opacification were examined. RESULTS: There were no significant differences in average refractive power or UCVA at 1 and 3 months (p > 0.05) between the two groups. At 3 months after cataract surgery, the quality of vision according to OQAS II®, the contrast sensitivity according to CGT 2000® with the glare either on or off, and visual field; showed no difference between the two groups (p > 0.05). Both IOLs had no glistening and posterior capsular opacity. The patients' response to the degree of brightness shows that MX60 (48.3%) has a higher degree of satisfaction. CONCLUSIONS: Yellow-tinted blue light-filtering IOL and clear UV light-filtering IOL had no difference in short-term visual acuity and quality of vision. Subjective brightness perception, however, was better with clear UV light-filtering IOL.
Cataract ; Contrast Sensitivity ; Glare ; Humans ; Lenses, Intraocular* ; Visual Acuity ; Visual Fields

PURPOSE: To evaluate the clinical outcomes of patients with refractive aspheric multifocal intraocular lens (IOL) (Lentis Mplus(R) LS-313) implantation. METHODS: Sixty-eight eyes of 53 patients received refractive aspheric multifocal IOL implantation. Uncorrected visual acuity (UCVA) at a long distanc, as well as intermediate and near distances were measured on the first day, after two weeks, and during the first, third and sixth months postoperatively. Optical quality was evaluated using the Optical Quality Analysis System II (OQAS II). High-order aberrations (HOA) and patient satisfaction questionnaires were evaluated at three months post-operation. RESULTS: At the six-month postoperative visit, the mean UCVA at a long, two intermediate (63 cm, 100 cm) and a near distance were 0.06 +/- 0.07, 0.18 +/- 0.14, 0.15 +/- 0.13 and 0.11 +/- 0.10 log MAR, respectively. The means of the objective scatter index, modulation transfer function (MTF) cut off value, Strehl ratio and pseudo-accommodation range measured by OQAS II were 1.20 +/- 0.69, 34.15 +/- 9.53 cdp, 0.17 +/- 0.05 and 3.09 +/- 0.25 D, respectively. HOA of 5 mm and 6 mm were each 0.61 +/- 0.14 and 1.07 +/- 0.20, respectively. Eighty-two percent of patients were satisfied with the postoperative results, and 71% of the patients reported that they would recommend the procedure to others, while 24% of patients reported moderate or severe visual disturbance at night. CONCLUSIONS: Implantation of the refractive aspheric multifocal IOLs in patients with cataracts provided excellent distant, intermediate, and near visual outcomes and high patient satisfaction as well as presbyopia correction.
Cataract ; Cytidine Diphosphate ; Humans ; Lenses, Intraocular ; Patient Satisfaction ; Presbyopia ; Surveys and Questionnaires ; Visual Acuity

PURPOSE: To investigate the effects of long-term contact lens (CL) wearing on corneal thickness, curvature, and endothelium. METHODS: Using ultrasonic pachymetry, Orbscan topography and specular microscopy, we evaluated the cornea of 53 subjects who had used soft CL for more than 5 years compared with 47 controls who had never used CL. RESULTS: There was a significant decrease of central corneal thickness in CL wearers. The difference of central corneal thickness between the two groups was 16.39 micrometer. The percentage of central corneal thickness less than 500 micrometer was 24.5% in the CL wearers and 12.2% in the controls. The mean corneal thickness of the CL wearers in the center and eight peripheral areas, as measured with Orbscan topography, was significantly reduced by about 7.28 to 17.87 micrometer compared with that of the controls. The corneal curvature and elevation were significantly steeper in the CL wearers than in the controls but no difference in the mean corneal astigmatism was found between the two groups. Endothelial density and percentage of hexagonal cells were decreased and the coefficient of cell area variation was increased in the CL wearers compared to the controls. The percentage of endothelial cell densities less than 2500 cells/mm2 was 24.5% in the CL wearers and 4.25% in the controls. CONCLUSIONS: Long-term soft contact lens use may have a significant effect on corneal thickness, curvatures and endothelial morphology.
Astigmatism ; Contact Lenses, Hydrophilic* ; Cornea ; Endothelial Cells ; Endothelium* ; Endothelium, Corneal ; Microscopy ; Ultrasonics

PURPOSE: To evaluate the efficacy and safety of pterygium excision using a large conjunctival autograft for the treatment of recurrent pterygium. METHODS: The medical records of 120 patients (126 eyes) with recurrent pterygium were reviewed. For each affected eye, pterygium excision with a large conjunctival autograft was performed. The graft was harvested from the superior bulbar area and measured more than 8 × 10 mm in size. Only patients who completed at least six months of follow-up were included. Postoperative clinical outcomes, recurrence rate, and complications were analyzed. Patients with any evidence of recurrence after surgery received a subconjunctival bevacizumab injection. RESULTS: The average patient age was 56.5 ± 10.2 years, and 45 out of 120 patients were male. The mean study follow-up period was 17.7 ± 17.6 months. Most patients were satisfied with the cosmetic outcome. Postoperative visual acuity improved from 0.69 to 0.75 (p < 0.05). Postoperative refractive astigmatism and corneal astigmatism decreased by 0.55 and 2.73 diopters, respectively (p < 0.05). The postoperative recurrence rate was 4.0%, and the average recurrence period was 7.4 ± 0.6 weeks. A subconjunctival injection of 5 mg bevacizumab was performed in cases of recurrence; no progression of the pterygium was observed following the injection. Postoperative complications included 2 cases of conjunctival graft edema in 2 eyes, 5 donor site scars in 5 eyes, 13 pyogenic granulomas in 13 eyes, and a conjunctival epithelial inclusion cyst in 7 eyes. CONCLUSIONS: Pterygium excision with a large conjunctival autograft for the treatment of recurrent pterygium produced an excellent cosmetic outcome, a low recurrence rate, and minimal complications. A subconjunctival bevacizumab injection given in cases of recurrence following surgery might be effective in preventing progression of the pterygium.
Astigmatism ; Autografts* ; Bevacizumab ; Cicatrix ; Edema ; Follow-Up Studies ; Granuloma, Pyogenic ; Humans ; Male ; Medical Records ; Postoperative Complications ; Pterygium* ; Recurrence ; Tissue Donors ; Transplants ; Visual Acuity

PURPOSE: To compare the efficacy and safety of photorefractive keratectomy with laser epithelial keratomileusis, for low to moderate myopia. METHODS: Patients with a manifest refraction less than -6.0 diopters were enrolled in this study. Patients were treated with photorefractive keratectomy (47 eyes) or laser epithelial keratomileusis (42 eyes). Preoperative and postoperative uncorrected visual acuity, refractive errors, keratometry, residual central corneal thickness, epithelial healing time, and corneal haze were evaluated for a 1 year follow-up period. RESULTS: There were no significant differences between photorefractive keratectomy and laser epithelial keratomileusis in uncorrected visual acuity, refractive errors or correction of refractive errors. Residual central corneal thickness increased until 6 months postoperative and thereafter in both photorefractive keratectomy and laser epithelial keratomileusis groups. There were no significant changes in keratometry after postoperative 1 month. Epithelial healing time of photorefractive keratectomy was shorter than that of laser epithelial keratomileusis. Corneal haze score had a peak at 1 month postoperative and then decreased rapidly until 3 months postoperative, it was stable after 6 months. Corneal haze score at 1 month was less than 0.5 in both groups and did not disturb visual acuity. CONCLUSIONS: Photorefractive keratectomy and laser epithelial keratomileusis have an equal effect in correction of visual acuity and refractive errors. They have equivalent levels of safety as measured by postoperative residual central corneal thickness and corneal haze. Both procedures are effective methods to correct low to moderate myopia.
Follow-Up Studies ; Humans ; Myopia* ; Photorefractive Keratectomy* ; Refractive Errors ; Visual Acuity

PURPOSE: To report the clinical results after the implantation of intrastromal corneal ring segments (Intacs(R)) by manual tunnel creation for the correction of keratoconus. METHODS: This retrospective case series was comprised of 10 eyes of 8 consecutive keratoconic patients. Visual acuity, refractive outcome, keratometric values, anterior chamber depth, central corneal thickness, and endothelial cell density were evaluated before and at 1 month, 3 months, and 6 months postoperatively. In addition, the implanted ring segment depth was measured by anterior segment optical coherence tomography at postoperative 6 months. Any postoperative complications were also recorded. RESULTS: Visual acuity was improved in 9 out of 10 eyes. Spherical equivalent and keratometric values were decreased in all eyes. There was no significant difference in central corneal thickness, but endothelial cell density and anterior chamber depth were slightly decreased. The depth of ring segments was almost constant at superior, middle, and inferior. There was a single case of descented implanted ring segments and 6 cases of stromal infiltration around ring segments, but visual acuity was unaffected. In addition, 1 case showed implanted ring exposure, thus the superior ring segment was removed at postoperative 4 months. CONCLUSIONS: Intrastromal corneal ring segment implantation (Intacs(R)) by manual tunnel creation appears to be effective in improving the visual acuity and stabilizing corneal refractive power in keratoconic patients.
Anterior Chamber ; Endothelial Cells ; Eye ; Humans ; Keratoconus ; Postoperative Complications ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Acuity