PURPOSE: We report a case of pseudophakic pupillary block after toxic anterior segment syndrome (TASS). CASE SUMMARY: An 84-year-old woman underwent phacoemulsification and intraocular lens implantation in the posterior chamber. Six days after surgery, anterior chamber inflammation was seen. Twenty-five days after surgery, a sudden increase in intraocular pressure (IOP) associated with pupillary block was observed. Despite the use of IOP-lowering medication, the IOP was not controlled. Peripheral laser iridotomy failed. After surgical peripheral iridectomy, IOP decreased significantly and was controlled. CONCLUSIONS: Despite the rarity of TASS combined with pseudophakic pupillary block, clinicians must be aware of this condition in patients showing prolonged inflammatory state and IOP elevation after surgery.
Aged, 80 and over ; Anterior Chamber ; Female ; Humans ; Inflammation ; Intraocular Pressure ; Iridectomy ; Lens Implantation, Intraocular ; Phacoemulsification ; Pseudophakia

PURPOSE: The purpose of this study is to investigate new prognostic factors in associated with primary anatomical failure after scleral buckling (SB) for uncomplicated rhegmatogenous retinal detachment (RRD). METHODS: The medical records of patients with uncomplicated RRD treated with SB were retrospectively reviewed. Eyes with known prognostic factors for RRD, such as fovea-on, proliferative vitreoretinopathy, pseudophakia, aphakia, multiple breaks, or media opacity, were excluded. Analysis was performed to find correlations between anatomical success and various parameters, including age. RESULTS: This study analyzed 127 eyes. Binary logistic regression analysis revealed that older age (≥35) was the sole independent prognostic factor (odds ratio, 3.5; p = 0.022). Older age was correlated with worse preoperative visual acuity (p < 0.001), shorter symptom duration (p < 0.001), presence of a large tear (p < 0.001), subretinal fluid drainage (p < 0.001), postoperative macular complications (p = 0.048), and greater visual improvement (p = 0.003). CONCLUSIONS: Older age (≥35) was an independent prognostic factor for primary anatomical failure in SB for uncomplicated RRD. The distinguished features of RRD between older and younger patients suggest that vitreous liquefaction and posterior vitreous detachment are important features associated with variation in surgical outcomes.
Aphakia ; Drainage ; Humans ; Logistic Models ; Medical Records ; Pseudophakia ; Retinal Detachment* ; Retinaldehyde* ; Retrospective Studies ; Scleral Buckling* ; Subretinal Fluid ; Tears ; Visual Acuity ; Vitreoretinopathy, Proliferative ; Vitreous Detachment

PURPOSE: To examine the relationship between the refractive astigmatism by automated refractometry and the corneal astigmatism by a dual Scheimpflug analyzer in pseudophakic eyes. METHODS: Prospectively, 75 patients (100 eyes) were enrolled in the present study. Refractive astigmatism was obtained by automated refraction. Corneal astigmatism was obtained using automated keratometry (ARK-530A®) and dual Scheimpflug scanning analysis (Galilei G4®). All refractive values were converted to the power vector components J0 and J45 for comparison and regression analysis of refractive versus corneal astigmatism. Bland-Altman plots were created to estimate the agreement between measurements. RESULTS: The average astigmatism from each measurement was -1.11 ± 1.44 D (refractive astigmatism from automated refraction), -0.77 ± 1.06 D (corneal astigmatism from automated keratometry), -0.93 ± 1.02 D (simulated K from Galilei G4®), and -1.11 ± 1.48 D (total corneal power from Galilei G4®). Refractive J0 and keratometric J0 were significantly correlated (r = 0.557, p ≤ 0.001), as well as the corresponding J45 values (r = 0.655, p = 0.025). Refractive astigmatism and total corneal power components were also significantly correlated (J0: r = 0.618, p ≤ 0.001; J45: r = 0.608, p = 0.04). In the Bland-Altman plots, keratometric J0 and total corneal power J0 showed the best agreement. CONCLUSIONS: The accuracy of measurements for corneal refraction and astigmatism in pseudophakic eyes is higher using the dual Scheimpflug analyzer, especially for total corneal power. This value of astigmatism can take into account the refractive astigmatism of pseudophakic eyes and can be used in evaluating postoperative corneal astigmatism.
Astigmatism ; Humans ; Prospective Studies ; Pseudophakia ; Refractometry*

PURPOSE: To evaluate visual outcomes following implantation of a trifocal diffractive intraocular lens (IOL) and to analyze their correlation with patient satisfaction and ease of performing daily tasks. METHODS: This was a prospective study enrolling 100 eyes of 50 patients undergoing cataract surgery with implantation of trifocal IOL AT LISA tri 839MP. Visual and refractive outcomes were evaluated during a 3-month follow-up. Postoperatively, a questionnaire was used to evaluate patient satisfaction with regard to surgical outcome, spectacle independence, perception of photic phenomena, and ease of performing some vision-related activities. RESULTS: A total of 91%, 87%, and 79% of eyes achieved a monocular uncorrected distance, near, and intermediate visual acuity of 0.1 logarithm of the minimum angle of resolution or better, respectively. After the surgery, 96% of the patients could perform their daily activities without problems. The mean spectacle independence scores for reading, doing computer work, and for distance were 10.33 ± 12.47, 5.71 ± 11.90, and 3.92 ± 9.77, respectively (scale: 0 = no spectacles needed; 40 = spectacles always needed). No correlation was found between spectacle independence and visual outcome (-0.101 ≤ r ≤ 0.244, p ≥ 0.087). Mean scores (0 = no symptoms; 40 = strong symptoms) for glare at night, ghost images, and halos were 15.15 ± 12.02, 4.49 ± 7.92, and 13.34 ± 10.82, respectively. No correlation was found between photic phenomena and visual outcome (-0.199 ≤ r ≤ 0.209, p ≥ 0.150). A total of 80% of patients reported satisfaction with the surgery outcome, and 86% would recommend the surgery to friends and family. CONCLUSIONS: Implantation of the AT LISA tri 839MP IOL after cataract surgery provides effective visual restoration associated with a minimal level of photic phenomena, a positive impact on the performance of vision-related daily activities, and a high level of postoperative patient satisfaction.
Cataract Extraction/*methods ; Eyeglasses ; Female ; Follow-Up Studies ; Humans ; Lens Implantation, Intraocular/*methods ; Male ; Middle Aged ; *Patient Satisfaction ; *Phakic Intraocular Lenses ; Prospective Studies ; Prosthesis Design ; Pseudophakia/*physiopathology ; Refraction, Ocular/*physiology ; Surveys and Questionnaires ; *Visual Acuity

PURPOSE: We report a case of amaurosis fugax associated with ipsilateral internal carotid artery agenesis. CASE SUMMARY: A 50-year-old woman presented with amaurosis fugax in her left eye; the frequency of episodes of the condition had recently increased to once a month. She had a history of hypertension and dyslipidemia, and was under medical therapy. The visual acuity of both eyes was 20/20. Slit-lamp examination was normal except for pseudophakia. Ophthalmoscopy revealed a myopic tigroid fundus and a myopic tilted disc. No abnormalities were evident in fluorescein fundus angiography. Brain computed tomography showed that the left bony carotid canal was absent, and magnetic resonance angiography showed that the left internal carotid artery was also absent. She was diagnosed with left internal carotid artery agenesis. Other neurological and hematological parameters were within normal ranges. The amaurosis fugax spontaneously disappeared and has not recurred over the past 12 months. Our case, although rare, suggests that amaurosis fugax may be associated with internal carotid artery agenesis.
Amaurosis Fugax* ; Angiography ; Blindness* ; Brain ; Carotid Artery, Internal* ; Dyslipidemias ; Female ; Fluorescein ; Humans ; Hypertension ; Magnetic Resonance Angiography ; Middle Aged ; Ophthalmoscopy ; Pseudophakia ; Reference Values ; Visual Acuity

No abstract available.
Cornea ; *Corneal Edema ; Edema ; Humans ; *Macular Edema ; Pseudophakia ; Visual Acuity

No abstract available.
Cornea ; *Corneal Edema ; Edema ; Humans ; *Macular Edema ; Pseudophakia ; Visual Acuity

Aged ; Anterior Eye Segment ; pathology ; Female ; Glaucoma ; therapy ; Humans ; Pseudophakia ; therapy ; Tomography, Optical Coherence ; methods

PURPOSE: To report transient corneal edema after phacoemulsification as a predictive factor for the development of pseudophakic cystoid macular edema (PCME). METHODS: A total of 150 eyes from 150 patients (59 men and 91 women; mean age, 68.0 ± 10.15 years) were analyzed using spectral domain optical coherence tomography 1 week and 5 weeks after routine phacoemulsification cataract surgery. Transient corneal edema detected 1 week after surgery was analyzed to reveal any significant relationship with the development of PCME 5 weeks after surgery. RESULTS: Transient corneal edema developed in 17 (11.3%) of 150 eyes 1 week after surgery. A history of diabetes mellitus was significantly associated with development of transient corneal edema (odds ratio [OR], 4.04; 95% confidence interval [CI], 1.41 to 11.54; p = 0.011). Both diabetes mellitus and transient corneal edema were significantly associated with PCME development 5 weeks after surgery (OR, 4.58; 95% CI, 1.56 to 13.43; p = 0.007; and OR, 6.71; CI, 2.05 to 21.95; p = 0.003, respectively). In the 8 eyes with both diabetes mellitus and transient corneal edema, 4 (50%) developed PCME 5 weeks after surgery. CONCLUSIONS: Transient corneal edema detected 1 week after routine cataract surgery is a predictive factor for development of PCME. Close postoperative observation and intervention is recommended in patients with transient corneal edema.
Adult ; Aged ; Aged, 80 and over ; Cornea/*pathology ; Corneal Edema/*diagnosis/etiology ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Fundus Oculi ; Glucosinolates ; Humans ; Macular Edema/diagnosis/*etiology ; Male ; Middle Aged ; *Phacoemulsification ; Pseudophakia/*complications/diagnosis ; Retrospective Studies ; Tomography, Optical Coherence

OBJECTIVE: To compare the quality of life using the National Eye Institute Refractive Error Quality of Life (NEI-RQL) instrument in 40-60 year-old patients with reading glasses and presbyopic LASIK correction and in 60-80 year-old patients with monofocal and multifocal intraocular lenses (IOLs).

METHODS: Patients aged 40-80 years old with reading glasses (group 1a) or presbyopic LASIK treatment (group 1b) and bilateral pseudophakia with monofocal (group 2a) or multifocal IOLs (group 2b) were recruited. All patients answered the NEI-RQL questionnaire. The responses in the self-administered questionnaires were collated, analyzed, and compared between the subgroups.

RESULTS: One hundred fifty patients (median age 60 years, range 41-80 years) completed the NEI-RQL questionnaire. Subjects (age 41-59 years) who underwent presbyopic LASIK correction had a higher mean NEI-RQL (p=0.19) and higher subscale score for satisfaction (p=0.42) than those wearing reading glasses. However, the differences were not satistically significant.

CONCLUSION: Presbyopic LASIK improved uncorrected near visual acuity and provided spectacle independence in presbyopes; however, patient satisfaction was similar to those who with reading glasses. Multifocal IOLs significantly improved uncorrected near visual acuity and spectacle independence in pseudophakic patients with high patient satisfaction.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Eyeglasses ; Lenses, Intraocular ; Keratomileusis, Laser In Situ ; Pseudophakia ; Refractive Errors ; Presbyopia ; Quality Of Life