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Kozhaya K, Kenny PI, Wang L, Weikert MP, Koch DD. Reply : Efficacy of segmented axial length and artificial intelligence approaches to intraocular lens power calculation in short eyes. J Cataract Refract Surg 2024; 50:313-314. [PMID: 38237066 PMCID: PMC10878438 DOI: 10.1097/j.jcrs.0000000000001400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Affiliation(s)
- Karim Kozhaya
- From the Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas
| | - Peter I. Kenny
- From the Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas
| | - Li Wang
- From the Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas
| | - Mitchell P. Weikert
- From the Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas
| | - Douglas D. Koch
- From the Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas
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Wang L, Kozhaya K, Weikert MP, Koch DD. Reply : Efficacy of segmented axial length and artificial intelligence approaches to intraocular lens power calculation in short eyes. J Cataract Refract Surg 2024; 50:195-196. [PMID: 38170943 DOI: 10.1097/j.jcrs.0000000000001387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024]
Affiliation(s)
- Li Wang
- From the Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas
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Kenny PI, Kozhaya K, Truong P, Wang L, Koch DD, Weikert MP. Performance of IOL calculation formulas that use measured posterior corneal power in eyes following myopic laser vision correction. J Cataract Refract Surg 2024; 50:7-11. [PMID: 37702522 DOI: 10.1097/j.jcrs.0000000000001300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 08/29/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE To compare the predictive accuracy of the biometer-embedded Barrett True-K TK and new total corneal power methods of intraocular lens (IOL) power calculation in eyes with prior laser vision correction (LVC) for myopia. SETTING Academic clinical practice. DESIGN Retrospective case series. METHODS IOL power formulas were assessed using measurements from a swept-source optical coherence biometer. Refractive prediction errors were calculated for the Barrett True-K TK, EVO 2.0, Pearl-DGS, and HofferQST, which use both anterior and posterior corneal curvature measurements. These were compared with the Shammas, Haigis-L, Barrett True-K No History (NH), optical coherence tomography, and 4-formula average (AVG-4) on the ASCRS postrefractive calculator, and to the Holladay 1 and 2 with non linear axial length regressions (H1- and H2-NLR). RESULTS The study comprised 85 eyes from 85 patients. Only the Barrett True-K TK and EVO 2.0 had mean numerical errors that were not significantly different from 0. The EVO 2.0, Barrett True-K TK, Pearl-DGS, AVG-4, H2-NLR, and Barrett True-K NH were selected for further pairwise analysis. The Barrett True-K TK and EVO 2.0 demonstrated smaller root-mean-square absolute error compared with the Pearl-DGS, and the Barrett True-K TK also had a smaller mean absolute error than the Pearl-DGS. CONCLUSIONS The Barrett True-K TK and EVO 2.0 formulas had comparable performance to existing formulas in eyes with prior myopic LVC.
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Affiliation(s)
- Peter I Kenny
- From the Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas
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Kozhaya K, Kenny PI, Esfandiari S, Wang L, Weikert MP, Koch DD. Effect of spherical aberration on visual acuity and depth of focus in pseudophakic eyes. J Cataract Refract Surg 2024; 50:24-29. [PMID: 37702444 DOI: 10.1097/j.jcrs.0000000000001314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 09/08/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE To assess the performance of 4 intraocular lenses (IOLs) in various spherical aberration (SA) conditions, using the VAO adaptive optics simulator. SETTING Cullen Eye Institute, Baylor College of Medicine, Houston, Texas. DESIGN Prospective case series. METHODS Distance-corrected visual acuities at distance (CDVA), intermediate (DCIVA), and near (DCNVA) were measured in 42 dilated pseudophakic eyes at baseline and with ocular SA ranging from -0.4 to +0.4 μm in increments of 0.2 μm (6.0-mm pupil). 4 IOL types were assessed: monofocal IOLs with zero-SA, enhanced-monofocal, extended depth-of-focus (EDOF), and continuous range-of-vision. RESULTS Compared with SA = 0 μm, significant changes (all P < .05) were: (1) zero-SA monofocal IOLs' DCNVA at high contrast improved by 0.13 logMAR with SA = -0.4 μm and worsened by 0.09 and 0.10 logMAR with SA = +0.2 and +0.4 μm, respectively. DCNVA at low contrast worsened by 0.09 logMAR with SA = +0.4 μm; and (2) with SA = -0.4 μm, the enhanced monofocal IOL lost 0.06 logMAR of CDVA at high contrast and gained 0.09 logMAR of DCNVA at low contrast. There were no significant changes from SA = 0 μm for EDOF and continuous range-of-vision IOLs. CONCLUSIONS Zero-SA and EDOF IOLs were the most and least sensitive to SA modulation, respectively. In perfect optical systems where all the optical elements are aligned, induction of targeted amounts of negative SA improved the depth of focus of some IOL types. No benefit was found with positive SA.
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Affiliation(s)
- Karim Kozhaya
- From the Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas
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Nair A, Zvietcovich F, Singh M, Weikert MP, Aglyamov SR, Larin KV. Optical coherence elastography measures the biomechanical properties of the ex vivo porcine cornea after LASIK. J Biomed Opt 2024; 29:016002. [PMID: 38223300 PMCID: PMC10787573 DOI: 10.1117/1.jbo.29.1.016002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/29/2023] [Accepted: 12/26/2023] [Indexed: 01/16/2024]
Abstract
Significance The biomechanical impact of refractive surgery has long been an area of investigation. Changes to the cornea structure cause alterations to its mechanical integrity, but few studies have examined its specific mechanical impact. Aim To quantify how the biomechanical properties of the cornea are altered by laser assisted in situ keratomileusis (LASIK) using optical coherence elastography (OCE) in ex vivo porcine corneas. Approach Three OCE techniques, wave-based air-coupled ultrasound (ACUS) OCE, heartbeat (Hb) OCE, and compression OCE were used to measure the mechanical properties of paired porcine corneas, where one eye of the pair was left untreated, and the fellow eye underwent LASIK. Changes in stiffness as a function of intraocular pressure (IOP) before and after LASIK were measured using each technique. Results ACUS-OCE showed that corneal stiffness changed as a function of IOP for both the untreated and the treated groups. The elastic wave speed after LASIK was lower than before LASIK. Hb-OCE and compression OCE showed regional changes in corneal strain after LASIK, where the absolute strain difference between the cornea anterior and posterior increased after LASIK. Conclusions The results of this study suggest that LASIK may soften the cornea and that these changes are largely localized to the region where the surgery was performed.
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Affiliation(s)
- Achuth Nair
- University of Houston, Department of Biomedical Engineering, Houston, Texas, United States
| | | | - Manmohan Singh
- University of Houston, Department of Biomedical Engineering, Houston, Texas, United States
| | - Mitchell P. Weikert
- Baylor College of Medicine, Cullen Eye Institute, Houston, Texas, United States
| | - Salavat R. Aglyamov
- University of Houston, Department of Mechanical Engineering, Houston, Texas, United States
| | - Kirill V. Larin
- University of Houston, Department of Biomedical Engineering, Houston, Texas, United States
- Baylor College of Medicine, Department of Physiology and Biophysics, Houston, Texas, United States
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Kozhaya K, Wang L, Weikert MP, Koch DD. Early outcomes of second-generation light-adjustable lenses in eyes with and without corneal refractive surgery. J Cataract Refract Surg 2023; 49:1180-1182. [PMID: 37867286 DOI: 10.1097/j.jcrs.0000000000001282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/02/2023] [Indexed: 10/24/2023]
Affiliation(s)
- Karim Kozhaya
- From the Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas
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Kenny PI, Kozhaya K, Truong P, Weikert MP, Wang L, Hill WE, Koch DD. Efficacy of segmented axial length and artificial intelligence approaches to intraocular lens power calculation in short eyes. J Cataract Refract Surg 2023; 49:697-703. [PMID: 36940190 DOI: 10.1097/j.jcrs.0000000000001185] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/14/2023] [Indexed: 03/21/2023]
Abstract
PURPOSE In short eyes, to compare the predictive accuracy of newer intraocular lens (IOL) power calculation formulas using traditional and segmented axial length (AL) measurements. SETTING Cullen Eye Institute, Baylor College of Medicine, Houston, Texas and East Valley Ophthalmology, Mesa, Arizona. DESIGN Multi-center retrospective case series. METHODS Measurements from an optical biometer were collected in eyes with AL <22 mm. IOL power calculations were performed with 15 formulas using 2 AL values: (1) machine-reported traditional AL (Td-AL) and (2) segmented AL calculated with the Cooke-modified AL nomogram (CMAL). 1 AL method and 7 formulas were selected for pairwise analysis of mean absolute error (MAE) and root mean square absolute error (RMSAE). RESULTS The study comprised 278 eyes. Compared with the Td-AL, the CMAL produced hyperopic shifts without differences in RMSAE. The ZEISS AI IOL Calculator (ZEISS AI), K6, Kane, Hill-RBF, Pearl-DGS, EVO, and Barrett Universal II (Barrett) formulas with Td-AL were compared pairwise. The ZEISS AI demonstrated smaller MAE and RMSAE than the Barrett, Pearl-DGS, and Kane. K6 had a smaller RMSAE than the Barrett formula. In 73 eyes with shallow anterior chamber depth, the ZEISS AI and Kane had a smaller RMSAE than the Barrett. CONCLUSIONS ZEISS AI outperformed Barrett, Pearl-DGS, and Kane. The K6 formula outperformed some formulas in selected parameters. Across all formulas, use of a segmented AL did not improve refractive predictions.
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Affiliation(s)
- Peter I Kenny
- From the Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas (Kenny, Kozhaya, Truong, Weikert, Wang, Koch); East Valley Ophthalmology, Mesa, Arizona (Hill)
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Kozhaya K, Chen AJ, Joshi M, Kenny PI, Koch DD, Fram N, Weikert MP, Wang L, Khandelwal SS. Comparison of Keratoconus Specific to Standard IOL Formulas in Patients With Keratoconus Undergoing Cataract Surgery. J Refract Surg 2023; 39:242-248. [PMID: 37040215 DOI: 10.3928/1081597x-20230124-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
PURPOSE To assess the performance of multiple intraocular lens (IOL) formulas in eyes with keratoconus. METHODS Eyes with stable keratoconus scheduled for cataract surgery with biometry measurements on the Lenstar LS900 (Haag-Streit) were included. Prediction errors were calculated using 11 different formulas, including two with keratoconus modifiers. Primary outcomes compared standard deviations, mean and median numerical errors, and percentage of eyes within diopter (D) ranges across all eyes with subgroup analysis according to anterior keratometric values. RESULTS Sixty-eight eyes from 44 patients were identified. In eyes with keratometric values less than 50.00 D, prediction error standard deviations ranged from 0.680 to 0.857 D. Percentages of eyes within ±0.50 D of target ranged from 57.89% to 73.68% with no statistical differences among formulas. In eyes with a keratometric value of more than 50.00 D, prediction error standard deviations ranged from 1.849 to 2.349 D and were not statistically different with heteroscedastic analysis; percentages of eyes within ±0.50 D of target ranged from 0% to 18.18% with no statistical differences among formulas. Only keratoconus-specific formulas (Barrett-KC and Kane-KC) and the Wang-Koch axial length adjustment version of SRK/T resulted in median numerical errors not significantly different than 0, regardless of keratometric values. CONCLUSIONS In keratoconic eyes, IOL formulas are less accurate than in normal eyes and result in hyperopic refractive outcomes that increase with steeper keratometric values. Using keratoconus-specific formulas and the Wang-Koch axial length adjustment version of SRK/T for axial lengths of 25.2 mm or greater improved IOL power prediction accuracy compared to other formulas. [J Refract Surg. 2023;39(4):242-248.].
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Paysse EA, Kong L, Achim C, Weikert MP, Whitlow BT, Romany G, Coats DK. Developmental Improvement in Children With Intellectual Disability After Photorefractive Keratectomy for Severe Isoametropia. Am J Ophthalmol 2022; 235:15-23. [PMID: 34450111 DOI: 10.1016/j.ajo.2021.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 07/31/2021] [Accepted: 08/11/2021] [Indexed: 11/01/2022]
Abstract
PURPOSE To assess the impact of refractive error correction from photorefractive keratectomy on development in children with severe isoametropia, subnormal visual acuity, and intellectual disability unable to use refraction correction. DESIGN Prospective noncomparative interventional case series. METHODS Before and after photorefractive keratometry (PRK), subjects who had plateaued developmentally for 18 or more months were assessed using a battery of developmental tests. The primary outcome measure was the change in the developmental quotient (DQ) 6 months after PRK. Secondary outcomes were the change in the DQ, uncorrected visual acuity, cycloplegic refraction, and corneal status 12, 24, and 36 months after PRK. RESULTS Sixteen subjects aged 2 to 8 years were included. Twelve were highly myopic (mean, -9.69 ± 3.82 diopters [D]), 3 highly hyperopic (mean, +5.75 ± 0.59 D) and 1 highly astigmatic (mean, +3.50 D). Six months after PRK, the DQ significantly improved for expressive communication (mean, 4.51 ± 2.27 months; P = .04), interpersonal relationships (mean, 9.45 ± 4.18 months; P = .02) and coping (mean, 6.44 ± 2.10 months; P = .05). Twelve months after PRK, the DQ significantly improved for receptive communication (8.04 ± 1.80 months; P < .001), expressive communication (6.99 ± 2.27 months; P < .05), written communication (9.28 ± 3.72 months; P < .04), domestic skills (6.50 ± 2.43 months; P < .03), interpersonal relationships (10.57 ± 4.17 months; P < .02), and coping (8.41 ± 3.25 months; P < .5). CONCLUSIONS PRK significantly improves developmental abilities of children with intellectual disability, severe isoametropia, and previously plateaued development, in addition to improving visual acuity and refractive error.
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Solyman O, Matharu KS, Wang Y, Weikert MP. A novel simulation model for penetrating keratoplasty. Indian J Ophthalmol 2021; 69:3785. [PMID: 34827053 PMCID: PMC8837378 DOI: 10.4103/ijo.ijo_489_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Omar Solyman
- Department of Surgery, Division of Ophthalmology, Texas Children's Hospital, Houston, Texas 77030, USA; Research Institute of Ophthalmology, Giza, Egypt, 12211; Department of Ophthalmology, Qassim University Medical City, Al-Qassim, Saudi Arabia
| | - Kanwal S Matharu
- Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, 77030, USA
| | - Yvonne Wang
- Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, 77030, USA
| | - Mitchell P Weikert
- Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, 77030, USA
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Matoba A, Weikert MP, Kim S. Corneal Manifestations of Miltefosine Toxicity in Acanthamoeba Keratitis. Ophthalmology 2021; 128:1273. [PMID: 34420590 DOI: 10.1016/j.ophtha.2021.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 05/28/2021] [Accepted: 06/02/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Alice Matoba
- Department of Ophthalmology, Baylor College of Medicine, Houston, Texas
| | | | - Stella Kim
- UTHealth McGovern Medical School, The University Of Texas Health Science Center, Houston, Texas
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Liu J, Wang L, Chai F, Han Y, Qian S, Koch DD, Weikert MP. Comparison of intraocular lens power calculation formulas in Chinese eyes with axial myopia. J Cataract Refract Surg 2020; 45:725-731. [PMID: 31146930 DOI: 10.1016/j.jcrs.2019.01.018] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 12/31/2018] [Accepted: 01/15/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE To assess the accuracy of intraocular lens (IOL) power calculation formulas in Chinese eyes with axial lengths (ALs) longer than 26.0 mm. SETTING Department of Cataract Surgery, Shanxi Eye Hospital, China. DESIGN Prospective case series. METHODS This study evaluated (1) two new formulas (Barrett Universal II and Hill-RBF 2.0), (2) three vergence formulas (Haigis, Holladay 1, and SRK/T), and (3) the original and modified Wang-Koch AL adjustment formulas with Holladay 1 and SRK/T. The User Group for Laser Interference Biometry lens constants were used for IOL power calculation. The refractive prediction error was calculated by subtracting the predicted refraction from the actual refraction postoperatively. The mean numerical error (MNE), percentage of eyes with hyperopic outcomes, and mean absolute error (MAE) were determined. RESULTS The study comprised 136 eyes. The Barrett and Hill-RBF formulas had MNEs close to zero (-0.09 D to 0.03 D), the Haigis, Holladay 1, and SRK/T produced hyperopic MNEs (0.25 to 0.70 D), and the original and modified Wang-Koch AL adjustment formulas induced myopic MNEs (-0.48 to -0.22 D). The original Wang-Koch formulas produced significantly lower percentages of eyes with hyperopic outcomes (15% to 18%) than all other formulas (28% to 91%). There were no significant differences in MAEs between the Barrett, Hill-RBF, Haigis, and original and modified Wang-Koch adjustment with the Holladay 1 (0.32 to 0.41 D). CONCLUSION The performances of the Barrett and Hill-RBF were comparable in long eyes. The incidence of hyperopic outcome with the Wang-Koch AL adjustment formula was significantly lower than other formulas.
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Affiliation(s)
- Jiewei Liu
- Shanxi Eye Hospital, Taiyuan, Shanxi Province, China.
| | - Li Wang
- Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA
| | - Feiyan Chai
- Shanxi Eye Hospital, Taiyuan, Shanxi Province, China
| | - Yu Han
- Shanxi Eye Hospital, Taiyuan, Shanxi Province, China
| | - Suqin Qian
- Changsha Vigor Pediatrics, Changsha, Hunan Province, China
| | - Douglas D Koch
- Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA
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Brunin G, Sajjad A, Kim EJ, Montes de Oca I, Weikert MP, Wang L, Koch DD, Al-Mohtaseb Z. Secondary intraocular lens implantation: Complication rates, visual acuity, and refractive outcomes. J Cataract Refract Surg 2019; 43:369-376. [PMID: 28410720 DOI: 10.1016/j.jcrs.2016.12.024] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 12/09/2016] [Accepted: 12/19/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE To compare complication rates, visual acuity, and refractive outcomes of secondary intraocular lens (IOLs) implantation. SETTING Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA. DESIGN Retrospective case series. METHODS All secondary IOLs placed by the anterior segment service were reviewed. Preoperative data, operative reports, and data from each subsequent postoperative visit were evaluated. Patients were divided into 5 groups based on the final IOL position: (1) sulcus with optic capture, (2) sulcus without optic capture, (3) anterior chamber (AC), (4) iris-fixated, and (5) transscleral-sutured. Complication rates, visual acuity, and refractive outcomes were compared for each group. RESULTS The sulcus with and without optic capture groups had the lowest complication rates and best visual acuity outcomes. There was no difference in final corrected distance visual acuity (CDVA) between the transscleral-sutured IOL, iris-fixated IOL, and AC IOL groups, although the AC IOL group had the lowest rates of early postoperative complications and a significant improvement in vision. The transscleral-sutured IOL group had the highest complication rates, and 25% of patients in the iris-fixated IOL group lost 2 or more lines of CDVA. CONCLUSIONS When a secondary IOL cannot be placed within the capsular bag, sulcus with optic capture is the best alternative, followed by sulcus without optic capture. There was no difference in visual acuity outcomes between transscleral-sutured IOLs, iris-fixated IOLs, and AC IOLs. Anterior chamber IOLs resulted in fewer early complications.
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Affiliation(s)
- Greg Brunin
- From the Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA
| | - Ahmar Sajjad
- From the Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA
| | - Eric J Kim
- From the Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA
| | - Ildamaris Montes de Oca
- From the Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA
| | - Mitchell P Weikert
- From the Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA
| | - Li Wang
- From the Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA
| | - Douglas D Koch
- From the Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA
| | - Zaina Al-Mohtaseb
- From the Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA.
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Ram R, Kang T, Weikert MP, Kong L, Coats DK, Paysse EA. Corneal indices following photorefractive keratectomy in children at least 5 years after surgery. J AAPOS 2019; 23:149.e1-149.e3. [PMID: 31103563 DOI: 10.1016/j.jaapos.2018.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 11/17/2018] [Accepted: 12/28/2018] [Indexed: 10/26/2022]
Abstract
PURPOSE To evaluate long-term corneal outcomes in pediatric patients who underwent photorefractive keratotomy (PRK) for the treatment of refractive amblyopia. METHODS In this prospective interventional case series, children with refractive amblyopia underwent PRK between January 1, 2007, and December 31, 2011, at Texas Children's Hospital's Department of Ophthalmology, a single tertiary eye center, and were followed for at least 5 years after surgery. Main outcome measures were 5+ years postoperative indices of corneal thickness, keratometry, degree of corneal haze, and presence or absence of keratectasia. RESULTS Twelve eyes of 8 subjects aged 3-9 years who underwent PRK and were followed for at least 5 years were included. The mean PRK treatment dose was 8.46 D for the myopic cohort and 4.49 D for the hyperopic cohort, which removed an average of 72 μm of corneal stromal tissue in addition to the 50 μm of corneal epithelium that was removed prior to laser ablation. The mean corneal thickness was 563 μm preoperatively, which decreased to 441 μm immediately following the PRK. The mean corneal thickness 5+ years after PRK was stable, at 498 μm, because of epithelial regrowth. None of the subjects developed visually significant corneal haze or topographic evidence of keratectasia. CONCLUSIONS In this study cohort, there were no topographic signs of keratectasia or corneal haze in children treated with PRK for high refractive error 5 years or more after surgery.
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Affiliation(s)
- Radha Ram
- Department of Ophthalmology, Baylor College of Medicine, Houston, Texas; Department of Ophthalmology, Texas Children's Hospital, Houston, Texas
| | - Terry Kang
- Department of Ophthalmology, Baylor College of Medicine, Houston, Texas; Department of Ophthalmology, Texas Children's Hospital, Houston, Texas
| | | | - Lingkun Kong
- Department of Ophthalmology, Texas Children's Hospital, Houston, Texas
| | - David K Coats
- Department of Ophthalmology, Baylor College of Medicine, Houston, Texas; Department of Ophthalmology, Texas Children's Hospital, Houston, Texas
| | - Evelyn A Paysse
- Department of Ophthalmology, Baylor College of Medicine, Houston, Texas; Department of Ophthalmology, Texas Children's Hospital, Houston, Texas.
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Golla A, Weikert MP, Chevez-Barrios P, Al-Mohtaseb Z. Anterior Segment Optical Coherence Tomography of Ocular Cystinosis Confirmed by Electron Microscopy. Ocul Oncol Pathol 2019; 5:110-113. [PMID: 30976588 DOI: 10.1159/000490389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 05/24/2018] [Indexed: 11/19/2022] Open
Abstract
Purpose To report a case of ocular cystinosis diagnosed by anterior segment optical coherence tomography (AS-OCT) and histopathology. Methods A 67-year-old man who presented with eye pain was found to have unilateral corneal crystal deposition. Ocular cystinosis was diagnosed by histopathology, AS-OCT, and lack of renal involvement of the disease. Results AS-OCT showed hyperreflective densities in the corneal epithelium. The patient underwent superficial keratectomy given irregular astigmatism prior to cataract surgery. Electron microscopy of the corneal scrapings revealed epithelial cells with intracystoplasmic membrane-bound crystals confirming the diagnosis of cystinosis. Conclusion To our knowledge, this is the first reported case of ocular cystinosis involving strictly the epithelial layer of the cornea that has been imaged by AS-OCT.
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Affiliation(s)
- Abhinav Golla
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA
| | - Mitchell P Weikert
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA
| | - Patricia Chevez-Barrios
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA
| | - Zaina Al-Mohtaseb
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA
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Wang L, Guimaraes de Souza R, Weikert MP, Koch DD. Evaluation of crystalline lens and intraocular lens tilt using a swept-source optical coherence tomography biometer. J Cataract Refract Surg 2018; 45:35-40. [PMID: 30309775 DOI: 10.1016/j.jcrs.2018.08.025] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/06/2018] [Accepted: 08/09/2018] [Indexed: 01/19/2023]
Abstract
PURPOSE To evaluate crystalline lens and intraocular lens (IOL) tilt using a swept-source optical coherence tomography (SS-OCT) biometer (IOLMaster 700). SETTING Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA. DESIGN Retrospective case series. METHODS The study patients were evaluated for 1) repeatability of the crystalline lens tilt measurement, 2) preoperative crystalline lens and postoperative IOL tilt in right eyes, 3) mirror symmetry between right eyes and left eyes, 4) the correlation between preoperative crystalline lens and postoperative IOL tilt, and 5) the correlation between the magnitude of lens tilt and ocular parameters. RESULTS The study comprised 333 patients. The repeatability was 0.1 degrees for tilt magnitude and 3.0 degrees for tilt direction. Both the crystalline lens and IOL had anterior tilt of the nasal portion with mean tilt magnitudes of 3.7 degrees ± 1.1 (SD) (range 0.4 to 6.9 degrees) for the crystalline lens and 4.9 ± 1.8 degrees (range 1.6 to 10.7 degrees) for the IOL. There was mirror symmetry between right eyes and left eyes. The mean IOL tilt magnitude exceeded crystalline lens tilt by 1.2 ± 1.1 degrees (range -3.2 to 4.0 degrees), and the 2 values were significantly correlated (all P < .01). The magnitude of crystalline lens tilt significantly increased with decreasing axial length and with increasing angle α (all P < .05). CONCLUSIONS The repeatability of crystalline lens tilt measurements using the SS-OCT biometer was excellent. There was mirror symmetry between the right eyes and left eyes. Preoperative crystalline lens tilt could be used to predict the postoperative IOL tilt. The lens tilt magnitude was greater in short eyes and in eyes with larger angle α.
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Affiliation(s)
- Li Wang
- Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA
| | | | | | - Douglas D Koch
- Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA.
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Golla A, Wang L, Morris C, Weikert MP, Khandelwal SS. Repeatability of central corneal thickness measurements of donor corneas in preservation chamber using Fourier-domain anterior segment optical coherence tomography. Cell Tissue Bank 2018; 19:717-720. [PMID: 30182303 DOI: 10.1007/s10561-018-9724-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 08/24/2018] [Indexed: 11/30/2022]
Abstract
To evaluate the repeatability of central corneal thickness (CCT) measurements in donor corneas using optical coherence tomography (OCT, RTVue-Optovue, Inc., Fremont, CA). Consecutive corneas were measured by a single observer using the RTVue. All corneas were preserved in the Transend chamber and Life4 °C media (Numedis, Inc., Isanti, MN/USA) and stored at 4 °C. The repeatability was evaluated using a pooled within-subject standard deviation (SD), coefficient of variation (CoV), and intraclass correlation coefficient (ICC). To investigate inter-observer repeatability, a second observer independently measured the CCT for each image scan. CCT was measured in 32 eyes from 18 donors. Measurements were independently repeated by a second observer. The corneas had a mean CCT of 490.99 μm ± 65.95 (381-642) as measured by Observer 1. For observer 1, the SD value for the CCT was 2.94 μm, the CoV value was 0.597%, and the ICC value was 0.998 (95% CI 0.996, 0.999). For observer 2, the SD value was 5.91 μm, the CoV value was 1.21%, and the ICC value was 0.992 (95% CI 0.985, 0.996). The Kappa statistic 21.88% with a p value < 0.001. The Bland-Altman plot shows that the average CCT measurements between the two observers were within 20 μm of each other. The CCT measurements of donor corneas in the preservation chamber using Fourier domain OCT is highly repeatable.
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Affiliation(s)
- Abhinav Golla
- Cullen Eye Institute, Baylor College of Medicine, 6565 Fannin St NC505B, Houston, TX, 77030, USA
| | - Li Wang
- Cullen Eye Institute, Baylor College of Medicine, 6565 Fannin St NC505B, Houston, TX, 77030, USA
| | - Caleb Morris
- Cullen Eye Institute, Baylor College of Medicine, 6565 Fannin St NC505B, Houston, TX, 77030, USA
| | - Mitchell P Weikert
- Cullen Eye Institute, Baylor College of Medicine, 6565 Fannin St NC505B, Houston, TX, 77030, USA.,Lions Eye Bank of Texas, 1977 Butler Blvd, Houston, TX, 77030, USA
| | - Sumitra S Khandelwal
- Cullen Eye Institute, Baylor College of Medicine, 6565 Fannin St NC505B, Houston, TX, 77030, USA. .,Lions Eye Bank of Texas, 1977 Butler Blvd, Houston, TX, 77030, USA.
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Chamberlain PD, Montes de Oca I, Shah R, Wang L, Weikert MP, Khandelwal SS, Al-Mohtaseb Z. Preoperative Prediction of the Optimal Toric Intraocular Lens Alignment Meridian. J Refract Surg 2018; 34:515-520. [PMID: 30089180 DOI: 10.3928/1081597x-20180530-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 05/25/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine whether any of three keratometry devices is superior to the others in predicting the ideal toric intraocular lens (IOL) alignment meridian. METHODS A retrospective review was performed to identify patients who underwent cataract phacoemulsification with toric IOL implantation from November 2014 to November 2016 at a single academic institution. For each patient, corneal measurements were performed with an optical low-coherence reflectometer/autokeratometer (OLCR), a dual Scheimpflug/Placido analyzer, and a color light-emitting diode (LED) topographer. Postoperatively, the ideal toric IOL alignment meridian that would have resulted in the least amount of residual astigmatism was determined using the online Berdhal & Hardten Toric Results Analyzer (BHTRA). To determine the prediction error, this ideal alignment meridian was compared to the corneal meridian with the highest refractive power, as provided by the three devices. RESULTS Fifty-six eyes of 56 patients were included in the study. The mean absolute errors in the toric IOL alignment meridians of the color LED topographer, dual Scheimpflug/Placido analyzer, and OLCR were 5.2° ± 5.2°, 7.6° ± 5.7°, and 5.4° ± 5.1°, respectively. There was no significant difference in the ability of each device to predict the ideal alignment meridian as determined by the BHTRA. CONCLUSIONS The color LED topographer, dual Scheimpflug/Placido analyzer, and OLCR may all be used to preoperatively determine the best alignment meridian for toric IOL placement. Surgeons should use their best judgment in determining which device to use in preoperative planning for individual patients. [J Refract Surg. 2018;34(8):515-520.].
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Le N, Weikert MP. June consultation #2. J Cataract Refract Surg 2018; 44:782-784. [DOI: 10.1016/j.jcrs.2018.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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20
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Weikert MP, Golla A, Wang L. Astigmatism induced by intraocular lens tilt evaluated via ray tracing. J Cataract Refract Surg 2018; 44:745-749. [PMID: 29861054 DOI: 10.1016/j.jcrs.2018.04.035] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 03/22/2018] [Accepted: 04/01/2018] [Indexed: 10/14/2022]
Abstract
PURPOSE To evaluate astigmatism induced by aspheric and toric intraocular lens (IOL) tilt using a ray-tracing model. SETTING Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA. DESIGN Experimental study. METHODS Ray-tracing eye models with aspheric IOLs (16.0 diopters [D], 22.0 D, and 28.0 D) and toric IOLs (16.0 D, 22.0 D, and 28.0 D each with toricities of 1.50 D, 3.75 D, and 6.00 D) were used. The IOLs were tilted from 1 to 10 degrees horizontally around a 90-degree vertical meridian. Toric IOLs were aligned at 90 degrees and 180 degrees to correct with-the-rule (WTR) and against-the-rule (ATR) corneal astigmatism, respectively. Astigmatism at the corneal plane induced by IOL tilt was calculated. RESULTS Induced astigmatism increased with increasing IOL tilt and power. Horizontal tilt around a vertical meridian induced ATR astigmatism. For 5 degrees of tilt, induced astigmatism was 0.08 D, 0.11 D, and 0.14 D for 16.0 D, 22.0 D, and 28.0 D aspheric IOLs, respectively. Ten degrees of IOL tilt produced 0.33 D, 0.44 D, and 0.56 D of induced astigmatism for 16.0 D, 22.0 D, and 28.0 D aspheric IOLs, respectively. Tilting toric IOLs aligned at 90 degrees around a vertical meridian increased the magnitude of induced ATR astigmatism. Tilting toric IOLs aligned at 180 degrees decreased the magnitude of induced WTR astigmatism. CONCLUSIONS Tilting aspheric IOLs horizontally around a vertical meridian induced ATR astigmatism. Tilting toric IOLs aligned at 90 degrees increased ATR astigmatism, resulting in overcorrection. Tilting toric IOLs aligned at 180 degrees decreased WTR astigmatism, producing undercorrection.
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Affiliation(s)
- Mitchell P Weikert
- From Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA.
| | - Abhinav Golla
- From Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA
| | - Li Wang
- From Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA
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Murri MS, Weikert MP. April consultation #5. J Cataract Refract Surg 2018; 44:518-519. [PMID: 29778113 DOI: 10.1016/j.jcrs.2018.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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22
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Clarke C, Ali SF, Murri M, Patel SN, Wang L, Tuft M, Weikert MP, Al-Mohtaseb Z. Outcomes and complication rates of primary resident-performed cataract surgeries at a large tertiary-care county hospital. J Cataract Refract Surg 2017; 43:1563-1570. [DOI: 10.1016/j.jcrs.2017.09.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 08/21/2017] [Accepted: 09/04/2017] [Indexed: 11/26/2022]
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Weikert MP. Consultation Section: Cataract. August consultation #2. J Cataract Refract Surg 2017; 43:1119-1120. [PMID: 28917418 DOI: 10.1016/j.jcrs.2017.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Deng SX, Lee WB, Hammersmith KM, Kuo AN, Li JY, Shen JF, Weikert MP, Shtein RM. Descemet Membrane Endothelial Keratoplasty: Safety and Outcomes: A Report by the American Academy of Ophthalmology. Ophthalmology 2017; 125:295-310. [PMID: 28923499 DOI: 10.1016/j.ophtha.2017.08.015] [Citation(s) in RCA: 268] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 08/09/2017] [Accepted: 08/09/2017] [Indexed: 10/18/2022] Open
Abstract
PURPOSE To review the published literature on the safety and outcomes of Descemet membrane endothelial keratoplasty (DMEK) for the surgical treatment of corneal endothelial dysfunction. METHODS Literature searches were last conducted in the PubMed and the Cochrane Library databases most recently in May 2017. The searches, which were limited to English-language abstracts, yielded 1085 articles. The panel reviewed the abstracts, and 47 were determined to be relevant to this assessment. RESULTS After DMEK surgery, the mean best-corrected visual acuity (BCVA) ranged from 20/21 to 20/31, with follow-up ranging from 5.7 to 68 months. At 6 months, 37.6% to 85% of eyes achieved BCVA of 20/25 or better and 17% to 67% achieved BCVA of 20/20 or better. Mean endothelial cell (EC) loss was 33% (range, 25%-47%) at 6 months. Overall change in spherical equivalent was +0.43 diopters (D; range, -1.17 to +1.2 D), with minimal induced astigmatism of +0.03 D (range, -0.03 to +1.11 D). The most common complication was partial graft detachment requiring air injection (mean, 28.8%; range, 0.2%-76%). Intraocular pressure elevation was the second most common complication (range, 0%-22%) after DMEK, followed by primary graft failure (mean, 1.7%; range, 0%-12.5%), secondary graft failure (mean, 2.2%; range, 0%-6.3%), and immune rejection (mean, 1.9%; range, 0%-5.9%). Overall graft survival rates after DMEK ranged from 92% to 100% at last follow-up. Best-corrected visual acuity after Descemet's stripping endothelial keratoplasty (DSEK) ranged from 20/34 to 20/66 at 9 months. The most common complications after DSEK were graft detachment (mean, 14%; range, 0%-82%), endothelial rejection (mean, 10%; range, 0%-45%), and primary graft failure (mean, 5%; range, 0%-29%). Mean EC loss after DSEK was 37% at 6 months. CONCLUSIONS The evidence reviewed supports DMEK as a safe and effective treatment for endothelial failure. With respect to visual recovery time, visual outcomes, and rejection rates, DMEK seems to be superior to DSEK and to induce less refractive error with similar surgical risks and EC loss compared with DSEK. The rate of air injection and repeat keratoplasty were similar in DMEK and DSEK after the learning curve for DMEK.
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Affiliation(s)
- Sophie X Deng
- Stein Eye Institute, University of California, Los Angeles, Los Angeles, California
| | - W Barry Lee
- Piedmont Hospital and Eye Consultants of Atlanta, Atlanta, Georgia
| | | | - Anthony N Kuo
- Duke Eye Center, Duke University Medical Center, Durham, North Carolina
| | - Jennifer Y Li
- UC Davis Eye Center, University of California, Davis, Sacramento, California
| | | | | | - Roni M Shtein
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
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Gökce SE, Zeiter JH, Weikert MP, Koch DD, Hill W, Wang L. Intraocular lens power calculations in short eyes using 7 formulas. J Cataract Refract Surg 2017; 43:892-897. [DOI: 10.1016/j.jcrs.2017.07.004] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 03/22/2017] [Accepted: 03/29/2017] [Indexed: 12/31/2022]
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Ma JX, Tang M, Wang L, Weikert MP, Huang D, Koch DD. Comparison of Newer IOL Power Calculation Methods for Eyes With Previous Radial Keratotomy. Invest Ophthalmol Vis Sci 2017; 57:OCT162-8. [PMID: 27409468 PMCID: PMC4968777 DOI: 10.1167/iovs.15-18948] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Purpose To evaluate the accuracy of the optical coherence tomography–based (OCT formula) and Barrett True K (True K) intraocular lens (IOL) calculation formulas in eyes with previous radial keratotomy (RK). Methods In 95 eyes of 65 patients, using the actual refraction following cataract surgery as target refraction, the predicted IOL power for each method was calculated. The IOL prediction error (PE) was obtained by subtracting the predicted IOL power from the implanted IOL power. The arithmetic IOL PE and median refractive PE were calculated and compared. Results All formulas except the True K produced hyperopic IOL PEs at 1 month, which decreased at ≥4 months (all P < 0.05). For the double-K Holladay 1, OCT formula, True K, and average of these three formulas (Average), the median absolute refractive PEs were, respectively, 0.78 diopters (D), 0.74 D, 0.60 D, and 0.59 D at 1 month; 0.69 D, 0.77 D, 0.77 D, and 0.61 D at 2 to 3 months; and 0.34 D, 0.65 D, 0.69 D, and 0.46 D at ≥4 months. The Average produced significantly smaller refractive PE than did the double-K Holladay 1 at 1 month (P < 0.05). There were no significant differences in refractive PEs among formulas at 4 months. Conclusions The OCT formula and True K were comparable to the double-K Holladay 1 method on the ASCRS (American Society of Cataract and Refractive Surgery) calculator. The Average IOL power on the ASCRS calculator may be considered when selecting the IOL power. Further improvements in the accuracy of IOL power calculation in RK eyes are desirable.
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Affiliation(s)
- Jack X Ma
- McGovern Medical School University of Texas Health Science Center at Houston, Houston, Texas, United States
| | - Maolong Tang
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States
| | - Li Wang
- Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, United States
| | - Mitchell P Weikert
- Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, United States
| | - David Huang
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States
| | - Douglas D Koch
- Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, United States
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Kim EJ, Sajjad A, Montes de Oca I, Koch DD, Wang L, Weikert MP, Al-Mohtaseb ZN. Refractive outcomes after multifocal intraocular lens exchange. J Cataract Refract Surg 2017; 43:761-766. [PMID: 28732609 DOI: 10.1016/j.jcrs.2017.03.034] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Revised: 02/07/2017] [Accepted: 03/15/2017] [Indexed: 01/19/2023]
Affiliation(s)
- Eric J Kim
- From the Cullen Eye Institute (Kim, Sajjad, Montes de Oca, Koch, Wang, Weikert, Al-Mohtaseb), Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA; the Shanxi Eye Hospital (Wang), Taiyuan, Shanxi Province, China
| | - Ahmar Sajjad
- From the Cullen Eye Institute (Kim, Sajjad, Montes de Oca, Koch, Wang, Weikert, Al-Mohtaseb), Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA; the Shanxi Eye Hospital (Wang), Taiyuan, Shanxi Province, China
| | - Ildamaris Montes de Oca
- From the Cullen Eye Institute (Kim, Sajjad, Montes de Oca, Koch, Wang, Weikert, Al-Mohtaseb), Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA; the Shanxi Eye Hospital (Wang), Taiyuan, Shanxi Province, China
| | - Douglas D Koch
- From the Cullen Eye Institute (Kim, Sajjad, Montes de Oca, Koch, Wang, Weikert, Al-Mohtaseb), Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA; the Shanxi Eye Hospital (Wang), Taiyuan, Shanxi Province, China
| | - Li Wang
- From the Cullen Eye Institute (Kim, Sajjad, Montes de Oca, Koch, Wang, Weikert, Al-Mohtaseb), Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA; the Shanxi Eye Hospital (Wang), Taiyuan, Shanxi Province, China
| | - Mitchell P Weikert
- From the Cullen Eye Institute (Kim, Sajjad, Montes de Oca, Koch, Wang, Weikert, Al-Mohtaseb), Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA; the Shanxi Eye Hospital (Wang), Taiyuan, Shanxi Province, China
| | - Zaina N Al-Mohtaseb
- From the Cullen Eye Institute (Kim, Sajjad, Montes de Oca, Koch, Wang, Weikert, Al-Mohtaseb), Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA; the Shanxi Eye Hospital (Wang), Taiyuan, Shanxi Province, China.
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28
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Ventura BV, Wang L, Ali SF, Koch DD, Weikert MP. Comparison of corneal power, astigmatism, and wavefront aberration measurements obtained by a point-source color light-emitting diode-based topographer, a Placido-disk topographer, and a combined Placido and dual Scheimpflug device. J Cataract Refract Surg 2016; 41:1658-71. [PMID: 26432123 DOI: 10.1016/j.jcrs.2014.11.051] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 11/07/2014] [Accepted: 11/09/2014] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate and compare the performance of a point-source color light-emitting diode (LED)-based topographer (color-LED) in measuring anterior corneal power and aberrations with that of a Placido-disk topographer and a combined Placido and dual Scheimpflug device. SETTING Cullen Eye Institute, Baylor College of Medicine, Houston, Texas USA. DESIGN Retrospective observational case series. METHODS Normal eyes and post-refractive-surgery eyes were consecutively measured using color-LED, Placido, and dual-Scheimpflug devices. The main outcome measures were anterior corneal power, astigmatism, and higher-order aberrations (HOAs) (6.0 mm pupil), which were compared using the t test. RESULTS There were no statistically significant differences in corneal power measurements in normal and post-refractive surgery eyes and in astigmatism magnitude in post-refractive surgery eyes between the color-LED device and Placido or dual Scheimpflug devices (all P > .05). In normal eyes, there were no statistically significant differences in 3rd-order coma and 4th-order spherical aberration between the color-LED and Placido devices and in HOA root mean square, 3rd-order coma, 3rd-order trefoil, 4th-order spherical aberration, and 4th-order secondary astigmatism between the color-LED and dual Scheimpflug devices (all P > .05). In post-refractive surgery eyes, the color-LED device agreed with the Placido and dual-Scheimpflug devices regarding 3rd-order coma and 4th-order spherical aberration (all P > .05). CONCLUSIONS In normal and post-refractive surgery eyes, all 3 devices were comparable with respect to corneal power. The agreement in corneal aberrations varied. FINANCIAL DISCLOSURE Drs. Wang, Koch, and Weikert are consultants to Ziemer Ophthalmic Systems AG. Dr. Koch is a consultant to Abbott Medical Optics, Inc., Alcon Surgical, Inc., and i-Optics Corp.
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Affiliation(s)
- Bruna V Ventura
- From the Cullen Eye Institute (Ventura, Wang, Ali, Koch, Weikert), Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA; Altino Ventura Foundation (Ventura), Recife, and the Department of Ophthalmology (Ventura), Federal University of São Paulo, São Paulo, Brazil.
| | - Li Wang
- From the Cullen Eye Institute (Ventura, Wang, Ali, Koch, Weikert), Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA; Altino Ventura Foundation (Ventura), Recife, and the Department of Ophthalmology (Ventura), Federal University of São Paulo, São Paulo, Brazil
| | - Shazia F Ali
- From the Cullen Eye Institute (Ventura, Wang, Ali, Koch, Weikert), Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA; Altino Ventura Foundation (Ventura), Recife, and the Department of Ophthalmology (Ventura), Federal University of São Paulo, São Paulo, Brazil
| | - Douglas D Koch
- From the Cullen Eye Institute (Ventura, Wang, Ali, Koch, Weikert), Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA; Altino Ventura Foundation (Ventura), Recife, and the Department of Ophthalmology (Ventura), Federal University of São Paulo, São Paulo, Brazil
| | - Mitchell P Weikert
- From the Cullen Eye Institute (Ventura, Wang, Ali, Koch, Weikert), Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA; Altino Ventura Foundation (Ventura), Recife, and the Department of Ophthalmology (Ventura), Federal University of São Paulo, São Paulo, Brazil
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de Oca IM, Kim EJ, Wang L, Weikert MP, Khandelwal SS, Al-Mohtaseb Z, Koch DD. Accuracy of toric intraocular lens axis alignment using a 3-dimensional computer-guided visualization system. J Cataract Refract Surg 2016; 42:550-5. [DOI: 10.1016/j.jcrs.2015.12.052] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 12/09/2015] [Accepted: 12/12/2015] [Indexed: 10/21/2022]
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Shah R, Weikert MP, Grannis C, Hamill MB, Kong L, Yen KG. Long-Term Outcomes of Iris-sutured Posterior Chamber Intraocular Lenses in Children. Am J Ophthalmol 2016; 161:44-9.e1. [PMID: 26429583 DOI: 10.1016/j.ajo.2015.09.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 09/16/2015] [Accepted: 09/18/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE To report the long-term outcomes and complications of iris-sutured posterior chamber intraocular lenses (PCIOLs) in the pediatric population. DESIGN Retrospective interventional case study. METHODS This study involved 12 consecutive pediatric patients (17 eyes) who underwent placement of foldable iris-sutured PCIOLs between September 2004 and September 2007. Outcome measures included change in visual acuity and complications. RESULTS Of the 17 eyes were reviewed, 6 (35%) had hereditary or idiopathic ectopia lentis, 5 (29%) had Marfan syndrome, 2 (12%) were aphakic after pars plana vitrectomy and 4 (24%) were aphakic after surgical intervention for trauma. Average follow-up was 4.69 ± 3.21 years and mean age of surgery was 7.21 ± 3.78 years. Seven eyes suffered dislocation of the PCIOL an average of 12.11 ± 11.97 months after surgery, with 2 patients undergoing dislocation a second time. There was a higher rate of dislocation in patients with a history of ectopia lentis due to Marfan syndrome, idiopathic causes, or hereditary causes than in patients being treated for aphakia resulting from other causes (71% vs 29%). Mean visual acuity improved in 12 of 17 patients (71%), from 0.80 ± 0.6 logMAR preoperatively to 0.35 ± 0.5 logMAR at most recent visit, P = .009. One eye of a Marfan patient sustained a retinal detachment 8 months after dislocation of the PCIOL, and 1 patient experienced iris capture of the PCIOL after surgery. CONCLUSIONS Iris-sutured intraocular lenses have been used as an alternative to transsclerally sutured intraocular lenses to correct aphakia in pediatric patients. Dislocation of the intraocular lenses can occur frequently, however. The procedure should be considered with caution in pediatric patients.
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Affiliation(s)
- Ravi Shah
- Department of Ophthalmology, Baylor College of Medicine, Houston, Texas
| | | | - Charity Grannis
- Department of Ophthalmology and Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
| | - Marshall B Hamill
- Department of Ophthalmology, Baylor College of Medicine, Houston, Texas
| | - Lingkun Kong
- Department of Ophthalmology and Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
| | - Kimberly G Yen
- Department of Ophthalmology and Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas.
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Weikert MP. August consultation #8. J Cataract Refract Surg 2015; 41:1790-1; discussion 1791. [PMID: 26432149 DOI: 10.1016/j.jcrs.2015.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ventura BV, Wang L, Weikert MP, Robinson SB, Koch DD. Surgical management of astigmatism with toric intraocular lenses. Arq Bras Oftalmol 2015; 77:125-31. [PMID: 25076481 DOI: 10.5935/0004-2749.20140032] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 03/13/2014] [Indexed: 11/20/2022] Open
Abstract
Correction of corneal astigmatism is a key element of cataract surgery, since post-surgical residual astigmatism can compromise the patient's uncorrected visual acuity. Toric intraocular lenses (IOLs) compensate for corneal astigmatism at the time of surgery, correcting ocular astigmatism. They are a predictable treatment. However, accurate measurement of corneal astigmatism is mandatory for choosing the correct toric IOL power and for planning optimal alignment. When calculating the power of toric IOLs, it is important to consider anterior and posterior corneal astigmatism, along with the surgically induced astigmatism. Accurate toric lens alignment along the calculated meridian is also crucial to achieve effective astigmatism correction. There are several techniques to guide IOL alignment, including the traditional manual marking technique and automated systems based on anatomic and topographic landmarks. The aim of this review is to provide an overview on astigmatism management with toric IOLs, including relevant patient selection criteria, corneal astigmatism measurement, toric IOL power calculation, toric IOL alignment, clinical outcomes and complications.
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Affiliation(s)
- Bruna V Ventura
- Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, United States of America
| | - Li Wang
- Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, United States of America
| | - Mitchell P Weikert
- Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, United States of America
| | - Shaun B Robinson
- Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, United States of America
| | - Douglas D Koch
- Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, United States of America
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Kim EJ, Berg JP, Weikert MP, Kong L, Hamill MB, Koch DD, Yen KG. Scleral-fixated capsular tension rings and segments for ectopia lentis in children. Am J Ophthalmol 2014; 158:899-904. [PMID: 25127699 DOI: 10.1016/j.ajo.2014.08.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 07/30/2014] [Accepted: 08/01/2014] [Indexed: 11/16/2022]
Abstract
PURPOSE To report the short-term outcomes and complications of implantation of scleral-fixated capsular tension rings and/or capsular tension segments with intraocular lenses (IOL) in pediatric patients with ectopia lentis. DESIGN Retrospective, observational case series. METHODS Thirteen consecutive pediatric patients (19 eyes) underwent placement of in-the-bag IOL with either a Cionni modified capsular tension ring or a capsular tension segment in conjunction with a conventional capsular tension ring between January 1, 2009 and March 30, 2013 by 3 anterior segment surgeons at a single academic center. The scleral fixation suture was 9-0 polypropylene in 16 eyes and CV-8 Gore-Tex (expanded polytetrafluoroethylene) in 3 eyes. Outcome measures included change in corrected distance visual acuity (CDVA) and complications. RESULTS The mean age was 10.2 years ± 4.8 (SD) and the median follow-up, 23.4 months. A Cionni modified capsular tension ring was implanted in 5 eyes and a capsular tension segment with an unsutured capsular tension ring was implanted in 12 eyes. In 2 eyes, capsular tension segment alone was placed. The mean CDVA at the final follow-up (0.10 ± 0.11 logMAR, 18 eyes) was significantly better than preoperatively (0.58 ± 0.26 logMAR, 15 eyes) (P < .001). The CDVA at the final follow-up was 20/40 or better in 18 eyes (94.7%). All IOLs were well centered. Posterior capsule opacification developed in 11 eyes (57.9%), 9 eyes (47.4%) required neodymium-yttrium-aluminum-garnet capsulotomy, and 3 eyes (15.8%) required pars plana vitrectomy and posterior capsulotomy. Other complications included broken suture (5.3%) (9-0 polypropylene at CTR eyelet, repaired with CV-8 Gore-Tex), conjunctival dehiscence (5.3%), suture exposure (5.3%) (trans-scleral 9-0 polypropylene), and vitreous strand at inferior paracentesis (5.3%). CONCLUSIONS Implantation of in-the-bag IOL with either a Cionni modified capsular tension ring or a capsular tension segment in conjunction with a conventional capsular tension ring appears to be a safe and effective technique for visual rehabilitation in pediatric ectopia lentis.
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Affiliation(s)
- Eric J Kim
- Department of Ophthalmology, Texas Children's Hospital, Houston, Texas; Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas
| | - James P Berg
- Department of Ophthalmology, Texas Children's Hospital, Houston, Texas; Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas
| | - Mitchell P Weikert
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas
| | - Lingkun Kong
- Department of Ophthalmology, Texas Children's Hospital, Houston, Texas; Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas
| | - Marshall B Hamill
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas
| | - Douglas D Koch
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas
| | - Kimberly G Yen
- Department of Ophthalmology, Texas Children's Hospital, Houston, Texas; Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas.
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Mahmoud AM, Nuñez MX, Blanco C, Koch DD, Wang L, Weikert MP, Frueh BE, Tappeiner C, Twa MD, Roberts CJ. Expanding the cone location and magnitude index to include corneal thickness and posterior surface information for the detection of keratoconus. Am J Ophthalmol 2013; 156:1102-11. [PMID: 24075426 DOI: 10.1016/j.ajo.2013.07.018] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 07/19/2013] [Accepted: 07/20/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE To extend the capabilities of the Cone Location and Magnitude Index algorithm to include a combination of topographic information from the anterior and posterior corneal surfaces and corneal thickness measurements to further improve our ability to correctly identify keratoconus using this new index: ConeLocationMagnitudeIndex_X. DESIGN Retrospective case-control study. METHODS Three independent data sets were analyzed: 1 development and 2 validation. The AnteriorCornealPower index was calculated to stratify the keratoconus data from mild to severe. The ConeLocationMagnitudeIndex algorithm was applied to all tomography data collected using a dual Scheimpflug-Placido-based tomographer. The ConeLocationMagnitudeIndex_X formula, resulting from analysis of the Development set, was used to determine the logistic regression model that best separates keratoconus from normal and was applied to all data sets to calculate PercentProbabilityKeratoconus_X. The sensitivity/specificity of PercentProbabilityKeratoconus_X was compared with the original PercentProbabilityKeratoconus, which only uses anterior axial data. RESULTS The AnteriorCornealPower severity distribution for the combined data sets are 136 mild, 12 moderate, and 7 severe. The logistic regression model generated for ConeLocationMagnitudeIndex_X produces complete separation for the Development set. Validation Set 1 has 1 false-negative and Validation Set 2 has 1 false-positive. The overall sensitivity/specificity results for the logistic model produced using the ConeLocationMagnitudeIndex_X algorithm are 99.4% and 99.6%, respectively. The overall sensitivity/specificity results for using the original ConeLocationMagnitudeIndex algorithm are 89.2% and 98.8%, respectively. CONCLUSIONS ConeLocationMagnitudeIndex_X provides a robust index that can detect the presence or absence of a keratoconic pattern in corneal tomography maps with improved sensitivity/specificity from the original anterior surface-only ConeLocationMagnitudeIndex algorithm.
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Koch DD, Jenkins RB, Weikert MP, Yeu E, Wang L. Correcting astigmatism with toric intraocular lenses: Effect of posterior corneal astigmatism. J Cataract Refract Surg 2013; 39:1803-9. [DOI: 10.1016/j.jcrs.2013.06.027] [Citation(s) in RCA: 160] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 06/12/2013] [Accepted: 06/14/2013] [Indexed: 10/26/2022]
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Al-Mohtaseb ZN, Wang L, Weikert MP. Repeatability and comparability of corneal thickness measurements obtained from Dual Scheimpflug Analyzer and from ultrasonic pachymetry. Graefes Arch Clin Exp Ophthalmol 2013; 251:1855-60. [PMID: 23417340 DOI: 10.1007/s00417-013-2280-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 12/17/2012] [Accepted: 01/28/2013] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND To assess the repeatability and comparability of central corneal thickness (CCT) measurements obtained from the Galilei Dual Scheimpflug Analyzer (Galilei-DSA) and from ultrasonic pachymetry (USP) in normal eyes and in eyes following laser refractive surgery. METHODS In this prospective observational study, 77 eyes of 39 patients with normal corneas and 39 eyes of 20 patients with prior laser refractive surgery were enrolled. All 116 eyes had three repeated measurements of central CCT with the Galilei-DSA first and then with USP by the same examiner. Reliability of both devices was assessed statistically, and CCT measurements by each were compared. RESULTS The mean CCT measurement of normal eyes was 549.2 ± 30.5 μm and 548.5 ± 33.1 μm by the Galilei-DSA and USP respectively; the difference between the two modalities was -0.7 ± 7.1 μm (P = 0.365). In post-refractive surgery eyes, the mean CCT measured by the Galilei-DSA and USP was 500.4 ± 44.8 and 494.3 ± 50.3 respectively; the difference between the two devices was -6.2 ± 9.9 μm (P < 0.001). For the three repeated measurements, the mean standard deviation was 2 μm with the Galilei-DSA and 1.8 μm with USP in normal eyes, and 2.4 μm with the Galilei-DSA and 1.9 μm with USP in post-refractive surgery eyes. CONCLUSION The Galilei-DSA has high repeatability and excellent to moderate agreement with ultrasonic pachymetry when measuring CCT in normal and post-refractive surgery eyes.
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Affiliation(s)
- Zaina N Al-Mohtaseb
- Cullen Eye Institute, Baylor College of Medicine, Houston, Houston, TX 77030, USA
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Weikert MP, Wang L, Barrish J, Dimalanta R, Koch DD. Quantitative measurement of wound architecture in microincision cataract surgery. J Cataract Refract Surg 2012; 38:1460-6. [DOI: 10.1016/j.jcrs.2012.03.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Revised: 02/28/2012] [Accepted: 03/03/2012] [Indexed: 10/28/2022]
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Wang L, Dixit L, Weikert MP, Jenkins RB, Koch DD. Healing changes in clear corneal cataract incisions evaluated using Fourier-domain optical coherence tomography. J Cataract Refract Surg 2012; 38:660-5. [DOI: 10.1016/j.jcrs.2011.10.030] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Revised: 10/26/2011] [Accepted: 10/31/2011] [Indexed: 11/30/2022]
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Poll JT, Wang L, Koch DD, Weikert MP. Correction of Astigmatism During Cataract Surgery: Toric Intraocular Lens Compared to Peripheral Corneal Relaxing Incisions. J Refract Surg 2011; 27:165-71. [DOI: 10.3928/1081597x-20100526-01] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2009] [Accepted: 04/16/2010] [Indexed: 11/20/2022]
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Gumus K, Crockett CH, Rao K, Yeu E, Weikert MP, Shirayama M, Hada S, Pflugfelder SC. Noninvasive assessment of tear stability with the tear stability analysis system in tear dysfunction patients. Invest Ophthalmol Vis Sci 2011; 52:456-61. [PMID: 20631241 DOI: 10.1167/iovs.10-5292] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To evaluate tear film stability in patients with tear dysfunction and an asymptomatic control group by using the novel, noninvasive Tear Stability Analysis System (TSAS). METHODS In this prospective case-control study, 45 patients with dysfunctional tear syndrome (DTS) were stratified into three groups (1, 2, and 3/4) based on clinical severity, with higher scores indicating more severe symptoms; 25 asymptomatic control subjects were evaluated. TSAS measurements were performed with the RT-7000 Auto Refractor-Keratometer (Tomey Corporation, Nagoya, Japan). Images of ring mires projected onto the cornea every second for 6 seconds were captured and analyzed. Focal changes in brightness were calculated as numerical ring breakup (RBU) values, and the elapsed time when the cumulative values (RBU sum) exceeded a threshold was defined as the ring breakup time (RBUT). RESULTS RBUTs in the DTS groups were all significantly lower than those in the control subjects, with the lowest values found in DTS 3/4. RBUT was significantly shorter in DTS 3/4 than in DTS 1 (P<0.001). The change in RBU sum over a 6-second period in the DTS groups combined or between the individual groups was statistically significant (P<0.001), as was the difference between the 1- and 6-second values. For distinguishing between asymptomatic controls and DTS, the sensitivity and specificity of a 5.0-second RBUT cutoff were 82.0% and 60.0%, respectively. CONCLUSIONS The TSAS may be a useful, noninvasive instrument for evaluating tear stability and for classifying DTS severity.
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Affiliation(s)
- Koray Gumus
- Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas 77030, USA
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Abbott RL, Adrean SD, Al-Muammar A, Akhtar J, Alfonso EC, Allen RC, Almond MC, Alvarenga L, Alward WLM, Ambrósio R, Anwar M, Azar DT, Ball JL, Barney NP, Bartow RM, Baum J, Belin MW, Bell JH, Benetz BA, Berbos Z, Beuerman RW, Bhasin AK, Bhat PV, Biber JM, Bidros M, Birnbaum AD, Bouchard CS, Bradley JC, Brandt JD, Brasington RD, Brilakis HS, Burkat CN, Calatayud M, Cameron JD, Campos M, Carpel EF, Cavanagh HD, Chan C, Chang RI, Chang BH, Chern KC, Ching S, Chodosh J, Choo PH, Chung G, Ciolino JB, Clayton JA, Cohen EJ, Comyn O, Cortina MS, Cowden JW, Croasdale CR, Davidson RS, Davis EA, Daya SM, Freitas DD, DeMill DL, de Oliveira LA, de Smet MD, de Sousa LB, Djalilian AR, Dohlman CH, Donnenfeld ED, Dortzbach RK, Driebe WT, Dunn SP, Eagle RC, Edelstein SL, Eiferman RA, Eliason JA, Farid M, Faulkner WJ, Feder RS, Feiz V, Feng MT, Fingert JH, Florakis GJ, Fontana L, Forster RK, Foster CS, Foster FS, Foulks GN, Friedlander MH, Fukuda M, Galor A, Gan TJ, Garg P, Garg S, Glasser DB, Goins KM, Goldstein DA, Gottlieb C, Grimmett MR, Gris O, Groos EB, Gruzensky WD, Güell JL, Gupta PK, Hamill MB, Hammersmith KM, Hamrah P, Hannush SB, Hardten DR, Harrison A, Heck EL, Heidemann DG, Herman DC, Heur JM, Hodge WG, Hoffman CJ, Holland EJ, Holland GN, Honig MA, Hood CT, Hoskins EN, Huang AJW, Huang D, Hui JI, Iuorno JD, Jackson WB, Jakobiec FA, Jeng BH, Jester JV, Jordan DR, Kaiura TL, Karp CL, Katz DG, Kaufman SC, Kersten RC, Khachikian SS, Kim JH, Kim JY, Kim SK, Kim T, Kirkness CM, Klyce SD, Koch DD, Kowalski RP, Krachmer JH, Laibson PR, Lane SS, Lass JH, Lee WB, Lee OA, Lemp MA, Lenhart PD, Li Y, Liesegang TJ, Lim MC, Lin LK, Lin MP, Lindquist TD, Lindstrom RL, Litoff D, Liu C, Lowder CY, Lubniewski AJ, McGee HT, McLean IW, Macsai MS, Manero F, Mannis MJ, Mantopoulos D, Martinez CE, Mártonyi CL, Mashor RS, Mathers WD, Mehta MN, Meisler DM, Mian SI, Miller D, Miller CA, Montoya M, Morral M, Moyes AL, Murphy ML, Nassiri N, Neff KD, Nelson JD, Nerad JA, Netto MV, Newton CJ, Nijm LM, Nishida T, Noble BA, Nordlund ML, Nussenblatt RB, O'Day DG, Ongkosuwito JV, Oxford KW, Palay DA, Palmon FE, Paranjpe DR, Parikh M, Park DH, Park DJJ, Parsons MR, Pavlin CJ, Pearlstein ES, Perry A, Petroll WM, Pfister DR, Pfister RR, Pflugfelder SC, Price FW, Price MO, Probst LE, Purcell JJ, Pyott AAE, Raizman MB, Raju LV, Randleman JB, Rao GN, Rapuano CJ, Reilly CD, de Candelaria Renesto A, Rezende RA, Robertson DM, Rootman DS, Rothman JS, Rubinfeld RS, Sadowsky AE, Saika S, Sakhalkar MV, Salz JJ, Sangwan VS, Scarpi M, Scharf BH, Schmidt G, Schmitt A, Schmitt FP, Schteingart MT, Schwab IR, Schwam BL, Schwartz GS, Sen HN, Shapiro MB, Shimmura S, Singal N, Skeens HM, Skolnick CA, Slomovic AR, Smith JA, Snyder ME, Solomon R, Soukiasian SH, Srinivasan S, Stamler JF, Steinert RF, Stoller GL, Streeten BW, Stulting RD, Sugar A, Sugar J, Tan D, Tauber J, Terry MA, Tessler HH, Torrabadella M, Traboulsi EI, Trattler WB, Tsai JH, Tse DT, Tu EY, Ursea R, Vaddavalli PK, Van Meter WS, Varley GA, Vasaiwala R, Verachtert AJ, Verdier DD, Vieira AC, Virasch VV, Wang L, Waring GO, Waring GO, Warner MA, Warrian KJ, Webster GF, Weikert MP, Weisenthal RW, Weiss JS, Wichiensin P, Wilhelmus KR, Wilson SE, Woodward MA, Yee RW, Yoo S. Contributors. Cornea 2011. [DOI: 10.1016/b978-0-323-06387-6.00005-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Wang L, Pitcher JD, Weikert MP, Koch DD. Custom selection of aspheric intraocular lenses after wavefront-guided myopic photorefractive keratectomy. J Cataract Refract Surg 2010; 36:73-81. [DOI: 10.1016/j.jcrs.2009.07.037] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2009] [Revised: 07/30/2009] [Accepted: 07/31/2009] [Indexed: 11/26/2022]
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Shirayama M, Wang L, Weikert MP, Koch DD. Comparison of corneal powers obtained from 4 different devices. Am J Ophthalmol 2009; 148:528-535.e1. [PMID: 19541287 DOI: 10.1016/j.ajo.2009.04.028] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Revised: 04/22/2009] [Accepted: 04/27/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE To assess the repeatability and comparability of anterior corneal power values obtained from the Galilei Dual Scheimpflug Analyzer (Ziemer, Port, Switzerland), Humphrey Atlas corneal topographer (Carl Zeiss, Jena, Germany), IOLMaster (Carl Zeiss), and a manual keratometer (Bausch & Lomb Inc, Rochester, New York, USA). DESIGN Prospective, comparative study. METHODS Prospectively, 20 subjects were enrolled. Three sets of corneal power measurements were obtained by a single observer using the Galilei, Atlas topographer, IOLMaster, and manual keratometer. Repeatability of the 3 measurements from each device was evaluated by means of coefficient of variation, standard deviation (SD), and intraclass correlation coefficient. An analysis of variance was used to compare the differences in corneal powers among devices. The Bland and Altman method also was performed to assess agreement in measurements between devices. Vector analysis was used to compare the astigmatism values obtained from different devices. RESULTS For each device, the coefficient of variation of repeated measurements was lower than 0.22%. The SD of 3 repeated measurements ranged from 0.042 to 0.096 diopters (D). The intraclass correlation coefficients were higher than 0.99 in all devices. Mean central corneal powers were 43.80 D, 43.88 D, 43.92 D, and 43.76 D for the Galilei, Atlas, IOLMaster, and manual keratometer, respectively. SDs of the differences between devices ranged from 0.07 D for Galilei and IOLMaster to 0.14 D for Galilei and Atlas. For astigmatism, the mean astigmatism values for the Galilei, Atlas, IOLMaster, and manual keratometer were 0.54 D at 84 degrees, 0.51 D at 88 degrees, 0.62 D at 88 degrees, and 0.52 D at 87 degrees, respectively. CONCLUSIONS The corneal power measurements from these 4 devices were highly reproducible, comparable, and correlated.
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Weikert MP. June consultation #4. J Cataract Refract Surg 2009. [DOI: 10.1016/j.jcrs.2009.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kopel AC, Carvounis PE, Hamill BM, Weikert MP, Holz ER. Iris-sutured intraocular lenses for ectopia lentis in children. J Cataract Refract Surg 2008; 34:596-600. [DOI: 10.1016/j.jcrs.2007.11.044] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2007] [Accepted: 11/18/2007] [Indexed: 11/17/2022]
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Wilhelmus KR, Jones DB, Matoba AY, Hamill MB, Pflugfelder SC, Weikert MP. Bilateral acanthamoeba keratitis. Am J Ophthalmol 2008; 145:193-197. [PMID: 18222188 DOI: 10.1016/j.ajo.2007.09.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2007] [Revised: 09/25/2007] [Accepted: 09/27/2007] [Indexed: 10/22/2022]
Abstract
PURPOSE To determine the prevalence and characteristics of binocular involvement among patients with Acanthamoeba keratitis. DESIGN Retrospective case series. METHODS Risk factors and outcomes of bilateral infection were explored among consecutive cases of Acanthamoeba keratitis diagnosed at a single institution from 1997 through mid 2007. RESULTS Fifty eyes were confirmed to have Acanthamoeba keratitis by microbiologic or histopathologic testing; two-thirds occurred during a regional outbreak beginning in 2004. Five (11%) of 45 patients had infection of both eyes, including three with concurrent involvement and two with successive disease of the contralateral cornea. Three binocularly infected patients used soft contact lenses, and two wore rigid gas-permeable lenses. Nine of 10 eyes achieved visual acuity of 20/30 or better after antiamebic therapy. CONCLUSIONS Bilateral Acanthamoeba keratitis is an infectious complication of contact lens wear. With laboratory confirmation, vision often can be restored with medical therapy.
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Weikert MP. May Consultation # 9. J Cataract Refract Surg 2007. [DOI: 10.1016/j.jcrs.2007.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
PURPOSE OF REVIEW This review examines the current status of accommodation restoration concepts with reference to the recent, published peer-reviewed literature with an emphasis on physiological aspects of accommodation and presbyopia. RECENT FINDINGS The mechanisms of accommodation and the causes of presbyopia are described. The physiological amenability of the accommodative structures in the presbyopic eye to accommodation restoration is discussed. General theoretical concepts of accommodation restoration are introduced. The methods that have been used to assess accommodation restoration, including the use of animal models, drug stimulated accommodation, subjective near-vision tests and objective measurements, are reviewed. SUMMARY While physiological and clinical evidence supports the notion that accommodation can be restored to the presbyopic eye, progress in this potentially exciting area is hindered by the scarcity of good, large-scale clinical studies using objective measurement techniques to evaluate the outcomes of accommodation restoration concepts.
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Affiliation(s)
- Mitchell P Weikert
- Baylor College of Medicine, 6565 Fannin, NC-205, Houston, TX 77030, USA.
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Weikert MP. The fine art of prescribing glasses without making a spectacle of yourself. Am J Ophthalmol 2005. [DOI: 10.1016/j.ajo.2004.12.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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