Hyperopic thermokeratoplasty: clinical evaluation.

A new procedure, hyperopic thermokeratoplasty (HTK), developed in the Soviet Union for the correction of hyperopia, uses controlled thermal burns of the corneal stroma with a retractable probe tip preset to penetrate the cornea at 95% depth. The coagulations are applied in a radial pattern for spherical hyperopia. Only the peripheral cornea is treated and the effect is titrated by varying the optical zone and number of rays.

Endophthalmitis investigative protocol: a plan for source identification and patient protection.

A survey of randomly selected ophthalmic outpatient surgical facilities revealed a lack of established investigative protocols to follow when postoperative endophthalmitis occurs. The survey also provided information about the incidence of endophthalmitis, the microorganisms encountered, and the precautions used to prevent postoperative infections. We present an endophthalmitis investigative protocol which provides a task list, investigation forms, incidence log, and quality assurance measures to identify patients at risk and to minimize the risk of recurrence of this rare but serious complication of ophthalmic surgery.

Effect of thermokeratoplasty on corneal curvature.

A cadaver eye model was used to evaluate and quantify the use of thermokeratoplasty for steepening the central cornea to correct hyperopia. Four groups of eye-bank eyes were treated with four separate surgical plans. Each plan involved the placement of controlled thermal burns (in the depths of the corneal stroma, using a cautery probe) applied in a radial pattern up to a premarked optical zone.

Advantages and limitations of current soft intraocular lenses.

We report our clinical experience with six soft intraocular lenses: (1) STAAR silicone, (2) CooperVision/Schlegel silicone, (3) IOLAB silicone, (4) Allergan Medical Optics (AMO) silicone, (5) Fyodorov silicone, and (6) Alcon hydrogel (IOGEL). We found that these soft intraocular lenses have several common design problems. The single-size design of five of the six soft lenses can lead to a windshield-wiper decentration effect in lenses too small for larger eyes.

Delayed regression of effect in myopic epikeratophakia vs myopic keratomileusis for high myopia.

We compared the effectiveness and stability of our first six consecutive myopic epikeratophakia procedures (mean follow-up 18 months, range 14 to 26) with our first four consecutive cryolathe myopic keratomileusis procedures (mean follow-up 28 months, range 14 to 35). Myopic keratomileusis reduced preoperative myopia (range -8.9 to -12.

Enhanced accuracy is necessary for refractive surgery instrumentation.

New optical zone markers, diamond knives, and gauge blocks were ordered from a random selection of manufacturers and inspected by an independent metallurgical engineer. This study revealed workmanship flaws and poor instrument accuracy. None of the 26 optical zone markers examined came with instructions as to whether the incisions were to be carried to or from the inside diameter or the outside diameter of the corneal impression made by the marker.

Small incisions to control astigmatism during cataract surgery.

Astigmatic changes in three series of cataract surgical procedures were compared. Two series comprised eyes having phacoemulsification and implantation of a foldable silicone lens through a 3.0 mm to 4.

Refractive evaluation of astigmatic keratotomy procedures.

We evaluated the efficacy of three transverse incision astigmatic keratotomy procedures using a vector analysis that enabled us to determine the magnitude of the effect and the axis in which it occurred. These procedures were used for low levels of astigmatism (0.5 diopter [D] to 3.

Hexagonal keratotomy for correction of low hyperopia: preliminary results of a prospective study.

Fifteen sighted eyes of 11 patients had hexagonal keratotomy for the correction of low hyperopia. Mean preoperative hyperopia of +3.21 diopters (range +1.

Glare disability devices for cataractous eyes: a consumer's guide.

We evaluated five commercially available glare testers to determine how accurately each device predicted outdoor Snellen acuity in cataract patients. Predicted outdoor Snellen acuity was compared to actual Snellen outdoor acuity for the Miller-Nadler glare tester, the brightness acuity tester (BAT), the InnoMed true vision analyzer (TVA), the VisTech VCT 8000, and the EyeCon 5. All five devices were evaluated in a single series of eyes.

The relationship between cataract type and glare disability as measured by the Miller-Nadler glare tester.

Cataract patients were tested for glare disability using the Miller-Nadler glare tester. Predicted outdoor visual acuity was then compared with the actual outdoor visual acuity. The Miller-Nadler glare test scores predicted actual outdoor visual impairment to within one Snellen line in 46.

The relationship between indoor and outdoor Snellen visual acuity in cataract patients.

One hundred six cataractous eyes of 78 patients were evaluated to examine the relationship between indoor and outdoor Snellen visual acuity. While 81 of all cataractous eyes (76.4%) had Snellen visual acuities of 20/40 or better when tested indoors, only 33 eyes (31.

Phacoemulsification devices: a consumer's update.

This report extends a previous paper on the various characteristics of the most popular phacoemulsification devices. An evaluation of 11 devices by ten different manufacturers was attempted. Only five manufacturers of six devices agreed to critical evaluation or reevaluation.

Complications associated with STAAR silicone implants.

We compared the incidence of various complications in consecutive series of cases in which 76 eyes received STAAR silicone intraocular implants and 76 eyes received small incision IOLAB G708G polymethylmethacrylate (PMMA) intraocular implants. All surgeries were performed by the same surgeon employing the same phacoemulsification technique. A higher incidence of lens subluxation, lens repositioning, corneal edema, and elevated intraocular pressure was observed in the eyes receiving STAAR silicone implants than in the eyes receiving IOLAB PMMA implants.