Zernike representation of corneal topography height data after nonmechanical penetrating keratoplasty.
PURPOSE: To demonstrate a mathematical method for decomposition of discrete corneal topography height data into a set of Zernike polynomials and to demonstrate the clinical applicability of these computations in the postkeratoplasty cornea. METHODS: Fifty consecutive patients with either Fuchs' dystrophy (n = 20) or keratoconus (n = 30) were seen at 3 months, 6 months, and 1 year (before suture removal) and again after suture removal following nonmechanical trephination with the excimer laser. Patients were assessed using regular keratometry, corneal topography (TMS-1, simulated keratometry [SimK]), subjective refraction, and best-corrected visual acuity (VA) at each interval. A set of Zernike coefficients with radial degree 8 was calculated to fit two model surfaces: a complete representation (TOTAL) and a representation with parabolic terms only to define an approximate spherocylindrical surface (PARABOLIC). The root mean square error (RMS) was calculated comparing the corneal raw height data with TOTAL (TOTALRMS) and PARABOLIC (PARABOLICRMS). The cylinder of subjective refraction was correlated with the keratometric readings, the SimK, and the respective Zernike parameter. Visual acuity was correlated with the tilt components of the Zernike expansion. RESULTS: The measured corneal surface could be approximated by the composed surface 1 with TOTALRMS < or = 1.93 microm and by surface 2 with PARABOLICRMS < or = 3.66 microm. Mean keratometric reading after suture removal was 2.8+/-0.6 D. At all follow-up examinations, the SimK yielded higher values, whereas the keratometric reading and the refractive cylinder yielded lower values than the respective Zernike parameter. The correlation of the Zernike representation and the refractive cylinder (P = 0.02 at 3 months, P = 0.05 at 6 months and at 1 year, and P = 0.01 after suture removal) was much better than the correlation of the SimK and refractive cylinder (P = 0.3 at 3 months, P = 0.4 at 6 months, P = 0.2 at 1 year, and P = 0.1 after suture removal). Visual acuity increased from 0.23+/-0.10 at the 3-month evaluation to 0.54+/-0.19 after suture removal. After suture removal, there was a statistically significant inverse correlation between VA and tilt (P = 0.02 in patients with keratoconus and P = 0.05 in those with Fuchs' dystrophy). CONCLUSIONS: Zernike representation of corneal topography height data renders a reconstruction of clinically relevant corneal topography parameters with a marked reduction of redundance and a small error. Correlation of amount/axis of refractive cylinder with respective Zernike parameters is more accurate than with keratometry or respective SimK values of corneal topography analysis. (+info)
Management of phacolytic glaucoma: experience of 135 cases.
We retrospectively analyzed 135 eyes with phacolytic glaucoma. A trabeculectomy was added to standard cataract surgery if symptoms endured for more than seven days, or if preoperative control of intraocular pressure (IOP) with maximal medical treatment was inadequate. In the early postoperative period, IOP was significantly lower in the combined surgery group (89 eyes) compared to the cataract surgery group (46 eyes) (p < 0.001). At 6 months there was no difference in IOP or visual acuity between the two groups. There were no serious complications related to trabeculectomy. It is reasonable to conclude that in eyes with a long duration of phacolytic glaucoma, addition of a trabeculectomy to cataract surgery is safe, prevents postoperative rise in intraocular pressure and decreases the need for systemic hypotensive medications. A randomized trial is on to further address this question. (+info)
Effect of pilocarpine on visual acuity and on the dimensions of the cornea and anterior chamber.
The effect of pilocarpine on visual acuity and on the dimensions of the cornea, anterior chamber, and lens were studied in two groups of subjects. Significant changes in ocular tension, corneal curvature, anterior chamber depth, and lens anterior radius were found in a group of 55 glaucomatous eyes as a result of pilocarpine treatment, but there was no change in corneal thickness. Out of 102 glaucomatous eyes 78 became relatively myopic, and this appears to be due to changes in the dimensions of the lens of the eye similar to those occurring in accommodation, as a result of the effect of the drug on the ciliary muscle. The effect of pilocarpine on anterior chamber depth, area, and volume was studied in 125 eyes using a photographic method, and a significant reduction in the dimensions of the anterior chamber was observed as a result of the administration of pilocarpine. A significant correlation between depth and volume was also noted and the implications of this are discussed. (+info)
De novo lesions in presumed ocular histoplasmosis-like syndrome.
Two patients with multifocal choroiditis similar or identical to POHS are presented. Colour photographs and fluorescein angiography document the occurrence of de novo lesions in the originally involved eye. The cases also demonstrate the development of new choroidal lesions within the originally involved eye, the early evolution of the "basic choroidal lesion", and the need for fluorescein angiography for visualizing the underlying choroidal lesion. (+info)
Prognosis of perforating eye injury.
The assessment of visual function in a series of 130 consecutive patients of perforating eye injuries, revealed that visual acuity of 6/12 or better was regained in 63 per cent, between 6/60 and 6/18 in 9-2 per cent, less than 6/60 in 15-3 per cent, and enucleation was necessary in 9-2 per cent. In 3 per cent, the eyes were retained as blind, symptomfree, and cosmetically satisfactory organs. Two eyes were found to develop complete traumatic aniridia. None in the series was found to have sympathetic ophthalmitis. (+info)
Vitrectomy in 125 eyes with diabetic vitreous haemorrhage.
A total of 125 consecutive eyes, all registered blind with diabetic vitreous haemorrhage, underwent pars plana vitrectomy with the vitrophage. Sixty-six per cent experienced some improvement in their visual acuity; 24 per cent were unchanged and 10 per cent were worse postoperatively. The major surgical complication was controllable haemorrhage (23 per cent). No retinal dialysis occurred. Significant postoperative complications were transient (71 per cent) and persistent (11 per cent) corneal oedema, early (8 per cent) and late (13 per cent) vitreous haemorrhage, transient (30 per cent) and persistent (6 per cent) rise in intraocular pressure, and rubeosis iridis (5 per cent). (+info)
A prospective study of xenon arc photocoagulation for central retinal vein occlusion.
Twenty patients with central retinal vein occlusion were randomly divided into two groups in a prospective study to evaluate the effects of xenon are photocoagulation in central retinal vein occlusion. The patients in one group were treated with 360 degrees scatter xenon photocoagulation and the others received no treatment. The average follow-up was 18 months. There were no cases of rubeosis or neovascular glaucoma in the treated group. Two patients in the untreated group developed rubeosis with subsequent neovascular glaucoma. There was no significant difference in the visual prognosis or in fundus neovascularization between the groups. (+info)
Characteristics of discrepancies between self-reported visual function and measured reading speed. Salisbury Eye Evaluation Project Team.
PURPOSE: Visual impairment is a risk factor for morbidity in the elderly and is often screened for by self-report. This study evaluates whether there are subsets for whom there is a discrepancy between self-reported and measured function. METHODS: The prevalence of a discrepancy between self-reported difficulty reading a newspaper and measured reading speed was determined in 2520 community-based men and women, aged 65 to 84 years, and the discrepant group characterized by polychotomous regression. RESULTS: Of subjects who reported minimal difficulty reading a newspaper, 10.8% (227/2107) read newsprint-sized text (0.21 degrees) more slowly than 80 words/min, a level previously shown to be necessary for sustained reading. Poor visual acuity, presence of psychiatric symptoms, and less satisfaction with vision were associated with being in the group that read slowly and reported difficulty with reading. Better cognition, better visual acuity, more years of education, white race, and fewer psychiatric symptoms were associated with being in the group that read more quickly and reported minimal difficulty. When reading the text size at which subjects read their fastest, only 2.6% of those with minimal difficulty remained discrepant. These individuals were more likely to have less education, be male, be African American, and have poorer cognitive status than those who did not remain discrepant. CONCLUSIONS: A subset of the elderly population have a substantial discrepancy between self-reported reading difficulty and measured reading speed. In some, this discrepancy may be based on underlying expectations and experiences, and in others it may represent a transition from no visual impairment to visual impairment. (+info)