The Asia-Pacific Journal of Ophthalmology

Articles in Press

APJO is pleased to offer electronic publication of accepted papers prior to formal publication. Any final changes in manuscripts will be made at the time of formal publication and will be reflected in the final electronic version of the issue.

Articles appearing in this section have been peer-reviewed and accepted for publication and posted online before formal publication. Articles appearing here may contain statements, opinions, and information that have errors in facts, figures, or interpretation. Accordingly, the editors and authors and their respective employees are not responsible or liable for the use of any such inaccurate or misleading data, opinion or information contained the articles in this section.

Original Study - Clinical

Long-Term Stability of Minimally Invasive Radial Keratotomy for Mild to Moderate Keratoconus Fujimoto, Kahoko; Osawa Hideya; Moriyama, Takashi; Miyamoto, Takako; Irie, Tomomi; Nishimura, Tetsuya; Inoue, Tomoyuki
Purpose: this study aimed to evaluate the long-term stability of mini-mally invasive radial keratotomy (mini-rK) for eyes with mild to moder-ate keratoconus.

Design: retrospective observational case series.

Methods: Eleven eyes from 6 patients with hard contact lens (Hcl)-intolerant keratoconus underwent mini-rK and were followed up for more than 5 years. the mini-rK consisted of 8 radial incisions with depths of 90% of the thinnest corneal thickness, based on the lindstrom nomogram. Best-corrected visual acuity (BcVa), keratometry, and cor-neal endothelial cell density (Ecd) were examined preoperatively and for 5 to 10 years postoperatively. Changes in keratometric astigmatism were evaluated using power vector analysis. Severities of keratoconus preoperatively and 1 year postoperatively were graded using the amsler-Krumeich classification. Results: the postoperative observation periods were from 6 to 10 years (mean, 7.9 years). there were no changes in the BcVa, Ecd, and kera-tometric astigmatism. the mean keratometric refraction significantly de-creased from 47.5 diopters (d) preoperatively to 44.0 d at 1 month after mini-rK (P = 0.037) and was stable over 5 years, whereas keratometric astigmatism did not change from the preoperative through the postop-erative period (P > 0.59). Keratoconus of grade 2 or higher improved to lower grades.

Conclusions: the mini-rK treatment was safe and effective for Hcl-intolerant eyes with mild to moderate keratoconus.
Evaluation of Corneal Endothelial Cell Loss After Uncomplicated Phacoemulsification Cataract Surgery With Intracameral Phenylephrine Teoh, Li Sar; Foo, Siu Wan; Mansurali, Vanessa Naseem; Ang, Ee Ling, Md Noh, Umi Kalthum; Bastion, Mae-Lynn Catherine
Purpose: to study the effects of intracameral phenylephrine 1.5% on corneal endothelial cell loss and morphological changes in patients who had uneventful phacoemulsification surgery.

Design: a double-blind randomized controlled trial.Methods: this study comprised 295 patients who were randomized into the intracameral (icM) mydriatic group or topical mydriatic group. central corneal endothelial cell density (Ecd), coefficient of variation (cV), and percentage of hexagonal cells were measured preoperatively and postoperatively at 1 week, 6 weeks, and 3 months with specular mi-croscope.

Results: there was no significant difference in endothelial cell density and endothelial cell loss between the topical and icM mydriatic groups. at 3 months, the mean endothelial cell density in the icM group was 2129.76 ± 423.53 cells/mm2 and 2100.54 ± 393.00 cells/mm2 in the topi-cal group (P = 0.539). the endothelial cell loss was 18.60 ± 12.79% in the icM group and 19.44 ± 11.24% in the topical group (P = 0.550). no significant difference was seen in the percentage of hexagonal cells and coefficient of variation of patients between the 2 groups.

Conclusions: intracameral phenylephrine was not associated with increased risk of postoperative endothelial cell loss or morphological changes. it can be safely injected into the anterior chamber for pupil dila-tation before phacoemulsification cataract surgery.
Prevalence and Factors Associated With Second Eye Cataract Surgery and the Trend in the Time Interval Between the Two Eye Surgeries Based on the Malaysian National Eye Database Ho, Shu Fen; Adnan, Tassha Hilda bin; Goh, Pik Pin
Purpose: To study the prevalence of second eye cataract surgery (SECS), trend in time interval between subsequent surgeries over the years, and factors associated with sEcs utilization among patients who underwent cataract surgeries in the Ministry of Health (MOH), Malaysia.

Design: Secondary cross-sectional analysis of the Malaysian National Eye Database (NED) data.

Methods: The Malaysian cataract surgery registry collected data on patients who had cataract surgery from 2002–2004 and 2007–2012. Data collected included demography, operative events, time interval between 2 surgeries, and postoperative visual outcomes. descriptive analysis was performed.

Results: Total surgeries increased from 11,954 in 2002 to 30,265 in 2012 with a proportionate increase in SECS (30.7% in 2002 to 34.3% in 2012). Poor vision (<6/12) was reduced from 81.1% to 14.2% after surgery. With improved data capturing, missing data reduced from 29.22% to 1.05%. The time interval between surgeries was 10.58 months in 2002 and 14.49 months in 2012. Malays (40.2%) and those aged 61–70 years (38.1%) had the highest number of SECs. Those aged 40–50 years (10.96 months) and with poorer vision (9.97 months) had the shortest time interval between the 2 surgeries. The commonest surgical method was phacoemulsification (72.3%). Negeri Sembilan State had the highest SECS rate (35.91%) and Melaka had the shortest interval between surgeries (10.15 months).

Conclusions: Despite an increase in the number of SECS, the time interval is still long. Poor presenting second eye vision and disparity among different states warrants the health authority’s attention and intervention.
The Effect of Eye Patching on Clear Corneal Incision Architecture in Phacoemulsification: A Randomized Controlled Trial Ho, Fui Li; Salowi, Mohamad Aziz; Bastion, Mae-Lynn Catherine
Purpose: To investigate the effects of postoperative eye patching on clear corneal incision architecture in phacoemulsification.

Design: A single-center, randomized controlled trial.

Methods: A total of 132 patients with uncomplicated phacoemulsification were randomly allocated to the intervention or control group. The intervention group received postoperative eye patching for approximately 18 hours, whereas the control group received eye shield. The clear corneal incision architecture was examined postoperatively at 2 hours, 1 day, and 7 days after surgery using optical coherence tomography.

Results: Epithelial gaping was significantly reduced on postoperative day 1 in the intervention group (52.4%) compared with control (74.2%) (P = 0.01). No differences were found for other architectural defects. Descemet membrane detachment was associated with lower intraocular pressure on postoperative day 7 (P = 0.02). Presence of underlying diabetes mellitus did not seem to influence architectural defects.

Conclusions: Postoperative eye patching facilitated epithelial healing and reduced the occurrence of epithelial gaping on postoperative day 1. It may play a role in protecting and improving corneal wounds during the critical immediate postoperative period.

Review Article

Visual Quality After Femtosecond Laser Small Incision Lenticule Extraction Miao, Huamao; Han, Tian; Tian, Mi; Wang, Xiaoying; Zhou, Xingtao
Femtosecond laser small incision lenticule extraction (SMILE) is a newly developed form of “flapless” corneal refractive surgery with all-in-one technology. Femtosecond laser SMILE is increasingly attractive for both doctors and patients because it is minimally invasive and does not require a flap to be lifted during surgery. It exhibits many advantages in terms of morphology, biomechanical effects, corneal wound healing, and nerve rehabilitation. However, visual quality assessment after refractive surgeries is just as important as these advantages and correlates with patient satisfaction. Evaluation indexes for visual quality include visual acuity, contrast sensitivity, aberration, intraocular scattering, and so on. This paper reviewed visual quality and patient satisfaction after SMILE for myopia correction.
Grafts in Glaucoma Surgery: A Review of the Literature Thakur, Sahil; Ichhpujani, Parul; Kumar, Suresh
Patients with bleb leakage, dehiscence, or infection after trabeculectomy need urgent bleb salvaging to prevent vision loss. Patients who have undergone a glaucoma drainage device surgery may have tube erosion, which is yet another devastating and outcome-compromising complication. The bleb or the tube in such cases needs to be patched by a biologic tissue, which is roofed by the conjunctiva and acts as a barrier against external infections. Sclera, pericardium, cornea, and dura mater are the commonly used patch graft materials. This review reports the outcomes of several new and old graft materials used to repair the post trabeculectomy compromised bleb and tube exposure in glaucoma drainage device surgeries.
APJO Express

More About APAO

  • 1
  • 2
  • 3
  • 4
  • 5
< >
All Rights Reserved © Asia-Pacific Academy of Ophthalmology