Purpose: To assess photopic and mesopic vision in patients implanted with the Bi-Flex® M 677 MY bifocal intraocular lens (IOL). Methods: In this prospective clinical study, 25 patients with cataract in both eyes were subjected to cataract surgery and bilateral implantation of the Bi-Flex® M 677MY (Medicontur, Hungary) IOL. Three months after surgery, high-contrast photopic uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were determined. Intermediate at 65 cm (DCIVA) and near at 40 cm (DCNVA) visual acuity were also measured, both with best distance correction. The CSV-1000 test chart was used to assess contrast sensitivity (CS). Defocus curves were constructed under photopic and mesopic conditions, determining binocular best-corrected visual acuity over the range +1.50 D to -4.00 D in 0.50-D steps. A KR-1W Wavefront Analyzer was used to measure pupil size and aberrometric outcomes. Presence and type of dysphotopsia were evaluated with the Likert scale. Results: Mesopic mean pupil diameter was 4.58 ± 0.73 mm. The mean values at 3 months were UDVA 0.03 ± 0.09, CDVA -0.05 ± 0.06, DCIVA 0.20 ± 0.07, and DCNVA 0.11 ± 0.08. Mean CS for the 4 frequencies examined were 1.66 ± 0.16, 1.75 ± 0.14, 1.39 ± 0.22, and 0.96 ± 0.19. Significant differences were observed in defocus curves for photopic and mesopic conditions. A significant correlation between pupil diameter and the dysphotopic photopic was found (r = 0.62; p = 0.02). Conclusions: The evaluated progressive apodized diffractive design IOL provides effective restoration of visual function in far and near vision distance with an adequate intermediate visual quality between -1.00 and -1.50 focus.

To assess the agreement between two different spectral domain (SD-OCT) and one swept source (SS-OCT) optical coherence tomography device to measure the insertion distance and the thickness of the horizontal rectus muscles. Seventy eyes from 35 healthy patients were studied. Three OCT instruments-Spectralis (Heidelberg Engineering Inc., Heidelberg, Germany), Cirrus 5000 (Carl Zeiss Meditec, Dublin, CA), and Triton (Topcon, Inc., Tokyo, Japan)-were used to measure the limbus insertion distance and the thickness of the lateral rectus and medial rectus muscles. The intraclass correlation coefficient (ICC) was calculated to determine the reproducibility and the agreement between the three methods. Measurement of the limbus insertion distance was possible in 100% of cases with the three OCT devices. The thickness could be measured in 75% or more patients with Spectralis, 74% or more with Cirrus, and 78% or more with Triton. The agreement of the insertion distance measurements between the three devices ranged from an ICC of 0.629 or greater to 0.887; for the muscle thickness, the ICC ranged from 0.495 or greater to 0.854. The best agreement existed between the Spectralis and Topcon devices for insertion distance (ICC = 0.715 to 0.887) and for muscle thickness (ICC = 0.641 to 0.854). The reproducibility of each device was good and was higher for insertion distance (ICC = 0.880) than for muscle thickness (ICC = 0.736). The highest reproducibility values were obtained with Triton. The three OCT devices permitted accurate and reproducible measurements of the limbus insertion distance and the thickness of the horizontal rectus muscles, showing moderate to good agreement between the SS-OCT and the two SD-OCT instruments. [J Pediatr Ophthalmol Strabismus. 2017;54(3):168-176.].

Purpose: To examine extraocular rectus muscle tendons in patients with Graves' ophthalmopathy using optical coherence tomography (OCT). Methods: This was a cross-sectional observational study conducted with 55 healthy controls, 45 patients with clinically inactive Graves' ophthalmopathy, and 12 patients with clinically active Graves' ophthalmopathy. Scanning was performed at the 3- and 9-o'clock positions. The medial rectus tendon thickness was measured at 7.2 and 9.2 mm from the limbus and the lateral rectus tendon thickness was measured at 8.5 and 10.5 mm from the limbus. Results: The 9.2-mm medial rectus, 8.5-mm lateral rectus, and 10.5-mm lateral rectus tendons were thicker in the inactive Graves' ophthalmopathy group than the control group (240 ± 70, 231 ± 63, and 228 ± 54 µm vs 201 ± 71, 199 ± 53, and 200 ± 32 µm, respectively; P ≤ .011), whereas the 8.5-mm lateral rectus and 9.2-mm medial rectus tendons were thicker in patients with active Graves' ophthalmopathy than patients with inactive Graves' ophthalmopathy (274 ± 77 and 283 ± 68 µm vs 231 ± 63 and 240 ± 70 µm, respectively; P ≤ .048). A correlation was detected between lateral rectus and medial rectus tendon thicknesses and the Graves' ophthalmopathy clinical activity score (R = 0.252, P = .035; and R = 0.291, P = .013, respectively). Conclusions: OCT emerged as an accurate method for measuring medial rectus and lateral rectus tendon thicknesses in patients with Graves' ophthalmopathy. The imaging tool was able to detect thicker horizontal rectus tendons in patients with inactive Graves' ophthalmopathy than in controls, and in patients with active compared to inactive disease. [J Pediatr Ophthalmol Strabismus. 201X;XX(X):XX–XX.]

The early failure of glaucoma surgery is mainly caused by over-fibrosis at the subconjunctival space, causing obliteration of the filtration bleb. Because fibrosis has a suspected basis of genetic predisposition, we have undertaken a prospective study to identify upregulated profibrotic genes in a population of glaucoma patients with signs of conjunctival fibrosis and early postoperative surgical failure. Clinical data of re-operated fibrosis patients, hyperfibrosis patients who re-operated more than once in a short time, and control patients with no fibrosis were recorded and analyzed at each follow-up visit. Conjunctival-Tenon surgical specimens were obtained intraoperatively to evaluate the local expression of a panel of genes potentially associated with fibrosis. In order to correlate gene expression signatures with protein levels, we quantified secreted proteins in primary cultures of fibroblasts from patients. Expression of VEGFA, CXCL8, MYC, and CDKN1A was induced in the conjunctiva of hyperfibrosis patients. VEGFA and IL8 protein levels were also increased in fibroblast supernatants. We propose that an increase in these proteins could be useful in detecting conjunctival fibrosis in glaucoma patients undergoing filtering surgery. Molecular markers could be crucial for early detection of patients at high risk of failure of filtration surgery, leading to more optimal and personalized treatments.