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Objective To compare the visual outcomes following bilateral implantation of 3 presbyopia correcting IOLs. Methods Results are reported for patients who underwent phacoemulsification with bilateral implantation of one of the following IOLs: Panoptix IOL, AT LISA tri IOL and Symphony IOL. Six months postoperative examination included monocular UIVA at 80 and 60 cm and monocular UNVA and DCNVA at 40 cm, monocular UDVA and CDVA, Spherical equivalent (SE) refraction, binocular defocus curve, contrast sensitivity, photopic phenomena, and spectacle independence. Results UIVA at 80 cm was significantly better in the AT LISA group and the Symfony groups than the Panoptix group, while UIVA at 60 cm was better in the Symfony group and the Panoptix group than the AT LISA group. A worse DCNVA was recorded in the Symfony group. At a defocus of −2.50 D, the near VA was similar in the PanOptix and AT LISA groups (0.05, 0.07 logMAR respectively), which were significantly better than the Symfony group (0.3 LogMAR). Binocular photopic and scotopic contrast sensitivity outcomes were similar among the three groups at all spatial frequencies. In Symphony group, the frequency and the degree of bother of photic phenomena was relatively higher than the other two groups. Higher percentage of patients in symphony group reported their need for reading glasses. Conclusion PanOptix IOL and AT LISA IOL would be a good choice for patients aiming for an optimum near vision, while Symfony IOL seems suitable for patients having the priority for good intermediate vision.

PURPOSE: To analyze the corneal tomographic parameters of patients with thyroid gland dysfunction. METHODS: This case–control study included 100 eyes of 50 patients with thyroid gland dysfunction and 100 eyes of 50 healthy controls. All eyes were examined by Pentacam (Oculus Optikgeräte GmbH). Pentacam parameters were compared between patients with thyroid gland dysfunction and controls. Spearman's correlation coefficient between different Pentacam parameters and the serum level of free thyroxin (T4) and thyroid-stimulating hormone (TSH) was calculated. RESULTS: Patients with hypothyroidism had significantly higher median values of steep and maximum simulated keratometric readings, central corneal thickness (CCT), and thinnest pachymetry (CTmin) than both patients with hyperthyroidism and controls ( P ⩽ .05). The median values of the average and maximum pachymetric progression index (PPI), posterior elevation, and back difference elevation were significantly higher in patients with hyperthyroidism than in patients with hypothyroidism and controls ( P ⩽ .05). The Ambrósio Relational Thickness (ARTmax) was significantly reduced in patients with hyperthyroidism ( P ⩽ .001). Both CCT and CTmin showed a moderately positive correlation with serum TSH level and a moderately negative correlation with serum free T4 level. Patients with non-autoimmune thyroid gland dysfunction had significantly thinner CCT, CTmin, and inferior vertical deviation than the autoimmune group ( P ⩽ .05). CONCLUSIONS: Thyroid gland dysfunction is associated with significant corneal tomographic changes. Patients with hyperthyroidism tend to have thinner corneas and more abnormal tomographic parameters correlating with keratoconus. No significant tomographic changes were found in association with autoimmune thyroid gland dysfunction. The authors recommend screening and regular follow-up of patients with thyroid gland dysfunction for early detection and management of keratoconus. [ J Refract Surg . 2021;37(3):192–197.]

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Background Various surgical techniques have been described, to be combined with cataract surgery in glaucoma patients, aiming for an additional reduction of intraocular pressure (IOP), hence minimizing the burden of anti-glaucoma medication (AGM). Ultrasound ciliary plasty (UCP) is a recent microinvasive glaucoma surgery (MIGS) recommended for primary and refractory glaucoma. This study was conducted to evaluate the safety and efficacy of a new technique; combined phacoemulsification and ultrasound ciliary plasty (Phaco-UCP) as a primary surgical treatment for coexisting cataract and open angle glaucoma. Methods A randomized clinical trial, including 61 eyes of 61 patients with visually significant cataract and open angle glaucoma, randomized to either Phaco-UCP (study group; 31 eyes) or phacoemulsification alone (Phaco-alone) (control group; 30 eyes). Primary outcomes included reduction in IOP and/or the number of AGM. Secondary outcomes included visual acuity improvement and complications. Qualified Success was defined as an IOP reduction ≥ 20% from baseline value, with an IOP 6–21 mmHg, with no additional AGM or glaucoma surgery. Failure was defined as either < 20% IOP reduction, despite AGM use, the need of glaucoma surgeries or serious complications. Results At 18 months postoperatively, Phaco-UCP group had a median IOP reduction of 7 mmHg (Q1, Q3 = 3, 10) compared to 2 mmHg (Q1, Q3 = 2, 3) in Phaco-alone group (P < 0.001). Phaco-UCP group had significantly higher success rate at all time points reaching 67.7% at the last follow-up versus 16.7% only in Phaco-alone group (P< 0.001). The median number of AGM significantly decreased from [3 (Q1, Q3 = 2, 4), 3 (Q1, Q3 = 2,3)] respectively, (P =0.3)] at baseline to [1 (Q1,Q3 = 1, 2), 2 (Q1,Q3 = 2, 2)] respectively, (P < 0.001)] at 18 months postoperatively. No serious intraoperative or postoperative complications were encountered in either group. Conclusion Phaco-UCP is a simple, safe and effective procedure for management of coexisting cataract and open angle glaucoma. Trial registration ClinicalTrials.gov identifier, NCT04430647; retrospectively registered. June 12, 2020.