Infectious keratitis is a more severe disease in elderly than in younger patients with more complications and a worse prognosis. Elderly patients have multiple and more diverse risk factors, making prevention difficult. Prevention should aim at minimizing topical steroid use and controlling blepharitis, ocular surface disease, and herpetic eye disease. Initial antibiotic treatment should include sufficient coverage of Gram-positive pathogens.
After the removal of dislocated lens fragments with a PPV, Artisan IOL implantation in aphakic patients without capsule support led to few complications and good visual acuity. Placement of an Artisan IOL requires fewer manipulations than transscleral suture fixation of a posterior chamber IOL.
ABSTRACT.Purpose: To evaluate whether the automated refraction (AR) correlates with subjective manifest (MR) refraction in eyes implanted with radially asymmetric multifocal intraocular lens (IOLs). Methods: This retrospective study evaluated 52 eyes (52 patients) implanted with a radially asymmetric multifocal IOL (LS-312 MF30, Oculentis, Germany). At 3 months postoperatively, the AR and MR values were compared to determine the correlation between the sphere (S), the spherical equivalent (SE) and the astigmatic components J0 and J45. Results: The difference of mean spherical measurement was +0.98D AE 0.62, with the AR measuring more myopic. The difference of the mean spherical equivalent was +1.11D AE 0.57, again with AR being more myopic. Both these differences were statistically significant (p < 0.001). The astigmatic components showed less differences, with the mean difference of the J0 being À0.09D AE 0.43, and the J45 of +0.04D AE 0.47, which were both not statistically significant (p = 0.123 and p = 0.531, respectively). Correlation analysis of the refractive parameters showed r 2 = 0.067, r 2 = 0.078, r 2 = 0.018 and r 2 = 0.015, respectively, all of which point to a low correlation between the AR and the MR. Conclusion: Autorefraction shows poor correlation to manifest subjective refraction with these radially asymmetric multifocal IOLs. The autorefraction systematically underestimates the spherical and spherical equivalent power, while the correlation between the astigmatic components was also low. Autorefraction seems not a valid starting point for manifest subjective refraction with these types of lenses, unless a corrective factor of about +1 dioptre is used.
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