Purpose To compare clinical outcomes between mechanical debridement photorefractive keratectomy (m-PRK) and trans-epithelial photorefractive keratectomy (t-PRK) in myopic patients. Methods Eighty eyes of 40 myopic patients with age between 18 and 55 years were included in this study. In each patient, one eye was randomly assigned for t-PRK, using the Amaris laser's ORK-CAM software and the other eye for m-PRK, using a spatula. Stromal ablation was done by Schwind Amaris 750S. Uncorrected and best corrected visual acuity (BCVA), refractive outcomes, epithelial healing, pain, and discomfort were compared between the groups on day 1, 3, 7 and month 1, 3, and 6. Results Preoperative spherical equivalent (SE) were −3.97 ± 2.08 diopter (D) and −3.98 ± 2.06 D in m-PRK and t-PRK eyes, respectively ( P = 0.981). Operation time was significantly shorter in the t-PRK group than m-PRK ( P < 0.001). Postoperative pain was experienced significantly higher in the t-PRK group measured by 11-point numeric scale of pain questionnaire on the first postoperative day ( P < 0.001). Photophobia, tearing, and vision fluctuation were also significantly higher in the t-PRK group postoperatively. However epithelial defect size and re-epithelialization time were lower in the t-PRK group ( P = 0.012 and P < 0.001, respectively). Postoperative parameters including SE, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and contrast acuity did not show any significant difference between the two groups during all intervals. Conclusions Although epithelial defect size and epithelial healing time were lower in t-PRK, postoperative pain, photophobia, and vision fluctuation were significantly less in the m-PRK group in the first postoperative days. There was no statistically significant difference between the groups after one week, and both mechanical and trans-epithelial techniques were shown to be safe and effective.
Purpose: To investigate the choroidal thickness and its association with age, gender, spherical equivalent (SE), and axial length (AL) in a sample of Iranian population with different refractive status using spectral-domain optical coherence tomography (SD-OCT). Methods: In a cross-sectional study, a total of 469 right eyes of 469 healthy subjects comprising 194 (41.4%) males and 275 (58.6%) females were examined. The mean age was 32.76 ± 15.77 years (range, 4-60 years). All subjects were divided into different groups according to their refractive status, age, and AL. The choroidal thickness was evaluated through enhanced-depth imaging (EDI) modality at subfoveal (Sf), 1, and 3 mm nasal (N1 and N3, respectively), temporal (T1 and T3, respectively), superior (S1 and S3, respectively), and inferior (I1 and I3, respectively) to the foveal center. Results: In the whole population, the mean subfoveal choroidal thickness (SfChT) was 329.83 ± 70.33 μm, and the choroid was thickest at S1 (342.04 ± 71.28 μm) and thinnest at N3 (209.00 ± 66.0 μm). Our data indicated a significant difference in the mean choroidal thickness across all points in different age groups (P < 0.0001). For emmetropic, myopic, and hyperopic subjects, mean SfChT values were 346.64 ± 59.63, 319.66 ± 73.17, and 364.00 ± 74.54 μm, respectively. Linear regression estimated that SfChT decreased about 12.8 and 8.71 μm for every 10 years of aging and each diopter increasing in myopia, respectively. Additionally, the SfChT decreased as 13.48 μm per mm increase in AL. Conclusions: The mean SfChT of a sample of Iranian emmetropic subjects was 346.64 ± 59.63 μm. The choroidal thickness has a decreasing trend with increasing age, and the choroid is thinner in myopes and thicker in hyperopes compared with emmetropic subjects. In the whole participants, the thickest and thinnest points were S1 and N3, respectively.
Purpose Visual evoked potentials (VEPs) provide important diagnostic information related to the functional integrity of the visual pathways. The aim of this study was to establish normative values of different components of pattern reversal VEPs on Iranian normal adult subjects. Methods Monocular and binocular pattern reversal VEPs were recorded on 59 healthy participants (22.55 ± 3.79 years old) using the Roland RETI system for two check sizes of 15 and 60 min of arc. The measured VEP components were the latencies of N75, P100, N135 and amplitude of N75–P100. Results Repeated measures ANOVA showed that viewing eye condition has a significant impact on the amplitude of N75–P100 ( P < 0.001, F = 13.89). Also, the effect of check size on the latencies of N75, P100, N135, amplitude of N75–P100 ( P ≤ 0.010), as well as the intraocular difference of P100 latency and amplitude N75–P100 ( P = 0.007) was significant. More specifically, the amplitude of N75–P100 in both check sizes significantly differed between gender groups ( P < 0.023). Conclusion According to the results of this study, VEPs components are affected by the stimulus size, monocular and binocular recording conditions and gender. Therefore, it is necessary to determine the normative values of VEPs in each population, so that the results could be used in clinical studies.
Purpose To compare the effect of full-correction versus under-correction on myopia progression. Methods A literature search was performed in PubMed, Scopus, Science Direct, Ovid, Web of Science and Cochrane library. Methodological quality assessment of the literature was evaluated according to the Critical Appraisal Skills Program. Statistical analysis was performed using Comprehensive Meta-Analysis (version 2, Biostat Inc., USA). Results The present meta-analysis included six studies (two randomized controlled trials [RCTs] and four non-RCTs) with 695 subjects (full-correction group, n = 371; under-correction group, n = 324) aged 6 to 33 years. Using cycloplegic refraction, the pooled difference in mean of myopia progression was – 0.179 D [lower and higher limits: −0.383, 0.025], which was higher but not in full correction group as compared to under correction group ( p = 0.085). Regarding studies using non-cycloplegic subjective refraction according to maximum plus for maximum visual acuity, the pooled difference in myopia progression was 0.128 D [lower and higher limits: −0.057, 0.312] higher in under-correction group compared with full-correction group ( p = 0.175). Although, difference in myopia progression did not reach significant level in either cycloplegic or non-cycloplegic refraction. Conclusions Our findings suggest that, myopic eyes which are fully corrected with non-cycloplegic refraction with maximum plus sphere, are less prone to myopia progression, in comparison to those which were under corrected. However, regarding cycloplegic refraction, further studies are needed to better understand these trends.
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