Purpose: To compare visual outcomes, contrast sensitivity, optical quality, spectacle independence, and visual disturbances in patients implanted with 2 models of monofocal intraocular lenses (IOLs). Setting: Eye Clinic, Department of NEUROFARBA, University of Florence, Italy. Design: Prospective case series Methods: Patients without ocular comorbidities and corneal astigmatism less than 0.75 diopters (D) had cataract surgery with bilateral implantation of either of 2 monofocal IOLs, the Tecnis ZCB00 or the Tecnis Eyhance ICB00 (Johnson & Johnson Vision Care, Inc.). Six months postoperatively, monocular and binocular uncorrected and corrected (at 4 m) distance visual acuities, as well as uncorrected (UIVA), distance corrected, and corrected intermediate (at 66 cm) and near (at 40 cm) visual acuities were measured. Photopic contrast sensitivity, binocular defocus curve, objective scatter index (OSI), Strehl ratio, modulation transfer function (MTF) cutoff, halo and glare perception, and spectacle independence were also evaluated. Results: A total of 80 eyes of 40 patients were evaluated in this study. Although monocular and binocular uncorrected and corrected distance and near visual acuities were similar between groups, monocular and binocular UIVA were significantly higher in the Eyhance group. There were no statistically significant differences between the 2 groups in terms of photopic contrast sensitivity, OSI, MTF cutoff, Strehl ratio, and glare and halo perception. The ICB00 IOL provided better spectacle independence than the ZCB00 IOL for intermediate distance. Conclusions: In patients without ocular comorbidities, the Eyhance ICB00 IOL provided better UIVA and higher intermediate spectacle independence without impairment of far vision and visual quality, compared with the ZCB00 IOL.
Background The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on practical activities and didactic teaching of residents and fellows. This survey aimed to propose long-term changes for ophthalmology training based on the changes experienced by trainees and their perception of new training opportunities. Methods An online survey was distributed to ophthalmology trainees in multiple countries. Descriptive statistics were used to analyse the data. Results A total of 504 analyzable responses were collected from 32 different countries. The current impact of COVID-19 pandemic was described as "severe" by most trainees (55.2%); however, the future perspective was more optimistic as demonstrated by the greater number of responses reporting a presumed "moderate" (37.3%), "mild" (14.1%) or "slight" (4.2%) long-term impact. The vast majority of trainees reported a decrease ≥50% of clinical activity (76.4%) and >75% of surgical activity (74.6%). Although an initial gap in didactic teaching has been experienced by many (55.4%), regular webbased teaching was reportedly attended by 67.7% of the respondents. A strong agreement was found regarding the worthwhile role of web-based case-presentations in clinical training (91.7%), web-based discussion of edited surgical videos (85.7%) and simulation-based practice (86.9%) in surgical training. Conclusions This survey, focusing on trainees' perspective, strongly reinforces the need to promptly include new technology-based training tools, such as web-based teaching, virtual surgical simulators, and telementoring, in long-term reorganisation of ophthalmology training to ensure its continuity and effectiveness, which would remain available even in the face of another unpredictable crisis within the health system.
ObjectivesTo evaluate the use of a three-dimensional heads-up microscope (3DM) during 25-gauge pars plana vitrectomy (PPV) compared with a traditional ophthalmic microscope (TM) in terms of efficacy, safety, and teaching and learning satisfaction.MethodsProspective comparative interventional study. Fifty eyes affected by one of the following diseases: rhegmatogenous or tractional retinal detachment, epiretinal membrane, full-thickness macular hole, vitreous hemorrhage, or dropped lens. The 50 eyes were randomly assigned to one of two groups: group A (25 eyes) underwent 25-gauge PPV with 3DM, and group B (25 eyes) underwent 25-gauge PPV with TM. The main outcome measures were the duration of the operation, intraoperative complications, and surgeon and observer satisfaction. A questionnaire was used to assess surgeon satisfaction according to the following parameters: comfort, visibility, image quality, depth perception, simplicity of use, maneuverability, and teaching. A questionnaire to assess observer satisfaction was completed by 20 observers (surgical residents or ophthalmic surgeons).ResultsThe degree of satisfaction was higher using 3DM for both surgeons and observers (P < 0.001). The average duration of the operation did not differ significantly between the two methods. No major complications occurred for either method.ConclusionsPPV with 3DM is more comfortable for the surgeon and poses no substantially greater risk of complications for the patient. The high-definition screen delivers excellent depth perception and better screen parameter control, which results in high-quality surgical performance. 3DM surgery helps to significantly improve teaching and learning intra-operative surgical procedures.
The safety and efficacy of 27-G PPV for rhegmatogenous retinal detachment appear similar to 25-GPPV. We found no anatomical or functional difference in terms of postoperative BCVA, IOP, complications, and operating time. Twenty-seven-G vitrectomy is therefore a valid option in the treatment of rhegmatogenous retinal detachment.
In the first month after the procedure, CXL induces a reduction in corneal volume. During the 24 months follow-up the cornea tends to recover its original volume with a persistence of the CXL efficacy.
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