No abstract

No author has a financial or proprietary interest in any material or method mentioned.

Advances in corneal refractive surgery have allowed ophthalmologists to correct ocular higher-order aberrations. To obtain more information on the ocular aberrations generated from the optical axis, mydriasis is required. The aim of this study is to evaluate the changes in higher-order aberrations with the use of various mydriatics. Higher-order aberrations were measured in 21 eyes of 21 subjects (age range 24-37 years; 13 males, 8 females). Repeated measurements were conducted before and after the installation of three different mydriatics: 10% phenylephrine, 1% tropicamide, or 1% cyclopentolate. At a pupil size of 6 mm, the average root mean square value of higher-order aberrations (HO-RMS) was 0.430 mum in undilated eyes, and 0.413, 0.410, and 0.477 mum after installation of phenylephrine, tropicamide, and cyclopentolate, respectively. There were no statistically significant differences in the HO-RMS between the four conditions. There was a significant difference in the spherical aberration between the undilated or phenylephrine-treated eyes, compared to those treated with tropicamide or cyclopentolate. Cycloplegic mydriatics seemed to shift spherical aberration in a positive direction. These results suggest that mydriatics may affect higher-order aberrations, especially spherical aberration, and this should be considered when performing wavefront analysis and when correcting wavefront errors.

We report a case of corneal deposition of pigments from cosmetic contact lenses after intense pulsed-light (IPL) therapy. A 30-year-old female visited our outpatient clinic with ocular pain and epiphora in both eyes; these symptoms developed soon after she had undergone facial IPL treatment. She was wearing cosmetic contact lenses throughout the IPL procedure. At presentation, her uncorrected visual acuity was 2/20 in both eyes, and the slit-lamp examination revealed deposition of the color pigment of the cosmetic contact lens onto the corneal epithelium. We scraped the corneal epithelium along with the deposited pigments using a no. 15 blade; seven days after the procedure, the corneal epithelium had healed without any complications. This case highlights the importance of considering the possibility of ocular complications during IPL treatment, particularly in individuals using contact lenses. To prevent ocular damage, IPL procedures should be performed only after removing the lenses and applying eyeshields.

We retrospectively analysed the course of postoperative corneal astigmatism and corrected visual acuity after extracapsular cataract extraction and posterior chamber lens implantation with either a corneal or a scleral incision in 170 eyes of 155 patients with and without glaucoma. A continuous 10/0 nylon shoelace suture was used for wound closure in two groups. In a third group, corneal wound closure was performed with a shorter shoelace suture in combination with two vicryl wing sutures at 11 and 1 o'clock. Although early postoperative mean astigmatism in eyes operated through a corneal incision was high (range 2.92-6.67 diopters at 1 month postoperatively) and significantly different when compared to eyes operated through a scleral incision (1.96 diopters), final mean astigmatism did not differ significantly between those two groups. Moreover, in 27% of eyes operated through a corneal incision, mean astigmatism at 2 months postoperatively was not significantly different from the scleral group and suture removal was not necessary. There was no statistically significant difference in corrected visual acuity over the entire study period between groups. Since safety and functional results of the corneal incision were not different from the scleral incision, we prefer a corneal incision in cataract surgery because of its surgical advantages, especially in patients with cataract and coexisting glaucoma.