bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical induced astigmatism in phaecoemulsification cataract surgery
Authors: LEE Ming-Yueh , Hilda Tasha , Ismail Mariam , Goh Pik-Pin 
Published: January 2021

Abstract Purpose: Surgical induced astigmatism is often-neglected issue in phaecoemulsification cataract surgery. It is a significant problem resulting in poor refractive outcome and patients’ satisfaction. The objective of this study was to describe the preoperative astigmatism and the postoperative surgical induced astigmatism and its contributing factors. Design: Retrospective study on the Malaysian Cataract Surgery Registry between year 2008 and 2011. Method: Data on phaecoemulsification cataract surgery from 37 Ophthalmology Units were studied and filtered. Patients more than 50 year-old with complete refractive assessment results and with no ocular comorbidity were included. Contributing factors namely patients’ age, race, gender, laterality of the operated eye, surgeon’s status and intraoperative complications were analyzed. Results: The mean age of the 5350 patients was 68.0 years with majority Chinese patients. The mean postoperative cylinder was 1.19D (SD=0.91) compared to the preoperative mean cylinder of 0.88D (SD=0.83D). Multivariate regression analysis on postoperative data revealed statistically significant high cylinder power (>1.0 Dioptre) for older patients, Chinese race, left operated eyes (p<0.001), performed by trainee ophthalmologists (p<0.001), and for those with intraoperative complications (p<0.001). The overall difference of cylinder power before and after phaecoemulsification cataract surgery was high; signifying high degree of surgical induced astigmatism. Conclusion: Surgical induced astigmatism could result in significant postoperative astigmatism with poor refractive outcome. The contributing factors are old age, Chinese race, left operated eyes, operated by trainee ophthalmologists and intraoperative complications.
Adult orbital tumor
Authors: Ho Shu Fen , Othman Radzlian 
Published: January 2021

Aim: to study the prevalence, demographics, clinical and histolopathological features of orbital tumors biopsied in Hospital Serdang, a national Oculoplastic referral centre in Malaysia.
Methods: A retrospective, observational study on all the consecutive orbital biopsies performed in Hospital Serdang from January 2008 to December 2014. Outcome measurement includes demographic data and histological diagnosis of biopsied orbital lesions.
Results: Among a total of 136 cases, there is slight male preponderence (59.6%). Malay is the commonest racial group (58.8%) followed by Chinese (32.4%). Lymphoproliferative lesion is the most common category (34.6%) followed by inflammatory (10.3%) and lacrimal lesion (9.6%). Benign lymphoid hyperplasia (16.9%) and Non Hodgkin lymphoma(BHL) (16.2%) were the most common histology diagnosis. Those with benign lymphoid hyperplasia developed at a younger age (mean 56 years) compared to those with Non Hodgkin Lymphoma (60.6 years old). Benign lymphoid hyperplasia occurred at a same frequency at orbit and lacrimal gland whilst those NHL were mostly located within the orbit. Lymphoproliferative disorders are more common among male and Chinese. Our patients develop cavernous haemangioma, pleomorphic adenoma and solitary fibrous tumor at an earlier age than Western counterparts. Benign orbital lesions whilst being more common, may be associated with significant visual and orbital comorbidities.
Conclusions: Lymphoproliferative lesions occur at a higher occurrence among Souteast Asian patients, especially among Chinese and male. Our patients also develop cavernous haemangioma, pleomorphic adenoma and solitary fibrous tumor at an earlier age compared to their Western counterparts. There is ethnic difference among different orbital pathologies. Delayed presentation of benign orbital lesions lead to significant morbidity and sometimes exenteration. Financial restraints may hinder clinicians in developing countries to obtain precise histological diagnosis.
The use of bone marrow derived mesenchymal stem cell for cornea regeneration in rabbit model
Authors: Then Kong Yong , Azlina M. , Ropilah A.R. , Ruszymah B.H.I. , Rohaina C.M. , Ng M.H. 
Published: January 2021

Aim or Purpose: To evaluate the use of autologous bone marrow derived mesenchymal stem cells (BM-MSCs) to treat cornea stromal defect in a rabbit model.
Methods: A non-randomized interventional controlled animal study involving twenty one adult New Zealand white rabbits. Corneal deep lamellar dissections were created in three groups of rabbits and treated accordingly. Group I; Autologous bone marrow derived MSCs with autologous fibrin and human amniotic membrane. Group II; Autologous fibrin with human amniotic membrane without MSCs. Group III; No treatment. Clinical outcome was evaluated by corneal re-epithelization, corneal opacity, corneal thickness and histology.
Results: BM-MSCs were successfully isolated from bone marrow of seven rabbits based on the adherence property of the cells to the plastic of the cell culture plate. At day 60 corneal thicknesses was significantly thicker in Group I. The localization of PKH26 labeled BM-MSCs showed an increase in cell density at the transplanted site, proving its role in cornea stromal regeneration. Although the cornea clarity was not achieved in this study, we believe that cornea stromal remodeling requires many months to years to regain its original optical quality.
Conclusion: Locally transplanted BM-MSCs may be a useful source for cornea stromal regeneration. The use of autologous BM-MSCs offers a promising option for treating corneal disorder without the risk of immune-rejection and calcification.
Knowledge, awareness, perception, and willingness towards eye donation among the literate working population
Authors: Egnasious Justin , Srinivasan Krithica , S Ve Ramesh , Noushad Babu 
Published: January 2021

Aim: To evaluate awareness, knowledge, and perception towards eye donation among the literate working population.
Methodology: A new questionnaire on eye donation was developed from existing literature and face validation was performed among subject experts. Repeatability of the questionnaire was performed among 30 subjects. A total of 23 questions were there, out of those 6 questions for evaluating awareness, 13 questions for evaluating knowledge, and 4 questions for dertermining the subjects' perception. The questionnaire was distributed among subjects working in both the health science and non-health science fields. From their responses, knowledge, awareness, and perception towards eye donation in working literate population were assessed. A pledge form was also given along with the questionnaire to find the subjects' actual willingness.
Results: Repeatability: The questions in the awareness and knowledge domain showed good repeatability (p > 0.05). More than 50 % of the parameters in the perception domain showed poor repeatability (p < 0.05). Out of 189 subjects assessed, there were 97 health science and 92 non-health science subjects with total mean age 30 ± 7 years. Good awareness was present between health science (96%) and non-health science (94%). Only 21% of the health science and 11% of the non-health science group had good knowledge about eye donation. Only 25% said ‘yes’ to willingness about eye donation. However, only 3% filled the pledge form. No-one from the non-health science population filled the pledge form. Health science professionals showed more willingness to donate eyes compared to the non-health science group after adjusting for qualification, age ,and gender (odds ratio 2.158, p = 0.031, 95% CI (1.073, 4.341)). Study participants shared willingness to donate eyes and responded against negative perceptions such as "Family members object to eye donation” (odds: 3.75, p = 0.030, 95% CI (1.14, 12.39)), “Dislike of separating eye from the body” (odds:7.02, p =0.006, 95% CI (1.73, 28.42)), and “Donating an organ is against my religious belief” (odds: 8.51,p = 0.039, 95% CI (1.11, 65.09)).
Conclusion: Our study showed that education qualification and the perception like ‘eye donation is against religious beliefs’ and ‘dislike to separate eye from the body’ showed significant effect on the willingness to donate eyes. More than awareness and knowledge, perception about eye donation had more impact on the willingness to donate eyes. Therefore, more campaigns emphasizing the importance of eye donation need to be conducted to change the perceptions about eye donation rather than improving awareness or knowledge.
Evaluation of anterior chamber volume using Pentacam and anterior segment optical coherence tomography among normal subjects
Authors: Anandan Vijaya , Srinivasan Rekha , Asokan Rashima , George Ronnie 
Published: January 2021

Aim: To compare the anterior chamber volume measurements obtained with Pentacam and derived from anterior segment optical coherence tomography.
Design: Cross-sectional study.
Methods: We included normal subjects who underwent a comprehensive eye examination including refraction, keratometry, Goldmann applanation tonometry, gonioscopy, anterior segment optical coherence tomography (AS-OCT) (Carl Zeiss Meditec Inc.; Dublin, CA, USA) and Pentacam (Oculus Inc.; Lynnwood, WA, USA). Fifty scans were selected for Pentacam and 12 images were selected for calculation of anterior chamber volume. Only the right eye was considered for analysis.
Results: One-hundred and nineteen eyes of 119 subjects were included for analysis. The mean age of the subjects was 42.58 ± 13.15 years, of which 74 were female and 45 were male. The mean anterior chamber volume measured using AS-OCT was 119.17 ± 26.56 mm3 and with Pentacam was 131.29 ± 34.26 mm3. The comparison of means between the two modalities was statistically significant (t = -8.857, Mean Difference (MD) = 12.11, 95% CI: (4.29, 19.95), p = 0.003). Bland-Altman plot showed poor agreement between the chamber volume measurements obtained by Pentacam and AS-OCT with MD of 12.1 mm3 (95 % CI: 41.4 to -17.1) and intra-class correlation between the two instruments was 0.94 (95% CI: 0.91, 0.96) (p < 0.0001).
Conclusion: The anterior chamber volume can be measured using Pentacam as well as AS-OCT since these measurements were reliable. However, these measurements were not interchangeable due to poor levels of agreement.
Contrast sensitivity before and after small incision lenticule extraction and femtosecond laser in situ keratomileusis
Authors: Pradhan Asik , Pradhan Kishore Raj , Shrestha Gauri Shankar , Dhunganga Purushottam , Kaiti Raju 
Published: January 2021

Introduction: Contrast sensitivity function after laser ablation of the cornea in refractive surgery is an important tool for measuring quality of visual function. The effect of small incision lenticule extraction (SMILE) and femtosecond laser in situ keratomileusis (FS-LASIK) on visual function can be compared by measuring spatial contrast sensitivity.
Purpose: This study was to compare contrast sensitivity function in patients undergoing refractive surgery for myopia at Tilganga Institute of Ophthalmology.
Methods: In a retrospective study, 15 subjects who underwent refractive surgeries comprising 9 cases of SMILE and 6 cases of FS-LASIK at Tilganga Eye Hospital were enrolled in the study. A major assessment included best corrected monocular contrast sensitivity with functional vision analyzer at spatial frequencies of 1.5, 3, 6, 12, and 18 cycles/deg in photopic condition (85 cd/m2) before, 3 months, and 1 year after the surgery. The average functional acuity contrast test scores for each spatial frequency were recorded. Differences between preoperative and postoperative contrast sensitivity at each spatial frequency were analyzed through parametric paired Student’s t-test.
Results: Contrast sensitivity of postoperative FS-LASIK and SMILE did not differ from preoperative values at a photopic level. However, at high spatial frequency (12 and 18 cycles/deg), contrast sensitivity function improved significantly (p < 0.05) in eyes after FS-LASIK. Eyes after SMILE surgery did not show any reduction in contrast sensitivity at all the spatial frequencies.
Conclusion: Under photopic conditions, the contrast sensitivity function is unaffected by SMILE or FS-LASIK.
Optimized imaging of the suprachoroidal space with swept-source OCT
Authors: Hanhart Joel , Yaacov Rozenman 
Published: January 2021

Purpose: To compare enhanced depth imaging (EDI) and non-EDI swept source optical coherence tomography (SS-OCT) in their ability to capture the suprachoroidal space (SCS).
Materials and methods: Twenty volunteers with a minimum age of 18 years without any ocular pathology and refractive error below Å} 2 diopters underwent SS-OCT foveal scanning, with and without EDI. Masked averaged B-scan lines were analyzed for presence of the SCS. When the SCS was seen, the percentage of the scan on which this structure could be unequivocally observed was measured. Scores obtained from the images taken with or without EDI were then compared.
Results: Thirty-seven eyes were analysed, since three eyes of three different patients were eliminated, as the outer border of the choroid was insufficiently delineated with both modalities. The SCS was not detected at all on 14 pictures (37.8%) obtained by non-EDI SS-OCT and 9 pictures (24.3%) obtained by EDI SS-OCT. When the SCS was detected with both modalities, it was observable on 27.2+/-24.2% of the scan without EDI and 40.4+/-30.3 of the scan with EDI (p < .001)
Conclusions: EDI SS-OCT enables a more frequent and extensive visualization of the suprachoroidal space than non-EDI SS-OCT. This new approach could be considered as the most accurate modality to currently visualize the SCS in vivo.
Characteristics and treatment outcomes of patients with primary ocular adnexal lymphoma in Northern Thailand
Authors: Seresirikachorn Kasem , Ausayakhun Sakarin , Wiwatwongwana Damrong , Mahanupab Ponsak , Daroontum Teerada , Norasetthada Lalita 
Published: January 2021

Purpose: To assess the characteristics and treatment outcomes of patients with primary ocular adnexal lymphoma (OAL) in Northern Thailand.
Design: Retrospective cohort study.
Methods: Data was collected from electronic medical records and operative notes from Chiang Mai University Hospital between January 2009 and December 2014. All available tissue biopsies of 54 patients were reviewed by agreement of two pathologists. The clinical characteristics and treatment outcomes were collected and analyzed.
Results: A total number of 54 patients were identified of which 57.4% were female. The median age was 61.0 years (range, 4-86). The most common subtype of lymphoma was extranodal marginal zone lymphoma (ENMZL) of mucosa-associated lymphoid tissue (MALT) (n = 46, 85.2%). Seventy-five percent of the patients presented with a mass at the ocular adnexa, while 14.8% of the patients presented with proptosis. The sites of origin were as follows: lacrimal (46.3%), orbit (31.5%), conjunctiva (13%) and eyelid (7.4%). Two-thirds of the patients had Ann-Arbor Stage I, while 22% of patients had Stage IV. The majority of the patients (68.1%) had a low-risk international prognosis index (IPI). Treatment modalities involved field radiation (IFRT, 50%), chemotherapy (31.6%), combined chemoradiotherapy (7.9%) and surgical resection (10.5%). The overall response rate was 100% with a complete response rate of 77.8%. In patients with low-grade lymphoma, including MALT lymphoma, the 3-year progression-free survival (PFS) and overall survival were 69.9% and 92.5%, respectively.
Conclusion: ENMZL of MALT was the major subtype of primary OAL. Radiotherapy was an effective treatment for the lower stages of disease providing a high response rate and encouraging survival outcomes.
Benzalkonium chloride corneal toxicity post-cataract surgery
Authors: Ong Keith , Ong Leonard 
Published: January 2021

Two patients with presumed benzalkonium chloride (BAK) corneal toxicity after routine cataract surgery are presented. Patient 1 had corneal stroma and Descemet’s membrane folds. Patient 2 had moderate superficial punctate epithelial erosions (SPEE). They were on Chlorsig, Maxidex, and Acular eye drops tds postoperatively. The corneas of these two patients improved when BAK was removed or minimized from the postoperative eye drop regimen. Two vials of 1 ml dexamethasone 4mg/ml for injection were added to Chlorsig 10 ml bottle to substitute for Maxidex eye drops.
BAK toxicity should be suspected when the cornea is not as clear as expected postoperatively. A practical way to eliminate BAK from postoperative eye drops is described, and would be useful until pharmaceuticals mass-produce BAK-free steroid eye drops economically.
Avoiding BAK in postoperative eye drops reduces the need for subconjunctival 5-FU injections post-trabeculectomy
Authors: Ong Keith , Ong Leonard 
Published: January 2021

Purpose: Subconjunctival fibrosis is one of the main causes of failure of glaucoma filtration surgery. It can result in absence of a filtration bleb, a small scarred bleb, or a cystic bleb. 5-Fluorouracil (5-FU), mitomycin C (MMC), and topical steroids have been used to suppress subconjunctival fibrosis.
Method: A study was done analyzing the number of postoperative subconjunctival 5-FU injections for trabeculectomy on pseudophakic eyes prior to and following the change to a BAK-free regimen. The cohort consisted of 16 consecutive cases undergoing primary trabeculectomy without intraoperative MMC or 5-FU. The trabeculectomy surgery included a groove sclerectomy procedure. Group A were 8 eyes of patients who had the author’s standard Chlorsig, Maxidex, and Prednefrin Forte eye drops tds. Group B were 8 eyes who had Chlorsig-dexamethasone and Optive-dexamethasone tds eye drops postoperatively.
Results: Group B (BAK-free) patients required fewer postoperative 5-FU subconjunctival injections (average: 2.9, range: 1-5 injections) compared to Group A (BAK) patients (average: 7.3, range: 4-18 injections). This difference was statistically significant (P = 0.02, unpaired t-test). All patients had functioning blebs and did not require glaucoma medications to maintain target intraocular pressure. The Group B (BAK-free) patients had more diffuse blebs than the Group A (BAK) patients.
Conclusion: The results demonstrated that when BAK was eliminated from postoperative eye drops in trabeculectomy, the number of postoperative 5-FU injections was reduced.
Arachnoid cyst of the optic nerve: therapeutic management and progress
Authors: Temblador-Barba Irene , Gálvez-Prieto-Moreno Carlos , Martínez-Jiménez María 
Published: January 2021

Purpose: To describe the management of a case of an arachnoid cyst of the optic nerve.
Methods: Here, we report a 27-year-old female patient who was diagnosed with arachnoid cyst of the left sheath optic nerve, drained in several occasions, and came to our service because of progressive blurring in the left eye.
Outcomes: Due to the location of the lesion, excision could not be performed; so we performed a microsurgical incision with drain by nasal superior transconjunctival approach. After that, the visual acuity (VA) was 0.7, and we could observe that the size of the cyst was smaller than previous examinations with magnetic resonance imaging (MRI). Nowadays, the patient keeps the same asymptomatic VA. So medical appointments are planned to closely follow-up, and periodically, we perform new scan images and visual fields.
Conclusions: Arachnoid cysts of the optic nerve are rare, benign, slowly progressive conditions. They can be asymptomatic lesions, especially smaller ones, or may result in proptosis and loss of vision because of the compression. The best imaging examination for their follow-up is MRI. They should be differentiated from optic nerve sheath meningioma and other conditions.
Differences of tear film osmolarity between two time-points of the day in healthy subjects
Authors: Pena-Verdeal Hugo , Vazquez-Sanchez Covadonga , Garcia-Queiruga Jacobo , Garcia-Resua Carlos 
Published: January 2021

Purpose: Tear film hyperosmolarity is considered one the core mechanism of the dry eye along with the tear film stability. Many tear physiological variables oscillate during the day. This study was designed to assess the differences in tear film osmolarity between morning and afternoon in a group of healthy subjects.
Materials and methods: A total of 25 healthy subjects who fulfilled the study’s inclusion criteria were enrolled for the study. Tear osmolarity was measured using the TearLab™ system in two separated sessions, at 9.30 am and 6.30 pm. A paired t-test and a Bland–Altman test were used to assess the differences between sessions.
Results: Tear osmolarity (mean ± SD) was 309.96 ± 9.00 and 296.48 ± 12.98 mOsm/l at 9.30 am and 6.30 pm, respectively, being significantly lower at 6.30 pm than at 9.30 am (mean difference ± SD = 13.48 ± 8.69 mOsm/l; paired t-test; p < 0.001).
Conclusions: Tear film osmolarity does appear to have some influence by the time of day in healthy patients.
Asymptomatic chronic hypotony due to subclinical choroidal effusion after blunt trauma
Authors: De Leon John Mark Sim , Medalle Ronald Steven 
Published: January 2021

Objective: To present a case report of asymptomatic post-traumatic chronic hypotony in which the cause was undetected until phacoemulsification.
Methodology: Case report.
Results: A 55-year-old female’s left eye suffered blunt trauma causing hyphema and iritis, which were successfully managed; however, up to a year after, the intraocular pressure (IOP) ranged from 3 to 5 mmHg and the anterior chamber remained very shallow (Van Herick grade 4) with the lens–iris diaphragm pushed anteriorly with difficulty assessing the angles for recession or clefts . Visual acuity was initially 20/20 upon resolution of the hyphema but worsened to 20/40 a year after, presumably due to a developing cataract. Periodic dilated fundus examinations revealed no hypotony maculopathy or choroidal effusions. Prior to phacoemulsification, ultrasound biomicroscopy (UBM) revealed 360 degrees of mild peripheral choroidal effusions. During phacoemulsification, after intraocular lens insertion, direct gonioscopy revealed a supero-nasal cyclodialysis cleft (2 clock hours) and this was repaired intraoperatively with direct cyclopexy through a partial thickness scleral flap. Postoperatively, the vision improved to 20/20 without correction and the IOP normalized to 16 to 18 mmHg.
Conclusion: Chronic hypotony post-trauma may be asymptomatic and the cause may not be clinically evident and may be detected by UBM (choroidal effusion). In our case, the proximate aetiology (cyclodialysis cleft) of the effusion was only observed intraoperatively after phacoemulsification for which cyclopexy was performed which increased the IOP to physiologic levels.