The members of the Management and Therapy Subcommittee undertook an evidence-based review of current dry eye therapies and management options. Management options reviewed in detail included treatments for tear insufficiency and lid abnormalities, as well as anti-inflammatory medications, surgical approaches, dietary modifications, environmental considerations and complementary therapies. Following this extensive review it became clear that many of the treatments available for the management of dry eye disease lack the necessary Level 1 evidence to support their recommendation, often due to a lack of appropriate masking, randomization or controls and in some cases due to issues with selection bias or inadequate sample size. Reflecting on all available evidence, a staged management algorithm was derived that presents a step-wise approach to implementing the various management and therapeutic options according to disease severity. While this exercise indicated that differentiating between aqueous-deficient and evaporative dry eye disease was critical in selecting the most appropriate management strategy, it also highlighted challenges, based on the limited evidence currently available, in predicting relative benefits of specific management options, in managing the two dry eye disease subtypes. Further evidence is required to support the introduction, and continued use, of many of the treatment options currently available to manage dry eye disease, as well as to inform appropriate treatment starting points and understand treatment specificity in relation to dry eye disease subtype.

TFOS DEWS II Management and Therapy Report

Risk assessment for ectasia after corneal refractive surgery.

Thank you very much for reading encyclopedia of research design. Maybe you have knowledge that, people have look hundreds times for their favorite books like this encyclopedia of research design, but end up in malicious downloads. Rather than enjoying a good book with a cup of coffee in the afternoon, instead they cope with some infectious bugs inside their desktop computer. encyclopedia of research design is available in our digital library an online access to it is set as public so you can download it instantly. Our books collection hosts in multiple locations, allowing you to get the most less latency time to download any of our books like this one. Kindly say, the encyclopedia of research design is universally compatible with any devices to read.

Encyclopedia Of Research Design

New updated! The latest book from a very famous author finally comes out. Book of principles and practice of ophthalmology, as an amazing reference becomes what you need to get. What's for is this book? Are you still thinking for what the book is? Well, this is what you probably will get. You should have made proper choices for your better life. Book, as a source that may involve the facts, opinion, literature, religion, and many others are the great friends to join with.

Principles and Practice of Ophthalmology

Purpose To examine a database of laser in situ keratomileusis (LASIK) procedures for preoperative and operative factors assumed to increase the risk for developing post-LASIK ectasia. Setting Private clinical practice. Methods A computer database was queried for eyes that had LASIK for myopic refractive errors with the following characteristics: preoperative corneal thickness 500 μm or less, mean keratometry greater than 47.0 diopters (D), patient age 25 years or younger, attempted correction greater than −8.0 D, refractive astigmatism not with-the-rule and greater than 2.0 D, and residual stromal bed thickness (RST) 250 μm or less. Flap thickness and RST were measured using ultrasound pachymetry. All recorded information was exported to MS Excel and analyzed for eyes that had ectasia. Results Of the 9700 eyes in the database, none with the above characteristics developed ectasia over mean follow-up periods exceeding 2 years. Seven eyes had multiple risk factors without ectasia. Three eyes with abnormal preoperative topography developed ectasia. Conclusions Individual preoperative and operative factors did not in and of themselves increase the risk for ectasia. Unmeasured and unknown factors that affect the individual cornea's biomechanical stability, in combination with some suspected risk factors as well as the current inability to identify corneas at risk for developing ectatic disorders, probably account for most eyes that develop ectasia today.

Analysis of ectasia after laser in situ keratomileusis: Risk factors

Endophthalmitis Occurring after Cataract Surgery: Outcomes of More Than 480 000 Cataract Surgeries, Epidemiologic Features, and Risk Factors.

PURPOSE: We describe ten patients who developed progressive keratectasia following laser in situ keratomileusis (LASIK) and identify possible factors that may lead to ectasia. METHODS: In this retrospective study, we reviewed the files of 3,634 patients (6941 eyes) who had LASIK between March 2000 and April 2003. Ten patients (14 eyes, 0.2%) developed progressive keratectasia. We also evaluated consequent therapeutic measures and final visual status of these patients. RESULTS: Patients were examined at a mean 24.9 ′8.1 months after LASIK. Ectasia developed within a mean 14 ′ 0.3 months after surgery. At baseline, mean keratometric power was 44.7 ′ 2.30 D, mean corneal thickness was 516 ′ 18.9 μm, and mean attempted correction was -10.85 ′ 3.20 D. We found a statistically significant correlation between residual stromal thickness, attempted correction, and occurrence of progressive keratectasia. We also found that preexisting abnormal corneal topography was a risk factor for progressive keratectasia. Ultimately, most patients had reasonable visual acuity after penetrating keratoplasty. CONCLUSION: Progressive keratectasia is a vision threatening complication of LASIK that may occur in previously healthy or diseased eyes. The most important risk factors are residual stromal thickness and preexisting abnormal corneal topography. Penetrating keratoplasty may be a reasonable therapeutic measure for severe cases of progressive keratectasia.

Progressive Keratectasia After Laser in situ Keratomileusis

Purpose To evaluate the outcome of accelerated and conventional corneal cross-linking (CXL) procedures regarding their effect on morphological and optical properties of the cornea. Methods One hundred fifty-three eyes of 153 patients were evaluated before and during a 15-month follow-up period after CXL (76 eyes in the conventional group and 77 eyes in the accelerated group). Measured variables include corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), refraction, maximum keratometry, endothelial cell density, anterior and posterior stromal keratocyte density, and subbasal nerve density. All variables were compared between the two study groups. Results Cylindrical and spherical components of refraction improved significantly during 15 months of follow-up. No difference was observed between the two study groups. UDVA and CDVA improved in the same manner, with no intergroup differences. Endothelial cell density did not change significantly during the follow-up period in either group. K-max increased slightly in the first month of the follow-up, but started to decrease at postoperative visits without any significant difference in the two groups. Anterior stromal keratocyte density and subbasal nerve density decreased significantly in both groups 1 month postoperatively. Both variables had a more significant decrease in the conventional group at all visits before the 1-year visit. At the final 15-month visit, there were no significant differences in any value between the two groups. Conclusions Accelerated and conventional CXL seem to have a comparable and acceptable effect on keratoconus in the short-term follow-up period.

Evaluation of corneal changes after conventional versus accelerated corneal cross-linking: a randomized controlled trial.

Purpose To determine the incidence of and risk factors for posterior capsule rupture and vitreous loss during phacoemulsification performed by ophthalmology residents. Setting Academic ophthalmology resident training center, Tehran, Iran. Design Cross-sectional study. Methods This study included patients who had phacoemulsification by ophthalmology residents from August 2010 to August 2011. The complications occurring during surgery and the rate of vitreous loss and posterior capsule rupture were studied. Results Five hundred eyes of 500 patients, including 255 (51%) men and 245 (49%) women with a mean age of 67 years ± 10 (SD) (range 27 to 105 years), were studied. Fifty-one eyes (10.2%) developed vitreous loss, and 48 eyes (9.6%) developed posterior capsule rupture and vitreous loss. On univariate analysis, significant risk factors for vitreous loss included diabetes mellitus ( P =.001), shallow anterior chamber ( P =.01), absence of supervision by a faculty member ( P =.007), larger capsulorhexis ( P =.02), anterior capsule tear ( P =.001), and longer effective phacoemulsification time (EPT) ( P =.003). Multivariate data analysis using stepwise logistic regression analysis showed anterior capsule tear (odds ratio [OR], 2.63; 95% confidence interval [CI], 1.09-6.29), longer EPT (OR, 1.01; 95% CI, 1.003-1.02), and lack of supervision by attending physicians (OR, 4.28; 95% CI, 1.44-12.67) to be significant independent risk factors associated with vitreous loss. Conclusion Direct attending supervision and careful case selection for the level of cataract surgery residency are of utmost importance in avoiding sight-threatening complications. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.

Incidence of and risk factors for vitreous loss in resident-performed phacoemulsification surgery.

Purpose To assess the clinical outcomes after continuous intracorneal ring (ICR) implantation for the management of keratoconus using femtosecond laser technology. Setting Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Design Prospective nonrandomized consecutive case series. Methods All patients presented with reduced visual acuity, contact lens intolerance, and a central corneal thickness of more than 360 μm. A Myoring ICR was inserted in an intrastromal pocket created by a femtosecond laser. The visual, refractive, aberrometric, and corneal biomechanical outcomes were measured preoperatively as well as 1, 3, and 6 months and 1 year postoperatively. Results The study comprised 98 keratoconic eyes of 98 patients with a mean age of 30.7 years ± 9.01 (SD). Fifteen eyes (15.3%) had grade I keratoconus, 37 eyes (37.7%) had grade II keratoconus, 24 eyes (24.5%) had grade III keratoconus, and 22 eyes (22.4%) had grade IV keratoconus. The uncorrected and corrected distance visual acuities and spherical and cylindrical errors improved 1 month after surgery ( P P >.05). The mean keratometry and corneal astigmatism decreased 1 month after surgery ( P P >.05). Primary coma decreased significantly ( P =.03), and spherical aberrations increased significantly ( P Conclusion Continuous ICR implantation in keratoconus appears to be an acceptable substitute for keratoplasty in advanced keratoconus. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.

Mahmoud Jabbarvand

Papers

Endophthalmitis Occurring after Cataract Surgery: Outcomes of More Than 480 000 Cataract Surgeries, Epidemiologic Features, and Risk Factors.

Progressive Keratectasia After Laser in situ Keratomileusis

Evaluation of corneal changes after conventional versus accelerated corneal cross-linking: a randomized controlled trial.

Incidence of and risk factors for vitreous loss in resident-performed phacoemulsification surgery.

Continuous intracorneal ring implantation for keratoconus using a femtosecond laser