Purpose: To examine the visual outcomes following bilateral Rayone enhanced mono-vision intraocular lens (EMV IOL) implantation. Study Design: Retrospective chart review. Place and Duration of Study: Al-Ehsan Welfare Eye Hospital, Lahore from January 2024 to December 2024. Method: Twenty patients (40 eyes) who underwent bilateral Rayone EMV (enhanced monovision) IOL implantation were included. Uncorrected distance visual acuity (UCDVA) at 6 meters, intermediate visual acuity (UCIVA) at 66 cm, and near visual acuity (UCNVA) at 40cm were measured after three months of cataract surgery. Binocular defocus curveand patient-reported satisfaction were also analyzed. Results: The mean age was 53.9 ± 4.5 years, with 65% males. After 3 months of IOL implantation, 90% of patients achieved UCDVA of 0.10 logMAR or better, with 70% reaching 0.00 (20/20). Ninety percent had UCIVA of 0.00 logMar or better. The defocus curve in both eyes showed a smooth functional vision from distance through -2.50D, reflecting strong performance across the visual range. In 75% of patients, spectacle independence was attained, with occasional near vision aid required in a minority. Reports of glare and halos were minimal. Patient satisfaction had mean score of 9.2/10). Conclusion: Bilateral Rayone EMVIOL implantation with a micro-monovision strategy achieved excellent near, intermediate, and distance vision with high level of spectacle independence and minimal disturbances.
Purpose: To assess the thickness of Macular ganglion cell/inner plexiform layer in glaucoma patients by using swept-source OCT and compare itwith peripapillary RNFL thickness. Study Design: Descriptive Cross-Sectional Study. Place and Duration of Study: Liaquat University of Medical and Health Sciences Jamshorofrom June 2021 to June 2022. Methods: Total 140 patients were enrolled in our study and divided in two groups. Group A included patients diagnosed with glaucoma and group B (control group), included non-glaucoma patients. Patients of either gender, above 30 years of age and intraocular pressure (IOP) of more than 21 mm Hg with open angle on gonioscopy were included in the study. All participants underwent examinations including visual acuity, refraction, IOP measurement, Gonioscopy, slit lamp examination with dilated fundus examination. Swept source OCT measurements Ganglion cell layer/inner plexiform layer (GCL/IPL) and Retinal nerve fiber layer (RNFL)thickness were measured. The independent t test and the chi-square were used. P-values less than 0.05 were deemed statistically significant. Results: There were 65.7% males and a mean age of 46.8±12.08 years. Glaucoma cases showed significantly higher IOP and cup to disc ratio compared to controls (p<0.001). RNFL and GCIPL thickness was markedly reduced in glaucoma eyes versus controls (p<0.001). GCIPL demonstrated strong discriminatory ability similar to RNFL for detecting glaucomatous changes. Conclusion: GCIPL thickness showed diagnostic performance comparable to RNFL measurements. Incorporating GCIPL assessment may enhance early and reliable detection of glaucoma.
Purpose: To evaluate the effectiveness and safety of combination therapy using suprachoroidal triamcinolone acetonide (TA) and intravitreal bevacizumab in patients with refractory diabetic macular edema (DME). Study Design: Interventional case series. Place and Duration of Study: Ibrahim Eye Center, from December 2024 to September 2025. Methods: This interventional case series included ten eyes with refractory DME that remained unresponsive despite receiving at least three previous intravitreal anti-VEGF injections. All patients received a single session of combination therapy consisting of intravitreal bevacizumab (1.25 mg/0.05 mL) and suprachoroidal triamcinolone acetonide (4 mg/0.1 mL). Central subfield thickness (CST) was measured using optical coherence tomography (OCT) at baseline and eight weeks after treatment. Changes in CST and treatment-related adverse events were evaluated. Results: There were 5 males and 5 females, all with uncontrolled type II diabetes mellitus (HbA1c >6.5%). The duration of diabetes ranged from 12 to 17 years, with a mean of 14.3±2.7 years. Mean CST decreased significantly from 667.5±150 µm at baseline to 363.4±150.22µm at eight weeks following treatment (p = 0.006). Eight eyes (80%) achieved a reduction in CST of at least 50µm. No serious ocular or systemic adverse events were observed. A transient rise in intraocular pressure occurred in two patients and was successfully controlled with topical anti-glaucoma medication. Conclusion: Combination therapy with suprachoroidal triamcinolone acetonide and intravitreal bevacizumab produced significant anatomical improvement in refractory DME with a favorable safety profile.
Purpose: To access the agreement between central corneal thickness and anterior chamber depth using two anterior segment imaging devices, Oculus Pentacam and CSO MS-39. Study Design: Cross-sectional study. Place and Duration of Study: Amanat Eye Hospital from July 2025 to October 2025. Methods: A total of 263 patients were included through consecutive sampling. Patients aged 18 years or above having clear corneas, no active ocular surface disease and no history of ocular surgery or corneal refractive procedures were included in this study. Central corneal thickness (CCT) and anterior chamber depth (ACD) were determined for each eye using the Oculus Pentacam and Advanced Anterior Segment Optical Coherence Tomograph (CSO MS-39). Paired t-test, Correlation analysis, and Bland-Altman plots were used to estimate mean differences and limits of agreement between the two devices. Results: The paired t-test showed no statistically significant changes between Pentacam and MS-39 for CCT and ACD measurements. The CCT mean difference was -0.51µm (p=0.4189), while for ACD the mean difference was -0.0154mm(p=0.2115). Interclass correlation analysis demonstrated excellent reliability for both CCT (ICC = 0.956, 95% CI: 0.945–0.966) and ACD (ICC = 0.813, 95% CI: 0.768–0.851) values. Bland-Altman analysis showed relatively low mean bias with 95% limits of agreement. Conclusion: The Pentacam and MS-39 showed good agreement in measuring CCT and ACD, with no systematic bias and no statistically significant differences. These findings support the use of either instrument for routine clinical evaluation andclinical decision making.
Purpose: To compare central corneal thickness (CCT) in eyes with primary open-angle glaucoma (POAG) and non-glaucomatous eyes using four different devices, and to evaluate the agreement and comparability of these devices in both groups. Study Design: Cross sectional study. Place and Duration of Study: Tertiary hospital in Semarang City from May 2025 to February 2026. Methods: CCT in right eye was measured using standard ultrasonic pachymetry (USP), optical coherence tomography (OCT), non-contact tono-pachymetry (NCT), and specular microscopy (SM). Differences, correlation levels, and agreement between the measurement results were assessed. Result: A total of 69 participants participated in this study (33 patients with glaucoma and 36 without glaucoma).The mean CCT measured using NCT (580.50±27 mm), USP (578.50±26 mm), SM (569.50±28 mm), and OCT (564.50±27 mm) did not differ statistically in the non-glaucoma group. Similar results were seen in glaucoma group with NCT (528±22 mm), USP (527±22 mm), SM (518±25 mm), and OCT (518±27 mm)(p>0.05). The difference between the two groups was statistically significant (p < 0.001). A strong positive correlation was observed among the four devices within each group (p<0.001). Bland-Altman analysis comparing each device to the USP gold standard showed bias values of 2.6 (NCT), -12.03 (SM), and -6.03 (OCT) in the glaucoma group, and 9.8 (NCT), -9.1 (SM), and -14.6 (OCT) in the non-glaucoma group. Conclusion: The CCT measurements using NCT, SM, and OCT were aligned with the USP measurements in both groups. This finding highlights that CCT monitoring may be interchangeable between devices. Keywords: Central Corneal Thickness, Non-Contact Tono- Pachymetry, Optical Coherence Tomography Specular Microscopy, Ultrasound Pachymetry.
