Microscopic and spectroscopic investigation of an explanted opacified intraocular lens

Energy Technology Data Exchange (ETDEWEB)

Simon, V., E-mail: viosimon@phys.ubbcluj.ro [Babeş-Bolyai University, Faculty of Physics and Interdisciplinary Research Institute on Bio-Nano-Sciences, 400084 Cluj-Napoca (Romania); Radu, T.; Vulpoi, A. [Babeş-Bolyai University, Faculty of Physics and Interdisciplinary Research Institute on Bio-Nano-Sciences, 400084 Cluj-Napoca (Romania); Rosca, C. [Optilens Clinic of Ophthalmology, 400604 Cluj-Napoca (Romania); Eniu, D. [Iuliu Haţieganu University of Medicine and Pharmacy, Department of Molecular Sciences, 400349 Cluj-Napoca (Romania)

2015-01-15

Highlights: • Changes on intraocular lens (IOL) surface after implantation. • Partial opacification of IOL central area. • Elemental composition on IOL surface prior to and after implantation. • First XPS depth profiling examination of the opacifying deposits. • Cell-mediated hydroxyapatite structuring. - Abstract: The investigated polymethylmethacrylate intraocular lens explanted an year after implantation presented a fine granularity consisting of ring-like grains of about 15 μm in diameter. In order to evidence the changes occurred on intraocular lens relative to morphology, elemental composition and atomic environments, microscopic and spectroscopic analyses were carried out using scanning electron microscopy (SEM), Fourier transform infrared (FTIR), energy-dispersive X-ray (EDS), and X-ray photoelectron (XPS) spectroscopies. The results revealed that the grains contain hydroxyapatite mineral phase. A protein layer covers the lens both in opacified and transparent zones. The amide II band is like in basal epithelial cells. The shape and size of the grains, and the XPS depth profiling results indicate the possibility of a cell-mediated process involving lens epithelial cells which fagocitated apoptotic epithelial cells, and in which the debris derived from cell necrosis were calcified. To the best of our knowledge, this is the first investigation on explanted intraocular lenses using XPS depth profiling in order to examine the inside of the opacifying deposits.

Phacoemulsification and intraocular lens implantation in patients with oculocutaneous albinism.

Science.gov (United States)

Dávila, Pedro J; Ulloa-Padilla, Jan P; Izquierdo, Natalio J

2017-01-01

To evaluate the benefits of phacoemulsification and intraocular lens implantation in patients with oculocutaneous albinism (OCA). The charts of 195 patients with OCA who visited a local eye clinic were reviewed. All of these patients had genetic linkage analysis to establish OCA type. Frequencies and Paired t-test analysis were determined. Of the 195 patients, nine (4.6%) underwent clear cornea phacoemulsification with intraocular lens implantation. Seven of the nine patients with OCA had the Hermansky-Pudlak (HPS) type 1; two had OCA type 1. Pre-operative BCVA of all eyes ranged from 1.0 to 2.3 logMAR with a mean of 1.42 logMAR and a standard deviation of 0.41 logMAR. Post-operative BCVA of all eyes ranged from 1.0 to 1.30 logMAR with a mean of 1.04 logMAR and a standard deviation of 0.10 logMAR. BCVA improved after phacoemulsification surgery and intraocular lens implantation (p = 0.002). Pre-operative astigmatism of all eyes ranged from +0.50 to +5.75 with a mean of +2.25 and a standard deviation of +2.40. Post-operative astigmatism of all eyes ranged from +0.50 to +2.00 with a mean of +1.23 and a standard deviation of +0.42. Astigmatism improved after phacoemulsification surgery and intraocular lens implantation (p = 0.05). Nine patients with OCA who underwent phacoemulsification and intraocular lens implant experienced improved visual acuity and reduced astigmatism post-operatively. These results suggest cataract surgery may improve vision and refractive errors, and thus quality of life, in patients with albinism.

Sutureless, Glueless, Scleral Fixation of Single-Piece and Toric Intraocular Lens: A Novel Technique

Directory of Open Access Journals (Sweden)

Aditya Kelkar

2015-07-01

Full Text Available Sutureless, glueless, scleral fixation of an intraocular lens is a known technique of fixing a lens in the scleral pockets. However, this technique is applied to single-piece and toric lenses instead of 3-piece lenses, allowing the advantage of the use of premium lenses in patients with poor capsular support. Favourable results without complications of pigment dispersion, iris transillumination defects, dysphotopsia, elevated intraocular pressure, intraocular hemorrhage and cystoid macular edema with a well-centered, stable intraocular lens have been observed in the 3-month postoperative period in both cases.

Pigment dispersion syndrome associated with intraocular lens implantation: a new surgical technique

Directory of Open Access Journals (Sweden)

M Isabel Canut Jordana

2010-11-01

Full Text Available M Isabel Canut Jordana1, Daniel Pérez Formigó1, Rodrigo Abreu González2, Jeroni Nadal Reus11Barraquer Ophthalmology Centre, Barcelona, Spain; 2University Hospital of La Candelaria, Tenerife, SpainAims: We report the case of a myopic patient who, after intraocular lens transplant in the posterior chamber, suffered elevated intraocular pressure due to pigment dispersion, with recurrent episodes of blurred vision. The patient was treated with a new surgical technique that can avoid potential iridolenticular contact.Methods: Complete ophthalmologic examination and optical coherence tomography (OCT of the anterior segment were performed.Results: Contact between the pigmentary epithelium and the iris with an intraocular lens was revealed by utrasound biomicroscopy and OCT. In this case, Nd:YAG laser iridotomy and laser iridoplasty were not effective for iridolenticular separation and control of the pigment dispersion. We propose a new technique: stitches on the surface of the iris to obtain good iridolenticular separation and good intraocular pressure control.Conclusion: Stitches on the iris surface should be considered as optional therapy in pigmentary glaucoma secondary to intraocular lens implantation. This surgical technique can avoid potential iridolenticular contacts more definitively.Keywords: pigmentary glaucoma, intraocular lens, optical coherence tomography, laser

Intraocular Lens Calcification; a Clinicopathologic Report

Directory of Open Access Journals (Sweden)

Mozhgan Rezaei-Kanavi

2009-04-01

Full Text Available

PURPOSE: To describe the clinical and pathological features of a case of hydrogel intraocular lens (IOL calcification. CASE REPORT: A 48-year-old man underwent explantation of a single-piece hydrophilic acrylic intraocular lens in his left eye because of decreased visual acuity and milky white opalescence of the IOL. The opacified lens was exchanged uneventfully with a hydrophobic acrylic IOL. Gross examination of the explanted IOL disclosed opacification of the optic and haptics. Full-thickness sections of the lens optic were stained with hematoxylin and eosin (H&E, von Kossa and Gram Tworts'. Microscopic examination of the sections revealed fine and diffuse basophilic granular deposits of variable size within the lens optic parallel to the lens curvature but separated from the surface by a moderately clear zone. The deposits were of high calcium content as evident by dark brown staining with von Kossa. Gram Tworts' staining disclosed no microorganisms. CONCLUSION: This report further contributes to the existing literature on hydrogel IOL calcification.

Pigment dispersion syndrome associated with intraocular lens implantation: a new surgical technique.

Science.gov (United States)

Canut Jordana, M Isabel; Pérez Formigó, Daniel; Abreu González, Rodrigo; Nadal Reus, Jeroni

2010-11-11

We report the case of a myopic patient who, after intraocular lens transplant in the posterior chamber, suffered elevated intraocular pressure due to pigment dispersion, with recurrent episodes of blurred vision. The patient was treated with a new surgical technique that can avoid potential iridolenticular contact. Complete ophthalmologic examination and optical coherence tomography (OCT) of the anterior segment were performed. Contact between the pigmentary epithelium and the iris with an intraocular lens was revealed by utrasound biomicroscopy and OCT. In this case, Nd:YAG laser iridotomy and laser iridoplasty were not effective for iridolenticular separation and control of the pigment dispersion. We propose a new technique: stitches on the surface of the iris to obtain good iridolenticular separation and good intraocular pressure control. Stitches on the iris surface should be considered as optional therapy in pigmentary glaucoma secondary to intraocular lens implantation. This surgical technique can avoid potential iridolenticular contacts more definitively.

Tinting of intraocular lens implants

International Nuclear Information System (INIS)

Zigman, S.

1982-01-01

Intraocular lens (IOL) implants of polymethyl methacrylate (PMMA) lack an important yellow pigment useful as a filter in the visual process and in the protection of the retina from short-wavelength radiant energy. The ability to produce a yellow pigment in the PMMA used in IOL implants by exposure to near-ultraviolet (UV) light was tested. It was found that the highly cross-linked material in Copeland lens blanks was tinted slightly because of this exposure. The absorptive properties of lens blanks treated with near-UV light in this way approached that of the absorptive properties of human lenses. This finding shows that it is possible to alter IOL implants simply so as to induce a pale-yellow pigment in them to improve the visual process and to protect the retinas of IOL users

Tinting of intraocular lens implants

Energy Technology Data Exchange (ETDEWEB)

Zigman, S.

1982-06-01

Intraocular lens (IOL) implants of polymethyl methacrylate (PMMA) lack an important yellow pigment useful as a filter in the visual process and in the protection of the retina from short-wavelength radiant energy. The ability to produce a yellow pigment in the PMMA used in IOL implants by exposure to near-ultraviolet (UV) light was tested. It was found that the highly cross-linked material in Copeland lens blanks was tinted slightly because of this exposure. The absorptive properties of lens blanks treated with near-UV light in this way approached that of the absorptive properties of human lenses. This finding shows that it is possible to alter IOL implants simply so as to induce a pale-yellow pigment in them to improve the visual process and to protect the retinas of IOL users.

Sensitivity of the corneal-plane refractive compensation to change in power and axial position of an intraocular lens

Directory of Open Access Journals (Sweden)

W. F. Harris

2009-12-01

Full Text Available If an intraocular lens is displaced or if its power is changed what are the consequences for the refractive compensation of the eye?  Gaussian optics is used to obtain explicit formulae for the sensitivityof the corneal-plane refractive compensation (also called the refraction, refractive state, etc to change in power and axial displacement of a thin intraocular lens implanted in a simple eye.  In particular, for a pseudophakic Gullstrand simplified eye with intraocular lens placed 5 mm behind the cornea the sensitivity to errors in the power of the intraocular lens is about  71 . 0 − 71 for an intraocular lens of power   for an intraocular lens of power 20 D, that is, the refractive compensation decreases by about 0.71 dioptres per dioptre increase in the power of the intraocular lens.  More generally the sensitivity is approximately  ( m   0037 . 0 63 . 0 F − − 0.63 ( 003 . 0 63 . 0 − − (0.0037mF where FI is the power of the intraocular lens.  Also for Gullstrand’s simplified eye the sensitivity of refractive compensation to axial displacement of the intraocular lens is approximately linear in FI about  (64D FI, in fact.  That is, for each dioptre of the power of the intraocular lens the refractive compensation increases by about 0.064 dioptres per millimetre of axial displacement towards the retina. 

Combined pars plana lensectomy-vitrectomy with open-loop flexible anterior chamber intraocular lens (AC IOL) implantation for subluxated lenses.

Science.gov (United States)

Kazemi, S; Wirostko, W J; Sinha, S; Mieler, W F; Koenig, S B; Sheth, B P

2000-01-01

To review our experience with combined pars plana lensectomy-vitrectomy and open-loop flexible anterior chamber intraocular lens (AC IOL) implantation for managing subluxated crystalline lenses. Retrospective review of 36 consecutive eyes (28 patients), all of which had subluxated crystalline lenses, managed by pars plana lensectomy-vitrectomy with insertion of an open-loop flexible AC IOL. The study was performed at the Medical College of Wisconsin, Milwaukee, over an 8-year period. An average preoperative visual acuity of 20/163 (range, 20/25 to hand motions) improved to 20/36 (range, 20/20 to 4/200) with surgery after a mean follow-up of 14 months (range, 1 to 59 months) (P IOL implantation appears to be an excellent technique for managing subluxated crystalline lenses. It is associated with a significant improvement in visual acuity (P subluxated lens through a limbal wound. Additionally, use of an AC IOL offers a simplified alternative to placement of a ciliary sulcus sutured posterior chamber intraocular lens (PC IOL).

[Intraocular lens implantation with one loop haptic amputated: a new propose to the subluxation lens surgical treatment].

Science.gov (United States)

Ventura, Marcelo; Endriss, Daniela

2010-01-01

To evaluate the postoperative results of congenital lens subluxation corrected by a new technique. Retrospective chart review of 21 eyes of 13 patients with no traumatic lens subluxation who underwent surgery in Altino Ventura Foundation from April, 1999 to April, 2004. The mean age was 8.7 +/- 5.4 years old, and the mean follow-up period was 21.5 +/- 19.3 months. Patients underwent phacoaspiration, endocapsular ring and intraocular lens (IOL) implantation. The implanted IOL had one loop haptic excised and was supported above the ring, inside the capsular bag promoting intraocular lens centralization. Visual acuity improvement was observed in all cases. There was a significant reduction of the spherical equivalent and spherical component comparing the pre and postoperative refraction (psubluxation surgical treatment, promoting lens centralization and postoperative visual acuity improvement.

Bilateral spontaneous dislocation of posterior chamber intraocular lens in a patient with gyrate atrophy

Directory of Open Access Journals (Sweden)

Michael Kinori

2012-01-01

Full Text Available We report a patient with gyrate atrophy, a rare metabolic disease, who had bilateral late spontaneous posterior dislocation of in-the-bag posterior chamber intraocular lens (PCIOL. He underwent pars plana vitrectomy, PCIOL retrieval and anterior chamber intraocular lens implantation in both eyes. This report may imply that patients with gyrate atrophy are at risk for spontaneous dislocation of intraocular lenses.

Comparison of Bigbag and Rayner620H intraocular lens in cataract surgeries in high myopia patients

Directory of Open Access Journals (Sweden)

Zhan-Jiang Liu

2016-01-01

Full Text Available AIM:To investigate the effects of Bigbag and Rayner620H intraocular lens in cataract surgeries in high myopia patients. METHODS:Seventy-seven patients(128 eyeswere treated by phacoemulsification combined with intraocular lens implantation from January 2014 to March 2015 in our hospital. Thirty-nine patients(65 eyeswere treated with Bigbag intraocular lens, 38 cases(63 eyeswere treated with Rayner620H. The best corrected visual acuity(BCVAdistribution, the actual refractive value, the difference between predictive refractive value and actual refractive value and complications were measured and recorded in the two groups at 1mo after surgeries. RESULTS:The difference between the two groups on BCVA are statistically significant(PWilcoxon rank sum test. The differences between predictive refractive value and actual refractive value of the two groups were statistically significant(PPCONCLUSION:The effect of Bigbag intraocular lens for patients with phacoemulsification and intraocular lens implantation is good, and it can reduce the risk of complications.

Two-step technique for posterior optic buttonholing of intraocular lens.

Science.gov (United States)

Agarwal, Tushar; Jhanji, Vishal; Singh, Digvijay; Khokhar, Sudarshan

2014-04-01

This study aims to describe a two-step surgical technique for placement of a posterior chamber intraocular lens (IOL) in cases with crystalline lens subluxation resulting from non-progressive zonular dialysis. The first stage entails a phacoemulsification with creation of a 4-mm posterior capsular opening using an automated vitrector. The second stage performed 6 weeks later includes an anterior vitrectomy and injection of a foldable three-piece IOL in the sulcus. The haptics of IOL are positioned in the sulcus while the optic is pushed behind the posterior capsular opening therefore "buttonholing" the IOL. Seven eyes of seven patients with posttraumatic zonular dialysis were operated using this technique. Follow-up of all cases revealed a well-centered IOL with good postoperative visual acuity (20/20 to 20/80). Our two-stage surgical technique precludes the insertion of capsular tension ring in cases with non-progressive zonular dialysis. The technique is recommended in the presence of less than or equal to 6 clock hours of zonular dialysis with preexisting posterior capsular tear or herniation of vitreous in the anterior chamber.

Effects of phacoemulsification combined with intraocular lens implantation on ocular surface

Directory of Open Access Journals (Sweden)

Ming Li

2013-10-01

Full Text Available AIM: To explore the changes of ocular surface after phacoemulsification combined with intraocular lens implantation. METHODS: Totally 78 cases of 78 eyes with age-related cataract were collected from August 2011 to October 2012, and they underwent corneal incision phacoemulsification combined with intraocular lens implantation. The score of dry eye symptoms; tear breakup time(BUT; Schirmer Ⅰ test(SⅠtand corneal fluorescein staining were observed and recorded in 3 days before, 1 day, 1 week, 1 month, 3 and 6 months after surgery respectively. The results were analyzed statistically. RESULTS: All the subjects complained of dry eye within 1 week after surgery. Compared with 3 days before the surgery, the corneal fluorescein staining increased and the amount of tear secretion reduced statistically significant in 1 day, 1 week and 1 month(PPP>0.05, and lasted to 3 months later. CONCLUSION: Phacoemulsification combined with intraocular lens implantation has obvious effect on the ocular surface to some extent. Preventions and treatment should be taken clinically.

Toric Intraocular Lens Outcomes in Patients With Glaucoma.

Science.gov (United States)

Brown, Reay H; Zhong, Le; Bozeman, Caroline W; Lynch, Mary G

2015-06-01

To report the outcomes of toric intraocular lens implantation in patients with glaucoma and corneal astigmatism. One hundred twenty-six eyes of 87 patients with glaucoma and corneal astigmatism that underwent cataract surgery with an AcrySof toric intraocular lens (Alcon Laboratories, Inc., Fort Worth, TX) implant were selected for this single-center, retrospective case series. Corrected distance visual acuity, intraocular pressure, and refractive astigmatism were measured in each eye preoperatively and postoperatively. Uncorrected distance visual acuity and toric alignment were measured postoperatively. The uncorrected distance visual acuity was 0.04 ± 0.08 logMAR (20/22 Snellen) for all eyes. Ninety-eight percent of all eyes achieved an uncorrected distance visual acuity of 20/40 or better, with 76% achieving 20/25 or better and 47% achieving 20/20. The corrected distance visual acuity for all eyes was 0.01 ± 0.03 logMAR (20/20.5 Snellen) postoperatively. The refractive cylinder improved from 1.47 ± 1.10 diopters preoperatively to 0.31 ± 0.37 diopters postoperatively. The residual refractive cylinder was 1.00 diopter or less in 97% of eyes, 0.75 diopters or less in 90% of eyes, and 0.50 diopters or less in 83% of eyes. Mean misalignment was 4.4° ± 5.1°. Intraocular pressure decreased by a mean of 2.3 ± 3.3 mm Hg following the surgery. Toric intraocular lenses can reliably reduce astigmatism and improve uncorrected vision in eyes with cataract and glaucoma. Copyright 2015, SLACK Incorporated.

Clinical assessment of diclofenac sodium eye drops in toric intraocular lens implantation

Directory of Open Access Journals (Sweden)

Yan Luo

2013-05-01

Full Text Available AIM:To evaluate the application of diclofenac sodium eye drops in toric intraocular lens implantation. METHODS: From January 2011 to February 2012, 38 eyes of 37 patients, who underwent toric intraocular lens implantation in this hospital, were randomly divided into diclofenac sodium eye drops group(trial groupand control group. Patient's degree of cooperation during surgery and inflammation postoperation after 1 day, 3,7, days, 1 month and 3 months were evaluated. RESULTS: Patient's degree of cooperation during surgery in the trial group(1.53±0.62was significantly better than in the control group(2.40±0.88, P<0.05. Inflammation reaction was gentle in the trial group 1 day postoperatively. CONCLUSION: Diclofenac sodium eye drops used during toric intraocular lens implantation can obviously alleviate eye irritation, and increase the cooperation of patients.

Liquid-crystal intraocular adaptive lens with wireless control

NARCIS (Netherlands)

Simonov, A.N.; Vdovine, G.V.; Loktev, M.

2007-01-01

We present a prototype of an adaptive intraocular lens based on a modal liquid-crystal spatial phase modulator with wireless control. The modal corrector consists of a nematic liquid-crystal layer sandwiched between two glass substrates with transparent low- and high-ohmic electrodes, respectively.

Analysis of phakic before intraocular lens implantation for fundus examination

OpenAIRE

Juan Chen; Zhong-Ping Chen; Rui-Ling Zhu

2014-01-01

AIM:To investigate the findings of the eyes which were examined preoperatively by three mirror contact lens before the implantation of implantable collamer lens(ICL). To analysis the retinal pathological changes and to explore the clinical analysis of early diagnosis and treatment in retinopathy on fundus examination before operation. METHODS:The retrospective case series study included 127 eyes of 64 patients who underwent phakic intraocular lens implantation were received the fundus examina...

Visual outcome with the Oculentis Mplus intraocular lens

Directory of Open Access Journals (Sweden)

Si-Yuan Liu

2017-11-01

Full Text Available AIM: To evaluate the visual outcome of Oculentis Mplus intraocular lens(IOL.METHODS: Totally 20 eyes in 20 patients received phacoemulsification and Oculentis Mplus intraocular lens implantation were as test group, and 20 eyes(Aspira-aA IOLwere as control group. The following postoperative examinations were performed after operation for 3mo: uncorrected visual acuity of distance and near, refractive results, UBM examination, the rate of wearing spectacles and the complications. RESULTS: At 3mo after surgery, distance visual acuity of test group with Oculentis Mplus IOL were 0.10±0.03,the difference with control group was not significant(t=1.74, P>0.05. Eyes in test group had an uncorrected near acuity 0.11±0.04, the difference with control group was significant(t=15.53, PCONCLUSION: The implantation of Oculentis Mplus IOL not only has a good distance uncorrected visual acuity, but also with better near visual acuity. The surgery is safe, reliable and no special complication induced.

Visual performance after the implantation of a new trifocal intraocular lens

Directory of Open Access Journals (Sweden)

Vryghem JC

2013-10-01

Full Text Available Jérôme C Vryghem,1,2 Steven Heireman1,21Brussels Eye Doctors, Brussels, Belgium; 2Clinique Saint-Jean, Brussels, BelgiumPurpose: To evaluate the subjective and objective visual results after the implantation of a new trifocal diffractive intraocular lens.Methods: A new trifocal diffractive intraocular lens was designed combining two superimposed diffractive profiles: one with +1.75 diopters (D addition for intermediate vision and the other with +3.50 D addition for near vision. Fifty eyes of 25 patients that were operated on by one surgeon are included in this study. The uncorrected and best distance-corrected monocular and binocular, near, intermediate, and distance visual acuities, contrast sensitivity, and defocus curves were measured 6 months postoperatively. In addition to the standard clinical follow-up, a questionnaire evaluating individual satisfaction and quality of life was submitted to the patients.Results: The mean age of patients at the time of surgery was 70 ± 10 years. The mean uncorrected and corrected monocular distance visual acuity (VA were LogMAR 0.06 ± 0.10 and LogMAR 0.00 ± 0.08, respectively. The outcomes for the binocular uncorrected distance visual acuity were almost the same (LogMAR −0.04 ± 0.09. LogMAR −010 ± 0.15 and 0.02 ± 0.06 were measured for the binocular uncorrected intermediate and near VA, respectively. The distance-corrected visual acuity was maintained in mesopic conditions. The contrast sensitivity was similar to that obtained after implantation of a bifocal intraocular lens and did not decrease in mesopic conditions. The binocular defocus curve confirms good VA even in the intermediate distance range, with a moderate decrease of less than LogMAR 0.2 at −1.5 D, with respect to the best distance VA at 0 D defocus. Patient satisfaction was high. No discrepancy between the objective and subjective outcomes was evidenced.Conclusion: The introduction of a third focus in diffractive multifocal

[Hyperopic Laser-in-situ-Keratomileusis after trifocal intraocular lens implantation : Aberration-free femto-Laser-in-situ-Keratomileusis treatment after implantation of a diffractive, multifocal, toric intraocular lens-case analysis].

Science.gov (United States)

Hemkeppler, E; Böhm, M; Kohnen, T

2018-05-29

A 52-year-old highly myopic female patient was implanted with a multifocal, diffractive, toric intraocular lens because of the wish to be independent of eyeglasses. Despite high-quality, extensive preoperative examinations, a hyperopic refractive error remained postoperatively, which led to the patient's dissatisfaction. This error was treated with Laser-in-situ-Keratomileusis (LASIK). After corneal LASIK treatment and implantation of a diffractive toric multifocal intraocular lens the patient showed a good postoperative visual result without optical phenomena.

Comparison of hydrophobic and hydrophilic intraocular lens in preventing posterior capsule opacification after cataract surgery

Science.gov (United States)

Zhao, Yang; Yang, Ke; Li, Jiaxin; Huang, Yang; Zhu, Siquan

2017-01-01

Abstract Background: Posterior capsular opacification (PCO) is a common long-term complication of cataract surgery. Intraocular lens design and material have been implicated in influencing the development of PCO. This study evaluated the association of hydrophobic and hydrophilic intraocular lenses on preventing PCO. Methods: Medline, Cochrane, EMBASE, and Google Scholar databases were searched until August 3, 2016, using the following search terms: cataract, posterior capsule opacification, and intraocular lens. Eligible studies included randomized controlled trials (RCTs), retrospective, and cohort studies. Results: Eleven studies were included in the study with a total of 889 eyes/patients. The overall analysis revealed that hydrophobic intraocular lenses were associated with lower Nd:YAG laser capsulotomy rates than hydrophilic lenses [odds ratio (OR) = 0.38, 95% confidence interval (95% CI) = 0.16–0.91, P = .029]. Hydrophobic intraocular lenses were also associated with lower subjective PCO score (diff. in means: −1.32, 95% CI = −2.39 to −0.25, P = .015) and estimated PCO score (diff. in means: −2.23; 95% CI, −3.80 to −0.68, P = .005) as compared with hydrophilic lenses. Objective PCO score was similar between lens types. (diff. in means: −0.075; 95% CI, −0.18 to 0.035; P = .182). Pooled analysis found that visual acuity was similar between hydrophobic and hydrophilic intraocular lenses (diff. in means: −0.016; 95% CI, −0.041 to 0.009, P = .208). Conclusion: In general, PCO scores and the rate of Nd:YAG laser capsulotomy were influenced by intraocular lens biomaterial. Lens made of hydrophobic biomaterial were overall superior in lowering the PCO score and the Nd:YAG laser capsulotomy rate, but not visual acuity. PMID:29095259

Clinical observation of four-fixable intraocular lens suspensory

Directory of Open Access Journals (Sweden)

Yu-Ming Teng

2015-06-01

Full Text Available AIM: To discuss the four-fixable intraocular lens(IOLsuspensory in the absence of capsular intraocular lens implantation, suspensory ligament rupture caused by congenital dislocation of the lens, traumatic cataract and posterior capsular rupture without capsular support, which need to line hanging IOL for intraoperative clinical observation.METHODS: The 31 cases(32 eyeswho were accepted the four-fixable IOL suspensory from May 2012 to May 2014 in our hospital were retrospectively analyzed. The postoperative visual acuity, corneal astigmatism, intraoperative and postoperative complications were comprehensively analyzed.RESULTS: Patients were followed up 6mo～1a, corrected visual acuity >0.5(12 eyes, 38%, 0.1～0.5(18 eyes, 56%, and CONCLUSION: It is designed to support non-capsular IOL implantation and design, and the concept of changing the past presence of suspended dislocated IOL implantation surgery, positional deviation and, sutures and other complications split the incidence is greatly reduced. It is consistent with the physiological characteristics of the human eye, and it is the IOL surgical sling best stability, intraoperative and postoperative complications, the best visual acuity and corneal astigmatism minimal surgical approachat least, and the four-point suspension suture fixation of IOL is designed to obtain a practical transformation of Chinese patent.

Primary intraocular lens implantation for penetrating lens trauma in Africa.

Science.gov (United States)

Bowman, R J; Yorston, D; Wood, M; Gilbert, C; Foster, A

1998-09-01

This study aimed to audit the surgical strategy of primary posterior chamber intraocular lens implantation for cases of recent penetrating trauma involving the lens in an African population. Retrospective, noncomparative case series. Seventy-two cases are reported, including all patients who underwent primary intraocular lens implantation for traumatic cataract extraction performed within 1 month of injury between 1988 and 1996. Demographic characteristics and follow-up attendance rates are analyzed. Surgical technique and the occurrence of intraoperative and postoperative complications are reported. Visual outcomes are reported with detailed analysis for cases of poor visual outcome. Mean age was 14.3 years (standard deviation = 11.1), 57 (79%) were male and 15 (21%) were female (chi-square = 23.66, P capsule had been breached by the trauma in 27 (38%) cases, and 15 of these required anterior vitrectomy. Capsular fixation of the implant was achieved in 49% of patients, the remainder having sulcus fixation. Intraoperative rupture of the posterior capsule occurred in four cases. The only common postoperative complication was acute fibrinous anterior uveitis, which occurred in 29 (40%) patients, and 32% of patients followed up for at least 6 months required secondary posterior capsulotomy. This was more common in younger patients (chi-square = 4.2, P < 0.05). Corrected postoperative visual acuities were available for 51 patients, of which 71% achieved 20/60 or better visual acuity. Patients 6 years of age or younger were less likely to achieve 20/60 (chi-square = 6.61, P = 0.01). This surgical strategy has proved successful, producing good visual results and causing no sight-threatening complications. Primary posterior capsulotomy may be appropriate for younger patients.

Vitrectorhexis and lens aspiration with posterior chamber intraocular lens implantation in spherophakia.

Science.gov (United States)

Al-Haddad, Christiane; Khatib, Lama

2012-07-01

We describe a technique that uses the vitrector to perform successful lens aspiration and posterior chamber intraocular lens (IOL) implantation in children with spherophakia and anterior lens subluxation. After an anterior chamber maintainer is placed, the ocutome is introduced through a limbal incision to perform a circular vitrectorhexis to avoid excessive manipulation of the unstable lens followed by gentle cortex aspiration. A foldable IOL is injected into the sulcus (3-piece IOL) or bag (1-piece IOL) if the capsule is sufficiently stable. Through a pars plana incision, the ocutome is then used to perform a posterior capsulotomy to prevent late posterior capsule opacification. In our patient, sulcus IOL placement was more stable than in-the-bag placement. Neither author has a financial or proprietary interest in any material or method mentioned. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Lente intra-ocular multifocal difrativa apodizada: resultados Diffractive apodized multifocal intraocular lens: results

Directory of Open Access Journals (Sweden)

Virgilio Centurion

2007-12-01

Full Text Available OBJETIVO: Mostrar os resultados visuais e refracionais com lente intra-ocular multifocal difrativa apodizada. MÉTODOS: Estudo de 100 olhos de 50 pacientes com catarata, submetidos à facoemulsificação com implante bilateral de lente intra-ocular (LIO multifocal difrativa apodizada. Foi avaliada a acuidade visual binocular sem e com correção para longe e perto, a previsibilidade refracional e a freqüência de uso de óculos. RESULTADOS: A acuidade visual sem correção para longe foi de e " 20/30 em 97,56% dos olhos operados e e" J2 em 100%, sendo que 82% dos pacientes nunca usam óculos e 16% usam de forma esporádica. CONCLUSÃO: A LIO multifocal difrativa apodizada mostrou ser uma opção previsível, reproduzível e segura na correção dos vícios de refração para longe e perto durante a cirurgia da catarata, permitindo elevado índice de independência ao uso de óculos.OBJECTIVE: To show visual and refraction results using multifocal diffractive apodized intraocular lens. METHODS: The study of 100 eyes of 50 patients with cataract, submitted to phacoemulsification with bilateral implant of multifocal diffractive apodized intraocular lens (IOL. Binocular visual acuity was evaluated with and without correction for near and distance, and refraction previsibility and frequency of wearing glasses. RESULTS: Visual acuity without correction for distance was e" 20/30 in 97.56% of eyes operated on and e" J2 in 100%, of these 82% of patients never wear glasses and 16% wear glasses sporadically. CONCLUSION: Multifocal diffractive apodized IOL proved to be a foreseeable option, reproducible and safe in the correction of refraction errors for distance and near during cataract surgery, enabling a high rate of independence from the use of glasses.

Outcomes and Complications of Scleral-Fixated Intraocular Lens Combined with Ahmed Tube Surgery

Directory of Open Access Journals (Sweden)

Nikhel Sachdev

2018-01-01

Full Text Available Background. To evaluate the outcome and complications of transscleral suture-fixated posterior chamber intraocular lens (PCIOL implantation combined with Ahmed glaucoma valve (AGV surgery in Asian eyes. Design. This was a retrospective study that included 22 eyes from 22 participants. The surgeries were performed at Singapore’s National University Hospital. Participants underwent an Ahmed tube surgery, together with transscleral suture-fixated posterior chamber intraocular lens. Main Outcome Measures. Complete success was defined as 6 ≤ intraocular pressure (IOP ≤ 21 mmHg without medications at the last follow-up visit, with no reoperation required and no progression to no perception of light (NPL. Results. At the last follow-up, there was a significant reduction in mean IOP (22.4 ± 6.5 mmHg versus 13.9 ± 3.9 mmHg; p<0.001 and mean number of intraocular pressure-lowering medications (2.45 ± 1.30 versus 0.05 ± 0.21; p<0.001. There was no significant change in visual acuity [1.43 ± 1.21 (LogMAR versus 1.09 ± 1.31 (p=0.204]. Sixteen eyes (72.7% achieved complete success. The 3 commonest complications were bullous keratopathy, choroidal detachment, and displacement of intraocular lens. Conclusion and Relevance. This technique showed good success for intraocular pressure control and vision preservation. Postoperative complications were relatively common although most were self-limiting. Patients at increased risk of trabeculectomy failure may be suitable for this procedure.

Clinical observation of Artisan iris-clip intraocular lens implantation at stage Ⅰ

Directory of Open Access Journals (Sweden)

Qing Zhou

2014-09-01

Full Text Available AIM: To observe the clinical efficacy of Artisan iris-clip intraocular lens(IOLimplantation on cataract with a wide range of lens dislocation.METHODS: Twenty-four hospital patients(28 eyesof cataract with lens subluxation by trauma(20 patients, 20 eyesand Marfan's syndrome(4 patients, 8 eyesduring May 2007 to December 2011 were selected. All of them underwent phacoemulsification or an anterior vitrectomy and Artisan iris-clip IOL implantation at stage Ⅰ. Postoperative visual acuity, corneal endothelial cell count, intraocular lens position and postoperative complications were observed. Follow-up time was 6mo.RESULTS:Compared with the preoperative, postoperative best corrected visual acuity improved to varying degrees, visual acuity of 0.1-0.5 was in 20 eyes, 0.5-1.0 in 8 eyes. After followed up 1-6mo, no artificial lens shift, iris inflammation, iris atrophy and corneal decompensation and other complications were observed.CONCLUSION: Cataract surgery with a wide range of lens dislocation is difficult, but as long as surgeons who have a wealth of clinical experience and superb skills, still can carry out phacoemulsification surgery or anterior vitrectomy and Artisan iris-clip IOL implantation and obtain a better outcome.

Development of an accommodating intra-ocular lens - In vitro prevention of re-growth of pig and rabbit lens capsule epithelial cells

NARCIS (Netherlands)

van Kooten, Theo G.; Koopmans, Steven; Terwee, Thom; Norrby, Sverker; Hooymans, J. M. M.; Busscher, Henk J.

2006-01-01

Cataract surgery is routinely performed to replace the clouded lens by a rigid polymeric intra-ocular lens unable to accommodate. By implanting a silicone gel into an intact capsular bag the accommodating properties of the natural lens can be maintained or enhanced. The implantation success of

Phacoemulsification using iris hooks and scleral fixation of the intraocular lens in patients with secondary glaucoma associated with lens subluxation.

Science.gov (United States)

Ma, K T; Lee, H K; Seong, G J; Kim, C Y

2008-09-01

We described the techniques and results of phacoemulsification using iris hook and scleral fixation of intraocular lens (IOL) in patients with secondary glaucoma associated with lens subluxation. Eight eyes of seven patients with secondary glaucoma associated with lens dislocation, who had undergone the surgery, were retrospectively reviewed. At a mean of 23.5 months+/-13.6 (SD) after the surgery, the mean best-corrected visual acuity improved from 0.24+/-0.21 to 0.83+/-0.3, and mean intraocular pressure (IOP) was changed from 38.4+/-11.4 to 15.5+/-1.8 mmHg at the final examination. There were no vitreoretinal complications except cystoid macular oedema in one eye. The technique appears to be safe and effective in terms of visual rehabilitation and controlling IOP in patients with secondary glaucoma associated with lens subluxation.

Sutureless Intrascleral Fixated Intraocular Lens Implantation.

Science.gov (United States)

Karadag, Remzi; Celik, Haci Ugur; Bayramlar, Huseyin; Rapuano, Christopher J

2016-08-01

To review sutureless intrascleral intraocular lens (IOL) fixation methods. Review of published literature. Sutureless intrascleral IOL fixation methods are newer and have been developed to eliminate the suture-related complications of sutured scleral fixation methods such as suture-induced inflammation or infection and IOL dislocation or subluxation due to suture degradation or suture breakage. Sutureless intrascleral fixation methods aim for intrascleral haptic fixation to achieve stability of the IOL. Various methods of sutureless scleral fixation have been described. Using a needle, a blade, or a trochar, sclerostomies are created in all techniques for intraocular access. Some surgeons prefer to create scleral tunnels, whereas others use scleral flaps for scleral fixation of haptics. The stability of IOLs is attained by the scar tissue formed around the haptics. Short-term results of these new methods are acceptable; studies including more cases with longer follow-up are needed to determine their long-term success. [J Cataract Refract Surg. 2016;32(9):586-597.]. Copyright 2016, SLACK Incorporated.

Neodymium:YAG laser cutting of intraocular lens haptics.

Science.gov (United States)

Gorn, R A; Steinert, R F

1985-11-01

Neodymium:YAG laser cutting of polymethylmethacrylate and polypropylene anterior chamber and posterior chamber intraocular lens haptics was studied in terms of ease of transection and physical structure of the cut areas as seen by scanning electron microscopy. A marked difference was discovered, with the polymethylmethacrylate cutting easily along transverse planes, whereas the polypropylene resisted cutting along longitudinal fibers. Clinical guidelines are presented.

Retropupillary iris-claw intraocular lens in ectopia lentis in Marfan syndrome

Directory of Open Access Journals (Sweden)

Faria MY

2016-06-01

Full Text Available Mun Yueh Faria,1 Nuno Ferreira,2 Eliana Neto,1 1Vitreo Retinal Department, 2Ophthalmology Department, Santa Maria Hospital, Lisbon, Portugal Objective: To report visual outcomes, complication rate, and safety of retropupillary iris-claw intraocular lens (ICIOL in ectopia lentis in Marfan syndrome (MFS. Design: Retrospective study. Methods: Six eyes of three MFS patients with ectopia lentis underwent surgery for subluxation lens and retropupillary ICIOL implantation from October 2014 to October 2015 at the Department of Ophthalmology, Santa Maria Hospital in Lisbon, Portugal. Demographics, preoperative and postoperative best-corrected visual acuity (BCVA, and intraocular pressure were evaluated. Endothelium cell count was assessed using specular microscopy; anterior chamber depth was measured using Pentacam postoperatively; and intraocular lens position was viewed by ultrasound biomicroscopy. All patients were female; mean age was 20±14.264 years (range: 7–38 years. Results: The average follow-up period was 6.66 months (range: 4–16 months. Preoperative BCVA was 0.568±0.149 logMAR units, and postoperative BCVA was 0.066±0.121 logMAR units. The mean BCVA gain was –0.502±0.221 on the logMAR scale. Postoperative average astigmatism and intraocular pressure were 1.292±0.697 mmHg (range: 0.5–2.25 mmHg and 16 mmHg (range: 12–18 mmHg, respectively. The average endothelial cell density decreased from 3,121±178 cells/mm2 before surgery to 2,835±533 cells/mm2 after surgery (measured at last follow-up visit and in the last follow-up, representing an average endothelial cell loss of 9.16%. Mean anterior chamber depth was 4.01 mm (±0.77 mm, as measured by Pentacam. No complications were found intra- or postoperatively in any of the six studied eyes. Conclusion: Retropupillary ICIOL implantation is a safe and effective procedure in the treatment of aphakia in MFS eyes, without capsular support after surgery for ectopia lens. The six eyes that

Advanced pigment dispersion glaucoma secondary to phakic intraocular collamer lens implant.

Science.gov (United States)

Ye, Clara; Patel, Cajal K; Momont, Anna C; Liu, Yao

2018-06-01

We report a case of pigment dispersion glaucoma secondary to uncomplicated phakic intraocular collamer lens (ICL) (Visian ICL™, Staar Inc., Monrovia, CA) implant that resulted in advanced visual field loss. A 50-year-old man presented for routine follow-up status post bilateral phakic intraocular collamer lens (ICL) placement 8 years earlier. He was incidentally found to have a decline in visual acuity from an anterior subcapsular cataract and elevated intraocular pressure (IOP) in the left eye. There were signs of pigment dispersion and no evidence of angle closure. Diffuse optic nerve thinning was consistent with advanced glaucomatous visual field defects. Pigment dispersion was also present in the patient's right eye, but without elevated IOP or visual field defects. The patient was treated with topical glaucoma medications and the phakic ICL in the left eye was removed concurrently with cataract surgery to prevent further visual field loss. Pigment dispersion glaucoma is a serious adverse outcome after phakic ICL implantation and regular post-operative monitoring may prevent advanced visual field loss.

Effect of hemodialysis on intraocular lens power calculation.

Science.gov (United States)

Çalışkan, Sinan; Çelikay, Osman; Biçer, Tolga; Aylı, Mehmet Deniz; Gürdal, Canan

2016-01-01

To evaluate changes in ocular biometric parameters after hemodialysis (HD) in patients with end-stage renal disease (ESRD). Forty eyes of 40 patients undergoing HD were included in this cross-sectional study. Keratometry (K) readings, white-to-white (WTW) distance, central corneal thickness (CCT), anterior chamber depth (ACD), pupil diameter, lens thickness (LT), axial length (AL), and intraocular lens (IOL) power calculation were measured with Lenstar LS 900 (Haag Streit AG, Koeniz, Switzerland) before and after hemodialysis. Intraocular pressure (IOP) was measured with a non-contact tonometer (Tonopachy NT-530P, Nidek Co., LTD, Tokyo, Japan). Main outcomes were changes in biometric parameters after HD. Reliability of the measurements (intraclass correlation coefficients (ICCs)) and the effect size (Cohen's d) were also calculated. Mean difference in AL before and after HD was -0.041 ± 0.022 mm with ICCs > 0.90 (p  0.90 (p = 0.041 and Cohen's d = 0.20). Hemodialysis had no significant effect on K readings, WTW distance, CCT, ACD, LT, or IOP. Axial length and pupil diameter increase after HD with small effect size, while HD does not significantly affect IOL power calculations.

Efficacy on chopping with lens loop-pad in the small incision extracapsular cataract surgery with intraocular lens implantation

Directory of Open Access Journals (Sweden)

Xiao-Ning Peng

2014-04-01

Full Text Available AIM: To study the clinical effects of chopping with lens loop-pad in the small incision extracapsular cataract surgery with intraocular lens implantation.METHODS:A total of 75 cases(80 eyes, in which loop-pad and chop knife were performed to chop nucleus before implanting intraocular lens. Visual acuity, postoperative astigmatism degree, intraoperative and postoperative complications were observed. The post-operative follow-up periods ranged from 3 to 12mo.RESULTS: The visual acuity was 0.3-0.5 in 37 eyes and 0.6 or better in 21 eyes at 1d, while was respectively in 43 eyes and in 26 eyes at 1mo. Compared with preoperative astigmatism(0.85±0.29D, there were significant difference at postoperative 1wk(1.75±0.55D(PP>0.05. Intraoperative posterior capsule rupture occurred in 4 eyes, which implantation was successful in 1 eye and 3 eyes was managed viaciliary sulcus. Two eyes had dermatoglyphic pattern edema in corneal endothelium which recovered after about 3d. Two eyes had local patchy opacities which recovered in 2wk. Two eyes had transient high intraocular pressure.CONCLUSION: The surgery is efficient, low cost, easy process and less complications, it is worth to be popularized.

Analysis of causes of intraocular lens explantations in the material of Department of Ophthalmology, Medical University of Lodz.

Science.gov (United States)

Wilczyński, Michał; Wilczyńska, Olena; Omulecki, Wojciech

2009-01-01

Implantation of intraocular lenses (IOLS) has become a standard practice in cataract surgery, however, similar to any other type of surgery, using IOLs is not complication-free and sometimes explantation of intraocular lenses may be necessary. This study was to gather data and analyze causes of intraocular lens explantations, performed in the Department of Ophthalmology, Medical University of Łódź. The data were gathered from medical documentation of all patients who underwent intraocular lens removal from January 2003 to July 2006. The examined group consisted of 16 patients (16 eyes): 9 women (fraction 0.56), and 7 men (fraction 0.44), at the age from 21 to 82 years (mean age 62.4 years, SD +/- 15.5). In all patients IOL explantation was performed under local, peribulbar anaesthesia. Two groups of patients were distinguished: patients who had an anterior chamber lens explanted (3 patients, fraction 0.19) and patients who underwent posterior chamber lens explantation (13 patients, fraction 0.81). Causes of AC IOL explantations were: vaulting of the IOL (1 eye, fraction 0.06), luxation of the IOL to the vitreous cavity (1 eye, fraction 0.06), and painful eyeball after anterior chamber lens implantation (1 eye, fraction 0.06). Causes of PC IOL explantations were: subluxation of the IOL (6 eyes, fraction 0.38), luxation of the lens to the vitreous cavity (3 eyes, fraction 0.19), luxation of the lens to the anterior chamber (1 eye, fraction 0.06), endophthalmitis (2 eyes, fraction 0.13) and incorrect lens power (1 eye, fraction 0.06). In the majority of eyes (n = 13, fraction 0.81) the removed implant was replaced by another intraocular lens, but 3 eyes (fraction 0.19) were left aphakic. We did not observe serious intra- or early postoperative complications which might influence the final result of the operation.

Resultados de implante de lente intraocular en niños Results of intraocular lens implantation in children

Directory of Open Access Journals (Sweden)

Nashelly I. Mejía Cruz

2007-12-01

Full Text Available En este estudio se describen los resultados obtenidos del implante de lente intraocular en niños, quienes acudieron al servicio de Oftalmología Pediátrica de Instituto Cubano de oftalmología “Ramón Pando Ferrer” con el diagnóstico de catarata de diversas etiologías, en período comprendido entre abril del 2002 al 2005 cuyo seguimiento fue durante un año. En nuestro universo de estudio se determinan algunos parámetros como la edad del paciente, etiología de las cataratas, agudeza visual, defecto refractivo preoperatorio y posoperatorio. Se identificó el poder dióptrico del lente intraocular más frecuente, la presencia de complicaciones durante la cirugía y después de esta. Se evaluaron finalmente, los pacientes que requerían de tratamiento adicional como la capsulotomía con láser o membranectomía quirúrgica. El implante del lente intraocular a temprana edad se relacionó con buenos resultados quirúrgicos: mejoría de la agudeza visual corregida, presentándose el astigmatismo como el error refractivo más frecuente. La complicación transoperatorio y postoperatoria más frecuente fue la membrana inflamatoria, mientras que la complicación posoperatoria más frecuente fue la opacidad de la cápsula posterior.This paper described the results of the intraocular lens implantation performed in children, who had been seen at the Pediatric Ophthalmologic Service of " Ramon Pando Ferrer " Cuban Institute of Ophthalmology and had been diagnosed as having cataract of various etiologies, from April 2002 to April 2005. They were all followed-up for a year. Some parameters like the patient’s age, the etiology of cataract, visual acuity, pre-operative and post-operative refractive defect were considered in our study. The dioptric power of the most common intraocular lens and the most frequent complications during and after surgery were identified. The patients requiring additional treatment such as laser capsulotomy and surgical

Autorefraction versus subjective refraction in a radially asymmetric multifocal intraocular lens

NARCIS (Netherlands)

Linden, J.W.M. van der; Vrijman, V.; El-Saady, R.; Meulen, I.J. van der; Mourits, M.P.; Lapid-Gortzak, R.

2014-01-01

PURPOSE: To evaluate whether the automated refraction (AR) correlates with subjective manifest (MR) refraction in eyes implanted with radially asymmetric multifocal intraocular lens (IOLs). METHODS: This retrospective study evaluated 52 eyes (52 patients) implanted with a radially asymmetric

Autorefraction versus subjective refraction in a radially asymmetric multifocal intraocular lens

NARCIS (Netherlands)

van der Linden, Jan Willem; Vrijman, Violette; Al-Saady, Rana; El-Saady, Rana; van der Meulen, Ivanka J.; Mourits, Maarten P.; Lapid-Gortzak, Ruth

2014-01-01

To evaluate whether the automated refraction (AR) correlates with subjective manifest (MR) refraction in eyes implanted with radially asymmetric multifocal intraocular lens (IOLs). This retrospective study evaluated 52 eyes (52 patients) implanted with a radially asymmetric multifocal IOL (LS-312

Intraocular lens calculations in atypical eyes

Directory of Open Access Journals (Sweden)

Aazim A Siddiqui

2017-01-01

Full Text Available Cataract surgery is the most performed surgical procedure in the field of ophthalmology. The process of intraocular lens (IOL calculations is a critical step to achieving successful outcomes. Many IOL formulae exist to guide surgeons through the difficult process of picking the most appropriate lens to achieve a certain target refraction. However, these formulae reach within 0.50 diopters of the target refraction only 75% of the time, leaving 25% of the eyes with a significant refractive surprise. A literature review was performed to investigate all the relevant published material on the history, progress, and recent advancements of IOL calculations. Based on this review, the appropriate history, evolution, progress, limitations, and recent advancements are analyzed and explained. Although the modern IOL formulae and biometric devices perform well for average eyes, they are suboptimal for eyes with atypical biometric parameters and also those that are postrefractive and keratoconic. There has not been a single, perfect formula that can resolve the complexities of this process. Various methods of formula optimization and newer generation of IOL formulae and devices may hold the key to improving outcomes in both typical and atypical eyes. These solutions minimize refractive error by introducing new input parameters and complex mathematical techniques to better estimate postoperative lens position.

Comparison of hydrophobic and hydrophilic intraocular lens in preventing posterior capsule opacification after cataract surgery: An updated meta-analysis.

Science.gov (United States)

Zhao, Yang; Yang, Ke; Li, Jiaxin; Huang, Yang; Zhu, Siquan

2017-11-01

Posterior capsular opacification (PCO) is a common long-term complication of cataract surgery. Intraocular lens design and material have been implicated in influencing the development of PCO. This study evaluated the association of hydrophobic and hydrophilic intraocular lenses on preventing PCO. Medline, Cochrane, EMBASE, and Google Scholar databases were searched until August 3, 2016, using the following search terms: cataract, posterior capsule opacification, and intraocular lens. Eligible studies included randomized controlled trials (RCTs), retrospective, and cohort studies. Eleven studies were included in the study with a total of 889 eyes/patients. The overall analysis revealed that hydrophobic intraocular lenses were associated with lower Nd:YAG laser capsulotomy rates than hydrophilic lenses [odds ratio (OR) = 0.38, 95% confidence interval (95% CI) = 0.16-0.91, P = .029]. Hydrophobic intraocular lenses were also associated with lower subjective PCO score (diff. in means: -1.32, 95% CI = -2.39 to -0.25, P = .015) and estimated PCO score (diff. in means: -2.23; 95% CI, -3.80 to -0.68, P = .005) as compared with hydrophilic lenses. Objective PCO score was similar between lens types. (diff. in means: -0.075; 95% CI, -0.18 to 0.035; P = .182). Pooled analysis found that visual acuity was similar between hydrophobic and hydrophilic intraocular lenses (diff. in means: -0.016; 95% CI, -0.041 to 0.009, P = .208). In general, PCO scores and the rate of Nd:YAG laser capsulotomy were influenced by intraocular lens biomaterial. Lens made of hydrophobic biomaterial were overall superior in lowering the PCO score and the Nd:YAG laser capsulotomy rate, but not visual acuity.

Spectral analysis and comparison of mineral deposits forming in opacified intraocular lens and senile cataractous lens

Science.gov (United States)

Lin, Shan-Yang; Chen, Ko-Hwa; Lin, Chih-Cheng; Cheng, Wen-Ting; Li, Mei-Jane

2010-10-01

This preliminary report was attempted to compare the chemical components of mineral deposits on the surfaces of an opacified intraocular lens (IOL) and a calcified senile cataractous lens (SCL) by vibrational spectral diagnosis. An opacified intraocular lens (IOL) was obtained from a 65-year-old male patient who had a significant decrease in visual acuity 2-years after an ocular IOL implantation. Another SCL with grayish white calcified plaque on the subcapsular cortex was isolated from a 79-year-old male patient with complicated cataract after cataract surgery. Optical light microscope was used to observe both samples and gross pictures were taken. Fourier transform infrared (FT-IR) and Raman microspectroscopic techniques were employed to analyze the calcified deposits. The curve-fitting algorithm using the Gaussian function was also used to quantitatively estimate the chemical components in each deposit. The preliminary results of spectral diagnosis indicate that the opacified IOL mainly consisted of the poorly crystalline, immature non-stoichiometric hydroxyapatite (HA) with higher content of type B carbonated apatites. However, the calcified plaque deposited on the SCL was comprised of a mature crystalline stoichiometric HA having higher contents of type A and type B carbonate apatites. More case studies should be examined in future.

Analysis of phakic before intraocular lens implantation for fundus examination

Directory of Open Access Journals (Sweden)

Juan Chen

2014-10-01

Full Text Available AIM:To investigate the findings of the eyes which were examined preoperatively by three mirror contact lens before the implantation of implantable collamer lens(ICL. To analysis the retinal pathological changes and to explore the clinical analysis of early diagnosis and treatment in retinopathy on fundus examination before operation. METHODS:The retrospective case series study included 127 eyes of 64 patients who underwent phakic intraocular lens implantation were received the fundus examination by three mirror from April 2011 to April 2012 in our hospital. The age, refractive diopter, the findings of Goldmann three mirror examination and the condition of retinal photocoagulation were analysed and concluded.RESULTS: A total of 34 eyes(26.8%out of all 127 eyes(64 caseswere found to have peripheral retinal pathological changes. Eight eyes(6.3%with retinal holes, 15 eyes(11.8%with retinal lattice degeneration, 5 eyes(3.9%with retina cream degeneration, 3 eyes(2.4%with retinal paving stone degeneration,2 eyes with vitreoretinal adhesion and traction,1 eye(0.8%with retinal hemorrhage. Twenty-five cases were given retinal photocoagulation and then received the ICL implantation after 3mo. The follow-up time was 1a. No retinal detachment happened.CONCLUSION:Phakic before intraocular lens implantation for fundus examination by three mirror is contributed to find the peripheral retinal pathological changes and abnormity. And make the appropriate treatment before operation for improving the security of operation, it can also give help to the postoperative follow-up of the fundus of these patients.

Intraocular lens dislocation after whole-body vibration.

Science.gov (United States)

Vela, José I; Andreu, David; Díaz-Cascajosa, Jesús; Buil, José A

2010-10-01

We present 2 cases of intraocular lens (IOL) dislocation that appeared shortly after the patients exercised on a vibration platform. The first patient was a 71-year-old woman who presented with lens subluxation in her right eye and a complete posterior IOL dislocation in her left eye. The second case was a 62-year-old woman who presented with unilateral IOL dislocation within the capsular bag in her right eye. Timing from IOL implantation to dislocation was approximately 6 years and 4 years, respectively. Pars plana vitrectomy with removal of the dislocated IOL was performed in both patients. Whole-body vibration training has become increasingly popular as a form of exercise training. It reportedly may provide benefits in physical function and in some diseases, especially in older people. However, evidence-based protocols ensuring safety and efficacy in this population are lacking. We discuss vibration as a cause of late IOL dislocation. Copyright © 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Lessons learned: wrong intraocular lens.

Science.gov (United States)

Schein, Oliver D; Banta, James T; Chen, Teresa C; Pritzker, Scott; Schachat, Andrew P

2012-10-01

To report cases involving the placement of the wrong intraocular lens (IOL) at the time of cataract surgery where human error occurred. Retrospective small case series, convenience sample. Seven surgical cases. Institutional review of errors committed and subsequent improvements to clinical protocols. Lessons learned and changes in procedures adapted. The pathways to a wrong IOL are many but largely reflect some combination of poor surgical team communication, transcription error, lack of preoperative clarity in surgical planning or failure to match the patient, and IOL calculation sheet with 2 unique identifiers. Safety in surgery involving IOLs is enhanced both by strict procedures, such as an IOL-specific "time-out," and the fostering of a surgical team culture in which all members are encouraged to voice questions and concerns. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Black diaphragm intraocular lens implantation and penetrating keratoplasty in aphakic eyes with traumatic aniridia

Directory of Open Access Journals (Sweden)

Xiao-Guang Dong

2013-04-01

Full Text Available AIM: To evaluate the long-term outcome of implantation of black diaphragm intraocular (BDI lens combined with penetrating keratoplasty (PKP for managing aphakic eyes with traumatic aniridia and corneal damage. METHODS: Six aphakic eyes of six patients with traumatic aniridia and corneal damage had BDI lens implantation at Qingdao Eye Hospital, Shandong Eye Institute from June 2008 to November 2011. Medical records of the patients were reviewed. Three patients received PKP and after 12-18months were implanted with BDI lens. The other three patients completed PKP and BDI lens implantation at the same time. The corrected visual acuity, intraocular pressure and number of corneal endothelial cells were monitored. RESULTS: The patients were followed up for an average of 24.3±12.1months (range 14-48 months. All BDI lenses were located well. The best corrected visual acuity got improved in 5 patients (0.1-1.0 and decreased in 1 patient from 0.4 to 0.2. Three patients had normal intraocular pressure (IOP after implantation. Two patients required antiglaucoma medications to control IOP within the normal range and 1 patient implanted Ahmed glaucoma valve to control IOP. The corneal grafts kept transparent in all eyes and the corneal endothelial counting >1 000/mm2, although two patients experienced acute graft rejection and loss more than 30% corneal endothelial cells. CONCLUSION: Implantation of BDI lens combined with PKP is an effective option for managing aphakic eyes with traumatic aniridia and corneal damage. Although the results in our study are encouraging, additional studies of the long-term safety and efficacy are required. A larger study population and longer follow-up may be beneficial.

Simple technique to treat pupillary capture after transscleral fixation of intraocular lens.

Science.gov (United States)

Jürgens, Ignasi; Rey, Amanda

2015-01-01

We describe a simple surgical technique to manage pupillary capture after previous transscleral fixation of an intraocular lens. Neither author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Intraocular lens subluxation in a patient with facial atopic dermatitis.

Science.gov (United States)

Yamazaki, S; Nakamura, K; Kurosaka, D

2001-02-01

A 66-year-old Japanese man presented with subluxation of a posterior chamber intraocular lens (IOL) caused by a rupture of part of Zinn's zonule but no retinal break 2 years after phacoemulsification with IOL implantation. He had a history of atopic dermatitis since infancy. This case presents a rare ocular complication of scratching and rubbing the face and eyelids because of itching related to atopic dermatitis.

Improved accuracy of intraocular lens power calculation with the Zeiss IOLMaster.

Science.gov (United States)

Olsen, Thomas

2007-02-01

This study aimed to demonstrate how the level of accuracy in intraocular lens (IOL) power calculation can be improved with optical biometry using partial optical coherence interferometry (PCI) (Zeiss IOLMaster) and current anterior chamber depth (ACD) prediction algorithms. Intraocular lens power in 461 consecutive cataract operations was calculated using both PCI and ultrasound and the accuracy of the results of each technique were compared. To illustrate the importance of ACD prediction per se, predictions were calculated using both a recently published 5-variable method and the Haigis 2-variable method and the results compared. All calculations were optimized in retrospect to account for systematic errors, including IOL constants and other off-set errors. The average absolute IOL prediction error (observed minus expected refraction) was 0.65 dioptres with ultrasound and 0.43 D with PCI using the 5-variable ACD prediction method (p ultrasound, respectively (p power calculation can be significantly improved using calibrated axial length readings obtained with PCI and modern IOL power calculation formulas incorporating the latest generation ACD prediction algorithms.

Net technique for intraocular lens support in aphakia without capsular support.

Science.gov (United States)

De Novelli, Fernando José; Neto, Theodomiro Lourenço Garrido; de Sena Rabelo, Gabriel; Blumer, Marcel Eduardo; Suzuki, Ricardo; Ghanem, Ramon Coral

2017-01-01

This paper describes a modified surgical technique for intraocular lens implantation in aphakic eyes with no capsular support. Retrospective case series. Seventeen eyes of 17 aphakic patients with no capsule support underwent intraocular lens (IOL) implantation using a standardized technique in which a net was created at the ciliary sulcus plane with two threads forming a net pattern. The net was used as support for the IOL. Follow-up ranged from 6 to 38 months, with an average of 23 months. In all cases, the IOL was safely implanted and remained stable during the follow-up. In 16 eyes, the IOL remained well centered; in one eye, slight decentration was observed. Distance-corrected visual acuity improved by a mean of 4 lines, from 1.13 (LogMAR) to 0.52 (P = 0.01). This technique might be especially useful in cases of insufficient capsular support associated with tissue loss or iris atrophy. In these cases, iris fixation is not feasible; thus, the only surgical alternative is IOL scleral fixation.

Iris reconstruction combined with iris-claw intraocular lens implantation for the management of iris-lens injured patients.

Science.gov (United States)

Hu, Shufang; Wang, Mingling; Xiao, Tianlin; Zhao, Zhenquan

2016-03-01

To study the efficiency and safety of iris reconstruction combined with iris-claw intraocular lens (IOL) implantation in the patients with iris-lens injuries. Retrospective, noncomparable consecutive case series study. Eleven patients (11 eyes) following iris-lens injuries underwent iris reconstructions combined with iris-claw IOL implantations. Clinical data, such as cause and time of injury, visual acuity (VA), iris and lens injuries, surgical intervention, follow-up period, corneal endothelial cell count, and optical coherence tomography, were collected. Uncorrected VA (UCVA) in all injured eyes before combined surgery was equal to or iris returned to its natural round shape or smaller pupil, and the iris-claw IOLs in the 11 eyes were well-positioned on the anterior surface of reconstructed iris. No complications occurred in those patients. Iris reconstruction combined with iris-claw IOL implantation is a safe and efficient procedure for an eye with iris-lens injury in the absence of capsular support.

Refractive Lens Exchange with Multifocal Intraocular Lens for Treatment of Chronic Intermittent Spasm of the Near Reflex

Directory of Open Access Journals (Sweden)

Guy Sallet

2017-12-01

Full Text Available We report the case of an emmetropic 32-year-old female with decreased uncorrected visual acuity and diplopia due to intermittent episodes of spasm of the near reflex. Neurologic, general, and ophthalmic examination could not find an organic cause. Attempts at spontaneous recovery, psychogenic therapy, and cycloplegic therapy were unsuccessful and the symptoms persisted for almost 5 years, leading to psychogenic distress. Final treatment with refractive lens exchange and implantation of a toric trifocal intraocular lens resolved the spasm of the near reflex, resulting in an uncorrected distance and near visual acuity of 20/20.

Transient anterior subcapsular vacuolar change of the crystalline lens in patients after posterior chamber phakic intraocular lens implantation.

Science.gov (United States)

Chung, Jin Kwon; Shin, Jin Hee; Lee, Sung Jin

2013-10-25

We present two cases of transient vacuolar changes in the anterior subcapsular space of the crystalline lens in patients after posterior chamber phakic intraocular lens implantation. Implantable collamer lenses (ICL) were implanted in healthy myopic patients. Vacuolar changes developed just after the irrigating procedure through the narrow space between the ICL and the crystalline lens. Slit-lamp examinations and spectral domain optical coherence tomography showed bleb-like lesions in the anterior subcapsular space of one eye in each case, though the lesions gradually improved without visual deterioration. Consequently, the lesions turned into a few anterior subcapsular small faint opacities. Direct irrigation of the narrow space confined by the ICL and the crystalline lens is at risk for the development of vacuolar changes in the crystalline lens. The observed spontaneous reversal indicates that surgeons should not rush to surgical intervention but rather opt for close follow over several weeks.

Clinical application of femtosecond laser assisted cataract surgery combined with triple-focus intraocular lens implantation in the treatment of cataract

Directory of Open Access Journals (Sweden)

Qing-Song Gao

2018-02-01

Full Text Available AIM:To evaluate the effect of femtosecond laser assisted cataract surgery combined with triple-focus intraocular lens implantation in the treatment of cataract. METHODS: Totally 86 cases(106 eyesof patients with double cataract in our hospital from January 2016 to January 2017 were selected, including 49 cases(59 eyeswere set as the observation group(treated with femtosecond laser assisted phacoemulsification combined with triple-focus intraocular lens implantation, and 37 cases(47 eyeswere set as the control group(received traditional phacoemulsification combined with triple-focus intraocular lens implantation. Corneal endothelial cell density, cumulative dissipated energy(CDE, distant and near visual accommodation before and after operation were compared between the two groups, postoperative complications were observed. RESULTS: The preoperative corneal endothelial cell density of two groups had no significant difference(P>0.05. The corneal endothelial cell density of two groups significantly decreased at postoperative 1wk, with statistic significance within groups(PPPPPP>0.05. The incidence of glare and halo in the observation group was 10.2% and 8.5% in the control group, and are in the patients whose age was above 60 years old, there was no significant difference between the two groups(P>0.05. CONCLUSION: Femtosecond laser assisted cataract surgery combined with triple-focus intraocular lens implantation in the treatment of cataract can not only improve curative effect, but also provide high safety, while the adverse events including glare, halo and other adverse visual circumstances should be considered after triple-focus intraocular lens implantation.

Comparison of hydrophobic and hydrophilic intraocular lens in preventing posterior capsule opacification after cataract surgery

OpenAIRE

Zhao, Yang; Yang, Ke; Li, Jiaxin; Huang, Yang; Zhu, Siquan

2017-01-01

Abstract Background: Posterior capsular opacification (PCO) is a common long-term complication of cataract surgery. Intraocular lens design and material have been implicated in influencing the development of PCO. This study evaluated the association of hydrophobic and hydrophilic intraocular lenses on preventing PCO. Methods: Medline, Cochrane, EMBASE, and Google Scholar databases were searched until August 3, 2016, using the following search terms: cataract, posterior capsule opacification, ...

Comparison of a new refractive multifocal intraocular lens with an inferior segmental near add and a diffractive multifocal intraocular lens.

Science.gov (United States)

Alio, Jorge L; Plaza-Puche, Ana B; Javaloy, Jaime; Ayala, María José; Moreno, Luis J; Piñero, David P

2012-03-01

To compare the visual acuity outcomes and ocular optical performance of eyes implanted with a multifocal refractive intraocular lens (IOL) with an inferior segmental near add or a diffractive multifocal IOL. Prospective, comparative, nonrandomized, consecutive case series. Eighty-three consecutive eyes of 45 patients (age range, 36-82 years) with cataract were divided into 2 groups: group A, 45 eyes implanted with Lentis Mplus LS-312 (Oculentis GmbH, Berlin, Germany); group B, 38 eyes implanted with diffractive IOL Acri.Lisa 366D (Zeiss, Oberkochen, Germany). All patients underwent phacoemulsification followed by IOL implantation in the capsular bag. Distance corrected, intermediate, and near with the distance correction visual acuity outcomes and contrast sensitivity, intraocular aberrations, and defocus curve were evaluated postoperatively during a 3-month follow-up. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), corrected distance near and intermediate visual acuity (CDNVA), contrast sensitivity, intraocular aberrations, and defocus curve. A significant improvement in UDVA, CDVA, and UNVA was observed in both groups after surgery (P ≤ 0.04). Significantly better values of UNVA (P<0.01) and CDNVA (P<0.04) were found in group B. In the defocus curve, significantly better visual acuities were present in eyes in group A for intermediate vision levels of defocus (P ≤ 0.04). Significantly higher amounts of postoperative intraocular primary coma and spherical aberrations were found in group A (P<0.01). In addition, significantly better values were observed in photopic contrast sensitivity for high spatial frequencies in group A (P ≤ 0.04). The Lentis Mplus LS-312 and Acri.Lisa 366D IOLs are able to successfully restore visual function after cataract surgery. The Lentis Mplus LS-312 provided better intermediate vision and contrast sensitivity outcomes than the Acri.Lisa 366D. However, the

Bottom-up fabrication of zwitterionic polymer brushes on intraocular lens for improved biocompatibility

Directory of Open Access Journals (Sweden)

Han Y

2016-12-01

Full Text Available Yuemei Han,1,* Xu Xu,1,* Junmei Tang,1,* Chenghui Shen,2 Quankui Lin,1,2 Hao Chen1,2 1School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, 2Wenzhou Institute of Biomaterials and Engineering, Chinese Academy of Sciences, Wenzhou, People’s Republic of China *These authors contributed equally to this work Abstract: Intraocular lens (IOL is an efficient implantable device commonly used for treating cataracts. However, bioadhesion of bacteria or residual lens epithelial cells on the IOL surface after surgery causes postoperative complications, such as endophthalmitis or posterior capsular opacification, and leads to loss of sight again. In the present study, zwitterionic polymer brushes were fabricated on the IOL surface via bottom-up grafting procedure. The attenuated total reflection-Fourier transform infrared and contact angle measurements indicated successful surface modification, as well as excellent hydrophilicity. The coating of hydrophilic zwitterionic polymer effectively decreased the bioadhesion of lens epithelial cells or bacteria. In vivo intraocular implantation results showed good in vivo biocompatibility of zwitterionic IOL and its effectiveness against postoperative complications. Keywords: RAFT, surface modification, endophthalmitis, PCO, in vivo

[To exercise caution in developing intraocular lens exchange].

Science.gov (United States)

Song, X D; Wang, X Z; Qian, J

2018-05-11

Nowadays cataract extraction combined intraocular lens (IOL) implantation has become the conventional treatment for cataract. Numbers of IOL exchange after cataract extraction combined IOL implantation have been increasing in recent years. As a non-routine surgery, IOL exchange is normally combined with other surgeries and accompanied by some complications to various extents. Is IOL exchange necessary for all abnomal IOLs? Can IOL exchange be avoided? How to avoid IOL exchange? The purpose of this article is to stress the importance of indication of IOL exchange and how to avoid IOL exchange. (Chin J Ophthalmol, 2018, 54: 324-327) .

Effect of aspherical and yellow tinted intraocular lens on blue-on-yellow perimetry Efeito das lentes intraoculares asféricas e com pigmentação amarela na campimetria azul-amarelo

Directory of Open Access Journals (Sweden)

Rodrigo França de Espíndola

2012-10-01

Full Text Available PURPOSE: To investigate the possible effect of aspherical or yellow tinted intraocular lens (IOL on contrast sensitivity and blue-on-yellow perimetry. METHODS: This prospective randomized bilateral double-masked clinical study included 52 patients with visually significant bilateral cataracts divided in two groups; 25 patients (50 eyes received aspherical intraocular lens in one eye and spherical intraocular lens in the fellow eye; and 27 patients (54 eyes received ultraviolet and blue light filter (yellow tinted IOL implantation in one eye and acrylic ultraviolet filter IOL in the fellow eye. The primary outcome measures were contrast sensitivity and blue-on-yellow perimetry values (mean deviation [MD] and pattern standard deviation [PSD] investigated two years after surgery. The results were compared intra-individually. RESULTS: There was a statistically significant between-group (aspherical and spherical intraocular lens difference in contrast sensitivity under photopic conditions at 12 cycles per degree and under mesopic conditions at all spatial frequencies. There were no between-group significant differences (yellow tinted and clear intraocular lens under photopic or mesopic conditions. There was no statistically significant difference between all intraocular lens in MD or PSD. CONCLUSION: Contrast sensitivity was better under mesopic conditions with aspherical intraocular lens. Blue-on-yellow perimetry did not appear to be affected by aspherical or yellow tinted intraocular lens. Further studies with a larger sample should be carried out to confirm or not that hypotheses.OBJETIVO: Investigar a possibilidade de efeitos na sensibilidade ao contraste e nos resultados da campimetria azul-amarelo com implante de uma lente intraocular (LIO asférica ou de pigmentação amarela. MÉTODOS: Trata-se de um estudo prospectivo, randomizado, duplo-mascarado, envolvendo 52 pacientes portadores de catarata senil bilateral, divididos em dois grupos; 25

Cataract and keratoconus: minimizing complications in intraocular lens calculations.

Science.gov (United States)

Bozorg, Sara; Pineda, Roberto

2014-01-01

Patients with both cataract and keratoconus present unique challenges for the surgeon. Accurate keratometry (K) and axial length (AL) readings may be impossible, and uncertainty is introduced when estimating the corneal power for intraocular lens (IOL) selection. Different options on how to choose an IOL and how to manage irregular astigmatism of a keratoconic patient with cataract have been proposed and are reviewed. The stage of keratoconus and the history of the patient are both critical in determining the strategy used in treatment of cataracts.

Scleral fixation of a single-piece multifocal intraocular lens.

Science.gov (United States)

Can, Ertugrul; Basaran, M Resat; Gül, Adem

2013-01-01

We describe an ab interno technique for injector implantation of a one-piece multifocal intraocular lens (IOL). Transscleral fixation of multifocal posterior chamber IOL implantation using an injector with ab interno technique was performed in an eye of a 9-year-old girl who had undergone pars plana lensectomy 2 years before for bilateral lens subluxation with unknown etiology. No major complications were encountered during a 3-month follow-up of the patient and excellent centration was observed during the follow-up period. Her preoperative best spectacle-corrected distance visual acuity of 20/32 improved to uncorrected distance visual acuity of 20/25. Closed-loop design of IOL served the function of eyelets and position of the IOL was provided using only a 2-point fixation. Intraoperative position adjustment of the IOL provided an excellent centralization of multifocal IOL.

Simultaneous and sequential implantation of intacs and verisyse phakic intraocular lens for refractive improvement in keratectasia.

Science.gov (United States)

Moshirfar, Majid; Fenzl, Carlton R; Meyer, Jay J; Neuffer, Marcus C; Espandar, Ladan; Mifflin, Mark D

2011-02-01

To evaluate the safety, efficacy, and visual outcomes of simultaneous and sequential implantation of Intacs (Addition Technology, Inc, Sunnyvale, CA) and Verisyse phakic intraocular lens (AMO, Santa Ana, CA) in selected cases of ectatic corneal disease. John A. Moran Eye Center, University of Utah, UT. Prospective data were collected from 19 eyes of 12 patients (5 eyes, post-laser in situ keratomileusis ectasia and 14 eyes, keratoconus). Intacs segments were implanted followed by insertion of a phakic Verisyse lens at the same session (12 eyes) in the simultaneous group or several months later (7 eyes) in the sequential group. The uncorrected visual acuity, best spectacle-corrected visual acuity (BSCVA), and manifest refraction were recorded at each visit. No intraoperative or postoperative complications were observed. At the last follow-up (19 ± 6 months), in the simultaneous group, mean spherical error was -0.79 ± 1.0 diopter (D) (range, -2.0 to +1.50 D) and cylindrical error +2.06 ± 1.21 D (range, +0.5 to +3.75 D). In the sequential group, at the last follow-up, at 36 ± 21 months, the mean spherical error was -1.64 ± 1.31 D (range, -3.25 to +1.0 D) and cylindrical error +2.07 ± 1.03 D (range, +0.75 to +3.25 D). There were no significant differences in mean uncorrected visual acuity or BSCVA between the 2 groups preoperatively or postoperatively. No eye lost lines of preoperative BSCVA. Combined insertion of Intacs and Verisyse was safe and effective in all cases. The outcomes of the simultaneous implantation of the Intacs and Verisyse lens in 1 surgery were similar to the results achieved with sequential implantation using 2 surgeries.

Image-guided system versus manual marking for toric intraocular lens alignment in cataract surgery

NARCIS (Netherlands)

Webers, V.S.C.; Bauer, N.J.C.; Visser, N.; Berendschot, T.T.J.M.; van den Biggelaar, F.J.H.M.; Nuijts, R.M.M.A.

2017-01-01

Purpose To compare the accuracy of toric intraocular lens (IOL) alignment using the Verion Image-Guided System versus a conventional manual ink-marking procedure. Setting University Eye Clinic Maastricht, Maastricht, the Netherlands. Design Prospective randomized clinical trial. Methods Eyes with

Clinical research of phacoemulsification with posterior chamber intraocular lens implantation for glaucoma with different goniosynechia ranges

Directory of Open Access Journals (Sweden)

Qing-Yu Li

2016-02-01

Full Text Available AIM:To study the effect of phacoemulsification with posterior chamber intraocular lens implantation to treat glaucoma with different angle-closure range, which may provide a better way to treat the angle-closure glaucoma.METHODS:There were 47 cases(54 eyeswith angle-closure glaucoma, and all of them underwent phacoemulsification and posterior chamber intraocular lens implantation. According to the range of goniosynechia, these patients were divided into three groups:the eyes with the range of goniosynechia≤1/2 were group A(13 eyes; the eyes with 1/23/4 were group C(23 eyes. We observed the status of anterior chamber angle and the intraocular pressure(IOPof the three groups at 2wk after operations. RESULTS:Compared to the preoperative condition, the IOP of the three groups at 2wk after operations decreased significantly. The IOP reductions of group B and C were more significant than that of group A, and the differences were significant(PPP3/4 appeared in group B; in group C, there were 5 eyes with goniosynechia>3/4, 1 eye with disappeared anterior chamber, 3 eyes with corneal edema, 1 eye with choroidal hemorrhage. The differences of postoperative complication rate among the three groups was statistically significant(PPCONCLUSION:For patients with angle closure glaucoma who have mild to moderate goniosynechia, phacoemulsification with posterior chamber intraocular lens implantation is an effective way. After operations, their closed anterior angle reopened. But to the patients with severe adhesions, there are more complications after operations, especially the glaucoma may reoccur.

Microscopic analysis of an opacified OFT CRYL® hydrophilic acrylic intraocular lens

Directory of Open Access Journals (Sweden)

Bruna Vieira Ventura

Full Text Available ABSTRACT A 51-year-old patient underwent posterior vitrectomy with perfluoropropane gas injection, phacoemulsification, and implantation of an Oft Cryl® hydrophilic acrylic intraocular lens (IOL because of traumatic retinal detachment and cataract in the right eye. On the first postoperative day, gas was filling the anterior chamber because of patient's non-compliance in terms of head positioning, and was reabsorbed within one week. Eight months later, the patient returned complaining of a significant decrease in vision. IOL opacification was noticed by slit-lamp examination. The lens was explanted to undergo gross and light microscopic analysis. The lens was also stained with the alizarin red method for calcium identification. Light microscopic analysis confirmed the presence of granular deposits, densely distributed in an overall circular pattern in the central part of the lens optic. The granules stained positive for calcium. This is the first case of the opacification of this type of hydrophilic lens. Surgeons should be aware of this potential postoperative complication, and the use of hydrophilic IOLs should be avoided in procedures involving intracameral gas because of the risk of IOL opacification.

Phakic iris-fixated intraocular lens placement in the anterior chamber: effects on aqueous flow.

Science.gov (United States)

Repetto, Rodolfo; Pralits, Jan O; Siggers, Jennifer H; Soleri, Paolo

2015-05-01

Phakic intraocular lenses (pIOLs) are used for correcting vision; in this paper we investigate the fluid dynamical effects of an iris-fixated lens in the anterior chamber. In particular, we focus on changes in the wall shear stress (WSS) on the cornea and iris, which could be responsible for endothelial and pigment cell loss, respectively, and also on the possible increase of the intraocular pressure, which is known to correlate with the incidence of secondary glaucoma. We use a mathematical model to study fluid flow in the anterior chamber in the presence of a pIOL. The governing equations are solved numerically using the open source software OpenFOAM. We use an idealized standard geometry for the anterior chamber and a realistic geometric description of the pIOL. We consider separately the main mechanisms that produce fluid flow in the anterior chamber. The numerical simulations allow us to obtain a detailed description of the velocity and pressure distribution in the anterior chamber, and indicated that implantation of the pIOL significantly modifies the fluid dynamics in the anterior chamber. However, lens implantation has negligible influence on the intraocular pressure and does not produce a significant increase of the shear stress on the cornea, while the shear stress on the iris, although increased, is not enough to cause detachment of cells. We conclude that alterations in the fluid dynamics in the anterior chamber as a result of lens implantation are unlikely to be the cause of medical complications associated with its use.

CLINICAL PRESENTATION OF LENS INDUCED GLAUCOMA: STUDY OF EPIDEMIOLOGY, DURATION OF SYMPTOMS, INTRAOCULAR PRESSURE AND VISUAL ACUITY

Directory of Open Access Journals (Sweden)

Venkataratnam

2015-10-01

Full Text Available BACKGROUND: Lens Induced Glaucoma is a common cause of ocular morbidity. OBJECTIVES: Our study was to know the Epidemiological factors, Duration of Symptoms, Visual Acuity and Intraocular Pressure in the clinical Presentation of Lens Induced Glaucoma. MATERIALS AND METHODS : This w as a tertiary hospital based prospective study in the department of Glaucoma, Sarojini Devi Eye Hospital and Regional Institute of Ophthalmology (RIO, Osmania Medical College, Hyderabad over a period from March 2015 to August 2015. 50 Patients clinically diagnosed as Lens Induced Glaucoma (LIG were studied with the data of Age, Sex, literacy, Laterality and Rural / Urban status with the duration of symptoms, Intraocular pressure and Visual Acuity. The data was analyzed by simple statistical methods. RESULT S: 50 patients, clinically diagnosed as Lens Induced Glaucoma (LIG were studied. Age group distribution was 1(2.0% in 40 - 50yrs, 13 ( 26.0% in >50 - 60yrs, 26(52.0% in >60 - 70yrs and 10(20.0% in > 70 yrs. Sex distribution was 23(46.0% of Males and 27(54.0% of Females. Urban / Rural status was 15(30.0% of Urban and 35(70.0% of Rural. Literacy status was 7(14.0% of Literate and 43(86.0% of Illiterate. Laterality was RE in 24(48.0% and LE in 26(52.0%. Duration of the presenting symptoms before re porting to the Hospital was 12.0% in 2wks. Intraocular pressure (IOP in mm of Hg showed no case (0.0% in 20 – 40, 27(54.0% in >40 - 60 and 5(10.0% >60 wit h the Mean IOP of 42.12 mm of Hg. Visual Acuity (VA was PL +ve in 24(48.0 and HM - 3/60. CONCLUSIONS: Increasing age, female gender, rural, illiterate, and delayed reporting to the hospital after the pre senting symptoms were the common risk factors with increased Intraocular pressure and poor visual acuity in the clinical presentation of Lens induced Glaucoma.

Retropupillary Fixation of Iris-Claw Intraocular Lens for Aphakic Eyes in Children.

Directory of Open Access Journals (Sweden)

Martina Brandner

Full Text Available To report outcome, complications and safety of retropupillary fixated iris-claw intraocular lenses in a pediatric population.Retrospective study.Ten consecutive pediatric patients (15 eyes underwent placement of retropupillary fixated iris-claw intraocular lenses between October 2007 and July 2013 at the Department of Ophthalmology, Medical University Graz and General Hospital Klagenfurt, Austria. Postoperative visual acuity and complications were analyzed.Median final best-corrected visual acuity improved by 0.12 logMAR from preoperative baseline. Mean postoperative spherical equivalent was -0.05 ± 1.76 D. No serious complications were observed intra- or postoperatively during the entire follow-up period of up to 40 months. One patient experienced a haptic disenclavation with IOL subluxation immediately after a car accident.Our study demonstrates that iris-claw intraocular lens implantation behind the iris is safe in children with lack of capsular support and yields excellent visual outcome with low complication rate.

Retropupillary Fixation of Iris-Claw Intraocular Lens for Aphakic Eyes in Children

Science.gov (United States)

Brandner, Martina; Thaler-Saliba, Sarah; Plainer, Sophie; Vidic, Bertram; El-Shabrawi, Yosuf; Ardjomand, Navid

2015-01-01

Purpose To report outcome, complications and safety of retropupillary fixated iris-claw intraocular lenses in a pediatric population. Design Retrospective study. Patients and Methods Ten consecutive pediatric patients (15 eyes) underwent placement of retropupillary fixated iris-claw intraocular lenses between October 2007 and July 2013 at the Department of Ophthalmology, Medical University Graz and General Hospital Klagenfurt, Austria. Postoperative visual acuity and complications were analyzed. Results Median final best-corrected visual acuity improved by 0.12 logMAR from preoperative baseline. Mean postoperative spherical equivalent was -0.05 ± 1.76 D. No serious complications were observed intra- or postoperatively during the entire follow-up period of up to 40 months. One patient experienced a haptic disenclavation with IOL subluxation immediately after a car accident. Conclusion Our study demonstrates that iris-claw intraocular lens implantation behind the iris is safe in children with lack of capsular support and yields excellent visual outcome with low complication rate. PMID:26110864

Subluxação congênita do cristalino: resultados visuais e posição das lentes intraoculares após a cirurgia Congenital lens subluxation: visual acuity outcomes and intraocular lens postoperative position

Directory of Open Access Journals (Sweden)

Caroline Arraes

2010-04-01

Full Text Available OBJETIVO: Avaliar os resultados visuais e investigar, através da biomicroscopia ultrassônica, o posicionamento das lentes intraoculares e do anel endocapsular em 17 olhos de 10 portadores de subluxação congênita do cristalino, submetidos à mesma técnica cirúrgica pelo mesmo cirurgião. MÉTODOS: O estudo foi realizado no Hospital de Olhos de Pernambuco e Fundação Altino Ventura. A técnica cirúrgica consistiu em facoaspiração com implante de anel endocapsular e de lentes intraoculares com amputação de uma das alças. A idade variou entre 7 e 22 anos. Foram coletados dados sobre acuidade visual para longe pré e pós-operatória, tempo de seguimento após a cirurgia e complicações. Os pacientes foram submetidos à biomicroscopia ultrassônica. RESULTADOS: O tempo de seguimento médio foi de 2,8 anos. Houve melhora da acuidade visual para longe nos 17 (100% olhos: 12 olhos (70,6% apresentaram acuidade visual para longe melhor que 20/40; 4 (23,5% apresentaram acuidade visual para longe entre 20/40 e 20/100 e 1 (5,9% apresentou acuidade visual para longe pior que 20/100, porém melhor que acuidade visual para longe pré-operatória. A opacificação da cápsula posterior ocorreu em 10 olhos (58,9%. Na biomicroscopia ultrassônica observou-se que todas as lentes intraoculares estavam parcialmente descentralizadas, contudo sem atingir o bordo pupilar. Em todos os casos observou-se um adequado posicionamento do anel e um bom suporte capsular. CONCLUSÃO É possível concluir que o tratamento cirúrgico avaliado proporciona uma boa centralização das lentes intraoculares e do anel endocapsular, com melhora da acuidade visual para longe, sendo uma opção viável, eficaz e segura na reabilitação visual dos pacientes com subluxação congênita do cristalino.PURPOSE: To evaluate the visual acuity outcomes and to investigate the intraocular lens (IOL and endocapsular ring positions with ultrasound biomicroscopy in 17 eyes of 10 patients

Contrast sensitivity after refractive lens exchange with a multifocal diffractive aspheric intraocular lens

Directory of Open Access Journals (Sweden)

Teresa Ferrer-Blasco

2013-04-01

Full Text Available PURPOSE: To evaluate distance and near contrast sensitivity (CS under photopic and mesopic conditions before and after refractive lens exchange (RLE and implantation of the aspheric AcrySof®ReSTOR® (SN6AD3 model intraocular lens (IOL. METHODS:Seventy-four eyes of 37 patients after RLE underwent bilateral implantation with the aspheric AcrySof ReSTOR IOL. The patient sample was divided into myopic and hyperopic groups. Monocular uncorrected visual acuity at distance and near (UCVA and UCNVA, respectively and monocular best corrected visual acuity at distance and near (BCVA and BCNVA, respectively were measured before and 6 months postoperatively. Monocular CS function was measured at three different luminance levels (85, 5 and 2.5 cd/m² before and after RLE. Post-implantation results at 6 months were compared with those found before surgery. RESULTS: Our results revealed that patients in both groups obtained good UCVA and BCVA after RLE at distance and near vision in relation to pre-surgery values. No statistically significant differences were found between the values of CS pre and post-RLE at distance and near, at any lighting condition and spatial frequency (p>0.002. CONCLUSIONS: Refractive lens exchange with aspheric AcrySof ReSTOR IOL in myopic and hyperopic population provided good visual function and yield good distance and near CS under photopic and mesopic conditions.

Follow up of intraocular lens subluxation with a combined topographer/aberrometer

OpenAIRE

Georgios A. Kontadakis; George D. Kymionis; Vardhaman P. Kankariya; Ioannis G. Pallikaris

2012-01-01

Purpose: To report a 36-year-old patient with intraocular lens (IOL) subluxation that was followed for IOL stability with evaluation of images captured with the iTrace combined aberrometer/topographer. Methods: The patient had undergone phacoemulsification with IOL implantation for congenital cataract 15 years before. He presented with bilateral IOL subluxation, more severe in his right eye. Right eye was operated for IOL exchange and left eye was followed with the iTrace images. The image...

Corneal edema and permanent blue discoloration of a silicone intraocular lens by methylene blue.

Science.gov (United States)

Stevens, Scott; Werner, Liliana; Mamalis, Nick

2007-01-01

To report a silicone intraocular lens (IOL) stained blue by inadvertent intraoperative use of methylene blue instead of trypan blue and the results of experimental staining of various lens materials with different concentrations of the same dye. A "blue dye" was used to enhance visualization during capsulorhexis in a patient undergoing phacoemulsification with implantation of a three-piece silicone lens. Postoperatively, the patient presented with corneal edema and a discolored IOL. Various IOL materials were experimentally stained using methylene blue. Sixteen lenses (4 silicone, 4 hydrophobic acrylic, 4 hydrophilic acrylic, and 4 polymethylmethacrylate) were immersed in 0.5 mL of methylene blue at concentrations of 1%, 0.1%, 0.01%, and 0.001%. These lenses were grossly and microscopically evaluated for discoloration 6 and 24 hours after immersion. The corneal edema resolved within 1 month after the initial surgical procedure. After explantation, gross and microscopic analyses of the explanted silicone lens revealed that its surface and internal substance had been permanently stained blue. In the experimental study, all of the lenses except the polymethylmethacrylate lenses were permanently stained by methylene blue. The hydrophilic acrylic lenses showed the most intense blue staining in all dye concentrations. This is the first clinicopathological report of IOL discoloration due to intraocular use of methylene blue. This and other tissue dyes may be commonly found among surgical supplies in the operating room and due diligence is necessary to avoid mistaking these dyes for those commonly used during ocular surgery.

Intraocular pressure measurement over soft contact lens by rebound tonometer: a comparative study.

Science.gov (United States)

Nacaroglu, Senay Asik; Un, Emine Seker; Ersoz, Mehmet Giray; Tasci, Yelda

2015-01-01

To evaluate the intraocular pressure (IOP) measurements by Icare rebound tonometer over a contact lens in comparison with Goldmann applanation tonometry (GAT). Fifty patients using contact lens were included in this study. One of the eyes of the patients was selected randomly and their IOP were measured by rebound tonometer with and without contact lens (RTCL, RT respectively) and by GAT, as well as their central corneal thickness (CCT) by optical pachymeter. The results of both methods were compared by correlation analysis, general linear method repeated measure and Bland-Altman analysis. Mean IOP values measured by RTCL, RT and GAT were 15.68±3.7, 14.50±3.4 and 14.16±2.8 (Pcontact lens by rebound tonometer was found to be higher than what was measured by GAT. Although this difference is statistically significant, it may be clinically negligible in the normal population.

Carbachol as miotic agent in intra-ocular lens implant surgery

Directory of Open Access Journals (Sweden)

Agarwal Jitendra

1988-01-01

Full Text Available The intra cameral use of 0.025% carbachol as a miotic agent in anterior chamber intraocular lens im-plant surgery us reported in 15 cases. Carbachol produced prompt and effective moisis and was found to be harmless and non-irritating to the anterior chamber structures. A rebound dialatation of the pipit was noticed in the post operative period in 3 of our first 5 cases where only carbachol was used. For prolonged miosis instillation of a more powerful miotic like pilocarpine is recommended at the completion of surgery:

Experiencia con la lente intraocular RAYNER 620H Experience gained with the use of intraocular lens RAYNER 620 H

Directory of Open Access Journals (Sweden)

Juan Raúl Hernández Silva

2008-06-01

cataract surgery is the industrial development that has taken place in the last few years with the introduction of new intraocular lens models such as Rayner 620 H, the improvement of surgical implements, systems of bimanual aspiration and irrigation and custom-made scalpel to place the intraocular lens injector. IOL Rayner 620 H meant a step forward for phacoemulsification and the control of postoperative posterior capsule opacity due to the peculiar design of its optics and haptics that allows a safe and easy implantation using tiny incision. A prospective descriptive study was conducted in 28 eyes diagnosed with cataract, which underwent phacoemulsification with Rayner 620 H intraocular lens implantation performed at the Ocular Microsurgery Center of "Ramón Pando Ferrer" Cuban Institute of Ophthalmology from June 2006 to February 2007. The majority of patients was included in the over 60 years age group. All the cases showed a significant increase of visual acuity with and without correction from the preoperative to the postoperative phases. The keratometric cylinder also increased but slightly. Loss of endothelial cells was low from preoperative to postoperative phase. There was no complication during or after the surgery. We assessed the effectiveness of IOL Rayner 620 H as satisfactory because of the higher visual acuity of the patient, low induced astigmatism, improved visual field, minimal loss of endothelial cells and lack of complications and postoperative dazzling in the patients.

Sectioning a luxated intraocular lens inside the vitreous cavity.

Science.gov (United States)

Vilaplana, Daniel; Pazos, Marta

2013-07-01

We describe a new technique for sectioning an intraocular lens (IOL) inside the vitreous cavity. The IOL had a broken haptic and was accidentally luxated after a complicated cataract surgery with posterior capsule rupture. The primary indication to cut the IOL in half inside the vitreous cavity is to preserve the anterior capsule integrity, especially in a small-sized capsulotomy, allowing subsequent implantation of a new IOL in the sulcus with the optical zone captured in the capsulorhexis. Neither author has a financial or proprietary interest in any material or method mentioned. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Vitrectomía pars plana y reimplante de lente intraocular en surco Pars plana vitrectomy and intraocular lens repositioning in the sulcus

Directory of Open Access Journals (Sweden)

Alejandro Guerra García

2010-01-01

Full Text Available Se presentó un caso de lente intraocular luxado a vítreo en paciente con conteo bajo de células endoteliales e intolerancia a lentes de contacto. Se practicó vitrectomía pars plana con reimplante de lente en surco ciliar con el objetivo de demostrar la fiabilidad de la técnica para casos que presenten condiciones adecuadas y situaciones especiales. Se revisó la bibliografía para conocer las tendencias actuales con respecto al manejo de esta patología. El paciente alcanzó una agudeza visual de 20/30. El lente permaneció estable en el surco 3 meses después de practicada la vitrectomía. El manejo de esta entidad debe ser personalizado. La técnica utilizada debe ser siempre la primera opción de tratamiento y parece ser segura en casos cuidadosamente escogidos.A case of dislocated intraocular lens moved to the vitreous cavity in a patient with low endothelial cell count and contact lens intolerance was reported. A pars plana vitrectomy with lens repositioning was performed to demonstrate the safety of this technique for some special cases under adequate conditions. The literature was reviewed to learn about the current management of this pathology. Finally, patient's best visual acuity was 20/30. The stability of the lens was confirmed three month l after the vitrectomy. Management of this disorder should be customized. This technique should be considered as the first option of treatment and seems to be safe in selected cases.

Cell adhesion of F{sup +} ion implantation of intraocular lens

Energy Technology Data Exchange (ETDEWEB)

Li, D.J. E-mail: dejunli@hotmail.com; Cui, F.Z.; Gu, H.Q

1999-04-01

The cell adhesion of ion implanted polymethylmethacrylate (PMMA) intraocular lens was studied using cultured cells in vitro. F{sup +} ion implantation was performed at the energies of 40, 60, 80, 100 keV with the fluences ranging from 5x10{sup 13} to 1x10{sup 15} ions/cm{sup 2} at room temperature. The cell adhesion tests gave interesting results that the number of the neutral granulocytes and the macrophages adhering on surface were reduced significantly after ion implantation. The optimal fluence was about 4x10{sup 14} ions/cm{sup 2}. The hydrophobicity imparted to the lens surface was also enhanced. The results of X-ray photoelectron spectroscopy analysis indicated that ion implantation resulted in the cleavage of some pendant groups, the oxidation of the surface, and the formation of some new chemical bonds, which was probably the main reason for the cell adhesion change.

Combined surgical management of capsular and iris deficiency with glued intraocular lens technique.

Science.gov (United States)

Kumar, Dhivya Ashok; Agarwal, Amar; Jacob, Soosan; Lamba, Mandeep; Packialakshmi, Sathiya; Meduri, Alessandro

2013-05-01

To determine the outcome after glued aniridia intraocular lens (IOL) and glued IOL with iridoplasty in eyes with combined lens capsular and iris deficiency. Twenty-seven eyes of 25 patients (6 had congenital aniridia with subluxated cataract and 19 had acquired lens/iris defects) were included. Glued IOL with aniridia IOL (Intra Ocular Care, Gujarat, India) was performed in eyes with total aniridia and iridoplasty with glued IOL with a three-piece foldable IOL (Sofport; Bausch & Lomb, Rochester, NY) was performed in eyes with partial aniridia. The postoperative outcomes were analyzed at follow-up examination (range: 6 to 48 months). Eleven eyes underwent glued aniridia IOL and 16 eyes underwent glued IOL with iridoplasty. There was significant improvement in (spectacle) corrected distance visual acuity (CDVA) (P = .002). Postoperatively, pigment dispersion on the IOL (n = 1) and raised intraocular pressure was seen in the glued aniridia IOL group and chronic uveitis (n = 1), cystoid macular edema (n = 1), and hyphema (n = 1) in the glued IOL with iridoplasty group. The CDVA remained unchanged in 14 eyes (51.8%) and improved in 13 eyes (48.1%). There was a difference in postoperative CDVA (P = .001) between eyes with glued aniridia IOL and glued IOL with iridoplasty. There was no IOL decentration, retinal detachment, corneal decompensation, or endophthalmitis. There was reduction in glare and photophobia. Both glued aniridia IOL and glued IOL/iridoplasty showed good functional and anatomical results with fewer complications in eyes with lens capsule and iris deficiency. However, long-term follow-up is required.[J Refract Surg. 2013;29(5):342-347.]. Copyright 2013, SLACK Incorporated.

Clinical observation of small-incision extracapsular cataract extraction with intraocular lens implantation for the treatment of cataract in the sight restoration project

Directory of Open Access Journals (Sweden)

Xiao-Jian Cheng

2014-04-01

Full Text Available AIM: To analyze the clinical effects of small-incision extracapsular cataract extraction with intraocular lens implantation for the treatment of cataract.METHODS:Totally 642 cases 676 eyes of cataract were treated by small-incision extracapsular cataract extraction with intraocular lens implantation. Complication during and after operations and postoperative visual acuity was observed.RESULTS:Visual acuity of 670 eyes was ≥0.05 and off-blindness rate was 99.11%, and there was 627 eyes ≥0.3 and the off-disability rate was 92.75% after 1mo. Rupture of posterior capsule during surgery occurred in 24 eyes. Fifty-four eyes were corneal edema, and anterior chamber exudation were 26 eyes, and 23 eyes were hypertension after operation. CONCLUSION: There are a little complications during and after operation for cataract treated by small-incision extracapsular cataract extraction with intraocular lens implantation. Patients have good recovery after operation. This operation does not need high-standard equipments and is suitable in the sight restoration project.

Implantação de lente intraocular com uma alça amputada: proposta para o tratamento cirúrgico da subluxação do cristalino Intraocular lens implantation with one loop haptic amputed: a new propose to the subluxation lens surgical treatment

Directory of Open Access Journals (Sweden)

Marcelo Ventura

2010-04-01

Full Text Available OBJETIVO: Avaliar os resultados pós-operatórios da subluxação congênita do cristalino, corrigida por uma nova abordagem cirúrgica. MÉTODOS: Foram estudados 21 olhos de 13 pacientes, portadores de subluxação não traumática do cristalino submetidos à cirurgia na Fundação Altino Ventura, no período de abril de 1999 a abril de 2004. A idade média foi de 8,7 ± 5,4 anos, e o tempo médio de seguimento foi 21,5 ± 19,3 meses. Os pacientes foram submetidos à facoaspiração, implante do anel endocapsular e lente intraocular (LIO. Uma das alças da LIO foi amputada e apoiada sobre o anel, no interior do saco capsular, centralizando a LIO. RESULTADOS: Houve melhora da acuidade visual (AV em todos os casos, e redução significante do equivalente esférico e componente esférico comparando-se a refração pré e pós-operatória (pPURPOSE: To evaluate the postoperative results of congenital lens subluxation corrected by a new technique. METHODS: Retrospective chart review of 21 eyes of 13 patients with no traumatic lens subluxation who underwent surgery in Altino Ventura Foundation from April, 1999 to April, 2004. The mean age was 8.7 ± 5.4 years old, and the mean follow-up period was 21.5 ± 19.3 months. Patients underwent phacoaspiration, endocapsular ring and intraocular lens (IOL implantation. The implanted IOL had one loop haptic excised and was supported above the ring, inside the capsular bag promoting intraocular lens centralization. RESULTS: Visual acuity improvement was observed in all cases. There was a significant reduction of the spherical equivalent and spherical component comparing the pre and postoperative refraction (p<0.01. There was no statistically significant difference between the pre and postoperative cylinder component (p=0.71. Posterior capsule opacification was a postoperative complication found in 71.4% of the cases. Early posterior capsulotomy was performed with no complications in these cases. CONCLUSION

Design of a Test Bench for Intraocular Lens Optical Characterization

Energy Technology Data Exchange (ETDEWEB)

Alba-Bueno, Francisco; Vega, Fidel; Millan, Maria S, E-mail: francisco.alba-bueno@upc.edu, E-mail: fvega@oo.upc.edu, E-mail: millan@oo.upc.edu [Departamento de Optica y Optometria, Universidad Politecnica de Cataluna, C/ Violinista Vellsola 37, 08222 Terrassa (Spain)

2011-01-01

The crystalline lens is the responsible for focusing at different distances (accommodation) in the human eye. This organ grows throughout life increasing in size and rigidity. Moreover, due this growth it loses transparency through life, and becomes gradually opacified causing what is known as cataracts. Cataract is the most common cause of visual loss in the world. At present, this visual loss is recoverable by surgery in which the opacified lens is destroyed (phacoemulsification) and replaced by the implantation of an intraocular lens (IOL). If the IOL implanted is mono-focal the patient loses its natural capacity of accommodation, and as a consequence they would depend on an external optic correction to focus at different distances. In order to avoid this dependency, multifocal IOLs designs have been developed. The multi-focality can be achieved by using either, a refractive surface with different radii of curvature (refractive IOLs) or incorporating a diffractive surface (diffractive IOLs). To analyze the optical quality of IOLs it is necessary to test them in an optical bench that agrees with the ISO119679-2 1999 standard (Ophthalmic implants. Intraocular lenses. Part 2. Optical Properties and Test Methods). In addition to analyze the IOLs according to the ISO standard, we have designed an optical bench that allows us to simulate the conditions of a real human eye. To do that, we will use artificial corneas with different amounts of optical aberrations and several illumination sources with different spectral distributions. Moreover, the design of the test bench includes the possibility of testing the IOLs under off-axis conditions as well as in the presence of decentration and/or tilt. Finally, the optical imaging quality of the IOLs is assessed by using common metrics like the Modulation Transfer Function (MTF), the Point Spread Function (PSF) and/or the Strehl ratio (SR), or via registration of the IOL's wavefront with a Hartmann-Shack sensor and its

Scleral suspension pars-plana lensectomy for ectopia lentis followed by suture fixation of intraocular lens

Directory of Open Access Journals (Sweden)

Mitra Sandip

2001-01-01

Full Text Available Purpose: To describe a simple technique of scleral suspension-pars plana lensectomy (SS-PPL in acquired and congenital ectopia lentis and scleral fixation of intraocular lens (IOL. Materials and Methods: Twenty eyes of 16 patients (12 unilateral and 4 bilateral cases of "essential familial lens subluxation" aged 10-40 years (mean 25 years underwent SS-PPL with implantation of scleral fixated IOL. Indications for surgery were best-corrected visual acuity <6/18, bisection of pupil by the lens, and lens-induced glaucoma. Prerequisites for SS-PPL were, visibility of part of the lens in the pupillary area and soft lens. Results: Postoperative visual acuity ranged from 6/6 - 6/36. Lens tilt in 3 cases(15% and small decentration in 2 cases(10% were seen; however these did not seriously compromise the visual result. Scant vitreous bleeding on the first postoperative day was seen in 3 cases (15%. Conclusion: The advantages of the scleral suspension of subluxated lens prior to lensectomy include stabilization; it allows proper viewing of the lens, avoids injury to the iris and cliary body during lensectomy and reduces the possibility of dislocation of the lens.

Bilateral intraocular lens subluxation secondary to haptic angulation.

Science.gov (United States)

Moreno-Montañés, Javier; Fernández-Hortelano, Ana; Caire, Josemaría

2008-04-01

An 82-year-old man had uneventful phacoemulsification with bilateral implantation of a hydrophilic acrylic, single-piece intraocular lens (IOL) (ACR6D SE, Laboratoires Cornéal). Five years later, simultaneous and bilateral IOL subluxations occurred. In both eyes, the subluxation was situated on the side of one haptic that had moved forward (temporal area in the right eye and superior area in the left eye). In the right eye, the haptic-capsular bag was entrapped by the pupil and produced endothelial damage. A transscleral suture was placed over and under the subluxated haptic through the anterior and posterior capsules to capture the haptic. The haptic was then sutured to the sclera. No postoperative complications developed. We hypothesize that 10-degree angulated and broad haptic junctions can lead to zonular damage and IOL subluxation.

[Opacification of an intraocular lens: calcification of hydrophilic intraocular lenses after gas tamponade of the anterior chamber].

Science.gov (United States)

Schmidinger, G; Pemp, B; Werner, L

2013-11-01

A patient with endothelial dystrophy was treated with Descemet stripping automated endothelial keratoplasty (DSAEK) combined with cataract extraction and implantation of a hydrophilic intraocular lens (IOL, Lentis-L312, Oculentis) but visual acuity dropped from 0.15 logMAR to 0.52 logMAR 18 months later due to calcification of the IOL. With new methods of lamellar corneal transplantation being used more frequently the number of necessary anterior chamber tamponades with air/gas are increasing. In cataract cases in which a gas tamponade and transplantation might be necessary later on (cornea guttata), hydrophilic IOLs should be avoided.

Phacoemulsification with intraocular lens implantation in primary angle-closure suspect, primary angle-closure and primary angle-closure glaucoma with cataract

Directory of Open Access Journals (Sweden)

Kun Zeng

2013-08-01

Full Text Available AIM: To evaluate the features and clinical outcomes of cataract extraction by phacoemulsification with intraocular lens implantation in primary angle-closure suspect(PACS, primary angle-closure(PACand primary angle-closure glaucoma(PACGwith cataract.METHODS:Phacoemulsification with intraocular lens implantation was performed on 86 cases(86 eyesdiagnosed as PACS, PAC and PACG co-existing cataract from January to December 2012. All cases were followed up for 3 months to 1 year. Pre-operative and post-operative visual acuity, intraocular pressure(IOP, gonioscopy, ultrasound biomicroscopy(UBM, visual field and usage of anti-glaucomaous eye drops were recorded.RESULTS:Zonular dialysis existed in 19 eyes(22%. The post-operative visual acuity improved in 84 eyes(98%. The post-operative visual acuity was CONCLUSION: PACS, PAC and PACG co-existing zonular dialysis is common. Phacoemulsification with IOL implantation can reduce IOP, deepen anterior chamber and open angle.

Fixed mydriatic pupil associated with an intraocular pressure rise as a complication of the implant of a Phakic Refractive Lens (PRL).

Science.gov (United States)

Pérez-Cambrodí, Rafael José; Piñero-Llorens, David Pablo; Ruiz-Fortes, Juan Pedro; Blanes-Mompó, Francisco Javier; Cerviño-Expósito, Alejandro

2014-07-01

We describe a case report of a patient that was implanted with a posterior chamber phakic intraocular lens (Phakic Refractive Lens, PRL) for the correction of moderate myopia and who developed postoperatively a fixed mydriasis compatible with an Urrets-Zavalia Syndrome (UZS). Specifically, a sudden acute increase of IOP in the left eye was observed in the immediate postoperative period. After IOP stabilization, the refractive result was good, but a fixed and mydriatic pupil appeared. This condition led the patient to experience visual discomfort, halos, and glare associated with high levels of higher-order aberrations in spite of the good visual result. A tinted-contact lens was fitted in order to minimize those symptoms. The UZS should be considered as a possible complication after implantation of posterior chamber phakic intraocular lenses.

Intraocular camera for retinal prostheses: Refractive and diffractive lens systems

Science.gov (United States)

Hauer, Michelle Christine

The focus of this thesis is on the design and analysis of refractive, diffractive, and hybrid refractive/diffractive lens systems for a miniaturized camera that can be surgically implanted in the crystalline lens sac and is designed to work in conjunction with current and future generation retinal prostheses. The development of such an intraocular camera (IOC) would eliminate the need for an external head-mounted or eyeglass-mounted camera. Placing the camera inside the eye would allow subjects to use their natural eye movements for foveation (attention) instead of more cumbersome head tracking, would notably aid in personal navigation and mobility, and would also be significantly more psychologically appealing from the standpoint of personal appearances. The capability for accommodation with no moving parts or feedback control is incorporated by employing camera designs that exhibit nearly infinite depth of field. Such an ultracompact optical imaging system requires a unique combination of refractive and diffractive optical elements and relaxed system constraints derived from human psychophysics. This configuration necessitates an extremely compact, short focal-length lens system with an f-number close to unity. Initially, these constraints appear highly aggressive from an optical design perspective. However, after careful analysis of the unique imaging requirements of a camera intended to work in conjunction with the relatively low pixellation levels of a retinal microstimulator array, it becomes clear that such a design is not only feasible, but could possibly be implemented with a single lens system.

In-the-bag decentration of a hydrophilic radially asymmetric multifocal intraocular lens secondary to capsule contraction.

NARCIS (Netherlands)

Linden, J.W.M. van der; Meulen, I.J. van der; Mourits, M.P.; Lapid-Gortzak, R.

2013-01-01

We report a case of in-the-bag decentration and tilt of a hydrophilic rotationally asymmetric multifocal intraocular lens (IOL) of the M Plus type secondary to capsule contraction. After uneventful surgery and follow-up for 3 months, progressive decentering and tilting of the IOL secondary to

Clinical and theoretical results of intraocular lens power calculation for cataract surgery after photorefractive keratectomy for myopia.

NARCIS (Netherlands)

Odenthal, M.T.; Eggink, C.A.; Melles, G.R.J.; Pameyer, J.H.; Geerards, A.J.; Beekhuis, W.H.

2002-01-01

OBJECTIVES: To describe the refractive results of cataract surgery after photorefractive keratectomy (PRK) for patients with myopia, and to find a more accurate method to predict intraocular lens (IOL) power in these cases. DESIGN: Nonrandomized, retrospective clinical study. PATIENTS AND METHODS:

Anterior haptic flexing and in-the-bag subluxation of an accommodating intraocular lens due to excessive capsular bag contraction.

Science.gov (United States)

Kramer, Gregory D; Werner, Liliana; Neuhann, Tobias; Tetz, Manfred; Mamalis, Nick

2015-09-01

We describe the case of a patient who had cataract surgery with implantation of the hydrophilic acrylic Tetraflex accommodating intraocular lens (IOL), with subsequent development of capsulorhexis phimosis and in-the-bag IOL subluxation. Contraction of the capsular bag secondary to fibrosis resulted in significant anterior flexing of the lens haptic component. Explantation of the IOL-capsular bag complex was required 7 years after implantation. Histopathologic analysis demonstrated multiple areas of thick anterior subcapsular fibrosis. Pseudoexfoliative material was present throughout the surface of the lens capsule. Intraocular lenses manufactured from hydrophilic acrylic material are highly flexible and may be more susceptible to capsule contraction, even in the absence of predisposing ocular and systemic conditions. This case highlights the importance of developing guidelines regarding patient screening and selection for the appropriate use of accommodating and other highly flexible IOLs. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Combined 23-gauge transconjunctival vitrectomy and scleral fixation of intraocular lens without conjunctival dissection in managing lens complications.

Science.gov (United States)

Yeung, Ling; Wang, Nan-Kai; Wu, Wei-Chi; Chen, Kuan-Jen

2018-04-23

To evaluate the safety and efficacy of combined 23-gauge transconjunctival pars plana vitrectomy and scleral fixation of intraocular lens (IOL) without conjunctival dissection. A retrospective study in Chang Gung Memorial Hospital, Keelung and Taoyuan, Taiwan. Patients receiving combined 23-gauge transconjunctival pars plana vitrectomy and scleral fixation of IOL without conjunctival dissection were enrolled. The ocular findings, causes of lens complication, surgical procedures, type of IOL used, and complications were documented. We included 40 eyes from 39 patients (27 male, 12 female) with a mean age of 59.5 [standard deviation (±) 14.8] years old. The mean follow-up duration was 6.8 ± 5.4 months. The cause of lens complications was ocular trauma in 24 (60%) eyes, cataract surgery complications in 11 (28%) eyes, and spontaneous subluxation of crystalline lens in 5 (13%) eyes. The overall best corrected visual acuity (BCVA) (logMAR) improved from 1.359 ± 0.735 to 0.514 ± 0.582 (p IOL decentration was found in 3 (8%) eyes and 1 (3%) eye respectively. Combined 23-gauge transconjunctival vitrectomy and scleral fixation of IOL without conjunctival dissection is effective and safe in managing a wide variety of lens complications, with good postoperative comfort and visual recovery. Retrospective study, not applicable.

Ultraviolet-B phototoxicity and hypothetical photomelanomagenesis: intraocular and crystalline lens photoprotection.

Science.gov (United States)

Mainster, Martin A; Turner, Patricia L

2010-04-01

Ultraviolet-B (UV-B) radiation can cause phototoxic macular injuries in young people who have been sunbathing but not sungazing and in welders. Welders have a reportedly increased risk of uveal melanoma. We analyze phakic and pseudophakic risks for solar and welding arc UV-B exposure. Optical radiation measurement, analysis, and perspective. Spectral transmittances were measured for UV-transmitting, UV-blocking, and blue-blocking intraocular lenses (IOLs). The photoprotective performances of crystalline and intraocular lenses were analyzed using relevant epidemiologic and laboratory data and action spectra for acute retinal phototoxicity and melanoma photocarcinogenesis. Crystalline lens UV-B retinal protection is deficient in children and young adults, increasing their potential susceptibility to acute retinal phototoxicity and hypothetical photomelanomagenesis. UV-B radiation has sufficient energy/photon to induce primary melanomagenic DNA lesions, unlike blue light or UV-A radiation. UV-blocking and blue-blocking IOLs have negligible UV-B transmittance. UV-transmitting IOL transmittance of UV-B radiation is equivalent to that of a 15-year-old crystalline lens. If optical radiation exposure is responsible for welders' increased risk of uveal melanoma, then UV-B radiation is the most probable causative agent and spectacle wear is a potential confounding factor in epidemiologic studies of ocular melanoma. Welders under 30 years of age are at greater risk for welding maculopathy than older welders. Children, adults under 30 years of age, and pseudophakic individuals with UV-transmitting IOLs should wear sunglasses in bright environments because of the UV-B window in their crystalline lenses or IOLs. Copyright 2010 Elsevier Inc. All rights reserved.

Postoperative diffuse opacification of a hydrophilic acrylic intraocular lens: analysis of an explant.

Science.gov (United States)

Cavallini, Gian Maria; Volante, Veronica; Campi, Luca; De Maria, Michele; Fornasari, Elisa; Urso, Giancarlo

2017-06-14

We describe the clinicopathological and ultrastructural features of an opaque single-piece hydrophilic acrylic intraocular lens (IOL) explanted from a patient. The main outcome of this report is the documentation of calcium deposits confirmed by surface analysis. The decrease in visual acuity was due to the opacification of the IOL. The opacification involved both the optic plate and the haptics. The analysis at the scansion electron microscope revealed that the opacity was caused by the deposition of calcium and phosphate within the lens optic and haptics. This is the first case about the opacification of an Oculentis L-313. The opacification was characterized by calcium and phosphate deposition probably due to a morphological alteration of the posterior surface of the IOL.

Capsular Outcomes After Pediatric Cataract Surgery Without Intraocular Lens Implantation

Science.gov (United States)

Tan, Xuhua; Lin, Haotian; Lin, Zhuoling; Chen, Jingjing; Tang, Xiangchen; Luo, Lixia; Chen, Weirong; Liu, Yizhi

2016-01-01

Abstract The objective of this study was to investigate capsular outcomes 12 months after pediatric cataract surgery without intraocular lens implantation via qualitative classification and quantitative measurement. This study is a cross-sectional study that was approved by the institutional review board of Zhongshan Ophthalmic Center of Sun Yat-sen University in Guangzhou, China. Digital coaxial retro-illumination photographs of 329 aphakic pediatric eyes were obtained 12 months after pediatric cataract surgery without intraocular lens implantation. Capsule digital coaxial retro-illumination photographs were divided as follows: anterior capsule opening area (ACOA), posterior capsule opening area (PCOA), and posterior capsule opening opacity (PCOO). Capsular outcomes were qualitatively classified into 3 types based on the PCOO: Type I—capsule with mild opacification but no invasion into the capsule opening; Type II—capsule with moderate opacification accompanied by contraction of the ACOA and invasion to the occluding part of the PCOA; and Type III—capsule with severe opacification accompanied by total occlusion of the PCOA. Software was developed to quantitatively measure the ACOA, PCOA, and PCOO using standardized DCRPs. The relationships between the accurate intraoperative anterior and posterior capsulorhexis sizes and the qualitative capsular types were statistically analyzed. The DCRPs of 315 aphakic eyes (95.8%) of 191 children were included. Capsular outcomes were classified into 3 types: Type I—120 eyes (38.1%); Type II—157 eyes (49.8%); Type III—38 eyes (12.1%). The scores of the capsular outcomes were negatively correlated with intraoperative anterior capsulorhexis size (R = −0.572, P PCOA increased in size from Type I to Type II, and the PCOO increased from Type II to Type III (all P < 0.05). Capsular outcomes after pediatric cataract surgery can be qualitatively classified and quantitatively measured by acquisition, division

Personalización de las constantes en las fórmulas de cálculo de la lente intraocular Personalization of constants in the intraocular lens calculation formulas

Directory of Open Access Journals (Sweden)

Anneé Miranda Carracedo

2012-12-01

Full Text Available Objetivo: personalizar las constantes A, factor cirujano y profundidad de la cámara anterior para las fórmulas de cálculo de la lente intraocular en la cirugía de catarata en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" de mayo de 2007 a enero de 2011. Métodos: se realizó un estudio descriptivo retrospectivo donde se estudiaron las constantes A, factor cirujano y profundidad de la cámara anterior. También se evaluó la longitud axial preoperatoria por IOL Master, la mejor agudeza visual sin corrección, el componente esférico esperado, el componente esférico obtenido y los resultados refractivos. Resultados: las constantes optimizadas por interferometría de coherencia parcial son diferentes a las propuestas por los fabricantes de las lentes intraoculares. Estas constantes personalizadas para cada cirujano no mostraron diferencias significativas. Las constantes optimizadas según las longitudes axiales, tienen diferencias significativas en los 3 grupos de estudio. La diferencia entre la lente intraocular implantada y la propuesta con las nuevas constantes resultó menor de 1 D de error en 83,1 % de los pacientes. El 75,4 % quedó bien corregido en relación con la diferencia entre la refracción esperada y la obtenida. Conclusiones: las constantes optimizadas por interferometría de coherencia parcial resultan más elevadas que las propuestas por el fabricante. La optimización de estas en el cálculo de la lente permite, de acuerdo a las características individuales de cada ojo (longitud axial, usar la fórmula adecuada e incrementa la predictibilidad de los resultados refractivos posoperatorios.Objective: to personalize the A, surgeon factor and anterior chamber depth constants for intraocular lens calculation formulas in the cataract surgery at the “Ramón Pando Ferrer” Cuban Ophthalmological Institute from May 2007 to January 2011. Method: a retrospective and descriptive study was made to study the A constant

[Laser magnetotherapy after cataract extraction with implantation of intraocular lens].

Science.gov (United States)

Maksimov, V Iu; Zakharova, N V; Maksimova, I S; Golushkov, G A; Evseev, S Iu

2002-01-01

Effects of low-intensive laser and alternating magnetic field on the course of the postoperative period were studied in patients with exudative reaction after extracapsular cataract extraction with implantation of intraocular lens (IOL). The results are analyzed for 148 eyes with early exudative reaction after IOL implantation (136 patients aged 42-75 years). The patients were observed for up to 6 months. The treatment efficiency was evaluated by the clinical picture of inflammatory reaction, visual acuity, and results of biochemical analysis of the lacrimal fluid (the ratio of lipid peroxidation products to antioxidants in cell membrane). The course of the postoperative period was more benign and recovery sooner in patients of the main group in comparison with the control.

Assessment of the safety and efficacy of primary retropupillary fixation of iris-claw intraocular lenses in children with large lens subluxations.

Science.gov (United States)

Rastogi, Anju; Goray, Apurva; Thacker, Prolima; Kamlesh; Babita

2017-08-17

To evaluate whether retropupillary fixation of the iris-claw intraocular lens (IOL) is a safe and effective treatment option in children with large lens subluxations. Fourteen eyes of children between the ages of 8-17 years with lens subluxations more than 7 clock hours underwent pars plana lensectomy-vitrectomy with implantation of the iris-claw IOL in the retropupillary position as a primary procedure. The best corrected visual acuity (BCVA), intraocular pressure (IOP), corneal endothelial count (EC) and the lens position using ultrasound biomicroscopy (UBM) were assessed pre- and postoperatively. Postoperatively, all patients had an increase in the BCVA with a mean of 0.351 ± 0.154 log MAR units which was statistically significant as compared to the preoperative value of 0.771 ± 0.132 log MAR units (p = 0.003). The difference between the mean preoperative IOP (13.642 ± 2.437 mmHg) and the mean postoperative intraocular pressure at the end of 6 months (13.5 ± 2.244 mmHg) was not statistically significant (p = 0.671). The mean EC decreased by 0.99% from 2838.42 ± 474.76 cells/mm 2 preoperatively to 2810 ± 461.24 cells/mm 2 at the end of 6 months postoperatively (p = 0.117). The lens position was analyzed using UBM and was found to be parallel to the iris plane in all cases at the end of 6 months. Our study shows that primary retropupillary iris-claw IOL implantation can be a safe and efficacious option for children with large (>7 clock hours) lens subluxations that is at least comparable to scleral-fixated PCIOLs.

Motorized injector-assisted intrascleral intraocular lens fixation.

Science.gov (United States)

Hung, Jia-Horung; Wang, Shih-Hao; Teng, Yu-Ti; Hsu, Sheng-Min

2017-03-01

For eyes with deficient capsular support, intraocular lens (IOL) implantation has long been a technical challenge. Recently, intrascleral fixation of the haptics of a three-piece posterior chamber IOL has become a popular option. In this procedure, externalization of the leading haptic during IOL injection is a stressful step. We present a modified technique to improve the ease and safety of this step. Our modified technique involves IOL injection with a motorized injector with several important modifications described here. With these modifications, a surgeon can easily maintain the correct orientation of the IOL in a well-controlled manner during IOL injection. The records of 13 patients who underwent this technique were retrospectively evaluated. Corrected-distance visual acuity improved significantly after surgery (pIOL decentration, or vitreous hemorrhage was noted during the follow-up period. In conclusion, the motorized injector-assisted intrascleral IOL fixation technique is a safe and effective alternative to the conventional procedure. This technique makes the process of leading haptic externalization easier and more controllable. Copyright © 2017. Published by Elsevier Taiwan.

Motorized injector-assisted intrascleral intraocular lens fixation

Directory of Open Access Journals (Sweden)

Jia-Horung Hung

2017-03-01

Full Text Available For eyes with deficient capsular support, intraocular lens (IOL implantation has long been a technical challenge. Recently, intrascleral fixation of the haptics of a three-piece posterior chamber IOL has become a popular option. In this procedure, externalization of the leading haptic during IOL injection is a stressful step. We present a modified technique to improve the ease and safety of this step. Our modified technique involves IOL injection with a motorized injector with several important modifications described here. With these modifications, a surgeon can easily maintain the correct orientation of the IOL in a well-controlled manner during IOL injection. The records of 13 patients who underwent this technique were retrospectively evaluated. Corrected-distance visual acuity improved significantly after surgery (p<0.05. No postoperative retinal detachment, endophthalmitis, IOL decentration, or vitreous hemorrhage was noted during the follow-up period. In conclusion, the motorized injector-assisted intrascleral IOL fixation technique is a safe and effective alternative to the conventional procedure. This technique makes the process of leading haptic externalization easier and more controllable.

Towards customized intraocular lenses

NARCIS (Netherlands)

de Jong, Tim

2017-01-01

In the eye there are two refractive components that make light focus on the retina and let you see: the cornea and the lens. When a eye develops cataract the lens becomes caractarous and is removed and replaced with a synthetic intraocular lens during a cataract surgery procedure. Although there was

Evaluation of Artisan aphakic intraocular lens in cases of pediatric aphakia with insufficient capsular support.

Science.gov (United States)

Gawdat, Ghada I; Taher, Sameh G; Salama, Marwa M; Ali, Adel A

2015-06-01

To evaluate the visual outcomes and complications after Artisan iris-claw lens implantation in aphakic children with insufficient capsular support. In this prospective, interventional noncontrolled study, aphakic eyes of consecutive patients >2 years of age with insufficient capsular support who underwent Artisan intraocular lens (IOL) implantation between June 2011 and December 2012 were followed for 1 year. Patients with anterior chamber depth IOL were included, 18 eyes with subluxated lens and 7 following trauma. The mean preoperative logMAR best-corrected visual acuity for traumatic aphakic patients was 0.95 ± 0.36; for patients with subluxation, 0.7 ± 0.26. Values improved at 1 year to 0.38 ± 0.15 (P IOL implantation for pediatric aphakia achieved a good visual outcome. Copyright © 2015 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

Associated depression in pseudophakic patients with intraocular lens with and without chromophore

Directory of Open Access Journals (Sweden)

Mendoza-Mendieta ME

2016-03-01

Full Text Available María Elena Mendoza-Mendieta, Ana Aurora Lorenzo-Mejía Association to Prevent Blindness in Mexico (APEC, Hospital “Dr Luis Sánchez Bulnes”, Mexico City, Mexico Background: With aging, the crystalline lens turns yellowish, which increases the absorption of wavelengths in the blue electromagnetic spectrum, reducing their photoreception in the retina. Since these wavelengths are the main stimulus in the regulation of the circadian rhythm, progressive reduction in their transmission is associated with chronic sleep disturbances and depression in elderly patients. Cataract extraction improves circadian photoreception at any age. However, lenses that block blue waves have 27% to 38% less melatonin suppression than lenses that block only ultraviolet (UV rays. Purpose: To assess the depression symptoms in subjects who have had bilateral phacoemulsification and intraocular lens (IOL implants, one group with yellow chromophore IOLs and the other group with transparent IOLs were compared. Setting: Association to Prevent Blindness in Mexico (APEC, Hospital “Dr Luis Sánchez Bulnes”. Design: This was an observational, cross-sectional, and single-center study. Materials and methods: Twenty-six subjects between 60 and 80 years of age, with a history of bilateral phacoemulsification and placement of the same type of IOL in both eyes from 4 to 12 months prior to the study, who attended the follow-up visits and agreed to participate in this study, and provided signed informed consent were included in the study. They were asked to answer the short version of the 15-item Geriatric Depression Scale. Results: The average age of the study participants was 72.5±5.94 years. The group without chromophore included 46.1% (n=12 of the patients and the group with chromophore included 53.9% (n=14 of the patients (P=0.088. Conclusion: In the group of patients with IOLs that block the passage of blue light, the depression rate was 21.4%, a rate similar to that

Implantation of iris-claw Artisan intraocular lens for aphakia in Fuchs′ heterochromic iridocyclitis

Directory of Open Access Journals (Sweden)

Ahmad Kheirkhah

2014-01-01

Full Text Available Implantation of iris-claw Artisan intraocular lens (IOL is a surgical option for correction of aphakia; however, these IOLs have not been used in eyes with uveitis including Fuchs′ heterochromic iridocyclitis (FHI due to possible risk of severe postoperative intraocular inflammation. In the case reported here, we secondarily implanted an Artisan IOL in a 28-year-old man with FHI who had aphakia with no capsular support due to a previous complicated cataract surgery. Enclavation was easily performed and no intraoperative complication was noted. Postoperative course was uneventful with no significant anterior chamber inflammation during 12 months of follow-up. Although there were few deposits on the IOL surface, the patient achieved a best-corrected visual acuity of 20/20 without developing glaucoma or other complications. Therefore, Artisan IOL may be considered for correction of aphakia in patients with FHI. However, studies on large number of patients are required to evaluate safety of the procedure.

Intraocular lens opacification after Descemet's stripping automated endothelial keratoplasty

Directory of Open Access Journals (Sweden)

Meng-Sheng Lee

2017-01-01

Full Text Available Compared with conventional penetrating keratoplasty, Descemet's stripping automated endothelial keratoplasty (DSAEK more effectively maintain global integrity and rapid vision rehabilitation with less ocular surface disorders in patients with endothelial dysfunction. Here, we report a case of a 76-year-old woman who experienced opacification of a hydrophilic intraocular lens (IOL approximately 10 months after DSAEK. The patient with no history of systemic disease developed pseudophakic bullous keratopathy in the right eye 2 years after undergoing cataract surgery. The best-corrected visual acuity (BCVA of the right eye was Snellen 0.01 when presented to our hospital. DSAEK was arranged and performed smoothly. However, the graft detached over the upper part of the cornea on postoperative day 1. Thus, rebubbling was performed immediately. After the procedure, the graft was well attached, and the cornea became clear gradually. The BCVA returned to Snellen 0.6. However, progressive opacification over the anterior surface of the IOL was observed 10 months postoperatively. Vision deteriorated to 0.5 with various refractive errors during 2-year follow-up. IOL exchange may be considered if the vision is getting worse. IOL opacification may result from a direct contact between the IOL surface and exogenous air, particularly in a hydrophilic IOL, and can be a rare but significant complication after DSAEK. Clinicians planning to perform DSAEK should consider the composition of the IOL, the amount of intracameral air, duration of air filling, and high intraocular pressure.

Use of intraocular lenses in children with traumatic cataract in south India

OpenAIRE

Eckstein, M.; Vijayalakshmi, P; Killedar, M.; Gilbert, C.; Foster, A.

1998-01-01

AIMS—To assess the long term results of intraocular lens (IOL) implantation for traumatic cataract in young children in a developing country.
METHODS—Prospective hospital based study of 52 children (age 2-10 years) undergoing unilateral cataract extraction and IOL insertion for traumatic cataract performed by a single surgeon in south India. Children were reviewed regularly and followed up initially for 3 years.
RESULTS—There were no serious operative complications. Clinically significant pos...

Pigment dispersion and Artisan phakic intraocular lenses: crystalline lens rise as a safety criterion.

Science.gov (United States)

Baïkoff, Georges; Bourgeon, Grégoire; Jodai, Horacio Jitsuo; Fontaine, Aline; Lellis, Fernando Viera; Trinquet, Laure

2005-04-01

To validate the theory that crystalline lens rise can be used as a safety criterion to prevent pigment dispersion in eyes with an Artisan phakic intraocular lens (IOL) (Ophtec BV). Monticelli Clinic, Marseilles, France. A comparative analysis of crystalline lens rise in 9 eyes with pigment dispersion and 78 eyes without dispersion was performed. All eyes had previous implantation of an Artisan IOL. Anterior segment imaging was done using an anterior chamber optical coherence tomography (AC OCT) prototype. Crystalline lens rise was defined by the distance between the anterior pole of the crystalline lens and the horizontal plane joining the opposite iridocorneal recesses. The study confirmed that crystalline lens rise can be considered a safety criterion for implantation of Artisan-type phakic IOLs. The higher the crystalline lens rise, the greater the risk for developing pigment dispersion in the area of the pupil. This complication occurred more frequently in hyperopic eyes than in myopic eyes. Results indicate there is little or no risk for pigment dispersion if the rise is less than 600 microm; 67% of eyes with a rise of 600 microm or more developed pupillary pigment dispersion. In some cases in which the IOL was loosely fixated, there was no traction on the iris root and dispersion was prevented or delayed. Crystalline lens rise should be considered a new safety criterion for Artisan phakic IOL implantation and should also be applied to other types of phakic IOLs. The distance remaining between the crystalline lens rise and a 600 microm theoretical safety level allows one to calculate how long the IOL can safely remain in the eye.

Lente intra-ocular opaca em diplopia intratável: relato de caso Opaque intraocular lens in intractable diplopia: case report

Directory of Open Access Journals (Sweden)

Fernanda Teixeira Krieger

2006-08-01

Full Text Available Diplopia intratável tem sido descrita em várias situações. Métodos convencionais como prismas e correção cirúrgica do estrabismo falham em neutralizá-la. O objetivo do trabalho é documentar o caso de uma paciente com estrabismo de longa data, cuja diplopia deteriorou-se ao longo dos anos, e não foi possível resolução com cirurgia, prisma, e oclusão com óculos e lente de contato com pupila opaca. A paciente foi então submetida à facoemulsificação com implante de lente intra-ocular opaca que atingiu o objetivo desejado.Intractable diplopia has been described in many situations but poor results are the rule with standard treatment modalities. The authors report a case of a woman with long-standing strabismus and diplopia who failed to improve following surgery, prism, and occlusive spectacles or contact lenses. Then, she was submitted to phacoemulsification and opaque intraocular lens implantation, which successfully neutralized diplopia.

Management of mydriasis and pain in cataract and intraocular lens surgery: review of current medications and future directions

Directory of Open Access Journals (Sweden)

Grob SR

2014-07-01

Full Text Available Seanna R Grob,1–3 Luis A Gonzalez-Gonzalez,1–3 Mary K Daly1,2,4 1Department of Ophthalmology, Veterans Administration Boston Healthcare System, Boston, MA, USA; 2Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; 3Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA; 4Department of Ophthalmology, Boston University School of Medicine, Boston, MA, USA Abstract: The maintenance of mydriasis and the control of postoperative pain and ­inflammation are critical to the safety and success of cataract and intraocular lens replacement surgery. Appropriate mydriasis is usually achieved by topical and/or intracameral administration of anticholinergic agents, sympathomimetic agents, or both, with the most commonly used being cyclopentolate, tropicamide, and phenylephrine. Ocular inflammation is common after cataract surgery. Topical steroids and nonsteroidal anti-inflammatory drugs are widely used because they have been proved effective to control postsurgical inflammation and decrease pain. Topical nonsteroidal anti-inflammatory drugs have also been shown to help maintain dilation. However, use of multiple preoperative drops for pupil dilation, inflammation, and pain control have been shown to be time consuming, resulting in delays to the operating room, and they cause dissatisfaction among perioperative personnel; their use can also be associated with systemic side effects. Therefore, ophthalmologists have been in search of new options to streamline this process. This article will review the current medications commonly used for intraoperative mydriasis, as well as pain and inflammation control. In addition, a new combination of ketorolac, an anti-inflammatory agent, and phenylephrine, a mydriatic agent has recently been designed to maintain intraoperative mydriasis and to reduce postoperative pain and irritation from intraocular lens replacement surgery. Two Phase III clinical trials evaluating this

Intraocular Lens Dislocation after Cataract Surgery in Tambolaka, Southwest Sumba, Indonesia: A Case Report

OpenAIRE

Ratna Sitompul

2018-01-01

Intraocular lens (IOL) dislocation is a rare complication of cataract extraction requiring prompt surgery. This case report aims to raise awareness of such cases and the importance of post-surgery follow-up. A 58-year-old female patient was found with anterior IOL dislocation a week after phacoemulsification surgery in her right eye. Visual acuity of the right eye was 1/60 with ciliary injection and IOL dislocation to the anterior chamber of the right eye. The patient underwent surgery of the...

Surgical management of spontaneous in-the-bag intraocular lens and capsular tension ring complex dislocation

Directory of Open Access Journals (Sweden)

Uzeyir Gunenc

2014-01-01

Full Text Available We describe a technique to manage late spontaneous intraocular lens (IOL and capsular tension ring (CTR dislocation within the intact capsular bag. The subluxated IOL and CTR complex can be positioned in a closed chamber and fixed to the pars plana at both 3 and 9 o′clock quadrants with the presented ab externo direct scleral suturation technique which provides an easy, safe and effective surgical option for such cases.

Professor Peter Choyce: an early pioneer of intraocular lenses and corneal/refractive surgery.

Science.gov (United States)

Pandey, Suresh K; Apple, David J

2005-06-01

Professor Peter Choyce, FRCS, DOMS, MS, was one of the pioneers of intraocular lens implant surgery. He developed an interest in artificial lens implantation following cataract surgery, a procedure that was widely criticized by the ophthalmic establishment in the UK, Europe, North America and other countries. Owing to the opposition to the intraocular lenses, Peter Choyce together with Sir Harold Ridley co-founded the International Intraocular Implant Club in 1966, which was responsible for the gradual acceptance of artificial lens implantation. Peter Choyce developed several models of intraocular lens, but did not patent the majority of them. The Choyce Mark IX, manufactured by Rayner Intraocular Lenses, became the first US Food and Drug Administration-approved intraocular lens in 1981. A review of Peter Choyce's record confirms a significant number of original innovations in the field of anterior segment surgery, including many procedures taken for granted today, but not associated with his name. These include early work on both kerato- and intraocular lens-refractive procedures, keratoprosthesis, pioneering paediatric implant procedures and others. Unfortunately his tenacious adherence to anterior chamber lens technology, while in general clinically sound, caused many to question his influence and hence he remained poorly understood even until after his death. He passed away on 8 August 2001 after a long fight with colon cancer. In this article, we provide evidence and elaborate Peter Choyce's accomplishments, which places him as one of the most innovative ophthalmologist in his surgical field in the twentieth century.

Avaliação da sensibilidade ao contraste e da estereopsia em pacientes com lente intra-ocular multifocal Contrast sensitivity and stereopsis in pseudophakic patients with multifocal intraocular lens

Directory of Open Access Journals (Sweden)

Filipe de Oliveira

2005-08-01

Full Text Available OBJETIVO: Avaliar a sensibilidade ao contraste e a acuidade estereoscópica em pacientes pseudofácicos, que receberam implante bilateral de lente intra-ocular multifocal. MÉTODOS: Prospectivamente foram realizados testes de sensibilidade ao contraste com o uso da tabela Pelli-Robson e teste de acuidade estereoscópica com emprego do Titmus Stereo Test, em 20 pacientes com implante bilateral de lente intra-ocular multifocal Acrysof Restor®, no pós-operatório de 1 a 2 meses e sem uso de qualquer correção óptica. RESULTADOS:O teste de sensibilidade ao contraste binocular demonstrou que 6 pacientes (30% apresentaram 1,80 unid. log, 13 (65% 1,65 e 1 (5% 1,50. No teste monocular, ocorreram as seguintes respostas: 17 pacientes (85% 1,65 unid. log e 3 (15% 1,50 para o teste do olho direito. O teste do olho esquerdo mostrou que 16 pacientes (80% apresentaram 1,65 unid. log e 4 (20% 1,50. A média e o desvio-padrão da sensibilidade ao contraste testada binocularmente foi 1,69 (±0,08, ao passo que monocularmente foi 1,63 (±0,05 para OD e 1,62 (±0,06 para OE. O teste de acuidade estereoscópica revelou que 12 pacientes (60% obtiveram 40", 6 (30% 50" e 2 (10% 60", com média de 45" e desvio-padrão de ±6,88". CONCLUSÃO: A lente intra-ocular empregada no estudo, proporcionou resultados de sensibilidade ao contraste e acuidade estereoscópica compatíveis e de acordo com critérios de normalidade estabelecidos anteriormente por outros estudos em grupos de pacientes fácicos e pseudofácicos, e portanto, impacto positivo na funcionalidade visual.PURPOSE: To evaluate the contrast sensitivity and stereopsis tests in patients who underwent bilateral implantation of multifocal intraocular lens. METHODS: Tests of contrast sensitivity using the Pelli-Robson chart and stereopsis evaluation with the Titmus Stereo Test were performed in 20 patients 30-60 days after the bilateral implantation of Acrysof Restor® multifocal intraocular lens. RESULTS: The

Bioptics in sutureless intrascleral multifocal posterior chamber intraocular lens fixation.

Science.gov (United States)

Pavlidis, Mitrofanis; de Ortueta, Diego; Scharioth, Gabor B

2011-05-01

To present a technique for sutureless fixation of a three-piece, multifocal, posterior chamber intraocular lens (IOL) in the ciliary sulcus. A 24-year-old woman presented with bilateral subluxation of the crystalline lens. Two straight sclerotomies were prepared with a 24-gauge cannula 2.0 mm from the limbus 180° apart from each other. The cannula was used to create a 2.0- to 3.0-mm tunnel parallel to the limbus starting from the sclerotomies. The leading haptic of the multifocal IOL was grasped at its tip with end-gripping, 25-gauge forceps and pulled through the sclerotomy. The forceps was used to introduce the IOL haptic into the scleral tunnel parallel to the limbus. Multifocal posterior chamber IOLs were stable and well centered. No postoperative complications occurred in the 16-month follow-up period. Preoperative astigmatism was corrected after IOL implantation with corneal wavefront-guided laser epithelial keratomileusis. Sutureless fixation of multifocal posterior chamber IOL haptics in a scleral tunnel parallel to the limbus can be successful, resulting in long-term centration and three-dimensional axial stability for optimal refractive results. If necessary, postoperative wavefront-guided refractive correction can be performed to optimize final refraction. Copyright 2011, SLACK Incorporated.

Comparison of a trifocal intraocular lens with a+3.0 D bifocal IOL: results of a prospective randomized clinical trial

NARCIS (Netherlands)

Jonker, S.M.R.; Bauer, N.J.C.; Makhotkina, N.Y.; Berendschot, T.T.J.M.; van den Biggelaar, F.J.H.M.; Nuijts, R.M.M.A.

Purpose To compare visual outcomes in patients with cataract surgery and bilateral implantation of a trifocal or bifocal intraocular lens (IOL). Setting University Eye Clinic Maastricht, the Netherlands. Design Prospective randomized clinical trial. Methods Eyes with cataract and less than 1.0

Intraocular pressure and ocular pulse amplitude using dynamic contour tonometry and contact lens tonometry.

Science.gov (United States)

Hoffmann, Esther M; Grus, Franz-H; Pfeiffer, Norbert

2004-03-23

The new Ocular Dynamic Contour Tonometer (DCT), investigational device supplied by SMT (Swiss Microtechnology AG, Switzerland) allows simultaneous recording of intraocular pressure (IOP) and ocular pulse amplitude (OPA). It was the aim of this study to compare the IOP results of this new device with Goldmann tonometry. Furthermore, IOP and OPA measured with the new slitlamp-mounted DCT were compared to the IOP and OPA measured with the hand-held SmartLens,a gonioscopic contact lens tonometer (ODC Ophthalmic Development Company AG, Switzerland). Nineteen healthy subjects were included in this study. IOP was determined by three consecutive measurements with each of the DCT, SmartLens, and Goldmann tonometer. Furthermore, OPA was measured three times consecutively by DCT and SmartLens. No difference (P = 0.09) was found between the IOP values by means of DCT (mean: 16.6 mm Hg, median: 15.33 mm Hg, SD: +/- 4.04 mm Hg) and Goldmann tonometry (mean: 16.17 mm Hg, median: 15.33 mm Hg, SD: +/- 4.03 mm Hg). The IOP values of SmartLens (mean: 20.25 mm Hg, median: 19.00 mm Hg, SD: +/- 4.96 mm Hg) were significantly higher (P = 0.0008) both from Goldmann tonometry and DCT. The OPA values of the DCT (mean: 3.08 mm Hg, SD: +/- 0.92 mm Hg) were significantly lower (P = 0.0003) than those obtained by SmartLens (mean: 3.92 mm Hg, SD: +/- 0.83 mm Hg). DCT was equivalent to Goldmann applanation tonometry in measurement of IOP in a small group of normal subjects. In contrast, SmartLens (contact lens tonometry) gave IOP readings that were significantly higher compared with Goldmann applanation tonometer readings. Both devices, DCT and SmartLens provide the measurement of OPA which could be helpful e.g. for the management of glaucoma.

Fungal endophthalmitis caused by Paecilomyces variotii, in an immunocompetent patient, following intraocular lens implantation

Directory of Open Access Journals (Sweden)

Anita K

2010-01-01

Full Text Available We report the case of a 70-year-old man who was admitted for anterior endophthalmitis following an intraocular lens implantation. He had developed a fluffy growth resembling a fungal mass on the iris of the right eye. The mass was removed and sent for fungal studies to our department. Direct microscopy revealed hyphae. Further studies helped identify the fungus to belong to genus Paecilomyces. This is a rare case of fungal endophthalmitis caused by Paecilomyces variotii in an immunocompetent person.

Reverse pupillary block associated with pigment dispersion syndrome after in-the-bag intraocular lens implantation.

Science.gov (United States)

Itagaki, Hideo; Kunikata, Toshio; Hiratsuka, Kentaro; Saito, Junichiro; Oshika, Tetsuro

2013-12-01

A 61-year-old man with high myopia who had received a systemic α1A-adrenoceptor antagonist had phacoemulsification and in-the-bag intraocular lens implantation in the right eye. One day postoperatively, marked pigment dispersion in the anterior chamber, posterior bowing of the iris, and iridodonesis were noted associated with a subsequent elevation in intraocular pressure (IOP). Pharmacological pupil dilation was effective in reducing pigment dispersion and IOP, and laser peripheral iridotomy was performed to alleviate posterior bowing of the iris. We hypothesize that dynamic changes in the aqueous humor flow by cataract surgery and latent flaccidity of the iris due to the systemic α1A-adrenoceptor antagonist caused reverse pupillary block. High myopia may be another risk factor for this complication. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Sutureless intrascleral intraocular lens fixation with lamellar dissection of scleral tunnel

Directory of Open Access Journals (Sweden)

Kawaji T

2016-01-01

Full Text Available Takahiro Kawaji,1,2 Tomoki Sato,2 Hidenobu Tanihara11Department of Ophthalmology, Faculty of Life Sciences, Kumamoto University, Chuo-ku, 2Sato Eye & Internal Medicine Clinic, Kumamoto, JapanPurpose: To report the results of sutureless scleral fixation of a posterior chamber intraocular lens (IOL by using our developed simple technique.Methods: We retrospectively reviewed the medical records of 48 eyes of 47 patients who underwent sutureless intrascleral IOL fixation by using our modified technique. A 25-gauge microvitreoretinal knife was used to perform sclerotomies and create limbus-parallel scleral tunnels with lamellar dissection in which the haptics were fixed.Results: The IOLs were fixed and centered well. The mean follow-up period was 26.7 months. Postoperative complications included smooth vitreous hemorrhage in four eyes (8.3%, cystoid macular edema in two eyes (4.2%, and iris capture of the IOL in two eyes (4.2%. No other complications, such as breakage of the IOL, spontaneous IOL dislocation, or retinal detachment, were detected during the follow-up period.Conclusion: The lamellar dissection of the limbus-parallel scleral tunnel can simplify the forceps-assisted introduction of the haptics into the scleral tunnel, and this technique seemed to be safe.Keywords: intraocular lenses, ophthalmologic surgical procedures, intrascleral fixation, sutureless fixation

A comparison of two different formulations of diclofenac sodium 0.1% in the treatment of inflammation following cataract-intraocular lens surgery.

Science.gov (United States)

Mester, Ulrich; Lohmann, Chris; Pleyer, U; Steinkamp, G; Völcker, E; Kruger, H; Raj, Palaniswamy Sunder

2002-01-01

To compare the efficacy, tolerability and local tolerance of diclofenac sodium 0.1% containing hydroxypropylgamma cyclodextrin preserved with benzalkonium chloride 0.005% (Voltaren Ophtha CD), with that of diclofenac sodium 0.1% preserved with thiomersal 0.004% (Voltaren Ophtha) in the treatment of inflammation after cataract-intraocular lens surgery. Randomised 2:1, double-masked, parallel-group study in six centres in Germany. 299 patients scheduled to undergo phacoemulsification with posterior chamber intraocular lens implantation. Study medications were instilled four times in the 30 minutes before surgery and four times daily from the first postoperative day. The key efficacy variable was the reduction in anterior chamber flare (photons/millisecond) from day 1 to day 6 to 8. Patients underwent comprehensive ocular examinations, including laser flaremetry (KOWA), preoperatively and postoperatively at days 1, 6 to 8 and 24 to 32. 268 patients (Voltaren Ophtha CD 177, Voltaren Ophtha 91) completed the day 6 to 8 visit without any protocol violations. Reduction in the degree of intraocular inflammation with Voltaren Ophtha CD was equivalent to that achieved with Voltaren Ophtha at the day 6 to 8 [95% confidence interval (CI) -3.07 to +0.54] and day 24 to 32 (95% CI -1.44 to +1.40) visits. Although there was no significant (p = 0.464) difference between the two study groups in patients' global assessment of local tolerance at day 24 to 32, ocular discomfort was significantly (p = 0.023) less with Voltaren Ophtha CD compared with Voltaren Ophtha. Voltaren Ophtha CD was as effective and well tolerated but had less ocular discomfort compared with Voltaren Ophtha in the treatment of ocular inflammation after phacoemulsification with intraocular lens implantation. This new formulation of diclofenac sodium 0.1% may be used as an alternative to the existing formulations of ophthalmic diclofenac sodium 0.1%.

Uneventful Anterior Migration of Intravitreal Ozurdex Implant in a Patient with Iris-Sutured Intraocular Lens and Descemet Stripping Automated Endothelial Keratoplasty.

Science.gov (United States)

Zafar, Andleeb; Aslanides, Ioannis M; Selimis, Vasileios; Tsoulnaras, Konstantinos I; Tabibian, David; Kymionis, George D

2018-01-01

We report here the case of a patient with anterior segment migration of intravitreal dexamethasone implant as well as its management and outcome. The patient had the following sequence of events: complicated cataract surgery, iris-sutured intraocular lens implant, followed by cystoid macular edema treated with intravitreal Avastin, retinal vein occlusion treated with intravitreal dexamethasone implant, corneal decompensation treated with Descemet stripping automated endothelial keratoplasty (DSAEK), and finally recurrence of macular edema treated with repeated intravitreal dexamethasone implant. Dexamethasone implant had completely dissolved from the eye 12 weeks after insertion without any complication. A conservative approach with regular monitoring in the situation of a quiet anterior segment without any corneal decompensation can provide enough time for the implant to dissolve without causing any complication to the involved eye, avoiding any additional surgical intervention, as presented in this case report. Despite the fact that the implant was left for natural dissolution, there were no adverse effects related to the graft or the eye.

A study regarding efficacy of various intraocular lens power calculation formulas in a subset of Indian myopic population

Directory of Open Access Journals (Sweden)

Ashish Mitra

2014-01-01

Full Text Available Efficacy of intraocular lens power calculation formulas in a subset of Indian myopic population. Retrospectively reviewed 43 patients who underwent phacoemulsification with high axial length (AL (>24.5 mm, range 24.75-32.35 mm. The power of the implanted intraocular lens (IOL was used to calculate the predicted post-operative refractive error by four formulas: Sanders-Retzlaff-Kraff (SRK II, SRK/T, Holladay 1, and Hoffer Q. The predictive accuracy of the formulas was analyzed by comparing the difference between the "actual" and "predicted" postoperative refractive errors. Repeated measures analysis of variance (ANOVA tests were done to have pair-wise comparisons between the formulas and P < 0.05 was considered significant. A subcategory of axial length 24.5-26.5 mm was also tested. Holladay 1, Hoffer Q and SRK/T formulas showed a slight tendency toward resultant hyperopia, with mean error of +0.24 diopters (D, +0.58 D, and +0.92 D, respectively. The Holladay 1 formula provided the best predictive result overall.

Validity of automated refraction after segmented refractive multifocal intraocular lens implantation.

Science.gov (United States)

Albarrán-Diego, César; Muñoz, Gonzalo; Rohrweck, Stephanie; García-Lázaro, Santiago; Albero, José Ricardo

2017-01-01

To evaluate the clinical utility of automated refraction (AR) and keratometry (KR) compared with subjective or manifest refraction (MR) after cataract or refractive lens exchange surgery with implantation of Lentis Mplus X (Oculentis GmbH) refractive multifocal intraocular lens (IOL). Eighty-six eyes implanted with the Lentis Mplus X multifocal IOL were included. MR was performed in all patients followed by three consecutive AR measurements using the Topcon KR-8000 autorefractor. Assessment of repeatability of consecutive AR before and after dilation with phenylephrine 10%, and comparison of the AR and KR with MR using vector analysis were performed at 3mo follow-up. Analysis showed excellent repeatability of the AR measurements. Linear regression of AR versus MR showed good correlation for sphere and spherical equivalent, whereas the correlation for astigmatism was low. The mean difference AR-MR was -1.28±0.29 diopters (D) for sphere. Astigmatism showed better correlation between KR and MR. We suggest AR sphere plus 1.25 D and the KR cylinder as the starting point for MR in eyes with a Lentis Mplus X multifocal IOL. If AR measurements are equal to MR, decentration of the IOL should be suspected.

[Slit lamp optical coherence tomography study of anterior segment changes after phacoemulsification and foldable intraocular lens implantation].

Science.gov (United States)

Yan, Pi-song; Zhang, Zhen-ping; Lin, Hao-tian; Wu, Wen-jie; Bai, Ling

2009-09-01

To investigate quantitative changes of the anterior segment configuration after clear corneal incision phacoemulsification and foldable intraocular lens (IOL) implantation with slit-lamp-adapted optical coherence tomography (SL-OCT). In prospective consecutive case series, clear corneal incision phacoemulsification and foldable intraocular lens implantation were performed in 44 eyes of 40 patients. The changes of the anterior segment configuration were performed by SL-OCT before and 1 day, 1 week, 2 weeks and 1 month after surgery. SPSS 16.0 software was used to analyze statistical difference. For all patients, the central corneal thickness (CCT) and the incisional corneal thickness (ICT) increased significantly 1 day after surgery (CCT increased 99.59 microm, ICT increased 234.57 microm; P = 0.490). At 1 month, the CCT almost had returned to baseline, but the ICT had been thicker about 19.25 microm than baseline(P = 0.001). The measurements of ACD, AOD500, AOD750, TISA500, TISA750 also increased significantly 1 day after surgery. Although the ACD had no changes within 2 weeks (all P 0.05). The SL-OCT could impersonality and quantificationally evaluate the anterior segment changes induced by cataract surgery.

Analysis on shift and rotation of intraocular lens after phakic collamer lens implantation

Directory of Open Access Journals (Sweden)

Yuan-Yuan Lu

2016-05-01

Full Text Available Recently, the incidence of myopia increases year by year. The effectiveness of refractive surgery for the correction of ametropia is widely recognized with rapid development of ophthalmic microsurgery. The laser in situ keratomileusis(LASIKhas been accepted as a regular refractive surgery technique to correct mild and moderate myopia. However, it shows inadequacy in ability to correct high refractive errors, and in patients with thin cornea and keratoconus. In 1993, Staar Surgical(A.G. Nidauintroduced a modified intraocular collamer lens(ICLfor the correction of high myopia, which emerged as a safe and effective operation for moderate or high myopia gradually. Although it has already been proved that ICL has safety and efficacy for the correction of high myopia, several studies reported dislocation and rotation of ICL after implantation, which led decreased vision and poor satisfaction. In severe cases, secondary glaucoma, anterior subcapsular cataract happened consequentially. These potential complications have drawn more and more attention by the majority of physicians and scholars. This paper aims to discuss the potential cause of shift and rotation of ICLs after implantation.

Preliminary study of a new intraocular method in the diagnosis and treatment of Propionibacterium acnes endophthalmitis following cataract extraction.

Science.gov (United States)

Owens, S L; Lam, S; Tessler, H H; Deutsch, T A

1993-04-01

Late endophthalmitis, due to Propionibacterium acnes, developed in three patients following uncomplicated extracapsular cataract extraction and posterior chamber intraocular lens (PC-IOL) insertion. Cultures from the capsular bag yielded P. acnes in all three. With topical anesthesia and through an anterior chamber paracentesis, culture specimens were taken from and clindamycin irrigated into the capsular bag. Filtered 100% oxygen was introduced into the anterior chamber in two; the third also received an injection of gentamicin and dexamethasone into the capsular bag. After treatment, two patients received oral antibiotics; one received hyperbaric oxygen therapy. Visual acuity was improved and inflammation reduced in all three. However, after treatment, ocular toxic effects due to clindamycin were suspected in one. This approach offers several clear advantages, including topical anesthesia, outpatient management, elimination of the need for vitrectomy, and retention of the intraocular lens (IOL).

Retropupillary iris claw intraocular lens implantation in aphakia for dislocated intraocular lens.

Science.gov (United States)

Faria, Mun Yueh; Ferreira, Nuno Pinto; Pinto, Joana Medeiros; Sousa, David Cordeiro; Leal, Ines; Neto, Eliana; Marques-Neves, Carlos

2016-01-01

Nowadays, dislocated intraocular lenses (IOLs) and inadequate capsular support are becoming a challenge for every ophthalmic surgeon. Explantation of dislocated IOL and iris claw IOL (ICIOL) are the techniques that have been used in our ophthalmic department. The aim of this study is to report our technique for retropupillar ICIOL. This study is a retrospective case series. A total of 105 eyes with dislocated IOL from the patients at the Department of Ophthalmology in Santa Maria Hospital, a tertiary reference hospital in Lisbon, Portugal, from January 2012 until January 2016, had been analyzed. Of these 105 eyes, 66 eyes had dislocated one-piece IOL and 39 eyes had dislocated three-piece IOL. The latter underwent iris suture of the same IOL and were excluded from this study. The remaining 66 eyes with dislocated one-piece IOL underwent pars plana vitrectomy, that is, explantation of dislocated IOL through corneal incision and an implantation of retropupillary ICIOL. Operative data and postoperative outcomes included best corrected visual acuity, IOL position, intraocular pressure, pigment dispersion, clinical signs of endothelial cell loss, and anterior chamber depth. The mean follow-up was 23 months (range: 6-48 months). The mean preoperative best corrected visual acuity was 1.260±0.771 logMAR, and postoperative best corrected visual acuity was 0.352±0.400 logMAR units. Mean vision gain was 0.909 logMar units. The patients had the following complications: 1) retinal detachment was found in one patient, 2) corneal edema was found in three patients, 3) high intraocular pressure was observed in twelve patients, 4) subluxation of the IOL was observed in one patient, and 5) macular edema was found in three eyes. The results demonstrate that retropupillary ICIOL is an easy and effective method for the correction of aphakia in patients not receiving capsule support. The safety of this procedure must be interpreted in the context of a surgery usually indicated in

Contrast visual acuity after multifocal intraocular lens implantation:aspheric versus spherical design

Directory of Open Access Journals (Sweden)

Jun-Hua Li

2014-02-01

Full Text Available AIM: To evaluate contrast visual acuity (CVA after implantation of an aspheric apodized diffractive intraocular lens (IOL or a spherical apodized diffractive IOL in cataract surgery.METHOD: This prospective randomized controlled study with a 12-month follow-up compared the results of cataract surgery with implantation of an aspheric AcrySof ReSTOR SN6AD3 IOL (30 eyes and a spherical AcrySof ReSTOR SN60D3 IOL (30 eyes. CVA with best distance correction was measured at 4 contrast levels (100%, 25%, 10% and 5% under 3 levels of chart luminance [250, 85 and 25 candelas per square meter (cd/m2] using a multi-functional visual acuity tester (MFVA-100．RESULTS:At 12 months after surgery, there were no statistically significant differences in 100% CVA and 25% CVA under 250cd/m2 (P100%=0.875 and P25%=0.057 and 85cd/m2 (P100%=0.198 and P25%=0.193 between the aspheric group and the spherical group. However, the 10% CVA and 5% CVA were significant better in aspheric group than spherical group under 250cd/m2 (P10%=0.042 and P5%=0.007 and 85cd/m2 (P10%=0.002 and P5%=0.039. Under the luminance level of 25cd/m2, no significant differences was found in the 100% CVA between the 2 group (P100%=0.245, while aspheric group had better visual acuity in the remaining 3 contracts (P25%=0.023, P10%=0.026 and P5%=0.002, respectively.CONCULSION:The aspheric AcrySof ReSTOR SN6AD3 IOL provided patients with better low-contrast visual acuity than the spherical AcrySof ReSTOR SN60D3 IOL.Keyword:cataract surgery; intraocular lens; contrast sensitivity; visual acuity

Characteristics of the retinal images of the eye optical systems with implanted intraocular lenses

Science.gov (United States)

Siedlecki, Damian; Zając, Marek; Nowak, Jerzy

2007-04-01

Cataract, or opacity of crystalline lens in the human eye is one of the most frequent reasons of blindness nowadays. Removing the pathologically altered crystalline lens and replacing it with artificial implantable intraocular lens (IOL) is practically the only therapy in this illness. There exist a wide variety of artificial IOL types on the medical market, differing in their material and design (shape). In this paper six exemplary models of IOL's made of PMMA, acrylic and silicone are considered. The retinal image quality is analyzed numerically on the basis of Liou-Brennan eye model with these IOL's inserted. Chromatic aberration as well as polychromatic Point Spread Function and Modulation Transfer Function are calculated as most adequate image quality measures. The calculations made with Zemax TM software show the importance of chromatic aberration correction.

Visual acuity after trans-scleral sutured posterior chamber intraocular lens

International Nuclear Information System (INIS)

Mahmood, S.A.; Zafar, S.

2014-01-01

To determine the changes in visual acuity in patients undergoing Trans-Scleral Sutured Posterior Chamber Intra-Ocular Lens (TSSPCIOL) implantation at a tertiary care hospital in Karachi, Pakistan. Study Design: Case series. Place and Duration of Study: LRBT Tertiary Eye Hospital, Karachi, from January 2006 to December 2010. Methodology: Records of all patients undergoing implantation of TSSPCIOL were reviewed. Patients with diagnosed glaucoma, diabetic retinopathy, macular degeneration, history of recurrent uveitis, corneal haze or central corneal scars were excluded. For the final analysis, 70 eyes out of a total of 75 were selected. Main outcomes of interest were pre and postoperative visual acuities and surgical complications. SPSS 21 was used for data analysis. Results: Pre-operatively, the average Best Spectacle-Corrected Visual Acuity (BSCVA) was 6/36 on the Snellen chart. This improved to 6/12 postoperatively. The mean improvement seen was 2.4 lines on the Snellen chart (p < 0.05). Complications include transient intraocular pressure elevation in 25 eyes (36%), IOL tilt in 4 eyes (7.1%), Cystoid Macular Edema (CME) in 4 eyes (5.7%), vitreous haemorrhage in 2 eyes (2.9%), hyphema in 2 eyes (2.9%), uveitis in 1 eye (1.4%), and retinal detachment 1 eye (1.4%). No IOL subluxation, suture erosion, iris capture, choroidal effusion or endophthalmitis was encountered and no re-operations were needed. Conclusion: TSSPCIOLs are a good management option for patients with aphakia in whom PC IOLs cannot be placed. (author)

Corneal injection track:an unusual complication of intraocular lens implantation and review

Directory of Open Access Journals (Sweden)

Julie Y.C. Lok

2015-06-01

Full Text Available Phacoemulsification is the main gold standard for cataract operation in the developed world together with foldable intraocular lens (IOL implantation by injection, allowing for stable wound construction and less postoperative astigmatism. It is a safe procedure with high success rate with the advancement in machines, improvement of IOL injection systems and further maturation of surgeons’ techniques. Despite the large number of operations performed every day, foldable IOL injection leading to an intra-stromal corneal track is a very rare complication. We report a case of this unusual finding in a 70-year-old gentleman who has undergone cataract operation in November 2011 in our hospital and will review on the complications related to foldable IOL injection.

Complications and visual outcomes after glued foldable intraocular lens implantation in eyes with inadequate capsules.

Science.gov (United States)

Kumar, Dhivya Ashok; Agarwal, Amar; Packiyalakshmi, Sathiya; Jacob, Soosan; Agarwal, Athiya

2013-08-01

To evaluate the complications and visual outcomes of glued intrascleral-fixated foldable intraocular lens (IOL) in eyes with deficient capsules. Dr Agarwal's Eye Hospital and Eye Research Centre, Chennai, India. Case series. Data were evaluated from the records of patients with a primary glued foldable IOL for intraoperative capsular loss or subluxated lens or secondary glued foldable IOL for aphakia. Exclusion criteria included preoperative glaucoma, aniridia, macular scar, traumatic subluxation, combined surgeries, incomplete operative medical records, and postoperative follow-up less than 6 months. The intraoperative and postoperative complication rates, reoperation rate, and visual outcomes were analyzed. The study comprised 208 eyes (185 patients). The mean follow-up was 16.7 months ± 10.2 (SD). The intraoperative complications were hyphema (0.4%), haptic breakage (0.4%), and deformed haptics (0.9%). Early complications occurred in 29 eyes (13.9%) and included corneal edema (5.7%), epithelial defect (1.9%), and grade 2 anterior chamber reaction (2.4%). Late complications occurred in 39 eyes (18.7%) and included optic capture (4.3%), IOL decentration (3.3%), haptic extrusion (1.9%), subconjunctival haptic (1.4%), macular edema (1.9%), and pigment dispersion (1.9%). Reoperation was required in 16 eyes (7.7%). Haptic position was altered in eyes with IOL decentration. Corrected distance visual acuity (CDVA) improved or remained unchanged in 84.6% of eyes. The postoperative CDVA was 20/40 or better and 20/60 or better in 38.9% and 48.5% of eyes, respectively. The foldable glued-IOL procedure showed satisfactory visual outcomes without serious complications. Intraocular lens decentration was due to haptic-related problems. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Refractive Results: Safety and Efficacy of Secondary Piggyback Sensar™ AR40 Intraocular Lens Implantation to Correct Pseudophakic Refractive Error

Directory of Open Access Journals (Sweden)

Alahmady Hamad Alsmman Hassan

2016-01-01

Full Text Available In this study we evaluate the visual outcomes, safety, efficacy, and stability of implanting of second sulcus intraocular lens (IOL to correct unsatisfied ametropic patients after phacoemulsification. Methods. Retrospective study of 15 eyes (15 patients underwent secondary intraocular lens implanted into the ciliary sulcus. The IOL used was a Sensar IOL three-piece foldable hydrophobic acrylic IOL. The first IOL in all patients was acrylic intrabagal IOL implanted in uncomplicated phacoemulsification surgery. Results. Fifteen eyes (15 patients were involved in this study. Preoperatively, mean log⁡MAR UDVA and CDVA were 0.88 ± 0.22 and 0.19 ± 0.13, respectively, with a mean follow-up of 28 months (range: 24 to 36 months. At the end of the follow-up, all eyes achieved log⁡MAR UDVA of 0.20 ± 0.12 with postoperative refraction ranging from 0.00 to −0.50 D of attempted emmetropia. Conclusions. Implantation of the second sulcus SensarAR40 IOL was found to be safe, easy, and simple technique for management of ametropia following uncomplicated phacoemulsification.

Correlación entre la localización del lente intraocular, según biomicroscopia ultrasónica,y diferentes parámetros quirúrgicos en pacientes operados de catarata Correlation between the location of the intraocular lens according to ultrasonic biomicroscopy and several surgical parameters in patients operated from cataract

Directory of Open Access Journals (Sweden)

Eneida de la C Pérez Candelaria

2010-01-01

Full Text Available OBJETIVO: Determinar la correlación entre la localización del lente intraocular en cámara posterior por biomicroscopia ultrasónica, diferentes parámetros quirúrgicos en pacientes operados de catarata. MÉTODOS: Se realizó un estudio descriptivo, prospectivo y transversal en el Instituto Cubano de Oftalmología «Ramón Pando Ferrer», durante el período de enero a junio del 2007. Se estudiaron variables como: edad, sexo, etiología de la catarata, técnica quirúrgica, localización del lente intraocular según biomicroscopia ultrasónica, así como complicaciones transoperatorias y posoperatorias. RESULTADOS: El 79 % de todos los pacientes operados tenían entre 60 y 79 años de edad y algo más de la mitad correspondió al sexo femenino con un 59 %. La catarata senil fue la etiología que predominó con un 74 % y en el 68 % de los casos el lente se localizó por biomicroscopia ultrasónica en el saco capsular. En los ojos donde el lente intraocular se localizó fuera del saco, la proporción de complicaciones transoperatorias y posoperatorias fueron significativamente mayoritarias, mientras que en los ojos donde el lente intraocular se encontraba en el saco, la mayoría no presentó complicaciones transoperatorias ni posoperatorias. CONCLUSIONES: Las diferencias entre las distintas localizaciones del lente intraocular se encontraron con significación estadística en el tipo de catarata, la presencia de complicaciones transoperatorias y posoperatorias, sin embargo, no se encontró relación estadística significativa entre la localización del lente intraocular con la técnica quirúrgica utilizada.OBJECTIVE: To determine the correlation between the location of the intraocular lens in the posterior chamber using ultrasonic biomicroscopy and the different surgical parameters in patients operated from cataract. METHODS: A prospective, descriptive and cross-sectional study was carried out in "Ramón Pando Ferrer" Cuban Institute of

Results of intraocular lens implantation with capsular tension ring in subluxated crystalline or cataractous lenses in children

OpenAIRE

Das, Pranab; Ram, Jagat; Brar, Gagandeep Singh; Dogra, Mangat R

2009-01-01

Purpose : To evaluate the outcome of intraocular lens (IOL) implantation using capsular tension ring (CTR) in subluxated crystalline or cataractous lenses in children. Setting : Tertiary care setting Materials and Methods : We prospectively studied 18 eyes of 15 children with subluxation of crystalline or cataractous lenses between 90° up to 210° after phacoemulsification, CTR and IOL implantation. Each child was examined for IOL centration, zonular dehiscence and posterior ...

DESIGN OF THE MULTIORDER INTRAOCULAR LENSES

Directory of Open Access Journals (Sweden)

V. G. Kolobrodov

2015-01-01

Full Text Available Intraocular lenses (IOLs are used to replace the natural crystalline lens of the eye. Just few basic designs of IOLs are used clinically. Multiorder diffractive lenses (MODL which operate simultaneously in several diffractive orders were proposed to decrease the chromatic aberration. Properties analysis of MODL showed a possibility to use them to develop new designs of IOLs. The purpose of this paper was to develop a new method of designing of multiorder intraocular lenses with decreased chromatic aberration. The theoretical research of the lens properties was carried out. The diffraction efficiency dependence with the change of wavelength was studied. A computer simulation of MODL in a schematic model of the human eye was carried out. It is found the capability of the multiorder diffractive lenses to focus polychromatic light into a segment on the optical axis with high diffraction efficiency. At each point of the segment is present each component of the spectral range, which will build a color image in combination. The paper describes the new design method of intraocular lenses with reduced chromaticism and with endless adaptation. An optical system of an eye with an intraocular lens that provides sharp vision of objects located at a distance of 700 mm to infinity is modeled.

Intraocular pressure and ocular pulse amplitude using dynamic contour tonometry and contact lens tonometry

Directory of Open Access Journals (Sweden)

Grus Franz-H

2004-03-01

Full Text Available Abstract Background The new Ocular Dynamic Contour Tonometer (DCT, investigational device supplied by SMT (Swiss Microtechnology AG, Switzerland allows simultaneous recording of intraocular pressure (IOP and ocular pulse amplitude (OPA. It was the aim of this study to compare the IOP results of this new device with Goldmann tonometry. Furthermore, IOP and OPA measured with the new slitlamp-mounted DCT were compared to the IOP and OPA measured with the hand-held SmartLens®, a gonioscopic contact lens tonometer (ODC Ophthalmic Development Company AG, Switzerland. Methods Nineteen healthy subjects were included in this study. IOP was determined by three consecutive measurements with each of the DCT, SmartLens®, and Goldmann tonometer. Furthermore, OPA was measured three times consecutively by DCT and SmartLens®. Results No difference (P = 0.09 was found between the IOP values by means of DCT (mean: 16.6 mm Hg, median: 15.33 mm Hg, SD: +/- 4.04 mm Hg and Goldmann tonometry (mean: 16.17 mm Hg, median: 15.33 mm Hg, SD: +/- 4.03 mm Hg. The IOP values of SmartLens® (mean: 20.25 mm Hg, median: 19.00 mm Hg, SD: +/- 4.96 mm Hg were significantly higher (P = 0.0008 both from Goldmann tonometry and DCT. The OPA values of the DCT (mean: 3.08 mm Hg, SD: +/- 0.92 mm Hg were significantly lower (P = 0.0003 than those obtained by SmartLens® (mean: 3.92 mm Hg, SD: +/- 0.83 mm Hg. Conclusions DCT was equivalent to Goldmann applanation tonometry in measurement of IOP in a small group of normal subjects. In contrast, SmartLens® (contact lens tonometry gave IOP readings that were significantly higher compared with Goldmann applanation tonometer readings. Both devices, DCT and SmartLens® provide the measurement of OPA which could be helpful e.g. for the management of glaucoma.

Validity of automated refraction after segmented refractive multifocal intraocular lens implantation

Directory of Open Access Journals (Sweden)

César Albarrán-Diego

2017-11-01

Full Text Available AIM: To evaluate the clinical utility of automated refraction (AR and keratometry (KR compared with subjective or manifest refraction (MR after cataract or refractive lens exchange surgery with implantation of Lentis Mplus X (Oculentis GmbH refractive multifocal intraocular lens (IOL. METHODS: Eighty-six eyes implanted with the Lentis Mplus X multifocal IOL were included. MR was performed in all patients followed by three consecutive AR measurements using the Topcon KR-8000 autorefractor. Assessment of repeatability of consecutive AR before and after dilation with phenylephrine 10%, and comparison of the AR and KR with MR using vector analysis were performed at 3mo follow-up. RESULTS: Analysis showed excellent repeatability of the AR measurements. Linear regression of AR versus MR showed good correlation for sphere and spherical equivalent, whereas the correlation for astigmatism was low. The mean difference AR-MR was -1.28±0.29 diopters (D for sphere. Astigmatism showed better correlation between KR and MR. CONCLUSION: We suggest AR sphere plus 1.25 D and the KR cylinder as the starting point for MR in eyes with a Lentis Mplus X multifocal IOL. If AR measurements are equal to MR, decentration of the IOL should be suspected.

Analysis of incidence and related factors on effusion of anterior chamber after phacoemulsification combined with intraocular lens implantation

Directory of Open Access Journals (Sweden)

Bing-Bing Zhao

2018-02-01

Full Text Available AIM: To investigate the incidence and related factors on effusion of anterior chamber(ACafter phacoemulsification(PEcombined with intraocular lens(IOLimplantation. METHODS: Totally 359 cases of cataract(375 eyesunderwent PE combined with IOL implantation were collected in our hospital. The incidence of AC exudation after operation and related factors were analyzed by single factor and multiple logistic regression analysis. RESULTS: The group was included in 359 cases(375 eyes. The incidence of postoperative AC exudation in the study group was 5.9%(22/375. The preoperative intraocular pressure(IOP, visual acuity before and after surgery, nuclear grades, posterior capsular rupture(PCRrate and ultrasonic accumulated energy complex parameter(AECPof the study group showed statistically significant difference compared with the control group(all P21mmHg, intraoperative pupil diameter 7.25(%×min, the lens nucleus grade ≥ IV were risk factors of AC exudation after PE combined with IOL implantation in patients with cataract(all P21mmHg, ultrasound AECP >7.25 were independent risk factors of AC exudation after PE combined with IOL implantation in patients with cataract(all PCONCLUSION: High myopia, glaucoma, uveitis, the lens nucleus grade ≥ IV, the incidence of intraoperative PCR, preoperative IOP>21mmHg, ultrasonic AECP>7.25 are independent risk factors of AC exudation after PE combined with IOL implantation in patients with cataract, with such risk factors in patients with cataract should be paid closely attention and timely diagnosis and treatment in clinic.

Application of diffractive aspheric multifocal intraocular lens in the Uighur in phacoemulsification

Directory of Open Access Journals (Sweden)

Nuersimanguli·Mijiti

2016-05-01

Full Text Available AIM:To research the efficacy and safety of diffractive aspheric multifocal intraocular lens(MIOLin the Uighur in phacoemulsification to provide guidance for the clinical treatment of cataracts patients in Xinjiang region. METHODS:Two hundred and twenty-eight Uygur patients(280 eyesreceived phacoemulsification from April 2012 to March 2013 were randomly divided into multifocal group(106 cases with 146 eyesand monofocal group(122 cases with 134 eyes. Patients were followed up for 3mo. The intraocular pressure(IOP, uncorrected distance visual acuity, uncorrected near vision, best-corrected distance visual acuity and best corrected near vision were measured. The delensed rate, visual quality, and satisfaction for lenses in the form of questionnaires were compared. RESULTS:Multifocal group was better on the uncorrected near vision than monofocal group(PP>0.05. The contrast sensitivity of multifocal group under scotopia at spatial frequency 3c/d was lower than that of monofocal group(PP>0.05. Delensed rate of multifocal group was higher than that of monofocal group(PP>0.05.CONCLUSION:MIOL with phacoemulsification can provide patient good full range vision, especially on good near vision. The patients with MIOL implanted have a higher delensed rate, less postoperative adverse symptoms, quicker recovery and satisfaction.

Factors associated with strabismus after cataract extraction and primary intraocular lens implantation in congenital cataracts

Directory of Open Access Journals (Sweden)

Soo Jung Lee

2014-06-01

Full Text Available AIM: To evaluate factors associated with the development of strabismus after cataract extraction and primary intraocular lens implantation.METHODS: The medical records of 122 patients, aged 1.5mo to 9y, who had undergone cataract extraction with primary intraocular lens implantation between January 1993 and August 2011 were reviewed. Fourteen patients (17 eyes with strabismus before cataract surgery were excluded. Patients were divided into those with congenital bilateral cataracts (64 patients, 128 eyes and those with unilateral cataracts (44 patients, 44 eyes. The associations between the development of strabismus and age at cataract surgery, pre- and post-cataract extraction corrected distance visual acuity (CDVA, interocular CDVA difference, nystagmus, surgical method, and secondary cataract were evaluated.RESULTS: Factors significantly associated with the development of strabismus included age at cataract surgery (≤1y, preoperative mean CDVA ≤20/100, presence of nystagmus in the bilateral cataract group and postoperative interocular CDVA difference ＞20/70 in the unilateral group. Postoperative CDVA ≤20/100 and preservation of posterior capsule, and presence of secondary cataract were significant factors in both groups.CONCLUSION: Children with congenital cataracts should be monitored carefully after cataract surgery for the development of strabismus, especially when they underwent surgery at age ≤1y, and they have nystagmus, large postoperative interocular CDVA difference, poor preoperative and postoperative CDVA, preservation of the posterior capsule, or secondary cataract.

Implantation of a double iris-claw intraocular lens in an aphakic nanophthalmic eye

Directory of Open Access Journals (Sweden)

Filiz Avsin Ozdemir Sarioglu

2017-01-01

Full Text Available A 55-year-old female with an aphakic nanophthalmic eye underwent a secondary intraocular lens implantation (IOL with double Artisan aphakia iris claw IOLs (ICIOLs and was evaluated in this research. The patient's preoperative best-corrected visual acuity (BCVA of the right eye was 0.4 (0.4 logMAR (with + 21.00 D, postoperative 1st and 3rd month, 1st year, and 3 years BCVAs were 0.4 (0.4 logMAR. The intraocular pressure was 15 mmHg preoperatively, and 14, 12, 12, and 15 mmHg postoperatively at 1st and 3rd month, 1st year, and 3 years, respectively. The preoperative endothelial cell density (ECD was 2372 cells/mm2, and postoperative ECDs were 2352, 2391, 2246, and 2240 cells/mm2 at 1st and 3rd months, at 1st year, and 3 years respectively. In aphakic nanophthalmic eyes with inadequate capsular support, which require high IOL dioptry, the implantation of double ICIOLs (one in front of the iris and the other behind the iris seems to be safe and provides good visual rehabilitation.

INTRAOCULAR LENS POSITION IN COMBINED PHACOEMULSIFICATION AND VITREORETINAL SURGERY.

Science.gov (United States)

Ozates, Serdar; Kiziltoprak, Hasan; Koc, Mustafa; Uzel, Mehmet Murat; Teke, Mehmet Yasin

2017-10-09

To assess the decentration and angle of tilt of the intraocular lens (IOL) according to the intravitreal tamponade types used in combined phacoemulsification and vitreoretinal surgery. This prospective and randomized clinical study involved 73 eyes of 69 patients who underwent combined vitreoretinal surgery. Eyes with intravitreal tamponades formed the study group and eyes without intravitreal tamponades formed the control group. The study group was further divided into silicone oil and gas tamponade subgroups. Cross-sectional IOL images were captured using a Pentacam HR (Oculus, Germany) and tilt and decentration were calculated with Adobe Photoshop software (Adobe, San Jose, CA). The mean angle of tilt and decentration at the vertical meridian were significantly higher in both tamponade groups than in the control group (P 0.05). When comparing the silicone oil and gas tamponade subgroups, no significant differences were noted on the position of IOL at both meridians (P > 0.05 for all). Intravitreal tamponades have an important effect on the position of IOL in combined vitreoretinal surgery. Silicone oil and gas tamponades may induce postoperative tilt and decentration of one-piece acrylic IOLs.

Combined ab interno trabeculotomy and lens extraction: a novel management option for combined uveitic and chronic narrow angle raised intraocular pressure.

Science.gov (United States)

Lin, Siying; Gupta, Bhaskar; Rossiter, Jonathan

2016-02-01

Minimally invasive glaucoma surgery is a developing area that has the potential to replace traditional glaucoma surgery, with its known risk profile, but at present there are no randomised controlled data to validate its use. We report on a case where sequential bilateral combined ab interno trabeculotomy and lens extraction surgery was performed on a 45-year-old woman with combined uveitic and chronic narrow angle raised intraocular pressure. Maximal medical management alone could not control the intraocular pressure. At 12-month follow-up, the patient had achieved stable intraocular pressure in both eyes on a combination of topical ocular antiglaucomatous and steroid therapies. This case demonstrates the effectiveness of trabecular meshwork ablation via ab interno trabeculotomy in a case of complex mixed mechanism glaucoma. 2016 BMJ Publishing Group Ltd.

Intracapsular lens extraction for the treatment of pupillary block glaucoma associated with anterior subluxation of the crystalline lens.

Science.gov (United States)

Kim, Yong Joon; Ha, Seung Joo

2013-01-01

To report a case of pupillary block glaucoma associated with spontaneous crystalline lens subluxation into the anterior chamber in a 34-year-old man. Dry vitrectomy was performed for securing enough retrolental space, and an intracapsular lens extraction was then performed via a corneolimbal incision. Additional endothelial cell damage was avoided with an injection of viscoelastics and gentle extraction of the crystalline lens. After deepening of the anterior chamber, scleral fixation of the intraocular lens was performed with an ab externo technique. Two months after the operation, a well-fixated intraocular lens was observed and intraocular pressure was stable. The postoperative corneal astigmatism was -3.5 dpt, and the patient had a best-corrected visual acuity of 20/25. Postoperative complications included decreased endothelial cell count and sector iris paralysis near the incision site. An anteriorly subluxated crystalline lens can cause pupillary block glaucoma in healthy young adults. To prevent intraoperative complications, intracapsular lens extraction with dry vitrectomy can be a good surgical option. The endothelial cell density should be closely monitored after surgery.

Evaluation of an interlaced triple procedure: penetrating keratoplasty, extracapsular cataract extraction, and nonopen-sky intraocular lens implantation.

Science.gov (United States)

Yang, Shuo; Wang, Bin; Zhang, Yangyang; Zhai, Hualei; Wang, Junyi; Wang, Shuang; Xie, Lixin

2017-09-01

To evaluate an interlaced triple procedure that involved penetrating keratoplasty (PKP), extracapsular cataract extraction (ECCE) using diathermy capsulotomy, and nonopen-sky intraocular lens (IOL) implantation.This retrospective study involved data from 34 patients who were diagnosed with severe corneal opacities and cataracts. These patients were divided into an interlaced procedure group (21 patients) and a traditional procedure group (13 patients). In the interlaced group, the method of continuous curvilinear capsulorhexis (CCC) was completed via diathermy capsulotomy. The donor corneal button was sutured at 8 positions (at equal intervals) using 10-0 nylon sutures, and the IOL was inserted into the capsular bag using a closed anterior chamber approach at the 10:30 to 12 o'clock positions between the sutures. In the traditional group, CCC was completed using side-port capsular forceps, and the IOL was implanted using an open anterior chamber approach.In the interlaced group, the CCC, open-sky, and total operation times were significantly shorter than in the traditional group (P < .05). Neither the best-corrected visual acuity (BCVA) nor corneal endothelial cell density was significantly different between the groups at 1 and 6 months after the operation.This interlaced triple procedure for the treatment of corneal diseases with cataracts appears to be feasible and practical.

Uneventful Anterior Migration of Intravitreal Ozurdex Implant in a Patient with Iris-Sutured Intraocular Lens and Descemet Stripping Automated Endothelial Keratoplasty

Directory of Open Access Journals (Sweden)

Andleeb Zafar

2018-02-01

Full Text Available Purpose: We report here the case of a patient with anterior segment migration of intravitreal dexamethasone implant as well as its management and outcome. Methods: The patient had the following sequence of events: complicated cataract surgery, iris-sutured intraocular lens implant, followed by cystoid macular edema treated with intravitreal Avastin, retinal vein occlusion treated with intravitreal dexamethasone implant, corneal decompensation treated with Descemet stripping automated endothelial keratoplasty (DSAEK, and finally recurrence of macular edema treated with repeated intravitreal dexamethasone implant. Results: Dexamethasone implant had completely dissolved from the eye 12 weeks after insertion without any complication. Conclusion: A conservative approach with regular monitoring in the situation of a quiet anterior segment without any corneal decompensation can provide enough time for the implant to dissolve without causing any complication to the involved eye, avoiding any additional surgical intervention, as presented in this case report. Despite the fact that the implant was left for natural dissolution, there were no adverse effects related to the graft or the eye.

[Capsule contraction as a cause of in-the-bag intraocular lens subluxation and simplified technique of IOL reposition].

Science.gov (United States)

Jurowski, Piotr

2005-01-01

Presentation of the case of the pseudophakic patient in whom 3 months after uncomplicated phacoemulsification severe capsule contraction syndrome, followed by equatorial capsule fibrosis, 240 degree zonular dialysis, and spontaneous in-the-bag intraocular lens subluxation, were observed. Consecutive surgical intervention consisting of simplified transscleral "free haptic" through the capsule fixation and additional plastic of phimotic capsulorrhexis allowed to restore the best corrected visual acuity to 20/25.

Facoemulsificação, vitrectomia via pars plana e implante de lente intra-ocular em olhos com retinopatia diabética proliferativa Phacoemulsification, pars plana vitrectomy and intraocular lens implant in eyes with proliferative diabetic retinopathy

Directory of Open Access Journals (Sweden)

Armando Belfort Mattos

2004-06-01

realizar a vitrectomia via pars plana, ao invés de se realizar uma segunda cirurgia, que seria somente para a remoção da catarata após a vitrectomia pars plana, é técnica segura e capaz de promover a melhora da acuidade visual além de ser menos agressiva para o paciente. O potencial para melhora da acuidade visual final é limitado pela gravidade da retinopatia diabética.PURPOSE: To evaluate the outcomes and the best technique for a combined phacoemulsification (PHACO, pars plana vitrectomy (PPV and posterior chamber intraocular lens insertion (PCIOL in one single procedure for patients with proliferative diabetic retinopathy. METHODS: We reviewed charts of 47 (53 eyes patients with proliferative diabetic retinopathy who underwent combined phacoemulsification with posterior chamber intraocular lens implant and pars plana vitrectomy performed between January 1991 and September 1998 at the Bascom Palmer Eye Institute, eye hospital affiliated with the University of Miami. The study was done in conjunction with the Federal University of São Paulo. A total of 43 eyes from 40 patients were elected to participate in the study. RESULTS: The follow-up range was three to 60 months (mean 20 months. The age ranged from 37 to 77 years with a mean of 59. Preoperative visual acuity improved two lines or more in 26 (60.4% eyes, remained the same in 9 (20.9% and got worse in 8 (18.6%. In 10 (23.2% eyes visual acuity improved to 20/40. The study showed to be statistically significant for the improvement of the final visual acuity. Recurrent vitreous hemorrhage was the most frequent postoperative complication found in 12 (27.9% eyes and it was followed by transient anterior chamber reaction in 9 (20.9% eyes. Intraoperative and postoperative complications related to phacoemulsification were rare. IOL capture was found in 2 (4.6% eyes and intraocular lens subluxation in 1 (2.3% eye. CONCLUSION: Combined phacoemulsification with posterior chamber intraocular lens implant and pars plana

Flanged Intrascleral Intraocular Lens Fixation with Double-Needle Technique.

Science.gov (United States)

Yamane, Shin; Sato, Shimpei; Maruyama-Inoue, Maiko; Kadonosono, Kazuaki

2017-08-01

To report the clinical outcomes of a new technique for transconjunctival intrascleral fixation of an intraocular lens (IOL). Prospective, noncomparative, interventional case series. One hundred eyes of 97 consecutive patients with aphakia, dislocated IOL, or subluxated crystalline lens who underwent posterior chamber sutureless implantation of an IOL were studied. Two angled incisions parallel to the limbus were made by 30-gauge thin-wall needles. Haptics of an IOL were externalized with the needles and cauterized to make a flange of the haptics. The flange of the haptics were pushed back and fixed into the scleral tunnels. Best-corrected visual acuity (VA), corneal endothelial cell density, IOL tilt, and complications were determined. The IOLs were fixed with exact centration and axial stability. The mean preoperative best-corrected VA was 0.25 logarithm of the minimum angle of resolution (logMAR) units; after surgery, it improved significantly to 0.11 logMAR, 0.09 logMAR, 0.12 logMAR, and 0.04 logMAR at 6, 12, 24, and 36 months, respectively (P IOL tilt was 3.4°±2.5°. The postoperative complications included iris capture by the IOL in 8 eyes (8%), vitreous hemorrhage in 5 eyes (5%), and cystoid macular edema in 1 eye (1%). There were no incidents of postoperative retinal detachment, endophthalmitis, or IOL dislocation. We have developed a new technique for intrascleral IOL fixation. The flanged IOL fixation technique is a simple and minimally invasive method for achieving good IOL fixation with firm haptic fixation. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Ocular lens availability of glutathione from collagen inserts for protection of eye from radiation

International Nuclear Information System (INIS)

Omer, S.A.

2003-01-01

Full text: Ocular inserts of glutathione ( G ) were prepared using 1 % collagen solution containing free G ,liposomal G and liposomal G with Concanavalin A ,a specific targeting agent of G to ocular lens. These inserts have to be sterilized for in-vivo ophthalmic application by exposure to U V radiation for 2 hr. using dry ice and acetone for protection of G from thermal degradation. In vitro release characteristics of G (17.0 μ mole) from the prepared inserts were investigated at 37deg C in phosphate buffer pH 7.4 . The results of release data showed that the release of G from inserts were arranged in the following order, free G, liposomal G with or without Concanavalin A. The extent of uptake of G from the collagen inserts by rabbit cornea was also tested. The results of ocular lens availability of G from collagen inserts revealed that a highly significant increase in the uptake of G by ocular lenses,where the percentages drug uptake from the applied doses at T max were 1.12% (p(0.05), 2.12% (p(0.01) and 3.4% (p(0.001) in case of using collagen inserts containing free G, liposomal G and liposomal G with Concanavalin A respectively. That is to say,lipid nature of liposomes together with Concanavlin A improved the penetration of the entrapped hydrophilic G through corneal barrier to the ocular lenses

The effectiveness of early lens extraction with intraocular lens implantation for the treatment of primary angle-closure glaucoma (EAGLE): study protocol for a randomized controlled trial.

Science.gov (United States)

Azuara-Blanco, Augusto; Burr, Jennifer M; Cochran, Claire; Ramsay, Craig; Vale, Luke; Foster, Paul; Friedman, David; Quayyum, Zahidul; Lai, Jimmy; Nolan, Winnie; Aung, Tin; Chew, Paul; McPherson, Gladys; McDonald, Alison; Norrie, John

2011-05-23

Glaucoma is the leading cause of irreversible blindness. Although primary open-angle glaucoma is more common, primary angle-closure glaucoma (PACG) is more likely to result in irreversible blindness. By 2020, 5·3 million people worldwide will be blind because of PACG. The current standard care for PACG is a stepped approach of a combination of laser iridotomy surgery (to open the drainage angle) and medical treatment (to reduce intraocular pressure). If these treatments fail, glaucoma surgery (eg, trabeculectomy) is indicated. It has been proposed that, because the lens of the eye plays a major role in the mechanisms leading to PACG, early clear lens extraction will improve glaucoma control by opening the drainage angle. This procedure might reduce the need for drugs and glaucoma surgery, maintain good visual acuity, and improve quality of life compared with standard care.EAGLE aims to evaluate whether early lens extraction improves patient-reported, clinical outcomes, and cost-effectiveness, compared with standard care. EAGLE is a multicentre pragmatic randomized trial. All people presenting to the recruitment centres in the UK and east Asia with newly diagnosed PACG and who are at least 50 years old are eligible.The primary outcomes are EQ-5D, intraocular pressure, and incremental cost per quality adjusted life year (QALY) gained. Other outcomes are: vision and glaucoma-specific patient-reported outcomes, visual acuity, visual field, angle closure, number of medications, additional surgery (e.g., trabeculectomy), costs to the health services and patients, and adverse events.A single main analysis will be done at the end of the trial, after three years of follow-up. The analysis will be based on all participants as randomized (intention to treat). 400 participants (200 in each group) will be recruited, to have 90% power at 5% significance level to detect a difference in EQ-5D score between the two groups of 0·05, and a mean difference in intraocular pressure of

The effectiveness of early lens extraction with intraocular lens implantation for the treatment of primary angle-closure glaucoma (EAGLE: study protocol for a randomized controlled trial

Directory of Open Access Journals (Sweden)

Chew Paul

2011-05-01

Full Text Available Abstract Background Glaucoma is the leading cause of irreversible blindness. Although primary open-angle glaucoma is more common, primary angle-closure glaucoma (PACG is more likely to result in irreversible blindness. By 2020, 5·3 million people worldwide will be blind because of PACG. The current standard care for PACG is a stepped approach of a combination of laser iridotomy surgery (to open the drainage angle and medical treatment (to reduce intraocular pressure. If these treatments fail, glaucoma surgery (eg, trabeculectomy is indicated. It has been proposed that, because the lens of the eye plays a major role in the mechanisms leading to PACG, early clear lens extraction will improve glaucoma control by opening the drainage angle. This procedure might reduce the need for drugs and glaucoma surgery, maintain good visual acuity, and improve quality of life compared with standard care. EAGLE aims to evaluate whether early lens extraction improves patient-reported, clinical outcomes, and cost-effectiveness, compared with standard care. Methods/Design EAGLE is a multicentre pragmatic randomized trial. All people presenting to the recruitment centres in the UK and east Asia with newly diagnosed PACG and who are at least 50 years old are eligible. The primary outcomes are EQ-5D, intraocular pressure, and incremental cost per quality adjusted life year (QALY gained. Other outcomes are: vision and glaucoma-specific patient-reported outcomes, visual acuity, visual field, angle closure, number of medications, additional surgery (e.g., trabeculectomy, costs to the health services and patients, and adverse events. A single main analysis will be done at the end of the trial, after three years of follow-up. The analysis will be based on all participants as randomized (intention to treat. 400 participants (200 in each group will be recruited, to have 90% power at 5% significance level to detect a difference in EQ-5D score between the two groups of 0·05

Intraocular pressure measurement over soft contact lens by rebound tonometer:a comparative study

Directory of Open Access Journals (Sweden)

Senay Asik Nacaroglu

2015-06-01

Full Text Available AIM: To evaluate the intraocular pressure (IOP measurements by Icare rebound tonometer over a contact lens in comparison with Goldmann applanation tonometry (GAT.METHODS: Fifty patients using contact lens were included in this study. One of the eyes of the patients was selected randomly and their IOP were measured by rebound tonometer with and without contact lens (RTCL, RT respectively and by GAT, as well as their central corneal thickness (CCT by optical pachymeter. The results of both methods were compared by correlation analysis, general linear method repeated measure and Bland-Altman analysis.RESULTS: Mean IOP values measured by RTCL, RT and GAT were 15.68±3.7, 14.50±3.4 and 14.16±2.8 (P<0.001, respectively. Mean IOP by RTCL was significantly higher than the measurements implemented by RT and GAT (P<0.001, while there was no difference between the measurements by GAT and RT (P=0.629. There was a good level of positive correlation between GAT and RTCL as well as RT (r=0.786 P<0.001, r=0.833 P<0.001, respectively. We have observed that CCT increase did not show any correlation with the differences of the measurements between RTCL and RT (P=0.329, RTCL and GAT (P=0.07 as well as RT and GAT (P=0.189 in linear regression model.CONCLUSION: The average of the measurements over contact lens by rebound tonometer was found to be higher than what was measured by GAT. Although this difference is statistically significant, it may be clinically negligible in the normal population.

Retropupillary iris claw intraocular lens implantation in aphakia for dislocated intraocular lens

Directory of Open Access Journals (Sweden)

Faria MY

2016-08-01

Full Text Available Mun Yueh Faria,1–3 Nuno Pinto Ferreira,1–3 Joana Medeiros Pinto,1–3 David Cordeiro Sousa,1–3 Ines Leal,1–3 Eliana Neto,1–3 Carlos Marques-Neves1–3 1Centro de Estudos da Visão, Universidade de Lisboa, 2Department of Ophthalmology, Hospital de Santa Maria, 3Faculty of Medicine, University of Lisbon, Lisbon, Portugal Background: Nowadays, dislocated intraocular lenses (IOLs and inadequate capsular support are becoming a challenge for every ophthalmic surgeon. Explantation of dislocated IOL and iris claw IOL (ICIOL are the techniques that have been used in our ophthalmic department. The aim of this study is to report our technique for retropupillar ICIOL.Methods: This study is a retrospective case series. A total of 105 eyes with dislocated IOL from the patients at the Department of Ophthalmology in Santa Maria Hospital, a tertiary reference hospital in Lisbon, Portugal, from January 2012 until January 2016, had been analyzed. Of these 105 eyes, 66 eyes had dislocated one-piece IOL and 39 eyes had dislocated three-piece IOL. The latter underwent iris suture of the same IOL and were excluded from this study. The remaining 66 eyes with dislocated one-piece IOL underwent pars plana vitrectomy, that is, explantation of dislocated IOL through corneal incision and an implantation of retropupillary ICIOL. Operative data and postoperative outcomes included best corrected visual acuity, IOL position, intraocular pressure, pigment dispersion, clinical signs of endothelial cell loss, and anterior chamber depth.Results: The mean follow-up was 23 months (range: 6–48 months. The mean preoperative best corrected visual acuity was 1.260±0.771 logMAR, and postoperative best corrected visual acuity was 0.352±0.400 logMAR units. Mean vision gain was 0.909 logMar units. The patients had the following complications: 1 retinal detachment was found in one patient, 2 corneal edema was found in three patients, 3 high intraocular pressure was observed in

Accommodative intraocular lens versus standard monofocal intraocular lens implantation in cataract surgery.

Science.gov (United States)

Ong, Hon Shing; Evans, Jennifer R; Allan, Bruce D S

2014-05-01

Following cataract surgery and intraocular lens (IOL) implantation, loss of accommodation or postoperative presbyopia occurs and remains a challenge. Standard monofocal IOLs correct only distance vision; patients require spectacles for near vision. Accommodative IOLs have been designed to overcome loss of accommodation after cataract surgery. To define (a) the extent to which accommodative IOLs improve unaided near visual function, in comparison with monofocal IOLs; (b) the extent of compromise to unaided distance visual acuity; c) whether a higher rate of additional complications is associated the use of accommodative IOLs. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2013, Issue 9), Ovid MEDLINE, Ovid MEDLINE in-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily Update, Ovid OLDMEDLINE (January 1946 to October 2013), EMBASE (January 1980 to October 2013), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to October 2013), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrial.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 10 October 2013. We include randomised controlled trials (RCTs) which compared implantation of accommodative IOLs to implantation of monofocal IOLs in cataract surgery. Two authors independently screened search results, assessed risk of bias and extracted data. All included trials used the 1CU accommodative IOL (HumanOptics, Erlangen, Germany) for their intervention group. One trial had an additional arm with the AT-45 Crystalens accommodative IOL (Eyeonics Vision). We performed a separate analysis comparing 1CU and AT-45 IOL. We included four RCTs, including 229 participants (256 eyes

Treatment of dystrophic calcification on a silicone intraocular lens with pars plana vitrectomy

Directory of Open Access Journals (Sweden)

Mehta N

2014-07-01

Full Text Available Nitish Mehta,1 Roger A Goldberg,2 Chirag P Shah21University of Massachusetts Medical School, Worcester, MA, USA; 2Department of Retina, Ophthalmic Consultants of Boston, Boston, Massachusetts, USAPurpose: Dense, vision-obscuring calcification on the posterior aspect of silicone intraocular lenses (IOLs is often not amenable to neodymium:yttrium-aluminum-garnet capsulotomy, and, in prior reports, has required IOL exchange. We report the successful removal of dense calcium deposition on the posterior surface of a three-piece silicone lens using pars plana vitrectomy (PPV.Materials and methods: A 23-gauge PPV was performed using the Stellaris® vitrectomy system. A light pipe was used to retroilluminate the IOL, and a dense fibrous tissue setting with a low cut-rate and high aspiration rate was able to clear the visual axis of the dystrophic calcification without damaging the IOL optic.Results: Visual acuity improved from 20/100 to 20/25.Conclusion: Small-gauge PPV may be utilized to remove dense dystrophic calcium deposits on the lens surface in lieu of IOL exchange. Keywords: cataract surgery, technique, Nd:YAG capsulotomy, IOL exchange

The effects of the modulus of the lens material on intraocular pressure measurement through soft contact lenses.

Science.gov (United States)

Boyraz, S; Güngör, I

2013-09-01

To investigate the effects of the modulus of the lens material on the intraocular pressure measurement using the Tono-Pen XL applanation tonometer through soft contact lenses. Thirty eyes of 15 patients with myopia were evaluated. Intraocular pressure (IOP) measurements were performed using Tono-Pen XL directly over cornea, and subsequently through three soft contact lenses made up of different lens materials. All were -3.00 diopter soft contact lenses: lotrafilcon A with a low water content (24%) and high modulus (1.4 MPa) (CL-I), balafilcon A with a moderate water content (36%) and moderate modulus (1.1 MPa) (CL-II), and vifilcon A with a moderate water content (55%) and low modulus (0.79 MPa) (CL-III). IOP measurements through contact lenses were compared with each other, and with direct corneal measurements. The mean age of the patients (11 males and 4 females) was 26.86±5.62 years. All measurements obtained through CLs were significantly higher than the direct corneal measurements. The measurements through CLs differed by 4.61±0.54 mmHg (P=0,001), 2.9±0.46 mmHg (P=0.001), and 1.94±0.51 mmHg (P=0,003) for CL-I, CL-II and CL-III, respectively. In the paired comparisons of measurements through CLs, all comparisons were significant except the comparison of measurements through CL-II and CL-III (P=0.128). IOP measurements through silicone-hydrogel contact lenses with a high modulus and low water content were higher compared to the other contact lenses. While measuring IOP through CLs, the clinicians should consider the effect of the lens material and the features of the device used.

Opacification of the C-flex 570C intraocular lens after sulcus fixation.

Science.gov (United States)

Daigle, Patrick; Carbonneau, Marjorie

2017-09-08

To report a case of diffuse intraocular lens (IOL) opacification in a patient who started complaining of blurred vision in his left eye over the course of three years after having phacoemulsification surgery combined with capsular bag fixation of a C-flex 570C IOL. The IOL had been repositioned in the ciliary sulcus following its subluxation. An IOL exchange was performed, and the explanted IOL was sent for histopathological analysis. Scanning electron microscopy identified multiple crystalline-like deposits on both sides of the IOL. The optic was more extensively involved than the haptics. Energy-dispersive X-ray spectroscopy confirmed the predominance of calcium within the deposits. The breakdown of the blood-aqueous barrier seems to be a key component of this calcification process. Ciliary sulcus fixation is not a suitable option for C-flex 570C IOLs.

Follow up of intraocular lens subluxation with a combined topographer/aberrometer

Science.gov (United States)

Kontadakis, Georgios A.; Kymionis, George D.; Kankariya, Vardhaman P.; Pallikaris, Ioannis G.

2012-01-01

Purpose To report a 36-year-old patient with intraocular lens (IOL) subluxation that was followed for IOL stability with evaluation of images captured with the iTrace combined aberrometer/topographer. Methods The patient had undergone phacoemulsification with IOL implantation for congenital cataract 15 years before. He presented with bilateral IOL subluxation, more severe in his right eye. Right eye was operated for IOL exchange and left eye was followed with the iTrace images. The images were captured with an infrared camera, and the pupil, the pupil center and the corneal vertex could be detected. The subluxated IOLs edge was visible through infrared light retroillumination. IOL position was evaluated with respect to the pupil, the pupil center and the corneal vertex. Results The patient's left eye was followed for 7 months, and IOL position was noted to be stable. Thus no intervention was planned. Conclusion Evaluation of iTrace images is a reliable method to follow eyes with IOL subluxation.

Solving intraocular lens-related pigment dispersion syndrome with repositioning of primary sulcus implanted single-piece IOL in the capsular bag.

Science.gov (United States)

Kohnen, Thomas; Kook, Daniel

2009-08-01

We describe 2 cases of pigment dispersion syndrome (PDS) after uneventful phacoemulsification and implantation of a posterior chamber single-piece intraocular lens (IOL) with a sharp-edge design. In both cases, several days after IOL implantation, marked pigment dispersion was seen on the iris and in the trabecular meshwork, associated with an elevation in intraocular pressure (IOP). Thorough examination showed that the implanted IOL was in the ciliary sulcus. After surgical repositioning of both IOLs in the capsular bag, the pigment dispersion regressed and the IOP returned to normal limits. The 2 cases suggest that particularly in PDS patients, an IOL with an anterior sharp-edge design should be implanted in the capsular bag. Implantation in the ciliary sulcus should be avoided.

Pathological findings in the lens capsules and intraocular lens in chronic pseudophakic endophthalmitis: an electron microscopy study.

Science.gov (United States)

Adán, A; Casaroli-Marano, R P; Gris, O; Navarro, R; Bitrian, E; Pelegrin, L; Sanchez-Dalmau, B

2008-01-01

The aim of this study was to describe the pathological findings in lens capsules and intraocular lens (IOL) studied by scanning and/or transmission electron microscopy (SEM and TEM, respectively) in a series of four eyes with chronic pseudophakic endophthalmitis (CPE). We performed a retrospective study of four patients presenting CPE in whom surgical treatment with pars plana vitrectomy, capsulectomy with extraction of the IOL, and intravitreous antibiotic therapy was thereafter performed. The extracted IOL and the capsular remains were studied by SEM and/or TEM and microbiologic analysis of aqueous humour and vitreous aspirate was also carried out in all the cases. The presence of microorganisms was observed in the material analysed in all the cases studied. The use of TEM identified bacterial contamination by Staphylococcus spp and mixed contamination with microorganisms presenting a bacillar morphology suggestive of infection by Propionibacterium acnes in addition to the presence of cocci in the capsular remains. In another two cases, SEM localized colonies of Staphylococcus spp on the surface of the IOL in one case and mixed bacterial colonization with cocci plus filamentous bacteria in the other. The presence of macrophages associated with bacteria was observed in the capsular remains. Microorganisms were found in the IOL or the capsular material in the four cases studied, thereby explaining the refractoriness and severity of infection. The possible presence of polymicrobial infections, especially in the cases with filamentous bacteria, also explains the recurrence of infection.

Surgical effect of traumatic lens dislocation with secondary glaucoma

Directory of Open Access Journals (Sweden)

Xiao-Dan Zhang

2014-10-01

Full Text Available AIM: To retrospectively evaluate the effect of lens extraction combined with vitrectomy to treat traumatic lens dislocation with secondary glaucoma.METHODS:Thirty-one eyes(31 casesof lens dislocation caused by blunt trauma with secondary glaucoma were treated respectively with cataract extraction combined with anterior vitrectomy, trabeculectomy and intraocular lens implantation. The visual acuity and pressure were observed 1wk, 1 and 3mo after operative. RESULTS:Thirty-one eyes were all complete the operation successfully, and 6 eyes were given combined trabeculectomy, 9 eyes were implanted anterior chamber intraocular lens implantation(IOLand 15 eyes were given posterior chamber suture fixation. Sixteen eyes were implanted in one-stage operation, while 8 eyes were implanted in two-stage operation. All intraocular pressure(IOPwere controlled to the normal level after operation and 23 eyes had visual acuity of more than 0.3.CONCLUSION:Lens extraction combined with vitrectomy is an effective method for treatment of lens dislocation with secondary glaucoma. In order to control the IOP and get well visual function, we should choose IOL implantation or trabeculectomy according to the patient's condition.

Refractive outcomes after multifocal intraocular lens exchange.

Science.gov (United States)

Kim, Eric J; Sajjad, Ahmar; Montes de Oca, Ildamaris; Koch, Douglas D; Wang, Li; Weikert, Mitchell P; Al-Mohtaseb, Zaina N

2017-06-01

To evaluate the refractive outcomes after multifocal intraocular lens (IOL) exchange. Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA. Retrospective case series. Patients had multifocal IOL explantation followed by IOL implantation. Outcome measures included type of IOL, surgical indication, corrected distance visual acuity (CDVA), and refractive prediction error. The study comprised 29 patients (35 eyes). The types of IOLs implanted after multifocal IOL explantation included in-the-bag IOLs (74%), iris-sutured IOLs (6%), sulcus-fixated IOLs with optic capture (9%), sulcus-fixated IOLs without optic capture (9%), and anterior chamber IOLs (3%). The surgical indication for exchange included blurred vision (60%), photic phenomena (57%), photophobia (9%), loss of contrast sensitivity (3%), and multiple complaints (29%). The CDVA was 20/40 or better in 94% of eyes before the exchange and 100% of eyes after the exchange (P = .12). The mean refractive prediction error significantly decreased from 0.22 ± 0.81 diopter (D) before the exchange to -0.09 ± 0.53 D after the exchange (P exchange to 0.23 D after the exchange (P exchange can be performed safely with good visual outcomes using different types of IOLs. A lower refractive prediction error and a higher likelihood of 20/40 or better vision can be achieved with the implantation of the second IOL compared with the original multifocal IOL, regardless of the final IOL position. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Neodymium:YAG laser cutting of intraocular lens haptics in vitro and in vivo.

Science.gov (United States)

Feder, J M; Rosenberg, M A; Farber, M D

1989-09-01

Various complications following intraocular lens (IOL) surgery result in explantation of the lenses. Haptic fibrosis may necessitate cutting the IOL haptics prior to removal. In this study we used the neodymium: YAG (Nd:YAG) laser to cut polypropylene and poly(methyl methacrylate) (PMMA) haptics in vitro and in rabbit eyes. In vitro we were able to cut 100% of both haptic types successfully (28 PMMA and 30 polypropylene haptics). In rabbit eyes we were able to cut 50% of the PMMA haptics and 43% of the polypropylene haptics. Poly(methyl methacrylate) haptics were easier to cut in vitro and in vivo than polypropylene haptics, requiring fewer shots for transection. Complications of Nd:YAG laser use frequently interfered with haptic transections in rabbit eyes. Haptic transection may be more easily accomplished in human eyes.

Facoemulsificación e implante de lente intraocular en cataratas causadas por uveitis Phacoemulsification and intraocular lens implantation in patients with cataract caused by uveitis

Directory of Open Access Journals (Sweden)

Dayamí Pérez Gómez

2008-06-01

Full Text Available OBJETIVO: Evaluar los resultados de la facoemulsificación y el implante de lente intraocular en cataratas causadas por uveítis. MÉTODOS: Se estudiaron 37 ojos con 6 meses de inactividad inflamatoria, agudeza visual menor de 0,6 y edad media de 47 años. Se excluyeron otras enfermedades que disminuyeran la visión. En el preoperatorio se prescribió antiinflamatorios. Se realizó la facoemulsificación con implante de lente intarocular (PMMA, óptica 6 mm; durante el seguimiento desde 24 h/6 meses se indicó antiinflamatorios esteroideos, no esteroideos e inmunosupresores hasta 6 semanas. RESULTADOS: Se observaron numerosas alteraciones del segmento anterior secundarias a las uveítis padecidas (posquirúrgicas, inespecíficas, ciclítis heterocrómica de Fuchs, postraumáticas, síndrome de Reiter, por toxoplasmosis y otras coroiditis infecciosas y por artritis reumatoide juvenil. No hubo recurrencia posquirúrgica de la uveítis en 9 ojos (24,3 %. Las complicaciones estuvieron relacionadas con la uveítis, la cirugía, la actividad inflamatoria, y la reacción del epitelio capsular. La opacidad capsular posterior apareció en 11 pacientes (29,7 % asociada a edad joven. La evolución individual se consideró satisfactoria en 30 (81,1 % pacientes con mejoría de la visión hasta 0,8-1,0 en 28 (75,6 % y 0,5-0,6 en 2 (5,4 %. CONCLUSIONES: La facoemulsificación con implante de lente intarocular es de gran utilidad en las cataratas posuveítis al condicionar poca agresión quirúrgica, ser controlable la inflamación y proporcionar buenos resultados visuales además del reordenamiento anatomofisiológico del segmento anterior.OBJECTIVE: To assess the results of phacoemulsification and intraocular lens implantation in cataracts caused by uveitis. METHODS: Thirty seven eyes with no inflammation for 6 months, visual acuity below 0.6 and average age of 47 years were studied. Other diseases affecting the vision were excluded. The preoperative

Effect of interface reflection in pseudophakic eyes with an additional refractive intraocular lens.

Science.gov (United States)

Schrecker, Jens; Zoric, Katja; Meßner, Arthur; Eppig, Timo

2012-09-01

To compare the surface reflections in a pseudophakic model eye with and without a monofocal additional refractive intraocular lens (add-on IOL). Department of Ophthalmology, Rudolf-Virchow-Klinikum Glauchau, Glauchau, and Experimental Ophthalmology, Saarland University, Homburg, Germany. Experimental study. The Liou and Brennan model eye was used to determine the retinal surface reflections in a pseudophakic model eye with and without an add-on IOL. The crystalline lens of the model eye was replaced by (1) a standard posterior chamber IOL (PC IOL) with a refractive power of 22.0 diopters (D) and (2) a PC IOL and an add-on IOL with refractive powers of 19.0 D and 2.5 D, respectively. To theoretically estimate the impact of the reflected images to visual impression, the signal-to-noise ratio (SNR) was calculated under 2 conditions: without and with straylight and double reflection effects. Compared with the pseudophakic model eye without an add-on IOL, the pseudophakic model eye with an add-on IOL showed no relevant differences in the SNR under both conditions. Findings indicate that implantation of monofocal add-on IOLs will not induce relevant additional disturbing glare compared with conventional pseudophakia. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Early lens extraction with intraocular lens implantation for the treatment of primary angle closure glaucoma: an economic evaluation based on data from the EAGLE trial

Science.gov (United States)

Javanbakht, Mehdi; Azuara-Blanco, Augusto; Burr, Jennifer M; Ramsay, Craig; Cooper, David; Cochran, Claire; Norrie, John; Scotland, Graham

2017-01-01

Objective To investigate the cost-effectiveness of early lens extraction with intraocular lens implantation for the treatment of primary angle closure glaucoma (PACG) compared to standard care. Design Cost-effectiveness analysis alongside a multicentre pragmatic two-arm randomised controlled trial. Patients were followed-up for 36 months, and data on health service usage and health state utility were collected and analysed within the trial time horizon. A Markov model was developed to extrapolate the results over a 5-year and 10-year time horizon. Setting 22 hospital eye services in the UK. Population Males and females aged 50 years or over with newly diagnosed PACG or primary angle closure (PAC). Interventions Lens extraction compared to standard care (ie, laser iridotomy followed by medical therapy and glaucoma surgery). Outcome measures Costs of primary and secondary healthcare usage (UK NHS perspective), quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) for lens extraction versus standard care. Results The mean age of participants was 67.5 (8.42), 57.5% were women, 44.6% had both eyes eligible, 1.4% were of Asian ethnicity and 35.4% had PAC. The mean health service costs were higher in patients randomised to lens extraction: £2467 vs £1486. The mean adjusted QALYs were also higher with early lens extraction: 2.602 vs 2.533. The ICER for lens extraction versus standard care was £14 284 per QALY gained at three years. Modelling suggests that the ICER may drop to £7090 per QALY gained by 5 years and that lens extraction may be cost saving by 10 years. Our results are generally robust to changes in the key input parameters and assumptions. Conclusions We find that lens extraction has a 67–89% chance of being cost-effective at 3 years and that it may be cost saving by 10 years. Trial registration number ISRCTN44464607; Results. PMID:28087548

Capsular Outcomes After Pediatric Cataract Surgery Without Intraocular Lens Implantation: Qualitative Classification and Quantitative Measurement.

Science.gov (United States)

Tan, Xuhua; Lin, Haotian; Lin, Zhuoling; Chen, Jingjing; Tang, Xiangchen; Luo, Lixia; Chen, Weirong; Liu, Yizhi

2016-03-01

The objective of this study was to investigate capsular outcomes 12 months after pediatric cataract surgery without intraocular lens implantation via qualitative classification and quantitative measurement.This study is a cross-sectional study that was approved by the institutional review board of Zhongshan Ophthalmic Center of Sun Yat-sen University in Guangzhou, China.Digital coaxial retro-illumination photographs of 329 aphakic pediatric eyes were obtained 12 months after pediatric cataract surgery without intraocular lens implantation. Capsule digital coaxial retro-illumination photographs were divided as follows: anterior capsule opening area (ACOA), posterior capsule opening area (PCOA), and posterior capsule opening opacity (PCOO). Capsular outcomes were qualitatively classified into 3 types based on the PCOO: Type I-capsule with mild opacification but no invasion into the capsule opening; Type II-capsule with moderate opacification accompanied by contraction of the ACOA and invasion to the occluding part of the PCOA; and Type III-capsule with severe opacification accompanied by total occlusion of the PCOA. Software was developed to quantitatively measure the ACOA, PCOA, and PCOO using standardized DCRPs. The relationships between the accurate intraoperative anterior and posterior capsulorhexis sizes and the qualitative capsular types were statistically analyzed.The DCRPs of 315 aphakic eyes (95.8%) of 191 children were included. Capsular outcomes were classified into 3 types: Type I-120 eyes (38.1%); Type II-157 eyes (49.8%); Type III-38 eyes (12.1%). The scores of the capsular outcomes were negatively correlated with intraoperative anterior capsulorhexis size (R = -0.572, P PCOA increased in size from Type I to Type II, and the PCOO increased from Type II to Type III (all P < 0.05).Capsular outcomes after pediatric cataract surgery can be qualitatively classified and quantitatively measured by acquisition, division, definition, and user

Influence of corneal asphericity on the refractive outcome of intraocular lens implantation in cataract surgery.

Science.gov (United States)

Savini, Giacomo; Hoffer, Kenneth J; Barboni, Piero

2015-04-01

To evaluate the possible influence of anterior corneal surface asphericity on the refractive outcomes in eyes having intraocular lens (IOL) implantation after cataract surgery. Fondazione G.B. Bietti IRCCS, Rome, Italy. Retrospective comparative case series. Intraocular lens power was calculated using the Haigis, Hoffer Q, Holladay 1, and SRK/T formulas. Asphericity (Q-value) was measured at 8.0 mm with a Placido-disk corneal topographer (Keratron), a rotating Scheimpflug camera (Pentacam), and a rotating Scheimpflug camera combined with Placido-disk corneal topography (Sirius). The relationship between the error in refraction prediction (ie, difference between expected refraction and refraction measured 1 month after surgery) and the Q-value was assessed by linear regression. The same IOL model (Acrysof SA60AT) was implanted in 115 eyes of 115 consecutive patients. Regression analysis showed a statistically significant relationship between the error in refraction prediction and the Q-value with all formulas and all devices. In all cases, a more negative Q-value (prolate cornea) was associated with a myopic outcome, whereas a more positive Q-value (oblate cornea) was associated with a hyperopic outcome. The highest coefficient of determination was detected between the Hoffer Q formula and the Placido-disk corneal topographer (R(2) = 0.2630), for which the error in refraction prediction (y) was related to the Q-value (x) according to the formula y = -0.2641 + 1.4589 × x. Corneal asphericity influences the refractive outcomes of IOL implantation and should be taken into consideration when using third-generation IOL power formulas. Dr. Hoffer receives book royalties from Slack, Inc., Thorofare, New Jersey, and formula royalties from all manufacturers using the Hoffer Q formula. No other author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Intermediate results of sutureless intrascleral posterior chamber intraocular lens fixation.

Science.gov (United States)

Scharioth, Gabor B; Prasad, Som; Georgalas, Ilias; Tataru, Calin; Pavlidis, Mitrofanis

2010-02-01

To report the intermediate multicenter results of a technique of sutureless intrascleral fixation of a standard 3-piece posterior chamber intraocular lens (PC IOL) in the ciliary sulcus. Four European ophthalmology centers. A technique for sutureless intrascleral fixation of the haptics of a standard 3-piece PC IOL was retrospectively evaluated. The technique uses standardized maneuvers to fixate the PC IOL without need for special haptic architecture or preparation or haptic suturing. All patients having IOL implantation by the technique were evaluated for preoperative status (visual acuity, refractive error, preexisting ocular conditions, optical biometry), postoperative status, complications, and need for further surgery. The study evaluated 63 consecutive patients from 4 institutions (4 surgeons). The median follow-up was 7 months. Two dislocated PC IOLs (3.6%) were decentered; the other 61 IOLs (96.8%) were stable and well centered. There were no cases of recurrent dislocation, endophthalmitis, retinal detachment, or glaucoma. Fixation of PC IOL haptics in a limbus-parallel scleral tunnel provided exact centration and axial stability of the IOL and prevented distortion and subluxation in most cases. Copyright 2010 ASCRS and ESCRS. All rights reserved.

A case report of intraocular lens luxation with the capsular bag after vitrectomy.

Science.gov (United States)

Kawai, Kenji; Bando, Masayasu; Suzuki, Takahiro; Hayakawa, Kenji

2004-04-01

We experienced a case of intraocular lens (IOL) luxation with the capsular bag after vitrectomy. The case was a 66-year-old female in whom an IOL was implanted one year after surgery for giant tear retinal detachment using silicone oil. Four years after the implantation surgery, the patient suffered subluxation of the IOL with the capsular bag. Examinations of the luxated IOL with the capsular bag using a stereoscopic microscope confirmed the presence of silicone oil droplets between the capsule and the IOL. Adhesion of vitreous body residues was observed in the capsule. Luxation of the IOL was thought to be connected with chronic inflammation resulting from the use of silicone oil and repeated vitrectomy. In addition to examining pathological findings of luxated IOL, it would also be important in the future to identify the pathology of the capsular bag.

Management of moderate and severe corneal astigmatism with AcrySof® toric intraocular lens implantation - Our experience.

Science.gov (United States)

Farooqui, Javed Hussain; Koul, Archana; Dutta, Ranjan; Shroff, Noshir Minoo

2015-01-01

Visual performance following toric intraocular lens implantation for cataract with moderate and severe astigmatism. Cataract services, Shroff Eye Centre, New Delhi, India. Case series. This prospective study included 64 eyes of 40 patients with more than 1.50 dioptre (D) of pre-existing corneal astigmatism undergoing phacoemulsification with implantation of the AcrySof® toric IntraOcular Lens (IOL). The unaided visual acuity (UCVA), best corrected visual acuity (BCVA), residual refractive sphere and refractive cylinders were evaluated. Toric IOL axis and alignment error was measured by slit lamp method and Adobe Photoshop (version 7) method. Patient satisfaction was evaluated using a satisfaction questionnaire at 3 months. The mean residual refractive astigmatism was 0.57 D at the final follow-up of 3 months. Mean alignment error was 3.44 degrees (SD = 2.60) by slit lamp method and 3.88 degrees (SD = 2.86) by Photoshop method. Forty-six (71.9%) eyes showed misalignment of 5 degrees or less, and 60 (93.8%) eyes showed misalignment of 10 degrees or less. The mean log MAR UCVA at 1st post-op day was 0.172 (SD = 0.02), on 7th post-op day was 0.138 (SD = 0.11), and on 30th post-op day was 0.081 (SD = 0.11). The mean log MAR BCVA at three months was -0.04 (SD = 0.76). We believe that implantation of AcrySof® toric IOL is an effective, safe and predictable method to correct high amounts of corneal astigmatism during cataract surgery.

New trends in intraocular lens imaging

Science.gov (United States)

Millán, María S.; Alba-Bueno, Francisco; Vega, Fidel

2011-08-01

As a result of modern technological advances, cataract surgery can be seen as not only a rehabilitative operation, but a customized procedure to compensate for important sources of image degradation in the visual system of a patient, such as defocus and some aberrations. With the development of new materials, instruments and surgical techniques in ophthalmology, great progress has been achieved in the imaging capability of a pseudophakic eye implanted with an intraocular lens (IOL). From the very beginning, optical design has played an essential role in this progress. New IOL designs need, on the one hand, theoretical eye models able to predict optical imaging performance and on the other hand, testing methods, verification through in vitro and in vivo measurements, and clinical validation. The implant of an IOL requires a precise biometry of the eye, a prior calculation from physiological data, and an accurate position inside the eye. Otherwise, the effects of IOL calculation errors or misplacements degrade the image very quickly. The incorporation of wavefront aberrometry into clinical ophthalmology practice has motivated new designs of IOLs to compensate for high order aberrations in some extent. Thus, for instance, IOLs with an aspheric design have the potential to improve optical performance and contrast sensitivity by reducing the positive spherical aberration of human cornea. Monofocal IOLs cause a complete loss of accommodation that requires further correction for either distance or near vision. Multifocal IOLs address this limitation using the principle of simultaneous vision. Some multifocal IOLs include a diffractive zone that covers the aperture in part or totally. Reduced image contrast and undesired visual phenomena, such as halos and glare, have been associated to the performance of multifocal IOLs. Based on a different principle, accommodating IOLs rely on the effort of the ciliary body to increase the effective power of the optical system of the

CUSTOM OPTIMIZATION OF INTRAOCULAR LENS ASPHERICITY

Science.gov (United States)

Koch, Douglas D.; Wang, Li

2007-01-01

Purpose To investigate the optimal amount of ocular spherical aberration (SA) in an intraocular lens (IOL) to maximize optical quality. Methods In 154 eyes of 94 patients aged 40 to 80 years, implantation of aspheric IOLs was simulated with different amounts of SA to produce residual ocular SA from −0.30 μm to +0.30 μm. Using the VOL-CT program (Sarver & Associates, Carbondale, Illinois), corneal wavefront aberrations up to 6th order were computed from corneal topographic elevation data (Humphrey Atlas, Carl Zeiss Meditec, Inc, Dublin, California). Using the ZernikeTool program (Advanced Medical Optics, Inc, Santa Ana, California), the polychromatic point spread function with Stiles-Crawford effect was calculated for the residual ocular higher-order aberrations (HOAs, 3rd to 6th order, 6-mm pupil), assuming fully corrected 2nd-order aberrations. Five parameters were used to quantify optical image quality, and we determined the residual ocular SA at which the maximal image quality was achieved for each eye. Stepwise multiple regression analysis was performed to assess the predictors for optimal SA of each eye. Results The optimal SA varied widely among eyes. Most eyes had best image quality with low amounts of negative SA. For modulation transfer function volume up to 15 cycles/degree, the amount of optimal SA could be predicted based on other HOAs of the cornea with coefficient of multiple determination (R2) of 79%. Eight Zernike terms significantly contributed to the optimal SA in this model; the order of importance to optimal SA from most to least was: Z60, Z62, Z42, Z53, Z64, Z3−1, Z33, and Z31. For the other 4 measures of visual quality, the coefficients of determination varied from 32% to 63%. Conclusion The amount of ocular SA producing best image quality varied widely among subjects and could be predicted based on corneal HOAs. Selection of an aspheric IOL should be customized according to the full spectrum of corneal HOAs and not 4th-order SA alone

Implante intra-ocular de lentes dobráveis "piggyback" em paciente portador de catarata congênita no primeiro ano de vida: relato de caso Piggyback foldable intraocular lens implant in patient with congenital cataract in the first year of life: case report

Directory of Open Access Journals (Sweden)

Leonardo Akaishi

2004-12-01

Full Text Available No presente relato os autores descrevem um caso de catarata congênita unilateral tratada cirurgicamente com implante intra-ocular de lentes dobráveis "piggyback", ainda não descrito na literatura nacional. São analisadas as diferenças e semelhanças com outros casos descritos na literatura.The authors report a case of congenital cataract, which was treated with piggyback foldable intraocular lens implant, not described in the Brazilian literature. The differences and similarities are analyzed with other reported cases in the literature.

The Effect of Various Contact Lenses on Intraocular Pressure Measurement by Goldman Tonometer

Directory of Open Access Journals (Sweden)

Monireh Mahjoob

2014-06-01

Full Text Available Background: Today, contact lenses have extensive usages. Contact lens places on cornea, so it may induce variation on cornea and these variations can influence the measurement of intraocular pressure (IOP by Goldman tonometer. The aim of this research was to study the effect of various contact lenses on measurement of intraocular pressure by Goldman tonometer. Materials and Methods: In this study, 80 subjects aged 18-25 were selected randomly among patients of Al-Zahra ophthalmology center. None of them has any eye pathological problems. Before wearing the lens, intraocular pressure was measured, and then patients were divided into two groups of soft and hard contact lenses. Soft and hard contact lenses were placed on the eye for two hours, and the intraocular pressure was measured again. Results: The mean of IOP before wearing contact lenses and two hours later was 15.96 mmHg and 13.93, s respectively. Paired test showed a significant difference between IOP before and after wearing contact lenses (p=0.001.There was no significant differences in mean of intraocular pressure decline before and after placing the contact lens in both soft and hard lenses. Conclusion: According to this study, the intraocular pressure decreases after wearing contact lenses (CL. This decline may be due to variation in properties of cornea after wearing CL that can also affect IOP measurement.

Resultados preliminares do implante de lente intra-ocular fácica artisan para correção de miopia Preliminary results of artisan phakic intraocular lens implantation to correct myopia

Directory of Open Access Journals (Sweden)

Leonardo Akaishi

2007-06-01

Artisan anterior chamber intra-ocular lens for the correction of myopia in the first 6 months. METHODS: A retrospective study of 18 patients (34 eyes that received the implantation of Artisan anterior chamber intraocular lens for the correction of myopia was conducted. Best visual preoperative acuity, best visual postoperative acuity, dynamic preoperative and postoperative refraction, loss and improvement of lines of vision and complications were evaluated. RESULTS: Eighteen patients (34 eyes were included in this study. Fourteen patients were females (77.8% and 4 were males. The mean age was 30 years (SD ± 7.3, range from 21 to 46 years. They were followed up for an average of 8.5 months (SD ± 3.6. The mean endothelial cell loss was 4.75% at 6 months follow-up. The average preoperative uncorrected visual acuity was 0.02 (20/800 range from 0.01 to 0.13. The average preoperative spherical equivalent was -13.25 D, range from -5.75 D to -19,75 D. On the last follow-up, uncorrected visual acuity was 0.64 (20/32, range from 0.33 to 1.00; the average spherical equivalent was -1.18 D (DP ± 0.92 range from +0.25 to -3.0. Complications were observed in 1 case (3.4% of our study, in one patient who had a dislocation of the lens after an ocular trauma. CONCLUSION: The use of Artisan anterior chamber intraocular lens in phakic eyes for the correction of myopia was safe, effective and predictable. However, a larger prospective study with a higher number of cases and longer follow-up is necessary to determine long-term safety of the lens.

Goldmann applanation tonometry over daily disposable contact lens: accuracy and safety of procedure.

Science.gov (United States)

Zeri, Fabrizio; Lupelli, Luigi; Formichella, Paolo; Masci, Carlo; Fletcher, Robert

2007-09-01

To study accuracy and safety, related to sensation (discomfort) and trauma, when using Goldmann applanation tonometry (GAT) on eyes wearing daily disposable soft contact lenses. The intra-ocular pressure (IOP) of 136 normal eyes of 68 subjects was measured by Goldmann tonometer. Measurements were made in one eye with a contact lens (hilafilcon A) without anaesthetic drops and then without the contact lens using one drop of 0.4% oxybuprocaine hydrochloride. Each contact lens used was identical as to back optic zone, back vertex power. Standard Goldmann procedure only was used for the fellow eye of each subject. Subjective sensation (discomfort) responses to both procedures were studied in a subgroup (66 eyes) using a scale of discomfort, from 1 (no sensation) to 5 (highest sensation). Epithelial staining after tonometry was evaluated for this subgroup. No significant differences were found for the IOP with and without contact lens (tcontact lens insertion, tonometry on contact lens and application of topical anaesthetic). Corneal epithelial staining following the standard tonometry procedure was significantly higher than following the procedure with a contact lens (pcontact lens is accurate, compared to the standard procedure and within the IOP's normal range studied here. Also using a contact lens results in less trauma whilst discomfort is similar.

Preoperative automatic visual behavioural analysis as a tool for intraocular lens choice in cataract surgery

Directory of Open Access Journals (Sweden)

Heloisa Neumann Nogueira

2015-04-01

Full Text Available Purpose: Cataract is the main cause of blindness, affecting 18 million people worldwide, with the highest incidence in the population above 50 years of age. Low visual acuity caused by cataract may have a negative impact on patient quality of life. The current treatment is surgery in order to replace the natural lens with an artificial intraocular lens (IOL, which can be mono- or multifocal. However, due to potential side effects, IOLs must be carefully chosen to ensure higher patient satisfaction. Thus, studies on the visual behavior of these patients may be an important tool to determine the best type of IOL implantation. This study proposed an anamnestic add-on for optimizing the choice of IOL. Methods: We used a camera that automatically takes pictures, documenting the patient’s visual routine in order to obtain additional information about the frequency of distant, intermediate, and near sights. Results: The results indicated an estimated frequency percentage, suggesting that visual analysis of routine photographic records of a patient with cataract may be useful for understanding behavioural gaze and for choosing visual management strategy after cataract surgery, simultaneously stimulating interest for customized IOL manufacturing according to individual needs.

Scheimpflug camera combined with placido-disk corneal topography and optical biometry for intraocular lens power calculation.

Science.gov (United States)

Kirgiz, Ahmet; Atalay, Kurşat; Kaldirim, Havva; Cabuk, Kubra Serefoglu; Akdemir, Mehmet Orcun; Taskapili, Muhittin

2017-08-01

The purpose of this study was to compare the keratometry (K) values obtained by the Scheimpflug camera combined with placido-disk corneal topography (Sirius) and optical biometry (Lenstar) for intraocular lens (IOL) power calculation before the cataract surgery, and to evaluate the accuracy of postoperative refraction. 50 eyes of 40 patients were scheduled to have phacoemulsification with the implantation of a posterior chamber intraocular lens. The IOL power was calculated using the SRK/T formula with Lenstar K and K readings from Sirius. Simulated K (SimK), K at 3-, 5-, and 7-mm zones from Sirius were compared with Lenstar K readings. The accuracy of these parameters was determined by calculating the mean absolute error (MAE). The mean Lenstar K value was 44.05 diopters (D) ±1.93 (SD) and SimK, K at 3-, 5-, and 7-mm zones were 43.85 ± 1.91, 43.88 ± 1.9, 43.84 ± 1.9, 43.66 ± 1.85 D, respectively. There was no statistically significant difference between the K readings (P = 0.901). When Lenstar was used for the corneal power measurements, MAE was 0.42 ± 0.33 D, but when simK of Sirius was used, it was 0.37 ± 0.32 D (the lowest MAE (0.36 ± 0.32 D) was achieved as a result of 5 mm K measurement), but it was not statistically significant (P = 0.892). Of all the K readings of Sirius and Lenstar, Sirius 5-mm zone K readings were the best in predicting a more precise IOL power. The corneal power measurements with the Scheimpflug camera combined with placido-disk corneal topography can be safely used for IOL power calculation.

Iris-claw intraocular lenses to correct aphakia in the absence of capsule support.

Science.gov (United States)

De Silva, Samantha R; Arun, Kikkeri; Anandan, Maghizh; Glover, Nicholas; Patel, Chetan K; Rosen, Paul

2011-09-01

To evaluate the indications, postoperative visual efficacy, and complication rate after intraocular implantation of an iris-claw aphakic intraocular lens (IOL). Oxford Eye Hospital, Oxford, United Kingdom. Case series. This chart review comprised eyes with no capsule support that had anterior iris-fixation IOL implantation for aphakia between 2001 and 2009. The study comprised 116 eyes (104 patients). Iris-claw IOLs were inserted during primary lens surgery in 18 eyes (15.5%), during an IOL exchange procedure for dislocated posterior chamber IOLs in 19 eyes (16.4%), and as a secondary procedure in 79 eyes (68.1%). The mean follow-up was 22.4 months (range 3 to 79 months). The final corrected distance visual acuity (CDVA) was 6/12 or better in 68.9% of all eyes and in 47 of 53 eyes (88.7%) with no preoperative comorbidity. Complications included wound leak requiring resuturing in 2.6% of eyes, postoperative intraocular pressure rise in 9.5% of eyes (glaucoma escalation 0.8%), and cystoid macular edema in 7.7% of eyes (0.8% chronic). Iris-claw IOL subluxation occurred in 6.0% of eyes from 5 days to 60 months postoperatively; all the IOLs were repositioned. Corneal decompensation occurred in 1.7% of eyes; 0.8% had retinal detachments. Iris-claw IOL implantation for aphakia gave a good visual outcome and can be used for a wide range of indications. Postoperative complication rates were comparable to, if not better than, those with conventional anterior chamber IOLs. Correct implantation technique is critical in avoiding postoperative IOL subluxation. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

The impact of a preloaded intraocular lens delivery system on operating room efficiency in routine cataract surgery.

Science.gov (United States)

Jones, Jason J; Chu, Jeffrey; Graham, Jacob; Zaluski, Serge; Rocha, Guillermo

2016-01-01

The aim of this study was to evaluate the operational impact of using preloaded intraocular lens (IOL) delivery systems compared with manually loaded IOL delivery processes during routine cataract surgeries. Time and motion data, staff and surgery schedules, and cost accounting reports were collected across three sites located in the US, France, and Canada. Time and motion data were collected for manually loaded IOL processes and preloaded IOL delivery systems over four surgery days. Staff and surgery schedules and cost accounting reports were collected during the 2 months prior and after introduction of the preloaded IOL delivery system. The study included a total of 154 routine cataract surgeries across all three sites. Of these, 77 surgeries were performed using a preloaded IOL delivery system, and the remaining 77 surgeries were performed using a manual IOL delivery process. Across all three sites, use of the preloaded IOL delivery system significantly decreased mean total case time by 6.2%-12.0% (Psystem also decreased surgeon lens time, surgeon delays, and eliminated lens touches during IOL preparation. Compared to a manual IOL delivery process, use of a preloaded IOL delivery system for cataract surgery reduced total case time, total surgeon lens time, surgeon delays, and eliminated IOL touches. The time savings provided by the preloaded IOL delivery system provide an opportunity for sites to improve routine cataract surgery throughput without impacting surgeon or staff capacity.

Intraocular lens alignment from purkinje and Scheimpflug imaging.

Science.gov (United States)

Rosales, Patricia; De Castro, Alberto; Jiménez-Alfaro, Ignacio; Marcos, Susana

2010-11-01

The improved designs of intraocular lenses (IOLs) implanted during cataract surgery demand understanding of the possible effects of lens misalignment on optical performance. In this review, we describe the implementation, set-up and validation of two methods to measure in vivo tilt and decentration of IOLs, one based on Purkinje imaging and the other on Scheimpflug imaging. The Purkinje system images the reflections of an oblique collimated light source on the anterior cornea and anterior and posterior IOL surfaces and relies on the well supported assumption of the linearity of the Purkinje images with respect to IOL tilt and decentration. Scheimpflug imaging requires geometrical distortion correction and image processing techniques to retrieve the pupillary axis, IOL axis and pupil centre from the three-dimensional anterior segment image of the eye. Validation of the techniques using a physical eye model indicates that IOL tilt is estimated within an accuracy of 0.261 degree and decentration within 0.161 mm. Measurements on patients implanted with aspheric IOLs indicate that IOL tilt and decentration tend to be mirror symmetric between left and right eyes. The average tilt was 1.54 degrees and the average decentration was 0.21 mm. Simulated aberration patterns using custom models of the patients eyes, built using anatomical data of the anterior cornea and foveal position, the IOL geometry and the measured IOL tilt and decentration predict the experimental wave aberrations measured using laser ray tracing aberrometry on the same eyes. This reveals a relatively minor contribution of IOL tilt and decentration on the higher-order aberrations of the normal pseudophakic eye.

Effect of infusion bottle height on lens power after lens refilling with and without a plug

NARCIS (Netherlands)

Koopmans, SA; Terwee, T; Haitjema, HJ; Kooijman, AC; Barkhof, J

2003-01-01

Purpose: To evaluate the influence of intraoperative infusion bottle height on the power of refilled pig lenses. Setting: Research Laboratory, Pharmacia Intraocular Lens Manufacturing Plant, Groningen, The Netherlands. Methods: This study comprised 2 groups of pig eyes. In 1 group, the lens was

Supracapsular glued intraocular lens in progressive subluxated cataracts: Technique to retain an intact vitreous face.

Science.gov (United States)

Jacob, Soosan; Narasimhan, Smita; Agarwal, Amar; Mazzotta, Cosimo; Rechichi, Miguel; Agarwal, Athiya

2017-03-01

We describe a technique to prevent late intraocular lens (IOL) subluxation and dislocation that can be associated with progressive zonulopathy. Supracapsular glued IOL fixation is done to retain an intact anterior hyaloid face and avoid vitreous disturbance while providing stable long-term IOL fixation. Phacoemulsification is followed by glued IOL implantation above intact anterior and posterior capsules. Sclerotomies are created ab interno in a supracapsular plane under diametrically opposite lamellar scleral flaps without entering the vitreous cavity. Haptics are externalized in the supracapsular plane and tucked into intrascleral tunnels. Intraoperative or postoperative posterior capsulorhexis or capsulotomy and anterior capsule relaxing cuts can prevent capsule phimosis. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Safety and effectiveness of a glistening-free single-piece hydrophobic acrylic intraocular lens (enVista

Directory of Open Access Journals (Sweden)

Packer M

2013-09-01

Full Text Available Mark Packer,1 Luther Fry,2 Kevin T Lavery,3 Robert Lehmann,4 James McDonald,5 Louis Nichamin,6 Brian Bearie,7,† Jon Hayashida,8 Griffith E Altmann,8 Omid Khodai8 1Department of Ophthalmology, Oregon Health and Science University, Eugene, OR, USA; 2University of Kansas Medical Center, Kansas City, KS, USA; 3Wayne State University, Detroit, MI, USA; 4Baylor College of Medicine, Houston, TX, USA; 5University of Arkansas for Medical Sciences, Little Rock, AR, USA; 6Laurel Eye Clinic, Brookville, PA, USA; 7Grand Rapids Eye Institute, Grand Rapids, MI, USA; 8Bausch & Lomb, Aliso Viejo, CA, USA †Brian Bearie passed away on March 9, 2011 Purpose: To evaluate the safety and effectiveness of a single-piece hydrophobic acrylic intraocular lens (IOL; enVista model MX60; Bausch & Lomb, Rochester, NY, USA when used to correct aphakia following cataract extraction in adults. Methods: This was a prospective case series (NCT01230060 conducted in private practices in the US. Eligible subjects were adult patients with age-related cataract amenable to treatment with standard phacoemulsification/extracapsular cataract extraction. With follow-up of 6 months, primary safety and effectiveness end points included the rates of US Food and Drug Administration (FDA-defined cumulative and persistent adverse events and the percentage of subjects who achieved best-corrected visual acuity (BCVA of 20/40 or better at final visit. To evaluate rotational stability, subjects were randomized (1:1:1:1 to have the lens implanted in one of four axis positions in 45° increments. Results: A total of 122 subjects were enrolled. The rate of cumulative and persistent adverse events did not significantly exceed historical controls, as per FDA draft guidance. At the final postoperative visit, all subjects (100% achieved a BCVA of 20/40 compared with the FDA historical control of 96.7%. Rotation of the IOL between the two final follow-up visits was ≤5° for 100% of eyes, and refractive

Spontaneous, late, in-the-bag intraocular lens subluxation in a patient with a previous acute angle-closure glaucoma attack.

Science.gov (United States)

Su, Wei-Wen; Chang, Shirley H L

2004-08-01

Cataract surgery was performed in a 49-year-old woman 16 months after an acute angle-closure glaucoma attack. Zonular dialysis was observed during surgery, but the intraocular lens (IOL) was implanted in the capsular bag uneventfully. At 4 1/2 months, 1 IOL loop wrapped in the bag herniated into the anterior chamber. The patient had no history of trauma. The IOL loop remained in the anterior chamber for 9 months, until the subluxated IOL spontaneously returned to its original position. Six months later, the IOL again dislocated into the anterior chamber.

Cyclodextrin-containing hydrogels as an intraocular lens for sustained drug release.

Directory of Open Access Journals (Sweden)

Xiao Li

Full Text Available To improve the efficacy of anti-inflammatory factors in patients who undergo cataract surgery, poly(2-hydroxyethyl methacrylate-co-methyl methacrylate (p(HEMA-co-MMA hydrogels containing β-cyclodextrin (β-CD (pHEMA/MMA/β-CD were designed and prepared as intraocular lens (IOLs biomaterials that could be loaded with and achieve the sustained release of dexamethasone. A series of pHEMA/MMA/β-CD copolymers containing different ratios of β-CD (range, 2.77 to 10.24 wt.% were obtained using thermal polymerization. The polymers had high transmittance at visible wavelengths and good biocompatibility with mouse connective tissue fibroblasts. Drug loading and release studies demonstrated that introducing β-CD into hydrogels increased loading efficiency and achieved the sustained release of the drug. Administering β-CD via hydrogels increased the equilibrium swelling ratio, elastic modulus and tensile strength. In addition, β-CD increased the hydrophilicity of the hydrogels, resulting in a lower water contact angle and higher cellular adhesion to the hydrogels. In summary, pHEMA/MMA/β-CD hydrogels show great potential as IOL biomaterials that are capable of maintaining the sustained release of anti-inflammatory drugs after cataract surgery.

Anterior vaulting of single piece in-the-bag intraocular lens after blunt trauma

Directory of Open Access Journals (Sweden)

Seung Hoon Oh

2012-01-01

Full Text Available A 64-year-old man complained of difficulty with far vision in the right eye after blunt trauma by his hand during sleep. He had undergone uneventful phacoemulsification and intraocular lens (IOL implantation of both eyes one week before the event. On slit lamp examination, the anterior chamber was shallow compared to postoperative one day or the left eye. After mydriasis, IOL position was perfect, within the capsulorrhexis margin, and no haptics were protruded. SE of his right eye was −4.00 diopter after trauma, although spherical equivalent (SE of both eyes was near emmetropia one day after cataract surgery. We decided on IOL reposition or exchange. Intraoperatively, we pushed the IOL posteriorly; the IOL was vaulted posteriorly, as expected. After surgery, his SE was +0.25 with the same diopter IOL. We report the case on the possibility of 4-point haptic IOL vaulting anteriorly by blunt trauma within the capsular bag.

Intraocular lenses and clinical treatment in paediatric cataract

Directory of Open Access Journals (Sweden)

Camila Ribeiro Koch Pena

2015-06-01

Full Text Available Pediatric cataract is the most common treatable cause of blindness in children. Prevalence, etiology and morphology vary with the socioeconomic development. The treatment goal is to reduce amblyopia, being difficult management especially in unilateral cases. The decision on aphakia or primary intraocular lens should be individualized as well as correction with contact lens or spectacles. The intraocular lens single-piece hydrophobic acrylic are the most implanted in children and the preferably is in the capsular bag. The Sanders-Retzlaff-Kraff theoretic (SRK/T stressing that is described as more predictable, following Holladay I and SRK II and the recommendation is to under correction +6.0 or +8.0 dioptrias expecting the growth of the eye. The posterior capsule opacity is the most frequent complication and varies with the material choice of the lens. Glaucoma is the most serious postoperative complication and depends on the timing of the surgery, primary lens implantation and time of post surgical follow-up. The adherence to occlusion therapy with patching is critical to the visual prognosis and is determined by the child’s age and laterality of the cataract. There was significant improvement in the surgery and in IOLs, however the final visual prognosis is still not desirable.

Pigment dispersion glaucoma induced by the chafing effect of intraocular lens haptics in Asian eyes.

Science.gov (United States)

Hong, Ying; Sun, Yan-Xiu; Qi, Hong; Zhou, Ji-Chao; Hao, Yan-Sheng

2013-03-01

To study the possible mechanism and treatment for pigment dispersion glaucoma (PDG) caused by single-piece acrylic (SPA) intraocular lens (IOL) ciliary sulcus fixation in Asian eyes. Patients referred for PDG caused by SPA IOL ciliary sulcus fixation to our hospital from April 2005 to June 2011 were included. The patients' general information, IOL type, interval between initial surgery and PDG occurrence, examination findings, antiglaucoma medicine regimen and surgical interventions were recorded. In total, six eyes from five Chinese patients were included in this study. The intraocular pressure (IOP) increased 19-30 days after cataract surgery and was not satisfactorily controlled with antiglaucoma medication. Dense pigmentation was deposited on the IOLs and on the anterior chamber angle. IOL haptic chafing was noted on the rear iris surface. IOL repositioning in the capsular bag was performed in three eyes and was combined with trabeculectomy in two eyes with progressive glaucoma. An IOL exchange with three-piece IOL ciliary sulcus fixation was performed in the other three eyes. Scanning electron microscopy of the explanted IOLs demonstrated a rough edge on the IOL haptics. SPA IOLs were not suitable for ciliary sulcus fixation. The chafing effect of the IOL haptics on the posterior iris pigment epithelium could induce PDG in Asian eyes. IOLs should be positioned in the capsular bag or a three-piece IOL should be used instead.

The rectenna design on contact lens for wireless powering of the active intraocular pressure monitoring system.

Science.gov (United States)

Cheng, H W; Jeng, B M; Chen, C Y; Huang, H Y; Chiou, J C; Luo, C H

2013-01-01

This paper proposed a wireless power harvesting system with micro-electro-mechanical-systems (MEMS) fabrication for noninvasive intraocular pressure (IOP) measurement on soft contact lens substructure. The power harvesting IC consists of a loop antenna, an impedance matching network and a rectifier. The proposed IC has been designed and fabricated by CMOS 0.18 um process that operates at the ISM band of 5.8 GHz. The antenna and the power harvesting IC would be bonded together by using flip chip bonding technologies without extra wire interference. The circuit utilized an impedance transformation circuit to boost the input RF signal that improves the circuit performance. The proposed design achieves an RF-to-DC conversion efficiency of 35% at 5.8 GHz.

Reverse pupillary block after implantation of a scleral-sutured posterior chamber intraocular lens: a retrospective, open study.

Science.gov (United States)

Bang, Seung Pil; Joo, Choun-Ki; Jun, Jong Hwa

2017-03-29

To report the clinical features of patients with reverse pupillary block (RPB) after scleral-sutured posterior chamber intraocular lens (PC IOL) implantation and biometric changes after laser peripheral iridotomy (LPI). Eight patients attending our hospital's ophthalmology outpatient clinic, who developed RPB after implantation of a scleral-sutured PC IOL due to subluxation of the crystalline lens or IOL, were investigated in this retrospective, observational study. Preoperative evaluations showed angle pigmentation in all cases and iridodonesis in 2 cases. Two subjects had used an α 1A -adrenoceptor antagonist for benign prostatic hyperplasia. Pars plana or anterior partial vitrectomy was performed in all cases. All eyes showed an extremely deep anterior chamber, a concave iris configuration, and contact between the IOL optic and the iris at the pupillary margin. Pupil capture was detected in 2 cases. The mean (± SD) anterior chamber angle (ACA) was 89.91 ± 10.06°, and the anterior chamber depth (ACD) was 4.42 ± 0.16 mm before LPI. After LPI, the iris immediately became flat with a decreased ACA (51.70 ± 2.59°; P = 0.018) and ACD (4.14 ± 0.15 mm; P = 0.012). After LPI, the intraocular pressure decreased from 19.75 ± 3.77 mmHg to 15.63 ± 4.30 mmHg (P = 0.011), and the spherical equivalent decreased from -0.643 ± 0.385 D to - 0.875 ± 0.505 D (P = 0.016). Concomitant vitrectomy, angle pigmentation, and iridodonesis may be risk factors for RPB after scleral-sutured PC IOL implantation. LPI is effective for relieving the RPB.

Efficacy of different kinds of artificial tears treatment in patients with xerophthalmia after phacoemulsification combined with intraocular lens implantation

Directory of Open Access Journals (Sweden)

Yu-Xia Ruan

2017-09-01

Full Text Available AIM: To explore efficacy of the different kinds of artificial tears treatment in patients with xerophthalmia after phacoemulsification combined with intraocular lens implantation.METHODS: Totally 280 patients(280 eyeswith xerophthalmia after operation in our hospital from January 2015 to June 2016 were selected. According to the different treatment methods, they were divided into control group(n=70; treated with tobramycin and dexamethasone eye ointment 3 times per day for 1wk, levofloxacin eye drops 3 times per day for 1wk, pranoprofen eye drops 4 times per day for 1mo, polyacrylic acid group(n=70; besides the treatment of control group, polyacrylic acid was used 4 times per for 1mo, polyethylene glycol group(n=70; besides the treatment of control group, polyethylene glycol was used 4 times per for 1moand sodium hyaluronate group(n=70; besides the treatment of control group, sodium hyaluronate was used 4 times per for 1mo. The tear film break up time(BUT, Schirmer Ⅰ test(SⅠt, symptoms of dry eye and corneal staining in four groups were observed. RESULTS:(1BUT: The BUT of the four groups significantly increased after treatment(PPPPPPPPPPP>0.05; sodium hyaluronate group was significant lower than other groups in corneal staining score at 3wk and 1mo after treatment(PCONCLUSION: Artificial tears in the treatment of xerophthalmia after cataract phacoemulsification combined with intraocular lens implantation has better clinical efficacy, which contains sodium hyaluronate may be the better than others.

Pentacam Scheimpflug quantitative imaging of the crystalline lens and intraocular lens.

Science.gov (United States)

Rosales, Patricia; Marcos, Susana

2009-05-01

To implement geometrical and optical distortion correction methods for anterior segment Scheimpflug images obtained with a commercially available system (Pentacam, Oculus Optikgeräte GmbH). Ray tracing algorithms were implemented to obtain corrected ocular surface geometry from the original images captured by the Pentacam's CCD camera. As details of the optical layout were not fully provided by the manufacturer, an iterative procedure (based on imaging of calibrated spheres) was developed to estimate the camera lens specifications. The correction procedure was tested on Scheimpflug images of a physical water cell model eye (with polymethylmethacrylate cornea and a commercial IOL of known dimensions) and of a normal human eye previously measured with a corrected optical and geometrical distortion Scheimpflug camera (Topcon SL-45 [Topcon Medical Systems Inc] from the Vrije University, Amsterdam, Holland). Uncorrected Scheimpflug images show flatter surfaces and thinner lenses than in reality. The application of geometrical and optical distortion correction algorithms improves the accuracy of the estimated anterior lens radii of curvature by 30% to 40% and of the estimated posterior lens by 50% to 100%. The average error in the retrieved radii was 0.37 and 0.46 mm for the anterior and posterior lens radii of curvature, respectively, and 0.048 mm for lens thickness. The Pentacam Scheimpflug system can be used to obtain quantitative information on the geometry of the crystalline lens, provided that geometrical and optical distortion correction algorithms are applied, within the accuracy of state-of-the art phakometry and biometry. The techniques could improve with exact knowledge of the technical specifications of the instrument, improved edge detection algorithms, consideration of aspheric and non-rotationally symmetrical surfaces, and introduction of a crystalline gradient index.

Management of moderate and severe corneal astigmatism with AcrySof® toric intraocular lens implantation – Our experience

Science.gov (United States)

Farooqui, Javed Hussain; Koul, Archana; Dutta, Ranjan; Shroff, Noshir Minoo

2015-01-01

Purpose Visual performance following toric intraocular lens implantation for cataract with moderate and severe astigmatism. Setting Cataract services, Shroff Eye Centre, New Delhi, India. Design Case series. Method This prospective study included 64 eyes of 40 patients with more than 1.50 dioptre (D) of pre-existing corneal astigmatism undergoing phacoemulsification with implantation of the AcrySof® toric IntraOcular Lens (IOL). The unaided visual acuity (UCVA), best corrected visual acuity (BCVA), residual refractive sphere and refractive cylinders were evaluated. Toric IOL axis and alignment error was measured by slit lamp method and Adobe Photoshop (version 7) method. Patient satisfaction was evaluated using a satisfaction questionnaire at 3 months. Results The mean residual refractive astigmatism was 0.57 D at the final follow-up of 3 months. Mean alignment error was 3.44 degrees (SD = 2.60) by slit lamp method and 3.88 degrees (SD = 2.86) by Photoshop method. Forty-six (71.9%) eyes showed misalignment of 5 degrees or less, and 60 (93.8%) eyes showed misalignment of 10 degrees or less. The mean log MAR UCVA at 1st post-op day was 0.172 (SD = 0.02), on 7th post-op day was 0.138 (SD = 0.11), and on 30th post-op day was 0.081 (SD = 0.11). The mean log MAR BCVA at three months was −0.04 (SD = 0.76). Conclusion We believe that implantation of AcrySof® toric IOL is an effective, safe and predictable method to correct high amounts of corneal astigmatism during cataract surgery. PMID:26586976

Late anterior traumatic subluxation of a circular in-the-bag intraocular lens associated with lack of posterior capsule opacification.

Science.gov (United States)

Billotte, Christian; Stéfani, Pierre; Lecoq, Pierre

2003-05-01

We report a case of traumatic subluxation of a circular poly(methyl methacrylate) intraocular lens (IOL) 5 years after surgery. Slitlamp examination revealed the lack of epithelial cells or fibrosis in the intact capsule bag. Trauma was minor, and no other complication was found in the eye and orbit. The subluxated IOL was easily relocated in the bag with a hook, revealing the poor capsule sealing. Among the factors ensuring the fixation of IOLs placed in the bag after continuous curvilinear capsulotomy are sealing of the anterior and posterior capsules and proliferation of epithelial cells from the equator of the bag.

A retrospective study of the indications and outcomes of capsular tension ring insertion during cataract surgery at a tertiary teaching hospital

Directory of Open Access Journals (Sweden)

Wang BZ

2013-03-01

Full Text Available Bob Z Wang, Elsie Chan, Rasik B Vajpayee The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia; Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia Background: The purpose was to determine preoperative indications, intraoperative procedures, and outcomes of capsular tension ring (CTR insertion during cataract surgery. Methods: A review of all patients undergoing cataract surgery with insertion of a CTR between July 2000 and June 2010 was conducted at The Royal Victorian Eye and Ear Hospital, a large tertiary teaching hospital in Victoria, Australia. Information relating to each patient's demographic details, preoperative assessment, surgical procedure, and postoperative assessment were obtained. Results: Eighty-four eyes of 82 patients were included in this study. The main indications for CTR insertion were previous trauma, pseudoexfoliation syndrome, and mature cataracts. Twenty-one eyes (25.0% did not have any obvious preoperative indication. A posterior capsule tear was the most common intraoperative complication (3.6%. An intraocular lens was successfully implanted in the bag in 72 eyes (85.7%. Postoperatively, the most common complications were a decentered intraocular lens (8.3% and persistent corneal edema (6.0%. Overall, 61 eyes (72.6% had better postoperative visual acuity compared with preoperative acuity, with 67 patients (79.8% achieving vision of 20/40 or better. Conclusion: For the majority of cases, CTR use in complex cataract surgeries is associated with improved postoperative outcomes. CTR implantation is most commonly required in patients with known risk factors for zonular instability. Keywords: capsular tension ring, cataract extraction, indications, outcomes

Research progress on the measurement of human lens thickness in vivo

Directory of Open Access Journals (Sweden)

Yu-Huan Yang

2017-05-01

Full Text Available The precise measurement in lens thickness in vivo, provides great application value for intraocular accommodation and ametropia development mechanism research. And it has great clinical significance for the diagnosis and treatment of glaucoma and cataract. Currently, many ultrasonic methods and optical methods are used in measuring lens thickness. The measurement principles, advantages, disadvantages and the accuracy of the instruments are summarized in this paper. Among these methods, Orbscan II, Pentacam, Lenstar and AS-OCT can be used to measure lens thickness instead of A-scan. More important is the fact that UL-OCT can dynamically monitor the change of the lens thickness with intraocular accommodation. Choosing an instrument with higher measuring accuracy to examine the lens thickness, can provide more accurate and convincing lens thickness data for clinical and scientific research.

Surgical treatment of hereditary lens subluxations.

Science.gov (United States)

Ozdek, Sengul; Sari, Ayca; Bilgihan, Kamil; Akata, Fikret; Hasanreisoglu, Berati

2002-01-01

To evaluate the effectiveness and results of pars plana vitreolensectomy approach with transscleral fixation of intraocular lens in hereditary lens subluxations. Fifteen eyes of 9 consecutive patients with a mean age of 12.8+/-6.2 years (6-26 years) with hereditary lens subluxation were operated on and the results were evaluated in a prospective study. Surgery was considered if best spectacle corrected visual acuity (BSCVA) was less than 20/70. All eyes underwent a 2-port pars plana vitreolensectomy and transscleral fixation of an intraocular lens (IOL). The mean follow-up period was 12.6+/-7.5 months (6-22 months). There was no major intraoperative complication. Preoperatively, 8 eyes (53.3%) had a BSCVA of counting fingers (CF) and 7 eyes (46.6%) had a BSCVA of 20/200 to 20/70. Postoperatively, 14 eyes (93.3%) had a BSCVA of 20/50 or better. None of the patients had IOL decentration or intraocular pressure (IOP) increase during the follow-up period. There was a macular hole formation in 1 eye postoperatively. The early results of pars plana vitreolensectomy with IOL implantation using scleral fixation technique had shown that it not only promises a rapid visual rehabilitation but it is also a relatively safe method. More serious complications, however, may occur in the long term.

Bacterial contamination of intraocular lens surgery.

OpenAIRE

Vafidis, G C; Marsh, R J; Stacey, A R

1984-01-01

One hundred sterile intraocular lenses were placed on the external eye of 50 patients during cataract surgery. Half of the specimens were cultured for bacteria, the other half were examined under the light microscope after fixing and staining. A bacterial contamination rate of 26% was recorded. This is significantly higher than that found in conjunctival swabs (6%) or irrigation specimens (8%) taken at the same time, and higher than that recorded in a group of control lenses (15.2%) exposed t...

Axial movement of the dual-optic accommodating intraocular lens for the correction of the presbyopia: Optical performance and clinical outcomes

Directory of Open Access Journals (Sweden)

Javier Tomás-Juan

2015-04-01

Full Text Available Presbyopia occurs in the aging eye due to changes in the ciliary muscle, zonular fibers, crystalline lens, and an increased lens sclerosis. As a consequence, the capacity of accommodation decreases, which hampers to focus near objects. With the aim of restoring near vision, different devices that produce multiple focuses have been developed and introduced. However, these devices are still unable to restore accommodation. In order to achieve that goal, dual-optic accommodating Intraocular Lenses have been designed, whose anterior optic displaces axially to increase ocular power, and focus near objects. Although dual-optic accommodating IOLs are relatively new, their outcomes are promising, as they provide large amplitudes of accommodation and a greater IOL displacement than single-optic accommodating IOLs. The outcomes show comfortable near vision, higher patients’ satisfaction rates, and minimal postoperative complications like Posterior Capsular Opacification and Anterior Capsular Opacification, due to their design and material.

DYNAMIC CHANGES OF THE POSTERIOR POLE OF THE EYE AFTER CATARACT PHACOEMULSIFICATION WITH INTRAOCULAR LENS IMPLANTATION

Directory of Open Access Journals (Sweden)

M. Р. Yugay

2017-01-01

Full Text Available Objective. To study the effect of uncomplicated phacoemulsification through the corneal incision with implantation of the intraocular lens (IOL for changes in the macular region of the retina. Methods: The study included 35 eyes of 35 patients who underwent uncomplicated phacoemulsification with IOL implantation. The average age of the patients was 67±2,3 years, among them were 19 women and 16 men. Exclusion criteria: retinal pathology (postthrombotic and diabetic retinopathy, wet form of age-related macular degeneration and other diseases of the retina, previous eye injuries, uveitis, intra-operative complications. Retinal thickness in the fovea, the macula, and macular volume were measured by optical coherence tomography on the first day, after 2 weeks, 1 and 3 months after surgery. Results. In the period between the first day and two weeks after surgery there were the statistically significant incensement in retinal thickness in the macula from 306,64±21,15 mkm to 321,46±27,83 mkm (p <0.05, in the fovea from 211,45±20,24 mkm to 218,69±17,84 mkm (p<0.05, macular volume from 8,08±0,35 cubic mm to 8,46±0,54 cubic mm were registered. By the end of the first month after surgery maximum retinal thickness was 327,23±27,16 mkm, thickness in the fovea 220,31±18,63 mkm, macular volume 8,61±0,55 cubic mm. After 3 months, the maximum thickness of the retina reached 325,11±26,13 mkm, in the fovea 220,31±18,63 mkm, macular volume 8,55±0,49 cubic mm. Conclusion. There was an incensement of macular volume and retinal thickness in the period between the first day and two weeks after uncomplicated cataract phacoemulsification with intraocular lens implantation. The growth of these indicators continued within the first month after surgery, three months after phacoemulsification there was a downward trend. This can be important in determining the duration of drug therapy in the postoperative period.

Effect of pupillary dilation on Haigis formula-calculated intraocular lens power measurement by using optical biometry

Directory of Open Access Journals (Sweden)

Khambhiphant B

2016-07-01

Full Text Available Bharkbhum Khambhiphant,1 Suganlaya Sasiwilasagorn,2 Nattida Chatbunchachai,3 Krit Pongpirul2,4 1Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 2Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, 3Department of Ophthalmology, Samut Prakan Hospital, Samut Prakan, Thailand; 4Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Purpose: The purpose of this study was to evaluate the effect of pupillary dilation on the Haigis formula-calculated intraocular lens (IOL power and ocular biometry measurements by using IOLMaster®. Methods: A prospective study was performed for biometry measurements of 373 eyes of 192 healthy subjects using the IOLMaster at the outpatient department of King Chulalongkorn Memorial Hospital from February 2013 to July 2013. The axial length (AL, anterior chamber depth (ACD, keratometry (K, and IOL power were measured before and after 1% tropicamide eye drop instillation. The Haigis formula was used in the IOL power calculation with the predicted target to emmetropia. Each parameter was compared by a paired t-test prior to and after pupillary dilation. Bland–Altman plots were also used to determine the agreement between each parameter. Results: The mean age of the subjects was 53.74±14.41 years (range 18–93 years. No differences in AL (P=0.03, steepest K (P=0.42, and flattest K (P=0.41 were obtained from the IOLMaster after pupillary dilation. However, ACD and IOL power were significantly different postdilation (P<0.01 and P<0.01, respectively. In ACD and IOL power measurements, the concordance rates were 93.03% and 97.05% within 95% limits of agreement (-0.48 to 0.26 mm and -1.09 to 0.88 D, respectively in the Bland–Altman plots. Conclusion: Biometry measurements in the cycloplegic stage should be considered in the IOL formulas that use parameters other than AL and K. Keywords: Haigis

Evaluation of pars plana sclera fixation of posterior chamber intraocular lens

Directory of Open Access Journals (Sweden)

Fangju Han

2014-01-01

Full Text Available Purpose: The purpose of this study was to evaluate the clinical efficacy and safety of modified posterior chamber intraocular lens (PCIOL implantation with transscleral fixation. Design and Setting: This is a study, which is conducted at Department of Ophthalmology, Jinan Eye Hospital, Jinan Second People′s Hospital. Materials and Methods: A total of 82 patients who were scheduled for sutured PCIOL were divided randomly into modified and conventional groups. The former underwent PCIOL through pars plana fixation with knot buried and without scleral flap and the latter underwent transscleral fixation of PCIOL in the ciliary sulcus. The main outcome measures included operative time, postoperative visual acuity, and postoperative complications. Results: The mean operative time of the modified group was 39.95 ± 5.87 min, which was significantly less than that of the conventional group (45.77 ± 5.21 min; P < 0.05. No difference was found in postoperative visual acuity between the two groups. There were no significant postoperative complications, including knot exposure, endophthalmitis, and retinal detachment in either group. The optical clamping of PCIOL was prone to occur in the conventional group. Conclusion: Modified sutured PCIOL implantation is a safe, effective, and feasible technique for the correction of aphakia in eyes without adequate posterior capsular support.

Implantation of a Multifocal Toric Intraocular Lens after Radial Keratotomy and Cross-Linking with Hyperopia and Astigmatism Residues: A Case Report

Directory of Open Access Journals (Sweden)

Raffaele Nuzzi

2017-08-01

Full Text Available Radial keratotomy is a refractive surgical technique, widely used in the 80s and early 90s to correct myopia and astigmatism, but now overcome by more recent laser techniques. Important consequences, often in patients with more than 45 years of age, are progressive hyperopic shift and/or an increase in corneal astigmatism, whose main cause seems to be an increase in the curvature radius of the central portion of the cornea. This seems to be due to radial keratotomy incisions – with the consequent need for cross-linking – intraocular pressure, and corneal biomechanical parameters. The authors propose phacoemulsification with a customized multifocal toric intraocular lens implantation to correct the induced shift and hyperopic astigmatism. A decent postoperative visual acuity was observed with good patient satisfaction. A specific protocol must be applied to optimize the correct diagnosis, presurgical evaluation and postsurgical outcomes that are to be maintained over time, without regressions.

Recurrent uveitis and pigment dispersion in an eye with in-the-bag acrylic foldable intraocular lens.

Science.gov (United States)

Thakur, Monica; Bhatia, Prashant; Chandrasekhar, Garudadri; Senthil, Sirisha

2016-02-26

Phacoemulsification with in-the-bag intraocular lens (IOL) implantation is the standard procedure for cataract surgery. Pigment dispersion and uveitis can result when an IOL is placed in the sulcus. We report a case of a 64-year-old woman, with pigmentary glaucoma, who developed recurrent uveitis following uneventful cataract surgery and an in-the-bag hydrophobic acrylic IOL implant. Recurrent uveitis did not subside despite use of topical steroids over 3 months. Dilated examination revealed capsulophimosis with anterior dislocation of the IOL haptic. The mechanical trauma to the iris due to the displaced haptic was implicated as the cause of recurrent uveitis, which completely resolved after capsular excision and IOL repositioning. This case illustrates a rare cause of recurrent uveitis due to IOL haptic dislocation following severe capsulophimosis. 2016 BMJ Publishing Group Ltd.

Retreatments after multifocal intraocular lens implantation: an analysis

Directory of Open Access Journals (Sweden)

Gundersen KG

2016-03-01

Full Text Available Kjell Gunnar Gundersen,1 Sarah Makari,2 Steffen Ostenstad,1 Rick Potvin2 1Ifocus Eye Clinic, Haugesund, Norway; 2Science in Vision, Akron, NY, USA Purpose: To determine the incidence and etiology of required retreatment after multifocal intraocular lens (IOL implantation and to evaluate the methods and clinical outcomes of retreatment.Patients and methods: A retrospective chart review of 416 eyes of 209 patients from one site that underwent uncomplicated cataract surgery with multifocal IOL implantation. Biometry, the IOL, and refractive data were recorded after the original implantation, with the same data recorded after retreatment. Comments related to vision were obtained both before and after retreatment for retreated patients.Results: The multifocal retreatment rate was 10.8% (45/416 eyes. The eyes that required retreatment had significantly higher residual refractive astigmatism compared with those who did not require retreatment (1.21±0.51 D vs 0.51±0.39 D, P<0.01. The retreatment rate for the two most commonly implanted primary IOLs, blended bifocal (10.5%, 16/152 and bilateral trifocal (6.9%, 14/202 IOLs, was not statistically significantly different (P=0.12. In those requiring retreatment, refractive-related complaints were most common. Retreatment with refractive corneal surgery, in 11% of the eyes, and piggyback IOLs, in 89% of the eyes, was similarly successful, improving patient complaints 78% of the time.Conclusion: Complaints related to ametropia were the main reasons for retreatment. Residual astigmatism appears to be an important determinant of retreatment rate after multifocal IOL implantation. Retreatment can improve symptoms for a high percentage of patients; a piggyback IOL is a viable retreatment option. Keywords: piggyback IOL, Sulcoflex, toric, STAAR, symptoms, astigmatism

Retropupillary iris-claw intraocular lens for the surgical correction of aphakia in cases with microspherophakia

Directory of Open Access Journals (Sweden)

Sameh Mosaad Fouda

2016-01-01

Full Text Available Purpose: This study aimed to evaluate the safety and efficacy of retropupillary fixation of an iris-claw intraocular lens (IOL; Verisyse polymethyl methacrylate IOL, Abbott Medical Optics [AMO], Netherlands for the surgical correction of aphakia in microspherophakic eyes without sufficient capsular support. Design: This was a prospective, interventional, noncomparative case series. Methods: This interventional case series comprised 17 eyes of 9 microspherophakic patients. Retropupillary fixation of the Verisyse iris-claw IOL (AMO was performed in all cases. The surgical time was measured. Corrected distance visual acuity, astigmatism, intraocular pressure (IOP, tissue reaction, pigment dispersion, and stability of the IOL were studied 1 day, 3 days, 1 week, 2 weeks, 1 month, and 6 months postoperatively. Results: Eight patients had familial microspherophakia and one patient had Marfan's syndrome. Eighty-two percent of the cases achieved a visual acuity of 0.3 or better. There was no significant postoperative inflammatory reaction. Transient elevation of IOP was recorded in two cases in the 1st week only. One IOL developed disengagement of one of the haptics from the iris and was successfully re-engaged. All the other IOLs were well centered and stable. The mean surgical time was 18.0 ± 4.5 min. Conclusions: Retropupillary fixation of an iris-claw IOL is a safe and effective procedure that provides early visual recovery. It is also a time-saving method for correcting aphakia in microspherophakic eyes without sufficient capsular support.

Mechanical properties of intra-ocular lenses

Science.gov (United States)

Ehrmann, Klaus; Kim, Eon; Parel, Jean-Marie

2008-02-01

Cataract surgery usually involves the replacement of the natural crystalline lens with a rigid or foldable intraocular lens to restore clear vision for the patient. While great efforts have been placed on optimising the shape and optical characteristics of IOLs, little is know about the mechanical properties of these devices and how they interact with the capsular bag once implanted. Mechanical properties measurements were performed on 8 of the most commonly implanted IOLs using a custom build micro tensometer. Measurement data will be presented for the stiffness of the haptic elements, the buckling resistance of foldable IOLs, the dynamic behaviour of the different lens materials and the axial compressibility. The biggest difference between the lens types was found between one-piece and 3-piece lenses with respect to the flexibility of the haptic elements

[Clinical results after implantation of a new segmental refractive multifocal intraocular lens].

Science.gov (United States)

Thomas, B C; Auffarth, G U; Philips, R; Novák, J; Blazek, J; Adamkova, H; Rabsilber, T M

2013-11-01

The aim of the study was a clinical evaluation of an intraocular lens (IOL) with a segmental multifocal optic design and near addition of + 3.0 D as part of a CE approval study. In a multicenter study the LENTIS Mplus LS-312 MF IOL (Oculentis) was implanted in 134 eyes of 79 patients with a mean age of 68 ± 12 years. The multifocality is achieved by implementation of a distance part and a segmented near sector. Three months after surgery, uncorrected and best corrected distance visual acuity (UCDVA and BCDVA, respectively), near visual acuity (UCNVA and BCNVA, respectively), contrast vision and patient satisfaction (questionnaire) were evaluated. The IOLs were implanted uneventfully either unilaterally or bilaterally and 3 months postoperatively (n = 86 eyes) the following mean visual acuities were obtained (logMAR): UCDVA = 0.05, BCDVA = - 0.01, UCNVA = 0.09 and BCNVA = 0.02. Contrast sensitivity (n = 25 eyes) was within normal limits. Of the 66 questioned patients 10.6% spontaneously reported halos and 3% glare. This new innovative multifocal IOL concept showed very good functional results as well as high patient satisfaction.

Can the accuracy of multifocal intraocular lens power calculation be improved to make patients spectacle free?

Science.gov (United States)

Ramji, Hasnain; Moore, Johnny; Moore, C B Tara; Shah, Sunil

2016-04-01

To optimise intraocular lens (IOL) power calculation techniques for a segmental multifocal IOL, LENTIS™ MPlus(®) (Oculentis GmbH, Berlin, Germany) and assess outcomes. A retrospective consecutive non-randomised case series of patients receiving the MPlus(®) IOL following cataract surgery or clear lens extraction was performed at a privately owned ophthalmic hospital, Midland Eye, Solihull, UK. Analysis was undertaken of 116 eyes, with uncomplicated lens replacement surgery using the LENTIS™ MPlus(®) lenses. Pre-operative biometry data were stratified into short (<22.00 mm) and long axial lengths (ALs) (≥22.00 mm). IOL power predictions were calculated with SRK/T, Holladay I, Hoffer Q, Holladay II and Haigis formulae and compared to the final manifest refraction. These were compared with the OKULIX ray tracing method and the stratification technique suggested by the Royal College of Ophthalmologists (RCOphth). Using SRK/T for long eyes and Hoffer Q for short eyes, 64% achieved postoperative subjective refractions of ≤±0.25 D, 83%≤±0.50 D and 93%≤±0.75 D, with a maximum predictive error of 1.25D. No specific calculation method performed best across all ALs; however for ALs under 22 mm Hoffer Q and Holliday I methods performed best. Excellent but equivalent overall refractive results were found between all biometry methods used in this multifocal IOL study. For eyes with ALs under 22 mm Hoffer Q and Holliday I performed best. Current techniques mean that patients are still likely to need top up glasses for certain situations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Outcomes Associated With Concurrent Iris-Sutured Intraocular Lens Placement and Subluxated Crystalline Lens Extraction.

Science.gov (United States)

McClellan, Scott F; Soiberman, Uri; Gehlbach, Peter L; Murakami, Peter N; Stark, Walter J

2015-08-01

We have developed a novel surgical technique, to our knowledge, for the management of subluxated crystalline lenses involving preplacement of an iris-sutured posterior chamber intraocular lens (PCIOL) before pars plana vitrectomy and lensectomy. To investigate the outcomes of eyes with subluxated crystalline lenses, predominantly a result of Marfan syndrome (14 eyes [58%]) or trauma (5 eyes [21%]), that underwent pars plana vitrectomy and lensectomy with placement of an iris-sutured PCIOL. We performed a retrospective, noncomparative case series of 24 eyes from 17 consecutive adult patients with surgically treated subluxated crystalline lenses presenting to the Wilmer Eye Institute at Johns Hopkins Hospital from October 6, 2006, through May 1, 2013. The mean (SD) postoperative follow-up was 24.4 (20.5) months for eyes with at least 6 months of follow-up (last date, October 13, 2014). We performed the analysis from January 21, 2014, through January 3, 2015. Improvement in best-corrected visual acuity using an automated Snellen chart and induction of astigmatism for eyes with at least 6 months of follow-up (n = 18) and IOL stability during follow-up for all eyes (n = 24). The mean (SD) age at surgery was 49.4 (10.7 [range, 29-67]) years. We found an improvement in mean (SD [95% CI]) best-corrected visual acuity from 0.66 (0.71 [0.30-1.02]) logMAR preoperatively (Snellen equivalent, approximately 20/90; range, 20/30 to hand motions) to 0.07 (0.11 [95% CI, 0.01-0.12]) logMAR postoperatively (Snellen equivalent, approximately 20/23; range, 20/15 to 20/50). We found little change in astigmatism postoperatively (mean change, -0.1 [95% CI, -0.5 to 0.13] diopters). Postoperative complications included retinal detachment (1 eye [4%]), retained cortical fragment (1 [4%]), cystoid macular edema (2 [8%]), and IOL subluxation (3 [13%]) owing to haptic slippage within 3 months of the procedure. The overall probability of successfully achieving placement of a centered iris

Axial movement of the dual-optic accommodating intraocular lens for the correction of the presbyopia: optical performance and clinical outcomes.

Science.gov (United States)

Tomás-Juan, Javier; Murueta-Goyena Larrañaga, Ane

2015-01-01

Presbyopia occurs in the aging eye due to changes in the ciliary muscle, zonular fibers, crystalline lens, and an increased lens sclerosis. As a consequence, the capacity of accommodation decreases, which hampers to focus near objects. With the aim of restoring near vision, different devices that produce multiple focuses have been developed and introduced. However, these devices are still unable to restore accommodation. In order to achieve that goal, dual-optic accommodating Intraocular Lenses have been designed, whose anterior optic displaces axially to increase ocular power, and focus near objects. Although dual-optic accommodating IOLs are relatively new, their outcomes are promising, as they provide large amplitudes of accommodation and a greater IOL displacement than single-optic accommodating IOLs. The outcomes show comfortable near vision, higher patients' satisfaction rates, and minimal postoperative complications like Posterior Capsular Opacification and Anterior Capsular Opacification, due to their design and material. Copyright © 2014. Published by Elsevier Espana.

Evaluation of a contact lens-embedded sensor for intraocular pressure measurement.

Science.gov (United States)

Twa, Michael D; Roberts, Cynthia J; Karol, Huikai J; Mahmoud, Ashraf M; Weber, Paul A; Small, Robert H

2010-08-01

To evaluate a novel contact lens-embedded pressure sensor for continuous measurement of intraocular pressure (IOP). Repeated measurements of IOP and ocular pulse amplitude (OPA) were recorded in 12 eyes of 12 subjects in sitting and supine positions using 3 configurations of the dynamic contour tonometer: slit-lamp mounted (DCT), hand-held (HH), and contact lens-embedded sensor (CL). The IOP and OPA for each condition were compared using repeated measures ANOVA and the 95% limits of agreement were calculated. The sitting IOP (mean and 95% CI) for each configuration was DCT: 16.3 mm Hg (15.6 to 17.1 mm Hg), HH: 16.6 mm Hg (15.6 to 17.6 mm Hg), and CL: 15.7 mm Hg (15 to 16.3 mm Hg). The sitting OPA for each configuration was DCT: 2.4 mm Hg (2.1 to 2.6 mm Hg), HH: 2.4 mm Hg (2.1 to 2.7 mm Hg), and CL: 2.1 mm Hg (1.8 to 2.3 mm Hg). Supine IOP and OPA measurements with the CL and HH sensors were both greater than their corresponding sitting measurements, but were significantly less with the CL sensor than the HH sensor. The mean difference and 95% Limits of Agreement were smallest for the DCT and CL sensor comparisons (0.7+/-3.9 mm Hg) and widest for the CL and HH sensors (-1.9+/-7.25 mm Hg); these wider limits were attributed to greater HH measurement variability. The CL sensor was comparable to HH and DCT sensors with sitting subjects and is a viable method for measuring IOP and OPA. Supine measurements of IOP and OPA were greater than sitting conditions and were comparatively lower with the CL sensor. HH measurements were more variable than CL measurements and this influenced the Limits of Agreement for both sitting and supine conditions.

Ab-interno scleral suture loop fixation with cow-hitch knot in posterior chamber intraocular lens decentration

Directory of Open Access Journals (Sweden)

Ertugrul Can

2016-01-01

Full Text Available Aim of Study: To describe a simplified ab-interno cow-hitch suture fixation technique for repositioning decentered posterior chamber intraocular lens (PC IOL. Materials and Methods: Two cases are presented with the surgical correction of decentered and subluxated IOL. Ab-interno scleral suture fixation technique with hitch-cow knot in the eye was performed with a ciliary sulcus guide instrument and 1 year follow-up was completed. Results: Both of the patients had well centered lenses postoperatively. Corrected distant and near visual acuities of the patients were improved. There was no significant postoperative complication. In the follow-up period of 1 year, no evidence of suture erosion was found. Conclusions: Ab-interno scleral suture loop fixation with hitch-cow knot in the eye was effective in repositioning decentered or subluxated PC IOLs with excellent postoperative centered lenses and visual outcomes.

[Representation and mathematical analysis of human crystalline lens].

Science.gov (United States)

Tălu, Stefan; Giovanzana, Stefano; Tălu, Mihai

2011-01-01

The surface of human crystalline lens can be described and analyzed using mathematical models based on parametric representations, used in biomechanical studies and 3D solid modeling of the lens. The mathematical models used in lens biomechanics allow the study and the behavior of crystalline lens on variables and complex dynamic loads. Also, the lens biomechanics has the potential to improve the results in the development of intraocular lenses and cataract surgery. The paper presents the most representative mathematical models currently used for the modeling of human crystalline lens, both optically and biomechanically.

Comparison of the Pentacam equivalent keratometry reading and IOL Master keratometry measurement in intraocular lens power calculations.

Science.gov (United States)

Karunaratne, Nicholas

2013-12-01

To compare the accuracy of the Pentacam Holladay equivalent keratometry readings with the IOL Master 500 keratometry in calculating intraocular lens power. Non-randomized, prospective clinical study conducted in private practice. Forty-five consecutive normal patients undergoing cataract surgery. Forty-five consecutive patients had Pentacam equivalent keratometry readings at the 2-, 3 and 4.5-mm corneal zone and IOL Master keratometry measurements prior to cataract surgery. For each Pentacam equivalent keratometry reading zone and IOL Master measurement the difference between the observed and expected refractive error was calculated using the Holladay 2 and Sanders, Retzlaff and Kraff theoretic (SRKT) formulas. Mean keratometric value and mean absolute refractive error. There was a statistically significantly difference between the mean keratometric values of the IOL Master, Pentacam equivalent keratometry reading 2-, 3- and 4.5-mm measurements (P variance). There was no statistically significant difference between the mean absolute refraction error for the IOL Master and equivalent keratometry readings 2 mm, 3 mm and 4.5 mm zones for either the Holladay 2 formula (P = 0.14) or SRKT formula (P = 0.47). The lowest mean absolute refraction error for Holladay 2 equivalent keratometry reading was the 4.5 mm zone (mean 0.25 D ± 0.17 D). The lowest mean absolute refraction error for SRKT equivalent keratometry reading was the 4.5 mm zone (mean 0.25 D ± 0.19 D). Comparing the absolute refraction error of IOL Master and Pentacam equivalent keratometry reading, best agreement was with Holladay 2 and equivalent keratometry reading 4.5 mm, with mean of the difference of 0.02 D and 95% limits of agreement of -0.35 and 0.39 D. The IOL Master keratometry and Pentacam equivalent keratometry reading were not equivalent when used only for corneal power measurements. However, the keratometry measurements of the IOL Master and Pentacam equivalent keratometry reading 4.5 mm may be

Intracameral phenylephrine and ketorolac injection (OMS302 for maintenance of intraoperative pupil diameter and reduction of postoperative pain in intraocular lens replacement with phacoemulsification

Directory of Open Access Journals (Sweden)

Lindstrom RL

2014-09-01

Full Text Available Richard L Lindstrom,1 James C Loden,2 Thomas R Walters,3 Steven H Dunn,4 J Steven Whitaker,5 Terry Kim,6 Gregory A Demopulos,5 Khiun Tjia7 1Minnesota Eye Consultants, Minneapolis, MN, USA; 2Loden Vision Centers, Goodlettsville, TN, USA; 3Texan Eye Care, Austin, TX, USA; 4Houston Eye Associates, Houston, TX, USA; 5Omeros Corporation, Seattle, WA, USA; 6Duke University Eye Center, Durham, NC, USA; 7Isala Clinics, Zwolle, the Netherlands Background: The purpose of this study was to evaluate the effect of OMS302 on intraoperative pupil diameter and early postoperative ocular pain when administered during intraocular lens replacement surgery.Methods: Four hundred and six patients (406 study eyes; 202 in the OMS302 group and 204 in the placebo group were entered into this randomized, double-masked, placebo-controlled, multicenter Phase III study, which was conducted at 15 centers in the USA and the Netherlands. The patients received OMS302 (60.75 mM phenylephrine HCl and 11.25 mM ketorolac tromethamine or placebo in irrigation solution during intraocular lens replacement. No other changes in procedure were required. Coprimary endpoints were change in pupil diameter over time from surgical baseline to end of procedure and patient-reported ocular pain during the first 12 hours postoperatively. Secondary endpoints included additional measures of pupil diameter and postoperative pain. Results: OMS302 was superior to placebo in maintaining intraoperative mydriasis, preventing miosis, and reducing postoperative pain. The weighted mean (standard error difference (OMS302 – placebo in change in the area under the curve from baseline for pupil dia­meter was 0.590 ([0.049]; 95% confidence interval 0.494 to 0.686; P<0.0001. For ocular pain scores, the weighted mean (standard error difference was –4.580 ([1.192]; 95% confidence interval –6.917 to 2.244; P=0.0002. All secondary efficacy results favored OMS302. Specifically, analyses supporting

Comparison between bilateral implantation of a trifocal intraocular lens and blended implantation of two bifocal intraocular lenses

Directory of Open Access Journals (Sweden)

Vilar C

2017-08-01

Full Text Available César Vilar,1,2 Wilson Takashi Hida,1–3 André Lins de Medeiros,1,2 Klayny Rafaella Pereira Magalhães,2 Patrick Frensel de Moraes Tzelikis,1,2 Mario Augusto Pereira Dias Chaves,2,4 Antônio Francisco Pimenta Motta,2,3 Pedro Carlos Carricondo,1–3 Milton Ruiz Alves,3 Walton Nosé5 1Cataract Division, Brasília Ophthalmologic Hospital (HOB, Brasília-DF, Brazil; 2Renato Ambrosio Ophthalmologic Research Center (CEORA, 3Ophthalmology Department, São Paulo University – USP, São Paulo-SP, Brazil; 4Cataract Division, ProVisão, João Pessoa-PB, Brazil; 5Ophthalmology Department, Paulista Medical School – UNIFESP, São Paulo-SP, Brazil Purpose: To compare visual outcomes and performance between bilateral implantation of a diffractive trifocal intraocular lens (IOL Acrysof®PanOptix® TFNT00 and blended implantation of two different near add power bifocal IOLs: Acrysof® Restor® SV25T0 in dominant eye and Acrysof® Restor® SN6AD1 in the nondominant eye.Methods: This prospective, nonrandomized, consecutive and comparative study assessed 20 patients (40 eyes who had bilateral cataract surgery performed using the IOLs described. Patients were divided into groups, bilateral trifocal implant and blended implant. Evaluation included measurement of binocular uncorrected and corrected distance visual acuity at 4 m (UDVA, CDVA and uncorrected intermediate (60 cm and near (at 40 cm visual acuity; contrast sensitivity (CS and visual defocus curve.Results: Postoperative CDVA comparison showed no statistical significance between groups. UDVA was significantly better in the trifocal groups. Under photopic conditions, the trifocal group had better CS in higher frequencies with and without glare. The binocular defocus curve demonstrated a trifocal behavior in both groups, with the bilateral trifocal group exhibiting better performance for intermediate vision.Conclusion: Both lens combinations were able to provide good near, intermediate and distance vision

[Iris hooks and modified capsular tension ring for subluxation lens in patients with Marfan's syndrome].

Science.gov (United States)

Wu, Wen-Jie; Zheng, Dan-ying; Zheng, Ying-feng; Cai, Xiao-yu

2007-02-01

To evaluate clinical efficiency and safety of the iris hooks and modified capsular tension ring (MCTR) for the treatment of subluxation lens in patients with Marfan's syndrome. This study comprised 5 patients (7 eyes) with Marfan's syndrome and subluxation lens. After 3.2 mm clear cornea incision and continuous curvilinear capsulorhexis (CCC), 2 - 4 disposable nylon iris hooks were inserted through the stab incisions and placed in the capsulorhexis to support the capsule and enlarged the CCC. Following irrigation/aspiration, a MCTR with suture in its eyelet was placed in the capsule bag. After tightening and tying the suture of MCTR, the capsular bag was centered and fixed. A foldable AcrySof one-piece intraocular lens (IOL) was then placed in the capsule bag. Twelve months after the operation, the best corrected visual acuity was >/= 0.8 in six eyes and 0.7 in one eye. The scheimpflug images obtained from the Pentacam demonstrated that the IOL were well centered. UBM showed that all the MCTR and the haptics of the IOL were in the capsule bag, the eyelet of the MCTR was rested stably between the capsulorhexis margin and the iris. The retroillumination photograph indicated that only one eye had obvious posterior capsular opacification. No intraoperative and postoperative complications such as prolapse of vitreous and retina detachment was occurred. The iris hooks can provide excellent intraoperative capsule-lens stability and facilitate the manipulation during operation. MCTR allows additional suture fixation to the eye wall without damaging the capsular bag and maintains the long-term stability of the intraocular lens. Furthermore, MCTR is helpful for avoiding dislocation of the IOL due to progressive weakening of the zonular fibers in some patients and provides long-term safety.

Intraocular lens dislocation in pseudoexfoliation: a systematic review and meta-analysis.

Science.gov (United States)

Vazquez-Ferreiro, Pedro; Carrera-Hueso, Francisco J; Fikri-Benbrahim, Narjis; Barreiro-Rodriguez, Lidia; Diaz-Rey, Marta; Ramón Barrios, María Auxiliadora

2017-05-01

To evaluate the impact of pseudoexfoliation syndrome on intraocular lens (IOL) dislocation after phacoemulsification cataract surgery and explore possible associations related to surgical technique. We systematically searched the MEDLINE, Embase, Web of Science, Cochrane, and Lilacs databases and grey literature sources and identified (on March 1, 2016) 14 cohort and case-control studies comparing IOL dislocation in patients with and without pseudoexfoliation syndrome who had undergone phacoemulsification. Study quality was assessed using the STROBE scale. An inverse-variance fixed-effects model was used to calculate weighted odds ratios (ORs) and 95% confidence intervals (CI). The pooled analysis yielded an OR of 6.02 (95% CI: 3.7, 9.79) for IOL dislocation in patients with pseudoexfoliation, and similarly, high ORs were detected for both early and late (3 months after surgery) dislocation (OR 5.26; 95% CI: 1.05; 26.32 versus OR 6.02; 95% CI: 3.67; 10.17). No significant associations were detected when the results were stratified by year, incision size or use of hooks or retractors. Patients with pseudoexfoliation syndrome have a high risk of late IOL dislocation after phacoemulsification cataract surgery, and this risk may be related to the use of large incisions and hooks or retractors. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Visual outcomes after lensectomy and iris claw artisan intraocular lens implantation in patients with Marfan syndrome.

Science.gov (United States)

Rabie, Hossein Mohammad; Malekifar, Parviz; Javadi, Mohammad Ali; Roshandel, Danial; Esfandiari, Hamed

2017-08-01

To review our experience with crystalline lens extraction and iris claw Artisan IOL implantation in patients with lens subluxation secondary to Marfan syndrome. A retrospective analysis of 12 eyes of 9 patients with lens subluxation due to Marfan syndrome who underwent crystalline lens removal and Artisan IOL (Ophtec, Groningen, Netherlands) implantation. A questionnaire of pre- and post-operative data, including demographics, pre- and postoperative comorbidities and complications was completed. Patients were evaluated for visual outcome and occurrence of complications. Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), and spherical equivalents (SE) were compared before and after lens extraction and IOL insertion. The mean age of the participants was 30.03 ± 15.02 years, and mean post-operative follow-up time was 44.5 ± 16.4 months. Mean BCVA also showed a significant improvement from 0.5 ± 0.3 at the baseline to 0.2 ± 0.2 post-operatively (P = 0.006). SE changed significantly from -11.38 ± 1.99 preoperatively to -0.45 ± 1.65 post-operatively (P = 0.003). All eyes had the IOL implanted at desired position. Post-operative complications were retinal detachment in one case and IOL dislocation in another patient. No other complication such as ocular hypertension, angle abnormalities, clinical cystoids macular edema, and corneal decompensation was observed during the follow-up period. Artisan IOL implantation after lens extraction appears to be an attractive alternative for optical correction in cases of Marfan syndrome with ectopia lentis. It confers a significant improvement in visual acuity with reasonable risk profile.

Management of subluxated capsular bag-fixated intraocular lenses using a capsular anchor

NARCIS (Netherlands)

Ton, Yokrat; Naftali, Modi; Lapid Gortzak, Ruth; Assia, Ehud I.

2016-01-01

We describe the use of the capsular anchor (AssiAnchor) to manage a subluxated intraocular lens (IOL) in the capsular bag. The anchor comprises 2 prongs that hold the anterior lens capsule and a central rod that is sutured to the scleral wall, enabling centration of the IOL-capsular bag complex. Six

Modification of hydrophobic acrylic intraocular lens with poly(ethylene glycol) by atmospheric pressure glow discharge: A facile approach

International Nuclear Information System (INIS)

Lin Lin; Wang Yao; Huang Xiaodan; Xu Zhikang; Yao Ke

2010-01-01

To improve the anterior surface biocompatibility of hydrophobic acrylic intraocular lens (IOL) in a convenient and continuous way, poly(ethylene glycol)s (PEGs) were immobilized by atmospheric pressure glow discharge (APGD) treatment using argon as the discharge gas. The hydrophilicity and chemical changes on the IOL surface were characterized by static water contact angle and X-ray photoelectron spectroscopy to confirm the covalent binding of PEG. The morphology of the IOL surface was observed under field emission scanning electron microscopy and atomic force microscopy. The surface biocompatibility was evaluated by adhesion experiments with platelets, macrophages, and lens epithelial cells (LECs) in vitro. The results revealed that the anterior surface of the PEG-grafted IOL displayed significantly and permanently improved hydrophilicity. Cell repellency was observed, especially in the PEG-modified IOL group, which resisted the attachment of platelets, macrophages and LECs. Moreover, the spread and growth of cells were suppressed, which may be attributed to the steric stabilization force and chain mobility effect of the modified PEG. All of these results indicated that hydrophobic acrylic IOLs can be hydrophilic modified by PEG through APGD treatment in a convenient and continuous manner which will provide advantages for further industrial applications.

Multifocal Intraocular Lens Results in Correcting Presbyopia in Eyes After Radial Keratotomy.

Science.gov (United States)

Kim, Kyeong Hwan; Seok, Kyung-Won; Kim, Wan Soo

2017-11-01

To report results of multifocal intraocular lens (IOL) implantation in 2 patients with refractive error and presbyopia after previous radial keratotomy (RK). A refractive multifocal IOL with rotational asymmetry (LS313-MF30; Oculentis, Berlin, Germany) was implanted. The first patient was a 60-year-old man with myopia who underwent unilateral RK 20 years before. His uncorrected distance visual acuity (UDVA) was 20/400, and his distance corrected near vision was J9 in both eyes. Six months after bilateral surgery, his binocular UDVA and uncorrected near visual acuity (UNVA) improved to 20/20 and J1, respectively, although he experienced diurnal fluctuation. The second patient was a 55-year-old woman with hyperopia who underwent bilateral RK 18 years before. Uncorrected distance visual acuity was 20/25 in both eyes, but UNVA was between J9 and J10. Three months after unilateral surgery, UDVA and UNVA of the postsurgical eye improved to 20/20 and J1, respectively. Neither patient reported any significant photic phenomena, and both were satisfied with the results of treatment. The desirable clinical outcomes and levels of satisfaction expressed by these patients indicate that surgery using this particular multifocal IOL may benefit presbyopic patients with previous RK.

Trifocal intraocular lenses: a comparison of the visual performance and quality of vision provided by two different lens designs

Directory of Open Access Journals (Sweden)

Gundersen KG

2017-06-01

Full Text Available Kjell G Gundersen,1 Rick Potvin2 1IFocus Øyeklinikk AS, Haugesund, Norway; 2Science in Vision, Akron, NY, USA Purpose: To compare two different diffractive trifocal intraocular lens (IOL designs, evaluating longer-term refractive outcomes, visual acuity (VA at various distances, low contrast VA and quality of vision.Patients and methods: Patients with binocularly implanted trifocal IOLs of two different designs (FineVision [FV] and Panoptix [PX] were evaluated 6 months to 2 years after surgery. Best distance-corrected and uncorrected VA were tested at distance (4 m, intermediate (80 and 60 cm and near (40 cm. A binocular defocus curve was collected with the subject’s best distance correction in place. The preferred reading distance was determined along with the VA at that distance. Low contrast VA at distance was also measured. Quality of vision was measured with the National Eye Institute Visual Function Questionnaire near subset and the Quality of Vision questionnaire.Results: Thirty subjects in each group were successfully recruited. The binocular defocus curves differed only at vergences of −1.0 D (FV better, P=0.02, −1.5 and −2.00 D (PX better, P<0.01 for both. Best distance-corrected and uncorrected binocular vision were significantly better for the PX lens at 60 cm (P<0.01 with no significant differences at other distances. The preferred reading distance was between 42 and 43 cm for both lenses, with the VA at the preferred reading distance slightly better with the PX lens (P=0.04. There were no statistically significant differences by lens for low contrast VA (P=0.1 or for quality of vision measures (P>0.3.Conclusion: Both trifocal lenses provided excellent distance, intermediate and near vision, but several measures indicated that the PX lens provided better intermediate vision at 60 cm. This may be important to users of tablets and other handheld devices. Quality of vision appeared similar between the two lens designs

Scleral fixation of a subluxated intraocular lens-capsular bag complex through a fibrotic continuous curvilinear capsulorhexis.

Science.gov (United States)

Gimbel, Howard V; Brucks, Matthew; Dardzhikova, Albena A; Camoriano, Gerardo D

2011-04-01

Several strategies have been devised to manage in-the-bag intraocular lens (IOL) subluxation. We describe a method of fixating the IOL-capsular bag complex to the sclera using the fibrotic ring that develops around the continuous curvilinear capsulorhexis (CCC). Two, preferably 3, double-armed 10-0 polypropylene sutures are passed around the fibrotic CCC rim of the capsule and out the Hoffman scleral pockets and then tied in the scleral tunnels to center the IOL-bag complex. This technique provides an alternative approach to repositioning and fixating the IOL-bag complex that is especially useful in cases in which removal and replacement of the IOL would be difficult. It also provides more than 2-point fixation to achieve perfect IOL centration. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Visual Performance of a Quadrifocal (Trifocal) Intraocular Lens Following Removal of the Crystalline Lens.

Science.gov (United States)

Kohnen, Thomas; Herzog, Michael; Hemkeppler, Eva; Schönbrunn, Sabrina; De Lorenzo, Nina; Petermann, Kerstin; Böhm, Myriam

2017-12-01

To evaluate visual performance after implantation of a quadrifocal intraocular lens (IOL). Setting: Department of Ophthalmology, Goethe University, Frankfurt, Germany. Twenty-seven patients (54 eyes) received bilateral implantation of the PanOptix IOL (AcrySof IQ PanOptixTM; Alcon Research, Fort Worth, Texas, USA) pre-enrollment. Exclusion criteria were previous ocular surgeries, corneal astigmatism of >1.5 diopter (D), ocular pathologies, or corneal abnormalities. Intervention or Observational Procedure(s): Postoperative examination at 3 months including manifest refraction; uncorrected visual acuity (UCVA) and distance-corrected visual acuity (DCVA) in 4 m, 80 cm, 60 cm, and 40 cm slit-lamp examination; defocus testing; contrast sensitivity (CS) under photopic and mesopic conditions; and a questionnaire on subjective quality of vision, optical phenomena, and spectacle independence was performed. At 3 months postoperatively, UCVA and DCVA in 4 m, 80 cm, 60 cm, and 40 cm (logMAR), defocus curves, CS, and quality-of-vision questionnaire results. Mean spherical equivalent was -0.04 ± 0.321 D 3 months postoperatively. Binocular UCVA at distance, intermediate (80 cm, 60 cm), and near was 0.00 ± 0.094 logMAR, 0.09 ± 0.107 logMAR, 0.00 ± 0.111 logMAR, and 0.01 ± 0.087 logMAR, respectively. Binocular defocus curve showed peaks with best visual acuity (VA) at 0.00 D (-0.07 logMAR) and -2.00 D (-0.02 logMAR). Visual performance of the PanOptix IOL showed good VA at all distances; particularly good intermediate VA (logMAR > 0.1), with best VA at 60 cm; and high patient satisfaction and spectacle independence 3 months postoperatively. Copyright © 2017 Elsevier Inc. All rights reserved.

Clinical outcomes of a new diffractive multifocal intraocular lens

Directory of Open Access Journals (Sweden)

Baha Toygar

2017-12-01

Full Text Available AIM: To evaluate clinical outcomes after implantation of a new diffractive aspheric multifocal intraocular lens (IOL with +3.00 addition power. METHODS: This is a retrospective, consecutive case series of cataract patients who underwent bilateral implantation of the Optiflex MO/HF D012 (Moss Vision Inc. Ltd, London, UK multifocal IOL. Patients followed for 6mo were included in the study. Data on distance, intermediate and near visual acuity, refractive error [manifest spherical equivalent (MSE], contrast sensitivity, adverse events, subjective symptoms, spectacle independence and patient satisfaction [visual function questionnaire (VFQ-25 questionnaire] were retrieved from electronic medical records and analyzed. RESULTS: Forty eyes of 20 patients with a mean age of 66.7±8.5y (range: 53-82 were included in the study. Mean uncorrected distance, near and intermediate visual acuity remained stable through postoperative visits and was 0.19±0.19 logMAR, Jaeger 4 and Jaeger 3 respectively at the 6mo visit. At the end of postoperative 6mo, MSE was -0.14±0.42 diopters (D and 98% of the eyes were within 1.00 D of target refraction. Postoperative low contrast (10% visual acuity remained stable (P=0.54 through follow up visits with a mean of 0.35±0.17 logMAR at the 6mo visit. There were no reported adverse events. None of the patients reported subjective symptoms of halo or glare. Spectacle independence rate was 90%. Mean VFQ-25 questionnaire score was 93.5±6.12. CONCLUSION: The Optiflex MO/HF-DO12 IOL was safely implanted and successfully restored distance, intermediate and near visual acuity without impairing contrast sensitivity. High levels of spectacle independence were achieved at all distances including intermediate distance.

Multiple methods of surgical treatment combined with primary IOL implantation on traumatic lens subluxation/dislocation in patients with secondary glaucoma.

Science.gov (United States)

Wang, Rui; Bi, Chun-Chao; Lei, Chun-Ling; Sun, Wen-Tao; Wang, Shan-Shan; Dong, Xiao-Juan

2014-01-01

To describe clinical findings and complications from cases of traumatic lens subluxation/dislocation in patients with secondary glaucoma, and discuss the multiple treating methods of operation combined with primary intraocular lens (IOL) implantation. Non-comparative retrospective observational case series. 30 cases (30 eyes) of lens subluxation/dislocation in patients with secondary glaucoma were investigated which accepted the surgical treatment by author in the Ophthalmology of Xi'an No.4 Hospital from 2007 to 2011. According to the different situations of lens subluxation/dislocation, various surgical procedures were performed such as crystalline lens phacoemulsification, crystalline lens phacoemulsification combined anterior vitrectomy, intracapsular cataract extraction combined anterior vitrectomy, lensectomy combined anterior vitrectomy though peripheral transparent cornea incision, pars plana lensectomy combined pars plana vitrectomy, and intravitreal cavity crystalline lens phacofragmentation combined pars plana vitrectomy. And whether to implement trabeculectomy depended on the different situations of secondary glaucoma. The posterior chamber intraocular lenses (PC-IOLs) were implanted in the capsular-bag or trassclerally sutured in the sulus decided by whether the capsular were present. visual acuity, intraocular pressure, the situation of intraocular lens and complications after the operations. The follow-up time was 11-36mo (21.4±7.13). Postoperative visual acuity of all eyes were improved; 28 cases maintained IOP below 21 mm Hg; 2 cases had slightly IOL subluxation, 4 cases had slightly tilted lens optical area; 1 case had postoperative choroidal detachment; 4 cases had postoperative corneal edema more than 1wk, but eventually recovered transparent; 2 cases had mild postoperative vitreous hemorrhage, and absorbed 4wk later. There was no postoperative retinal detachment, IOL dislocation, and endophthalmitis. To take early treatment of traumatic lens

Error induced by the estimation of the corneal power and the effective lens position with a rotationally asymmetric refractive multifocal intraocular lens.

Science.gov (United States)

Piñero, David P; Camps, Vicente J; Ramón, María L; Mateo, Verónica; Pérez-Cambrodí, Rafael J

2015-01-01

To evaluate the prediction error in intraocular lens (IOL) power calculation for a rotationally asymmetric refractive multifocal IOL and the impact on this error of the optimization of the keratometric estimation of the corneal power and the prediction of the effective lens position (ELP). Retrospective study including a total of 25 eyes of 13 patients (age, 50 to 83y) with previous cataract surgery with implantation of the Lentis Mplus LS-312 IOL (Oculentis GmbH, Germany). In all cases, an adjusted IOL power (PIOLadj) was calculated based on Gaussian optics using a variable keratometric index value (nkadj) for the estimation of the corneal power (Pkadj) and on a new value for ELP (ELPadj) obtained by multiple regression analysis. This PIOLadj was compared with the IOL power implanted (PIOLReal) and the value proposed by three conventional formulas (Haigis, Hoffer Q and Holladay I). PIOLReal was not significantly different than PIOLadj and Holladay IOL power (P>0.05). In the Bland and Altman analysis, PIOLadj showed lower mean difference (-0.07 D) and limits of agreement (of 1.47 and -1.61 D) when compared to PIOLReal than the IOL power value obtained with the Holladay formula. Furthermore, ELPadj was significantly lower than ELP calculated with other conventional formulas (P<0.01) and was found to be dependent on axial length, anterior chamber depth and Pkadj. Refractive outcomes after cataract surgery with implantation of the multifocal IOL Lentis Mplus LS-312 can be optimized by minimizing the keratometric error and by estimating ELP using a mathematical expression dependent on anatomical factors.

Análise da fórmula SRK/T no cálculo de lente intra-ocular em cães portadores de catarata Analysis of the SRK/T formula for calculation of intra-ocular lens in dogs carrying cataract

Directory of Open Access Journals (Sweden)

T.P. Peixoto

2008-12-01

Full Text Available Foram utilizados 20 cães de raças e idades variadas, machos e fêmeas, portadores de catarata e não diabéticos, os quais foram submetidos ao exame oftálmico. Posteriormente, realizaram-se mensurações oculares empregando-se um ecobiômetro ultra-sônico (ultra-sonografia modo-A para o cálculo do poder dióptrico da lente intra-ocular por meio da fórmula SRK/T. O comprimento axial médio foi de 19,94±1,12mm. Todos os animais foram submetidos à facoemulsificação extracapsular. A lente calculada foi implantada no transoperatório da cirurgia de catarata, obtendo-se média de 37,33±3,05D. A avaliação pós-cirúrgica do erro refracional aos 60 dias de pós-operatório, pela retinoscopia, com a utilização da esquiascopia, foi de 5,57±1,59D. A fórmula SRK/T não ofereceu bons resultados.Twenty males and females non-diabetic dogs of different breeds and ages underwent ophthalmic examination because they presented catarats. Ocular measurements were performed by echobiometry (A-scan ultrasound for intraocular lens power calculation using the SRK/T formula. The obtained mean axial length was 19.94±1.12mm. All animals were submitted to extracapsular phacoemulsification; the mean intraocular lens power implanted was 37.33±3.05. At 60 days postoperative, the refractional error assessed via retinoscopy was 5.57±1.59 D. The SRK/T formula did not offer good results.

[The effect of yellow filter intraocular lens on the macula after cataract phacoemulsification in patients with age macular degeneration].

Science.gov (United States)

Shpak, A A; Maliugin, B É; Fadeeva, T V

2012-01-01

Macula changes diagnosed with optical coherence tomography (OCT) within a year after cataract phacoemulsification (PE) with intraocular lens implantation with and without yellow filter are presented. 32 patients (36 eyes) with early stages of age macular degeneration (AMD) were included into the experimental group and 35 patients (36 eyes) served as controls. IOLs with yellow filter were implanted in 21 eyes, and in 15 cases IOLs without filter were used in each group. According to OCT data thickening of fovea and increasing of macula volume developed within 6 months after cataract PE. Implantation of yellow filter IOLs reduced the intensity of these changes after surgery in patients with AMD. The progression of early AMD into advanced stages within a year after PE was not observed.

A study of patient satisfaction after cataract surgery with implantation of different types of intraocular lenses

Directory of Open Access Journals (Sweden)

Wei Ching-Kuo

2012-10-01

Full Text Available Abstract Background The implementation of capitated payment has driven medical institutions through developing balance billing for medical services. By exploring the patients’ decision-making factors on different self-pay items, a reference for the pricing and sales strategy for the related products can be formed. The major purposes of this study were to analyze the determinants of preoperative selection and postoperative satisfaction with implantation of different types of intraocular lenses in cataract surgery. Methods This cross-sectional study consisted of 127 patients that were 50 years of age and older, and who had phacoemulsification with intraocular lens implantation in both eyes. Data were collected by using a structured questionnaire. The following parameters were measured: access to medical care, attitude towards receiving medical products at one’s own expense, overall patient satisfaction and postoperative visual clarity. Results The results showed that the patient’s gender, educational level and economic status influenced the type of intraocular lens chosen. Patients in the insurance group cared about access to medical care, and patients in the balance billing group cared about product differentiation. ANOVA results showed no statistically significant differences in the overall satisfaction of the patients among the groups with different types of intraocular lenses. Patients that received cataract surgery with implantation of multifocal intraocular lenses had better vision when trying to view smaller objects and when looking at objects under strong light. Conclusions Manufacturers should increase the number of differences between their products, and health care providers can then recommend the appropriate intraocular lens in accordance with the needs or demands of their patients, and also by keeping in mind the financial constraints of their patients.

A study of patient satisfaction after cataract surgery with implantation of different types of intraocular lenses.

Science.gov (United States)

Wei, Ching-Kuo; Wang, Shun-Mu; Lin, Jen-Chieh

2012-10-29

The implementation of capitated payment has driven medical institutions through developing balance billing for medical services. By exploring the patients' decision-making factors on different self-pay items, a reference for the pricing and sales strategy for the related products can be formed. The major purposes of this study were to analyze the determinants of preoperative selection and postoperative satisfaction with implantation of different types of intraocular lenses in cataract surgery. This cross-sectional study consisted of 127 patients that were 50 years of age and older, and who had phacoemulsification with intraocular lens implantation in both eyes. Data were collected by using a structured questionnaire. The following parameters were measured: access to medical care, attitude towards receiving medical products at one's own expense, overall patient satisfaction and postoperative visual clarity. The results showed that the patient's gender, educational level and economic status influenced the type of intraocular lens chosen. Patients in the insurance group cared about access to medical care, and patients in the balance billing group cared about product differentiation. ANOVA results showed no statistically significant differences in the overall satisfaction of the patients among the groups with different types of intraocular lenses. Patients that received cataract surgery with implantation of multifocal intraocular lenses had better vision when trying to view smaller objects and when looking at objects under strong light. Manufacturers should increase the number of differences between their products, and health care providers can then recommend the appropriate intraocular lens in accordance with the needs or demands of their patients, and also by keeping in mind the financial constraints of their patients.

Magnetic resonance imaging diagnosis of intraocular lenses. Die kernspintomographische Diagnostik der Hinterkammerlinse

Energy Technology Data Exchange (ETDEWEB)

Tosch, U. (Strahlenklinik und Poliklinik, Universitaetsklinik Rudolf Virchow, Berlin (Germany)); Bleckmann, H. (Strahlenklinik und Poliklinik, Universitaetsklinik Rudolf Virchow, Berlin (Germany)); Kaczmarek, U. (Strahlenklinik und Poliklinik, Universitaetsklinik Rudolf Virchow, Berlin (Germany))

1994-09-01

Intraocular lenses were investigated by MRI to obtain information about the quality of this method. In experimental studies, seven lenses of between 0 and 30 diopters were visualized. By MRI it was possible to differentiate the various diameters of lenses. It was not possible to discriminate the material of the intraocular lenses. After these first studies the eyes of two corpses and eight patients were investigated. Because of the resolution of MRI it was possible to tell the diopter of implanted lenses. However, by use of MRI in the regular position, a tilting or decentration of the intraocular lens was demonstrated. (orig.)

Implante de lente intraocular en niños como solución a los problemas sociales de la ceguera por catarata congénita Intraocular lens implants for children as a solution to social problems caused by blindness from congenital cataract

Directory of Open Access Journals (Sweden)

Rosa María Naranjo Fernández

2011-12-01

congenital cataract ranges from 1 to 4 per 10 000 children in underdeveloped countries and 0,1 to 0,4 in industrialized countries. In Cuba, 2,1 million inhabitants are under 15 years of age and the congenital cataract is regarded as the second cause of infantile blindness. In the last 20 years, the surgical treatment of cataract in children has completely changed based on the remarkable improvement of the surgical techniques. In our country, the pediatric cataract surgery with intraocular lens implantation began in 1990 after the inauguration of the Ocular Microsurgery Center in 1988. The importance of this pediatric cataract surgery with intraocular lens implants was shown as a solution to the social problems caused by the visual deficit of inadequately treated patients, since the application of modern technology improves the quality of life of children both at social and educational level, and allows fully re-inserting them into the society.

The impact of a preloaded intraocular lens delivery system on operating room efficiency in routine cataract surgery

Directory of Open Access Journals (Sweden)

Jones JJ

2016-06-01

Full Text Available Jason J Jones,1 Jeffrey Chu,2 Jacob Graham,2 Serge Zaluski,3 Guillermo Rocha4 1Jones Eye Clinic, Sioux City, IA, 2Quorum Consulting Inc., San Francisco, CA, USA; 3VISIS, Perpignan, France; 4Ocular Microsurgery & Laser Centre, Brandon, MB, Canada Purpose: The aim of this study was to evaluate the operational impact of using preloaded intraocular lens (IOL delivery systems compared with manually loaded IOL delivery processes during routine cataract surgeries. Methods: Time and motion data, staff and surgery schedules, and cost accounting reports were collected across three sites located in the US, France, and Canada. Time and motion data were collected for manually loaded IOL processes and preloaded IOL delivery systems over four surgery days. Staff and surgery schedules and cost accounting reports were collected during the 2 months prior and after introduction of the preloaded IOL delivery system. Results: The study included a total of 154 routine cataract surgeries across all three sites. Of these, 77 surgeries were performed using a preloaded IOL delivery system, and the remaining 77 surgeries were performed using a manual IOL delivery process. Across all three sites, use of the preloaded IOL delivery system significantly decreased mean total case time by 6.2%–12.0% (P<0.001 for data from Canada and the US and P<0.05 for data from France. Use of the preloaded delivery system also decreased surgeon lens time, surgeon delays, and eliminated lens touches during IOL preparation. Conclusion: Compared to a manual IOL delivery process, use of a preloaded IOL delivery system for cataract surgery reduced total case time, total surgeon lens time, surgeon delays, and eliminated IOL touches. The time savings provided by the preloaded IOL delivery system provide an opportunity for sites to improve routine cataract surgery throughput without impacting surgeon or staff capacity. Keywords: time and motion, provider impact, surgical throughput, IOL

Delayed diagnosis of homocystinuria presenting as bilateral congenital lens subluxation

Directory of Open Access Journals (Sweden)

Jelić-Vuković Marija

2017-01-01

Full Text Available Introduction. Homocystinuria is an autosomal recessively inherited defect leading to hyperhomocysteinemia and associated with ocular manifestations, mainly myopia and ectopia lentis. Case outline. A 26-year-old male with secondary glaucoma due to bilateral lens subluxation was admitted to the Department of vitreoretinal surgery. Horizontal nystagmus, bilateral lens subluxation, and bilateral amblyopia were first discovered at the age of three years. Preoperative laboratory workup revealed elevated levels of homocysteine. Bilateral pars plana lensectomy and vitrectomy followed by a sulcus fixation of the intraocular lens (ALCON MA60 Acrysof IOL were performed. The patient was prescribed folic acid, methionine, and pyridoxine, and was urged to maintain a methionine-low diet. After a bilateral lensectomy and sulcus fixation of the intraocular lens and a methionine restriction therapy combined with vitamin B6, B9, and B12 supplementation, his condition improved greatly. Conclusion. In this report of a rare case we emphasize the importance of examining differential diagnoses of lens subluxation, since early intervention can prevent serious complications.

Spontaneous bilateral anterior partial in-the-bag intraocular lens dislocation following routine annual eye examination.

Science.gov (United States)

Ford, Joshua R; Werner, Liliana; Owen, Leah; Vasavada, Shail A; Crandall, Alan

2014-09-01

We present the case of an 81-year-old man with pseudoexfoliation syndrome (PXF) in whom spontaneous bilateral anterior partial in-the-bag intraocular lens (IOL) dislocation was diagnosed following a routine dilated examination that demonstrated only mild pseudophacodonesis with no evidence of subluxation. Uneventful cataract surgery with placement of single-piece hydrophobic acrylic posterior chamber IOLs had been performed in both eyes 7 years previously. Bilateral IOL repositioning with scleral fixation was performed to correct the dislocation. Postoperative examinations showed remarkable improvement in visual acuity and IOL stability. We hypothesize that zonular weakness secondary to PXF predisposed the patient to bilateral IOL partial dislocation. Pupil dilation in the setting of mild pseudophacodonesis at the time of routine examination may have been a precipitating factor. To our knowledge, bilateral IOL subluxation/dislocation has been described in a limited number of case reports. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Correction of High Astigmatism after Penetrating Keratoplasty with Toric Multifocal Intraocular Lens Implantation

Directory of Open Access Journals (Sweden)

Raffaele Nuzzi

2017-07-01

Full Text Available After penetrating keratoplasty (PK, high astigmatism is often induced, being frequently about 4–6 dpt. According to the entity and typology of astigmatism, different methods of correction can be used. Selective suture removal, relaxing incisions, wedge resections, compression sutures, photorefractive keratectomy, and laser-assisted in situ keratomileusis can reduce corneal astigmatism and ametropia, but meanwhile they can cause a reduction in the corneal integrity and cause an over- or undercorrection. In case of moderate-to-high regular astigmatisms, the authors propose a toric multifocal intraocular lens (IOL implantation to preserve the corneal integrity (especially in PK after herpetic corneal leukoma keratitis. We evaluated a 45-year-old patient who at the age of 30 was subjected to PK in his left eye due to corneal leukoma herpetic keratitis, which led to high astigmatism (7.50 dpt cyl. 5°. The patient was subjected to phacoemulsification and customized toric multifocal IOL implantation in his left eye. The correction of PK-induced residual astigmatism with a toric IOL implantation is an excellent choice but has to be evaluated in relation to patient age, corneal integrity, longevity graft, and surgical risk. It seems to be a well-tolerated therapeutic choice and with good results.

Observations on the relationship between the levels of serum IL-6 and TNF-α and the severity of diabetic retinopathy and curative effect in cataract extraction with intraocular lens implantation in diabetics

International Nuclear Information System (INIS)

Wang Yumin; Ma Xinying; Song Yuebing; Liang Yong; Zhang Xiaoguang

2001-01-01

Objective: To determine the sequential changes of blood levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in diabetics with extracapsular extraction and posterior chamber intraocular lens implantation and to study their correlation with curative effects and pos-operative complications. Methods: The serum concentrations of IL-6 and TNF-α in 39 diabetics and non-diabetics were measured by radioimmunoassay at preoperative, post-operative and on days 7, 14 and 90 postoperatively. Results: There was significant difference in the levels of the two factors between the diabetic group and non-diabetic group preoperatively (P<0.05). The serum levels of the two factors in patients with proliferative diabetic retinopathy were higher than those in non-diabetic retinopathy, and simple diabetic retinopathy post-operative (P<0.01). Post-operative complication rate was higher in patients with proliferative diabetic retinopathy than those without retinopathy and those having simple diabetic retinopathy. Conclusion: The levels of the two factors correlate with complications and curative effect of patients with proliferative diabetic retinopathy undergoing intraocular lens implantation

Error induced by the estimation of the corneal power and the effective lens position with a rotationally asymmetric refractive multifocal intraocular lens

Directory of Open Access Journals (Sweden)

David P. Piñero

2015-06-01

Full Text Available AIM:To evaluate the prediction error in intraocular lens (IOL power calculation for a rotationally asymmetric refractive multifocal IOL and the impact on this error of the optimization of the keratometric estimation of the corneal power and the prediction of the effective lens position (ELP.METHODS:Retrospective study including a total of 25 eyes of 13 patients (age, 50 to 83y with previous cataract surgery with implantation of the Lentis Mplus LS-312 IOL (Oculentis GmbH, Germany. In all cases, an adjusted IOL power (PIOLadj was calculated based on Gaussian optics using a variable keratometric index value (nkadj for the estimation of the corneal power (Pkadj and on a new value for ELP (ELPadj obtained by multiple regression analysis. This PIOLadj was compared with the IOL power implanted (PIOLReal and the value proposed by three conventional formulas (Haigis, Hoffer Q and Holladay Ⅰ.RESULTS:PIOLReal was not significantly different than PIOLadj and Holladay IOL power (P>0.05. In the Bland and Altman analysis, PIOLadj showed lower mean difference (-0.07 D and limits of agreement (of 1.47 and -1.61 D when compared to PIOLReal than the IOL power value obtained with the Holladay formula. Furthermore, ELPadj was significantly lower than ELP calculated with other conventional formulas (P<0.01 and was found to be dependent on axial length, anterior chamber depth and Pkadj.CONCLUSION:Refractive outcomes after cataract surgery with implantation of the multifocal IOL Lentis Mplus LS-312 can be optimized by minimizing the keratometric error and by estimating ELP using a mathematical expression dependent on anatomical factors.

Intraocular foreign-body hazard during vitrectomy.

Science.gov (United States)

Bovino, J A; Marcus, D F

1982-03-01

We noted two instances of forceps-induced fragmentation of the bar used for scleral plug storage during vitreous surgery. The silicone bar material was adherent to the plug in both cases. Because this represents a significant intraocular foreign body hazard, the scleral plug should be carefully inspected before insertion.

Multiple methods of surgical treatment combined with primary IOL implantation on traumatic lens subluxation/dislocation in patients with secondary glaucoma

Directory of Open Access Journals (Sweden)

Rui Wang

2014-04-01

Full Text Available AIM:To describe clinical findings and complications from cases of traumatic lens subluxation/dislocation in patients with secondary glaucoma, and discuss the multiple treating methods of operation combined with primary intraocular lens (IOL implantation.METHODS:Non-comparative retrospective observational case series. Participants:30 cases (30 eyes of lens subluxation/dislocation in patients with secondary glaucoma were investigated which accepted the surgical treatment by author in the Ophthalmology of Xi''an No.4 Hospital from 2007 to 2011. According to the different situations of lens subluxation/dislocation, various surgical procedures were performed such as crystalline lens phacoemulsification, crystalline lens phacoemulsification combined anterior vitrectomy, intracapsular cataract extraction combined anterior vitrectomy, lensectomy combined anterior vitrectomy though peripheral transparent cornea incision, pars plana lensectomy combined pars plana vitrectomy, and intravitreal cavity crystalline lens phacofragmentation combined pars plana vitrectomy. And whether to implement trabeculectomy depended on the different situations of secondary glaucoma. The posterior chamber intraocular lenses (PC-IOLs were implanted in the capsular-bag or trassclerally sutured in the sulus decided by whether the capsular were present. Main outcome measures:visual acuity, intraocular pressure, the situation of intraocular lens and complications after the operations.RESULTS: The follow-up time was 11-36mo (21.4±7.13. Postoperative visual acuity of all eyes were improved; 28 cases maintained IOP below 21 mm Hg; 2 cases had slightly IOL subluxation, 4 cases had slightly tilted lens optical area; 1 case had postoperative choroidal detachment; 4 cases had postoperative corneal edema more than 1wk, but eventually recovered transparent; 2 cases had mild postoperative vitreous hemorrhage, and absorbed 4wk later. There was no postoperative retinal detachment, IOL

Management of sulcus-fixated single-piece intraocular lens-induced pigmentary glaucoma with 3-piece IOL exchange.

Science.gov (United States)

Rabie, Hossein Mohammad; Esfandiari, Hamed; Rikhtegar, Mohammad Hassan; Hekmat, Vahid

2018-02-01

To describe our experience with exchanging sulcus-fixated single-piece intraocular lens (IOL) with 3-piece IOLs for management of pigmentary glaucoma. In this retrospective study, records of patients who underwent sulcus-fixated single-piece IOL exchanged with 3-piece IOLs were retrieved, and demographic and baseline data of patients, type of IOL, pre- and post-IOL exchange BCVA, IOP, number of anti-glaucoma medications, and optic nerve head examination were documented. Baseline and final examinations were analyzed and compared. Mean age of the patients was 59 ± 10 years, and 5 (41.6%) were female. Mean interval between primary cataract extraction operation and IOL exchange was 17 ± 5 months. Nine patients received in sulcus implantation of Alcon SA60AT, and three patients had SN60WF model at the end of primary surgery. BCVA changed insignificantly from 0.06 ± 0.06 logMAR to 0.06 ± 0.06 after IOL exchange. (P = 0.22) IOP was controlled in 8 cases (66.6%), but four cases (33.3%) needed glaucoma surgery to further control glaucoma condition. IOP decreased significantly from preoperative 17 ± 3 to 14 ± 1 mmHg postoperatively. Patients with advanced age and higher baseline IOP were more likely to undergo glaucoma surgery after IOL exchange. (P = 0.07 and 0.00, respectively). single-piece IOL exchange with 3-piece IOL dramatically decreases pigment release and reduces IOP. Those with advanced age and higher IOP are less likely to respond to IOL exchange and may need glaucoma surgery to control high intraocular pressure.

Aphakia correction with retropupillary fixated iris-claw lens (Artisan – long-term results

Directory of Open Access Journals (Sweden)

Schallenberg M

2013-12-01

Full Text Available Maurice Schallenberg,1,2 Dirk Dekowski,1 Angela Hahn,1 Thomas Laube,1,3 Klaus-Peter Steuhl,1 Daniel Meller11Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; 2HELIOS Klinikum Wuppertal, Wuppertal, Germany; 3Zentrum für Augenheilkunde PD Dr Laube, Düsseldorf, GermanyPurpose: To evaluate the technique, safety, and efficacy of the retropupillary implantation of iris-claw intraocular lenses in a long-term follow-up study.Patients and methods: This retrospective study included 31 eyes of 31 patients who underwent an Artisan aphakic intraocular lens implantation between January 2006 and February 2011 at the University Hospital Essen, Essen, Germany and at the Zentrum für Augenheilkunde PD Dr Laube, Düsseldorf, Germany. Preoperative data collected included demographics, etiology of aphakia, previous surgeries, preoperative eye pathology, intraocular pressure, clinical signs of endothelial cell loss, and best corrected visual acuity. Operative data and postoperative outcomes included the best corrected visual acuity, lens position, intraocular pressure, pigment dispersion, clinical signs of endothelial cell loss, development of macular edema, and other complications.Results: Thirty-one patients were included. The mean follow-up was 25.2 months (range: 4–48 months. The mean best corrected visual acuity postoperatively was 0.64 logarithm of the minimum angle of resolution (logMAR and varied from 0 logMAR to 3 logMAR. Some patients had a low visual acuity preoperatively because of preoperative eye pathologies. In 22 patients the visual acuity improved, in two patients the visual acuity remained unchanged, and seven patients showed a decreased visual acuity. Complications were peaked pupils (n=10 and retinal detachment in one case. Four patients showed an iris atrophy and high intraocular pressure was observed only in one patient. Subluxation of the intraocular lens, endothelial cell loss, and

Glued intrascleral fixation of posterior chamber intraocular lens in children.

Science.gov (United States)

Kumar, Dhivya Ashok; Agarwal, Amar; Prakash, Dimple; Prakash, Gaurav; Jacob, Soosan; Agarwal, Athiya

2012-04-01

To evaluate the short-term results of glued intrascleral fixation of posterior chamber intraocular lens (glued IOL) in children without adequate capsular support. Noncomparative retrospective observational case series. Institutional practice. Forty-one eyes of 33 children who underwent glued IOL implantation were retrospectively evaluated. The indications were postsurgical aphakia, subluxated cataract, ectopia lentis, traumatic subluxation, and decentered IOL. Visual acuity (VA), endothelial cell changes, intraoperative and postoperative complications. The mean age at the time of glued IOL was 10.7±3.6 years (range 5-15). The mean duration of follow-up after surgery was 17.5±8.5 months (range 12-36). The mean postoperative best spectacle-corrected visual acuity (BCVA in decimal equivalent) was 0.43±0.33 and there was significant change noted (P20/60 BCVA was obtained in 17.1% and 46.3% of eyes respectively. BCVA improvement more than 1 line was seen in 22 eyes (53.6%). The mean postoperative refraction was myopic (-1.19±0.7 diopters [D]) in 19 eyes and hyperopic (+1.02±0.7 D) in 22 eyes. The mean endothelial loss was 4.13% (range 1.3%-5.94%). The 3 causes of reduced BCVA were the preexisting corneal, retinal pathology, and amblyopia. Postoperative complications included optic capture in 1 eye (2.4%), macular edema in 2 eyes (4.8%), and clinical decentration in 2 eyes (4.8%). There was no postoperative retinal detachment, IOL dislocation, endophthalmitis, or glaucoma. Short-term results in children after glued IOL were favorable, with a low rate of complications. However, regular follow-ups are required since long-term risks are unknown. Copyright © 2012 Elsevier Inc. All rights reserved.

The efficiency of aspheric intraocular lens according to biometric measurements.

Science.gov (United States)

Whang, Woong-Joo; Piao, Junjie; Yoo, Young-Sik; Joo, Choun-Ki; Yoon, Geunyoung

2017-01-01

To analyze internal spherical aberration in pseudophakic eyes that underwent aspheric intraocular lens (IOL) implantation, and to investigate the relationships between biometric data and the effectiveness of aspheric IOL implantation. This retrospective study included 40 eyes of 40 patients who underwent implantation of an IOL having a negative spherical aberration of -0.20 μm (CT ASPHINA 509M; Carl Zeiss Meditec Inc., Germany). The IOLMaster (version 5.0; Carl Zeiss AG, Germany) was used for preoperative biometric measurements (axial length, anterior chamber depth, central corneal power) and the measurement of postoperative anterior chamber depth. The spherical aberrations were measured preoperatively and 3 months postoperatively using the iTrace (Tracey Technologies, Houston, TX, USA) at a pupil diameter of 5.0 mm. We investigated the relationships between preoperative biometric data and postoperative internal spherical aberration, and compared biometric measurements between 2 subgroups stratified according to internal spherical aberration (spherical aberration ≤ -0.06 μm vs. spherical aberration > -0.06 μm). The mean postoperative internal spherical aberration was -0.087 ± 0.063 μm. Preoperative axial length and residual total spherical aberration showed statistically significant correlations with internal spherical aberration (p = 0.041, 0.002). Preoperative axial length, postoperative anterior chamber depth, IOL power, and residual spherical aberration showed significant differences between the 2 subgroups stratified according to internal spherical aberration (p = 0.020, 0.029, 0.048, 0.041 respectively). The corrective effect of an aspheric IOL is influenced by preoperative axial length and postoperative anterior chamber depth. Not only the amount of negative spherical aberration on the IOL surface but also the preoperative axial length should be considered to optimize spherical aberration after aspheric IOL implantation.

Scharioth Macula Lens: A new intraocular implant for low-vision patients with stabilized maculopathy- first experience.

Science.gov (United States)

Nekolova, Jana; Rozsival, Pavel; Sin, Martin; Jiraskova, Nada

2017-06-01

To present the initial results of Scharioth Macula Lens (SML) implantation. The SML is a new add-on intraocular lens designed to increase uncorrected near visual acuity (UCVA) in patients with stabilized maculopathy. Eight patients were included in the study. All met the indication criteria before SML implantation. An SML was implanted in the better seeing eye. Near and distance visual acuity were tested. Possible complications and patient complaints were recorded and patients were asked about their quality of vision after SML implantation. The examination was carried out on day 1, 1 week, 1, 3 and 6 months after surgery. Six-month-results are presented. Apart from one, all patients with the SML had good near visual acuity at a recommended reading distance of 15 cm. Preoperatively, the mean (min-max) near UCVA was J13 (J8-J16), mean distance BCVA was 0.27. Postoperatively, the best results were after 1 month - near UCVA was J2.5 (J1-J7), distance BCVA was 0.26. Three months after surgery, this decreased to J4.5 (J1-J8); distance VA remained 0.25. Six months postoperatively - near vision was J4 (J1-J8) and distance VA was unchanged. Patients reported problems with reading speed and reading distance. Daily exercise improved their reading ability. One patient converted to wet AMD 3 months post-implantation. The SML is a new hope for low-vision patients. It acts as a magnifier in the eye. It is a suitable method for increasing near visual acuity in patients with inactive maculopathy.

Results of intraocular lens implantation with capsular tension ring in subluxated crystalline or cataractous lenses in children.

Science.gov (United States)

Das, Pranab; Ram, Jagat; Brar, Gagandeep Singh; Dogra, Mangat R

2009-01-01

To evaluate the outcome of intraocular lens (IOL) implantation using capsular tension ring (CTR) in subluxated crystalline or cataractous lenses in children. Tertiary care setting. We prospectively studied 18 eyes of 15 children with subluxation of crystalline or cataractous lenses between 90 degrees up to 210 degrees after phacoemulsification, CTR and IOL implantation. Each child was examined for IOL centration, zonular dehiscence and posterior capsular opacification (PCO). Age of the patient ranged between five to 15 years. Out of 18 eyes, seven had traumatic and 11 had spontaneous subluxation of crystalline or cataractous lens. Phacoemulsification was successfully performed with CTR implantation in the capsular bag. Intraoperative zonular dialysis occurred in two eyes. Anterior vitrectomy was performed in six eyes to manage vitreous prolapse. IOL implanted was polymethyl methacrylate (PMMA) in eight eyes, hydrophobic acrylic in seven and hydrophilic acrylic in three. Follow-up ranged from 24 months to 72 months. Sixteen eyes had a best corrected visual acuity of 20/40 or better. Nine eyes developed significant PCO and were managed with Neodymium Yttrium Aluminum Garnet (Nd:YAG) laser posterior capsulotomy. One eye with acrylic IOL in the capsular bag had IOL dislocation after two years which was managed with vitrectomy and secondary trans-scleral fixation of IOL. Phacoaspiration with CTR implantation makes capsular bag IOL fixation possible in most of the eyes with subluxated crystalline or cataractous lenses. PCO still remains a challenge in children with successful phacoaspiration with CTR implantation.

A pilot study to determine if intraocular lens choice at the time of cataract surgery has an impact on patient-reported driving habits

Directory of Open Access Journals (Sweden)

Beiko GHH

2015-08-01

Full Text Available George HH Beiko1,2 1Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada; 2Division of Ophthalmology, Department of Surgery, McMaster University, Hamilton, ON, CanadaPurpose: To determine if intraocular lens (IOL choice at the time of cataract surgery affects driving habits.Materials and methods: Pseudophakes who were 28–35 months postbilateral cataract surgery with one of two contemporary one-piece hydrophobic acrylic IOLs (SN60WF or ZCB00 were asked to complete the Driving Habits Questionnaire, a validated instrument for determining self-reported driving status, frequency, and difficulty. To determine if there were any differences in driving habits between the two groups, t-tests and χ2 tests were used.Results: Of 90 respondents, 72 (40 SN60WF and 32 ZCB00 were still active drivers. The SN60WF-implanted subjects were less likely to drive at the same speed or faster than the general flow of traffic, less likely to rate their quality of driving as average/above average, less likely to have traveled beyond their immediate neighborhood, less likely to drive at night, more likely to have moderate-to-severe difficulty driving at night, and more likely to have self-reported road traffic accidents. The differences did not reach statistical significance.Conclusion: Changes in patients’ driving habits 2–3 years after cataract surgery may be associated with the type of IOL implanted. A larger study, powered to demonstrate statistical significance, is needed to verify the trends identified in this pilot study and discover possible contributing factors.Keywords: intraocular lens, cataract surgery, driving habits, disability glare, retinal straylight, accidents

Dislocation of polyfocal full-optics accommodative intraocular lens after neodymium-doped yttrium aluminum garnet capsulotomy in vitrectomized eye

Directory of Open Access Journals (Sweden)

Kyung Tae Kang

2013-01-01

Full Text Available We report a case of dislocation of WIOL-CF® polyfocal full-optics intraocular lens (IOL after neodymium-doped yttrium aluminum garnet (Nd: YAG laser capsulotomy in the vitrectomized eye. At 22 months before the dislocation of the IOL, a 55-year-old male patient underwent phacoemulsification with WIOL-CF® IOL implantation in a local clinic and 10 months after the cataract surgery the patient underwent pars plana vitrectomy, endolaser photocoagulation and 14% C 3 F 8 gas tamponade for the treatment of rhegmatogenous retinal detachment. At 9 months after the vitrectomy, the patient visited our clinic for a sudden decrease of vision after Nd: YAG capsulotomy in the local clinic. On fundus examination, the dislocated IOL was identified and the Nd: YAG capsulotomy site and the larger break, which is suspected to have been a route of the dislocation were observed in the posterior capsule.

Safety and effect of femtosecond laser-assisted cataract surgery combined with Cionni capsular tension ring implantation in the management of traumatic lens subluxation

Directory of Open Access Journals (Sweden)

Jia-Hui Chen

2017-07-01

Full Text Available AIM:To investigate the safety and effect of femtosecond laser-assisted cataract surgery with Cionni modified capsular tension ring(MCTRimplantation in the management of traumatic lens subluxation.METHODS: Totally 11 patients(11 eyeswith traumatic lens subluxation were divided into three groups according to the severity of lens dislocation, ranging from 90° to 120°(4 eyes, 120° to 180°(5 eyesand 180° to 270°(2 eyes. The contact LenSx femtosecond laser cataract surgery platform was applied to create the capsulotomy, prepare nuclear fragmentation and make corneal wound creation. Anterior vitrectomy was performed in some patients during the surgery. After capsular retractors insertion and phacoemulsification, the MCTR was inserted to the capsular bag and fixed to the sclera. Finally, the IOL was implanted into the capsular bag. Postoperative visual acuity, intra- and post-operative complications, anterior capsular opening, IOL and MCTR position and intraocular pressure(IOPwere assessed.RESULTS:The duration of follow-up was 2mo. All the operations were completed successfully. Five eyes underwent cataract surgery combined with anterior vitrectomy. Four eyes had been inserted with 2-eyelet MCTR and seven eyes with 1-eyelet MCTR. The best corrected visual acuity(BCVAafter operation was better than 0.5 in 4 eyes, between 0.3 and 0.5 in 3 eyes, between 0.1 and 0.3 in 3 eyes, and less than 0.1 in 1 eye. Compared with preoperative BCVA, the difference was statistically significant(PCONCLUSION:Femtosecond laser-assisted cataract surgery can improve the success rate of capsulorhexis, and reduce the difficulty of nuclear fragmentation. Femtosecond laser-assisted cataract surgery combined with MCTR implantation is an ideal surgical method for traumatic lens subluxation.

Intraocular lens power selection and positioning with and without intraoperative aberrometry.

Science.gov (United States)

Hatch, Kathryn M; Woodcock, Emily C; Talamo, Jonathan H

2015-04-01

To determine the value of intraoperative aberrometry in cases of toric intraocular lens (IOL) implantation and positioning. In this non-randomized retrospective comparative trial, two groups of eyes underwent cataract extraction with toric IOL implantation: the aberrometry group (n = 37 eyes), where toric IOL power and alignment were determined before surgery with automated keratometry, standard optical biometry, and an online calculator and then refined using intraoperative aberrometry, and the toric calculator group (n = 27 eyes), where IOL selection was performed in a similar manner but without intraoperative aberrometry. The primary outcome measure was mean postoperative residual refractive astigmatism (RRA). Mean RRA measured at follow-up after surgery was 0.46 ± 0.42 and 0.68 ± 0.34 diopters (D) in the aberrometry and toric calculator groups, respectively (P = .0153). A 75% and 57% reduction in cylinder was noted between preoperative keratometric astigmatism and postoperative RRA in the aberrometry and toric calculator groups, respectively (P = .0027). RRA of 0.25 D or less, 0.50 D or less, 0.75 D or less, and 1.00 D or less was seen 38%, 78%, 86%, and 95% of the time, respectively, in the aberrometry group and 22%, 33%, 74%, and 89% of the time, respectively, in the toric calculator group. These data show that the chance of a patient being in a lower postoperative RRA range increased when intraoperative aberrometry was used (P = .0130). Patients undergoing cataract extraction with toric IOL placement aided by intraoperative aberrometry were 2.4 times more likely to have less than 0.50 D of RRA compared to standard methods. Copyright 2015, SLACK Incorporated.

The influence of lens power and center thickness on the intraocular pressure measured through soft lenses: a comparison of two noncontact tonometers.

Science.gov (United States)

Ogbuehi, Kelechi C

2012-06-01

To quantify the influence of soft contact lens power and thickness on the intraocular pressure (IOP). Thirty-nine young, healthy adult volunteers completed this study. One eye of each subject was randomly assigned either a +6D or a -6D high water content daily disposable lens. The other eye was fitted with the second lens. Triplicate measurements of IOP were taken before, during, and after contact lens wear. Each time, IOP was assessed in a randomized order with two noncontact tonometers. The lenses were swapped between eyes during a second session of measurements, one week later. In the first session with the +6D lenses, the average IOPs (±SDs) before, with the lenses fitted, and after the lenses were removed, were: 14.3 ± 2.9 mmHg, 17.0 ± 3.3 mmHg and 13.9 ± 3.1 mmHg, respectively, for the CT80 and 13.6 ± 3.1 mmHg, 17.1 ± 4.5 mmHg and 13.3 ± 2.9 mmHg, respectively, for the PT100. The corresponding values for the first session with the -6D lenses were: 14.3 ± 3.1 mmHg, 13.1 ± 3.1 mmHg and 14.1 ± 3.3 mmHg, respectively, for the CT80 and 13.6 ± 3.2 mmHg, 13.0 ± 3.0 mmHg and 13.6 ± 3.2 mmHg, respectively, for the PT100. IOP significantly (Psoft contact lens-induced changes were consistent between sessions but varied between tonometers. The measurement of IOP through soft contact lenses resulted in consistent, statistically significant differences in IOP, which were not uniform across tonometers and which did not appear to be solely related to the central thickness of the soft contact lenses. Copyright © 2012 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Chitosan/alginate based multilayers to control drug release fromophthalmic lens

OpenAIRE

Silva, Diana; Pinto, Luís F. V.; Bozukova, Dimitriya; Santos, Luís F.; Serro, Ana Paula; Saramago, Benilde

2016-01-01

In this study we investigated the possibility of using layer-by-layer deposition, based in natural polymers (chitosan and alginate), to control the release of different ophthalmic drugs from three types of lens materials: a silicone-based hydrogel recently proposed by our group as drug releasing soft contact lens (SCL) material and two commercially available materials: CI26Y for intraocular lens (IOLs) and Definitive 50 for SCLs. The optimised coating, consisting in one double layer of (algin...

Evaluation of Different Power of Near Addition in Two Different Multifocal Intraocular Lenses

Directory of Open Access Journals (Sweden)

Ugur Unsal

2016-01-01

Full Text Available Purpose. To compare near, intermediate, and distance vision and quality of vision, when refractive rotational multifocal intraocular lenses with 3.0 diopters or diffractive multifocal intraocular lenses with 2.5 diopters near addition are implanted. Methods. 41 eyes of 41 patients in whom rotational +3.0 diopters near addition IOLs were implanted and 30 eyes of 30 patients in whom diffractive +2.5 diopters near addition IOLs were implanted after cataract surgery were reviewed. Uncorrected and corrected distance visual acuity, intermediate visual acuity, near visual acuity, and patient satisfaction were evaluated 6 months later. Results. The corrected and uncorrected distance visual acuity were the same between both groups (p=0.50 and p=0.509, resp.. The uncorrected intermediate and corrected intermediate and near vision acuities were better in the +2.5 near vision added intraocular lens implanted group (p=0.049, p=0.005, and p=0.001, resp. and the uncorrected near vision acuity was better in the +3.0 near vision added intraocular lens implanted group (p=0.001. The patient satisfactions of both groups were similar. Conclusion. The +2.5 diopters near addition could be a better choice in younger patients with more distance and intermediate visual requirements (driving, outdoor activities, whereas the + 3.0 diopters should be considered for patients with more near vision correction (reading.

Midline sclerotomy approach for intraocular foreign body removal in phakic eyes using endoilluminator: A novel technique

Science.gov (United States)

Ravani, Raghav; Chawla, Rohan; Azad, Shorya Vardhan; Gupta, Yogita; Kumar, Vinod; Kumar, Atul

2018-01-01

Purpose: The objective of this study is to describe the removal of retained intraocular foreign body (RIOFB) by bimanual pars plana vitrectomy through midline sclerotomy in phakic patients. Technique: Four eyes with RIOFB and clear lens underwent microincision vitrectomy surgery. A chandelier illumination was placed through one of the existing ports. The foreign body (FB) was localized by direct visualization (intravitreal) or indentation (pars plana), stabilized using an intraocular magnet/FB forceps introduced through a midline sclerotomy and freed of vitreous from all sides using a vitrectomy cutter through the other port bimanually, reoriented along their long axis and extracted through the midline sclerotomy. Results: All four FBs were removed successfully without slippage or damage to the clear lens. Conclusion: Chandelier illumination-assisted removal of FB through midline sclerotomy helps in easier localization, stabilization and removal, avoiding lens touch even in anteriorly located FBs such as at pars plana. PMID:29676316

Solid intraocular xanthogranuloma in three Miniature Schnauzer dogs.

Science.gov (United States)

Zarfoss, Mitzi K; Dubielzig, Richard R

2007-01-01

Macrophages that contain abundant intracytoplasmic lipid are called 'foam cells'. In four canine globes submitted to the Comparative Ocular Pathology Laboratory of Wisconsin (COPLOW), foam cells formed a solid intraocular mass. The purpose of this study was to describe the histopathologic findings in these cases. The electronic COPLOW database (1993-2006) was searched for the diagnosis of 'foam cell tumor'. Clinical history, gross pathology and histopathology (5-micron sections, hematoxylin and eosin and Alcian blue periodic acid Schiff) were reviewed in all cases. Cases were included if the globe was grossly filled by a solid mass and if all intraocular structures were effaced by lipid-laden foam cell macrophages admixed with birefringent, Alcian blue-positive crystals oriented in stellate patterns. All three patients (four globes) satisfying the selection criteria were Miniature Schnauzers. In all cases the clinical history included diabetes mellitus, hyperlipidemia and chronic bilateral uveitis that was interpreted to be lens-induced. All globes were enucleated because of glaucoma. The term solid intraocular xanthogranuloma was used to describe these cases because the intraocular contents were effaced by a solid mass of foam cells and birefringent crystals. The cases in this report suggest that diabetic Miniature Schnauzers with hyperlipidemia are at risk for lipid and macrophage-rich uveitis, which may in some cases form a solid inflammatory intraocular mass, precipitate glaucoma, and lead to enucleation.

Simulation of airbag impact on eyes with different axial lengths after transsclerally fixated posterior chamber intraocular lens by using finite element analysis

Directory of Open Access Journals (Sweden)

Huang J

2015-02-01

Full Text Available Jane Huang,1 Eiichi Uchio,1 Satoru Goto2 1Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, 2Nihon ESI KK Technical Division, Tokyo, Japan Purpose: To determine the biomechanical response of an impacting airbag on eyes with different axial lengths with transsclerally fixated posterior chamber intraocular lens (PC IOL.Materials and methods: Simulations in a model human eye were performed with a computer using a finite element analysis program created by Nihon, ESI Group. The airbag was set to be deployed at five different velocities and to impact on eyes with three different axial lengths. These eyes were set to have transsclerally fixated PC IOL by a 10-0 polypropylene possessing a tensile force limit of 0.16 N according to the United States Pharmacopeia XXII.Results: The corneoscleral opening was observed at a speed of 40 m/second or more in all model eyes. Eyes with the longest axial length of 25.85 mm had the greatest extent of deformity at any given impact velocity. The impact force exceeded the tensile force of 10-0 polypropylene at an impact velocity of 60 m/second in all eyes, causing breakage of the suture. Conclusion: Eyes with transsclerally fixated PC IOL could rupture from airbag impact at high velocities. Eyes with long axial lengths experienced a greater deformity upon airbag impact due to a thinner eye wall. Further basic research on the biomechanical response for assessing eye injuries could help in developing a better airbag and in the further understanding of ocular traumas. Keywords: airbag, ocular trauma, computer simulation, transsclerally fixated posterior chamber intraocular lens, finite element analysis

Cionni ring and in-the-bag intraocular lens implantation for subluxated lenses: a prospective case series.

Science.gov (United States)

Vasavada, Abhay R; Praveen, Mamidipudi R; Vasavada, Viraj A; Yeh, Ru-Yin; Srivastava, Samaresh; Koul, Archana; Trivedi, Rupal H

2012-06-01

To report the intraoperative performance and postoperative outcomes of the Cionni-modified capsule tension ring (CTR) implantation in eyes with subluxated lenses. Prospective, observational case series. This study was carried out at Iladevi Cataract & IOL Research Centre, Ahmedabad, India. The study population comprised 41 eyes with subluxated lenses that underwent lens extraction, capsular bag fixation with modified CTR, and in-the-bag single-piece AcrySof intraocular lens (IOL) implantation. Main outcome measures were intraoperative performance and postoperative best-corrected visual acuity (BCVA), IOL centration, and complications. The mean age was 29.46 ± 16.16 years (3-68 years). Mean extent of subluxation was 6.1 ± 1.0 clock hours. Preoperatively, vitreous was detected in the anterior chambers of 5 eyes (12.2%). Two-port anterior chamber vitrectomy was performed in 2 eyes. Mean follow-up was 45.8 ± 2.9 months. Mean preoperative BCVA was 0.66 ± 0.22 logMAR (35 eyes). Mean postoperative BCVA at final follow-up was 0.33 ± 0.21 logMAR (41 eyes) (P IOL decentration was noted and repositioning was required in 2 eyes. Posterior capsule opacification developed in 14 eyes (34.2%); 12 eyes (29.3%) required Nd:YAG capsulotomy. Other complications included cystoid macular edema in 1 eye (2.4%), posterior synechiae in 1 eye (2.4%), and retinal detachment in 1 eye (2.4%). In-the-bag implantation of a Cionni-modified CTR with IOL appears to be a safe option in eyes with subluxated cataract, ensuring a stable IOL with few complications. Copyright © 2012 Elsevier Inc. All rights reserved.

Results of intraocular lens implantation with capsular tension ring in subluxated crystalline or cataractous lenses in children

Directory of Open Access Journals (Sweden)

Das Pranab

2009-01-01

Full Text Available Purpose : To evaluate the outcome of intraocular lens (IOL implantation using capsular tension ring (CTR in subluxated crystalline or cataractous lenses in children. Setting : Tertiary care setting Materials and Methods : We prospectively studied 18 eyes of 15 children with subluxation of crystalline or cataractous lenses between 90° up to 210° after phacoemulsification, CTR and IOL implantation. Each child was examined for IOL centration, zonular dehiscence and posterior capsular opacification (PCO. Results : Age of the patient ranged between five to 15 years. Out of 18 eyes, seven had traumatic and 11 had spontaneous subluxation of crystalline or cataractous lens. Phacoemulsification was successfully performed with CTR implantation in the capsular bag. Intraoperative zonular dialysis occurred in two eyes. Anterior vitrectomy was performed in six eyes to manage vitreous prolapse. IOL implanted was polymethyl methacrylate (PMMA in eight eyes, hydrophobic acrylic in seven and hydrophilic acrylic in three. Follow-up ranged from 24 months to 72 months. Sixteen eyes had a best corrected visual acuity of 20/40 or better. Nine eyes developed significant PCO and were managed with Neodymium Yttrium Aluminum Garnet (Nd:YAG laser posterior capsulotomy. One eye with acrylic IOL in the capsular bag had IOL dislocation after two years which was managed with vitrectomy and secondary trans-scleral fixation of IOL. Conclusions : Phacoaspiration with CTR implantation makes capsular bag IOL fixation possible in most of the eyes with subluxated crystalline or cataractous lenses. PCO still remains a challenge in children with successful phacoaspiration with CTR implantation

Comparação entre os resultados pós-operatórios de pacientes submetidos ao procedimento tríplice e transplante de córnea combinado a fixação secundária de lente intra-ocular Comparison between the postoperative results of triple procedure and combined penetrating keratoplasty/ transsclerally sutured posterior chamber lens implantation

Directory of Open Access Journals (Sweden)

Daniela Maggioni Pereira Leão

2006-08-01

Full Text Available OBJETIVO: Comparar os resultados pós-operatórios de 2 grupos de pacientes submetidos a transplante de córnea com técnicas e tempo cirúrgico diferentes, em relação à abordagem do cristalino e/ou lente intra-ocular. MÉTODOS: Neste estudo retrospectivo foram analisados 37 olhos de pacientes divididos em 2 grupos: extração de catarata, implante de lentes intra-oculares (LIO e transplante de córnea no mesmo tempo cirúrgico - grupo 1 (G1 e extração de catarata sem implante de lentes intra-oculares no primeiro tempo cirúrgico e fixação secundária de lentes intra-oculares associada a transplante de córnea no segundo tempo cirúrgico - grupo 2 (G2. As variáveis estudadas foram: acuidade visual, pressão intra-ocular (PIO, astigmatismo refracional, astigmatismo ceratométrico e complicações pós-operatórias. RESULTADOS: Foi observado melhora da acuidade visual nos 2 grupos (G1 pPURPOSE: To compare the outcomes of two surgical techniques of penetrating keratoplasty with different surgical time, regarding the crystalline and the intraocular lens. METHODS: This retrospective study included 37 patients' eyes divided into 2 groups: extracapsular cataract extraction, posterior chamber intraocular lens implantation and penetrating keratoplasty (Group 1, G1 and transscleral fixation of posterior chamber lens and penetrating keratoplasty (Group 2, G2. The following parameters were recorded: visual acuity, intraocular pressure, refractive astigmatism, complication and keratometric astigmatism. RESULTS: Visual acuity improved in the two groups (G1 p<0.001 and G2 p=0.008. In G2 a significant change for the worse of intraocular pressure outcome was observed when compared with the other group (p=0.014. Regarding refractive and keratometric astigmatism no significant differences between the groups were found. The follow-up was 11 months. CONCLUSION: The most important negative prognostic factor affecting visual acuity was the postkeratoplasty

[Multifocal phakic intraocular lens implant to correct presbyopia].

Science.gov (United States)

Baikoff, G; Matach, G; Fontaine, A; Ferraz, C; Spera, C

2005-03-01

Presbyopic surgery is considered as the new frontier in refractive surgery. Different solutions are proposed: myopization of one eye, insertion of an accommodative crystalline lens, scleral surgery, the effects of which are still unknown, and finally multifocal phakic implants. We therefore decided to undertake a prospective study under the Huriet law to determine its efficacy and specify the conditions required for an anterior chamber multifocal phakic implant. Fifty-five eyes of 33 patients received an anterior chamber foldable multifocal phakic implant. Twenty-one females and 12 males underwent surgery. Initial refraction was between -5D and +5D. The implant's single addition was +2.50. Recuperating a distant uncorrected visual acuity of 0.6 or better and near uncorrected vision of Parinaud 3 or better can be considered a very good postoperative result. Average follow-up was 42.6+/-18 weeks. Mean postoperative refraction was -0.12+/-0.51 D. Mean postoperative uncorrected visual acuity was 0.78+/-0.20. Postoperative uncorrected visual acuity was Parinaud 2.3+/-0.6. Eighty-four percent of eyes operated on recuperated 0.6 or better without correction and Parinaud 3 or better without correction. Lenses in four eyes were explanted for different reasons, essentially optical, and no severe anatomical complications were observed. Placing an anterior chamber multifocal phakic implant to correct presbyopia is an effective technique with good predictability and has the advantage of being reversible in case of intolerance, optical parasite effects or undesired complications. Considering the particularity of this surgery, it is imperative to respect very strict inclusion criteria: anterior chamber depth equal to or above 3.1 mm, open angle, endothelial cell count equal to or above 2000 cells/mm2, absence of an incipient cataract or the slightest evidence of macular alteration.

Corneal Collagen Cross-Linking Combined with an Artiflex Iris-Fixated Anterior Chamber Phakic Intraocular Lens Implantation in a Patient with Progressive Keratoconus

Directory of Open Access Journals (Sweden)

Sharif Hashmani

2017-10-01

Full Text Available We present here the case of a 24-year-old male who experienced progressive keratoconus and vision loss which adversely affected his ability to carry out everyday tasks. This landed him in the Hashmanis Hospital for consultation. He had a preoperative best corrected visual acuity of 6/12. He underwent multiple Oculus Pentacam examinations, which showed progressive keratoconus. Corneal collagen cross-linking (CXL was performed to stabilize his cornea and, subsequently, an Artiflex anterior chamber iris-fixated phakic intraocular lens (ACIF-PIOL was implanted to alleviate his refractive errors. The patient achieved a postoperative uncorrected visual acuity of 6/12. This report shows that CXL combined with ACIF-PIOL can be safe and effective in those with progressive keratoconus.

Autorefraction versus subjective refraction in a radially asymmetric multifocal intraocular lens.

Science.gov (United States)

van der Linden, Jan Willem; Vrijman, Violette; Al-Saady, Rana; El-Saady, Rana; van der Meulen, Ivanka J; Mourits, Maarten P; Lapid-Gortzak, Ruth

2014-12-01

To evaluate whether the automated refraction (AR) correlates with subjective manifest (MR) refraction in eyes implanted with radially asymmetric multifocal intraocular lens (IOLs). This retrospective study evaluated 52 eyes (52 patients) implanted with a radially asymmetric multifocal IOL (LS-312 MF30, Oculentis, Germany). At 3 months postoperatively, the AR and MR values were compared to determine the correlation between the sphere (S), the spherical equivalent (SE) and the astigmatic components J0 and J45. The difference of mean spherical measurement was +0.98D ± 0.62, with the AR measuring more myopic. The difference of the mean spherical equivalent was +1.11D ± 0.57, again with AR being more myopic. Both these differences were statistically significant (p < 0.001). The astigmatic components showed less differences, with the mean difference of the J0 being -0.09D ± 0.43, and the J45 of +0.04D ± 0.47, which were both not statistically significant (p = 0.123 and p = 0.531, respectively). Correlation analysis of the refractive parameters showed r(2) = 0.067, r(2) = 0.078, r(2) = 0.018 and r(2) = 0.015, respectively, all of which point to a low correlation between the AR and the MR. Autorefraction shows poor correlation to manifest subjective refraction with these radially asymmetric multifocal IOLs. The autorefraction systematically underestimates the spherical and spherical equivalent power, while the correlation between the astigmatic components was also low. Autorefraction seems not a valid starting point for manifest subjective refraction with these types of lenses, unless a corrective factor of about +1 dioptre is used. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Intraocular lens calculation adjustment after laser refractive surgery using Scheimpflug imaging.

Science.gov (United States)

Schuster, Alexander K; Schanzlin, David J; Thomas, Karin E; Heichel, Christopher W; Purcell, Tracy L; Barker, Patrick D

2016-02-01

To test a new method of intraocular lens (IOL) calculation after corneal refractive surgery using Scheimpflug imaging (Pentacam HR) and partial coherence interferometry (PCI) (IOLMaster) that does not require historical data; that is, the Schuster/Schanzlin-Thomas-Purcell (SToP) IOL calculator. Shiley Eye Center, San Diego, California, and Walter Reed National Military Medical Center, Bethesda, Maryland, USA. Retrospective data analysis and validation study. Data were retrospectively collected from patient charts including data from Scheimpflug imaging and refractive history. Target refraction was calculated using PCI and the Holladay 1 and SRK/T formulas. Regression analysis was performed to explain the deviation of the target refraction, taking into account the following influencing factors: ratio of posterior-to-anterior corneal radius, axial length (AL), and anterior corneal radius. The regression analysis study included 61 eyes (39 patients) that had laser in situ keratomileusis (57 eyes) or photorefractive keratectomy (4 eyes) and subsequent cataract. Two factors were found that explained the deviation of the target refraction using the Holladay 1 formula; that is, the ratio of the corneal radii and the AL and the ratio of corneal radii for the SRK/T formula. A new IOL adjustment calculator was derived and validated at a second center using 14 eyes (10 patients). The error in IOL calculation for normal eyes after laser refractive treatment was related to the ratio of posterior-to-anterior corneal radius. A formula requiring Scheimpflug data and suggested IOL power only yielded an improved postoperative result for patients with previous corneal laser refractive surgery having cataract surgery. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. All rights reserved.

Late in-the-bag intraocular lens dislocation in patients with uveitis.

Science.gov (United States)

Steeples, Laura R; Jones, Nicholas P

2015-09-01

Late in-the-bag intraocular lens (IOL) dislocation is an unusual complication of cataract surgery, being strongly associated with pseudoexfoliation, less so with previous vitreoretinal surgery, myopia and uveitis. We present the clinical features, management and outcomes of late spontaneous IOL dislocation in a series of patients with uveitis. A retrospective case series of IOL dislocation affecting patients in the Manchester Uveitis Clinic, UK. The uveitis diagnosis, IOL type, presentation and management are discussed. Six patients from out of 1056 undergoing cataract surgery (0.57%) were affected. Uveitis was the only identified risk factor for IOL dislocation, which occurred a mean 10.3 years following uncomplicated cataract surgery by phakoemulsification with endocapsular IOL implantation. The dislocation was in-the-bag in all six cases. Two patients presented with the IOL in the anterior chamber, and required removal of the IOL-bag complex, and are using aphakic refractive correction. Two patients with inferior IOL subluxation have been managed conservatively. Two patients underwent pars plana vitrectomy with sutureless scleral fixation of the existing IOL in one case, and IOL exchange with a scleral sutured IOL in the other. IOL dislocation is an uncommon late complication in patients with uveitis. Conservative management is appropriate in patients with tolerable symptoms, or in those with difficult uveitis. Otherwise, fixation of the existing IOL, or removal and implantation of a secondary IOL, may be necessary. Angle-supported, or iris-enclaved IOLs, are not of proven safety in this patient group; scleral-fixated posterior chamber IOLs are the favoured approach in our service. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A randomised comparative study of the effect of Airtraq optical laryngoscope vs. Macintosh laryngoscope on intraocular pressure in non-ophthalmic surgery

Directory of Open Access Journals (Sweden)

Bikramjit Das

2016-02-01

Full Text Available BACKGROUND: We compared intraocular pressure changes following laryngoscopy and intubation with conventional Macintosh blade and Airtraq optical laryngoscope. METHODS: Ninety adult patients were randomly assigned to study group or control group. Study group (n = 45 - Airtraq laryngoscope was used for laryngoscopy. Control group (n = 45 - conventional Macintosh laryngoscope was used for laryngoscopy. Preoperative baseline intraocular pressure was measured with Schiotz tonometer. Laryngoscopy was done as per group protocol. Intraocular pressure and haemodynamic parameters were recorded just before insertion of the device and subsequently three times at an interval of one minute after insertion of the device. RESULTS: Patient characteristics, baseline haemodynamic parameters and baseline intraocular pressure were comparable in the two groups. Following insertion of the endotracheal tube with Macintosh laryngoscope, there was statistically significant rise in heart rate and intraocular pressure compared to Airtraq group. There was no significant change in MAP. Eight patients in Macintosh group had tongue-lip-dental trauma during intubation, while only 2 patients received upper airway trauma in Airtraq group. CONCLUSION: We conclude that Airtraq laryngoscope in comparison to Macintosh laryngoscope results in significantly fewer rises in intraocular pressure and clinically less marked increase in haemodynamic response to laryngoscopy and intubation.

Comparison of two optical biometers in intraocular lens power calculation

Directory of Open Access Journals (Sweden)

Sheng Hui

2014-01-01

Full Text Available Aims: To compare the consistency and accuracy in ocular biometric measurements and intraocular lens (IOL power calculations using the new optical low-coherence reflectometry and partial coherence interferometry. Subjects and Methods: The clinical data of 122 eyes of 72 cataract patients were analyzed retrospectively. All patients were measured with a new optical low-coherence reflectometry system, using the LENSTAR LS 900 (Haag Streit AG/ALLEGRO BioGraph biometer (Wavelight., AG, and partial coherence interferometry (IOLMaster V.5.4 [Carl Zeiss., Meditec, AG] before phacoemulsification and IOL implantation. Repeated measurements, as recommended by the manufacturers, were performed by the same examiner with both devices. Using the parameters of axial length (AL, corneal refractive power (K1 and K2, and anterior chamber depth (ACD, power calculations for AcrySof SA60AT IOL were compared between the two devices using five formulas. The target was emmetropia. Statistical analysis was performed using Statistical Package for the Social Sciences software (SPSS 13.0 with t-test as well as linear regression. A P value < 0.05 was considered to be statistically significant. Results: The mean age of 72 cataract patients was 64.6 years ± 13.4 [standard deviation]. Of the biometry parameters, K1, K2 and [K1 + K2]/2 values were significantly different between the two devices (mean difference, K1: −0.05 ± 0.21 D; K2: −0.12 ± 0.20 D; [K1 + K2]/2: −0.08 ± 0.14 D. P <0.05. There was no statistically significant difference in AL and ACD between the two devices. The correlations of AL, K1, K2, and ACD between the two devices were high. The mean differences in IOL power calculations using the five formulas were not statistically significant between the two devices. Conclusions: New optical low-coherence reflectometry provides measurements that correlate well to those of partial coherence interferometry, thus it is a precise device that can be used for the

Changes in the accommodation-convergence relationship after the Artisan phakic intraocular lens implantation for myopic patients.

Science.gov (United States)

Ryu, Ik Hee; Han, Jinu; Lee, Hyung Keun; Kim, Jin Kook; Han, Sueng-Han

2014-04-01

To evaluate the change of accommodation-convergence parameters after implantation of Artisan phakic intraocular lens (PIOL). Prospective study for the patients with the Artisan PIOL implantation was performed. A total of 37 patients (3 males and 34 females) enrolled the study. Preoperatively, convergence amplitude, the stimulus accommodative convergence per unit of accommodation (AC/A) ratio and the near point of convergence (NPC) were evaluated. After the Artisan PIOL implantation, the identical evaluations were repeated at 1 week, 1, 3, and 6 months after the surgery. Mean age was 24.3 ± 4.8 years old, and preoperative refractive error was -8.92 ± 4.13 diopters (D). After the implantation, mean refractive errors significantly decreased to within ±1.00 D, and noticeable complications were not found. The convergence amplitude and the stimulus AC/A ratio increased 1 month after the surgery, but progressively stabilized afterward to near preoperative values. NPC didn't show any significant change over follow-up period up to 6 months. These results regarding implantation of the Artisan PIOL revealed the increase of accommodation-convergence relationship within first 1 month after the surgery, but progressive stabilization was noted during follow-up periods.

Clinical and patient-reported outcomes of bilateral implantation of a +2.5 diopter multifocal intraocular lens.

Science.gov (United States)

Maxwell, Andrew; Holland, Edward; Cibik, Lisa; Fakadej, Anna; Foster, Gary; Grosinger, Les; Moyes, Andrew; Nielsen, Stephen; Silverstein, Steven; Toyos, Melissa; Weinstein, Arthur; Hartzell, Scott

2017-01-01

To assess the effectiveness and safety of a multifocal intraocular lens (IOL) with +2.5 diopter (D) additional power compared with a monofocal IOL. Fifteen sites in the United States. Prospective randomized patient- and observer-masked clinical trial. Randomized patients received multifocal or monofocal IOLs bilaterally. Visual acuity (33 cm, 40 cm, 53 cm, 60 cm, 4 m) was measured; safety was assessed through adverse event rates. Patient-reported visual outcomes were evaluated using the Visual Tasks questionnaire. The frequency and severity of visual disturbances were evaluated using the Assessment of Photic Phenomena and Lens EffectS questionnaire. The multifocal IOL (n = 155) provided better corrected distance visual acuity at 53 cm than the monofocal IOL (n = 165) (0.322 versus 0.512 logMAR; between-group difference, -0.190 logMAR; P < .0001) and 40 cm but not at 4 m. Ocular adverse event rates were less than 3.84% in both groups. Serious adverse event rates were comparable between the 2 IOL types. Patients with multifocal IOLs reported less difficulty with near tasks (with and without correction) and intermediate tasks (without correction). Difficulty with extended-intermediate and distance tasks was similar between groups. The most frequently reported self-rated severe phenomena were halos, starbursts, and glare. Most patients (monofocal ≥72%; multifocal ≥73%) reported never experiencing blurred, distorted, or double vision. The +2.5 D multifocal IOL provided better vision at 40 cm and 53 cm and similar vision at 4 m compared with the monofocal IOL. Safety profiles and visual phenomena were comparable between groups. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Toric intraocular lens implantation versus astigmatic keratotomy to correct astigmatism during phacoemulsification.

Science.gov (United States)

Titiyal, Jeewan S; Khatik, Mukesh; Sharma, Namrata; Sehra, Sri Vatsa; Maharana, Parfulla K; Ghatak, Urmimala; Agarwal, Tushar; Khokhar, Sudarshan; Chawla, Bhavana

2014-05-01

To compare toric intraocular lens (IOL) implantation and astigmatic keratotomy (AK) in correction of astigmatism during phacoemulsification. Tertiary care hospital. Prospective randomized trial. Consecutive patients with visually significant cataract and moderate astigmatism (1.25 to 3.00 diopters [D]) were randomized into 2 groups. Temporal clear corneal 2.75 mm phacoemulsification with toric IOL implantation was performed in the toric IOL group and with 30-degree coupled AK at the 7.0 mm optic zone in the keratotomy group. The uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, keratometry, topography, central corneal thickness, and endothelial cell density were evaluated preoperatively and 1 day, 1 week, and 1 and 3 months postoperatively. The study enrolled 34 eyes (34 patients), 17 in each group. There was no difference in UDVA or CDVA between the 2 groups at any follow-up visit. The mean preoperative and postoperative refractive cylinder was 2.00 D ± 0.49 (SD) and 0.33 ± 0.17 D, respectively, in the toric IOL group and 1.95 ± 0.47 D and 0.57 ± 0.41 D, respectively, in the keratotomy group (P=.10). The mean residual astigmatism at 3 months was 0.44 ± 1.89 @ 160 in the toric IOL group and 0.77 ± 1.92 @ 174 in the keratotomy group (P=.61). All eyes in the toric IOL group and 14 eyes (84%) in the keratotomy group achieved a residual refractive cylinder of 1.00 D or less (P=.17). Toric IOL implantation was comparable to AK in eyes with moderate astigmatism having phacoemulsification. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Effectiveness of early lens extraction for the treatment of primary angle-closure glaucoma (EAGLE): a randomised controlled trial.

Science.gov (United States)

Azuara-Blanco, Augusto; Burr, Jennifer; Ramsay, Craig; Cooper, David; Foster, Paul J; Friedman, David S; Scotland, Graham; Javanbakht, Mehdi; Cochrane, Claire; Norrie, John

2016-10-01

Primary angle-closure glaucoma is a leading cause of irreversible blindness worldwide. In early-stage disease, intraocular pressure is raised without visual loss. Because the crystalline lens has a major mechanistic role, lens extraction might be a useful initial treatment. From Jan 8, 2009, to Dec 28, 2011, we enrolled patients from 30 hospital eye services in five countries. Randomisation was done by a web-based application. Patients were assigned to undergo clear-lens extraction or receive standard care with laser peripheral iridotomy and topical medical treatment. Eligible patients were aged 50 years or older, did not have cataracts, and had newly diagnosed primary angle closure with intraocular pressure 30 mm Hg or greater or primary angle-closure glaucoma. The co-primary endpoints were patient-reported health status, intraocular pressure, and incremental cost-effectiveness ratio per quality-adjusted life-year gained 36 months after treatment. Analysis was by intention to treat. This study is registered, number ISRCTN44464607. Of 419 participants enrolled, 155 had primary angle closure and 263 primary angle-closure glaucoma. 208 were assigned to clear-lens extraction and 211 to standard care, of whom 351 (84%) had complete data on health status and 366 (87%) on intraocular pressure. The mean health status score (0·87 [SD 0·12]), assessed with the European Quality of Life-5 Dimensions questionnaire, was 0·052 higher (95% CI 0·015-0·088, p=0·005) and mean intraocular pressure (16·6 [SD 3·5] mm Hg) 1·18 mm Hg lower (95% CI -1·99 to -0·38, p=0·004) after clear-lens extraction than after standard care. The incremental cost-effectiveness ratio was £14 284 for initial lens extraction versus standard care. Irreversible loss of vision occurred in one participant who underwent clear-lens extraction and three who received standard care. No patients had serious adverse events. Clear-lens extraction showed greater efficacy and was more cost-effective than

Efficacy and safety of multifocal intraocular lenses following cataract and refractive lens exchange: Metaanalysis of peer-reviewed publications.

Science.gov (United States)

Rosen, Emanuel; Alió, Jorge L; Dick, H Burkhard; Dell, Steven; Slade, Stephen

2016-02-01

We performed a metaanaysis of peer-reviewed studies involving implantation of a multifocal intraocular lens (IOL) in presbyopic patients with cataract or having refractive lens exchange (RLE). Previous reviews have considered the use of multifocal IOLs after cataract surgery but not after RLE, whereas greater insight might be gained from examining the full range of studies. Selected studies were examined to collate outcomes with monocular and binocular uncorrected distance, intermediate, and near visual acuity; spectacle independence; contrast sensitivity; visual symptoms; adverse events; and patient satisfaction. In 8797 eyes, the mean postoperative monocular uncorrected distance visual acuity (UDVA) was 0.05 logMAR ± 0.006 (SD) (Snellen equivalent 20/20(-3)). In 6334 patients, the mean binocular UDVA was 0.04 ± 0.00 logMAR (Snellen equivalent 20/20(-2)), with a mean spectacle independence of 80.1%. Monocular mean UDVA did not differ significantly between those who had a cataract procedure and those who had an RLE procedure. Neural adaptation to multifocality may vary among patients. Dr. Alió is a clinical research investigator for Hanita Lenses, Carl Zeiss Meditec AG, Topcon Medical Systems, Inc., Oculentis GmbH, and Akkolens International BV. Dr. Dell is a consultant to Bausch & Lomb and Abbott Medical Optics, Inc. Dr. Slade is a consultant to Alcon Surgical, Inc., Carl Zeiss Meditec AG, and Bausch & Lomb. None of the authors has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Mesopic visual quality after three kinds of aspheric acrylic monofocal intraocular lenses

Directory of Open Access Journals (Sweden)

Hai-Lun Ji

2013-08-01

Full Text Available AIM:To evaluate best corrected visual acuity(BCVAand contrast sensitivity(CSunder mesopic condition with no glare in patients following implantation of three different kinds of aspheric acrylic monofocal intraocular lens(IOLs.METHODS: Seventy-seven cases(90 eyesof age-related cataract patients were selected, who were undergone phacoemulsification and intraocular lens(IOLimplantation in our hospital during December 2011 to November 2012. Preoperatively, the patients were randomly divided into three groups: 30 eyes(25 caseswere implanted with hydrophobic yellow-tinted acrylic(HOYAIOLs in group 1; 30 eyes(28 caseswith hydrophilic acrylic IOLs(Raynerin group 2; 30 eyes(24 caseswith hydrophilic acrylic surface heparin processing IOLs(XOin group 3. All eyes were evaluated at 1 month and 3 months postoperatively. The BCVA and CS under mesopic condition without glare were measured and underwent statistical analysis.RESULTS: There was neither statistically significant difference in the BCVA(P>0.05, nor statistically significant difference in CS results(after standardization of contrast sensitivity value: lgCS(P>0.05between groups under mesopic condition, but the lgCS of the HOYA group decreased slightly. CONCLUSION: There were not marked differences of BCVA and CS between groups of patients at the follow-up intervals of 1 month and 3 months under mesopic condition. The blue-filter type artificial lens may protect the retina, thus, it is advisable to implant yellow-tinted filter blue artificial lens, especially for patients who are children or young persons.

Comparison of clear lens extraction and collamer lens implantation in high myopia

Directory of Open Access Journals (Sweden)

Ahmed M Emarah

2010-05-01

Full Text Available Ahmed M Emarah, Mostafa A El-Helw, Hazem M YassinCairo University, Cairo, EgyptAim: To compare the outcomes of clear lens extraction and collamer lens implantation in high myopia.Patients and methods: Myopic patients younger than 40 years old with more than 12 diopters of myopia or who were not fit for laser-assisted in situ keratomileusis were included. Group 1 comprised patients undergoing clear lens extraction and Group 2 patients received the Visian implantable collamer lens. Outcome and complications were evaluated.Results: Postoperative best corrected visual acuity was -0.61 ± 0.18 in Group 1 and 0.79 ± 0.16 in Group 2. In Group 1, 71.4% achieved a postoperative uncorrected visual acuity better than the preoperative best corrected visual acuity, while only 51.8% patients achieved this in Group 2. Intraocular pressure decreased by 12.55% in Group 1, and increased by 15.11% in Group 2. Corneal endothelial cell density decreased by 4.47% in Group 1 and decreased by 5.67% in Group 2. Posterior capsule opacification occurred in Group 1. In Group 2, lens opacification occurred in 11.11%, significant pigment dispersion in 3.7%, and pupillary block glaucoma in 3.7%.Conclusion: Clear lens extraction presents less of a financial load up front, and less likelihood of the need for a secondary intervention in the future. Clear lens extraction is a more viable solution in developing countries with limited financial resources.Keywords: clear lens extraction, implantable collamer lens, myopia

An angle-supported foldable phakic intraocular lens for correction of myopia: A five-year follow-up.

Science.gov (United States)

Alió, J L; Plaza-Puche, A B; Cavas, F; Yébana Rubio, P; Sala, E

2017-01-01

To evaluate the efficacy and safety of an angle-supported foldable phakic intraocular lens (pIOL) for the correction of moderate to high myopia after 5 years follow-up. Prospective and retrospective, observational, longitudinal, non-randomised consecutive series of cases conducted on a total of 100 eyes of 67 patients with moderate to high myopia implanted with an Acrysof Cachet pIOL (Alcon Laboratories Inc.) with the aim of minimising the refractive error. The ages ranged between 18 to 60years. Uncorrected distance visual acuity (UDVA), manifest refraction, corrected distance visual acuity (CDVA), endothelial cells density, pIOL position, intraocular pressure, and complications were recorded preoperatively and during the 5 year follow-up. Five years after implantation, the mean manifest spherical equivalent refraction reduced significantly from -11.62±3.35 dioptres (D) to -0.33±0.85D. UDVA was 20/20 or better in 5 of 25 cases (20%), and 20/40 or better in 22 cases (88%). CDVA was 20/20 or better in 17 cases (68%), and 20/32 or better in 23 cases (92%) of eyes. The residual refractive error was within ±0.50D of emmetropia in 12 cases (48%), and within ±1.00D in 19 cases (76%). Mean endothelial cell loss at 5 years was 11.8% central, and 13.7% peripheral. Mean endothelium-pIOL distance was 2.11±0.18mm, and mean pIOL-crystalline distance was 0.88±0.20mm. This angle supported pIOL provided a favourable refractive correction and predictability, as well as acceptable safety in patients with moderate to high myopia. Although endothelial cell density decreased over 5years, the results are within the range reported in previous studies with other pIOLs. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

Preliminary evaluation of an algorithm to minimize the power error selection of an aspheric intraocular lens by optimizing the estimation of the corneal power and the effective lens position

Directory of Open Access Journals (Sweden)

David P. Piñero

2016-06-01

Full Text Available AIM: To evaluate the refractive predictability achieved with an aspheric intraocular lens(IOLand to develop a preliminary optimized algorithm for the calculation of its power(PIOL.METHODS: This study included 65 eyes implanted with the aspheric IOL LENTIS L-313(Oculentis GmbHthat were divided into 2 groups: 12 eyes(8 patientswith PIOL≥23.0 D(group A, and 53 eyes(35 patientswith PIOLIOLadjwas calculated considering a variable refractive index for corneal power estimation, the refractive outcome obtained, and an adjusted effective lens position(ELPadjaccording to age and anatomical factors. RESULTS: Postoperative spherical equivalent ranged from -0.75 to +0.75 D and from -1.38 to +0.75 D in groups A and B, respectively. No statistically significant differences were found in groups A(P=0.64and B(P=0.82between PIOLadj and the IOL power implanted(PIOLReal. The Bland and Altman analysis showed ranges of agreement between PIOLadj and PIOLReal of +1.11 to -0.96 D and +1.14 to -1.18 D in groups A and B, respectively. Clinically and statistically significant differences were found between PIOLadj and PIOL obtained with Hoffer Q and Holladay I formulas(PCONCLUSION: The refractive predictability of cataract surgery with implantation of an aspheric IOL can be optimized using paraxial optics combined with linear algorithms to minimize the error associated to the estimation of corneal power and ELP.

Positional accommodative intraocular lens power error induced by the estimation of the corneal power and the effective lens position

Directory of Open Access Journals (Sweden)

David P Piñero

2015-01-01

Full Text Available Purpose: To evaluate the predictability of the refractive correction achieved with a positional accommodating intraocular lenses (IOL and to develop a potential optimization of it by minimizing the error associated with the keratometric estimation of the corneal power and by developing a predictive formula for the effective lens position (ELP. Materials and Methods: Clinical data from 25 eyes of 14 patients (age range, 52-77 years and undergoing cataract surgery with implantation of the accommodating IOL Crystalens HD (Bausch and Lomb were retrospectively reviewed. In all cases, the calculation of an adjusted IOL power (P IOLadj based on Gaussian optics considering the residual refractive error was done using a variable keratometric index value (n kadj for corneal power estimation with and without using an estimation algorithm for ELP obtained by multiple regression analysis (ELP adj . P IOLadj was compared to the real IOL power implanted (P IOLReal , calculated with the SRK-T formula and also to the values estimated by the Haigis, HofferQ, and Holladay I formulas. Results: No statistically significant differences were found between P IOLReal and P IOLadj when ELP adj was used (P = 0.10, with a range of agreement between calculations of 1.23 D. In contrast, P IOLReal was significantly higher when compared to P IOLadj without using ELP adj and also compared to the values estimated by the other formulas. Conclusions: Predictable refractive outcomes can be obtained with the accommodating IOL Crystalens HD using a variable keratometric index for corneal power estimation and by estimating ELP with an algorithm dependent on anatomical factors and age.

Spectral properties of common intraocular lens (IOL) types

Science.gov (United States)

Milne, Peter J.; Chapon, Pascal F.; Hamaoui, Marie; Parel, Jean-Marie A.; Clayman, H.; Rol, Pascal O.

1999-06-01

Currently over 50 kinds of intraocular lenses (IOLs) are approved for patient use in the treatment of cataracts and ametropia. These lenses are manufactured from at least 2 kinds of silicones as well as several kinds of acrylic polymers including polyHEMA, Poly HOXEMA, a range of polymethacrylate and polyacrylate formulations. We sought to measure spectral transmission curves of a range of IOLS in the UV-visible and near IR spectral regions in order to better characterize their optical properties and to provide a baseline from which to assess their alteration following implantation over time. Consideration of how this may best be achieved are discussed. The variable ability of both explained IOLs and some samples from a range of manufacturers to block UV wavelengths is commented upon.

IOL Implants: Lens Replacement and Cataract Surgery (Intraocular Lenses)

Science.gov (United States)

... Oncology Oculoplastics/Orbit Refractive Management/Intervention Retina/Vitreous Uveitis Focus On Pediatric Ophthalmology ... Are Cataracts? Pediatric Cataracts Cataract Diagnosis and Treatment Cataract Surgery IOL Implants: Lens Replacement After Cataracts ...

Visual and Refractive Outcomes after Cataract Surgery with Implantation of a New Toric Intraocular Lens

Directory of Open Access Journals (Sweden)

Cinzia Mazzini

2013-06-01

Full Text Available Purpose: The aim of this study was to evaluate and report the visual, refractive and aberrometric outcomes of cataract surgery with implantation of the new aspheric Tecnis ZCT toric intraocular lens (IOL in eyes with low to moderate corneal astigmatism. Methods: We conducted a prospective study of 19 consecutive eyes of 17 patients (mean age: 78 years with a visually significant cataract and moderate corneal astigmatism [higher than 1 diopter (D] undergoing cataract surgery with implantation of the aspheric Tecnis ZCT toric IOL (Abbott Medical Optics. Visual, refractive and aberrometric changes were evaluated during a 6-month follow-up. Ocular aberrations as well as IOL rotation were evaluated by means of the OPD-Station II (Nidek. Results: The six-month postoperative spherical equivalent and power vector components of the refractive cylinder were within ±0.50 D in all eyes (100%. Postoperative logMAR uncorrected and corrected distance visual acuities (UDVA/CDVA were 0.1 (about 20/25 or better in almost all eyes (94.74%. The mean logMAR CDVA improved significantly from 0.41 ± 0.23 to 0.02 ± 0.05 (p Conclusion: Cataract surgery with implantation of the aspheric Tecnis ZCT IOL is a predictable and effective procedure for visual rehabilitation in eyes with cataract and low to moderate corneal astigmatism, providing an excellent postoperative ocular optical quality.

Small-incision 4-point scleral suture fixation of a foldable hydrophilic acrylic intraocular lens in the absence of capsule support.

Science.gov (United States)

Terveen, Daniel C; Fram, Nicole R; Ayres, Brandon; Berdahl, John P

2016-02-01

To determine the visual outcomes and complications of a new small-incision technique for 4-point fixation of a hydrophilic acrylic posterior chamber intraocular lens (IOL) in the absence of capsule support. Three North American tertiary referral centers and a private practice. Retrospective case series. Secondary IOL placement was performed from 2011 to 2014. Indications for surgery, clinical results, and complications were analyzed. Primary outcomes included postoperative corrected distance visual acuity (CDVA) and surgical complications. Charts of 35 patients (37 eyes) were reviewed. The mean age at surgery was 56 years, and the mean follow-up was 6 months (range 3 to 24 months). Clinical indications included a dislocated IOL (30%), ocular trauma (19%), crystalline lens subluxation (19%), uveitis-glaucoma-hyphema syndrome (5%), post-complicated cataract (8%), congenital cataract (8%), and decompensated cornea (3%). The mean CDVA improved from 20/80 preoperatively to 20/40 postoperatively (P IOL dislocation (3%). Small-incision 4-point scleral fixation of the Akreos AO60 hydrophilic acrylic IOL in the absence of capsule support appears to be a safe and effective technique for secondary IOL placement. Drs. Berdahl and Ayres are consultants to Bausch & Lomb, Inc. Drs. Ayres and Fram have received speaker fees from Bausch & Lomb. Dr. Terveen does not have a financial or proprietary interest in any material or methods mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Changes in blood pressure and sleep duration in patients with blue light-blocking/yellow-tinted intraocular lens (CHUKYO study).

Science.gov (United States)

Ichikawa, Kazuo

2014-07-01

Blood pressure and sleep duration may be influenced by retinal light exposure. Cataracts may exert such an influence by decreasing the transparency of the crystalline lens. A large-scale clinical study was conducted to examine changes in blood pressure and sleep duration after intraocular lens (IOL) implantation during cataract surgery and to investigate how different types of IOL influence the degree of these effects. Using a questionnaire, we collected information, including blood pressure measurement and sleep duration, from 1367 patients (1367 eyes) before IOL implantation, 1 week after IOL implantation and 1 month after IOL implantation. Systolic and diastolic blood pressures were significantly decreased in the total patient group after implantation. The decrease in systolic blood pressure 1 month after implantation was significantly more in patients who received a yellow-tinted IOL than it was in those who received an ultraviolet (UV) light-filtering IOL. The post-implantation sleep duration, including naps, became shorter in patients who had slept too much and became longer in those who had slept too little before IOL implantation. Our observations suggest that a yellow-tinted IOL is better for patients with high blood pressure than a UV light-filtering IOL. Furthermore, the yellow-tinted IOL is as good as the UV light-filtering IOL for improving sleep duration. A pale yellow-tinted IOL is likely to be superior to a moderate yellow-tinted IOL in terms of allowing patients to discriminate different colors. Thus, the pale yellow-tinted IOL appears to be better for patients than the UV light-filtering IOL and the moderate yellow-tinted IOL.

Light-distortion analysis as a possible indicator of visual quality after refractive lens exchange with diffractive multifocal intraocular lenses.

Science.gov (United States)

Brito, Pedro; Salgado-Borges, José; Neves, Helena; Gonzalez-Meijome, José; Monteiro, Manuel

2015-03-01

To study the perception of light distortion after refractive lens exchange (RLE) with diffractive multifocal intraocular lenses (IOLs). Clínica Oftalmológica das Antas, Porto, Portugal. Retrospective comparative study. Refractive lens exchange was performed with implantation of an AT Lisa 839M (trifocal) or 909MP (bifocal toric) IOL, the latter if corneal astigmatism was more than 0.75 diopter (D). The postoperative visual and refractive outcomes were evaluated. A prototype light-distortion analyzer was used to quantify the postoperative light-distortion indices. A control group of eyes in which a Tecnis ZCB00 1-piece monofocal IOL was implanted had the same examinations. A trifocal or bifocal toric IOL was implanted in 66 eyes. The control IOL was implanted in 18 eyes. All 3 groups obtained a significant improvement in uncorrected distance visual acuity (UDVA) (P refractive cylinder was less than 1.00 D in 86.7% of cases with the toric IOL. The mean light-distortion index was significantly higher in the multifocal IOL groups than in the monofocal group (P light-distortion index and CDVA. The multifocal IOLs provided excellent UDVA and functional UNVA despite increased light-distortion indices. The light-distortion analyzer reliably quantified a subjective component of vision distinct from visual acuity; it may become a useful adjunct in the evaluation of visual quality obtained with multifocal IOLs. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Influence on Visual Quality of Intraoperative Orientation of Asymmetric Intraocular Lenses.

Science.gov (United States)

Bonaque-González, Sergio; Ríos, Susana; Amigó, Alfredo; López-Gil, Norberto

2015-10-01

To evaluate visual quality when changing the intraocular orientation of the Lentis Mplus LS-312MF nonrotational symmetric +3.00 diopters aspheric multifocal intraocular lens ([IOL] Oculentis GmbH, Berlin, Germany) in normal eyes. An artificial eye was used to measure the in vitro wavefront of the IOL. The corneal topography of 20 healthy patients was obtained. For each eye, a computational analysis simulated the implantation of the IOL. The modulation transfer function (MTF) and an image quality parameter (visually modulated transfer function [VSMTF] metric) were calculated for a 5.0-mm pupil and for three conditions: distance, intermediate, and near vision. The procedure was repeated for each eye after a rotation of the IOL with respect to the cornea from 0° to 360° in 1° steps. Statistical analysis showed significant differences in mean VSMTF values between orientations for distance vision. Optimal orientation of the IOL (different for each eye) showed a mean improvement of 58% ± 19% (range: 20% to 121%) in VSMTF values with respect to the worst possible orientation. For these orientations, intermediate and near vision quality were statistically indistinguishable. The MTFs were different between orientations, showing a mean difference of approximately 5 cycles per degree in the maximum spatial frequencies that can be transferred between the best and the worst orientations for distance vision. The results suggest that implantation of this nonrotational symmetric IOL should improve visual outcomes if it is oriented to coincide with a customized meridian. A simple, practical method is proposed to find an approximation to the angle that an Mplus IOL should be inserted. Copyright 2015, SLACK Incorporated.

Chronic and Intermittent Angle Closure Caused by In-The-Bag Capsular Tension Ring and Intraocular Lens Dislocation in Patients With Pseudoexfoliation Syndrome.

Science.gov (United States)

Bochmann, Frank; Strümer, Jörg

2017-11-01

A subluxation or dislocation of the intraocular lens (IOL) is a well-known complication after cataract surgery in patients with pseudoexfoliation syndrome (PEX). Capsular tension rings (CTR) are frequently used to prevent postoperative complications caused by zonular weakness. Here we present a series of 7 cases, 2 with intermittent and 5 with acute angle closure caused by a combination of PEX-associated zonular weakness and a resulting unstable capsular bag-CTR-IOL complex. We describe the typical clinical course with elevated intraocular pressure, myopic shift, and shallowing of the anterior chamber in 7 patients with a new type of secondary angle closure. The diagnostic challenges and treatment options are discussed in detail. In all cases, the mechanism of angle closure identified by ultrasound biomicroscopy was an anterior dislocation of the peripheral iris by the capsular bag-CTR-IOL complex. The IOL was removed together with the capsular bag and the CTR and replaced by an iris-fixated IOL in all cases. We present a new type of secondary angle closure caused by an anterior dislocated capsular bag-CTR-IOL complex. The cause of both, this atypical presentation and the ineffectiveness of the laser peripheral iridotomy is the large diameter CTR. Therefore CTR implantation might also be the source of late postoperative complications. If a secondary angle closure associated with PEX and unstable capsular bag-CTR-IOL complex is encountered, IOL explantation and replacement by an iris-fixated IOL is a simple and effective treatment option.

WHAT HAPPENS TO INTRAOCULAR PRESSURE AFTER PERIBULBAR ANAESTHESIA?

Directory of Open Access Journals (Sweden)

Krishnamoorthy Segharipuram Ranganathan

2017-08-01

Full Text Available BACKGROUND Most of intraocular surgeries are done under local anaesthesia. The peribulbar anaesthesia provides adequate anaesthesia and akinesia. There is no reported intraoperative and/or postoperative amaurosis. The peribulbar anaesthesia provides adequate anaesthesia and akinesia. The disadvantages of it are the larger quantity of the aesthetic agent. Increasing the bulk load on the globe and a reported rise of intraocular pressure. MATERIALS AND METHODS A study of fifty cases was conducted in patients who received peribulbar anaesthesia undergoing cataract extraction with intraocular lens implantation and their intraocular pressures were noted and studied after giving the peribulbar anaesthesia all given by the same surgeon. RESULTS This study did show that the peribulbar anaesthesia increases the intraocular pressure in all the cases. The external ocular compression indeed helps to dissipate the anaesthetic load thereby reducing the enormous rise in IOP, which is only expected if you recollect the fact that the eyeball occupies one sixth of the total volume of the orbit that is 5 mL and 30 mL. The volume of peribulbar anaesthesia (6 mL does add its effects to increase the IOP. Hence, a properly planned post peribulbar compression helps to minimise the transient rise in IOP. CONCLUSION Summarising the study, it is better to give peribulbar injection initially followed by external ocular compression after a delay of at least 2 to 5 minutes. It is also advised that an initial compression maybe given in slightly risk cases, so that the peribulbarinduced rise may not be alarming. The anaesthetic solution maybe fragmented and the second injection maybe delayed by 5 minutes or omitted if good akinesia and anaesthesia are achieved already.

Outcomes of iris-claw anterior chamber versus iris-fixated foldable intraocular lens in subluxated lens secondary to Marfan syndrome.

Science.gov (United States)

Hirashima, Denise E; Soriano, Eduardo S; Meirelles, Rodrigo L; Alberti, Gustave N; Nosé, Walton

2010-08-01

To compare the outcome of phacoemulsification using 2 different iris-fixation techniques for intraocular lens (IOL) replacement, a foldable posterior chamber IOL (PCIOL; AcrySof MA60AC, Alcon Laboratories Inc, Fort Worth, TX) and an iris-claw anterior chamber IOL (ACIOL; Artisan, Ophtec BV), for treatment of subluxated lenses in patients with Marfan syndrome (MFS). Randomized, controlled trial. A total of 31 eyes of 16 patients with subluxated lenses associated with MFS and a preoperative corrected visual acuity (CVA) IOL type. Preoperative and postoperative ophthalmologic examination, optical coherence tomography, and endothelial cell counts were performed. We recorded CVA results at 3, 6, and 12 months, complications, endothelial cell loss, and central retinal thickness. In the iris-fixated PCIOL group, CVA was significantly improved at 3 (P = 0.011; n = 16), 6 (P = 0.006; n = 16), and 12 months (P = 0.002; n = 16). In the iris-claw ACIOL group, CVA was significantly improved at 3 (P = 0.001; n=15), 6 (P = 0.001; n = 15), and 12 months (P = 0.009; n = 12). The CVA results did not differ significantly between groups. Dislocation of the IOL occurred in 3 of 16 (18.75%) eyes in the PCIOL group. Retinal detachment occurred in 3 eyes (2 in the PCIOL group and 1 in the ACIOL group) and was successfully repaired. Postoperative foveal tomograms in both groups revealed a decrease in the mean foveal thickness (MFT; IOL dislocation tended to occur more frequently in the iris-fixated PCIOL group, the difference was not significant. At 6 months postoperatively, all study patients tended to have a thinner MFT. None of the patients in either group developed cystoid macular edema. Copyright 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Outcomes of scleral-sutured conventional and aniridia intraocular lens implantation performed in a university hospital setting.

Science.gov (United States)

Lockington, David; Ali, Noor Q; Al-Taie, Rasha; Patel, Dipika V; McGhee, Charles N J

2014-04-01

To evaluate the outcomes of transscleral sutured posterior chamber intraocular lens (PC IOL) implantation. Public university hospital, Auckland, New Zealand. Retrospective case series. A modified no-touch transscleral sutured PC IOL implantation technique with a 1-piece monofocal IOL (Alcon CZ70BD) or an aniridia IOL (type 67G, Morcher) was assessed. Seventy-eight cases (80.8% men; 53.9% aphakic) were identified. The mean follow-up was 35.5 months and the mean age at surgery, 41 years±21 (SD). The preoperative corrected distance visual acuity (CDVA) was worse than 6/30 in 66.7%. Indications included ocular trauma (46.2%), nontraumatic crystalline lens subluxation (16.7%), post-complicated cataract surgery (10.3%), idiopathic IOL dislocation (10.3%), and congenital cataract/aphakia (10.3%). An aniridia IOL was required in 39.7% of eyes. There were no significant intraoperative complications in 74.4% of eyes. Postoperative complications included transient corneal edema (15.4%), wound leak requiring resuturing (7.7%), retinal detachment (7.7%), and cystoid macular edema (6.4%). One eye (1.3%) developed suture breakage-related late IOL dislocation. Overall, 91.3% of eyes had improved visual acuity or were within 1 line of the presenting CDVA. In eyes with a guarded prognosis, 34.8% achieved a CDVA of 6/12 or better and 43.5% a CDVA of 6/15 to 6/48. In the better prognosis group, 73.9% achieved a CDVA of better than 6/12 and all achieved better than 6/30. Scleral-sutured IOLs achieved good visual outcomes in a public hospital setting. The rate of complications was moderate in this series with a high proportion of severe ocular trauma and a large percentage of aniridia IOLs. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Safety assessment of a new single-use small-incision injector for intraocular lens implantation.

Science.gov (United States)

Satanovsky, Alexandra; Ben-Eliahu, Shmuel; Apple, David J; Kleinmann, Guy

2011-07-01

To evaluate the safety of a new injector, the Raysert R-INJ-04/18, for implantation of the C-flex intraocular lens (IOL). Ophthalmology Department, Kaplan Medical Center, Rehovot, Israel. Experimental study. Sixty IOLs were subdivided into 2 equally sized groups. Group A IOLs were injected using the established R-INJ-04 injector, and those in Group B were injected with the new injector. The IOLs were injected into a Petri dish. Subsequently, all IOLs and injectors were evaluated macroscopically and microscopically and then photographed under light microscopy (LM). Two IOLs in each group were randomly chosen and sent for evaluation by scanning electron microscopy (SEM) and energy dispersive analysis of x-ray. All remaining IOLs were sent for power and modulation transfer function (MTF) analysis. All Group B IOLs were successfully injected without evident signs of scratching, cracks, or deposits on LM and SEM examination. In Group A, findings were confined to a singular incidence of a small deposit detected on the periphery of the posterior optical surface of the IOL, with corresponding findings detected on the injector nozzle. No signs of scratching, cracks, or deposits were found in the rest of the IOLs or injectors. The power and MTF analyses were within the normal range for all IOLs. The new 1.8 mm external diameter soft-tipped injector for 2.4 to 2.2 mm incisions was shown to be safe for the implantation of the C-flex 21.0 diopter IOL. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Foldable micro coils for a transponder system measuring intraocular pressure

Energy Technology Data Exchange (ETDEWEB)

Ullerich, S.; Schnakenberg, U. [Technische Hochschule Aachen (Germany). Inst. of Materials in Electrical Engineering 1; Mokwa, W. [Technische Hochschule Aachen (Germany). Inst. of Materials in Electrical Engineering 1]|[Fraunhofer Inst. of Microelectronic Circuits and Systems, Duisburg (Germany); Boegel, G. vom [Fraunhofer Inst. of Microelectronic Circuits and Systems, Duisburg (Germany)

2001-07-01

A foldable transponder system consisting of a chip and a micro coil for measuring intraocular pressure continuously is presented. The system will be integrated in the haptic of a soft artificial intraocular lens. Calculations of planar micro coils with 6 mm and 10.3 mm in diameter show the limits for planar coils with an outer diameter of 6 mm. For the realisation of the transponder system a 20 {mu}m thick coil with an outer diameter of 10.3 mm, an inner diameter of 7.7 mm, 16 turns and a gap of 20 {mu}m between the windings was selected. Measurements show a good agreement between calculated and measured values. Wireless pressure measurements were carried out showing a linear behaviour of the output signal with respect to the applied pressure. (orig.)

21 CFR 886.1385 - Polymethylmethacrylate (PMMA) diagnostic contact lens.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Polymethylmethacrylate (PMMA) diagnostic contact lens. 886.1385 Section 886.1385 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... directly on the globe or cornea of the eye for diagnosis or therapy of intraocular abnormalities. (b...

A modified-simple technique of removing the lens cortex during cataract surgery

Directory of Open Access Journals (Sweden)

Kyung Eun Han

2017-01-01

Full Text Available We describe here a surgical technique of removing the remaining cortex after phacoemulsification without performing the conventional irrigation/aspiration (I/A procedure. In this technique, the remaining cortex attached to the posterior capsule was separated and dissected into several pieces by continuous irrigation with balanced salt solution, which was supplied through a syringe attached to a bent, blunt-tip needle. Approximately, 10 s of manual irrigation separated most of the remaining cortex from the posterior capsule. Then, the capsular bag was inflated with an ophthalmic viscoelastic device (OVD, and this pushed the separated cortex toward the capsular fornix mechanically. An intraocular lens was inserted into the capsular bag, following which the remaining cortex and OVD were removed concomitantly using an automated I/A handpiece. This technique is a simple and easy maneuver to remove the cortex from all areas, including the subincisional area, and reduce the possibility of a posterior capsule tear.

Comparison of visual outcomes and subjective visual quality after bilateral implantation of a diffractive trifocal intraocular lens and blended implantation of apodized diffractive bifocal intraocular lenses

Directory of Open Access Journals (Sweden)

Gundersen KG

2016-05-01

Full Text Available Kjell G Gundersen,1 Rick Potvin21IFocus Øyeklinikk AS, Haugesund, Norway; 2Science in Vision, Akron, NY, USAPurpose: To compare the visual acuity (VA and quality of vision between bilateral implantation of a trifocal intraocular lens (IOL and blended bifocal IOLs with an intermediate add in the dominant eye and a near add in the nondominant eye.Patients and methods: Patients with either trifocal or blended bifocal IOLs implanted were recruited after surgery. Subjects returned for a single diagnostic visit between 3 and 24 months after surgery. VA was tested at various distances, including low-contrast acuity and acuity at their preferred reading distance. A binocular defocus curve was obtained, and subjective visual function and quality of vision were evaluated.Results: Twenty-five trifocal subjects and 30 blended bifocal subjects were enrolled. There were no significant differences in low-contrast acuity, preferred reading distance, or acuity at that reading distance. Binocular vision at 4 m, 60 cm, and 40 cm was not statistically significantly different. The trifocal provided statistically significantly better visual acuity (P<0.05 at vergences from -0.5 to -1.5 D (from 2 m to 67 cm viewing distance, P<0.05. There was no statistically significant difference in the near vision subscale scores of the 39-question National Eye Institute Visual Function Questionnaire or the overall scores of the Quality of Vision questionnaire, though significantly more trifocal subjects reported that the observed visual disturbances were “bothersome” (P<0.05.Conclusion: Both lens modalities provided subjects with excellent binocular near and distance vision, with similar low rates of visual disturbances and good reported functional vision. The trifocal IOL provided significantly better intermediate VA in the viewing distance range of 2 m to 67 cm, corresponding to viewing things such as a car dashboard or grocery shelf. VA was similar between groups at

Lens dislocation has a possible relationship with laser iridotomy

Directory of Open Access Journals (Sweden)

Mutoh T

2012-12-01

Full Text Available Tetsuya Mutoh,1,2 Kevin F Barrette,2 Yukihiro Matsumoto,1 Makoto Chikuda11Department of Ophthalmology, Dokkyo Medical University Koshigaya Hospital, Koshigaya City, Saitama, Japan; 2Department of Ophthalmology, Boston University School of Medicine, Boston, MA, USAAbstract: We report our recent experience of four eyes with spontaneous lens dislocation in four patients with no history of trauma or any systemic disease associated with zonular dialysis. Lens dislocation developed with 0.5 to 6 months following laser iridotomy. All patients were male and two eyes were complicated with acute primary angle closure glaucoma preoperatively. Case 1 showed bilateral lens dislocation, while cases 2 and 3 involved unilateral lens dislocation. Cases 2 and 3 showed lenses completely dislocated into the vitreous cavity. All cases needed lens removal and scleral fixation of intraocular lenses. Final visual acuity was 1.2 in all cases. We suspect that laser iridotomy may induce localized zonular dialysis that results in progressive zonular weakness, leading to lens dislocation.Keywords: lens dislocation, laser iridotomy, primary angle closure glaucoma

Food and Drug Administration study update. One-year results from 671 patients with the 3M multifocal intraocular lens.

Science.gov (United States)

Lindstrom, R L

1993-01-01

The clinical evaluation of the Food and Drug Administration study of the 3M diffractive multifocal intraocular lens (IOL) is presented here to demonstrate the results of 1-year postoperative data accumulated for 671 patients, the first of whom received the implant in 1987. Patients were selected for study if they had absence of preoperative pathology, were at least 60 years of age, and had a reasonable postoperative prognosis. Extensive evaluations took place at 4 to 6 months and 12 to 14 months after surgery, including five different visual acuity measurements and contrast sensitivity. All testing was completed on both eyes. Data from the fellow eye served as a control when implanted with a monofocal IOL. Overall uncorrected distance visual acuity at 1 year after surgery shows 57% patients with 20/40 or better acuity. In this same group, 78% achieved J3 or better near vision, which improved to 82% in the best case group. Uncorrected visual acuity of 20/40 or better and J3 or better was achieved by 50% of best case multifocal IOL patients, compared with 26% of the monofocal best case comparison group. Measurements of contrast sensitivity consistently document a small loss, which is considered clinically insignificant. Statistical analysis of satisfaction ratings shows that predictors of satisfaction include uncorrected distance acuity, final near acuity, and fellow eye spherical equivalent. This multifocal lens appears to work very well for most patients, with more than half having functional uncorrected distance and near vision. The study showed several considerations that are important for optimizing clinical performance and patient satisfaction: patient selection, realistic expectations, accurate biometry, and adequate control of surgical procedures.

[Management of post-traumatic aphakia and aniridia: Retrospective study of 17 patients undergoing scleral-sutured artificial iris intraocular lens implantation. Management of aphakia-aniridia with scleral-sutured artificial iris intraocular lenses].

Science.gov (United States)

Villemont, A-S; Kocaba, V; Janin-Manificat, H; Abouaf, L; Poli, M; Marty, A-S; Rabilloud, M; Fleury, J; Burillon, C

2017-09-01

To evaluate the long-term outcomes of artificial iris intraocular lenses sutured to the sclera for managing traumatic aphakia and aniridia. All consecutive cases receiving a Morcher ® combination implant from June 2008 to February 2016 in Edouard-Herriot Hospital (Lyon, France) were included in this single-center retrospective study. Visual acuity, subjective degree of glare, quality of life and surgical complications were evaluated. Seventeen eyes of 17 patients were included, among which 82% were male. The mean age was 42 years. The injuries consisted of 23.5% contusion and 70.5% open globe injuries, of which 41% were globe ruptures. There was one postoperative case. A penetrating keratoplasty was performed at the same time for eight eyes. The mean follow-up was 32 months. Best-corrected visual acuity improved in 41.2%, remained the same in 17.6% and decreased in 41.2% of our cases. Distance vision averaged 1±0.25 line better and near vision 2.2±0.32 lines better when visual acuity was quantifiable before surgery. Glare improved in 80% of patients and remained stable in 20%, decreasing on average from 3.3/5 [min. 3-max. 4; SD: 0.48] before surgery to 1.9/5 [min. 0-max. 4; SD: 1.197] after surgery. Regarding the esthetic results, 78% of the patients declared themselves reasonably to very satisfied; 57% reported no limitation of activities of daily living, and 43% reported mild limitation. Ocular hypertension and glaucoma, found in 40% of eyes, were the main postoperative complications. Implantation of prosthetic iris device combined with an intraocular lens appears to be safe and effective in reducing glare disability and improving visual acuity. Close, long-term monitoring is essential for the success of this surgery. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Single suture iris-to-capsulorhexis fixation for in-the-bag intraocular lens subluxation.

Science.gov (United States)

Siegel, Michael J; Condon, Garry P

2015-11-01

We present a simplified modification to a technique for early or mild in-the-bag subluxation that avoids conjunctival and scleral incisions and minimizes intraocular manipulation. While the capsulorhexis edge is grasped with an intraocular forceps to stabilize the IOL-capsular bag complex, a 10-0 polypropylene suture on a long curved needle is used to secure the fibrotic superior capsulorhexis edge to the midperipheral iris at 12 o'clock using a combination of a modified McCannel suture and a Siepser sliding knot. Dr. Condon receives speaker and consultant fees from Alcon Surgical, Inc., Allergan, Inc., and Microsurgical Technology. Although the Microsurgical Technology Condon snare instrument is named after him, Dr. Condon reports no patents, fees, or payments related to it. Dr. Siegel has no financial or proprietary interest in any material or method mentioned. Copyright © 2015. Published by Elsevier Inc.

Pupil Influence on the Visual Outcomes of a New-Generation Multifocal Toric Intraocular Lens With a Surface-Embedded Near Segment.

Science.gov (United States)

Wang, Mengmeng; Corpuz, Christine Carole C; Huseynova, Tukezban; Tomita, Minoru

2016-02-01

To evaluate the influences of preoperative pupil parameters on the visual outcomes of a new-generation multifocal toric intraocular lens (IOL) model with a surface-embedded near segment. In this prospective study, patients with cataract had phacoemulsification and implantation of Lentis Mplus toric LU-313 30TY IOLs (Oculentis GmbH, Berlin, Germany). The visual and optical outcomes were measured and compared preoperatively and postoperatively. The correlations between preoperative pupil parameters (diameter and decentration) and 3-month postoperative visual outcomes were evaluated using the Spearman's rank-order correlation coefficient (Rs) for the nonparametric data. A total of 27 eyes (16 patients) were enrolled into the current study. Statistically significant improvements in visual and refractive performances were found after the implantation of Lentis Mplus toric LU-313 30TY IOLs (P 0; P .05). Lentis Mplus toric LU-313 30TY IOLs provided excellent visual and optical performances during the 3-month follow-up. The preoperative pupil size is an important parameter when this toric multifocal IOL model is contemplated for surgery. Copyright 2016, SLACK Incorporated.

[Subluxation of hydrophilic acrylate intraocular lenses due to massive capsular fibrosis].

Science.gov (United States)

Kramer, S; Schröder, A C; Brückner, K; Jonescu-Cuypers, C; Seitz, B

2010-05-01

Compared with other biomaterials, hydrophilic acrylate provides better uveal biocompatibility, lower adhesion rates of bacteria and silicone oil, and less glare. Because of reduced capsular biocompatibility, increased fibrosis may initiate dislocation of the intraocular lens (IOL). In six eyes of four patients, enhanced fibroses led to IOL dislocation, leading to an IOL exchange an average of 40 weeks after implantation of the same hydrophilic acrylate lens type. Predisposing factors were found in 90% of all reported cases of IOL dislocation in the literature, but not in the cases described here. The lens type that was implanted was unable to adapt to the massive fibrosis induced by its hydrophilic biomaterial. The pattern of lens opacification should receive attention when one is choosing an IOL type. Eyes showing pseudoexfoliation syndrome as well as post-uveitis eyes might require a hydrophilic IOL for less cellular reaction, whereas a posterior subcapsular cataract might need a hydrophobic IOL to prevent a massive capsular fibrosis. In the case of increased capsular contraction, unreflected YAG laser capsulotomy may result in IOL subluxation when the lens design cannot handle capsule shrinkage, as demonstrated here.

Acute Central Retinal Artery Occlusion Associated with Intraocular Silicone Oil Tamponade

Directory of Open Access Journals (Sweden)

Mehmet Yasin Teke

2012-05-01

Full Text Available Many systemic and ocular factors may cause acute central retinal artery occlusion (CRAO. Herein, we aimed to describe a case of CRAO due to intraocular silicone oil (SO tamponade. To the best of our knowledge, a case like our has not been reported previously. A 58-yearold male patient had undergone combined pars plana vitrectomy-lensectomy and intraocular SO for lens luxation and vitreus hemorrhage associated with a blunt ocular trauma in his right eye. Two weeks after the surgery, he presented with acute vision loss in the same eye. He was diagnosed with acute CRAO and it should be related with mechanical press or raised intraocular pressure (IOP associated with SO. He was treated by partial removal of SO immediately. In spite of the regression of retina edema, his visual acuity did not improve due to optic atrophy. SO may cause CRAO due to raised IOP and/or its mechanical pressure and this complication must be kept in mind. (Turk J Oph thal mol 2012; 42: 238-40

Image-guided system versus manual marking for toric intraocular lens alignment in cataract surgery.

Science.gov (United States)

Webers, Valentijn S C; Bauer, Noel J C; Visser, Nienke; Berendschot, Tos T J M; van den Biggelaar, Frank J H M; Nuijts, Rudy M M A

2017-06-01

To compare the accuracy of toric intraocular lens (IOL) alignment using the Verion Image-Guided System versus a conventional manual ink-marking procedure. University Eye Clinic Maastricht, Maastricht, the Netherlands. Prospective randomized clinical trial. Eyes with regular corneal astigmatism of at least 1.25 diopters (D) that required cataract surgery and toric IOL implantation (Acrysof SN6AT3-T9) were randomly assigned to the image-guided group or the manual-marking group. The primary outcome was the alignment of the toric IOL based on preoperative images and images taken immediately after surgery. Secondary outcome measures were residual astigmatism, uncorrected distance visual acuity (UDVA), and complications. The study enrolled 36 eyes (24 patients). The mean toric IOL misalignment was significantly less in the image-guided group than in the manual group 1 hour (1.3 degrees ± 1.6 [SD] versus 2.8 ± 1.8 degrees; P = .02) and 3 months (1.7 ± 1.5 degrees versus 3.1 ± 2.1 degrees; P image-guided group and manual group, respectively (P > .05). The mean UDVA was 0.03 ± 0.10 logarithm of minimum angle of resolution (logMAR) and 0.04 ± 0.09 logMAR, respectively (both P > .05). No intraoperative complications occurred during any surgery. The IOL misalignment was significantly less with digital marking than with manual marking; this did not result in a better UDVA or lower residual refractive astigmatism. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Clinical observation of capsular tension ring implantation in congenital lens subluxation treating by phacoemulsification

OpenAIRE

Liang-Nan Sun; Bai-Jun Li; Yuan-Fei Zhu; Xin-Hua Liu

2017-01-01

AIM: To evaluate the clinical results of capsular tension ring(CTR)implantation in phacoemulsification for eyes with congenital lens subluxation. METHODS: This study comprised 18 patients(31 eyes)with congenital ectopia lentis. All patients received phacoemulsification with CTR and intraocular lens(IOL)implantation. Visual acuity before and after surgery were examined. IOL decentration were measured with Image-Pro Plus image processing software. The complications were also recorded preoperati...

Comparison of the Retinal Straylight in Pseudophakic Eyes with PMMA, Hydrophobic Acrylic, and Hydrophilic Acrylic Spherical Intraocular Lens

Directory of Open Access Journals (Sweden)

Ya-wen Guo

2014-01-01

Full Text Available Purpose. To investigate the intraocular straylight value after cataract surgery. Methods. In this study, 76 eyes from 62 patients were subdivided into three groups. A hydrophobic acrylic, a hydrophilic acrylic, and a PMMA IOL were respectively, implanted in 24 eyes, 28 eyes, and 24 eyes. Straylight was measured using C-Quant at 1 week and 1 month postoperatively in natural and dilated pupils. Results. The hydrophilic acrylic IOLs showed significantly lower straylight values than those of the hydrophobic acrylic IOLs in dilated pupils at 1 week and 1 month after surgery (P0.05. Moreover, no significant difference was found in straylight between natural and dilated pupils in each group at 1 week and 1 month postoperatively (P>0.05. Conclusions. Although the hydrophobic acrylic IOL induced more intraocular straylight, straylight differences among the 3 IOLs were minimal. Pupil size showed no effect on intraocular straylight; the intraocular straylight was stable 1 week after surgery.

Multiple methods of surgical treatment combined with primary IOL implantation on traumatic lens subluxation/dislocation in patients with secondary glaucoma

OpenAIRE

Wang, Rui; Bi, Chun-Chao; Lei, Chun-Ling; Sun, Wen-Tao; Wang, Shan-Shan; Dong, Xiao-Juan

2014-01-01

AIM:To describe clinical findings and complications from cases of traumatic lens subluxation/dislocation in patients with secondary glaucoma, and discuss the multiple treating methods of operation combined with primary intraocular lens (IOL) implantation.METHODS:Non-comparative retrospective observational case series. Participants:30 cases (30 eyes) of lens subluxation/dislocation in patients with secondary glaucoma were investigated which accepted the surgical treatment by author in the Opht...

Vision in semi-aquatic snakes: Intraocular morphology, accommodation, and eye: Body allometry

Science.gov (United States)

Plylar, Helen Bond

Vision in vertebrates generally relies on the refractive power of the cornea and crystalline lens to facilitate vision. Light from the environment enters the eye and is refracted by the cornea and lens onto the retina for production of an image. When an animal with a system designed for air submerges underwater, the refractive power of the cornea is lost. Semi-aquatic animals (e.g., water snakes, turtles, aquatic mammals) must overcome this loss of corneal refractive power through visual accommodation. Accommodation relies on change of the position or shape of the lens to change the focal length of the optical system. Intraocular muscles and fibers facilitate lenticular displacement and deformation. Snakes, in general, are largely unstudied in terms of visual acuity and intraocular morphology. I used light microscopy and scanning electron microscopy to examine differences in eye anatomy between five sympatric colubrid snake species (Nerodia cyclopion, N. fasciata, N. rhombifer, Pantherophis obsoletus, and Thamnophis proximus) from Southeast Louisiana. I discovered previously undescribed structures associated with the lens in semi-aquatic species. Photorefractive methods were used to assess refractive error. While all species overcame the expected hyperopia imposed by submergence, there was interspecific variation in refractive error. To assess scaling of eye size with body size, I measure of eye size, head size, and body size in Nerodia cyclopion and N. fasciata from the SLU Vertebrate Museum. In both species, body size increases at a significantly faster rate than head size and eye size (negative allometry). Small snakes have large eyes relative to body size, and large snakes have relatively small eyes. There were interspecific differences in scaling of eye size with body size, where N. fasciata had larger eye diameter, but N. cyclopion had longer eyes (axial length).

Influence of aspheric intraocular lens on frequency doubling technology and contrast sensitivity: a fellow eye study

Directory of Open Access Journals (Sweden)

Rodrigo França de Espíndola

2014-12-01

Full Text Available Purpose: To evaluate whether implantation of an aspheric intraocular lens (IOL results in reduced ocular aberrations and improved contrast sensitivity after cataract surgery and, therefore, changes on frequency-doubling technology (FDT testing. Methods: The present prospective clinical study enrolled 25 patients with bilateral cataract (50 eyes, who randomly received either an aspheric (Akreos AO or a spherical (Akreos Fit IOL in one eye and the other IOL in the second eye. Assessment 12 months postoperatively included photopic and mesopic contrast sensitivity testing. Higher-order aberrations (HOAs were computed. FDT testing was divided into four areas to evaluate the variation of the values at different points. The median values of the local pattern thresholds (median area contrast sensitivity [MACS] obtained with that division were calculated. Results: The Akreos AO group obtained statistically significantly lower values of HOAs and spherical aberration compared with the Akreos Fit group. There was a statistically significant between-group difference in contrast sensitivity under mesopic conditions at all spatial frequencies. No statistically significant differences were observed in mean deviation and pattern standard deviation. The aspheric IOL exhibited higher MACS in all areas, although a statistically significant difference was reached only in the 20-degree field area (P=0.043. Conclusion: Aspheric IOLs significantly reduced spherical aberration and HOAs, improving mesopic contrast sensitivity. Although there was a trend toward slightly improved FDT in the aspheric IOL group, it was not statistically significant.

Incidência de opacificação de cápsula posterior em pacientes submetidos à facoemulsificação e implante de lentes intra-oculares acrílicas hidrofílicas expansíveis Incidence of posterior capsule opacification in patients submitted to phacoemulsification and expandable acrylic intraocular lens implantation

Directory of Open Access Journals (Sweden)

Hilton Arcoverde Gonçalves de Medeiros

2006-06-01

Full Text Available OBJETIVO: Avaliar prospectivamente os resultados das lentes intra-oculares de polímeros expansíveis implantadas em pacientes submetidos à facoemulsificação, quanto à incidência de opacificação de cápsula posterior, levando em consideração a biocompatibilidade das lentes expansíveis. MÉTODOS: O grupo de estudo foi composto por 830 pacientes, 1.200 olhos, que foram submetidos a facoemulsificação, utilizando a mesma técnica, variando-se apenas o diâmetro da capsulorrexe, pelo mesmo cirurgião, no período de 1998 a 2002, com implante de lente intra-ocular hidrofílica expansível. O acompanhamento médio foi de 2,4 anos, variando de seis meses a quatro anos. RESULTADOS: O número total de opacificação de cápsula posterior foi de 54 casos. CONCLUSÃO: A incidência de opacificação de cápsula posterior encontrada no grupo foi de 4,6%.PURPOSE: To evaluate prospectively the results of expandable acrylic intraocular lenses in patients submitted to phacoemulsification as regard posterior capsule opacification. METHODS: The study group consisted of 830 patients, 1,200 eyes that underwent phacoemulsification from 1998 to 2002, by the same surgeon, using the same technique but with different diameters of capsulorrhexis, with expandable hydrophilic acrylic intraocular lens implantation. The mean follow-up was 2.4 years, ranging from 6 months to 4 years. RESULTS: The total number of posterior capsule opacification was 54 cases. CONCLUSIONS: The incidence of posterior capsule opacification was 4.6% in these patients.

Lubricant effects on low Dk and silicone hydrogel lens comfort.

Science.gov (United States)

Ozkan, Jerome; Papas, Eric

2008-08-01

To investigate the influence of three lubricants of varying viscosity, on postinsertion and 6 h comfort with contact lens wear. Comfort and associated symptoms of dryness were assessed in 15 experienced contact lens wearers. Subjects wore a low Dk lens in one eye and a silicone hydrogel in the other and participated in four separate trials involving no lubricant (baseline), saline, and two commercially available lubricants of differing viscosity. The in-eye lubricants were used immediately following lens insertion and every 2 h postinsertion for a 6 h wear period. Postlens insertion comfort was significantly better for both lens types when lubricants or saline were used compared with no lubricant use. After 6 h lens wear, comfort was influenced by lens type and not by in-eye lubricant or saline use. Also after 6 h lens wear, less dryness sensation was reported for silicone hydrogel lenses when using lubricants but not saline. Although lubricant use does help reduce dryness symptoms with silicone hydrogel lens wear, there appears to be minimal longer-term benefit to comfort. Furthermore, increased lubricant viscosity did not lead to improved longer-term comfort.

Qualidade de vida de pacientes pseudofácicos submetidos à cirurgia de catarata com implante de lente intra-ocular acomodativa Quality of life of pseudophakic patients with accommodative intraocular lens implant

Directory of Open Access Journals (Sweden)

Filipe de Oliveira

2004-06-01

Full Text Available OBJETIVO: Avaliar a função visual e satisfação dos pacientes submetidos à cirurgia de catarata com implante de lente intra-ocular acomodativa e o impacto na sua qualidade de vida. MÉTODOS: Retrospectivamente, foram avaliados questionários aplicados após um ano da cirurgia de 22 pacientes que foram incluídos num estudo clínico para avaliar segurança e eficácia de uma lente intra-ocular de silicone de câmara posterior designada para corrigir visão para longe e perto. RESULTADOS: Do total dos pacientes operados, 16 (73% eram bilaterais e 6 (27% unilaterais, com idade média de 70,2 anos. Dos pacientes com implante unilateral, 5 (83,3% declararam melhora acentuada da visão e 1 (16,7% referiu máxima melhora. Quanto ao nível de satisfação, 5 (83,3% ficaram satisfeitos e 1 (16,7% muito satisfeito com o resultado cirúrgico. A visão noturna foi declarada como sem dificuldade por 3 (50,0%, pouca dificuldade por 2 (33,3% e dificuldade moderada por 1 (16,7%. No grupo bilateral, 7 (43,8% consideraram excelente a qualidade da visão para perto, 7 (43,8% muito boa, 1 (6,2% adequada e 1 (6,2% ruim. A visão intermediária foi classificada como excelente por 6 (37,5%, muito boa por 9 (56,3% e adequada por 1 (6,2%. A qualidade da visão para longe foi considerada excelente por 9 (56,3%, muito boa por 3 (43,8%, adequada por 2 (12,5% e não muito boa por 2 (12,5%. Em relação à visão noturna 9 (56,3% declararam não ter dificuldade alguma, 5 (31,2% pouca dificuldade e 2 (12,5% dificuldade moderada. CONCLUSÕES: Considerando a propriedade óptica da LIO, a maioria dos pacientes apresentou uma melhora considerável da função visual, sem a necessidade de correção óptica, e, portanto, com impacto positivo na qualidade de vida.PURPOSE: To evaluate the visual function and satisfaction of patients who underwent cataract surgery and were implanted with an accommodative intraocular lens and the impact in their quality of life. METHODS

Comparison of the Results of Secondary Anterior Chamber and Secondary Scleral-Fixated Intraocular Lens Implantation in Complicated Phacoemulsification Cases

Directory of Open Access Journals (Sweden)

Nimet Yeşim Erçalık

2014-03-01

Full Text Available Objectives: To compare the visual prognosis and postoperative complication rates of secondary anterior chamber (AC IOL and scleralfixated (SF intraocular lenses (IOL after complicated phacoemulsification surgery. Materials and Methods: Thirty eyes of thirty patients were reviewed for this retrospective study. The patients with secondary AC IOL implantation formed group 1 (n=15, and the patients with secondary SF IOL implantation formed group 2 (n=15. Best-corrected visual acuity (BCVA with Snellen chart, biomicroscopic examination, intraocular pressure (IOP measurement with applanation tonometer, gonioscopy performed by Goldmann’s 3-mirror contact lens, and fundus examination were performed preoperatively in all patients. Results: There was no statistically significant difference in postoperative BCVA (p=0.492 and postoperative success (BCVA not changed or better postoperatively between the 2 groups (p=0.598. Postoperative success rate was 80% in group 1 and 93.7% in Group 2. The postoperative cylindrical power of the eyes did not differ significantly between the groups (p=0.220. The postoperative complications in group 1 were as follows: transient corneal edema in 5 eyes, transient IOP elevation in 2 eyes, postoperative fibrinous reaction in the anterior chamber in one eye, late-onset secondary glaucoma in one eye, hyphema in one eye, cystoid macular edema in one eye, vitreous prolapse into the anterior chamber in one eye, and IOL malposition in one eye. The postoperative complications in group 2 were as follows: transient corneal edema in 3 eyes, vitreous prolapse into the anterior chamber in 2 eyes, IOL malposition in 2 eyes, transient IOP elevation in one eye, and retinal detachment in one eye. Conclusion: In this study, both IOL types were observed to be preferable in cases without adequate capsular support following complicated cataract surgery. However, further studies with large numbers of patients are needed to define the best choice

Computerized calculation scheme for toric intraocular lenses.

Science.gov (United States)

Langenbucher, Achim; Seitz, Berthold

2004-06-01

While a number of intraocular lens (IOL) power prediction formulae are well established for determination of spherical lenses, no common strategy has been published for the computation of toric IOLs. The purpose of this study is to describe a paraxial computing scheme for tracing an axial pencil of rays through the 'optical system eye' containing astigmatic refractive surfaces with their axes at random. The capabilities of this computing scheme are demonstrated with clinical examples. Based on a schematic model eye with spherocylindric surfaces, we use two alternative notations for description of vergences or prescriptions: (1) standard notation (refraction in both cardinal meridians and axis), and (2) component notation (spherical equivalent and cylindric component in 0 degrees and 45 degrees. Refractive surfaces are added to the vergence in component notation, whereas the transformation of the vergence through media is performed in the standard notation for both cardinal meridians. For calculation of the toric lens implant, a pencil of rays is traced through the spectacle and the cornea to the estimated lens position as well as backwards from the retina to the estimated lens position. For calculation of residual spectacle refraction, a pencil of rays is traced backwards from the retina through the toric lens implant and the cornea to the spectacle plane. In example 1 we calculate a 'thin toric lens' for compensation of a corneal astigmatism to achieve a spherical target refraction. In example 2 we compute a 'thick toric lens', which has to compensate for an oblique corneal astigmatism and rotate the spectacle cylinder to the against the rule position to enhance near vision. In example 3 we estimate the residual refraction at the corneal plane after implantation of a thick toric lens, when the cylinder of the lens implant is compensating the corneal cylinder in part and the axis of implantation is not fully aligned with the axis of the corneal astigmatism. This

Calidad visual en pacientes con lente intraocular multifocal modelo OcuFlex operados de catarata The quality of vision in patients operated on from cataract and implanted with OcuFlex multifocal intraocular lenses

Directory of Open Access Journals (Sweden)

Eneida Pérez Candelaria

2010-01-01

Full Text Available OBJETIVO: Describir la calidad visual en 8 pacientes operados de catarata bilateral con la técnica de Faco-chop e implante de lente intraocular multifocal modelo OcuFlex, en el ICO "Ramón Pando Ferrer", desde septiembre 2007 a febrero 2008. MÉTODOS: Se realizó un estudio observacional, descriptivo, longitudinal y prospectivo para lo cual se analizaron variables como equivalente esférico, sensibilidad al contraste en el preoperatorio y posoperatorio; fenómenos visuales, centrado y localización del lente intraocular, así como el estado de satisfacción subjetiva de los pacientes. Se utilizó la estadística descriptiva con ayuda del sistema Microsoft Excel y Word 2003, para Windows XP. RESULTADOS: El equivalente esférico medio posoperatorio fue -0,59 tanto para frecuencias bajas como medias, en visión binocular la sensibilidad al contraste media fue de 1,12 unid.log en el preoperatorio y de 1,74 unid.log. en el posoperatorio. Por biomicroscopia con lámpara de hendidura en el 100 % de los casos el lente intraocular estaba centrado y por biomicroscopia ultrasónica el 93,75 % se encontraba en el saco capsular. Ningún paciente refirió la presencia de glare y solamente uno (12,5 % reportó visión de halos nocturnos. La totalidad de los pacientes se manifestaron satisfechos. CONCLUSIONES: Los lentes multifocales disminuyen la dependencia de las gafas después de la cirugía de catarata, razón por la que constituye una buena opción en la recuperación de la función visual óptima.OBJECTIVE: To describe the quality of vision in 8 patients, who were operated on from bilateral cataract using Phaco-chop technique and implanted with Ocuflex multifocal intraocular lens in "Ramón Pando Ferrer" Cuban Institute of Ophthalmology from September 2007 to February 2008. METHODS: A prospective, longitudinal, observational and descriptive study was made in which the variables spheral equivalent, contrast sensitivity in the pre- and post

Clinical Outcomes after Uncomplicated Cataract Surgery with Implantation of the Tecnis Toric Intraocular Lens

Directory of Open Access Journals (Sweden)

Wojciech Lubiński

2016-01-01

Full Text Available Purpose. To evaluate the clinical outcomes after uncomplicated cataract surgery with implantation of an aspheric toric intraocular lens (IOL during a 6-month follow-up. Methods. Prospective study including 27 consecutive eyes of 18 patients (mean age: 66.1±11.4 years with a visually significant cataract and corneal astigmatism ≥ 0.75 D and undergoing uncomplicated cataract surgery with implantation of the Tecnis ZCT toric IOL (Abbott Medical Optics. Visual, refractive, and keratometric outcomes as well as IOL rotation were evaluated during a 6-month follow-up. At the end of the follow-up, patient satisfaction and perception of optical/visual disturbances were also evaluated using a subjective questionnaire. Results. At 6 months after surgery, mean LogMAR uncorrected (UDVA and corrected distance visual acuity (CDVA were 0.19±0.12 and 0.14±0.10, respectively. Postoperative UDVA of 20/40 or better was achieved in 92.6% of eyes. Mean refractive cylinder decreased significantly from −3.73±1.96 to −1.42±0.88 D (p<0.001, while keratometric cylinder did not change significantly (p=0.44. Mean absolute IOL rotation was 1.1±2.4°, with values of more than 5° in only 2 eyes (6.9%. Mean patient satisfaction score was 9.70±0.46, using a scale from 0 (not at all satisfied to 10 (very satisfied. No postoperative optical/visual disturbances were reported. Conclusion. Cataract surgery with implantation of the Tecnis toric IOL is an effective method of refractive correction in eyes with corneal astigmatism due to the good IOL positional stability, providing high levels of patient’s satisfaction.

Hourly awakening vs continuous contact lens sensor measurements of 24-hour intraocular pressure: effect on sleep macrostructure and intraocular pressure rhythm.

Science.gov (United States)

Aptel, Florent; Tamisier, Renaud; Pépin, Jean-Louis; Mottet, Benjamin; Hubanova, Ralitsa; Romanet, Jean-Paul; Chiquet, Christophe

2014-10-01

All studies of 24-hour intraocular pressure (IOP) rhythm conducted to date have used repeated IOP measurements requiring nocturnal awakenings, potentially disturbing sleep macrostructure. To evaluate the effects on sleep architecture and IOP rhythm of hourly awakening vs a contact lens sensor (CLS) to continuously monitor IOP without awakening. Cross-sectional study at a referral center of chronobiology among 12 young healthy volunteers, with a mean (SD) age of 22.3 (2.3) years. Volunteers underwent two 24-hour IOP measurement sessions during a 2-month period. The eye order and session order were randomized. During one session, the IOP of the first eye was continuously monitored using a CLS, and the IOP of the fellow eye was measured hourly using a portable noncontact tonometer (session with nocturnal hourly awakening). During the other session, the IOP of the first eye was continuously monitored using a CLS, and the IOP of the fellow eye was not measured (session without nocturnal awakening). Overnight polysomnography was performed during the 2 sessions. A nonlinear least squares, dual-harmonic regression analysis was used to model the 24-hour IOP rhythm from the CLS data. Comparisons of acrophase, bathyphase, amplitude, and the midline estimating statistic of rhythm were used to evaluate the effect of hourly awakening on IOP rhythm. To evaluate the effects of hourly awakening on sleep architecture, comparisons of sleep structure were used, including total sleep period, rapid eye movement, wake after sleep onset, absolute and relative total sleep time, and non-rapid eye movement sleep (N1, N2, and N3). A 24-hour IOP rhythm was found in all individuals for the sessions with and without awakening (P  .30). Hourly awakening during noncontact tonometer IOP measurements did not seem to alter the mean variables of the 24-hour IOP pattern evaluated using CLS, including signal, maximum signal, minimum signal, acrophase, and bathyphase (P > .15). The 24-hour IOP

Evaluating the risk of eye injuries: intraocular pressure during high speed projectile impacts.

Science.gov (United States)

Duma, Stefan M; Bisplinghoff, Jill A; Senge, Danielle M; McNally, Craig; Alphonse, Vanessa D

2012-01-01

To evaluate the risk of eye injuries by determining intraocular pressure during high speed projectile impacts. A pneumatic cannon was used to impact eyes with a variety of projectiles at multiple velocities. Intraocular pressure was measured with a small pressure sensor inserted through the optic nerve. A total of 36 tests were performed on 12 porcine eyes with a range of velocities between 6.2 m/s and 66.5 m/s. Projectiles selected for the test series included a 6.35  mm diameter metal ball, a 9.25  mm diameter aluminum rod, and an 11.16  mm diameter aluminum rod. Experiments were designed with velocities in the range of projectile consumer products such as toy guns. A range of intraocular pressures ranged between 2017 mmHg to 26,426 mmHg (39 psi-511 psi). Four of the 36 impacts resulted in globe rupture. Intraocular pressures dramatically above normal physiological pressure were observed for high speed projectile impacts. These pressure data provide critical insight to chronic ocular injuries and long-term complications such as glaucoma and cataracts.

Use of hydroxypropylmethylcellulose 2% for removing adherent silicone oil from silicone intraocular lenses

OpenAIRE

Wong , S Chien; Ramkissoon , Yashin D; Lopez , Mauricio; Page , Kristopher; Parkin , Ivan P; Sullivan , Paul M

2009-01-01

Abstract Background / aims: To investigate the effect of hydroxypropylmethylcellulose (HPMC) on the physical interaction (contact angle) between silicone oil and a silicone intraocular lens (IOL). Methods: In vitro experiments were performed, to determine the effect of HPMC (0.5%, 1% or 2%), with or without an additional simple mechanical manoeuvre, on the contact angle of silicone oil at the surface of both silicone and acrylic (control) IOLs. A balanced salt solu...

Refractive outcomes of intraoperative wavefront aberrometry versus optical biometry alone for intraocular lens power calculation

Directory of Open Access Journals (Sweden)

Zina Zhang

2017-01-01

Full Text Available Purpose: To compare the outcomes of intraoperative wavefront aberrometry versus optical biometry alone for intraocular lens (IOL power calculation in eyes undergoing cataract surgery with monofocal IOL implantation. Methods: Preoperative data were obtained with the IOLMaster. Intraoperative aphakic measurements and IOL power calculations were obtained in some patients with the optiwave refractive analysis (ORA system. Analysis was performed to determine the accuracy of monofocal IOL power prediction and postoperative manifest refraction at 1 month of the ORA versus IOLMaster. Results: Two hundred and ninety-five eyes reviewed, 61 had only preoperative IOLMaster measurements and 234 had both IOLMaster and ORA measurements. Of these 234 eyes, 6 were excluded, 107 had the same recommended IOL power by ORA and IOLMaster. Sixty-four percent of these eyes were within ±0.5D. 95 eyes had IOL power implantation based on ORA instead of IOLMaster. Seventy percent of these eyes were within ±0.5D of target refraction. 26 eyes had IOL power chosen based on IOLMaster predictions instead of ORA. Sixty-five percent were within ±0.5D. In the group with IOLMaster without ORA measurements, 80% of eyes were within ±0.5D of target refraction. The absolute error was statistically smaller in those eyes where the ORA and IOLMaster recommended the same IOL power based on preoperative target refraction compared to instances in which IOL selection was based on ORA or IOLMaster alone. Neither prediction errors were statistically different between the ORA and IOLMaster alone. Conclusion: Intraoperative wavefront aberrometry with the ORA system provides postoperative refractive results comparable to conventional biometry with the IOLMaster for monofocal IOL selection.

Pathologic evidence of pseudoexfoliation in cases of in-the-bag intraocular lens subluxation or dislocation.

Science.gov (United States)

Liu, Erica; Cole, Scott; Werner, Liliana; Hengerer, Fritz; Mamalis, Nick; Kohnen, Thomas

2015-05-01

To provide complete histopathologic evaluation of explanted capsular bags that spontaneously dislocated in the late postoperative period, with the main objective being to assess the presence of pseudoexfoliation (PXF) material. Goethe-University Frankfurt, Frankfurt, Germany, and John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. Retrospective case series. Standard gross and light microscopy and complete histopathology were performed on explanted subluxated and dislocated capsular bags containing an intraocular lens (IOL) or a capsular tension ring (CTR) and an IOL. Questionnaires were sent to explanting surgeons, and a patient chart review was performed, when available. The specimens were represented by capsular bags containing an IOL (n = 37) or an IOL-CTR (n = 3). The IOLs included 3-piece hydrophobic acrylic (n = 13), 1-piece hydrophobic acrylic (n = 7), 3-piece silicone (n = 6), 1-piece hydrophilic acrylic (n = 6), 3-piece hydrophilic acrylic (n = 2), and 1-piece poly(methyl methacrylate) (PMMA) (n = 6) designs; all CTRs were PMMA. Soemmering ring formation was mild in 8 specimens, moderate in 18 specimens, and severe in 14 specimens. Excessive contraction of the capsular bag with capsulorhexis phimosis was observed in 24 specimens. Twenty-six specimens had histopathologic evidence of PXF; 13 had a clinical history or evidence of PXF. Pseudoexfoliation might be implicated in a larger proportion of late in-the-bag IOL subluxations and dislocations than previously thought as a result of significant clinical underdiagnosis. This might indicate a need for new considerations during the preoperative and postoperative cataract surgery assessments and follow-up. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Exchange of tears under a contact lens is driven by distortions of the contact lens.

Science.gov (United States)

Maki, Kara L; Ross, David S

2014-12-01

We studied the flow of the post-lens tear film under a soft contact lens to understand how the design parameters of contact lenses can affect ocular health. When a soft contact lens is inserted, the blinking eyelid causes the lens to stretch in order to conform to the shape of the eye. The deformed contact lens acts to assume its un-deformed shape and thus generates a suction pressure in the post-lens tear film. In consequence, the post-lens tear fluid moves; it responds to the suction pressure. The suction pressure may draw in fresh fluid from the edge of the lens, or it may eject fluid there, as the lens reassumes its un-deformed shape. In this article, we develop a mathematical model of the flow of the post-lens tear fluid in response to the mechanical suction pressure of a deformed contact lens. We predict the amount of exchange of fluid exchange under a contact lens and we explore the influence of the eye's shape on the rate of exchange of fluid. © The Author 2014. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.

Efectividad de la lente intraocular ACRI. SMART 46-S en la cirugía de catarata por microincisiones Effectiveness of the intraocular lens ACRI SMART 46-S in micro-incision cataract surgery

Directory of Open Access Journals (Sweden)

Juan Raúl Hernández Silva

2007-12-01

catarata, también permitiría desarrollar en el futuro materiales y tecnologías que abrirían nuevos caminos para la cirugía oftalmológica, y la aplicación de parámetros facodinámicos óptimos conllevaría a un bajo porcentaje de complicaciones.Improvement and application of an industry devoted to modernize intraocular lenses and surgical tools have prompted a set of advances that allow optimizing, correcting and refining the surgical techniques for cataract surgery, particularly phacoemulsification. The most important aspect in this chain of advacements is aimed at reducing the surgical incision size in order to avoid a significant number of complications that are relatively frequent when using conventional extracapsular and intracapsular surgeries with over 10mm incisions. At present, new surgical techniques such as microincision cataract surgery have been developed. A retrospective and descriptive study was performed in 27 patients (eyes diagnosed with pre-senile and senile cataract, who were surgically treated with microincision phacoemulsification and received the implant of an ACRi Smart 46.S 11 x 6mm acrylic intraocular lens in the posterior chamber at the Ocular Microsurgery Center of “Ramón Pando Ferrer” Ophthalmology Institute in the period from January 2004 to January 2005. It was found that most of cases were older than 50 years; the best corrected visual acuity recovered significantly in the postoperative period and induced astigmatism was low. Regarding the used phacodynamic parameters, the ultrasound power was generally low. There were few complications, being vitreous detachment secondary to break in the posterior capsule. It was concluded that microincision cataract surgery with Acri Smart 46 S lens implant is a valid, safe and effective choice of catract treatment that will allow developing in the future materials and technologies which would open up new paths for eye surgery, and also the use of optimal phacodynamic parameters would lead to a

[Effect of intraocular pressure measurement through therapeutic soft contact lenses by noncontact tonometer].

Science.gov (United States)

Sugimoto-Takeuchi, R; Yamamoto, R; Kuwayama, Y; Kinoshita, S

1991-09-01

The measurement of intraocular pressure (IOP) was compared with and without soft contact lenses by a non-contact tonometer. The soft contact lenses examined were Plano-T and Plano-B4 therapeutic contact lenses and Breath-O refractive lens. Twenty-nine eyes of 18 patients with an IOP ranging from 9 to 48mmHg were studied. The measurements of IOP were 19.7 +/- 8.6mmHg with Plano-T and 18.9 +/- 9.2mmHg with Plano-B4. Both numbers were not statistically different, when compared with controls (19.3 +/- 9.8mmHg without lens). There was, however, a significant difference significant difference with (44.7 +/- 10.7mmHg) and without the Breath-O (p less than 0.01). The results suggest that accurate IOP measurements can be obtained through therapeutic soft contact lens by a non-contact tonometer.

Application of lens capsules tension reducing capsulorhexis and conventional capsulorhexis in the white cataract phacoemulsification

Directory of Open Access Journals (Sweden)

Rong-Feng Liu

2017-09-01

Full Text Available Objective: To explore the clinical effect of lens capsules tension reducing capsulorhexis and conventional capsulorhexis in the white cataract phacoemulsification. Methods: A total of 68 patients (76 eyes with white cataract who were admitted in our hospital from June, 2011 to June, 2016 were included in the study and divided into the experiment group (n=34, 36 eyes and the control group (n=34, 40 eyes according to the difference of intraoperative capsulorhexis. All the patients were performed with cataract phacoemulsification in combined with intraocular lens implantation. The patients in the experiment group were performed with lens capsules tension reducing capsulorhexis, while the patients in the control group were performed with conventional capsulorhexis. The integrity of the anterior capsule capsulorhexis, the degree of corneal endothelium edema, the intraocular lens deviation, uncorrected visual acuity, and corneal endothelial cell count in the two groups were compared. Results: A total of 34 eyes (94.44% in the experiment group and 35 eyes (87.50% in the control group successfully completed continuous annular capsulorhexis, and there was no significant difference between the 2 groups. The number of patients whose uncorrected visual acuity was greater than 0.5 increased 1 d-6 months after operation, and that in the experiment group was significantly higher than that in the control group. The difference of intraocular lens deviation rates between the 2 groups at different times after operation was not significant. The corneal endothelial cell count 1 d-6 months after operation in the 2 groups was significantly decreased when compared with before operation, but the difference between the 2 groups was not significant. The number of eyes without edema in the experiment group 1d after operation was significantly higher than that in the control group, and the number of eyes with grade Ⅱ edema was significantly less than that in the control

Evaluation of the True Wavefront Aberrations in Eyes Implanted With a Rotationally Asymmetric Multifocal Intraocular Lens.

Science.gov (United States)

Akondi, Vyas; Pérez-Merino, Pablo; Martinez-Enriquez, Eduardo; Dorronsoro, Carlos; Alejandre, Nicolás; Jiménez-Alfaro, Ignacio; Marcos, Susana

2017-04-01

Standard evaluation of aberrations from wavefront slope measurements in patients implanted with a rotationally asymmetric multifocal intraocular lens (IOL), the Lentis Mplus (Oculentis GmbH, Berlin, Germany), results in large magnitude primary vertical coma, which is attributed to the intrinsic IOL design. The new proposed method analyzes aberrometry data, allowing disentangling the IOL power pupillary distribution from the true higher order aberrations of the eye. The new method of wavefront reconstruction uses retinal spots obtained at both the near and far foci. The method was tested using ray tracing optical simulations in a computer eye model virtually implanted with the Lentis Mplus IOL, with a generic cornea or with anterior segment geometry obtained from custom quantitative spectral-domain optical coherence tomography in a real patient. The method was applied to laser ray tracing aberrometry data at near and far fixation obtained in a patient implanted with the Lentis Mplus IOL. Higher order aberrations evaluated from simulated and real retinal spot diagrams following the new reconstruction approach matched the nominal aberrations (approximately 98%). Previously reported primary vertical coma in patients implanted with this IOL lost significance with the application of the proposed reconstruction. Custom analysis of ray tracing-based retinal spot diagrams allowed decoupling of the true higher order aberrations of the patient's eye from the power pupillary distribution of a rotationally asymmetric multifocal IOL, therefore providing the appropriate phase map to accurately evaluate through-focus optical quality. [J Refract Surg. 2017;33(4):257-265.]. Copyright 2017, SLACK Incorporated.

Novel Technique to Overcome the Nonavailability of a Long Needle 9-0 Polypropylene Suture for Sutured Scleral Fixation of the Posterior Chamber Intraocular Lens Using a Single Fisherman's Knot.

Science.gov (United States)

Shin, Yong Un; Seong, Mincheol; Cho, Hee Yoon; Kang, Min Ho

2017-01-01

To describe a method to overcome the nonavailability of a long needle 9-0 polypropylene suture for sutured scleral fixation of the posterior chamber intraocular lens (PC-IOL) using a single fisherman's knot (SFK). First, a 10-0 polypropylene suture was passed from the sclera to the ciliary sulcus using a long needle. A 9-0 suture was tied to the unpassed portion of the 10-0 suture with an SFK. We pulled the 10-0 suture to pass the SFK through the sclera, and then we cut the knot and removed the 10-0 suture. IOL fixation with 9-0 sutures used the conventional techniques used for sutured scleral-fixated IOL. Preoperative and postoperative visual acuity, corneal astigmatism, and endothelial cell count and intraoperative/postoperative complications were evaluated. An SFK joining the two sutures was passed through the sclera without breakage or slippage. A total of 35 eyes from 35 patients who underwent sutured scleral fixation of the IOL. An intraoperative complication (minor intraocular hemorrhage) was recorded in four cases. Knot exposure, IOL dislocation, subluxation, and retinal detachment were not observed. The SFK offers the opportunity to use 9-0 sutures for the long-term safety and may not require the surgeon to learn any new technique.

Postoperative visual performance with a bifocal and trifocal diffractive intraocular lens during a 1-year follow-up

Directory of Open Access Journals (Sweden)

Peter Mojzis

2017-10-01

Full Text Available AIM: To evaluate and compare the clinical outcomes with a diffractive bifocal and trifocal intraocular lens (IOL during a 12-month follow-up. METHODS: Prospective comparative study including 75 eyes of 38 patients (44-70y undergoing uneventful cataract surgery. Each patient was randomly assigned to one type of IOL, bifocal (35 eyes or trifocal (40 eyes. Visual, refractive, and contrast sensitivity changes were evaluated in a 12-month follow-up. The binocular defocus curve was also measured at 12mo postoperatively. RESULTS: No statistically significant differences between groups were found in postoperative uncorrected and corrected distance visual acuities (P≥0.276. Postoperative corrected near visual acuity (33 cm was significantly better in the trifocal group during all follow-up (P≤0.004 as well as 6-month uncorrected near (P=0.008 and distance-corrected near visual acuities (P=0.016 (33/40 cm. Significantly better uncorrected intermediate and distance corrected-intermediate visual acuity were found during all follow-up in the trifocal group (P<0.001, which was consistent with differences among groups in binocular defocus curve. Differences among groups in contrast sensitivity were minimal, being only significant at 6 months for some low to medium spatial frequencies (P≤0.006. CONCLUSION: Bifocal and trifocal diffractive IOLs are able to provide an effective visual restoration which is maintained during a 12-month follow-up, with a clear benefit of the trifocal IOL for the intermediate vision.

In-the-bag capsular tension ring and intraocular lens subluxation or dislocation: a series of 23 cases.

Science.gov (United States)

Werner, Liliana; Zaugg, Brian; Neuhann, Tobias; Burrow, Michael; Tetz, Manfred

2012-02-01

To describe clinical and pathologic findings from cases of in-the-bag capsular tension ring (CTR) and intraocular lens (IOL) subluxation or dislocation. Retrospective case series with clinicopathologic correlation. Twenty-three explanted subluxated/dislocated capsular bags containing a CTR and an IOL explanted in Europe and submitted in fixative to the Berlin Eye Research Institute. Standard gross and light microscopy of specimens, complete histopathologic analyses of selected specimens done at the University of Utah, as well as questionnaire sent to explanting surgeons, and patient chart review, when available. Lens design, material, and abnormalities, capsular bag anomalies, patient demographic data, surgical dates, and presence or absence of known risk factors. Patients were aged 76.31 ± 8.24 years at explantation, which was performed 81.5 ± 32.2 months after implantation. The IOLs in these cases were 3-piece hydrophobic acrylic (N = 11), 1-piece hydrophobic acrylic (n = 6), 3-piece silicone (n = 4), or 1-piece hydrophilic acrylic (n = 2) designs; all CTRs were made of poly(methyl methacrylate). Available information on associated ocular conditions included pseudoexfoliation (n = 17), glaucoma (n = 4), vitrectomy/retina surgery (n = 3), and trauma (n = 1). Complete histopathologic assessment in 3 specimens showed signs consistent with pseudoexfoliation, without available history related to this condition in one of the cases. Moderate/severe degrees of Soemmering's ring formation and capsulorhexis phimosis were observed or reported in 13 and 11 specimens, respectively. Fourteen eyes were implanted and explanted by the same surgeon, with an interval of 92.7 ± 23.4 months between the procedures. His rate of explantation because of subluxation/dislocation was 0.76% of the CTRs implanted during the time considered. Explantation because of postoperative subluxation or dislocation of CTR-IOL-capsular bag complexes occurred approximately 6.8 years after implantation

Capsule-Fixated Intraocular Lens Implantation in Small Pupil Cases.

Science.gov (United States)

Schojai, Merita; Schultz, Tim; Burkhard Dick, H

2017-08-01

To describe a new technique for implantation of capsule-fixated intraocular lenses (IOLs) (FEMTIS; Oculentis, Berlin, Germany) in patients with small pupils. In 4 eyes with small pupils, an anterior capsule-fixated IOL was implanted into the capsular bag after femtosecond laser treatment. The two large and two small flaps of the IOL were elevated to the front of the iris and the anterior capsule. Finally, the iris was flipped over the flaps to ensure a fixation of the capsule inside of the capsulotomy. In all cases, the implantation of anterior capsule-fixated IOLs was possible. No complications occurred during surgery or within the first months after surgery. With the described technique, capsulefixated IOLs can be implanted in eyes with small pupil easily and safely. This type of IOL has great potential to improve the refractive outcome by better prediction of the postoperative IOL position and eliminating IOL rotation after cataract surgery. [J Refract Surg. 2017;33(8):568-570.]. Copyright 2017, SLACK Incorporated.

Biofilm Formation by Staphylococcus epidermidis on Foldable and Rigid Intraocular Lenses.

Science.gov (United States)

Fazly Bazzaz, Bibi Sedigheh; Jalalzadeh, Monireh; Sanati, Maryam; Zarei-Ghanavati, Syamak; Khameneh, Bahman

2014-05-01

Biofilm formation of Staphylococcus epidermidis is a major etiological factor of inducing device-related infections. The ability of biofilm formation by the S. epidermidis was assessed in vitro on two brands of foldable (hydrophilic) and two brands of rigid (hydrophobic) intraocular lens materials in order to investigate the role of lens material in postoperative endophthalmitis. To ensure reproducibility of biofilm formation on intraocular lenses, two strains of S. epidermidis and three quantification methods were performed. The S. epidermidis strains, DSMZ3270 (biofilm-producer) and ATCC12228 (non-biofilm-producer) were applied. Organisms were cultivated on disks of different brands of foldable hydrophilic Intra Ocular Lens (IOL) made of acrylic (Didar, Iran; (A) and Omni, India; (B)), and rigid hydrophobic IOL made of polymethyl methacrylate (PMMA; Didar, Iran; (C) and Hexavision, France; (D)). Biofilms were stained with crystal violet (CV) dye, which is an index of biofilm formation. The bacterial population was counted after biofilm homogenization. Scanning electron microscopy (SEM) was performed to examine the extent of biofilm formation. Adherence of DSMZ3270 strain on both types of foldable and rigid IOLs, was significantly more than ATCC12228 (P brands of foldable and PMMA IOLs. According to statistical analyses the incubation time influenced the biofilm formation on both types of IOLs which meant that by increasing incubation time, the biofilm formation increased. According to the SEM pictures, biofilm seems to be lysed at 72 hours. These data demonstrated that the attachment of bacteria to hydrophilic acrylic IOLs was more than hydrophobic PMMA ones independent of the brand. According to these results the bacterial strain might have more hydrophilic properties. Augmenting the biomass of biofilm by passing of time demonstrated the key role of time in biofilm formation on the IOL surfaces. The differences between IOL brands in the biofilm formation

Applanation tonometry in silicone hydrogel contact lens wearers.

Science.gov (United States)

Allen, R J; Dev Borman, A; Saleh, G M

2007-12-01

Previous studies have investigated intraocular pressure (IOP) measurements through conventional soft (hydrogel) therapeutic contact lenses, and have found that an accurate IOP can be recorded in normal eyes, and in eyes with abnormal anterior segments. The IOP measurement through soft contact lenses may be affected by the water content and centre thickness of the lens. Silicone hydrogel contact lenses are now being used as therapeutic contact lenses due to their high oxygen permeability. The purpose of this study is to investigate if IOP can be accurately measured in a subject wearing a silicone hydrogel contact lens. In a cohort study, the IOP was measured with a Goldmann applanation tonometer without a contact lens and then repeated with a hydrogel contact lens in situ. The IOP of 20 eyes of 10 volunteers with no ocular pathology was measured. The mean difference (+/-S.D.) found between IOP measurement with (mean 15.55+/-1.70 mmHg) and without (mean 16.05+/-1.90 mmHg) contact lens was found to be -0.5+/-0.89 mmHg. Statistical analysis was performed which revealed a correlation coefficient of 0.89. No significant statistical difference was found between the two groups with paired t-test (p=0.19). Accurate measurement of IOP by applanation tonometry can be achieved through a silicone hydrogel contact lens.

Comparison of glare in YAG-damaged intraocular lenses: injection-molded versus lathe-cut.

Science.gov (United States)

Bath, P E; Dang, Y; Martin, W H

1986-11-01

A comparative analysis of YAG laser intraocular lens (IOL) damage was undertaken on injection-molded and lathe-cut IOLs. Damage sites were evaluated with polarized light. A consistent positive polarization was observed in the damage sites of lathe-cut IOLs. A consistent negative polarization was observed in the damage sites of injection-molded IOLs. The presence of positive polarization in IOL damage sites may be correlated with increased potential for glare. Results and clinical implications are discussed.

Combining zonal refractive and diffractive aspheric multifocal intraocular lenses.

Science.gov (United States)

Muñoz, Gonzalo; Albarrán-Diego, César; Javaloy, Jaime; Sakla, Hani F; Cerviño, Alejandro

2012-03-01

To assess visual performance with the combination of a zonal refractive aspheric multifocal intraocular lens (MIOL) (Lentis Mplus, Oculentis GmbH) and a diffractive aspheric MIOL (Acri.Lisa 366, Acri.Tech GmbH). This prospective interventional cohort study comprised 80 eyes from 40 cataract patients (mean age: 65.5±7.3 years) who underwent implantation of the Lentis Mplus MIOL in one eye and Acri.Lisa 366 MIOL in the fellow eye. The main outcome measures were refraction; monocular and binocular uncorrected and corrected distance, intermediate, and near visual acuities; monocular and binocular defocus curves; binocular photopic contrast sensitivity function compared to a monofocal intraocular lens (IOL) control group (40 age-matched pseudophakic patients implanted with the AR-40e [Abbott Medical Optics]); and quality of vision questionnaire. Binocular uncorrected visual acuities were 0.12 logMAR (0.76 decimal) or better at all distances measured between 6 m and 33 cm. The Lentis Mplus provided statistically significant better vision than the Acri.Lisa at distances between 2 m and 40 cm, and the Acri.Lisa provided statistically significant better vision than the Lentis Mplus at 33 cm. Binocular defocus curve showed little drop-off at intermediate distances. Photopic contrast sensitivity function for distance and near were similar to the monofocal IOL control group except for higher frequencies. Moderate glare (15%), night vision problems (12.5%), and halos (10%) were reported. Complete independence of spectacles was achieved by 92.5% of patients. The combination of zonal refractive aspheric and diffractive aspheric MIOLs resulted in excellent uncorrected binocular distance, intermediate, and near vision, with low incidence of significant photic phenomena and high patient satisfaction. Copyright 2012, SLACK Incorporated.

Variations in retinal nerve fiber layer measurements on optical coherence tomography after implantation of trifocal intraocular lens.

Science.gov (United States)

García-Bella, Javier; Martínez de la Casa, José M; Talavero González, Paula; Fernández-Vigo, José I; Valcarce Rial, Laura; García-Feijóo, Julián

2018-01-01

To establish the changes produced after implantation of a trifocal intraocular lens (IOL) on retinal nerve fiber layer measurements performed with Fourier-domain optical coherence tomography (OCT). This prospective study included 100 eyes of 50 patients with bilateral cataract in surgical range, no other associated ocular involvement, refractive errors between +5 and -5 spherical diopters, and less than 1.5 D of corneal astigmatism. The eyes were operated by phacoemulsification with implantation of 2 different trifocal IOLs (FineVision and AT LISA tri 839MP) in randomized equal groups. Cirrus OCT and Spectralis OCT were performed before surgery and 3 months later. Both analyzed the thickness of the nerve fiber layer and thickness divided by quadrants (6 in case of Spectralis and 4 in case of Cirrus HD). The mean age of patients was 67.5 ± 5.8 years. The global nerve fiber layer thickness measured with Spectralis OCT was 96.77 μm before surgery and 99.55 μm after. With Cirrus OCT, the global thickness was 85.29 μm before surgery and 89.77 μm after. Statistically significant differences in global thickness measurements between preimplantation and postimplantation of the IOL were found with both OCT in the 2 groups. Statistically significant differences were also found in temporal and superior quadrants. The implantation of a diffractive trifocal IOL alters the results of the optic nerve fiber layer on Fourier-domain OCT in these patients, which should be taken into account in the posterior study of these patients.

[Scheimpflug photography for the examination of phakic intraocular lenses].

Science.gov (United States)

Baumeister, M

2014-10-01

High myopia phakic intraocular lenses (IOL) have become an established means of surgical correction for high ametropia. Scheimpflug photography is one of the methods which are frequently applied for postoperative examination of the implants. Results from published studies employing Scheimpflug photography for examination of anterior chamber angle-fixated, iris-fixated and sulcus-fixated phakic IOLs were evaluated. In several published studies Scheimpflug photography was used to examine the position of the implant and opacification of the crystalline lens. The results provided valuable evidence for the improvement of phakic IOL design. Scheimpflug photography offers an easy to use, rapid non-contact examination of phakic IOLs.

Outcomes of excimer laser enhancements in pseudophakic patients with multifocal intraocular lens

Directory of Open Access Journals (Sweden)

Schallhorn SC

2016-04-01

Full Text Available Steven C Schallhorn,1–3 Jan A Venter,2 David Teenan,2 Julie M Schallhorn,3 Keith A Hettinger,2 Stephen J Hannan,2 Martina Pelouskova2 1Department of Ophthalmology, University of California, San Francisco, CA, USA; 2Optical Express, Glasgow, UK; 3Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA Purpose: The aim of this study was to assess visual and refractive outcomes of laser vision correction (LVC to correct residual refraction after multifocal intraocular lens (IOL implantation. Patients and methods: In this retrospective study, 782 eyes that underwent LVC to correct unintended ametropia after multifocal IOL implantation were evaluated. Of all multifocal lenses implanted during primary procedure, 98.7% were refractive and 1.3% had a diffractive design. All eyes were treated with VISX STAR S4 IR excimer laser using a convectional ablation profile. Refractive outcomes, visual acuities, patient satisfaction, and quality of life were evaluated at the last available visit. Results: The mean time between enhancement and last visit was 6.3±4.4 months. Manifest spherical equivalent changed from -0.02±0.83 D (-3.38 D to +2.25 D pre-enhancement to 0.00±0.34 D (-1.38 D to +1.25 D post-enhancement. At the last follow-up, the percentage of eyes within 0.50 D and 1.00 D of emmetropia was 90.4% and 99.5%, respectively. Of all eyes, 74.9% achieved monocular uncorrected distance visual acuity 20/20 or better. The mean corrected distance visual acuity remained the same before (-0.04±0.06 logMAR [logarithm of the minimum angle of resolution] and after LVC procedure (-0.04±0.07 logMAR; P=0.70. There was a slight improvement in visual phenomena (starburst, halo, glare, ghosting/double vision following the enhancement. No sight-threatening complications related to LVC occurred in this study. Conclusion: LVC in pseudophakic patients with multifocal IOL was safe, effective, and predictable in a large cohort of

Intralenticular metal foreign body: case report Corpo estranho metálico intracristaliniano: relato de caso

Directory of Open Access Journals (Sweden)

Flavio Mac Cord Medina

2006-10-01

Full Text Available Intralenticular foreign bodies comprise about 5% to 10% of all intraocular foreign bodies and can result in serious complications. The management depends on some factors like size, location, material type and the risk of infection. We present a patient with an intralenticular metal foreign body in the left eye that, following initial treatment with topical steroid and antibiotic, underwent lens aspiration with removal of the intralenticular foreign body and insertion of a posterior chamber intraocular lens with good visual outcome.Os corpos estranhos intracristalinianos representam cerca de 5 a 10% de todos os corpos estranhos intra-oculares. A conduta depende de alguns fatores, como: tamanho, localização, tipo de material e probabilidade de infecção. Relatamos um caso de um paciente com um corpo estranho metálico intracristaliniano no olho esquerdo que, após realizar tratamento inicial com esteróide e antibiótico tópicos, submeteu-se à aspiração do cristalino, retirada do corpo estranho e implante de lente intra-ocular com bom resultado visual.

ECTOPIC LENS EXTRACTION IN CHILDREN

Directory of Open Access Journals (Sweden)

Vladimir Pfeifer

2002-12-01

Full Text Available Background. Ectopia lentis continues to be a therapeutic challenge for ophthalmologists. It can occur as an isolated condition, after ocular trauma, in association with other ocular disorders, as part of a systemic mesodermal disease or a complication of general metabolic disorders. Minimal subluxation of the lens may cause no visual symptoms, but in more advanced cases serious optical disturbances arise. The most important is amblyopia. Surgical treatment options include iris manipulation, lens discission, aspiration, intracapsular or extracapsular extraction, and pars plana lensectomy. The choice of surgical technique remains controversial, in part because of the historically poor visual results and high rate of perioperative complications, including vitreous loss and retinal detachment.Methods. We describe a surgical technique based on the use of the Cionni endocapsular tension ring, dry irrigation aspiration of lens material, centration of the capsular bag and foldable intraocular lens implantation into the bag. With mentioned surgical technique 8 patients were operated; 4 boys and 4 girls, together 11 eyes.Results. The final BCVA after follow up period improved in 9 eyes and it remained the same as before operation in one eye. Statistical comparison of preoperative and postoperative visual acuities showed significant improvement. On the other hand there was no correlation between preoperative and postoperative visual acuity.Conclusions. This surgical procedure is an alternative approach in solving this challenging cases of ectopia lentis with good postoperative visual rehabilitation.

A Comparison of the American Society of Cataract and Refractive Surgery post-myopic LASIK/PRK Intraocular Lens (IOL calculator and the Ocular MD IOL calculator

Directory of Open Access Journals (Sweden)

Hsu M

2011-09-01

Full Text Available David L DeMill1, Majid Moshirfar1, Marcus C Neuffer1, Maylon Hsu1, Shameema Sikder21John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA; 2Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USABackground: To compare the average values of the American Society of Cataract and Refractive Surgery (ASCRS and Ocular MD intraocular lens (IOL calculators to assess their accuracy in predicting IOL power in patients with prior laser-in-situ keratomileusis (LASIK or photorefractive keratectomy.Methods: In this retrospective study, data from 21 eyes with previous LASIK or photorefractive keratectomy for myopia and subsequent cataract surgery was used in an IOL calculator comparison. The predicted IOL powers of the Ocular MD SRK/T, Ocular MD Haigis, and ASCRS averages were compared. The Ocular MD average (composed of an average of Ocular MD SRK/T and Ocular MD Haigis and the all calculator average (composed of an average of Ocular MD SRK/T, Ocular MD Haigis, and ASCRS were also compared. Primary outcome measures were mean arithmetic and absolute IOL prediction error, variance in mean arithmetic IOL prediction error, and the percentage of eyes within ±0.50 and ±1.00 D.Results: The Ocular MD SRK/T and Ocular MD Haigis averages produced mean arithmetic IOL prediction errors of 0.57 and –0.61 diopters (D, respectively, which were significantly larger than errors from the ASCRS, Ocular MD, and all calculator averages (0.11, –0.02, and 0.02 D, respectively, all P < 0.05. There was no statistically significant difference between the methods in absolute IOL prediction error, variance, or the percentage of eyes with outcomes within ±0.50 and ±1.00 D.Conclusion: The ASCRS average was more accurate in predicting IOL power than the Ocular MD SRK/T and Ocular MD Haigis averages alone. Our methods using combinations of these averages which, when compared with the individual averages, showed a trend of decreased mean arithmetic IOL

Central Corneal Thickness And Its Relationship To Intra-ocular And Epidemiological Determinants

International Nuclear Information System (INIS)

Tayyab, A.; Masrur, A.

2016-01-01

Objective: To measure central corneal thickness in Pakistani population and determine its relationship to intra-ocular pressure, age, gender and ethnicity. Study Design: Cross-sectional observation study. Place and Duration of Study: Pakistan Institute of Medical Sciences, Islamabad, Pakistan, between December 2013 and February 2015. Methodology: The right eyes of 1000 cases (496 males and 504 females) were recruited for this study. Inclusion criteria were Pashtun or Punjabi ethnicity, intra-ocular pressure < 22 mmHg, gonioscopically open angles, cup-disk-ratio < 0.5, and age matched normal visual fields. Cases with prior ocular surgery, contact lens use, corneal pathologies, myopia or hypermetropia > ±3.0 diopters, astigmatism of > ±1.0 diopters were excluded. Central corneal thickness was measured using a TopCon non-contact specular microscope. Intra-ocular pressure was measured using Goldmann applanation tonometer. Frequency distribution, test of significance, and regression analysis was carried out using Statistical Package for Social Sciences version 20.0. Result: Mean age was 47.31 ±11.78 years. Ethnic composition was 51.6 percentage (n=516) Pashtun and 48.4 percentage (n=484) Punjabi. The mean central corneal thickness was 503.96 (±12.47) meu m, while the mean intra-ocular pressure was 15.61 (±2.68) mmHg. Regression analysis showed a significant association between central corneal thickness and intra-ocular pressure (p=0.00) and age (p=0.00). A ±100 μ change in central corneal thickness was associated with change in IOP of ±3.30 mmHg, whereas central corneal thickness decreased by 0.12 meu m per year. No significant association could be established between central corneal thickness and ethnicity (p=0.19). Conclusion: Central corneal thickness of the studied races was comparable to non-Caucasians which affects intra-ocular pressure measurements, and decreases with increasing age. No relationship was observed between central corneal thickness and

Implantation of refractive multifocal intraocular lens with a surface-embedded near section for cataract eyes complicated with a coexisting ocular pathology.

Science.gov (United States)

Ouchi, M; Kinoshita, S

2015-05-01

To evaluate the postoperative outcomes of cataract eyes complicated with coexisting ocular pathologies that underwent implantation of a refractive multifocal intraocular lens (MIOL) with a surface-embedded near section. LENTIS MPlus (Oculentis GmbH) refractive MIOLs were implanted in 15 eyes with ocular pathologies other than cataract (ie, six high-myopia eyes with an axial length longer than 28 mm, two fundus albipunctatus eyes, two branch retinal-vein occlusion eyes, four glaucoma eyes (one with high myopia), and two keratoconus eyes). Uncorrected or corrected distance and near visual acuity (VA) (UDVA, UNVA, CDVA, and CNVA), contrast sensitivity, and defocus curve were measured at 1 day and 6 months postoperatively, and each patient completed a 6-month postoperative questionnaire regarding vision quality and eyeglass use. Thirteen eyes (87%) registered 0 or better in CDVA and 12 eyes (73%) registered better than 0 in CNVA. Contrast sensitivity in the eyes of all patients was comparable to that of normal healthy subjects. No patient required eyeglasses for distance vision, but three patients (20%) required them for near vision. No patient reported poor or very poor vision quality. With careful case selection, sectorial refractive MIOL implantation is effective for treating cataract eyes complicated with ocular pathologies.

Novel Technique to Overcome the Nonavailability of a Long Needle 9-0 Polypropylene Suture for Sutured Scleral Fixation of the Posterior Chamber Intraocular Lens Using a Single Fisherman’s Knot

Directory of Open Access Journals (Sweden)

Yong Un Shin

2017-01-01

Full Text Available Purpose. To describe a method to overcome the nonavailability of a long needle 9-0 polypropylene suture for sutured scleral fixation of the posterior chamber intraocular lens (PC-IOL using a single fisherman’s knot (SFK. Methods. First, a 10-0 polypropylene suture was passed from the sclera to the ciliary sulcus using a long needle. A 9-0 suture was tied to the unpassed portion of the 10-0 suture with an SFK. We pulled the 10-0 suture to pass the SFK through the sclera, and then we cut the knot and removed the 10-0 suture. IOL fixation with 9-0 sutures used the conventional techniques used for sutured scleral-fixated IOL. Preoperative and postoperative visual acuity, corneal astigmatism, and endothelial cell count and intraoperative/postoperative complications were evaluated. Results. An SFK joining the two sutures was passed through the sclera without breakage or slippage. A total of 35 eyes from 35 patients who underwent sutured scleral fixation of the IOL. An intraoperative complication (minor intraocular hemorrhage was recorded in four cases. Knot exposure, IOL dislocation, subluxation, and retinal detachment were not observed. Conclusions. The SFK offers the opportunity to use 9-0 sutures for the long-term safety and may not require the surgeon to learn any new technique.

Clinical features of secondary glaucoma caused by lens suspensory ligament laxity or occult subluxation

Directory of Open Access Journals (Sweden)

Yi Ma

2018-04-01

Full Text Available AIM: To investigate the clinical characteristics of secondary glaucoma caused by lens suspensory ligament laxity or occult subluxation, and to analyze the influence of operation on visual acuity and intraocular pressure(IOP. METHODS: Totally 38 cases(38 eyesof the secondary glaucoma caused by lens suspensory ligament laxity or occult subluxation in ophthalmology department of our hospital from December 2014 to December 2016 were enrolled and their medical records were analyzed retrospectively to observe the clinical characteristics of glaucoma. Preoperative mydriasis was carried out and surgical methods were chosen according to the lenses location and extent of suspensory ligament. Preoperative and postoperative anterior chamber depth, corneal endothelial cell density, IOP, visual field, visual acuity and complications were analyzed. RESULTS: The average intraocular pressure was 18.17±1.43mmHg at postoperatively 10d, which was significantly lower than 38.77±2.45mmHg before operation, the difference had statistical significance(PP>0.05. The postoperative anterior chamber depth was 2.45±0.44mm, which was significantly higher than 1.23±0.35mm before operation, the difference had statistical significance(P2 and decreased significantly, compared with 1735.32±340.32/mm2 before operation, the difference had statistical significance(PCONCLUSION: Clinical symptoms and signs of secondary glaucoma in patients with lens suspensory ligament laxity or occult subluxation are more complex, which needs to be distinguished with other types of glaucoma in clinical treatment, and its surgical methods shall be chosen according to different suspensory ligament site and lens subluxation scope.

A model for predicting sulcus-to-sulcus diameter in posterior chamber phakic intraocular lens candidates: correlation between ocular biometric parameters.

Science.gov (United States)

Ghoreishi, Mohammad; Abdi-Shahshahani, Mehdi; Peyman, Alireza; Pourazizi, Mohsen

2018-02-21

The aim of this study was to determine the correlation between ocular biometric parameters and sulcus-to-sulcus (STS) diameter. This was a cross-sectional study of preoperative ocular biometry data of patients who were candidates for phakic intraocular lens (IOL) surgery. Subjects underwent ocular biometry analysis, including refraction error evaluation using an autorefractor and Orbscan topography for white-to-white (WTW) corneal diameter and measurement. Pentacam was used to perform WTW corneal diameter and measurements of minimum and maximum keratometry (K). Measurements of STS and angle-to-angle (ATA) were obtained using a 50-MHz B-mode ultrasound device. Anterior optical coherence tomography was performed for anterior chamber depth measurement. Pearson's correlation test and stepwise linear regression analysis were used to find a model to predict STS. Fifty-eight eyes of 58 patients were enrolled. Mean age ± standard deviation of sample was 28.95 ± 6.04 years. The Pearson's correlation coefficient between STS with WTW, ATA, mean K was 0.383, 0.492, and - 0.353, respectively, which was statistically significant (all P correlation of STS with WTW and mean K and potential of direct and essay measurement of WTW and mean K, it seems that current IOL sizing protocols could be estimating with WTW and mean K.

Does the apodized diffractive intraocular lens Acrysof ReSTOR NaturalTM interfere with FDT Matrix perimetry results? A lente difrativa apodizada Acrysof ReSTOR NaturalTM pode interferir nos resultados da perimetria por FDT Matrix?

Directory of Open Access Journals (Sweden)

Karine Duarte Bojikian

2009-12-01

Full Text Available PURPOSE: To compare the effect of an apodized diffractive intraocular lens (IOL (Acrysof ReSTOR NaturalTM and its yellow counterpart (Natural IQ TM on frequency doubling technology (FDT perimetry results. METHODS: This study included 37 eyes from 22 patients at the "Centro Oftalmológico Tranjan" who had undergone uncomplicated phacoemulsification and intraocular lens implantation (17 Acrysof ReSTOR NaturalTM, 20 Natural IQ TM performed by the same surgeon, at least three months prior to the study. Patients were subject to frequency doubling technology Matrix Perimeter testing. RESULTS: The patients were between 41 to 79 years old (mean, 70.78 ± 9.83 in the Natural IQ TM and 49 to 81 years old (mean, 67.11± 11.48 in the Acrysof ReSTOR NaturalTM group, and the mean IOP was 13.64 ± 2.02 mmHg in the Natural IQ TM 12.94 ± 1.39 mmHg in the Acrysof ReSTOR NaturalTM group. The mean pupillary diameter under scotopic conditions was 6.63 ± 1.16 mm in the Natural IQ TM group and 7.20 ± 1.8 mm in the Acrysof ReSTOR NaturalTM group (p=0.20. The mean deviation was -1.83 ± 3.46 dB in the Natural IQ TM group and -1.77 ± 3.94 dB in the Acrysof ReSTOR NaturalTM group (p=0.28. The pattern standard deviation was 3.49 ± 0.79 dB in the Natural IQ TM group and 3.20 ± 0.86 dB in the Acrysof ReSTOR NaturalTM group (p=0.27. CONCLUSION: There was no difference in the results of FDT Matrix perimetry in eyes that received apodized diffractive IOLs implant or eyes that received monofocal intraocular lens implant.OBJETIVO: Comparar o efeito da lente difrativa apodizada (Acrysof ReSTOR NaturalTM e da lente de mesma plataforma amarela (Natural IQ TM sobre os resultados da perimetria de dupla frequência (FDT. MÉTODOS: O estudo incluiu 37 olhos de 22 pacientes do Centro Oftalmológico Tranjan que foram submetidos a cirurgia de facoemulsificação e implante de lentes intraoculares (17 Acrysof ReSTOR NaturalTM, 20 Natural IQ TM sem complicações, realizadas pelo mesmo

Clinical Evaluation of Functional Vision of +1.5 Diopters near Addition, Aspheric, Rotational Asymmetric Multifocal Intraocular Lens.

Science.gov (United States)

Kretz, Florian Tobias Alwin; Khoramnia, Rahmin; Attia, Mary Safwat; Koss, Michael Janusz; Linz, Katharina; Auffarth, Gerd Uwe

2016-10-01

To evaluate postoperative outcomes and visual performance in intermediate distance after implantation of a +1.5 diopters (D) addition, aspheric, rotational asymmetric multifocal intraocular lens (MIOL). Patients underwent bilateral cataract surgery with implantation of an aspheric, asymmetric MIOL with +1.5 D near addition. A complete ophthalmological examination was performed preoperatively and 3 months postoperatively. The main outcome measures were monocular and binocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), distance corrected intermediate visual acuity (DCIVA), uncorrected near visual acuity (UNVA) and distance corrected keratometry, and manifest refraction. The Salzburg Reading Desk was used to analyze unilateral and bilateral functional vision with uncorrected and corrected reading acuity, reading distance, reading speed, and the smallest log-scaled print size that could be read effectively at near and intermediate distances. The study comprised 60 eyes of 30 patients (mean age, 68.30 ± 9.26 years; range, 34 to 80 years). There was significant improvement in UDVA and CDVA. Mean UIVA was 0.01 ± 0.09 logarithm of the minimum angle of resolution (logMAR) and mean DCIVA was -0.02 ± 0.11 logMAR. In Salzburg Reading Desk analysis for UIVA, the mean subjective intermediate distance was 67.58 ± 8.59 cm with mean UIVA of -0.02 ± 0.09 logMAR and mean word count of 96.38 ± 28.32 words/min. The new aspheric, asymmetric, +1.5 D near addition MIOL offers good results for distance visual function in combination with good performance for intermediate distances and functional results for near distance.

The effect of blue-blocking and neutral intraocular lenses on circadian photoentrainment and sleep one year after cataract surgery

DEFF Research Database (Denmark)

Brøndsted, Adam Elias; Haargaard, Birgitte; Sander, Birgit

2017-01-01

surgery with implantation of either a neutral or a blue-blocking intraocular lens (IOL). Main outcome was activation of the intrinsically photosensitive retinal ganglion cells (ipRGC) measured by chromatic pupillometry. The circadian rhythm was analysed by 24-hr melatonin profiles and actigraphy......PURPOSE: To compare the long-term effect on circadian photoentrainment and sleep in patients implanted with neutral and blue-blocking intraocular lenses 1 year after cataract surgery. METHODS: Randomized, controlled trial involving 67 patients with age-related cataract. Intervention was cataract...... compared with neutral IOLs. Cataract surgery improved the response of ipRGCs and sleep quality. However, the effect of cataract surgery on sleep quality may be unrelated to circadian photoentrainment....

Molecular characterization and potential sources of aqueous humor bacterial contamination during phacoemulsification with intraocular lens implantation in dogs.

Science.gov (United States)

Lacerda, Luciana C C; de Souza-Pollo, Andressa; Padua, Ivan Ricardo M; Conceição, Luciano F; da Silveira, Camila P Balthazar; Silva, Germana A; Maluta, Renato P; Laus, José L

2018-01-01

Bacterial contamination of the anterior chamber during cataract surgery is one of the main responsible for endophthalmitis postoperative. Phacoemulsification is a less invasive technique for cataract treatment, although it does not exclude the possibility of contamination. In this study, bacterial contaminants of aqueous humor collected pre- and post-phacoemulsification with intraocular lens implantation (IOL) of twenty dogs were identified. As the conjunctival microbiota constitute a significant source of anterior chamber contamination, bacterial isolates from aqueous humor were genetically compared with those present in the conjunctival surface of the patients. Three dogs presented bacterial growth in both aqueous humor and conjunctival surface samples. Bacterial isolates from these samples were grouped according to their genetic profiles by repetitive-element PCR (rep-PCR) and their representatives were identified by 16S rRNA sequencing. Isolates from conjunctival surface were identified as Enterobacter spp., Staphylococcus spp. and S. aureus; and from aqueous humor samples as Enterobacter spp., Pantoea spp., Streptococcus spp. and Staphylococcus spp., respectively in decreasing order of prevalence. According to the rep-PCR analysis, 16.6% of Enterobacter spp. isolates from conjunctival surface were genetically similar to those from aqueous humor. The rest of isolates encountered in aqueous humor were genetically distinct from those of conjunctival surface. The significant genetic diversity of bacterial isolates found in the aqueous humor samples after surgery denoted the possibility of anterior chamber contamination during phacoemulsification by bacteria not only from conjunctival surface but also from different sources related to surgical environment. Copyright © 2017 Elsevier B.V. All rights reserved.

Accidental injections of dexamethasone intravitreal implant (Ozurdex) into the crystalline lens.

Science.gov (United States)

Coca-Robinot, Javier; Casco-Silva, Bruno; Armadá-Maresca, Felix; García-Martínez, Jesús

2014-01-01

To describe the side effects and management after inadvertent injection of a dexamethasone implant (Ozurdex) into the crystalline lens. Two case reports. Two patients with macular edema due to unilateral retinal vein occlusion were scheduled for an intravitreal injection of Ozurdex. During the procedure, the implant was accidentally injected into the crystalline lens. Both patients developed cataracts during the course of several weeks and in both there was an intraocular pressure (IOP) increase, which required treatment with topical hypotensives. Macular edema improved only slightly. Cataract surgery with uneventful removal of the implant was performed 3 (case 1) and 6 months (case 2) after the injection. After inadvertent injection of Ozurdex into the crystalline lens, cataract surgery with removal of the implant should be performed as soon as possible in order to avoid IOP increase and so that the underlying condition may be treated adequately.

Bilateral implantation of +2.5 D multifocal intraocular lens and contralateral implantation of +2.5 D and +3.0 D multifocal intraocular lenses: Clinical outcomes

NARCIS (Netherlands)

Nuijts, Rudy M. M. A.; Jonker, Soraya M. R.; Kaufer, Robert A.; Lapid-Gortzak, Ruth; Mendicute, Javier; Martinez, Cristina Peris; Schmickler, Stefanie; Kohnen, Thomas

2016-01-01

To assess the clinical visual outcomes of bilateral implantation of Restor +2.5 diopter (D) multifocal intraocular lenses (IOLs) and contralateral implantation of a Restor +2.5 D multifocal IOL in the dominant eye and Restor +3.0 D multifocal IOL in the fellow eye. Multicenter study at 8

Rotationally asymmetric multifocal IOL implantation with and without capsular tension ring: refractive and visual outcomes and intraocular optical performance.

Science.gov (United States)

Alió, Jorge L; Plaza-Puche, Ana B; Piñero, David P

2012-04-01

To ascertain whether the refractive, visual, and intraocular optical quality outcomes of a rotationally asymmetric multifocal intraocular lens (IOL) are enhanced by the use of a capsular tension ring. Ninety consecutive eyes from 53 patients (age range: 36 to 82 years) were divided into two groups: the no ring group comprised 43 eyes implanted with the multifocal rotationally asymmetric Lentis Mplus LS-312 (Oculentis GmbH) without a capsular tension ring; and the ring group comprised 47 eyes with the same IOL with a capsular tension ring. Distance and near visual acuity and refractive outcomes were evaluated pre- and postoperatively. Contrast sensitivity, intraocular aberrations, and defocus curve were evaluated postoperatively. Significant postoperative differences between groups were found in sphere, spherical equivalent refraction, and near addition (P<.02). Regarding defocus curve, significantly better visual acuity was present in eyes with the capsular tension ring for intermediate vision conditions (P<.05). Intraocular aberrometry did not differ significantly between groups (P<.09). Refractive predictability and intermediate visual outcomes with the Lentis Mplus LS-312 IOL improved significantly when implanted in combination with a capsular tension ring. Copyright 2012, SLACK Incorporated.

Glass molding of 3mm diameter aspheric plano-convex lens

Science.gov (United States)

Sung, Hayeong; Hue, Myung sang; Lee, Giljae; Ryu, Geunman; Kim, Dongguk; Yang, Suncheol

2017-10-01

The many industries and research fields have demands for small scale optical systems. To satisfy the demands, many studies are conducted and the miniaturization technologies have been developed. The optical lens is directly related to the optical systems and a key component for the miniaturization. So the aspheric surface which can replace multispherical lenses is applied to the optical lens. And fabrication methods to reduce the diameter of the lens have been developed. The glass molding pressing (GMP) process is an attractive method to fabricate aspheric lens among the lens manufacturing processes. Because the GMP process has advantages of productivity, repeatability and so on. In this study, a 3 mm diameter aspheric plano-convex lens was fabricated using the GMP process. The GMP process was divided into heating, pressing, annealing and cooling. And the process was conducted using a commercial glass molding machine. Mold tools consist of an upper and a lower mold insert, an inner and an outer guide. The aspheric and the flat surfaces of the mold inserts were coated with ta-C to prevent the sticking of the glass to the mold. The surfaces of molded lens were measured by white interferometry and surface profilometer. The height and the diameter were measured using optical microscopy. As results, the aspheric surface of the lens was 5.1187 nm in Ra and 0.242 um in Pt. And the flat surface was 2.6697 nm in Ra and 0.13 um in Pt. The height and the diameter were 1.935 mm and 3.002 mm respectively.

Ocular discomfort responses after short periods of contact lens wear.

Science.gov (United States)

Papas, Eric; Tilia, Daniel; McNally, John; de la Jara, Percy Lazon

2015-06-01

To investigate if contact lens-related discomfort is a function of the time of day at which lenses are worn. This was a randomized, crossover, open-label clinical trial where subjective responses, with and without contact lenses, were assessed every 2 hours during five stages (A to E). Each stage began at the time when subjects would normally have inserted their contact lenses (T0). During stage A, no lenses were worn, whereas in stage B, lenses were worn continuously for 12 hours. In stages C to E, lenses were worn for only 4 hours. Contact lenses were inserted at T0 for stage C, but for stages D and E, lenses were not inserted until T0 + 4 and T0 + 8 hours, respectively. Mixed linear models were used for statistical analysis. In the absence of contact lenses, ocular comfort and dryness remained reasonably constant throughout the observation period. Ocular comfort and dryness decreased during 12 hours of continuous lens wear and became significantly worse from the 8-hour time onward compared with insertion (p 0.05) to the first 4 hours of continuous contact lens wear. Comparing the scores of each of these stages with the no-lens response at the corresponding time showed no significant differences for comfort (p > 0.23) or dryness (p > 0.37). Short periods of wear can be experienced at any time of day without significant change in ocular discomfort and dryness. This suggests that subjective responses at the end of the day are determined by the length of time lenses are in contact with the eye, rather than the time of day at which lenses are worn.

A Rapid and Convenient Procedure to Evaluate Optical Performance of Intraocular Lenses

Directory of Open Access Journals (Sweden)

Frank Schaeffel

2014-09-01

Full Text Available A new portable lens scanner was developed and tested for measuring focal lengths and relative contrast transfer of mono- and multifocal intraocular lenses (IOLs. A photograph of a natural scene was imaged in white light through an IOL in a water-filled cuvette, with their +21D base power largely neutralized by a −20D trial lens, using a USB monochrome video camera that could be focused via a laptop-controlled stepping motor from −8.5 to + 8.0D. The output of 10000 ON-OFF antagonistic “receptive fields” measuring the video image with adjustable diameter was continuously recorded by custom written software to quantify focus and relative contrast. Six monofocal and four multifocal IOLs, as well as two radial refractive gradient (RRG lenses were measured. After calibration with trial lenses the optical powers and relative contrast transfer of mono- and multifocal IOLs were readily measured. Refractive power profiles measured in RRG lenses closely matched data obtained from the manufacturer. The lens scanner uses a rapidly operating procedure, is portable and can be used to verify positions of the focal planes of mono- and multifocal IOLs in less than 3 s.

Phakic intraocular lenses for the treatment of refractive errors: an evidence-based analysis.

Science.gov (United States)

2009-01-01

.6 per 10,000 people in Canada have low vision. The 2001 Participation and Activity Limitation Survey (PALS) found that 594,350 (2.5%) Canadians had "difficulty seeing ordinary newsprint or clearly seeing the face of someone from 4 m," and the Canadian National Institute for the Blind (CNIB) registry classified 105,000 (.35%) Canadians as visually disabled. PHAKIC INTRAOCULAR LENSES (PIOL): A phakic intraocular lens (pIOL) is a supplementary lens that is inserted into the anterior or posterior chamber of the eye to correct refractive errors (myopia, hyperopia, and astigmatism). Unlike in cataract surgery, the eye's natural crystalline lens is not removed when the pIOL is inserted, so the eye retains its accommodative ability. In Canada and the United States, iris-fixated (anterior chamber lenses that are anchored to the iris with a claw) and posterior chamber lenses are the only types of pIOLs that are licensed by Health Canada and the Food and Drug Administration, respectively. EVIDENCE-BASED ANALYSIS METHOD: RESEARCH QUESTIONS #ENTITYSTARTX00026; What are the effectiveness, cost-effectiveness, and safety of pIOLs for the treatment of myopia, hyperopia, and astigmatism?Do certain subgroups (e.g. high myopia and low vision) benefit more from pIOLs?How do pIOLs compare with alternative surgical treatment options (LASIK, PRK, and CLE)?Using appropriate keywords, a literature search was conducted up to January 2009. Systematic reviews, meta-analyses, randomized controlled trials, and observational studies with more than 20 eyes receiving pIOLs were eligible for inclusion. The primary outcomes of interest were uncorrected visual acuity (UCVA), predictability of manifest refraction spherical equivalent (MRSE), and adverse events. The GRADE approach was used to systematically and explicitly evaluate the quality of evidence. The search identified 1,131 citations published between January 1, 2003, and January 16, 2009. Including a health technology assessment (HTA) identified in

Thermal lens measurements in the cornea.

Science.gov (United States)

Venkatesh, S; Guthrie, S; Cruickshank, F R; Bailey, R T; Foulds, W S; Lee, W R

1985-02-01

Q-switched pulses from a neodymium/YAG (yttrium-aluminium-garnet) laser were passed through corneal discs taken from the enucleated eyes of three baboons and four rabbits. The time course of heat dissipation following absorption of laser energy by the tissue was studied with the use of a second continuous wave laser beam acting as a probe. It was found that the absorption of each neodymium/YAG pulse created a transient divergent lens within the cornea as theoretical considerations predicted. The relaxation time that characterised the decay of this thermal lens for a 1/e laser beam diameter of 2.0 mm was found to be 2.3 +/- 0.1 s (mean +/- standard error for 12 separate groups of measurements). Our results show that Q-switched laser pulses passing through apparently unaffected transparent tissues can induce thermal lens effects which persist for several seconds. The optical transfer of each pulse in a stream will be identical only if enough time is left between pulses for the tissues to return to their initial state. Therefore, when such laser pulses sharply focused to perform high precision intraocular surgery are used, thermal lensing in the transparent ocular media must limit the rate at which pulses can be usefully delivered.

Assessment of visual function based on IOL-Master comparing with traditional ultrasonic biometry for intraocular lens calculation in high myopia patients

Directory of Open Access Journals (Sweden)

Lu Zhang

2013-10-01

Full Text Available AIM: To evaluate the clinical feasibility of using a new optical coherence interferometry(IOL-Master, comparing with traditional ultrasonic biometry and manual keratometry in the accuracy and characteristics for intraocular lens calculation of high myopia.METHODS: The measurement of axial length was performed in 60 eyes(30 eyes for each groupwith senile cataract of high myopia(≥-6.00Dusing IOL-Master and ultrasonic biometry. The measurement of corneal power(Kwas also performed in the patient using IOL-Master and manual keratometry preoperatively. Phacoemulsification and foldable lens implantation were done on the patients. IOL power calculation was carried out according to the SRK/T formula on the basis of the group-related data. Best corrected visual acuity, refraction, contrast sensitivity and wave front aberration root mean square(RMSwere re-tested after 3 months postoperatively.RESULTS: Significant difference between the two methods in axial length measurement which was 29.81±1.53mm by ultrasound and 29.63±1.81mm by IOL-Master(P=0.001. And in corneal power measurement which was 43.22±1.67K by manual keratometry and 44.27±1.39K by IOL-Master(P=0.006. There was a significant difference between the two groups(P=0.001. 63.0% vs 31.2% had a mean absolute refractive error(MAREwithin ±0.50 diopter for the IOL-Master and A-scan groups, respectively(χ2=3.1, Pth order aberration, 4th order spherical aberration and total high order aberration in the IOL-Master group were lower than those in the A-scan group at 6mm pupil diameter 3 months later. CONCLUSION: IOL-Master is a non-contact, accurate, safe and reliable tool for calculating IOL power and it is more accurate on the design of the IOL in the cataract surgery on the high myopia patients.

Aderência in vitro do Staphylococcus epidermidis e da Pseudomonas alcaligenes em lentes intra-oculares In vitro adherence of Staphylococcus epidermidis and Pseudomonas alcaligenes to intraocular lenses

Directory of Open Access Journals (Sweden)

Patrícia Ioschpe Gus

2006-06-01

used in the experiment. Four of polymethylmethacrylate (PMMA, four of silicone, four of hidrogel and two of acrylic. Eight intraocular lenses were placed in eight test tubes containing 4 ml of Pseudomonas alcaligenes suspension, and six intraocular lenses were placed in six test tubes containing 4 ml of Staphylococcus epidermidis suspension. The bacterial suspension used for adherence tests was 10(8 colony-forming units per milliliter (CFU/mL which corresponds to 0.5 in the scale of McFarland. The lenses were incubated at 37° for two hours. After this, intraocular lenses were removed from the test tubes and dried twice with the use of distilled and sterile water. The material was spread on blood-agar for cultivation at 35-37°C and was evaluated every 24 hours up to 72 hours. In the samples where there was bacterial growth, the colonies were counted using the conventional laboratory methods. All assays were performed in duplicate. RESULTS: Adherence of Staphylococcus epidermidis to PMMA intraocular lenses was lower than to hydrogel and silicone intraocular lenses. Adherence of Pseudomonas alcaligenes to hydrogel intraocular lenses was lower than to PMMA, acrylic and silicone intraocular lenses. CONCLUSIONS: Results suggest that in vitro adherence of Staphylococcus epidermidis and Pseudomonas alcaligenes to intraocular lenses is influenced by type of material of the lens and by microorganism species. Bacterial adherence may play a role in the pathogenesis of some forms of endophthalmitis after cataract surgery. More in vitro and clinical studies are necessary to elucidate the mechanisms by which Staphylococcus epidermidis and Pseudomonas alcaligenes cause endophthalmitis.

Clinical application of capsular tension ring on cataract surgery in patients with pseudoexfoliation syndrome after trabeculectomy

Directory of Open Access Journals (Sweden)

Yi Zhang

2014-09-01

Full Text Available AIM:To investigate the safety and efficacy of capsular tension ring(CTRinsertion combined with phacoemulsification and intraocular lens(IOLimplantation in patient with pseudoexfoliation syndrome after anti-glaucoma surgery.METHODS: A retrospective study was conducted of 10 eyes from 10 cataract patients with pseudoexfoliation syndrome following trabeculectomy surgery, and who underwent CTR insertion combined with phacoemulsification and IOL implantation between January, 2012 and June, 2013. All cases had nuclear cataracts(nuclear hardness Ⅱ 1 eye, nuclear hardness Ⅲ 4 eyes, nuclear hardness Ⅳ 5 eyes. One case with Ⅳ nuclear hardness cataract had iridodonesis and lens subluxation. Postoperative visual acuity, intra- and post-operative complications, anterior capsular opening, IOL position, and postoperative intraocular pressure(IOPwere assessed. Follow-ups ranged from 3 to 14mo. The t test was used to analyze the variables studied.RESULTS: All patients had a successful CTR insertion combined with phacoemulsification and IOL implantation. A modified CTR insertion was performed in one case, the others underwent a standard CTR insertion. The best corrected visual acuity(BCVAwas ≥0.5 in 3 eyes and 0.3-t=1.9955, P>0.05. The most common intrao- and post-operative complications were corneal edema, small pupil, residual cortex, spontaneous zonular dialysis.CONCLUSION: Suitable CTR insertion in appropriate occasion may be beneficial to patients with pseudoexfoliation syndrome after trabeculectomy during cataract surgery. It prevents the IOL decentration and decrease the surgical complication. Less complication occurs at the early stage.

Comparison of axial length, anterior chamber depth and intraocular lens power between IOLMaster and ultrasound in normal, long and short eyes.

Science.gov (United States)

Dong, Jing; Zhang, Yaqin; Zhang, Haining; Jia, Zhijie; Zhang, Suhua; Wang, Xiaogang

2018-01-01

To compare the axial length (AL), anterior chamber depth (ACD) and intraocular lens power (IOLP) of IOLMaster and Ultrasound in normal, long and short eyes. Seventy-four normal eyes (≥ 22 mm and ≤ 25 mm), 74 long eyes (> 25 mm) and 78 short eyes (devices in the order of IOLMaster followed by Ultrasound. The IOLP were calculated using a free online LADAS IOL formula calculator. The difference in AL and IOLP between IOLMaster and Ultrasound was statistically significant when all three groups were combined. The difference in ACD between IOLMaster and Ultrasound was statistically significant in the normal group (Peye group (Peye group (P = 0.465). For the IOLP difference between IOLMaster and Ultrasound in the normal group, the percentage of IOLP differences eye group, they were 90.5%, 5.4%, 4.1% and 0%, respectively. For the short eye group, they were 61.5%, 23.1%, 10.3%, and 5.1%, respectively. IOLMaster and Ultrasound have statistically significant differences in AL measurements and IOLP (using LADAS formula) for normal, long eye and short eye. The two instruments agree regarding ACD measurements for the long eye group, but differ for the normal and short eye groups. Moreover, the high percentage of IOLP differences greater than |0.5|D in the short eye group is noteworthy.

The effect of hydrogel and silicone hydrogel contact lenses on the measurement of intraocular pressure with rebound tonometry.

Science.gov (United States)

Zeri, Fabrizio; Calcatelli, Paolo; Donini, Bernardo; Lupelli, Luigi; Zarrilli, Luciana; Swann, Peter G

2011-12-01

To assess the accuracy of intraocular pressure (IOP) measurements using rebound tonometry over disposable hydrogel (etafilcon A) and silicone hydrogel (senofilcon A) contact lenses (CLs) of different powers. The experimental group comprised 36 subjects (19 male, 17 female). IOP measurements were undertaken on the subject's right eyes in random order using a rebound tonometer (ICare). The CLs had powers of +2.00D, -2.00D and -6.00D. Six measurements were taken over each contact lens and also before and after the CLs had been worn. A good correlation was found between IOP measurements with and without CLs (all r≥0.80; pContact Lens Association. Published by Elsevier Ltd. All rights reserved.

Secondary Angle Closure due to Crystalline Lens Dislocation in a Patient with Atopic Dermatitis and Chronic Eye Rubbing

Directory of Open Access Journals (Sweden)

Justin Kuiper

2018-03-01

Full Text Available Purpose: To report an unusual case of ectopia lentis and angle closure in a patient with chronic eye rubbing. Methods: A 57-year-old male with a history of poorly controlled atopic dermatitis presented with right eye pain, decreased vision, and an intraocular pressure (IOP of 55 mm Hg. He had no past history of ocular disease and no reported history of trauma. He did report a history of chronic eye rubbing. Results: Best corrected visual acuity was hand motions. The examination revealed severe atopic keratoconjunctivitis in both eyes, microcystic corneal edema of the right eye, and 2+ nuclear sclerosis in both eyes. Gonioscopy showed no visible angle structures OD and an open angle OS. Topical and oral IOP-lowering medications and a laser iridotomy were unsuccessful at lowering IOP. He was taken to the operating room for a lensectomy and was found to have 9 clock hours of zonular dehiscence and a dislocated lens. After lensectomy, the IOP improved to 9 mm Hg on postoperative day 1. A follow-up examination at 2 weeks showed improved acuity to 20/150 with a pinhole and an IOP of 10 mm Hg. A dilated examination OS did not reveal significant phacodonesis, and the patient was referred for a possible sutured sulcus lens or anterior chamber intraocular lens. Conclusions: It is important for the provider to consider ectopia lentis in the differential for patients with pupillary block angle closure. For patients with atopic disease, one should be aware that eye rubbing may be a cause of zonular dehiscence, even in the absence of reported trauma or prior intraocular surgery.

Clinical and optical intraocular performance of rotationally asymmetric multifocal IOL plate-haptic design versus C-loop haptic design.

Science.gov (United States)

Alió, Jorge L; Plaza-Puche, Ana B; Javaloy, Jaime; Ayala, María José; Vega-Estrada, Alfredo

2013-04-01

To compare the visual and intraocular optical quality outcomes with different designs of the refractive rotationally asymmetric multifocal intraocular lens (MFIOL) (Lentis Mplus; Oculentis GmbH, Berlin, Germany) with or without capsular tension ring (CTR) implantation. One hundred thirty-five consecutive eyes of 78 patients with cataract (ages 36 to 82 years) were divided into three groups: 43 eyes implanted with the C-Loop haptic design without CTR (C-Loop haptic only group); 47 eyes implanted with the C-Loop haptic design with CTR (C-Loop haptic with CTR group); and 45 eyes implanted with the plate-haptic design (plate-haptic group). Visual acuity, contrast sensitivity, defocus curve, and ocular and intraocular optical quality were evaluated at 3 months postoperatively. Significant differences in the postoperative sphere were found (P = .01), with a more myopic postoperative refraction for the C-Loop haptic only group. No significant differences were detected in photopic and scotopic contrast sensitivity among groups (P ⩾ .05). Significantly better visual acuities were present in the C-Loop haptic with CTR group for the defocus levels of -2.0, -1.5, -1.0, and -0.50 D (P ⩽.03). Statistically significant differences among groups were found in total intraocular root mean square (RMS), high-order intraocular RMS, and intraocular coma-like RMS aberrations (P ⩽.04), with lower values from the plate-haptic group. The plate-haptic design and the C-Loop haptic design with CTR implantation both allow good visual rehabilitation. However, better refractive predictability and intraocular optical quality was obtained with the plate-haptic design without CTR implantation. The plate-haptic design seems to be a better design to support rotational asymmetric MFIOL optics. Copyright 2013, SLACK Incorporated.

The Relationship between Anterior Chamber Depth, Axial Length and Intraocular Lens Power among Candidates for Cataract Surgery.

Science.gov (United States)

Sedaghat, Mohammad Reza; Azimi, Ali; Arasteh, Peyman; Tehranian, Naghmeh; Bamdad, Shahram

2016-10-01

Basic anatomical parameters in ophthalmology are variable in different countries according to ethnic groups, genetics and some environmental factors. The aim of this study was to determine the relationship between axial length (AL), anterior chamber depth (ACD) and intraocular lens power (IOL) in a referral center from eastern Iran among patients who had cataract surgery, in comparison to studies from other regions of the world. In a cross-sectional retrospective study from 2011 to 2013, the records of 698 cataract patients referring to Khatam Al Anbia general hospital in Mashhad, Iran were evaluated. We divided patients, based on their AL and ACD, into three separate groups and compared their results. The SPSS software was used for data analysis. The Chi-Square test and the Independent-samples t-test were used to compare qualitative and quantitative data between two groups, respectively. The Kendall and the Pearson product-moment correlation tests were used to assess the relationship between AL and ACD. The linear Regression model was used to obtain a mathematical model to estimate ACD, using AL, age and sex. Among individuals who had normal AL (between 22-24.5mm), there was a positive correlation between AL and ACD (p24.5mm), no significant correlation was detected. We also found that older people have shorter AL (p=0.001 and r=-0.287). Men have an average longer AL (23.7±2.4mm vs. 22.9±2.1mm; pworld and although some anatomical variations may exist regarding ophthalmic anatomy, factors like race and geographical area have little effect on the relationship between ACD, AL and IOL power calculation, furthermore our results support the use of third and fourth generation formulas for IOL power calculation.

Iris-fixated phakic intraocular lens implantation to correct myopia and a predictive model of endothelial cell loss.

Science.gov (United States)

Bouheraoua, Nacim; Bonnet, Clemence; Labbé, Antoine; Sandali, Otman; Lecuen, Nicolas; Ameline, Barbara; Borderie, Vincent; Laroche, Laurent

2015-11-01

To report long-term results of Artisan phakic intraocular lens (pIOL) to correct myopia and to propose a model predicting endothelial cell loss after pIOL implantation. Quinze-Vingts National Ophthalmology Hospital, Paris, France. Retrospective, interventional case series. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and central endothelial cell count (ECC) were determined before and at yearly intervals up to 5 years after pIOL implantation. Linear model analysis was performed to present a model that describes endothelial cell loss as a linear decrease and an additional decrease depending on postoperative loss. A total of 49 patients (68 eyes) implanted with pIOLs from January 2000 to January 2009 were evaluated. The mean preoperative and final spherical equivalent (SE) were -13 ± 4.10 and -0.75 ± 0.74 diopters (D), respectively. The mean preoperative and final central ECC were 2629 ± 366 and 2250 ± 454 cells/mm(2), respectively. There were no intraoperative complications for any of the eyes. One eye required surgery for repositioning the pIOL, and 1 eye required pIOL exchange for postoperative refractive error. The model predicted that for patients with preoperative ECC of 3000, 2500, and 2000 cells/mm(2), a critical ECC of 1500 cells/mm(2) will be reached at 39, 28, and 15 years after implantation, respectively. Implantation of the pIOL was an effective and stable procedure after 5 years of follow-up. The presented model predicted EC loss after pIOL implantation, which can assist ophthalmologists in patient selection and follow-up. The authors report no conflict of interest. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Desempenho visual após implante de uma lente intraocular asférica multifocal difrativa Visual performance after implantation of an aspheric multifocal diffractive intraocular lens

Directory of Open Access Journals (Sweden)

Leonardo Akaishi

2010-08-01

Full Text Available OBJETIVO: Avaliar a acuidade visual a distancia, intermediária e perto após o implante de uma lente intraocular (LIO asférica multifocal difrativa AcrySof® ReSTOR® SN6AD1. MÉTODOS: Estudo prospectivo de 50 pacientes com catarata submetidos à facoemulsificação e implante de LIO AcrySof® ReSTOR®. Foram avaliados acuidade visual sem correção (AVSC, acuidade visual com correção (AVCC para longe, acuidade visual para perto corrigida para longe (AVPC e acuidade visual intermediária corrigida para longe (AVIC. Um questionário de satisfação e fenômenos visuais foi administrado ao final do estudo. RESULTADO: Após três meses de cirurgia, a média das acuidades (logMAR era: AVSC, 0,05 ± 0,07; AVCC, 0,00 ± 0,01; AVPC, 0,00 ± 0,0, e AVIC, 0,15 ± 0,05. A AVCC e AVPC era de 20/25 ou melhor em todos os pacientes, sendo a AVIC J3 ou melhor em 83% dos pacientes. Pacientes relataram excelente desempenho visual nas questões relacionadas a atividades para distância, intermediário, e perto com pouca ou nenhuma dificuldade. Nenhum paciente relatou halos ou 'glare' severos, sendo os mesmos caracterizados entre nenhum a moderado. CONCLUSÃO: A LIO asférica AcrySof® ReSTOR® SN6AD1 mostrou excelentes resultados na visão para longe, perto e intermediário, além de apresentar uma baixa incidência de fenômenos visuais.PURPOSE: To evaluate distance, intermediate, and near vision after aspheric multifocal diffractive AcrySof® ReSTOR® SN6AD1 intraocular lens (IOL implantation. METHODS: Prospective study of 50 patients with cataract that had phacoemulsification and AcrySof® ReSTOR® IOL implantation. Uncorrected distance vision acuity (UDVA, corrected distance visual acuity (CDVA, distance-corrected near visual acuity (DCNVA, and distance-corrected intermediate visual acuity (DCIVA were measured postoperatively. A patient-satisfaction and visual phenomena questionnaire was administered at the end of the study. RESULTS: Three months

Spiral CT versus conventional CT in the preoperative assessment of metallic intraocular foreign bodies

International Nuclear Information System (INIS)

Prokesch, R.; Bankier, A.; Ba-Ssalamah, A.; Imhof, H.; Lakits, A.; Scholda, C.

1998-01-01

Purpose: To compare the effectiveness of spiral CT versus conventional CT in the preoperative assessment of metallic intraocular foreign bodies. Results: All foreign bodies were detected by each scanning modality on the axial and on the reconstructed planes. The quality of the axial images was similar for spiral and conventional CT. The spiral technique provided high-quality reconstructed images which allowed accurate localization of the foreign bodies in all cases. Reconstructions by conventional technique were inadequate for preoperative assessment. The examination time for the total orbital volume was 18 s for spiral CT and 52 s for conventional CT. Radiation dose delivered to the lens was 35 mGy for spiral CT and 56 mGy for conventional CT axial scanning. Conclusion: Spiral CT multiplanar offers several significant advantages for the preoperative assessment of metallic intraocular foreign bodies compared to the conventional CT technique in clinical practice, including short examination time, minimized motion artifacts, reduced radiation exposure, and accurate localization. (orig.) [de

The Effects of Phacoemulsification and Intraocular Lens Implantation on Anatomical and Functional Parameters in Patients with Primary Angle Closure: A Prospective Study. (An American Ophthalmological Society Thesis).

Science.gov (United States)

Traverso, Carlo Enrico; Cutolo, Carlo Alberto

2017-08-01

To investigate the clinical, anatomical, and patient-reported outcomes of phacoemulsification (PE) with intraocular lens implantation performed to treat primary angle closure (PAC) and primary angle-closure glaucoma (PACG). Patients were evaluated at baseline and at 6 months after PE. The examination included visual acuity, intraocular pressure (IOP), visual field, optic nerve head, endothelial cell count (ECC), aqueous depth, and ocular biometric parameters. Patient-reported visual function and health status were assessed. Coprimary outcome measures were IOP changes, angle widening, and patient-reported visual function; secondary outcome measures were visual acuity changes, use of IOP-lowering medications, and complications. Univariate and multivariate analyses were performed to determine the predictors of IOP change. Thirty-nine cases were identified, and postoperative data were analyzed for 59 eyes, 39 with PACG and 20 with PAC. Globally, PE resulted in a mean reduction in IOP of -6.33 mm Hg (95% CI, -8.64 to -4.01, P <.001). Aqueous depth and angle measurements improved ( P <.01), whereas ECC significantly decreased ( P <.001). Both corrected and uncorrected visual acuity improved ( P <.01). The EQ visual analog scale did not change ( P =.16), but VFQ-25 improved ( P <.01). The IOP-lowering effect of PE was greater in the PACG compared to the PAC group ( P =.04). In both groups, preoperative IOP was the most significant predictor of IOP change ( P <.01). No sight-threatening complications were recorded. Our data support the usefulness of PE in lowering the IOP in patients with PAC and PACG. Although PE resulted in several anatomical and patient-reported visual improvements, we observe that a marked decrease in ECC should be carefully weighed before surgery.

A classification system of intraocular lens dislocation sites under operating microscopy, and the surgical techniques and outcomes of exchange surgery.

Science.gov (United States)

Hayashi, Ken; Ogawa, Soichiro; Manabe, Shin-Ichi; Hirata, Akira; Yoshimura, Koichi

2016-03-01

The aim of this study was to examine the recent status of intraocular lens (IOL) dislocation according to a classification system based on vertical dislocation position, as well as the surgical techniques and outcomes of IOL exchange surgery. The medical records of 230 eyes from 214 consecutive patients who experienced IOL dislocation and underwent exchange surgery between 2006 and 2014 were reviewed. Vertical dislocation sites observed preoperatively under operating microscopy were examined, along with the surgical techniques and outcomes of IOL exchange. Dislocation sites included (1) the anterior chamber (12.2 %), (2) pseudophakodonesis (19.1 %), (3) the anterior vitreous cavity (47.4 %), (4) trap door-like dislocation (dangling in the peripheral vitreous cavity; 16.1 %), and (5) the retinal surface (5.2 %). The IOL retained in the anterior segment was moved onto the iris by pulling it up through the limbal side ports with an anterior vitrectomy (67.8 %), or by pushing it up from the pars plana with an anterior vitrectomy (26.5 %), while the IOL dropped on the retina was lifting it up from the retina after pars plana vitrectomy (5.7 %). Mean uncorrected and distance-corrected visual acuity significantly improved postoperatively (p system, approximately 95 % of dislocated IOLs were retained in the anterior segment, and these IOLs were exchanged using an anterior approach through limbal incisions with an anterior vitrectomy. Visual acuity improved significantly, and serious complications were uncommon, probably because the IOL exchange techniques were standardized and simplified without pars plana vitrectomy.

Comparative evaluation of toric intraocular lens alignment and visual quality with image-guided surgery and conventional three-step manual marking.

Science.gov (United States)

Titiyal, Jeewan S; Kaur, Manpreet; Jose, Cijin P; Falera, Ruchita; Kinkar, Ashutosh; Bageshwar, Lalit Ms

2018-01-01

To compare toric intraocular lens (IOL) alignment assisted by image-guided surgery or manual marking methods and its impact on visual quality. This prospective comparative study enrolled 80 eyes with cataract and astigmatism ≥1.5 D to undergo phacoemulsification with toric IOL alignment by manual marking method using bubble marker (group I, n=40) or Callisto eye and Z align (group II, n=40). Postoperatively, accuracy of alignment and visual quality was assessed with a ray tracing aberrometer. Primary outcome measure was deviation from the target axis of implantation. Secondary outcome measures were visual quality and acuity. Follow-up was performed on postoperative days (PODs) 1 and 30. Deviation from the target axis of implantation was significantly less in group II on PODs 1 and 30 (group I: 5.5°±3.3°, group II: 3.6°±2.6°; p =0.005). Postoperative refractive cylinder was -0.89±0.35 D in group I and -0.64±0.36 D in group II ( p =0.003). Visual acuity was comparable between both the groups. Visual quality measured in terms of Strehl ratio ( p image-guided surgery group. Significant negative correlation was observed between deviation from target axis and visual quality parameters (Strehl ratio and MTF) ( p Image-guided surgery allows precise alignment of toric IOL without need for reference marking. It is associated with superior visual quality which correlates with the precision of IOL alignment.

Intraocular pressure reduction and regulation system

Science.gov (United States)

Baehr, E. F.; Burnett, J. E.; Felder, S. F.; Mcgannon, W. J.

1979-01-01

An intraocular pressure reduction and regulation system is described and data are presented covering performance in: (1) reducing intraocular pressure to a preselected value, (2) maintaining a set minimum intraocular pressure, and (3) reducing the dynamic increases in intraocular pressure resulting from external loads applied to the eye.

Anterior capsular support for posterior chamber intraocular lenses following vitreous loss in endocapsular surgery

Directory of Open Access Journals (Sweden)

Jacob Pushpa

1993-01-01

Full Text Available We used anterior capsular support for posterior chamber intraocular lenses (PC IOLs in fourteen eyes with large posterior capsular ruptures. An endocapsular technique preserved the anterior capsule and facilitated implantation. With a median follow up of 8.5 months, all patients had a visual acuity of 6/9 or better. One lens was lost in the vitreous and one patient had a clinically significant cystoid macular edema. In the event of a posterior capsular rupture we suggest this technique as an alternative to anterior chamber or scleral-fixated lenses

[Impact of an Aspherical Aberration Correcting Monofocal Intraocular Lens on Patient Satisfaction for Daily Life Activities: The Heidelberg Daily Task Evaluation (DATE) Questionnaire].

Science.gov (United States)

Kretz, F T A; Son, H; Liebing, S; Tandogan, T; Auffarth, G U

2015-08-01

A clinical evaluation of the functional results and its impact on daily activities of an aspherical, aberration correcting intraocular lens (IOL) was undertaken. Twenty-one patients aged from 50 to 83 years underwent cataract surgery with implantation of the aspheric IOL (Tecnis ZCB00, Abbott Medical Optics). They were evaluated 2 to 4 months after surgery for their subjective satisfaction of vision quality and its impact on performance of daily activities as well as functional results and refractive outcome. Patients were asked to fill out a questionnaire - the Heidelberg DATE (DAily Tasks Evaluation) questionnaire. Significant changes from pre- to postoperative results were found in refraction (p ≤ 0.03), with a mean prediction error of + 0.21 ± 0.43 D. UDVA and CDVA improved significantly (p < 0.01), with a postoperative CDVA of 0.0 logMAR or better in 97.1 % of eyes. All patients would recommend the procedure to a relative or a friend and 93.8 % of patients reported to be satisfied with the outcome. The implantation of the aspheric IOL Tecnis ZCB00 after cataract surgery allows the restoration of visual function, providing an optimised optical quality and a high level of patient satisfaction. Georg Thieme Verlag KG Stuttgart · New York.

Predicting crystalline lens fall caused by accommodation from changes in wavefront error

Science.gov (United States)

He, Lin; Applegate, Raymond A.

2011-01-01

PURPOSE To illustrate and develop a method for estimating crystalline lens decentration as a function of accommodative response using changes in wavefront error and show the method and limitations using previously published data (2004) from 2 iridectomized monkey eyes so that clinicians understand how spherical aberration can induce coma, in particular in intraocular lens surgery. SETTINGS College of Optometry, University of Houston, Houston, USA. DESIGN Evaluation of diagnostic test or technology. METHODS Lens decentration was estimated by displacing downward the wavefront error of the lens with respect to the limiting aperture (7.0 mm) and ocular first surface wavefront error for each accommodative response (0.00 to 11.00 diopters) until measured values of vertical coma matched previously published experimental data (2007). Lens decentration was also calculated using an approximation formula that only included spherical aberration and vertical coma. RESULTS The change in calculated vertical coma was consistent with downward lens decentration. Calculated downward lens decentration peaked at approximately 0.48 mm of vertical decentration in the right eye and approximately 0.31 mm of decentration in the left eye using all Zernike modes through the 7th radial order. Calculated lens decentration using only coma and spherical aberration formulas was peaked at approximately 0.45 mm in the right eye and approximately 0.23 mm in the left eye. CONCLUSIONS Lens fall as a function of accommodation was quantified noninvasively using changes in vertical coma driven principally by the accommodation-induced changes in spherical aberration. The newly developed method was valid for a large pupil only. PMID:21700108

Intraocular (Eye) Melanoma—Health Professional Version

Science.gov (United States)

Intraocular (uveal) melanoma of the uveal tract (iris, ciliary body, and choroid), though rare, is the most common primary intraocular malignancy in adults. Find evidence-based information on intraocular melanoma treatment.

Visual outcome and changes in corneal endothelial cell density following aphakic iris-fixated intraocular lens implantation in pediatric eyes with subluxated lenses.

Science.gov (United States)

Siddiqui, Sorath Noorani; Khan, Ayesha

2013-01-01

To evaluate the visual outcome and corneal endothelial cell density after Artisan aphakic intraocular lens (IOL) implantation (Ophtec, Groningen, the Netherlands) in pediatric eyes with subluxated lenses. Artisan aphakic IOLs were implanted in 18 eyes of 11 children with subluxated lenses. Idiopathic subluxations and ectopia lentis due to Marfan syndrome were included, whereas subluxations due to trauma or buphthalmos were excluded. Best-corrected visual acuity (BCVA) and endothelial cell density were monitored. Mean postoperative BCVA and endothelial cell density at last follow-up visit were calculated. The age of children at the time of Artisan aphakic IOL implantation ranged from 8 to 16 years (mean: 11.58 ± 2.9 years). Mean follow-up was 9.12 ± 4.30 months. Mean postoperative logarithm of the minimum angle of resolution BCVA was 0.26 ± 0.13 (P = .001) and mean postoperative endothelial cell density was 2,860 ± 435 cells/mm(2) (P = .000). Mean endothelial cell loss was 17.1%. Artisan aphakic IOL implantation is a safe surgical choice in the management of ectopia lentis in the pediatric age group. It has minimal complications and is less traumatic to pediatric eyes. However, long-term follow-up of these children is required.[J Pediatr Ophthalmol Strabismus 2013;50(3):178-182.]. Copyright 2013, SLACK Incorporated.

Treatment of a dislocated lens by transcorneal vitrectomy and bimanual phacoemulsification

Directory of Open Access Journals (Sweden)

Watanabe A

2014-08-01

Full Text Available Akira Watanabe, Tamaki Gekka, Hiroshi Tsuneoka Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan Background: As a method of treatment for a dropped lens nucleus, which occurred during cataract surgery, the dropped lens nucleus was removed through the corneal wound without using pars plana vitrectomy (PPV. After vitrectomy, the dropped lens nucleus was floated on the perfluorocarbon liquid (PFCL. The floating lens nucleus was then phacoemulsified and aspirated. During surgery, irrigation from the anterior chamber was performed. This method was very effective for treatment of a dropped hard nucleus.Case report: During cataract surgery on the left eye of an 80-year-old woman, a posterior capsule rupture occurred. As a result, the lens nucleus dropped into the vitreous cavity. Irrigation to the anterior chamber was performed, with an anterior chamber maintainer inserted through a newly created side port at the corneal limbus. A vitreous cutter and a light guide were inserted in order to perform vitrectomy through the corneal incisions that were created for the cataract surgery. After vitrectomy, the dropped lens nucleus was floated using PFCL. The floating lens nucleus was removed by a bimanual phacoemulsification technique, with the anterior chamber irrigation continuing. The separation of the irrigation port and the aspiration port allowed for effective treatment of the dropped nucleus that was floating on the PFCL, even using a ­phacoemulsification machine with a peristaltic pump system. Safe and effective vitrectomy, similar to a PPV, could be performed with this method using three corneal ports.Conclusion: This technique may allow safer and more effective treatment for a dropped lens nucleus compared with conventional PPV. With this technique, corneal distortion due to surgical manipulation can lead to reduced visibility of the posterior eye. Keywords: dislocated lens, transcorneal vitrectomy, bimanual

The influence of end of day silicone hydrogel daily disposable contact lens fit on ocular comfort, physiology and lens wettability.

Science.gov (United States)

Wolffsohn, James; Hall, Lee; Mroczkowska, Stephanie; Hunt, Olivia A; Bilkhu, Paramdeep; Drew, Tom; Sheppard, Amy

2015-10-01

To quantify the end-of-day silicone-hydrogel daily disposable contact lens fit and its influence of on ocular comfort, physiology and lens wettability. Thirty-nine subjects (22.1±3.5 years) were randomised to wear each of 3 silicone-hydrogel daily-disposable contact lenses (narafilcon A, delefilcon A and filcon II 3), bilaterally, for one week. Lens fit was assessed objectively using a digital video slit-lamp at 8, 12 and 16h after lens insertion. Hyperaemia, non-invasive tear break-up time, tear meniscus height and comfort were also evaluated at these timepoints, while corneal and conjunctival staining were assessed on lens removal. Lens fit assessments were not different between brands (P>0.05), with the exception of the movement at blink where narafilcon A was more mobile. Overall, lag reduced but push-up speed increased from 8 to 12h (P0.05). Movement-on-blink was unaffected by wear-time (F=0.403, P=0.670). A more mobile lens fit with one brand did not indicate that person would have a more mobile fit with another brand (r=-0.06 to 0.63). Lens fit was not correlated with comfort, ocular physiology or lens wettability (P>0.01). Among the lenses tested, objective lens fit changed between 8h and 12h of lens wear. The weak correlation in individual lens fit between brands indicates that fit is dependent on more than ocular shape. Consequently, substitution of a different lens brand with similar parameters will not necessarily provide comparable lens fit. Copyright © 2015 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Lens subluxation grading system: predictive value for ectopia lentis surgical outcomes

Directory of Open Access Journals (Sweden)

Mauro Waiswol

2009-03-01

Full Text Available Objective: To present a classification system to grade ectopia lentis and to assess its usefulness as a predictor for surgical outcomes. Methods: Fifty-one eyes of 28 patients with either simple (19 patients or Marfan syndrome-associated ectopia lentis (nine patients with variable degrees of subluxation were operated on. Lens subluxation intensity was graded according to the lens subluxation grading system (LSGS from grade 1 (lens on the whole pupillary area up to grade 4 (lens absent from the pupillary area. Thirty eyes underwent cataract extraction (“dry” aspiration with endocapsular ring and in-the-bag intraocular lens (IOL implantation. Twenty-one eyes underwent cataract extraction (“dry” aspiration with scleral fixation of the IOL. The predictive value of the LSGS was assessed by analyzing the post-operative outcomes, including visual acuity (VA, endothelial cell loss, and complications for each grade on the grading system. Rresults: Patients were classified into grade 1 (19.6%, grade 2 (51% and grade 3 (29.4%. Post-operative VA was lower for eyes with larger degrees of subluxation. The higher the subluxation grade, the higher the endothelial cell loss, as well as, the frequency of vitreous loss and surgical time. Higher subluxation grades prevented optimal surgical outcomes with endocapsular ring and in-the-bag IOL implantation. Cconclusions: The LSGS provides an estimate of the surgical success of ectopia lentis. Adequate standardization of lens subluxation is crucial for understanding studies dealing with the surgical correction of this disorder.

Biometry and intraocular lens power calculation results with a new optical biometry device: comparison with the gold standard.

Science.gov (United States)

Kaswin, Godefroy; Rousseau, Antoine; Mgarrech, Mohamed; Barreau, Emmanuel; Labetoulle, Marc

2014-04-01

To evaluate the agreement in axial length (AL), keratometry (K), anterior chamber depth (ACD) measurements; intraocular lens (IOL) power calculations; and predictability using a new partial coherence interferometry (PCI) optical biometer (AL-Scan) and a reference (gold standard) PCI optical biometer (IOLMaster 500). Service d'Ophtalmologie, Hopital Bicêtre, APHP Université, Paris, France. Evaluation of a diagnostic device. One eye of consecutive patients scheduled for cataract surgery was measured. Biometry was performed with the new biometer and the reference biometer. Comparisons were performed for AL, average K at 2.4 mm, ACD, IOL power calculations with the Haigis and SRK/T formulas, and postoperative predictability of the devices. A P value less than 0.05 was statistically significant. The study enrolled 50 patients (mean age 72.6 years±4.2 SEM). There was a good correlation between biometers for AL, K, and ACD measurements (r=0.999, r=0.933, and r=0.701, respectively) and between IOL power calculation with the Haigis formula (r=0.972) and the SRK/T formula (r=0.981). The mean absolute error (MAE) in IOL power prediction was 0.42±0.08 diopter (D) with the new biometer and 0.44±0.08 D with the reference biometer. The MAE was 0.20 D with the Haigis formula and 0.19 with the SRK/T formula (P=.36). The new PCI biometer provided valid measurements compared with the current gold standard, indicating that the new device can be used for IOL power calculations for routine cataract surgery. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Clinical Evaluation of Reading Performance Using the Salzburg Reading Desk With a Refractive Rotational Asymmetric Multifocal Intraocular Lens.

Science.gov (United States)

Linz, Katharina; Attia, Mary S A; Khoramnia, Ramin; Tandogan, Tamer; Kretz, Florian T; Auffarth, Gerd Uwe

2016-08-01

To evaluate functional results and reading performance using the Salzburg Reading Desk after implantation of a sector-shaped near-embedded, rotational asymmetrical multifocal intraocular lens (IOL) and a multifocal toric IOL with a +3.00 diopter (D) near addition. In a prospective study, the LentisMplus and Mplus toric IOLs (Oculentis GmbH, Berlin, Germany) were implanted in 34 eyes of 18 patients at the University Eye Hospital of Heidelberg. Uncorrected and corrected distance visual acuity (UDVA, CDVA) and uncorrected and corrected near visual acuity (UNVA, CNVA) were evaluated using standardized visual acuity charts (ETDRS). The Salzburg Reading Desk was used to analyze unilateral and bilateral uncorrected and corrected reading acuity, reading distance, reading speed, and the smallest log-scaled print size that could be read effectively at a set (40 cm/80 cm) and subjective chosen near and intermediate distance. Postoperatively, the median UDVA was 0.08 logMAR (20/25 Snellen) and the median CDVA was 0.01 logMAR (20/20 Snellen). The median UNVA was 0.12 logMAR (20/25 Snellen) and the median CNVA was 0.03 logMAR (20/20 Snellen). The median uncorrected reading acuity measured with the Salzburg Reading Desk for near distance at 40 cm was 0.18 logMAR (20/32 Snellen). The subjectively preferred near distance was 39 cm and revealed similar visual acuity results. The best reading acuity for intermediate distance with a median of 0.22 logMAR (20/32 Snellen) was achieved at a median distance of 62 cm. Reading performance of the multifocal IOL corresponded for near standardized and individual distance, whereas reading function was better at the patient's preferred intermediate distance. [J Refract Surg. 2016;32(8):526-532.]. Copyright 2016, SLACK Incorporated.

Effect of Anterior Chamber Depth on Intraocular Pressure after Uneventful Phacoemulsification Surgery in Nonglaucomatous Eyes with CataractEffect of Anterior Chamber Depth on Intraocular Pressure after Uneventful Phacoemulsification Surgery in Nonglaucomatous Eyes with CataractEffect of Anterior Chamber Depth on Intraocular Pressure after Uneventful Phacoemulsification Surgery in Nonglaucomatous Eyes with Cataract

Directory of Open Access Journals (Sweden)

Tansu Gönen

2011-08-01

Full Text Available Purpose: To evaluate the effect of preoperative anterior chamber depth (ACD on intraocular pressure (IOP after uneventful phacoemulsification and intraocular lens (IOL implantation in nonglaucomatous eyes. Material and Method: The medical records of fifty-five patients (30 male and 25 female were reviewed retrospectively. The patients who had undergone uneventful phacoemulsification and IOL implantation were divided into two groups according to the values of preoperative ACD: 30 eyes in group 1 (ACD≤3.27 mm and 25 eyes in group 2 (ACD>3.27 mm. IOP was measured using non-contact tonometer preoperatively and postoperatively (1 day, 1 week, 1 month, and 3 months. Results: Three months after phacoemulsification and IOL implantation, the mean IOP decreased 23.6% in group 1 and 13.7% in group 2. There was a statistically significant difference between the groups (p= 0.025. Discussion: The mean IOP decreases in eyes with shallow anterior chamber more than in normal eyes after uncomplicated phacoemulsification and IOL implantation. (Turk J Ophthalmol 2011; 41: 207-12

The effect of ionizing radiation on intraocular lenses

International Nuclear Information System (INIS)

Ellerin, Bruce E.; Nisce, Lourdes Z.; Roberts, Calvin W.; Thornell, Cliff; Sabbas, Albert; Wang Huili; Li, P. Mark; Nori, Dattatreyudu

2001-01-01

Background: The native crystalline lens is the principal shield against ultraviolet radiation (UV), damage to the human retina. Every year in the United States, more than one million patients undergo removal of the natural lens in the course of cataract surgery (phakectomy), at which time an intraocular lens (IOL) is placed in the lens capsule. The IOL thenceforth serves as the principal barrier to ultraviolet radiation over the life of the implant, potentially for decades. The synthetic organic molecules of which IOLs are composed offer little UV protection unless ultraviolet-absorbing chromophores are incorporated into the lens material during manufacture. However, chromophores are alkenes potentially subject to radiolytic degradation. It is unknown whether ionizing radiation at clinical doses (e.g., to the brain or in the head-and-neck region) affects the UV-absorbing capacity of chromophore-bearing IOLs and consequently exposes the retina to potentially chronic UV damage. In addition, the polymers of which IOLs are composed are themselves subject to radiation damage, which theoretically might result in optical distortion in the visible light range. Objective: To determine whether megavoltage photon ionizing radiation alters the absorption spectra of ultraviolet-shielding polymethylmethacrylate (PMMA) and organopolysiloxane (silicone) intraocular lenses (IOLs) in the UV (280 nm ≤ λ < 400 nm), visible (400 nm ≤ λ ≤ 700 nm), and low-end near-infrared (700 nm < λ ≤ 830 nm) ranges. Design: Prospective, nonrandomized trial of dose-paired IOL cohorts. Methods: Fourteen IOLs, seven of PMMA (Chiron 6842B) and seven of silicone (IOLAB L141U), were paired and examined for absorption spectra in 1-nm intervals over the range λ = 280-830 nm on a Cary 400 deuterium and quartz halogen source-lamp UV/visible spectrophotometer before and after undergoing megavoltage ionizing irradiation to doses of 2, 5, 10, 20, 40, 60, and 100 Gray, respectively. Because of

Patients with Fuchs Endothelial Dystrophy and Cataract Undergoing Descemet Stripping Automated Endothelial Keratoplasty and Phacoemulsification with Intraocular Lens Implant: Staged versus Combined Procedure Outcomes.

Science.gov (United States)

Sykakis, Evripidis; Lam, Fook Chang; Georgoudis, Panagiotis; Hamada, Samer; Lake, Damian

2015-01-01

Purpose. To compare the surgical outcomes of staged and combined phacoemulsification with intraocular lens implant (phaco+IOL) and Descemet stripping automated endothelial keratoplasty (DSAEK) in patients with Fuchs' endothelial dystrophy and cataract. Setting. Corneoplastic Unit and Eye Bank, Queen Victoria Hospital, East Grinstead, UK. Methods. Retrospective study of patients who had combined phaco+IOL and DSAEK (group 1) or phaco+IOL followed within 2 months by DSAEK (group 2). Patients who had previous eye surgery or any other ocular comorbidities were excluded. Results. There were 28 eyes in group 1 and 31 in group 2. There were no significant differences in the demographics and corneal tissue characteristics of the two groups. The endothelial disc dislocation and rebubbling rate within 1 week in group 1 was 21.42% and in group 2 was 3.2% (P = 0.04), while the endothelial cell density at 12 months was 1510 ± 433 for group 1 and 1535 ± 482 for group 2 (P = 0.89). The mean 12-month logMAR visual acuity was 0.28 ± 0.24 for group 1 and 0.33 ± 0.15 for group 2 (P = 0.38). Conclusions. Although the combined procedure seems to be associated with a higher complication rate the final outcomes seem to be similar to both methods.

[Correlation of intraocular pressure variation after visual field examination with 24-hour intraocular pressure variations in primary open-angle glaucoma].

Science.gov (United States)

Noro, Takahiko; Nakamoto, Kenji; Sato, Makoto; Yasuda, Noriko; Ito, Yoshinori; Ogawa, Shumpei; Nakano, Tadashi; Tsuneoka, Hiroshi

2014-10-01

We retrospectively examined intraocular pressure variations after visual field examination in primary open angle glaucoma (POAG), together with its influencing factors and its association with 24-hour intraocular pressure variations. Subjects were 94 eyes (52 POAG patients) subjected to measurements of 24-hour intraocular pressure and of changes in intraocular pressure after visual field examination using a Humphrey Visual Field Analyzer. Subjects were classified into three groups according to the magnitude of variation (large, intermediate and small), and 24-hour intraocular pressure variations were compared among the three groups. Factors influencing intraocular pressure variations after visual field examination and those associated with the large variation group were investigated. Average intraocular pressure variation after visual field examination was -0.28 ± 1.90 (range - 6.0(-) + 5.0) mmHg. No significant influencing factors were identified. The intraocular pressure at 3 a.m. was significantly higher in the large variation group than other two groups (p field examination. Increases in intraocular pressure during the night might be associated with large intraocular pressure variations after visual field examination.

Effect of an ultraviolet-filtering intraocular lens on cystoid macular edema

Energy Technology Data Exchange (ETDEWEB)

Kraff, M.C.; Sanders, D.R.; Jampol, L.M.; Lieberman, H.L.

1985-03-01

A prospective double-masked study of 301 patients was undertaken to compare the effect of ultraviolet (UV) filtering in implant intraocular lenses (IOL) on the angiographic incidence of cystoid macular edema (CME) in patients undergoing extracapsular cataract extraction. Patients were randomized to receive either a posterior chamber IOL that contained UV-absorbing chromophore or an identical IOL which did not contain such a chromophore. All patients were scheduled for fluorescein angiography between three and six months after surgery; 228 angiograms were obtained that were readable for the presence or absence of angiographic CME. The mean interval following surgery was 4.3 months. The incidence of CME was 18.8% (21 of 112) in patients who received lenses without UV-filtering chromophore and 9.5% (11 of 116) in patients who received IOLs that contained UV-filtering chromophore. These findings show that UV-filtering-IOLs resulted in a statistically significant decrease in the incidence of CME. The presence or absence of the UV-filtering chromophore did not, however, significantly affect visual acuity in the early postoperative period.

Crystalline lens dislocation secondary to bacterial endogenous endophthalmitis.

Science.gov (United States)

Sangave, Amit; Komati, Rahul; Weinmann, Allison; Samuel, Linoj; Desai, Uday

2017-09-01

To present an unusual case of endogenous endophthalmitis secondary to Group A streptococcus (GAS) that resulted in dislocation of the crystalline lens. An immunocompetent 51-year-old man presented to the emergency room (ER) with upper respiratory infection (URI) symptoms and painful right eye. He was diagnosed with URI and viral conjunctivitis and discharged on oral azithromycin and polytrim eyedrops. He returned to the ER 30 h later with sepsis and findings consistent with endophthalmitis, including light perception only vision. Ophthalmology was consulted at this time and an emergent vitreous tap and injection was performed. Both blood and vitreous cultures grew an atypical non-hemolytic variant of GAS ( Streptococcus pyogenes ). The primary source of infection was presumed to be secondary to pharyngitis or cutaneous dissemination. Final vision in the affected eye was no light perception, likely from a combination of anterior segment scarring, posterior segment damage, and hypotony. Interestingly, head computed tomography (CT) at the initial ER presentation showed normal lens position, but repeat CT at re-presentation revealed posterior dislocation of the lens. Endophthalmitis secondary to GAS has been sparsely reported in the literature, and this case highlights a unique clinical presentation. We suspect that this atypical non-hemolytic strain may have evaded detection on initial pharyngeal cultures. Additionally, we hypothesize that GAS-mediated protease release resulted in breakdown of the zonular fibers and subsequent lens dislocation. Ophthalmologists should be aware of GAS and its devastating intraocular manifestations.

LONG-TERM INTRAOCULAR PRESSURE AFTER UNCOMPLICATED PARS PLANA VITRECTOMY FOR IDIOPATHIC EPIRETINAL MEMBRANE.

Science.gov (United States)

Tognetto, Daniele; Pastore, Marco R; Cirigliano, Gabriella; DʼAloisio, Rossella; Borelli, Massimo; De Giacinto, Chiara

2017-11-16

To investigate long-term intraocular pressure trends after uncomplicated pars plana vitrectomy for idiopathic epiretinal membrane. Three hundred and sixty-eight eyes of 368 consecutive patients were enrolled. Changes in intraocular pressure 1, 3, 6, and 12 months after surgery and during the final follow-up visit were evaluated in vitrectomized eyes and nonvitrectomized fellow eyes. The median follow-up period was 36 months (range 12-92 months). Longitudinal data analysis evidenced a 2.5-mmHg (2.2 mmHg; 2.7 mmHg, 95% confidence interval) statistically significant difference in intraocular pressure 30 days after surgery between treated and fellow untreated eyes, gradually recovering to a not significant 0.2-mmHg (-0.1 mmHg; 0.4 mmHg, 95% confidence interval) difference within 26 months. The incidence of late-onset ocular hypertension was 5.7% (21 over 347, 2%; 12%, 95% confidence interval) without difference between the treated eyes and the group control. No significant difference in the incidence of late-onset ocular hypertension and sex, lens status, or gauge of vitrectomy instruments was detected. Only patient's age was significantly higher (mean difference 4.2 years; 0.1-8.0 years, Monte Carlo, 95% confidence interval) in those who developed late-onset ocular hypertension in the vitrectomized eye. Uncomplicated pars plana vitrectomy for idiopathic epiretinal membrane seems not to increase the risk of late-onset ocular hypertension or open-angle glaucoma development.

Methods of fixation of intraocular lenses according to the anatomical structures in trauma eyes.

Science.gov (United States)

Fiorentzis, Miltiadis; Viestenz, Anja; Heichel, Jens; Seitz, Berthold; Hammer, Thomas; Viestenz, Arne

2018-01-01

Ocular trauma can lead to severe visual impairment and morbidity, depending on the anatomical structures affected. The main causes of ocular trauma include foreign bodies, impact by an object, falls, and chemicals. Most ocular traumas occur in children or young male adults. A meticulous slit lamp examination is crucial for assessing all anatomical structures. Trauma to the crystalline lens can result in dislocation, an intralenticular foreign body, cataract, fragmentation, and capsular breach. An intraocular lens (IOL) can endure subluxation or luxation under the conjunctiva, into the anterior chamber or the vitreous, or can be extruded. The surgical approach depends on the condition and morphology of the lens and the anatomical structures surrounding it. If there is capsular bag support, a secondary IOL can be placed in the sulcus using remnants of the damaged capsule. If there is no capsular bag support, a secondary IOL can be fixated to the anterior chamber angle, to the iris, or to the sclera. A detailed history of injury cannot always be obtained in trauma settings. Proper education, supervision, and certified safety eye protectors could prevent up to 90% of ocular injuries. Lens trauma can be treated with various surgical procedures and fixation techniques, which nevertheless require advanced surgical skills owing to the fine anatomical structure of the anterior segment. A careful surgical strategy should be established for a globe reconstruction after trauma with secondary lens implantation. Clin. Anat. 31:6-15, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Graft-free Ahmed tube insertion: a modified method at 5 mm from limbus

Directory of Open Access Journals (Sweden)

Juan Carlos Mesa-Gutiérrez

2010-04-01

Full Text Available Juan Carlos Mesa-Gutiérrez, Juan Lillo-Sopena, Anna Monés-Llivina, Silvia Sanz-Moreno, Jorge Arruga-GinebredaDepartment of Ophthalmology, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, SpainObjective: To determine the medium-term outcome of Ahmed implants inserted through a needle tract at 5 mm from limbus that eliminates the need for a donor scleral graft.Methods: A retrospective case series of 19 patients undergoing Ahmed implant surgery for refractory glaucoma with a mean follow-up of 12 months. Primary outcome measures included control of intraocular pressure after surgery. Secondary outcome measure included the frequency of intraoperative and postoperative complications.Results: Intraocular pressure was maintained between 6 and 21 mmHg throughout the study. There was no postoperative hypotony. There were no complications related to this modified technique.Conclusion: Needle tract at 5 mm from limbus maintains implant’s ability to control intraocular pressure and eliminates the need for a donor scleral graft or heterologous material.Keywords: surgical technique, Ahmed implant, refractory glaucoma, donor scleral graft, tube shunt device

Intraocular pressure measurement with the noncontact tonometer through soft contact lenses.

Science.gov (United States)

Liu, Yi-Chun; Huang, Jehn-Yu; Wang, I-Jong; Hu, Fung-Rong; Hou, Yu-Chih

2011-03-01

To assess the accuracy of measuring intraocular pressure (IOP) through a soft contact lens (SCL) with different refractive powers using a noncontact tonometer (NCT). Thirty-two healthy adult volunteers free of glaucoma or corneal disease participated in this study. IOP was measured in the right eyes without SCLs and with different lens powers, from -3.0 to -12.0 D as measured by NCT. IOP of the left eyes was also measured, as an internal control. Corneal curvature was measured in both eyes using an autokeratometer. Sixteen volunteers wore one brand of SCL (group A) and the other 16 wore a different brand, with 2 different curvatures (groups B and C). Statistical data were analyzed by SPSS using the Wilcoxon signed rank test for comparison of IOP readings and multiple linear regression analysis for the relationship among power of contact lenses, corneal power, and difference in IOP measurements. The difference in mean IOP between eyes without lenses and those with lenses was statistically significant in lens with -6.0 D and below in all 3 groups. The decrease in IOP significantly correlated with the refractive power of contact lenses in all 3 groups. The difference in IOP measurements was influenced by the mean K in group A but not in group B or C. There was no statistically significant difference in the IOP measurements in the left eyes or in the mean K between the right and left eyes. IOP measurement through myopic SCLs by NCT may be inaccurate and tends toward underestimation, especially in high myopic lenses. A strong relationship exists between IOP reduction and myopic lens power.

Clinical observation of capsular tension ring implantation in congenital lens subluxation treating by phacoemulsification

Directory of Open Access Journals (Sweden)

Liang-Nan Sun

2017-07-01

Full Text Available AIM: To evaluate the clinical results of capsular tension ring(CTRimplantation in phacoemulsification for eyes with congenital lens subluxation. METHODS: This study comprised 18 patients(31 eyeswith congenital ectopia lentis. All patients received phacoemulsification with CTR and intraocular lens(IOLimplantation. Visual acuity before and after surgery were examined. IOL decentration were measured with Image-Pro Plus image processing software. The complications were also recorded preoperatively and postoperatively. RESULTS: Uncorrected vision of all eyes increased after surgery, and all cases had different degree of IOL decentration after surgery. Two eyes received CTR scleral fixation 3mo after surgery because the IOL decentration aggravated during the follow-up period. CONCLUSION: Phacoemulsification with CTR and IOL implantation is effective and safe for congenital lens subluxation. The implantation of CTR increase the stability of the capsular bag, improve the safety of surgery, and maintain the right position of IOL. CTR scleral fixation is a effective supplement for progressive cases.

[Clinical applications of ultrasound biomicroscopy in diagnosis and treatment of lens subluxation].

Science.gov (United States)

Liu, Yi-Zhi; Liu, Yu-Hua; Wu, Ming-Xing; Luo, Li-Xia; Zhang, Xin-Yu; Cai, Xiao-Yu; Chen, Xiu-Qi

2004-03-01

To evaluate the clinical value in diagnosis and treatment of lens subluxation using ultrasound biomicroscopy (UBM). This study comprised 29 patients (32 eyes) that had cataract with subluxated lenses due to different causes admitted into our hospital between November 2000 and January 2002. All eyes received UBM examination preoperatively and postoperatively. Capsular tension ring (CTR) implantations were performed using different technique according to UBM examination. Then all patients received phacoemulsification and intraocular lens (IOL) implantation. The location of IOL and CTR and complications were evaluated postoperatively. Different kinds of subluxated lens shown different manifestations in UBM. The degree of zonular defect can be evaluated with UBM preoperatively. With UBM examination preoperatively, extent of lens subluxation less than 1/2 quadrant in 19 eyes while more than 1/2 quadrant in other 13 eyes were observed. Postoperative UBM examination in this series shown that CTRs were holding in place except one attached to the iris root. IOLs in 29 eyes were in proper position while IOLs in 3 patients were slightly tilted. The degree and extent of lens subluxation can be evaluated using UBM examinations preoperatively, which is necessary in the selection of surgical protocol. With postoperative UBM examinations, a precise observation on the actual location of CTR and IOL can be achieved to produce an objective evaluation of the surgical outcomes.

Comparison of the effects of intraocular irrigating solutions on the corneal endothelium in intraocular lens implantation.

Science.gov (United States)

Matsuda, M; Kinoshita, S; Ohashi, Y; Shimomura, Y; Ohguro, N; Okamoto, H; Omoto, T; Hosotani, H; Yoshida, H

1991-01-01

We conducted a randomised prospective controlled study to determine the effects of a glucose glutathione bicarbonate solution (BSS Plus) and a citrate acetate bicarbonate solution (S-MA2) on the corneal endothelium in patients undergoing extracapsular cataract extraction with posterior chamber lens implantation. One eye of each patient was randomly assigned to receive BSS Plus, and the other eye to receive S-MA2. BSS Plus caused significantly less corneal swelling on the first postoperative day than did S-MA2. There was no difference between the two solutions in their effect on corneal thickness one week and one month postoperatively. Computer assisted morphometric analysis of wide-field specular microscopic photographs demonstrated minimal changes in endothelial morphological characteristics in the eyes irrigated with BSS Plus. By comparison S-MA2, caused a significant loss of endothelial cells and a marked reduction in the figure coefficient. These results indicated that BSS Plus has a clinical advantage over S-MA2 with respect to the corneal endothelium. PMID:1873266

Potential contact and intraocular lenses based on hydrophilic/hydrophobic sulfonated syndiotactic polystyrene membranes

Directory of Open Access Journals (Sweden)

Simona Zuppolini

2017-10-01

Full Text Available Crystalline films of syndiotactic polystyrene (s-PS, a commercially available thermoplastic polymer, having a highly hydrophilic amorphous phase, were achieved by using a mild solid-state sulfonation procedure. Despite the used mild process conditions, an easy and uniform sulfonation of the phenyl rings of the amorphous phase is obtained. The crystallinity of the polymer was not affect by the sulfonation degree (S, at least at S less than 20%, and the obtained polymer films show the nanoporous crystalline form of s-PS. As widely reported in literature, the nanoporous nature of the polymer crystalline phase gives to these materials the ability to absorb and release organic molecules of appropriate size and polarity. This property, coupled to transparency, makes these materials potentially useful intraocular lens (IOLs and contact lens applications. Sulfonation procedure and sulfonated film samples characterization by using wide-angle X-ray diffraction (WAXD, Fourier-transform infrared (FTIR and ultraviolet-visible (UV-vis spectroscopy techniques and water sorption tests were reported. Furthermore, the biocompatibility study demonstrated no cytotoxicity and appropriate cell interaction properties for the specific applications.

Intraocular lymphoma

Directory of Open Access Journals (Sweden)

Li-Juan Tang

2017-08-01

Full Text Available Intraocular lymphoma (IOL is a rare lymphocytic malignancy which contains two main distinct forms. Primary intraocular lymphoma (PIOL is mainly a sub-type of primary central nervous system lymphoma (PCNSL. Alternatively, IOL can originate from outside the central nervous system (CNS by metastasizing to the eye. These tumors are known as secondary intraocular lymphoma (SIOL. The IOL can arise in the retina, uvea, vitreous, Bruch’s membrane and optic nerve. There are predominantly of B-cell origin; however there are also rare T-cell variants. Diagnosis remains challenging for ophthalmologists and pathologists, due to its ability to masquerade as noninfectious or infectious uveitis, white dot syndromes, or occasionally as other metastatic cancers. Laboratory tests include flow cytometry, immunocytochemistry, interleukin detection (IL-10: IL-6, ratio >1, and polymerase chain reaction (PCR amplification. Methotrexate-based systemic chemotherapy with external beam radiotherapy and intravitreal chemotherapy with methotrexate are useful for controlling the disease, but the prognosis remains poor. Therefore, it is important to make an early diagnose and treatment. This review is focused on the clinical manifestations, diagnosis, treatment and prognosis of the IOL.

Patients with Fuchs Endothelial Dystrophy and Cataract Undergoing Descemet Stripping Automated Endothelial Keratoplasty and Phacoemulsification with Intraocular Lens Implant: Staged versus Combined Procedure Outcomes

Directory of Open Access Journals (Sweden)

Evripidis Sykakis

2015-01-01

Full Text Available Purpose. To compare the surgical outcomes of staged and combined phacoemulsification with intraocular lens implant (phaco+IOL and Descemet stripping automated endothelial keratoplasty (DSAEK in patients with Fuchs’ endothelial dystrophy and cataract. Setting. Corneoplastic Unit and Eye Bank, Queen Victoria Hospital, East Grinstead, UK. Methods. Retrospective study of patients who had combined phaco+IOL and DSAEK (group 1 or phaco+IOL followed within 2 months by DSAEK (group 2. Patients who had previous eye surgery or any other ocular comorbidities were excluded. Results. There were 28 eyes in group 1 and 31 in group 2. There were no significant differences in the demographics and corneal tissue characteristics of the two groups. The endothelial disc dislocation and rebubbling rate within 1 week in group 1 was 21.42% and in group 2 was 3.2% P=0.04, while the endothelial cell density at 12 months was 1510±433 for group 1 and 1535±482 for group 2 P=0.89. The mean 12-month logMAR visual acuity was 0.28±0.24 for group 1 and 0.33±0.15 for group 2 P=0.38. Conclusions. Although the combined procedure seems to be associated with a higher complication rate the final outcomes seem to be similar to both methods.

Accuracy of intraocular pressure measurements in dogs using two different tonometers and plano therapeutic soft contact lenses.

Science.gov (United States)

Ahn, Jeong-Taek; Jeong, Man-Bok; Park, Young-Woo; Kim, Se-Eun; Ahn, Jae-Sang; Lee, Yes-Ran; Lee, Eui-Ri; Seo, Kangmoon

2012-03-01

To compare and evaluate the accuracy of intraocular pressure (IOP) measured through a therapeutic contact lens, using applanation (TonoPen XL(®)) and rebound (TonoVet(®)) tonometers in enucleated dog eyes. A total of 30 enucleated eyes from 15 beagle dogs. To measure accurate IOP, the anterior chamber of each enucleated eye was cannulated with two 26-gauge needles and two polyethylene tubes were connected vertically to an adjustable reservoir bag of normal saline and a pressure transducer. IOP was measured by the TonoPen XL(®) followed by the TonoVet(®) without a contact lens. After a contact lens was applied to the cornea, IOP was re-measured in the same order. Three consecutive IOP measurements were performed using both tonometers. Without the contact lens, the IOP values obtained by both tonometers correlated well according to the regression analysis (TonoVet(®): γ(2) = 0.98, TonoPen XL(®): γ(2) = 0.97, P contact lens was applied to the cornea. Bland-Altman analysis was used to determine the lower and upper limits of agreement (TonoVet(®): -29.7 and +21.1 mmHg, TonoPen XL(®): -3.9 and +3.6 mmHg) between the two devices. This study suggests that the TonoPen XL(®) is a useful tonometer for dogs wearing therapeutic contact lenses, and importantly, contact lenses would not need to be removed prior to IOP measurement. © 2012 American College of Veterinary Ophthalmologists.

Estudo comparativo do desempenho óptico de diversas lentes intra-oculares (LIO) multifocais

OpenAIRE

Antunes, Telma Nicole Nogueira

2012-01-01

A cirurgia da catarata tem vindo a evoluir ao longo dos anos, tendo sido realizado o primeiro implante de uma lente intra-ocular em 1949. Desde então, várias técnicas foram utilizadas e descontinuadas devido a insucessos. Actualmente é utilizada a técnica de facoemulsificação. Tal como a técnica cirúrgica a lente implantada também tem vindo a evoluir, tanto a nível do material como a nível de design. Com as evoluções, tanto a nível de técnica cirúrgica como a nível de forma e material das len...

Images created in a model eye during simulated cataract surgery can be the basis for images perceived by patients during cataract surgery

Science.gov (United States)

Inoue, M; Uchida, A; Shinoda, K; Taira, Y; Noda, T; Ohnuma, K; Bissen-Miyajima, H; Hirakata, A

2014-01-01

Purpose To evaluate the images created in a model eye during simulated cataract surgery. Patients and methods This study was conducted as a laboratory investigation and interventional case series. An artificial opaque lens, a clear intraocular lens (IOL), or an irrigation/aspiration (I/A) tip was inserted into the ‘anterior chamber' of a model eye with the frosted posterior surface corresponding to the retina. Video images were recorded of the posterior surface of the model eye from the rear during simulated cataract surgery. The video clips were shown to 20 patients before cataract surgery, and the similarity of their visual perceptions to these images was evaluated postoperatively. Results The images of the moving lens fragments and I/A tip and the insertion of the IOL were seen from the rear. The image through the opaque lens and the IOL without moving objects was the light of the surgical microscope from the rear. However, when the microscope light was turned off after IOL insertion, the images of the microscope and operating room were observed by the room illumination from the rear. Seventy percent of the patients answered that the visual perceptions of moving lens fragments were similar to the video clips and 55% reported similarity with the IOL insertion. Eighty percent of the patients recommended that patients watch the video clip before their scheduled cataract surgery. Conclusions The patients' visual perceptions during cataract surgery can be reproduced in the model eye. Watching the video images preoperatively may help relax the patients during surgery. PMID:24788007

Intraocular Foreign Body Detected by Gonioscopy in the Anterior Chamber Angle

Directory of Open Access Journals (Sweden)

Özdemir Özdemir

2013-08-01

Full Text Available 45-year-old male patient was referred to our hospital with suspicion of foreign body in the right eye. It was learned that a metal burr entered his right eye 2 days ago. Best-corrected visual acuity in the right eye was 9/10. Biomicroscopic examination showed a 2-mm fullthickness corneal incision in the lower paracentral cornea. Defect on the iris corresponding to the incision line drew our attention. Seidel test was negative. After dilatation, the anterior lens capsule and fundus examinations were performed and were normal. The presence of intraocular foreign body (IOFB was suspected and it was detected in the lower quadrant of the iridocorneal angle by gonioscopy. Emergency surgery was performed and IOFB was extracted. (Turk J Ophthalmol 2013; 43: 278-81

Optical ensemble analysis of intraocular lens performance through a simulated clinical trial with ZEMAX.

Science.gov (United States)

Zhao, Huawei

2009-01-01

A ZEMAX model was constructed to simulate a clinical trial of intraocular lenses (IOLs) based on a clinically oriented Monte Carlo ensemble analysis using postoperative ocular parameters. The purpose of this model is to test the feasibility of streamlining and optimizing both the design process and the clinical testing of IOLs. This optical ensemble analysis (OEA) is also validated. Simulated pseudophakic eyes were generated by using the tolerancing and programming features of ZEMAX optical design software. OEA methodology was verified by demonstrating that the results of clinical performance simulations were consistent with previously published clinical performance data using the same types of IOLs. From these results we conclude that the OEA method can objectively simulate the potential clinical trial performance of IOLs.

Spectacle independence and subjective satisfaction of ReSTOR® multifocal intraocular lens after cataract or presbyopia surgery in two European countries

Directory of Open Access Journals (Sweden)

Béatrice Cochener

2010-02-01

Full Text Available Béatrice Cochener1, Luis Fernández-Vega2, Jose F Alfonso2, Frédérique Maurel3, Juliette Meunier4, Gilles Berdeaux5,61Centre Hospitalier de Brest, Brest, France; 2Instituto Oftalmologico Fernandez Vega, Oviedo, Spain; 3IMS Health, Health Economics Department, Puteaux, France; 4Mapi Values, Lyon, France; 5Alcon France, Health Economics Department, Rueil-Malmaison, France; 6Conservatoire National des Arts et Métiers, Paris, FrancePurpose: To determine the percentage of patients implanted bilaterally with ReSTOR® requiring spectacles at 18 months, the patient satisfaction, and factors that predict spectacles independence.Methods: The medical and surgical data were collected from patient records. The ‘Freedom from Spectacles Value Scale’ (FGVS was used to rank their experiences via telephone interview. A Bayesian network was used to predict postoperative spectacles use.Results: 304 patients (65.6 years were included. Postoperative visual acuity was ≥0.8 in 93.3% of patients for near vision and in 88.6% of patients for distance vision. After surgery, 87.2% of the patients were spectacles free. 88.2% of the patients rated their vision as being better following the surgery and 93.1% thought that surgery resulted in a positive change. FGVS mean scores (5 the most favorable rating were: ‘Practical Advantages’ 3.8, ‘Psychological Advantages’ 3.8, ‘Evaluation of the Result’ 4.5, ‘Feelings’ 4.4, and ‘Global Judgement’ 4.4. Patients who stated that spectacles wear was particularly bothersome and those who thought that their appearance was more favorable without spectacles were 3 times more likely not to wear spectacles postoperatively.Conclusion: ReSTOR® provides patients with good distance and near vision, a high rate of spectacles independence, and a high degree of patient satisfaction.Keywords: cataract surgery, multifocal intraocular lens, patient satisfaction, spectacles independence

Evaluation of visual quality of spherical and aspherical intraocular lenses by Optical Quality Analysis System

Directory of Open Access Journals (Sweden)

Yan Chen

2017-06-01

Full Text Available AIM: To evaluate the impact of spherical and aspherical intraocular lenses on the postoperative visual quality of age-related cataract patients using Optical Quality Analysis System (OQAS. METHODS: Seventy-four eyes with age-related cataracts were randomly divided into spherical and aspherical lens implantation groups. Best-corrected visual acuity (BCVA was measured preoperatively, one day, one week, two weeks, one month and two months after surgery. A biometric systems analysis using the OQAS objective scattering index (OSI was performed. RESULTS: There were no significant differences in visual acuity (P>0.05 before and after spherical and aspheric lens implantation. There was a negative linear correction between the OSI value and BCVA (r=-0.634, P=0.000, and positive corrections between the OSI value and the lens LOCUS III value of nucleus color (NC, nucleus opacity (NO, cortex (C and posterior lens capsular (P (r=0.704, P=0.000; r=0.514, P=0.000; r=0.276, P=0.020; r=0.417, P=0.000, respectively. OSI values of spherical vs aspherical lenses were 11.5±3.6 vs 11.8±3.4, 4.1±0.9 vs 3.3±0.8, 3.5±0.9 vs 2.7±0.7, 3.3±0.8 vs 2.6±0.7, 3.2±0.7 vs 2.5±0.8, and 3.2±0.8 vs 2.5±0.8 before and 1d, 1, 2wk, 1 and 2mo after surgery, respectively. All time points varied significantly (P<0.01 between the two groups. CONCLUSION: Aspherical IOLs does not significantly affect visual acuity compared with spherical IOLs. The OSI value, was significantly lower in the aspherical lens group compared with the spherical lens. This study shows that objective visual quality of aspheric IOLs is better than that of the spherical lens by means of OQAS biological measurement method.

Proton radiation therapy for retinoblastoma: Comparison of various intraocular tumor locations and beam arrangements

International Nuclear Information System (INIS)

Krengli, Marco; Hug, Eugen B.; Adams, Judy A.; Smith, Alfred R.; Tarbell, Nancy J.; Munzenrider, John E.

2005-01-01

Purpose: To study the optimization of proton beam arrangements for various intraocular tumor locations; and to correlate isodose distributions with various target and nontarget structures. Methods and materials: We considered posterior-central, nasal, and temporal tumor locations, with straight, intrarotated, or extrarotated eye positions. Doses of 46 cobalt grey equivalent (CGE) to gross tumor volume (GTV) and 40 CGE to clinical target volume (CTV) (2 CGE per fraction) were assumed. Using three-dimensional planning, we compared isodose distributions for lateral, anterolateral oblique, and anteromedial oblique beams and dose-volume histograms of CTVs, GTVs, lens, lacrimal gland, bony orbit, and soft tissues. Results: All beam arrangements fully covered GTVs and CTVs with optimal lens sparing. Only 15% of orbital bone received doses ≥20 CGE with a lateral beam, with 20-26 CGE delivered to two of three growth centers. The anterolateral oblique approach with an intrarotated eye resulted in additional reduction of bony volume and exposure of only one growth center. No appreciable dose was delivered to the contralateral eye, brain tissue, or pituitary gland. Conclusions: Proton therapy achieved homogeneous target coverage with true lens sparing. Doses to orbit structures, including bony growth centers, were minimized with different beam arrangements and eye positions. Proton therapy could reduce the risks of second malignancy and cosmetic and functional sequelae

Fluid dynamics simulation of aqueous humour in a posterior-chamber phakic intraocular lens with a central perforation.

Science.gov (United States)

Kawamorita, Takushi; Uozato, Hiroshi; Shimizu, Kimiya

2012-06-01

A modified implantable collamer lens (ICL) with a central hole (diameter, 0.36 mm), a "Hole-ICL", was created to improve aqueous humour circulation. The aim of this study was to investigate the fluid dynamic characteristics of aqueous humour in a Hole-ICL using computational fluid dynamics. Fluid dynamics simulation using an ICL was performed with thermal-hydraulic analysis software FloEFD V5 (Mentor Graphics Corp.). For the simulation, three-dimensional eye models based on a modified Liou-Brennan model eye with conventional ICL (Model ICM, STAAR SURGICAL) and a Hole-ICL were used. Both ICLs were -9.0 diopters (D) and 12.0 mm in length, with an optic of 5.5 mm. The vaulting was 0.50 mm. The quantity of aqueous humour produced by the ciliary body was set at 2.80 μl/min. Flow distribution between the anterior surface of the crystalline lens and the posterior surface of the ICL was also calculated, and trajectory analysis was performed. The flow velocity 0.25 mm in front of the centre of the crystalline lens was 1.52 × 10(-1) mm/sec for the Hole-ICL and 1.21 × 10(-5) mm/sec for the conventional ICL. Outward flow from the hole in the Hole-ICL was confirmed by trajectory analysis. These results suggest that Hole-ICLs improve the circulation of aqueous humour to the anterior surface of the crystalline lens.

Cytokine changes in tears and relationship to contact lens discomfort.

Science.gov (United States)

Willcox, Mark D P; Zhao, Zhenjun; Naduvilath, Thomas; Lazon de la Jara, Percy

2015-01-01

To determine the reproducibility of a multiplex bead assay for measuring cytokines in tears and correlations between ocular discomfort with or without contact lens wear and the concentration of cytokines in tears. Ninety participants (divided into two groups) were enrolled in this prospective study. They were asked to rate their ocular comfort and collect their tears in the morning and just before sleep for 10 days with or without contact lenses. The participants collected their tears using a glass microcapillary tube for both stages. Galyfilcon A lenses were worn on a daily disposable basis during the contact lens stage, and comfort scores and tears were collected before lens insertion and prior to lens removal at the end of the day. Tears were analyzed for cytokine concentrations using a 27-plex multibead assay. Correlations were sought between cytokine concentrations and comfort. There was a significant (p-0.5 Log pg/ml, p-0.2 Log pg/ml, ptears was correlated to ocular comfort, but this was not changed by contact lens wear. Ocular comfort during the day is magnified by contact lens wear. However, the increase in the change in comfort during lens wear was not associated with changes in 15 cytokines in the tear film.

The measurement of intraocular pressure over positive soft contact lenses by rebound tonometry.

Science.gov (United States)

Zeri, Fabrizio; De Cusatis, Mario; Lupelli, Luigi; Swann, Peter Graham

2016-01-01

To investigate if the accuracy of intraocular pressure (IOP) measurements using rebound tonometry over disposable hydrogel (etafilcon A) contact lenses (CL) is affected by the positive power of the CLs. The experimental group comprised 26 subjects, (8 male, 18 female). IOP measurements were undertaken on the subjects' right eyes in random order using a Rebound Tonometer (ICare). The CLs had powers of +2.00D and +6.00D. Measurements were taken over each contact lens and also before and after the CLs had been worn. The IOP measure obtained with both CLs was significantly lower compared to the value without CLs (t test; p<0.001) but no significant difference was found between the two powers of CLs. Rebound tonometry over positive hydrogel CLs leads to a certain degree of IOP underestimation. This result did not change for the two positive lenses used in the experiment, despite their large difference in power and therefore in lens thickness. Optometrists should bear this in mind when measuring IOP with the rebound tonometer over plus power contact lenses. Copyright © 2016 The Authors. Published by Elsevier Espana.. All rights reserved.

Management of subluxated capsular bag-fixated intraocular lenses using a capsular anchor.

Science.gov (United States)

Ton, Yokrat; Naftali, Modi; Gortzak, Ruth Lapid; Assia, Ehud I

2016-05-01

We describe the use of the capsular anchor (AssiAnchor) to manage a subluxated intraocular lens (IOL) in the capsular bag. The anchor comprises 2 prongs that hold the anterior lens capsule and a central rod that is sutured to the scleral wall, enabling centration of the IOL-capsular bag complex. Six pseudophakic patients presenting with subluxated posterior chamber IOLs in the capsular bag were operated on using the device. The anchor was used successfully in all cases, although in 2 cases only 1 prong was placed under the capsulorhexis edge. In 1 eye, 2 anchors were used 1 month apart following repeated traumatic zonular injury. The capsular bag holding the IOL remained centered and stable throughout the follow-up period. The anchoring device, which was originally designed to preserve the lens capsule and stabilize subluxated crystalline lenses, can also be used to treat subluxation of a capsular bag-fixated IOL. Dr. Assia is the inventor of the AssiAnchor, has a licensed patent of the anchor, and is consultant to Hanita Lenses. Dr. Lapid-Gortzak is a consultant to and speaker for Alcon Surgical, Inc., Hanita Lenses, Orca Surgical, and Sanoculis Ltd.; a speaker for Santen; and a consultant to Icon. Drs. Ton and Naftali have no financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Correlation of visual performance with quality of life and intraocular aberrometric profile in patients implanted with rotationally asymmetric multifocal IOLs.

Science.gov (United States)

Ramón, María L; Piñero, David P; Pérez-Cambrodí, Rafael J

2012-02-01

To examine the visual performance of a rotationally asymmetric multifocal intraocular lens (IOL) by correlating the defocus curve of the IOL-implanted eye with the intraocular aberrometric profile and impact on the quality of life. A prospective, consecutive, case series study including 26 eyes from 13 patients aged between 50 and 83 years (mean: 65.54±7.59 years) was conducted. All patients underwent bilateral cataract surgery with implantation of a rotationally asymmetric multifocal IOL (Lentis Mplus LS-312 MF30, Oculentis GmbH). Distance and near visual acuity outcomes, intraocular aberrations, defocus curve, and quality of life (assessed using the National Eye Institute Visual Functioning Questionnaire-25) were evaluated postoperatively (mean follow-up: 6.42±2.24 months). A significant improvement in distance visual acuity was found postoperatively (P<.01). Mean postoperative logMAR distance-corrected near visual acuity was 0.19±0.12 (∼20/30). Corrected distance visual acuity and near visual acuity of 20/20 or better were achieved by 30.8% and 7.7% of eyes, respectively. Of all eyes, 96.2% had a postoperative addition between 0 and 1.00 diopter (D). The defocus curve showed two peaks of maximum visual acuity (0 and 3.00 D of defocus), with an acceptable range of intermediate vision. LogMAR visual acuity corresponding to near defocus was directly correlated with some higher order intraocular aberrations (r⩾0.44, P⩽.04). Some difficulties evaluated with the quality of life test correlated directly with near and intermediate visual acuity (r⩾0.50, P⩽.01). The Lentis Mplus multifocal IOL provides good distance, intermediate, and near visual outcomes; however, the induced intraocular aberrometric profile may limit the potential visual benefit. Copyright 2012, SLACK Incorporated.

Complications of cataract surgery in eyes filled with silicone oil.

Science.gov (United States)

Kanclerz, Piotr; Grzybowski, Andrzej; Schwartz, Stephen G; Lipowski, Paweł

2018-03-01

The aim of the study was to evaluate complications of cataract surgery in eyes filled with silicone oil. This retrospective, noncomparative, consecutive case series analyzed medical files of patients with eyes filled with silicone oil undergoing cataract surgery. Phacoemulsification with posterior chamber intraocular lens implantation was conducted with or without concurrent silicone oil removal. In this study, 121 eyes of 120 patients were included. In 32 eyes (26.4%) with evident silicone oil microemulsification or silicone oil-associated open-angle glaucoma, silicone oil was removed prior to phacoemulsification through a pars plana incision and no cases of posterior capsular rupture occurred during the subsequent cataract surgery. In the remaining 89 eyes, phacoemulsification was performed with silicone oil in the vitreous cavity. In these eyes, the rate of posterior capsular rupture was 9/89 (10.1%) and the rate of silicone oil migration into the anterior chamber through an apparently intact posterior capsule was 5/89 (5.6%). In 94 eyes (77.7%), an intraocular lens was inserted into the capsular bag, in 3 eyes (2.5%) into the sulcus, and in 1 eye (0.8%) a transscleral suturing was performed. In this series, complications related to the silicone oil were not uncommon during cataract surgery. In the majority of patients without evident silicone oil microemulsification or silicone oil-associated open-angle glaucoma, cataract surgery and posterior chamber intraocular lens implantation were performed while leaving the silicone oil in place.

The effect of EGb 761 on retinal lipid peroxidation and glutathione peroxidase level in experimental lens induced uveitis.

Science.gov (United States)

Bilgihan, A; Aricioğlu, A; Bilgihan, K; Onol, M; Hasanreisoğlu, B; Türközkan, N

1994-01-01

An acute lens-induced necrotizing intraocular inflammation was produced in pigmented guinea pigs. Treatment of these animals by 100 mg/kg/day EGb 761 a free oxygen radical scavenger for 10 days, reduced retinal lipid peroxidation (p > 0.05) and increased the retinal glutathione peroxidase level (p > 0.05). Although not significantly, these findings suggest that EGb 761 could be combined with other antiinflammatory drugs and may be beneficial in the treatment of uveitis.

Chitosan/alginate based multilayers to control drug release from ophthalmic lens.

Science.gov (United States)

Silva, Diana; Pinto, Luís F V; Bozukova, Dimitriya; Santos, Luís F; Serro, Ana Paula; Saramago, Benilde

2016-11-01

In this study we investigated the possibility of using layer-by-layer deposition, based in natural polymers (chitosan and alginate), to control the release of different ophthalmic drugs from three types of lens materials: a silicone-based hydrogel recently proposed by our group as drug releasing soft contact lens (SCL) material and two commercially available materials: CI26Y for intraocular lens (IOLs) and Definitive 50 for SCLs. The optimised coating, consisting in one double layer of (alginate - CaCl2)/(chitosan+glyoxal) topped with a final alginate-CaCl2 layer to avoid chitosan degradation by tear fluid proteins, proved to have excellent features to control the release of the anti-inflammatory, diclofenac, while keeping or improving the physical properties of the lenses. The coating leads to a controlled release of diclofenac from SCL and IOL materials for, at least, one week. Due to its high hydrophilicity (water contact angle≈0) and biocompatibility, it should avoid the use of further surface treatments to enhance the useŕs comfort. However, the barrier effect of this coating is specific for diclofenac, giving evidence to the need of optimizing the chemical composition of the layers in view of the desired drug. Copyright © 2016 Elsevier B.V. All rights reserved.

Comparative measurement of intraocular pressure by Icare tonometry and Airpuff tonometry in healthy subjects and patients wearing therapeutic soft contact lenses.

Science.gov (United States)

Anton, Alexandra; Neuburger, Matthias; Böhringer, Daniel; Jordan, Jens F

2013-07-01

The aim of the present study was to compare the measurement of intraocular pressure (IOP) through a therapeutic soft contact lens with the "native" measurement. We additionally investigate whether a rebound tonometer (RT) or non-contact tonometer (NCT) is more suitable to measure IOP through a bandage contact lens. The IOP was determined using each of the two methods, three times successively with (lens measurement) and without (native measurement) a soft contact lens. The Icare tonometer (Icare® TA01i, Icare Finland Oy, 23 subjects) and the Airpuff tonometer (Nidek NT 53OP, Nidek CO., LTD, Hiroishi Gamagori, Aichi, Japan, 16 subjects) were used. We compared the mean values (validity parameter) and standard deviation (precision parameter) of the three individual measurements in each case using the paired t-test. In addition, we conducted a power analysis to estimate the maximum error in the measurement caused by the contact lens (power level set to 0.8). With the Airpuff tonometer we detected no statistically significant between the lens and the native measurement (15.6 ± 2.6 vs. 15.3 ± 2.6 mmHg; p = 0.42). The power analysis revealed that the maximum error caused by the contact lens was 1.2 mmHg. The Icare tonometry, however, trended toward higher values in the contact lens measurements (17.5 ± 4.3 vs. 16.4 ± 3.5 mmHg in the native measurements; p = 0.05). Interestingly, this difference exhibited a statistically significant correlation with the corneal thickness (0.03 mmHg per μm corneal thickness; p = 0.04). The use of NCT and RT for IOP measurement over a soft contact lens is feasible. The accuracy appears to be sufficient for the most common clinical applications.

Comparison of the visual and intraocular optical performance of a refractive multifocal IOL with rotational asymmetry and an apodized diffractive multifocal IOL.

Science.gov (United States)

Alió, Jorge L; Plaza-Puche, Ana B; Javaloy, Jaime; Ayala, María José

2012-02-01

To compare the visual outcomes and intraocular optical quality observed postoperatively in patients implanted with a rotationally asymmetric multifocal intraocular lens (IOL) and an apodized diffractive multifocal IOL. Seventy-four consecutive eyes of 40 cataract patients (age range: 36 to 79 years) were divided into two groups: zonal refractive group, 39 eyes implanted with a rotationally asymmetric multifocal IOL (Lentis Mplus LS-312 IOL, Oculentis GmbH); and diffractive group, 35 eyes implanted with an apodized diffractive multifocal IOL (ReSTOR SN6AD3, Alcon Laboratories Inc). Distance and near visual acuity outcomes, contrast sensitivity, intraocular optical quality, and defocus curves were evaluated during 3-month follow-up. Calculation of the intraocular aberrations was performed by subtracting corneal aberrations from total ocular aberrations. Uncorrected near visual acuity and distance-corrected near visual acuity were better in the diffractive group than in the zonal refractive group (P=.01), whereas intermediate visual acuity (defocus +1.00 and +1.50 diopters) was better in the zonal refractive group. Photopic contrast sensitivity was significantly better in the zonal refractive group (P=.04). Wavefront aberrations (total, higher order, tilt, primary coma) were significantly higher in the zonal refractive group than in the diffractive group (P=.02). Both multifocal IOLs are able to successfully restore visual function after cataract surgery. The zonal refractive multifocal IOL provides better results in contrast sensitivity and intermediate vision, whereas the diffractive multifocal IOL provides better near vision at a closer distance. Copyright 2012, SLACK Incorporated.

Characterization of Soft Contact Lens Edge Fitting during Daily Wear Using Ultrahigh-Resolution Optical Coherence Tomography

Directory of Open Access Journals (Sweden)

Lele Cui

2018-01-01

Full Text Available Purpose. To determine conjunctival overlap over the edge of soft contact lens and to visualize the peripheral postlens tear film (PoLTF underneath soft contact lenses using ultrahigh-resolution optical coherence tomography (UHR-OCT. Methods. Twenty participants (4 males and 16 females, 23.0 ± 3.7 years were fitted with two different types of soft contact lenses randomly. The limbus with lens was imaged with the UHR-OCT at the horizontal meridian every two hours up to 6 hours during lens wear. The conjunctival overlap was ranked as the percentage of the edge covered by the conjunctiva. The frequency of occurrence for visualized peripheral PoLTF was determined. Results. The average conjunctival overlaps at insertion were 49% and 73% for galyfilcon A and balafilcon A lenses and increased significantly to 84% and 90% by 6 hours of lens wear (P<0.001. Lenses with rounded edges had more conjunctival overlap than the lenses with angled edges (P=0.014. There were significant decreases for PoLTF on the conjunctiva (P=0.014 and peripheral cornea (P=0.004 over the study period compared to insertion. The percentage of subjects with PoLTF on the conjunctiva (32.5% and peripheral cornea (36% were greater in subjects wearing balafilcon A lenses (P=0.017. Conclusions. Increased conjunctival overlap over the lens edges and reduced PoLTF underneath the peripheral region of soft contact lenses were shown during lens daily wear. The lens edge configuration may play a role in conjunctival response and peripheral PoLTF.

Optical Coherence Tomography–Based Corneal Power Measurement and Intraocular Lens Power Calculation Following Laser Vision Correction (An American Ophthalmological Society Thesis)

Science.gov (United States)

Huang, David; Tang, Maolong; Wang, Li; Zhang, Xinbo; Armour, Rebecca L.; Gattey, Devin M.; Lombardi, Lorinna H.; Koch, Douglas D.

2013-01-01

Purpose: To use optical coherence tomography (OCT) to measure corneal power and improve the selection of intraocular lens (IOL) power in cataract surgeries after laser vision correction. Methods: Patients with previous myopic laser vision corrections were enrolled in this prospective study from two eye centers. Corneal thickness and power were measured by Fourier-domain OCT. Axial length, anterior chamber depth, and automated keratometry were measured by a partial coherence interferometer. An OCT-based IOL formula was developed. The mean absolute error of the OCT-based formula in predicting postoperative refraction was compared to two regression-based IOL formulae for eyes with previous laser vision correction. Results: Forty-six eyes of 46 patients all had uncomplicated cataract surgery with monofocal IOL implantation. The mean arithmetic prediction error of postoperative refraction was 0.05 ± 0.65 diopter (D) for the OCT formula, 0.14 ± 0.83 D for the Haigis-L formula, and 0.24 ± 0.82 D for the no-history Shammas-PL formula. The mean absolute error was 0.50 D for OCT compared to a mean absolute error of 0.67 D for Haigis-L and 0.67 D for Shammas-PL. The adjusted mean absolute error (average prediction error removed) was 0.49 D for OCT, 0.65 D for Haigis-L (P=.031), and 0.62 D for Shammas-PL (P=.044). For OCT, 61% of the eyes were within 0.5 D of prediction error, whereas 46% were within 0.5 D for both Haigis-L and Shammas-PL (P=.034). Conclusions: The predictive accuracy of OCT-based IOL power calculation was better than Haigis-L and Shammas-PL formulas in eyes after laser vision correction. PMID:24167323

Results of Posterior Chamber Lens Implantation for Correction of Myopia

Directory of Open Access Journals (Sweden)

Pınar Sorgun Evcili

2012-10-01

Full Text Available Pur po se: To evaluate the results of posterior chamber phakic intraocular lens implantation in myopic patients. Ma te ri al and Met hod: Posterior chamber phakic intraocular lens (STAAR ICL implantation was performed in 58 eyes of 33 patients with mean spherical equivalent of -13.12±5.31 diopters (D (-2.5 - -24.75 D between August 2007 and October 2010 at Dr. Lütfi Kırdar Kartal Training and Research Hospital, Second Eye Clinic. The mean age of the patients was 32.84 ± 9.95 years (18-55 years - 24 (72.7% were male and 9 (27.3% were female. The study was designed as prospective case series. The patients were evaluated regarding visual acuity, refraction, endothelial cell count, and complications in postoperative period. Re sults: The mean follow-up time was 21.5±4.9 (12-24 months months. The mean spherical equivalent was -1.29±1.53 D (-5.6 D - +2.60 D at the last postoperative follow-up visit. Visual acuity was better or equal to preoperative best-corrected value in 42 (72.4% of eyes at the last follow-up visit postoperatively. Mean spherical equivalent was regressed to -1.13±1.59D at 1-month and -1.39±1.53D at 24-month postoperative follow-up visit. Pupillary-block glaucoma in 1 eye (1.7%, anterior subcapsular opacification not affecting the vision in 4 eyes, and retinal detachment in 1 eye were detected at follow-up visits. Dis cus si on: ICL implantation was observed to be an effective and safe method for correction of myopia in two-year follow-up. As possible retinal complications may develop, the patients must be followed carefully during the preoperative and postoperative period. (Turk J Ophthalmol 2012; 42: 349-54

Early versus late traumatic cataract surgery and intraocular lens implantation.

Science.gov (United States)

Tabatabaei, S A; Rajabi, M B; Tabatabaei, S M; Soleimani, M; Rahimi, F; Yaseri, M

2017-08-01

PurposeTo determine the proper time for traumatic cataract surgery after open globe injuries.SettingFarabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.DesignRandomized clinical trial.Patients and methodsIn a randomized clinical trial, 30 eyes with traumatic cataract after open globe injury with IOL implantation underwent early (in the first week after the trauma) and 30 eyes underwent late cataract surgery (from the first to second month after the trauma). We excluded patients who were under 12-year-old. All patients were visited at 1 week, 4 weeks, 12 weeks, and 6 months after surgery. In each visit, patients were examined regarding visual acuity, intraocular pressure (IOP), anterior chamber inflammation, IOL position, and posterior synechiae. In addition, posterior segment evaluation and fundoscopy were performed. Intraoperative complication including posterior capsular rupture, anterior vitrectomy, and zonulysis as well as the site of IOL implantation were documented and post-operative complications including raised IOP, anterior chamber inflammation, visual axis opacity, posterior synechiae, subluxation of IOL, and IOL pigment deposition were listed.ResultsBest-corrected visual acuity 6 months after surgery was not different between the two groups. Also in early cataract surgery group, the rate of posterior capsular rupture was not significantly higher than the late surgery group (P=0.069). On the other hand, zonulysis was significantly higher in the late procedure group (P=0.039). Other complications including anterior vitrectomy, raised IOP, anterior chamber inflammation, visual axis opacity, posterior synechiae, subluxation of IOL, and IOL pigment deposition were not different in the two groups.ConclusionsEarly and late traumatic cataract surgery and IOL implantation after open globe injuries, have no significant difference regarding the post-surgical BCVA and prominent intraoperative and post-operative complications.

Intraocular inflammation in autoimmune diseases.

Science.gov (United States)

Pras, Eran; Neumann, Ron; Zandman-Goddard, Gisele; Levy, Yair; Assia, Ehud I; Shoenfeld, Yehuda; Langevitz, Pnina

2004-12-01

The uveal tract represents the vascular organ of the eye. In addition to providing most of the blood supply to the intraocular structures, it acts as a conduit for immune cells, particularly lymphocytes, to enter the eye. Consequently, the uveal tract is represented in many intraocular inflammatory processes. Uveitis is probably a misnomer unless antigens within the uvea are the direct targets of the inflammatory process. A better term of the condition is "intraocular inflammation" (IOI). To review the presence of IOI in autoimmune diseases, the immunopathogenic mechanisms leading to disease, and treatment. We reviewed the English medical literature by using MEDLINE (1984-2003) employing the terms "uveitis," "intraocular inflammation," and "autoimmune diseases." An underlying autoimmune disease was identified in up to 40% of patients with IOI, and included spondyloarthropathies, Behcets disease, sarcoidosis, juvenile chronic arthritis, Vogt-Koyanagi-Harada syndrome (an inflammatory syndrome including uveitis with dermatologic and neurologic manifestations), immune recovery syndrome, and uveitis with tubulointerstitial disease. The immunopathogenesis of IOI involves enhanced T-cell response. Recently, guidelines for the use of immunosuppressive drugs for inflammatory eye disease were established and include: corticosteroids, azathioprine, methotrexate, mycophenolate mofetil, cyclosporine, tacrolimus, cyclophosphamide, and chlorambucil. New therapies with limited experience include the tumor necrosis factor alpha inhibitors, interferon alfa, monoclonal antibodies against lymphocyte surface antigens, intravenous immunoglobulin (IVIG), and the intraocular delivery of immunosuppressive agents. An underlying autoimmune disease was identified in up to 40% of patients with IOI. Immunosuppressive drugs, biologic agents, and IVIG are employed for the treatment of IOI in autoimmune diseases.

Sutureless glueless intrascleral fixation of posterior chamber intraocular lens: Boon for aphakic

Directory of Open Access Journals (Sweden)

Nagendra Shekhawat

2017-01-01

Full Text Available Purpose: To report results of intrascleral fixation of 3-piece IOL without the help of suture and glue. Methods: Study included intrascleral fixation of haptic in 50 eyes by T-fixation technique. Preoperative and postoperative visual acuity, slit lamp and fundus examination, applanation tonometry, keratometry, biometry, optical coherence tomography, Scheimpflug imaging were done for extensive evaluation. Qualitative and quantitative data were summarized in the form of proportion and mean and standard deviation, respectively. The significance of difference was measured by Chi-square test or unpaired t-test or ANOVA whichever is appropriate. P < 0.05 was considered as statistically significant. Results: There was one case in which haptic broke during handshake maneuver and another IOL was required. Postoperative complications included corneal edema (4%, increased intraocular pressure (6%, cystoid macular edema (2%, decentration (4%, and dislocation (2%, which were all managed to the level of good visual recovery. There was no significant change in corneal astigmatism. There was significant change found in best-corrected visual acuity and uncorrected visual acuity after surgery. Conclusion: This modified technique seems to be a good alternative in IOL implantation in eyes with deficient capsules in view of the decrease in the learning time and surgical time and risk for complications.

21 CFR 886.4275 - Intraocular fluid.

Science.gov (United States)

2010-04-01

... DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4275 Intraocular fluid. (a) Identification. An intraocular fluid is a device consisting of a nongaseous fluid intended to be introduced into the eye to aid... section 515 of the act is required before this device may be commercially distributed. See § 886.3. ...

A Case Report of Intraocular Metastasis Treated with Radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Kim, Ok Bae; Byun, Sang Jun; Kim, Kwang Soo; Kim, Jin Hee [Keimyung University School of Medicine, Daegu (Korea, Republic of); Lee, Ho Jun [Daegu Catholic University School of Medicine, Daegu (Korea, Republic of)

2009-09-15

Intraocular metastasis is the most common malignancy of the eye. The frequency of intraocular metastasis in all the patients dying of cancer is about 12% and ocular metastases will be detected more frequently in the future because the patients with malignant tumor are now living longer. Intraocular metastasis can cause a serious clinical problem such as blindness. The early recognition and treatment of intraocular metastasis are very important clinical oncologic issues to maintain vision and to maximize the quality of life. However, significance of intraocular metastasis is still under-evaluated for practicing oncologists. External beam radiotherapy is a safe, effective palliative treatment in terms of preserving both the vision and the eye globe.

21 CFR 886.4270 - Intraocular gas.

Science.gov (United States)

2010-04-01

... DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4270 Intraocular gas. (a) Identification. An intraocular gas is a device consisting of a gaseous fluid intended to be introduced into the eye to place pressure... required. As of May 28, 1976, an approval under section 515 of the act is required before this device may...

Quality of vision in patients implanted with aspherical and spherical intraocular lens: Intraindividual comparison

Directory of Open Access Journals (Sweden)

Francesco Semeraro

2014-01-01

Full Text Available Aims: To compare the quality of vision in pseudophakic patients implanted with aspherical and spherical intraocular lenses (IOLs. Materials and Methods: Randomized prospective longitudinal intrapatient comparison between aspherical and spherical IOLs performed on 22 patients who underwent bilateral cataract surgery. Best corrected visual acuity, subjective contrast sensitivity, Strehl ratio and spherical aberrations (SA, and higher order wavefront aberrations for a 3.5 mm and a 6.0 mm pupil were measured after 3 months of cataract surgery. Results: SA (Z4,0 decreased significantly in eyes with aspherical IOL implant (P = 0.004. Modulation transfer function (MTF and point spread function (PSF resulted no significant difference between the two groups (P = 0.87; P = 0.32. Conclusion: Although the SA is significantly lower in eyes implanted with aspherical IOL, the quality of vision determined with MTF and PSF does not significantly differ for subjective and objective parameters that were analyzed.

Changes in corneal endothelium cell characteristics after cataract surgery with and without use of viscoelastic substances during intraocular lens implantation

Directory of Open Access Journals (Sweden)

Schulze SD

2015-11-01

Full Text Available Stephan D Schulze,1 Thomas Bertelmann,1 Irena Manojlovic,2 Stefan Bodanowitz,2 Sebastian Irle,3 Walter Sekundo11Department of Ophthalmology, Philipps University of Marburg, Marburg, 2Private Practice and Ambulatory Surgical Center, Bremen, 3Freelance Statistician, Friedberg, GermanyPurpose: To evaluate whether the use of balanced salt solution (BSS or an ophthalmic viscoelastic device (OVD during hydrophilic acrylic intraocular lens (IOL implantation variously impacts corneal endothelial cell characteristics in eyes undergoing uneventful phacoemulsifications.Methods: Prospective nonrandomized observational clinical trial. Patients were assigned either to the BSS plus® or to the OVD Z-Celcoat™ group depending on the substance used during IOL implantation. Corneal endothelium cell characteristics were obtained before, 1 week, and 6 weeks after surgery. Intraoperative parameters (eg, surgery time, phacoemulsification energy were recorded.Results: Ninety-seven eyes were assigned to the BSS plus and 86 eyes to the Z-Celcoat group. Preoperative corneal endothelium cell density (ECD and endothelium cell size were 2,506±310 cells/mm2/2,433±261 cells/mm2 and 406±47 µm2/416±50 µm2 (P=0.107/P=0.09. After 1 and 6 weeks, ECD decreased and endothelium cell size increased significantly in both groups (each P<0.001 without significant differences between both groups (each P>0.05. Irrigation–aspiration suction time (30.3±16.6 versus 36.3±14.5 seconds and overall surgical time (7.2±1.2 versus 8.0±1.4 minutes were significantly longer in the OVD Z-Celcoat group (each P<0.001. No complications or serious side effects occurred.Conclusion: Implantation of a hydrophilic acrylic IOL under BSS infusion seems to be a useful and faster alternative in experienced hands without generating higher ECD loss rates.Keywords: phacoemulsification, ophthalmic viscoelastic device, endothelial cell density, IOL

[Influence of different multifocal intraocular lens concepts on retinal stray light parameters].

Science.gov (United States)

Ehmer, A; Rabsilber, T M; Mannsfeld, A; Sanchez, M J; Holzer, M P; Auffarth, G U

2011-10-01

Multifocal intraocular lenses (MIOL) are known to induce various photic phenomena depending on the optical principle. The aim of this study was to investigate the correlation between stray light measurements performed with the C-Quant (Oculus, Germany) and the results of a subjective patient questionnaire. In this study three different MIOLs were compared: AMO ReZoom (refractive design, n=10), AMO ZM900 (diffractive design, n=10) and Oculentis Mplus (near segment design, n=10). Cataract and refractive patients were enrolled in the study. Functional results were evaluated at least 3 months postoperatively followed by stray light measurements and a subjective questionnaire. Surgery was performed for all patients without complications. The three groups were matched for age, IOL power and corrected distance visual acuity (CDVA). Significantly different stray light (median) values log(s) were found (Kruskal-Wallis test, p<0.05): 1.12 log (refractive), 1.13 log (segment) and 1.28 log (diffractive). The subjective questionnaire did not show differences in glare perception but refractive MIOL patients noticed more halos surrounding light sources than the diffractive and segment MIOL patients. Stray light and subjective photopic phenomena do not show any basic correlation. Measurements in patients with refractive MIOLs showed less stray light than near segment or diffractive MIOLs. However, refractive MIOLs induced more halos compared to the other groups analyzed.

Treatment Approach to Small Inadvertent Injury of the Crystalline Lens Anterior Capsule During Iridodialysis Repair Surgery

Directory of Open Access Journals (Sweden)

Gökçen Gökçe

2013-01-01

Full Text Available A 22-year-old man presented to our ophthalmology department with photophobia. On ophthalmic examination, iridodialysis secondary to blunt trauma that occurred 5 years ago was diagnosed. During iridodialysis repair surgery, long curved double-armed needle of 10-0 polypropylene suture (PC-9 inserted into the 19 gauge side port turned down inadvertently by its own weight, resulting in crystalline lens anterior capsule perforation. Postoperative clinical observation revealed no lens opacification affecting visual acuity. This case report showed that lens aspiration surgery should be postponed if the capsule injury is small.(Turk J Ophthalmol 2013; 43: 61-3

Psychophysical Measurements of Luminance Contrast Sensitivity and Color Discrimination with Transparent and Blue-Light Filter Intraocular Lenses.

Science.gov (United States)

da Costa, Marcelo Fernandes; Júnior, Augusto Paranhos; Lottenberg, Claudio Luiz; Castro, Leonardo Cunha; Ventura, Dora Fix

2017-12-01

The purpose of this study was to measure luminance contrast sensitivity and color vision thresholdfs in normal subjects using a blue light filter lens and transparent intraocular lens material. Monocular luminance grating contrast sensitivity was measured with Psycho for Windows (version 2.36; Cambridge Research Systems) at 3.0, 6.0, 12.0, 20.0, and 30.0 cycles per degree of visual angle (cpd) in 15 normal subjects (eight female), with a mean age of 21.6 years (SD = 3.8 years). Chromatic discrimination was assessed with the Cambridge colour test (CCT) along the protan, deutan, and tritan color confusion axes. Both tests were performed in a darkened room under two situations: with a transparent lens and with blue light filter lens. Subjective impressions were taken by subjects regarding their visual experience under both conditions. No difference was found between the luminance contrast sensitivity measured with transparent and blue light filter. However, 13/15 (87%) of the subjects reported more comfortable vision with the blue filter. In the color vision test, tritan thresholds were significantly higher for the blue filter compared with the transparent filter (p = 0.003). For protan and deutan thresholds no differences were found. Blue-yellow color vision is impaired with the blue light filter, and no impairment occurs with the transparent filter. No significant differences in thresholds were found in the luminance contrast sensitivity comparing the blue light and transparent filters. The impact of short wavelength light filtering on intrinsically photosensitive retinal ganglion cells is also discussed.

Long-term follow-up after scleral lens fixation in patients with Marfan syndrome.

Science.gov (United States)

Luebke, Jan; Reinhard, Thomas; Agostini, Hansjuergen; Boehringer, Daniel; Eberwein, Philipp

2017-12-06

The dislocation of the crystalline lens is a common finding in patients with Marfan syndrome (MFS). Scleral intraocular lens (IOL) fixation is an accepted treatment method of this complication. To now, no long-term data on scleral IOL fixation in MFS exist. We present a retrospective study of 27 eyes of 17 MFS patients that underwent scleral lens fixation at our clinic between 1999 and 2012. These patients are compared to an age- and surgeon-matched group of 31 eyes of 27 patients who underwent the same procedure for reasons other than MFS. The median age in the MFS group was 35.4 years versus 35.6 years in the non-MFS group. The median follow-up was 4 years for MFS and 3 years for non-MFS. In the MFS group, significantly more IOL-dislocations occurred than compared to the non-MFS group (30% vs. 6.5%, p = 0.02). Retinal detachment occurred in four MFS-eyes compared to three eyes in the non-MFS group. Biometry prediction error was 1.11 diopters (D) for MFS and 1.33 D for non-MFS (p = 0.11). Median BCVA (best-corrected visual acuity, logMAR) was 0.1 in the MFS group versus 0.3 in non-MFS patients. Scleral lens fixation in MFS patients achieves satisfying visual and refractive outcomes. Our data shows a significantly higher rate of IOL dislocations in patients with MFS. We therefore recommend addressing this complication preoperatively.

Posterior chamber lens implantation with scleral fixation in children with traumatic cataract.

Science.gov (United States)

Caca, Ihsan; Sahin, Alparslan; Ari, Seyhmus; Alakus, Fuat

2011-01-01

To evaluate the outcomes of posterior chamber lens implantation with scleral fixation (SF-PCIOL) in children with traumatic cataract. Twenty-four eyes of 24 cases were included. All patients had corneal or corneoscleral lacerations that were primarily repaired. Traumatic cataract subsequently developed and SF-PCIOL was performed due to insufficient posterior capsule support. The average age of the patients was 5.8 years (range: 4 to 10 years). All cases had SF-PCIOL implanted via internal route using triangular double scleral flaps made of 9-0 polypropylene after a complete anterior vitrectomy. Average follow-up was 14.6 ± 4.3 months (range: 11 to 18 months). Visual acuity was increased at the last visit in 23 (96%) patients. Common postoperative complications were fibrinous reaction in 6 (25%) patients, transient intraocular pressure increase in 4 (17%) patients, membrane formation requiring removal in 1 (4%) patient, transient intraocular hemorrhage as vitreous hemorrhage in 1 (4%) patient, and retinal detachment in 1 (4%) patient after the postoperative second month. SF-PCIOL is an effective and reliable method in patients with pediatric traumatic cataract who had insufficient posterior capsule support. Copyright 2011, SLACK Incorporated.

Removal of intraocular foreign body in anterior chamber angle with prism contact lens and 23-gauge foreign body forceps.

Science.gov (United States)

Huang, Yan-Ming; Yan, Hua; Cai, Jin-Hong; Li, Hai-Bo

2017-01-01

To introduce a novel approach in removal of anterior chamber angle foreign body (ACFB) using a prism contact lens and 23-gauge foreign body forceps. Data of 42 eyes of 42 patients who had undergone removal of ACFB using a prism contact lens and 23-gauge foreign body forceps from January 2008 to October 2013 were collected and analyzed. Twenty eyes in group A received the conventional approach by using toothed forceps through corneal limbus incision, and 22 eyes in group B underwent the novel method through the opposite corneal limbus incision. The success rate of ACFB once removal was 75% (15/20) in group A, and 100% (22/22) in group B. The average operation time of group A was significantly longer compared with group B (34.9±9.88min vs 22.13±8.85min; P contact lens and 23-gauge foreign body forceps is a safer, more effective, and convenient technique compared with the conventional approach.

Single lens to lens duplication: The missing link

OpenAIRE

Bhatt, Rupal; Jethani, Jitendra; Saluja, Praveen; Bharti, Vinay

2008-01-01

Congenital anomalies of the lens include a wide range from lens coloboma to primary aphakia and doubling of lens. There have been few case reports of double lens; the etiology suggested is metaplastic changes in the surface ectoderm that leads to formation of two lens vesicles and hence resulting in double lens. We report a case with bilobed lens, which raises the possibility of explaining the etiology of double lens.