Acuidade visual em implantes bilaterais de lentes intra-oculares monofocais e multifocais Visual acuity of bilateral implants of monofocal and multifocal intraocular lenses

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Leonardo Akaishi

2003-01-01

Full Text Available OBJETIVO: Comparar a acuidade visual de longe e perto de pacientes submetidos à facoemulsificação binocular não simultânea com implante de lentes multifocais ou monofocais. MÉTODOS: Foram selecionados 20 pacientes com lentes multifocais bilaterais e outros 20 pacientes com lentes monofocais também bilaterais, com acuidade visual sem correção melhor ou igual a 0,63 (20/30, medidos separadamente, nos três primeiros meses de pós-operatório. Foi medida a acuidade visual para longe e perto com e sem correção e testes de sensibilidade ao contraste e ofuscamento. RESULTADOS: A acuidade visual sem correção para longe no grupo das monofocais teve média de 0,82 (DP± 0,16 e no grupo das multifocais, 0,94 (DP±0,12, valor de p 0,001. Os dois grupos de lentes tiveram visão com correção para longe igual a 1. No grupo das multifocais, 75% tiveram J1 e 100% tiveram J3 ou melhor sem correção. No grupo das lentes monofocais, 10% tiveram J1 e 70% tiveram J3 ou melhor sem correção. Não houve diferença significante na avaliação com o teste de sensibilidade ao contraste entre os grupos pesquisados. No teste de ofuscamento, os dois grupos tiveram redução da visão, que foi mais acentuada no grupo dos pacientes com lentes multifocais. CONCLUSÃO: A acuidade visual para longe com correção nos pacientes com implante multifocal foi semelhante a dos pacientes com implantes monofocais, embora a acuidade visual para perto no grupo em que foi implantado lente multifocal foi bastante superior ao grupo da lente monofocal. A sensibilidade ao contraste manteve-se semelhante nos dois grupos, já o ofuscamento ("glare test" no grupo multifocal foi maior que no grupo monofocal.PURPOSE: To compare distant and near visual acuity between patients submitted to bilateral nonsimultaneous facoemulsification and implantation of multifocal or monofocal intraocular lenses (IOL. METHODS: Twenty patients with bilateral multifocal IOL and 20 patients with

DESIGN OF THE MULTIORDER INTRAOCULAR LENSES

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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.

Power profiles of single vision and multifocal soft contact lenses.

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Wagner, Sandra; Conrad, Fabian; Bakaraju, Ravi C; Fedtke, Cathleen; Ehrmann, Klaus; Holden, Brien A

2015-02-01

The purpose of this study was to investigate the optical zone power profile of the most commonly prescribed soft contact lenses to assess their potential impact on peripheral refractive error and hence myopia progression. The optical power profiles of six single vision and ten multifocal contact lenses of five manufacturers in the powers -1.00 D, -3.00 D, and -6.00 D were measured using the SHSOphthalmic (Optocraft GmbH, Erlangen, Germany). Instrument repeatability was also investigated. Instrument repeatability was dependent on the distance from the optical centre, manifesting unreliable data for the central 1mm of the optic zone. Single vision contact lens measurements of -6.00 D lenses revealed omafilcon A having the most negative spherical aberration, lotrafilcon A having the least. Somofilcon A had the highest minus power and lotrafilcon A the biggest deviation in positive direction, relative to their respective labelled powers. Negative spherical aberration occurred for almost all of the multifocal contact lenses, including the centre-distance designs etafilcon A bifocal and omafilcon A multifocal. Lotrafilcon B and balafilcon A seem to rely predominantly on the spherical aberration component to provide multifocality. Power profiles of single vision soft contact lenses varied greatly, many having a negative spherical aberration profile that would exacerbate myopia. Some lens types and powers are affected by large intra-batch variability or power offsets of more than 0.25 dioptres. Evaluation of power profiles of multifocal lenses was derived that provides helpful information for prescribing lenses for presbyopes and progressing myopes. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Subjective evaluation of uncorrected vision in patients undergoing cataract surgery with (diffractive multifocal lenses and monovision

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Stock RA

2017-07-01

Full Text Available Ricardo Alexandre Stock, Thaís Thumé, Luan Gabriel Paese, Elcio Luiz Bonamigo Universidade do Oeste de Santa Catarina, Rua Getúlio Vargas, Joaçaba, Santa Catarina, Brazil Purpose: To analyze patient satisfaction and difficulties with bilateral multifocal intraocular lenses (IOLs implantation and aspheric monofocal IOLs implantation using monovision, after cataract surgery.Materials and methods: A total of 61 participants were included in the study, 29 with monovision and 32 with multifocal lenses. The inclusion criteria were patients undergoing phacoemulsification for bilateral visual impairment due to cataracts and presenting with postoperative visual acuity of 20/30 or better for distance and line J3 or better for near vision.Results: The 2 groups had similar results regarding difficulties with daily activities such as distance vision, near vision, watching television, reading, cooking, using a computer or cellphone, shaving/putting on makeup and shopping. There were differences in responses between the groups regarding difficulty with night vision (P=0.0565 and night driving (P=0.0291. Degree of satisfaction in terms of distance vision without glasses was statistically significantly better in monovision group (P=0.0332, but not for near (P=0.9101.Conclusion: Both techniques yielded satisfactory results regarding visual acuity for different activities without the need to use glasses. Multifocal lenses are a good option for patients with the exception of night driving, and who desire independence from glasses. Keywords: cataract extraction, aphakia, postcataract, patient satisfaction, night vision

Autorefraction versus subjective refraction in a radially asymmetric multifocal intraocular lens

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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

[In Vitro Evaluation of the Optical Quality of Segmental Refractive Multifocal Intraocular Lenses].

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Yildirim, Timur Mert; Auffarth, Gerd Uwe; Tandogan, Tamer; Liebing, Stephanie; Labuz, Grzegorz; Choi, Chul Young; Khoramnia, Ramin

2017-11-08

In customised patient care, it is important to know the optical quality of different intraocular lenses (IOL). In this study, the optical quality of three segmental intraocular lenses were compared. The LENTIS Comfort LS-313 MF15, LENTIS Mplus X LS-313 MF30 and LENTIS High Add IOL LS-313 MF80 (Oculentis, Berlin, Germany) with a far power of + 21 D were analysed at the optical bench OptiSpheric IOL PRO (Trioptics GmbH, Wedel, Germany). The lenses have almost the same optical design but differ in the power of the near segment. The MF15 has a + 1.5 D addition to improve vision in intermediate distances, the MF30 has a near addition of + 3 D and the MF80 has a near addition of + 8 D. The modulation transfer function area (MTFa) and the Strehl ratio were examined for apertures of 3 mm (photopic) and 4.5 mm (mesopic). The MTFa values for the far focus are 33.34/30.80/51.53 (MF15/MF30/MF80) with an aperture of 3 mm and 25.38/22.52/43.15 for 4.5 mm. The MTFa values for the intermediate focus are 29.85/16.21/6.25 for a 3 mm aperture and 23.92/8.05/3.08 for 4.5 mm. The MTFa values for the near focus are 9.75/21.49/33.12 for an aperture of 3 mm and 4.95/22.70/31.68 for 4.5 mm. The Strehl ratio of the far focus is 0.34/0.30/0.52 for an aperture of 3 mm and 0.24/0.22/0.43 for 4.5 mm. For the intermediate focus, the Strehl ratio is 0.30/0.17/0.07 for an aperture of 3 mm and 0.24/0.08/0.03 for 4.5 mm. The Strehl ratio of the near focus is 0.10/0.22/0.33 for an aperture of 3 mm and 0.05/0.23/0.32 for 4.5 mm. We confirmed that the addition influences the optical quality of segmental bifocal intraocular lenses. For the far focus, the results of the MF15 and MF30 are similar. In intermediate distances, the MF15 achieves the best results. For near distances, the MF30 achieves better optical values than the MF15. The lens MF80, which has been designed for patients with maculopathies, achieves good results for far and near distances. Georg

Comparison of the visual and intraocular optical performance of a refractive multifocal IOL with rotational asymmetry and an apodized diffractive multifocal IOL.

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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.

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

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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.

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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.

Influence of Near-Segment Positioning in a Rotationally Asymmetric Multifocal Intraocular Lens.

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Song, In Seok; Yoon, Sam Young; Kim, Jae Yong; Kim, Myoung Joon; Tchah, Hungwon

2016-04-01

To compare visual performance and higher order aberrations (HOAs) based on the position of the near segment in eyes with rotationally asymmetric multifocal intraocular lenses (IOLs). Asymmetric multifocal IOLs (Lentis Mplus LS-313; Oculentis Optikgeräte GmbH, Wetzlar, Germany) were implanted with the near segment positioned either inferiorly, superiorly, or temporally. Uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuity, corrected distance visual acuity (CDVA), and distance-corrected intermediate (DCIVA) and near (DCNVA) visual acuity, contrast sensitivity, HOAs, and subjective symptom questionnaires were compared at 1 month postoperatively. Forty-five eyes from 45 patients were evaluated (n = 25, 9, and 11 eyes in the inferior, superior, and temporal groups, respectively). No significant differences in UDVA, UIVA, UNVA, CDVA, DCIVA, or DCNVA were found between the three groups (P > .05). The temporal group showed the best results in UDVA, CDVA, and DCNVA, but the inferior group showed the best results in DCIVA and UNVA and the superior group showed the best results in UIVA. Contrast sensitivity and the subjective symptom questionnaire also did not demonstrate any significant differences (P > .05). Total HOA and spherical aberration did not demonstrate any statistically significant differences (P > .05), but vertical coma and horizontal coma demonstrated significant differences based on near segment position (P < .001). The position of the near segment in eyes with rotationally asymmetric multifocal IOLs demonstrates no significant effect on visual performance. Copyright 2016, SLACK Incorporated.

Spectacle Independence after Cataract Extraction in Post-Radial Keratotomy Patients Using Hybrid Monovision with ReSTOR® Multifocal and TECNIS® Monofocal Intraocular Lenses

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Isha Gupta

2014-05-01

Full Text Available Background: We report 2 patients who have undergone radial keratotomy (RK preceding ReSTOR® multifocal intraocular lens (IOL; Alcon, Fort Worth, Tex., USA implantation in their nondominant eyes and TECNIS® monofocal IOL (Abbott Medical Optics, Abbott Park, Ill., USA in their dominant eyes. Methods: Retrospective review of 2 patients who underwent hybrid monovision with ReSTOR® multifocal and TECHNIS® monofocal IOLs at the time of cataract surgery after a remote history of RK. Results: Implantation of the ReSTOR® multifocal and the TECHNIS® monofocal IOLs was successful, with no reported adverse events. The patients were able to achieve spectacle freedom. Conclusion: We report a novel technique for the management of post-RK patients to optimize their chances for spectacle independence.

The Mathematical Theory of Multifocal Lenses

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Jacob RUBINSTEIN

2017-01-01

This paper presents the fundamental optical concepts of designing multifocal ophthalmic lenses and the mathematical methods associated with them.In particular,it is shown that the design methodology is heavily based on differential geometric ideas such as Willmore surfaces.A key role is played by Hamilton's eikonal functions.It is shown that these functions capture all the information on the local blur and distortion created by the lenses.Along the way,formulas for computing the eikonal functions are derived.Finally,the author lists a few intriguing mathematical problems and novel concepts in optics as future projects.

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

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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.)

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

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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

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

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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.

Scleral fixation of a single-piece multifocal intraocular lens.

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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.

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.

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.

Power Profiles of Commercial Multifocal Soft Contact Lenses.

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Kim, Eon; Bakaraju, Ravi C; Ehrmann, Klaus

2017-02-01

To evaluate the optical power profiles of commercially available soft multifocal contact lenses and compare their optical designs. The power profiles of 38 types of multifocal contact lenses-three lenses each-were measured in powers +6D, +3D, +1D, -1D, -3D, and -6D using NIMO TR1504 (Lambda-X, Belgium). All lenses were measured in phosphate buffered saline across 8 mm optic zone diameter. Refractive index of each lens material was measured using CLR 12-70 (Index Instruments, UK), which was used for converting measured power in the medium to in-air radial power profiles. Three basic types of power profiles were identified: center-near, center-distance, and concentric-zone ring-type designs. For most of the lens types, the relative plus with respect to prescription power was lower than the corresponding spectacle add. For some lens types, the measured power profiles were shifted by up to 1D across the power range relative to their labeled power. Most of the lenses were designed with noticeable amounts of spherical aberration. The sign and magnitude of spherical aberration can either be power dependent or consistent across the power range. Power profiles can vary widely between the different lens types; however, certain similarities were also observed between some of the center-near designs. For the more recently released lens types, there seems to be a trend emerging to reduce the relative plus with respect to prescription power, include negative spherical aberration, and keep the power profiles consistent across the power range.

Evaluation of Optical Quality: Ocular Scattering and Aberrations in Eyes Implanted with Diffractive Multifocal or Monofocal Intraocular Lenses.

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Liao, Xuan; Lin, Jia; Tian, Jing; Wen, BaiWei; Tan, QingQing; Lan, ChangJun

2018-06-01

To compare objective optical quality, ocular scattering and aberrations of eyes implanted with an aspheric monofocal intraocular lens (IOL) or an aspheric apodized diffractive multifocal IOL three months after surgery. Prospective consecutive nonrandomized comparative cohort study. A total of 80 eyes from 57 cataract patients were bilaterally or unilaterally implanted with monofocal (AcrySof IQ SN60WF) or multifocal (AcrySof IQ ReSTOR SN6AD1) IOLs. Respectively, 40 eyes of 27 patients were implanted with monofocal IOLs, and 40 eyes of 30 patients were implanted with multifocal IOLs. Ocular high-order aberration (HOA) values were obtained using Hartmann-Shack aberrometer; objective scatter index (OSI), modulation transfer function (MTF) cutoff, Strehl ratio (SR), and contrast visual acuity OV at 100%, 20%, and 9% were measured using Objective Quality Analysis System II (OQAS II). Ocular aberrations performed similar in both groups (p > 0.05). However, significantly higher values of OSI and lower values of MTF cutoff, SR and OV were found in the SN6AD1 group (p < 0.05). Both ocular scattering and wave-front aberrations play essential role in retinal image quality, which may be overestimated when only aberrations were taken into account. Combining the effect of ocular scattering with HOA will result in a more accurate assessment of the visual and optical quality.

Comparison of visual function and patient satisfaction with AcrySof ReSTORSN6AD1 multifocal intraocular compared to monofocal intraocular lenses 5

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Aisa S Alchinova

2016-12-01

Full Text Available Aim. To compare visual function and satisfaction in patients after implantation of AcrySof ReSTOR SN6AD1 multifocal intraocular lens (IOL, AcrySof SA60AТ spherical monofocal IOL, or Akreos АО aspheric monofocal IOL during cataract surgery. Materials. Overall, 34 patients received SN6AD1 multifocal (group 1, 48 eyes, 19 patients received Akreos АО monofocal aspheric (group 2, 30 eyes, and 13 patients received AcrySof SA60AТ monofocal spherical (group 3, 18 eyes IOL. Patients with multifocal IOL were closely matched for age, sex, and ocular findings with patients who had monofocal IOL implantation. Six months postoperatively, uncorrected/corrected distance visual acuity (UDVA/CDVA, uncorrected intermediate (60 cm and near (35 cm visual acuity (UNVA, defocus curve, contrast sensitivity, and a quality-of-life questionnaire were evaluated. Furthermore, independence from glasses and presence of optical phenomena were assessed. Results. Patients in group 2 had statistically significant increase in UDVA than that in group 1 (p = 0.037. There was no significant difference in the mean uncorrected intermediate and best corrected distance visual acuities between the groups. UNVA was better in group 1 than that in groups 2 and 3 (p < 0.0001. Photopic contrast sensitivity for high spatial frequencies was better in groups 2 and 3. Glare was reported in 5.9% of patients in group 1. Halos occurred in 32.4% of patients in group 1. No one reported undesirable visual symptoms in groups 2 and 3. Conclusion. Multifocal IOLs provided higher spectacle independence and satisfactory functional vision over a broad range of distances but were associated with increased subjective visual symptoms and reduced photopic contrast sensitivity for high spatial frequencies and distance visual quality compared with monofocal IOLs.

Visual performance after bilateral implantation of 2 new presbyopia-correcting intraocular lenses: Trifocal versus extended range of vision.

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Monaco, Gaspare; Gari, Mariangela; Di Censo, Fabio; Poscia, Andrea; Ruggi, Giada; Scialdone, Antonio

2017-06-01

To compare the visual outcomes and quality of vision of 2 new diffractive multifocal intraocular lenses (IOLs) with those of a monofocal IOL. Fatebenefratelli e Oftalmico Hospital, Milan, Italy. Prospective case series. Patients had bilateral cataract surgery with implantation of a trifocal IOL (Panoptix), an extended-range-of-vision IOL (Symfony), or a monofocal IOL (SN60WF). Postoperative examinations included assessing distance, intermediate, and near visual acuity; binocular defocus; intraocular and total aberrations; point-spread function (PSF); modulation transfer function (MTF); retinal straylight; and quality-of-vision (QoV) and spectacle-dependence questionnaires. Seventy-six patients (152 eyes) were assessed for study eligibility. Twenty patients (40 eyes) in each arm of the study (60 patients, 120 eyes) completed the outcome assessment. At the 4-month follow-up, the trifocal group had significantly better near visual acuity than the extended-range-of-vision group (P = .005). The defocus curve showed the trifocal IOL had better intermediate/near performance than the extended-range-of-vision IOL and both multifocal IOLs performed better than the monofocal IOL. Intragroup comparison of the total higher-order aberrations, PSF, MTF, and retinal straylight were not statistically different. The QoV questionnaire results showed no differences in dysphotopsia between the multifocal IOL groups; however, the results were significantly higher than in the monofocal IOL group. Both multifocal IOLs seemed to be good options for patients with intermediate-vision requirements, whereas the trifocal IOL might be better for patients with near-vision requirements. The significant perception of visual side effects indicates that patients still must be counseled about these effects before a multifocal IOL is implanted. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Bilateral implantation of +3.0 D multifocal toric intraocular lenses: results of a US Food and Drug Administration clinical trial.

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Lehmann, Robert; Modi, Satish; Fisher, Bret; Michna, Magda; Snyder, Michael

2017-01-01

The purpose of this study was to evaluate the clinical outcomes of apodized diffractive +3.0 D multifocal toric intraocular lens (IOL) implantations in subjects with preoperative corneal astigmatism. This was a prospective cohort study conducted at 21 US sites. The study population consisted of 574 subjects, aged ≥21 years, with preoperative astigmatism 0.75-2.82 D, and potential postoperative visual acuity (VA) ≥0.2 logMAR, undergoing bilateral cataract removal by phacoemulsification. The intervention was bilateral implantation of aspheric apodized diffractive +3.0 D multifocal toric or spherical multifocal nontoric IOLs. The main outcome measures were monocular uncorrected near and distance VA and safety at 12 months. A total of 373/386 and 182/188 subjects implanted with multifocal toric and nontoric IOLs, respectively, completed 12-month follow-up after the second implantation. Toric IOLs were nonin-ferior in monocular uncorrected distance (4 m) and near (40 cm) VA but had >1 line better binocular uncorrected intermediate VA (50, 60, and 70 cm) than nontoric IOLs. Toric IOLs reduced cylinder to within 0.50 D and 1.0 D of target in 278 (74.5%) and 351 (94.1%) subjects, respectively. Mean ± standard deviation (SD) differences between intended and achieved axis orientation in the first and second implanted eyes were 5.0°±6.1° and 4.7°±4.0°, respectively. Mean ± SD 12-month IOL rotations in the first and second implanted eyes were 2.7°±5.8° and 2.2°±2.7°, respectively. No subject receiving toric IOLs required secondary surgical intervention due to optical lens properties. Multifocal toric IOLs were noninferior to multifocal nontoric IOLs in uncorrected distance and near VAs in subjects with preexisting corneal astigmatism and effectively corrected astigmatism of 0.75-2.82 D.

Effect of Unifocal versus Multifocal Lenses on Cervical Spine Posture in Patients with Presbyopia.

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Abbas, Rami L; Houri, Mohamad T; Rayyan, Mohammad M; Hamada, Hamada Ahmad; Saab, Ibtissam M

2018-04-04

There are many environmental considerations which may or may not lead to the development of faulty cervical mechanics. The design of near vision lenses could contribute to the development of such cervical dysfunction and consequently neck pain. Decision making regarding proper type of lens prescription seems important for presbyopic individuals. To investigate the effect of unifocal and multifocal lenses on cervical posture. Thirty subjects (18 females and 12 males) participated in the study with an age range from 40 to 64 years. Each subject wore consequently both unifocal and multifocal lenses randomly while reading. Then lateral cervical spine X-ray films were taken for each subject during each lens wearing. X-ray films were analyzed with digital software (Autocad software, 2 D) to measure segmental angles of the cervical vertebrae (Occiput/C1, C1/C2, C2/C3, C3/C4, C4/C5, C5/C6, C6/C7, C3/C7, C0/C3, and occiput/C7). Higher significant extension angle in the segments C0/C7, C1/C2, C5/C6, C6/C7, and C3/C7 (p<0.05) during multifocal lenses wearing were observed in contrast with higher flexion angle between C3/C4 and C4/C5 (p<0.05) with unifocal lenses wear. Multifocal lens spectacles produces increased extension in the cervical vertebrae angles when compared with the use of unifocal lenses.

Refractive outcomes after multifocal intraocular lens exchange.

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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.

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

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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

Bioptics in sutureless intrascleral multifocal posterior chamber intraocular lens fixation.

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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.

Bilateral spontaneous subluxation of scleral-fixated intraocular lenses.

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Assia, Ehud I; Nemet, Arie; Sachs, Dani

2002-12-01

Two young men with primary ectopic lenses had intracapsular cataract extraction and scleral fixation of posterior chamber intraocular lenses (PC IOLs) using 10-0 polypropylene sutures tied to the IOL eyelets. Three to 9 years after implantation, spontaneous IOL vertical subluxation occurred in all 4 eyes (5 IOL loops), probably because of suture breakage. Late subluxation of a sutured IOL may occur several years after implantation. Double fixation and thicker sutures should be considered, especially in young patients.

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

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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

Small-Gauge Pars Plana Vitrectomy for the Management of Symptomatic Posterior Vitreous Detachment after Phacoemulsification and Multifocal Intraocular Lens Implantation: A Pilot Study from the Pan-American Collaborative Retina Study Group

Science.gov (United States)

Navarro, Rodrigo M.; Machado, Leonardo M.; Maia, Ossires; Wu, Lihteh; Farah, Michel E.; Magalhaes, Octaviano; Arevalo, J. Fernando; Maia, Mauricio

2015-01-01

Purpose. To determine the efficacy of 23-gauge pars plana vitrectomy (PPV) for symptomatic posterior vitreous detachment (PVD) on visual acuity (VA) and quality after multifocal intraocular lenses (IOLs). Methods. In this prospective case series, patients who developed symptomatic PVD and were not satisfied with visual quality due to floaters and halos after multifocal IOL implantation underwent PPV. Examinations included LogMAR uncorrected visual acuity (UCVA), intraocular pressure, biomicroscopy, and indirect ophthalmoscopy at baseline and 1, 7, 30, and 180 days postoperatively. Ultrasonography and aberrometry were performed. The Visual Functioning Questionnaire 25 (VFQ-25) was administered preoperatively and at 30 days postoperatively. Both the postoperative UCVA and questionnaire results were compared to preoperative findings using the Wilcoxon test. Results. Sixteen eyes of 8 patients were included. VA significantly improved from 0.17 to 0.09 postoperatively (P = 0.017). All patients reported improvement of halos, glare, and floaters. VFQ-25 scores significantly improved in general vision (P = 0.023), near activities (P = 0.043), distance activities (P = 0.041), mental health (P = 0.011), role difficulties (P = 0.042), and driving (P = 0.016). Conclusion. PPV may increase UCVA and quality of vision in patients with bilateral multifocal IOLs and symptomatic PVD. Larger studies are advised. PMID:26504590

[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.

Retreatments after multifocal intraocular lens implantation: an analysis

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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

Visual outcome and optical quality after bilateral implantation of aspheric diffractive multifocal, aspheric monofocal and spherical monofocal intraocular lenses: a prospective comparison

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Ke Yao

2013-06-01

Full Text Available AIM: To evaluate the visual function after bilateral implantation of aspheric diffractive multifocal Tecnis ZMA00, aspheric monofocal ZA9003 versus spherical monofocal Akreos Adapt intraocular lenses (IOLs.METHODS: Tecnis ZMA00, Tecnis ZA9003 or Akreos Adapt IOLs were bilaterally implanted in 180 eyes from 90 patients. The following parameters were assessed 3 months postoperatively: monocular and binocular uncorrected visual acuity (UCVA and distance-corrected visual acuity (DCVA for distance, intermediate and near, spherical aberration (SA, contrast and glare sensitivity, near point refractive power, uncorrected and best-corrected near stereoscopic acuity (NSA. Patient satisfaction was assessed by a questionnaire.RESULTS: Three months postoperatively, the monocular and binocular UCVA and DCVA at near of Tecnis ZMA00 were significantly better than other two groups. The mean SA for 5.0mm optical zone in Tecnis ZMA00 and Tecnis ZA9003 was significantly lower than that in Akreos Adapt. Mean contrast sensitivity and glare sensitivity were better for Tecnis ZA9003 group than for other two groups. Patients with Tecnis ZMA00 had higher monocular and binocular near point refractive power and uncorrected NSA than monofocal groups. The patients in Tecnis ZMA00 had higher mean values for halo compared with other two groups.CONCLUSION: Tecnis ZMA00 provided better near VA and uncorrected NSA and higher near point refractive power than monofocal IOLs and patients were spectacle independent. The IOLs with Tecnis aspheric design improved contrast and glare sensitivity. Patients with Tecnis ZMA00 reported more disturbances on visual phenomena of halo.

A contralateral eye study comparing apodized diffrative and full diffrative lenses: wavefront analysis and distance and near uncorrected visual acuity

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Marcony Rodrigues de Santhiago

2009-01-01

Full Text Available PURPOSE: To evaluate intraindividual visual acuity, wavefront errors and modulation transfer functions in patients implanted with two diffractive multifocal intraocular lenses. METHODS: This prospective study examined 40 eyes of 20 cataract patients who underwent phacoemulsification and implantation of a spherical multifocal ReSTOR intraocular lens in one eye and an aspheric Tecnis ZM900 multifocal intraocular lens in the other eye. The main outcome measures, over a 3-month follow-up period, were the uncorrected photopic distance and near visual acuity and the defocus curve. The visual acuity was converted to logMAR for statistical analysis and is presented in decimal scale. The wavefront error and modulation transfer function were also evaluated in both groups. RESULTS: At the 3-month postoperative visit, the mean photopic distance uncorrected visual acuity (UCVA was 0.74 ± 0.20 in the ReSTOR group and 0.76 ± 0.22 in the Tecnis group (p=0.286. The mean near UCVA was 0.96 ± 0.10 in the ReSTOR group and 0.93 ± 0.14 in the Tecnis group (p=0.963. The binocular defocus curve showed measurements between the peaks better than 0.2 logMAR. The total aberration, higher-order aberration and coma aberration were not significantly different between the groups. The spherical aberration was significantly lower in the Tecnis group than in the ReSTOR group. (p=0.004. Both groups performed similarly for the modulation transfer function. CONCLUSION: The ReSTOR SN60D3 and Tecnis ZM 900 intraocular lenses provided similar photopic visual acuity at distance and near. The diffractive intraocular lenses studied provided a low value of coma and spherical aberrations, with the Tecnis intraocular lens having a statistically lower spherical aberration compared to the ReSTOR intraocular lens. In the 5 mm pupil diameter analyses, both intraocular lens groups showed similar modulation transfer functions.

[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.

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

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Patrícia Ioschpe Gus

2006-06-01

Full Text Available OBJETIVO: Quantificar e comparar a aderência in vitro das bactérias Staphylococcus epidermidis e Pseudomonas alcaligenes em diferentes tipos de lentes intra-oculares (LIOs. MÉTODOS: Quatorze lentes intra-oculares foram usadas no experimento. Quatro de polimetilmetacrilato (PMMA, quatro de silicone, quatro de hidrogel e duas de acrílico. Oito lentes intra-oculares foram colocadas em oito tubos de ensaio contendo 4 ml de suspensão de Pseudomonas alcaligenes, e seis lentes intra-oculares foram colocadas em seis tubos de ensaio contendo 4 ml de suspensão de Staphylococcus epidermidis. A concentração do caldo utilizada para o teste de aderência foi de 10(8 unidades formadoras de colônias por mililitro (CFU/mL que corresponde a 0,5 na escala de McFarland. As lentes foram incubadas a 37° por duas horas. Após, foram removidas dos caldos e enxaguadas em água destilada estéril por duas vezes. As lentes foram cultivadas em placas de ágar-sangue a 35-37° e evaliadas a cada 24h por um período de 72h. Nas amostras que tiveram crescimento bacteriano, foram contadas as colônias utilizando os métodos convencionais de laboratório. Todos os ensaios foram executados em duplicata. RESULTADOS: A aderência do Staphylococcus epidermidis nas lentes de PMMA foi menor se comparada com as de silicone e de hidrogel. A aderência daPseudomonas alcaligenes nas lentes de hidrogel foi menor se comparada com as de silicone, PMMA e acrílico. CONCLUSÃO: Os resultados sugerem que a aderência do Staphylococcus epidermidis e da Pseudomonas alcaligenes nas lentes intra-oculares é influenciada pelo tipo de material da lente e pela espécie do microorganismo. A aderência bacteriana pode ter papel importante na patogenicidade da endoftalmite pós-cirurgia de catarata.PURPOSE: To quantify and compare the in vitro adherence of Staphylococcus epidermidis and Pseudomonas alcaligenes to different intraocular lenses (IOLs. METHODS: Fourteen intraocular lenses were

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.

Antireflection coatings for intraocular lenses of sapphire and fianite

Energy Technology Data Exchange (ETDEWEB)

Babin, A.A.; Konoplev, Yu.N.; Mamaev, Yu.A. [Inst. of Applied Physics, Nizhnii Novgorod (Russian Federation)] [and others

1995-10-01

Broadband antireflection coatings for intraocular lenses of sapphire and fianite are calculated and implemented practically. Their residual reflectance in the liquid with a refracting index of 1.336 is below 0.2% from each face virtually over the entire visible region. 7 refs., 2 figs., 2 tabs.

Straylight from glistenings in intraocular lenses : In vitro study

NARCIS (Netherlands)

Łabuz, Grzegorz; Reus, Nicolaas J; van den Berg, Thomas J T P

PURPOSE: To assess light scattering from intraocular lenses (IOLs) with different numbers of laboratory-induced glistenings and create a model for predicting glistening effects on straylight. SETTING: Rotterdam Ophthalmic Institute, Rotterdam, the Netherlands. DESIGN: Experimental study. METHODS:

[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.

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

Validity of automated refraction after segmented refractive multifocal intraocular lens implantation

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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.

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

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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.

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.

In vitro study of antibiotic effect on bacterial adherence to acrylic intraocular lenses.

Science.gov (United States)

Gaál, Valéria; Kilár, Ferenc; Acs, Barnabás; Szijjártó, Zsuzsanna; Kocsis, Béla; Kustos, Ildikó

2005-11-10

Implantation of artificial intraocular lenses into the eye during ophthalmic surgical procedures ensures an unliving surface on which bacterial pathogens may attach and form biofilms. Despite antibiotic treatment bacteria growing in biofilms might cause inflammation and serious complications. In this study the adhesive ability of 7 Staphylococcus aureus and 11 coagulase-negative Staphylococcus (CNS) strains to the surface of acrylic intraocular lenses had been examined by the ultrasonic method. In untreated cases adhesion of the S. aureus and CNS strains did not differ significantly. We could not demonstrate significant differences between the adhesive ability of the standard strains and the clinical isolates. In this study a single--60 min long--antibiotic (ciprofloxacin and tobramycin) treatment had been applied, that correlate well with the single or intermittant antibiotic prophylaxis of patients. Ciprofloxacin administration was able to reduce significantly the number of attached cells on the surface of acrylic lenses both in the case of S. aureus and CNS strains. Dependence of the effect from concentration could also be demonstrated. Tobramycin treatment was able to inhibit significantly the attachment of S. aureus cells. Despite the debate on antibiotic prophylaxis we presented in our experiments that a single antibiotic administration can decrease the attachment of bacterial cells to the surface of acrylic intraocular lenses, and might be effective in the prevention of postoperative endophthalmitis, that is a rare but serious complication of ophthalmic surgery.

[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.

Light distribution in diffractive multifocal optics and its optimization.

Science.gov (United States)

Portney, Valdemar

2011-11-01

To expand a geometrical model of diffraction efficiency and its interpretation to the multifocal optic and to introduce formulas for analysis of far and near light distribution and their application to multifocal intraocular lenses (IOLs) and to diffraction efficiency optimization. Medical device consulting firm, Newport Coast, California, USA. Experimental study. Application of a geometrical model to the kinoform (single focus diffractive optical element) was expanded to a multifocal optic to produce analytical definitions of light split between far and near images and light loss to other diffraction orders. The geometrical model gave a simple interpretation of light split in a diffractive multifocal IOL. An analytical definition of light split between far, near, and light loss was introduced as curve fitting formulas. Several examples of application to common multifocal diffractive IOLs were developed; for example, to light-split change with wavelength. The analytical definition of diffraction efficiency may assist in optimization of multifocal diffractive optics that minimize light loss. Formulas for analysis of light split between different foci of multifocal diffractive IOLs are useful in interpreting diffraction efficiency dependence on physical characteristics, such as blaze heights of the diffractive grooves and wavelength of light, as well as for optimizing multifocal diffractive optics. Disclosure is found in the footnotes. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

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.

Peripheral refraction with dominant design multifocal contact lenses in young myopes

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Daniela Lopes-Ferreira

2013-04-01

Conclusion: It is possible to induce significant changes in the pattern of relative peripheral refraction in the myopic direction with commercially available dominant design multifocal contact lenses. The higher add (+3.00 D induced an significantly higher effect than the +2.00 D add lens, although an increase of 1 D in add power does not correspond to the same amount of increase in RPRE.

Effect of multizone refractive multifocal contact lenses on standard automated perimetry.

Science.gov (United States)

Madrid-Costa, David; Ruiz-Alcocer, Javier; García-Lázaro, Santiago; Albarrán-Diego, César; Ferrer-Blasco, Teresa

2012-09-01

The aim of this study was to evaluate whether the creation of 2 foci (distance and near) provided by multizone refractive multifocal contact lenses (CLs) for presbyopia correction affects the measurements on Humphreys 24-2 Swedish interactive threshold algorithm (SITA) standard automated perimetry (SAP). In this crossover study, 30 subjects were fitted in random order with either a multifocal CL or a monofocal CL. After 1 month, a Humphrey 24-2 SITA standard strategy was performed. The visual field global indices (the mean deviation [MD] and pattern standard deviation [PSD]), reliability indices, test duration, and number of depressed points deviating at P0.5% on pattern deviation probability plots were determined and compared between multifocal and monofocal CLs. Thirty eyes of 30 subjects were included in this study. There were no statistically significant differences in reliability indices or test duration. There was a statistically significant reduction in the MD with the multifocal CL compared with monfocal CL (P=0.001). Differences were not found in PSD nor in the number of depressed points deviating at P0.5% in the pattern deviation probability maps studied. The results of this study suggest that the multizone refractive lens produces a generalized depression in threshold sensitivity as measured by the Humphreys 24-2 SITA SAP.

Toric Intraocular Lenses in the Correction of Astigmatism During Cataract Surgery

DEFF Research Database (Denmark)

Kessel, Line; Andresen, Jens; Tendal, Britta

2016-01-01

TOPIC: We performed a systematic review and meta-analysis to evaluate the benefit and harms associated with implantation of toric intraocular lenses (IOLs) during cataract surgery. Outcomes were postoperative uncorrected distance visual acuity (UCDVA) and distance spectacle independence. Harms were...

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.

Barriers, motivators and enablers for dispensing multifocal contact lenses in Mumbai, India.

Science.gov (United States)

Thite, Nilesh; Shah, Ukti; Mehta, Jasmin; Jurkus, Janice

2015-01-01

To understand the potential barriers, motivators and enablers in dispensing multifocal contact lenses (MFCL). Two focus group discussions were conducted to design questionnaires regarding the prescribing habits for multifocal contact lenses (MFCL). Questions on potential barriers and motivators were included. The questionnaires were distributed among 133 eye care practitioners across Mumbai, India. Practitioners fitting one or less patient per month with MFCL completed the survey describing potential barriers, while those who prescribed more MFCL's per month completed the survey describing enablers and motivators. Responses from 102 practitioners were received. Most common potential barriers in prescribing MFCL were increased chair time (75%), lack of readily available trials (69%) and limitation in power range (63%). Lack of awareness among patients (90%) was the most common barrier from patients' outlook. Professional satisfaction (88%) and better business proposition (82%) were observed as main motivators while availability of the trials (84%) and correct patient selection (82%) were the major enablers. Graduate Optometrists felt dispensing MFCL did not offer a good business proposition (p=0.02). Experienced practitioners were observed to be least motivated (p=0.01) and believed that their patients found these lenses expensive (p=0.02). To enhance the MFCL practice, barriers like lack of awareness and limitations in power range must be addressed. Trial lens availability may motivate practitioners to prescribe MFCL. Further probing is required to understand lack of motivation among experienced practitioners. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

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.

A simple technique of intraocular lenses explantation for single-piece foldable lenses

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Arup Bhaumik

2017-01-01

Full Text Available Foldable intraocular lenses (IOLs are most commonly used in modern-day cataract surgery. Explantation of these IOLs is not frequently encountered, but sometimes extreme situations may demand the same. Commonly explantation is achieved by bisecting the IOL inside the anterior chamber with a cutter and delivering the pieces out one by one. This may require corneal wound extension with associated damage and endothelial loss leading to visual deterioration. We devised a simple, innovative IOL explantation technique utilizing a modified Alcon A cartridge and snare. This can successfully refold the IOL to be explanted inside the eye and deliver it out through the same wound. The device has limitations with very thick optic lenses, multipiece, and silicon IOLs. In conclusion, we describe a simple, innovative, and reproducible technique to explant almost any single piece IOL without compromising the original surgery and yielding very satisfactory outcomes.

Comparative study on optical performance and visual outcomes between two diffractive multifocal lenses: AMO Tecnis ® ZMB00 and AcrySof ® IQ ReSTOR ® Multifocal IOL SN6AD1

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Mario Augusto Pereira Dias Chaves

2016-06-01

Full Text Available ABSTRACT Purpose: To compare the optical performance and visual outcomes between two diffractive multifocal lenses: AMO Tecnis® ZMB00 and AcrySof® ReSTOR® SN6AD1. Methods: This prospective, non-randomized comparative study included the assessment of 74 eyes in 37 patients referred for cataract surgery and candidates for multifocal intraocular lens implants. Exclusion criteria included existence of any other eye disease, previous eye surgery, high axial myopia, preoperative corneal astigmatism of >1.00 cylindrical diopter (D, and intraoperative or postoperative complications. Ophthalmological evaluation included the measurement of uncorrected distance visual acuity (UDVA, corrected distance visual acuity (CDVA, distance-corrected near visual acuity (DCNVA, and distance-corrected intermediate visual acuity (DCIVA, with analysis of contrast sensitivity (CS, wavefront, and visual defocus curve. Results: Postoperative UDVA was 0.09 and 0.08 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.868; postoperative CDVA was 0.04 and 0.02 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.68; DCIVA was 0.17 and 0.54 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.000; and DCNVA was 0.04 and 0.09 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.001. In both cases, there was an improvement in the spherical equivalent and UDVA (p<0.05. Under photopic conditions, the SN6AD1 group had better CS at low frequencies without glare (p=0.04; however, the ZMB00 group achieved better sensitivity at high frequencies with glare (p=0.003. The SN6AD1 and ZMB00 lenses exhibited similar behavior for intermediate vision, according to the defocus curve; however, the ZMB00 group showed a shorter reading distance than the SN6AD1 group. There were no significant differences regarding aberrometry between the two groups. Conclusion: Both lenses promoted better quality of vision for both long and short distances and exhibited a similar behavior for

Evaluation of refractive correction for standard automated perimetry in eyes wearing multifocal contact lenses

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Kazunori Hirasawa

2017-10-01

Full Text Available AIM: To evaluate the refractive correction for standard automated perimetry (SAP in eyes with refractive multifocal contact lenses (CL in healthy young participants. METHODS: Twenty-nine eyes of 29 participants were included. Accommodation was paralyzed in all participants with 1% cyclopentolate hydrochloride. SAP was performed using the Humphrey SITA-standard 24-2 and 10-2 protocol under three refractive conditions: monofocal CL corrected for near distance (baseline; multifocal CL corrected for distance (mCL-D; and mCL-D corrected for near vision using a spectacle lens (mCL-N. Primary outcome measures were the foveal threshold, mean deviation (MD, and pattern standard deviation (PSD. RESULTS: The foveal threshold of mCL-N with both the 24-2 and 10-2 protocols significantly decreased by 2.2-2.5 dB CONCLUSION: Despite the induced mydriasis and the optical design of the multifocal lens used in this study, our results indicated that, when the dome-shaped visual field test is performed with eyes with large pupils and wearing refractive multifocal CLs, distance correction without additional near correction is to be recommended.

Implantation of a multifocal toric intraocular lens with a surface-embedded near segment after repeated LASIK treatments.

Science.gov (United States)

Khoramnia, Ramin; Auffarth, Gerd U; Rabsilber, Tanja M; Holzer, Mike P

2012-11-01

We report a 66-year-old patient who presented with increasing hyperopia, astigmatism, and presbyopia in both eyes 8 years after bilateral laser in situ keratomileusis (LASIK) and LASIK enhancement in the left eye aiming for spectacle independence. Bilateral multifocal toric Lentis Mplus intraocular lenses (IOLs) with an embedded near segment and individually customized cylinder correction were implanted uneventfully following phacoemulsification. The Haigis-L formula after previous hyperopia correction was chosen for IOL power calculation and provided reliable results. Emmetropia was targeted and achieved. Three months postoperatively, the uncorrected distance visual acuity had increased from 0.40 logMAR to 0.10 logMAR in the right eye and from 0.20 logMAR to 0.00 logMAR in the left eye. The patient gained 6 lines of uncorrected near visual acuity: 0.20 logMAR in the right eye and 0.10 logMAR in the left eye. This case shows that customized premium IOL implantation can provide accurate results even in challenging cases. The International Vision Correction Research Centre, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany, has received research grants, lecture fees, and travel reimbursement from Oculentis GmbH. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

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

Refractive lens exchange with a multifocal diffractive aspheric intraocular lens

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Teresa Ferrer-Blasco

2012-06-01

Full Text Available PURPOSE: To evaluate the safety, efficacy and predictability after refractive lens exchange with multifocal diffractive aspheric intraocular lens implantation. METHODS: Sixty eyes of 30 patients underwent bilateral implantation with AcrySof® ReSTOR® SN6AD3 intraocular lens with +4.00 D near addition. Patients were divided into myopic and hyperopic groups. Monocular best corrected visual acuity at distance and near and monocular uncorrected visual acuity at distance and near were measured before and 6 months postoperatively. RESULTS: After surgery, uncorrected visual acuity was 0.08 ± 0.15 and 0.11 ± 0.14 logMAR for the myopic and hyperopic groups, respectively (50% and 46.67% of patients had an uncorrected visual acuity of 20/20 or better in the myopic and hyperopic groups, respectively. The safety and efficacy indexes were 1.05 and 0.88 for the myopic and 1.01 and 0.86 for the hyperopic groups at distance vision. Within the myopic group, 20 eyes remained unchanged after the surgery, and 3 gained >2 lines of best corrected visual acuity. For the hyperopic group, 2 eyes lost 2 lines of best corrected visual acuity, 21 did not change, and 3 eyes gained 2 lines. At near vision, the safety and efficacy indexes were 1.23 and 1.17 for the myopic and 1.16 and 1.13 for the hyperopic groups. Best corrected near visual acuity improved after surgery in both groups (from 0.10 logMAR to 0.01 logMAR in the myopic group, and from 0.10 logMAR to 0.04 logMAR in the hyperopic group. CONCLUSIONS: The ReSTOR® SN6AD3 intraocular lens in refractive lens exchange demonstrated good safety, efficacy, and predictability in correcting high ametropia and presbyopia.

UV laser ablation of intraocular lenses: SEM and AFM microscopy examination of the biomaterial surface

International Nuclear Information System (INIS)

Spyratou, E.; Asproudis, I.; Tsoutsi, D.; Bacharis, C.; Moutsouris, K.; Makropoulou, M.; Serafetinides, A.A.

2010-01-01

Several new materials and patterns are studied for the formation and etching of intraocular lenses (IOLs), in order to improve their optical properties, to reduce the diffractive aberrations and to decrease the incidence of posterior capsular opacification. The aim of this study is to investigate the use of UV (λ = 266 nm) laser pulses to ablate the intraocular lenses materials, and thus to provide an alternative to conventional surface shaping techniques for IOLs fabrication. Ablation experiments were conducted using various polymer substrates of hydrophobic acrylic IOLs and PMMA IOLs. We investigated the ablation efficiency and the morphology of the ablated area by imaging the surface modification with atomic force microscopy (AFM) and scanning electron microscopy (SEM). The morphological appearance of IOL samples reveals the effect of a photochemical and photothermal ablation mechanism.

UV laser ablation of intraocular lenses: SEM and AFM microscopy examination of the biomaterial surface

Energy Technology Data Exchange (ETDEWEB)

Spyratou, E., E-mail: ellas5@central.ntua.gr [National Technical University of Athens, School of Applied Mathematical and Physical Sciences, Department of Physics, Zografou Campus, Athens, 15780 (Greece); Asproudis, I. [Department of Ophthalmology, University Hospital of Ioannina, Ioannina, 45110 (Greece); Tsoutsi, D. [Department of Chemistry, University of Ioannina, Ioannina, 45110 (Greece); Bacharis, C.; Moutsouris, K.; Makropoulou, M.; Serafetinides, A.A. [National Technical University of Athens, School of Applied Mathematical and Physical Sciences, Department of Physics, Zografou Campus, Athens, 15780 (Greece)

2010-02-01

Several new materials and patterns are studied for the formation and etching of intraocular lenses (IOLs), in order to improve their optical properties, to reduce the diffractive aberrations and to decrease the incidence of posterior capsular opacification. The aim of this study is to investigate the use of UV ({lambda} = 266 nm) laser pulses to ablate the intraocular lenses materials, and thus to provide an alternative to conventional surface shaping techniques for IOLs fabrication. Ablation experiments were conducted using various polymer substrates of hydrophobic acrylic IOLs and PMMA IOLs. We investigated the ablation efficiency and the morphology of the ablated area by imaging the surface modification with atomic force microscopy (AFM) and scanning electron microscopy (SEM). The morphological appearance of IOL samples reveals the effect of a photochemical and photothermal ablation mechanism.

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.

Evaluation of refractive correction for standard automated perimetry in eyes wearing multifocal contact lenses.

Science.gov (United States)

Hirasawa, Kazunori; Ito, Hikaru; Ohori, Yukari; Takano, Yui; Shoji, Nobuyuki

2017-01-01

To evaluate the refractive correction for standard automated perimetry (SAP) in eyes with refractive multifocal contact lenses (CL) in healthy young participants. Twenty-nine eyes of 29 participants were included. Accommodation was paralyzed in all participants with 1% cyclopentolate hydrochloride. SAP was performed using the Humphrey SITA-standard 24-2 and 10-2 protocol under three refractive conditions: monofocal CL corrected for near distance (baseline); multifocal CL corrected for distance (mCL-D); and mCL-D corrected for near vision using a spectacle lens (mCL-N). Primary outcome measures were the foveal threshold, mean deviation (MD), and pattern standard deviation (PSD). The foveal threshold of mCL-N with both the 24-2 and 10-2 protocols significantly decreased by 2.2-2.5 dB ( P correction without additional near correction is to be recommended.

Extreme depth-of-field intraocular lenses

Science.gov (United States)

Baker, Kenneth M.

1996-05-01

A new technology brings the full aperture single vision pseudophakic eye's effective hyperfocal distance within the half-meter range. A modulated index IOL containing a subsurface zeroth order coherent microlenticular mosaic defined by an index gradient adds a normalizing function to the vergences or parallactic angles of incoming light rays subtended from field object points and redirects them, in the case of near-field images, to that of far-field images. Along with a scalar reduction of the IOL's linear focal range, this results in an extreme depth of field with a narrow depth of focus and avoids the focal split-up, halo, and inherent reduction in contrast of multifocal IOLs. A high microlenticular spatial frequency, which, while still retaining an anisotropic medium, results in a nearly total zeroth order propagation throughout the visible spectrum. The curved lens surfaces still provide most of the refractive power of the IOL, and the unique holographic fabrication technology is especially suitable not only for IOLs but also for contact lenses, artificial corneas, and miniature lens elements for cameras and other optical devices.

Effect of gamma radiation on the optical properties of intraocular lenses

International Nuclear Information System (INIS)

Naguib, N.I.

2006-01-01

The effect of gamma rays in the range of doses up to 150 gray on optical and thermal properties of the intraocular lenses (IOL) made of polymethyl methacrylate (PMMA) was studied. Thermogravimetric analysis (TGA) and differential scanning colorimetry (DSC) have been performed to study the effect of gamma irradiation on the IOL. The results indicate that irradiation up to 150 Gy did not affect greatly the optical and thermal properties of the investigated IOL

Effect of transscleral neodymium: YAG cyclophotocoagulation on intraocular lenses

Energy Technology Data Exchange (ETDEWEB)

Blomquist, P.H.; Gross, R.L.; Koch, D.D. (Baylor College of Medicine, Houston, TX (USA))

1990-03-01

A neodymium: YAG laser operating in the thermal mode was used to irradiate isolated intraocular lenses (IOLs) and to perform transscleral cyclophotocoagulation on pseudophakic autopsy eyes to investigate the potential damage to IOL haptics such irradiation may cause. In the isolated IOLs, 70 mJ of energy deformed and partially melted both polymethylmethacrylate (PMMA) and polypropylene haptics. One of the capsular-fixated PC-IOL haptics in an autopsy eye partially melted when irradiated with the maximum energy level (8.8 J), with the aiming beam focused 1 mm posterior to the limbus and maximal posterior focus offset.

Clinical outcomes of a new diffractive multifocal intraocular lens

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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.

Anterior capsular support for posterior chamber intraocular lenses following vitreous loss in endocapsular surgery

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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

Extended depth of focus contact lenses vs. two commercial multifocals: Part 1. Optical performance evaluation via computed through-focus retinal image quality metrics.

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Bakaraju, Ravi C; Ehrmann, Klaus; Ho, Arthur

To compare the computed optical performance of prototype lenses designed using deliberate manipulation of higher-order spherical aberrations to extend depth-of-focus (EDOF) with two commercial multifocals. Emmetropic, presbyopic, schematic eyes were coupled with prototype EDOF and commercial multifocal lenses (Acuvue Oasys for presbyopia, AOP, Johnson & Johnson & Air Optix Aqua multifocal, AOMF, Alcon). For each test configuration, the through-focus retinal image quality (TFRIQ) values were computed over 21 vergences, ranging from -0.50 to 2.00D, in 0.125D steps. Analysis was performed considering eyes with three different inherent aberration profiles: five different pupils and five different lens decentration levels. Except the LOW design, the AOP lenses offered 'bifocal' like TFRIQ performance. Lens performance was relatively independent to pupil and aberrations but not centration. Contrastingly, AOMF demonstrated distance centric performance, most dominant in LOW followed by MED and HIGH designs. AOMF lenses were the most sensitive to pupil, aberrations and centration. The prototypes demonstrated a 'lift-off' in the TFRIQ performance, particularly at intermediate and near, without trading performance at distance. When compared with AOP and AOMF, EDOF lenses demonstrated reduced sensitivity to pupil, aberrations and centration. With the through focus retinal image quality as the gauge of optical performance, we demonstrated that the prototype EDOF designs were less susceptible to variations in pupil, inherent ocular aberrations and decentration, compared to the commercial designs. To ascertain whether these incremental improvements translate to a clinically palpable outcome requires investigation through human trials. Copyright © 2017 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

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

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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.

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

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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.

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

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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 ...

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

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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.

Light transmission through intraocular lenses with or without yellow chromophore (blue light filter) and its potential influence on functional vision in everyday environmental conditions.

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Owczarek, Grzegorz; Gralewicz, Grzegorz; Skuza, Natalia; Jurowski, Piotr

2016-01-01

In this research the factors used to evaluate the light transmission through two types of acrylic hydrophobic intraocular lenses, one that contained yellow chromophore that blocks blue light transmission and the other which did not contain that filter, were defined according to various light condition, e.g., daylight and at night. The potential influence of light transmission trough intraocular lenses with or without yellow chromophore on functional vision in everyday environmental conditions was analysed.

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

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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).

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

Clinical and optical intraocular performance of rotationally asymmetric multifocal IOL plate-haptic design versus C-loop haptic design.

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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.

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.

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.

Effects of intraocular lenses with different diopters on chromatic aberrations in human eye models

OpenAIRE

Song, Hui; Yuan, Xiaoyong; Tang, Xin

2016-01-01

Background In this study, the effects of intraocular lenses (IOLs) with different diopters (D) on chromatic aberration were investigated in human eye models, and the influences of the central thickness of IOLs on chromatic aberration were compared. Methods A Liou-Brennan-based IOL eye model was constructed using ZEMAX optical design software. Spherical IOLs with different diopters (AR40e, AMO Company, USA) were implanted; modulation transfer function (MTF) values at 3?mm of pupil diameter and...

Comparison between OPD-scan results and contrast sensitivity of three intraocular lenses: spheric AcrySof SN60AT, aspheric AcrySof SN60WF and multifocal AcrySof Restor lens Estudo comparativo da análise de frente de onda e sensibilidade ao contraste entre as lentes intra-oculares multifocal AcrySof Restor SN60D3, monofocal AcrySof SN60WF asférica e a monofocal SN60AT esférica

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Celso Takashi Nakano

2009-08-01

ção com implantes de lentes intraoculares AcrySof SN60D3 multifocal, AcrySof SN60WF monofocal asférica e AcrySof SA60AT monofocal esférica. Métodos: Trinta e dois olhos com a lente intraocular multifocal, 32 olhos com a lente intraocular monofocal asférica e 32 olhos com a lente intraocular monofocal esférica. A avaliação oftalmológica foi realizada no primeiro, terceiro, sétimo, e nonagésimo dia pós-operatório. Todos os exames foram padronizados, realizada por um único examinador sob condições controladas de luminosidade fotópicas estabelecidas em 85 cd/m², medida por meio de tabelas de ETDRS, sensibilidade ao contraste e análise de aberrometria com OPD-Scan. Resultados: As médias de aberração total foi superior no grupo SN60AT (KW = 9.42; p=0.009 quando comparada com o grupo SN60D3 (p=0.016 e o grupo SN60WF (p=0.0047. O grupo SN60AT (KW = 16.20; p=0.0003 apresentou superioridade nas medias de aberração esférica comparada com o grupo SN60WF (p=0.00046 e o grupo SN60D3 (p=0.0014. Nenhuma diferença significante foi encontrada na acuidade visual para longe com e sem correção óptica com a tabela de ETDRS a 100% e 9% de contraste. O grupo SN60D3 comparada a SN60AT (p=0.016 apresentou baixa sensibilidade ao contraste em condições fotópicas com diferença estatística a 6.0 cpg (KW = 7.84; p=0.0199, mas sem diferença estatística entre os grupos SN60WF e SN60AT (p=0.91 e entre os grupos SN60WF e SN60D3 (p=0.051. O grupo SN60D3 apresentou baixa sensibilidade ao contraste em condições mesópicas (KW = 10.79; p=0,0045 a 6cpg quando comparada com o grupos SN60AT (p=0.011 e SN60WF (p=0.007. Conclusão: As lentes intraoculares multifocais e asféricas apresentaram menos aberração esférica quando comparadas à lente intraocular esférica, além da prevista multifocalidade sem correção para longe e perto. Entretanto, o grupo multifocal apresentou baixa sensibilidade ao contraste.

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.

Desempenho visual após implante de uma lente intraocular asférica multifocal difrativa Visual performance after implantation of an aspheric multifocal diffractive intraocular lens

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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

Visual performance after the implantation of a new trifocal intraocular lens

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Vryghem JC

2013-10-01

intraocular lenses improves the intermediate vision with minimal visual discomfort for the patient.Keywords: lens implantation, trifocal diffractive intraocular lens, third focus, diffractive multifocal

Opacification of hydrophilic intraocular lenses after Descemet stripping automated endothelial keratoplasty

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Morgan-Warren PJ

2015-02-01

Full Text Available Peter J Morgan-Warren, Walter Andreatta, Amit K Patel Department of Ophthalmology, Solihull Hospital, Heart of England NHS Foundation Trust, Birmingham, UK Purpose: Opacification of hydrophilic acrylic intraocular lenses (IOLs is an emerging complication following Descemet stripping automated endothelial keratoplasty (DSAEK. We report six cases and review the current literature.Methods: In this retrospective, noncomparative, observational case series, patients with IOL opacification after previous DSAEK surgery were identified from corneal clinic records. Case notes were reviewed for demographic details, indication for DSAEK, IOL model, incidence of rebubbling, and postoperative course.Results: Six patients developed IOL opacification after DSAEK. All patients had Fuchs’ endothelial dystrophy and had previously received hydrophilic acrylic IOL models. Central anterior IOL opacification was noted in all six cases. Five cases (83% had required rebubbling due to dislocated graft tissue, and one had an early postoperative intraocular pressure (IOP rise. Five cases (83% were managed conservatively, and one case with a failed graft underwent redo DSAEK and IOL exchange.Conclusion: Repeated exposure to intracameral air, raised IOP, and other patient influences may be major etiological factors for IOL opacification after DSAEK. We advise avoiding hydrophilic acrylic IOL models in patients who may require future endothelial keratoplasty. Keywords: IOL, DSAEK, lamellar keratoplasty, endothelial corneal transplantation

INTRAOCULAR CORRECTION OF PRESBYOPIA BY MONOVISION IN PATIENTS WITH CATARACT AND CORNEAL ASTIGMATISM

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E. I. Belikova

2017-01-01

Full Text Available Purpose: To evaluate the results of intraocular correction of presbyopia by monovision in patients with cataract and primary corneal astigmatism and conduct a comparative analysis of these outcomes with the results of binocular multifocal IOLs implantation. Patients and methods. There were 21 patients with bilateral cataract surgery performed using toric monofocal intraocular lenses (monovision group in the study. The indications for the operation were: 1 primary corneal astigmatism ≥ 1.0D in patients with cataract, 2 inability to conduct excimer laser correction. Reduction of spectacle dependence by monovision was discussed during preoperative conversation. The age of patients range from 32 to 65 years. Target refraction: Emetronopia on the dominant eye (DG and myopia at 1.0–2.0 D in the non-dominant eye (NDG. Evaluation included measurement of uncorrected visual acuity, refraction, stereopsis, contrast sensitivity and patient satisfaction. The results were compared with the outcomes of binocular multifocal Iols implantation in 22 patients (44 eyes. Results. The spherical component decreased from 3.39±2.63D to 0.34±0.24D, cylinder decreased from 3.05±1.47D to 0.44±0,35D (P <0.01 in the monovision group three months after surgery . The deviation from target refraction was 0.30±0.35D. The mean difference between postoperative refraction on the two eyes was 1.92±0.57D. Postoperative corrected visual acuity significantly exceeded preoperative parameters. In 18 patients (88% the stereoscopic visual acuity did not exceed 60 seconds and corresponded to the age norm, in 3 patients (12% it was at the level of 80–100 arc seconds. In patients with multifocal IOLs, the stereovision values were identical (Ferrer-Blasco T. et al, 2008. Conclusion. The monovision is an effective method of reducing dependence on additional correction in patients with cataract and corneal astigmatism. Refractive outcomes, binocular visual acuity, predictability and

Optical performance of multifocal soft contact lenses via a single-pass method.

Science.gov (United States)

Bakaraju, Ravi C; Ehrmann, Klaus; Falk, Darrin; Ho, Arthur; Papas, Eric

2012-08-01

A physical model eye capable of carrying soft contact lenses (CLs) was used as a platform to evaluate optical performance of several commercial multifocals (MFCLs) with high- and low-add powers and a single-vision control. Optical performance was evaluated at three pupil sizes, six target vergences, and five CL-correcting positions using a spatially filtered monochromatic (632.8 nm) light source. The various target vergences were achieved by using negative trial lenses. A photosensor in the retinal plane recorded the image point-spread that enabled the computation of visual Strehl ratios. The centration of CLs was monitored by an additional integrated en face camera. Hydration of the correcting lens was maintained using a humidity chamber and repeated instillations of rewetting saline drops. All the MFCLs reduced performance for distance but considerably improved performance along the range of distance to near target vergences, relative to the single-vision CL. Performance was dependent on add power, design, pupil, and centration of the correcting CLs. Proclear (D) design produced good performance for intermediate vision, whereas Proclear (N) design performed well at near vision (p 4 mm in diameter. Acuvue Oasys bifocal produced performance comparable with single-vision CL for most vergences. Direct measurement of single-pass images at the retinal plane of a physical model eye used in conjunction with various MFCLs is demonstrated. This method may have utility in evaluating the relative effectiveness of commercial and prototype designs.

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.

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

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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.

Customized computer models of eyes with intraocular lenses.

Science.gov (United States)

Rosales, P; Marcos, S

2007-03-05

We compared experimental wave aberrations in pseudophakic eyes with aspheric intraocular lenses (IOLs) to simulate aberrations from numerical ray tracing on customized computer eye models using corneal topography, angle lambda, ocular biometry, IOL geometry, and IOL tilt and decentration measured on the same eyes. We found high correlations between real and simulated aberrations even for the eye with only the cornea, and these increased on average when the IOL geometry and position were included. Relevant individual aberrations were well predicted by the complete eye model. Corneal spherical aberration and horizontal coma were compensated by the IOL, and in 58.3% of the cases IOL tilt and decentration contributed to compensation of horizontal coma. We conclude that customized computer eye models are a good representation of real eyes with IOLs and allow understanding of the relative contribution of optical, geometrical and surgically-related factors to image quality. Corneal spherical aberration is reduced by aspheric IOLs, although other corneal high order aberrations are still a major contributor to total aberrations in pseudophakic eyes. Tilt and decentration of the IOLs represent a relatively minor contribution of the overall optical quality of the eye.

[Reasons for exchange and explantation of intraocular lenses].

Science.gov (United States)

Neuhann, I; Fleischer, F; Neuhann, T

2012-08-01

This study was performed to analyse the reasons for explantation/exchange of intraocular lenses (IOL), which had originally been implanted for the correction of aphakia during cataract extraction. All cases with IOL explantation, which had been performed at one institution between 1/2008 and 12/2009 were analysed retrospectively. A total of 105 eyes of 100 patients were analysed. The median time interval between implantation and explantation of the IOL was 5.9 years (min. 0, max. 29.6). The most frequent cause for the intervention was subluxation/dislocation of the implant in 55.2% of cases. This group comprised 21% of cases with subluxation within the capsular bag in pseudoexfoliation syndrome. Other reasons were optical problems/incorrect IOL power (21%), calcification of hydrophilic acrylic IOL (7.6%), corneal decompensation associated with an anterior chamber lens (4.8%), and single cases with varying problems. The reasons for IOL exchange presented in this study are comparable to those of other series in the literature. Explantations due to optical problems may gain weight in the future due to a rise in refractive procedures and demands. © Georg Thieme Verlag KG Stuttgart · New York.

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

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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.

Studies on Development of Polymeric Materials Using Gamma Irradiation for Contact and Intraocular Lenses

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Pranshu Chhabra

2009-01-01

Full Text Available For the development of materials for contact lenses and intraocular lenses, the selection criteria is based on the (i capacity to absorb and retain water, (ii hydrophilicity and hydrophobicity, (iii refractive index and (iv hardness besides the other essential properties. Various monomers are being studied to develop suitable materials for such applications. Selection of suitable monomers that can be converted into optical materials of desired characteristics is the most essential step. In the present paper, an attempt has been made to develop suitable optical polymers based on 2-hydroxy ethyl methacrylate (HEMA, N-vinyl pyrrolidone (NVP, methyl methacrylate (MMA, methacrylic acid (MAA, and styrene. Compositions were prepared in such a way that polymers of varying hydrophilicity or hydrophobicity could be obtained keeping HEMA as the base (main monomer. For polymerization, gamma irradiation (Co-60 as a source was used. The results of the study showed that: (i an increase in NVP and MAA content brought in an increase in hydrophilicity of polymerized HEMA (pHEMA, while the addition of styrene and MMA decreased hydrophilicity of polymerized HEMA (pHEMA, (ii polymers for contact lenses with water retention capacity as high as >50 wt.% and as low as <10 wt% with varying content of suitable comonomers can be designed, (iii polymeric materials for contact lenses can be made by using radiation processing such as Co-60 and (iv a dose of 40 kGy was found to be ideal for purpose.

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

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.

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

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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

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....

clinical and experimental study

OpenAIRE

Tornow, Christoph

2011-01-01

Posterior capsule opacity (PCO) is a frequent complication in extracapsular cataract extraction in conjunction with an intraocular lens implant. Different studies have shown that a reduction in PCO frequency can be achieved via a number of factors. Lens design is a significant criterion in this process. In this study, two multifocal intraocular lenses (MIOLs) were compared. The design of these lenses differed due to their varying optical principles. They are the refractive MIOL A...

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.

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.

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.

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.

Neodymium: YAG laser damage threshold. A comparison of injection-molded and lathe-cut polymethylmethacrylate intraocular lenses.

Science.gov (United States)

Wilson, S E; Brubaker, R F

1987-01-01

The possibility that injection-molded intraocular lenses (IOLs) with imperfections called iridescent clefts could have a decreased threshold to neodymium: YAG (Nd:YAG) laser-induced damage was investigated. Thresholds for Nd:YAG laser-induced damage were determined for injection-molded and lathe-cut polymethylmethacrylate lenses. When aimed at a membrane in contact with a posterior convex surface, the average thresholds were 0.96 +/- 0.18 mJ (Standard deviation [SD]) and 1.80 +/- 0.55 mJ, respectively. The difference was significant at P = 0.001. When injection-molding polymethylmethacrylate was used to make lathe-cut IOLs, very few iridescent clefts were present, and the threshold to Nd:YAG laser-induced damage was 0.94 +/- 0.25 mJ. Iridescent clefts are therefore produced during the injection-molding process but they do not lower the threshold to Nd:YAG laser-induced damage. Rather, the reduced threshold in injection-molded lenses is most probably a result of the polymethylmethacrylate used in their manufacture. Clinically, iridescent clefts in a lens suggest that it has been manufactured by an injection-molding process and that Nd:YAG laser posterior capsulotomy must be performed at the lowest possible energy level to avoid damage.

[Incremental cost effectiveness of multifocal cataract surgery].

Science.gov (United States)

Pagel, N; Dick, H B; Krummenauer, F

2007-02-01

Supplementation of cataract patients with multifocal intraocular lenses involves an additional financial investment when compared to the corresponding monofocal supplementation, which usually is not funded by German health care insurers. In the context of recent resource allocation discussions, however, the cost effectiveness of multifocal cataract surgery could become an important rationale. Therefore an evidence-based estimation of its cost effectiveness was carried out. Three independent meta-analyses were implemented to estimate the gain in uncorrected near visual acuity and best corrected visual acuity (vision lines) as well as the predictability (fraction of patients without need for reading aids) of multifocal supplementation. Study reports published between 1995 and 2004 (English or German language) were screened for appropriate key words. Meta effects in visual gain and predictability were estimated by means and standard deviations of the reported effect measures. Cost data were estimated by German DRG rates and individual lens costs; the cost effectiveness of multifocal cataract surgery was then computed in terms of its marginal cost effectiveness ratio (MCER) for each clinical benefit endpoint; the incremental costs of multifocal versus monofocal cataract surgery were further estimated by means of their respective incremental cost effectiveness ratio (ICER). An independent meta-analysis estimated the complication profiles to be expected after monofocal and multifocal cataract surgery in order to evaluate expectable complication-associated additional costs of both procedures; the marginal and incremental cost effectiveness estimates were adjusted accordingly. A sensitivity analysis comprised cost variations of +/- 10 % and utility variations alongside the meta effect estimate's 95 % confidence intervals. Total direct costs from the health care insurer's perspective were estimated 3363 euro, associated with a visual meta benefit in best corrected visual

Effect of cefuroxime and moxifloxacin on Staphylococcus epidermidis adherence to intraocular lenses.

Science.gov (United States)

Karadağ, Serhat; Ozkan, Berna; Karabaş, V Levent; Alintaş, Ozgül; Yumuk, Zeki; Cağlar, Yusuf

2009-12-01

To investigate and compare the effect of cefuroxime and moxifloxacin on adhesion of Staphylococcus epidermidis to intraocular lenses (IOLs). Experimental study. The 3-pieced hydrophobic acrylic lenses were contaminated with S. epidermidis (American Type Culture Collection 35983) solutions containing 108 colony-forming units. IOLs were inoculated into test tubes containing tryptic soy broth after being held in antibiotic solutions for 15 minutes. Sonication and vortex procedures were performed in order to remove all the remaining bacteria. From each tube 10 microL and 100 microL was taken and inoculated into sheep blood agar. The colonies were counted overnight. The statistical analyses were made using one-way ANOVA, Turkey Honestly Significant Differences test (HSD) and independent t tests, and a p value less than 0.05 was considered statistically significant. Overall, the mean numbers of colony-forming units on the lenses that were held in control, cefuroxime, moxifloxacin 0.5 mg/0.1 mL and moxifloxacin 0.1 mg/0.1 mL solutions were 1398 (SE 10.01 x 10(3)), 29.9 (SE 1.16 x 10(3)), 0.23 (SD 0.04 x 10(3)), and 0.41 (SD 0.05 x 10(3)), respectively. The evaluation using one-way ANOVA and Turkey HSD tests revealed significant statistical differences among the groups (p = 0.000). The evaluation using independent t tests revealed significant statistical differences between the 2 moxifloxacin groups (p < 0.05). Our results suggest that moxifloxacin and cefuroxime significantly inhibit bacterial adherence to IOLs. The effect of moxifloxacin on inhibition of bacterial adherence was significantly greater than that of cefuroxime. For this reason moxifloxacin might be considered as a better prophylactic agent.

Micro-Raman analysis of glisterings in intraocular lenses

Science.gov (United States)

Rusciano, G.; Martinez, A.; Pesce, G.; Zito, G.; Sasso, A.

2017-06-01

The phenomenon of inclusions or microvacuoles in intraocular lenses (IOL), often referred to glistenings due to their appearance when visualized in slit-lamp exams, is main cause of decreased visual in people after IOL implantation. For this reason, there is a huge request by the market of new polymers able to reduce, or even eliminate, the formation of such microvacuoles. In such frame, the use of advanced optical techniques, able to provide a deeper insight on the glistering formation, is strongly required. In particular, Raman spectroscopy (RS) is ideally suited for the analysis of polymers, due to its well-know sensitivity to highly polarizable chemical groups, commonly found in the polymer chains backbones. Moreover, the combination of RS with optical microscopy (Raman micro-spectroscopy) paves the way for real, information-rich chemical mapping of polymeric materials (Raman imaging). In this paper, we analyze the formation of microvacuoles in IOLs following a thermal treatment. In particular, we performed a chemical mapping of a single microvacuole, which allowed us to infer on its effective chemical composition. In order to investigate on the reversibility of glistenings formation, this analysis was repeated as function of time after thermal treatment, in different IOL environments. It turns out that this phenomenon is partially reversible, with an almost complete disappearance of microvacuoles in a dry environment.

Reliability of power profiles measured on NIMO TR1504 (Lambda-X) and effects of lens decentration for single vision, bifocal and multifocal contact lenses.

Science.gov (United States)

Kim, Eon; Bakaraju, Ravi C; Ehrmann, Klaus

2016-01-01

To evaluate the repeatability of power profiles measured on NIMO TR1504 (Lambda-X, Belgium) and investigate the effects of lens decentration on the power profiles for single vision (SV), bifocal (BF) and multifocal (MF) contact lenses. Accuracy of the sphere power was evaluated using single vision BK-7 calibration glass lenses of six minus and six plus powers. Three SV and four BF/MF contact lenses - three lenses each, were measured five times to calculate the coefficients of repeatability (COR) of the instrument. The COR was computed for each chord position, lens design, prescription power and operator. One lens from each type was measured with a deliberate decentration up to ±0.5mm in 0.1mm steps. For all lenses, the COR varied across different regions of the half-chord position. In general, SV lenses showed lower COR compared to the BF/MF group lenses. There were no noticeable trends of COR between prescription powers for SV and BF/MF lenses. The shape of the power profiles was not affected when lenses were deliberately decentered for all SV and PureVision MF lenses. However, for Acuvue BF lenses, the peak to trough amplitude of the power profiles flattened up to 1.00D. The COR across the half-chord of the optic zone diameter was mostly within clinical relevance except for the central 0.5mm half-chord position. COR were dependent on the lens type, whereby BF/MF group produced higher COR than SV lenses. The effects of deliberate decentration on the shape of power profiles were pronounced for lenses where the profiles had sharp transitions of power. Copyright © 2015 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

Aderência bacteriana in vitro a lentes intra-oculares de polimetilmetacrilato e de silicone In vitro bacterial adherence to silicone and polymetylmethacrylate intraocular lenses

Directory of Open Access Journals (Sweden)

Claudete Inês Locatelli

2004-04-01

Full Text Available OBJETIVOS: Verificar a aderência bacteriana a lentes intra-oculares de silicone e de polimetilmetacrilato como possível fator de risco no desenvolvimento de endoftalmite pós-operatória, utilizando-se um modelo in vitro com três microrganismos potencialmente patogênicos. MÉTODOS: As análises foram realizadas com cepas de Staphylococcus aureus ATCC 29213, Staphylococcus epidermidis (amostra clínica e Pseudomonas aeruginosa ATCC 27853 incluindo a determinação de curvas de crescimento, testes para verificação de produção de cápsula, avaliação da hidrofobicidade, testes de aderência a diferentes materiais, microscopia óptica, microscopia eletrônica de varredura e microscopia de força atômica. RESULTADOS: A produção de cápsula e a aderência das três diferentes cepas não mostraram qualquer relação com a quantidade de microrganismos; em relação às lentes intra-oculares de polimetilmetacrilato e de silicone, não houve diferença estatisticamente significativa na aderência de S. aureus e S. epidermidis; P. aeruginosa foi o microrganismo mais aderente a ambos os materiais. A microscopia eletrônica de varredura confirmou estes achados em relação à aderência, ao peso que a microscopia de força atômica evidenciou a produção de biofilme pelas cepas de S. aureus, S. epidermidis e P. aeruginosa. CONCLUSÕES: Constatou-se, in vitro, que os materiais analisados não diferiram com relação à taxa de aderência bacteriana, porém, P. aeruginosa apresentou maior eficiência de adesão entre as bactérias testadas. Todas as cepas produziram biofilme. Silicone foi o material mais hidrofóbico, quando comparado ao polimetilmetacrilato.PURPOSE: To evaluate bacterial adherence to silicone and polymetylmethacrylate (PMMA intraocular lenses as a risk factor for postsurgery endophthalmitis by using an in vitro model with three potentially pathogenic microorganisms. METHODS: In vitro experiments were carried out with the

Optical implementation of multifocal programmable lens with single and multiple axes

Energy Technology Data Exchange (ETDEWEB)

Romero, Lenny A; Millan, Maria S; Perez-Cabre, Elisabet, E-mail: lenny.alexandra.romero@upc.edu [Optics and Optometry Dep. Technical University of Catalonia Violinista Vellsola 37, 08222 Terrassa (Spain)

2011-01-01

In this work we analyse the generation of a diffractive optical element (DOE) consisting of a multifocal Fresnel lens by means of an LCoS (liquid cristal on silicon) spatial light modulator (SLM). The multifocal lens is composed of a set of lenses of different focal length that share a common optical axis (coaxial combination) or have different axes in parallel (multi-axis combination). For both configurations, we present several ways to combine the phase distributions for three lenses with different focal lengths (f1, f2, f3), into a single-phase distribution addressed to the SLM. Numerical simulations were carried out along with the experimental analysis to corroborate the results.

21 CFR 886.4300 - Intraocular lens guide.

Science.gov (United States)

2010-04-01

...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4300 Intraocular lens guide. (a) Identification. An intraocular lens guide is a device intended to be inserted into the eye during surgery to direct... lenses, the device is exempt from the premarket notification procedures in subpart E of part 807 of this...

Surface modification of polymethyl methacrylate intraocular lenses by plasma for improvement of antithrombogenicity and transmittance

Energy Technology Data Exchange (ETDEWEB)

Zhang Lihua; Wu Di; Chen Yashao; Wang Xiaoli; Zhao Guowei; Wan Haiyan [Key Laboratory of Applied Surface and Colloid Chemistry (Shaanxi Normal University), Ministry of Education, School of Chemistry and Materials Science, Chang' an South Road 199, Xi' an 710062 (China); Huang Changzheng [Able Eye Device Co. Ltd, Zhengzhou 450008 (China)

2009-05-15

To improve antithrombogenicity and reduce ultraviolet transmittance, polymethyl methacrylate intraocular lenses (PMMA IOLs) were pretreated with Ar plasma and combined with heparin (Hp), with polyglycol (PEG) and with both Hp and PEG in a plasma atmosphere. The resulting modified PMMA IOLs denoted as PEG-PMMA, Hp-PMMA and Hp-PEG-PMMA were characterized by attenuated total reflectance Fourier transfer infrared spectroscopy (ATR-FTIR), X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM), ultraviolet-visible spectroscopy (UV-vis), contact angle (CA) and platelet adhesion experiments. The results indicated that Hp and PEG had been successfully immobilized onto the surfaces of PMMA IOLs. Antithrombogenicity was improved remarkably and ultraviolet transmittance was reduced as well.

Multifocal choroiditis following simultaneous hepatitis A, typhoid, and yellow fever vaccination

Directory of Open Access Journals (Sweden)

Escott S

2013-02-01

Full Text Available Sarah Escott, Ahmad B Tarabishy, Frederick H DavidorfHavener Eye Institute, The Ohio State University, Columbus, OH, USAAbstract: The paper describes the first reported case of multifocal choroiditis following simultaneous hepatitis-A, typhoid, and yellow fever vaccinations. A 33-year-old male developed sudden onset of flashing lights and floaters in his right eye 3 weeks following hepatitis A, typhoid, and yellow fever vaccinations. Fundus examination and angiography confirmed the presence of multiple peripheral chorioretinal lesions. These lesions demonstrated characteristic morphologic changes over a period of 8 weeks which were consistent with a diagnosis of self-resolving multifocal choroiditis. Vaccine-induced intraocular inflammation has been described infrequently. We demonstrate the first case of self-resolving multifocal choroiditis following simultaneous administration of hepatitis A, yellow fever, and typhoid immunizations.Keywords: multifocal choroiditis, vaccination, hepatitis A, typhoid, yellow fever

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

Refractive accuracy with light-adjustable intraocular lenses.

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Villegas, Eloy A; Alcon, Encarna; Rubio, Elena; Marín, José M; Artal, Pablo

2014-07-01

To evaluate efficacy, predictability, and stability of refractive treatments using light-adjustable intraocular lenses (IOLs). University Hospital Virgen de la Arrixaca, Murcia, Spain. Prospective nonrandomized clinical trial. Eyes with a light-adjustable IOL (LAL) were treated with spatial intensity profiles to correct refractive errors. The effective changes in refraction in the light-adjustable IOL after every treatment were estimated by subtracting those in the whole eye and the cornea, which were measured with a Hartmann-Shack sensor and a corneal topographer, respectively. The refractive changes in the whole eye and light-adjustable IOL, manifest refraction, and visual acuity were obtained after every light treatment and at the 3-, 6-, and 12-month follow-ups. The study enrolled 53 eyes (49 patients). Each tested light spatial pattern (5 spherical; 3 astigmatic) produced a different refractive change (Plight adjustments induced a maximum change in spherical power of the light-adjustable IOL of between -1.98 diopters (D) and +2.30 D and in astigmatism of up to -2.68 D with axis errors below 9 degrees. Intersubject variability (standard deviation) ranged between 0.10 D and 0.40 D. The 2 required lock-in procedures induced a small myopic shift (range +0.01 to +0.57 D) that depended on previous adjustments. Light-adjustable IOL implantation achieved accurate refractive outcomes (around emmetropia) with good uncorrected distance visual acuity, which remained stable over time. Further refinements in nomograms and in the treatment's protocol would improve the predictability of refractive and visual outcomes with these 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.

Single-suture scleral fixation of subluxated foldable intraocular lenses.

Science.gov (United States)

Yarangumeli, Alper; Alp, Mehmet Numan; Kural, Gulcan

2012-01-01

To evaluate the results of single-suture scleral fixation of subluxated foldable intraocular lenses (IOL) in eyes with sufficient residual capsular support. The results of IOL repositioning by single-suture scleral fixation in 6 eyes of 6 patients with IOL subluxation were included. All subluxated IOLs were single-piece hydrophilic acrylic. Subluxation resulted from posterior capsule tears in 3 eyes, zonular dialyses in 2 eyes, and zonular dialysis with a capsulorhexis tear in 1 eye. A similar technique was used in all eyes in which one haptic was externalized through a superior clear corneal incision and tied with a Pair-PAK 10-0 polypropylene suture, and was finally retracted and fixated behind the iris close to the ciliary sulcus at the 12:00 meridian. All patients were followed up for at least 6 months. Best-corrected visual acuities ranged between finger counting and 20/70 (mean logMAR 1.02±0.64) preoperatively, and between 20/100 and 20/20 (mean logMAR 0.22±0.26) at the final postoperative visit. All IOLs remained centered and no significant postoperative complications were encountered except for an IOL tilt which resulted in a considerable oblique astigmatism in one eye. Subluxated foldable IOLs may safely be repositioned and secured with a single scleral fixation suture in selected cases with adequate amount of capsular remnants.

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

Instrumental studies on silicone oil adsorption to the surface of intraocular lenses

Energy Technology Data Exchange (ETDEWEB)

Kim, Chun Ho [Lab. of Tissue Engineering, Korea Institute of Radiological and Medical Sciences, Seoul 139-706 (Korea, Republic of); Joo, Choun-Ki [Department of Ophthalmology and Visual Science, Medical College of Catholic University, Seoul 137-701 (Korea, Republic of); Chun, Heung Jae, E-mail: chunhj@catholic.ac.kr [Institute of Cell and Tissue Engineering, Medical College of Catholic University, Seoul 137-701 (Korea, Republic of); Yoo, Bok Ryul [Organosilicone Chemistry Laboratory, Korea Institute of Science and Technology, Seoul 130-650 (Korea, Republic of); Noh, Dong Il; Shim, Young Bock [Research Institute of Biomedical Engineering, Korea Bone Bank Co. Ltd., Seoul 153-782 (Korea, Republic of)

2012-12-01

Highlights: Black-Right-Pointing-Pointer It was found that PHEMA and Acrysof IOLs possess silicone oil repellant ability. Black-Right-Pointing-Pointer The residual silicone oil was detected on the surfaces of PMMA and silicone IOLs. Black-Right-Pointing-Pointer XPS studies showed that silicone oil coverage of PMMA lenses was 12%. Black-Right-Pointing-Pointer Silicone oil covered the entire surface of the silicone IOLs. - Abstract: The purpose of this study was to examine the degree of adherence of silicone oil to various intraocular lenses (IOLs) through comparison of the physico-chemical properties of the oil and IOLs. Four kinds of IOLs comprising various biomaterials were examined: PMMA (720A Trade-Mark-Sign ), PHEMA (IOGEL 1103 Trade-Mark-Sign ), Acrysof (MA60BM Trade-Mark-Sign ), and silicone (SI30NB Trade-Mark-Sign ). Each lens was immersed in silicone oil or carboxylated silicone (CS-PDMS) oil for 72 h. For determination of the changes in chemical and elemental compositions on the surfaces of IOLs caused by the contact with silicone oil, IOLs were washed and rinsed with n-pentane to remove as much of the adsorbed silicone oil as possible, then subjected to Fourier transform infrared spectroscopic (FTIR) and X-ray photoelectron spectroscopic (XPS) analyses. The results of FTIR studies strongly indicate that washing with n-pentane completely removed the adhered silicone oil on the surfaces of PHEMA and Acrysof IOLs, whereas the residual silicone oil was detected on the surfaces of PMMA and silicone IOLs. XPS studies showed that silicone oil coverage of PMMA lenses was 12%, even after washing with n-pentane. In the case of silicone IOLs, the relative O1s peak area of carboxyl group in the residual CS-PDMS oil was found to be {approx}2.7%. Considering that 2.8% carboxyl group-substituted silicone oil was used in the present study, CS-PDMS oil covered the entire surface of the silicone IOLs.

Epidemiological evaluation of YAG capsulotomy incidence for posterior capsule opacification in various intraocular lenses in Japanese eyes

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Nishi Y

2015-09-01

Full Text Available Yutaro Nishi,1,2 Tomohiro Ikeda,1 Kayo Nishi,2 Osamu Mimura1 1Department of Ophthalmology, Hyogo College of Medicine, Hyogo, 2Nishi Eye Hospital, Osaka, Japan Background and objective: We investigated the yttrium aluminum garnet (YAG capsulotomy rates in various intraocular lenses (IOLs. Study design/patients and methods: We retrospectively analyzed 23,440 eyes implanted with either MA60BM, MA60AC, VA-60BB, CeeOnEdge, Clariflex, Technis Z9002, SI-40NB, or UV26T IOLs. We calculated the YAG capsulotomy rates at 1, 3, 5, and 10 years post lens implantation. Results: YAG capsulotomy rates at 3 years postimplantation for the eight groups of IOLs were, respectively, 3.7%, 3.9%, 23.7%, 3.4%, 4.5%, 4.7%, 10.4%, and 21.0%. YAG capsulotomy rates at 10 years postimplantation for the MA60BM and SI-40NB IOLs were, respectively, 9.1% and 15% (P<0.05. The average YAG rates for all sharp-edged and round-edged IOLs at 5 years postimplantation were, respectively, 5.2%±0.7% and 25.6%±9.0% (P<0.05. Conclusion: In all studied IOLs, posterior capsule opacification prevention seemed to be associated with the posterior optic sharp-edge design. Round-edged silicone IOLs may also retard posterior capsule opacification formation, though not as much as sharp-edged IOLs. As the follow-up period progressed, round-edged silicone IOLs showed significantly higher YAG rates than sharp-edged IOLs. Keywords: silicone, intraocular lenses, sharp optic edge, chi-square test, implantation surgery, posterior capsule opacification

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

Calcification of Hydrophilic Acrylic Intraocular Lenses With a Hydrophobic Surface: Laboratory Analysis of 6 Cases.

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Gartaganis, Sotirios P; Prahs, Philipp; Lazari, Eftichia D; Gartaganis, Panos S; Helbig, Horst; Koutsoukos, Petros G

2016-08-01

To investigate the nature and characteristic features of deposits causing opacification of intraocular lenses (IOLs) based on the examination of clinical findings using scanning electron microscopy (SEM) and energy-dispersive x-ray spectroscopy (EDX) analysis. Retrospective, observational case series. This is a multicenter study of 6 hydrophilic acrylic IOLs (Lentis LS-502-1; Oculentis GmbH, Berlin, Germany) with a hydrophobic surface that were explanted from 5 patients because of opacification. Three patients had an uncomplicated phacoemulsification. One patient underwent combined phacoemulsification and pars plana vitrectomy for retinal detachment and later silicone oil endotamponade owing to redetachment. The last patient had a pars plana vitrectomy and silicone oil instillation combined with phacoemulsification for tractive retinal detachment and diabetic retinopathy. The explanted lenses were submitted to our laboratory and were examined by SEM and EDX in order to identify the morphologic features and the composition of the deposits. SEM and EDX analyses confirmed the presence of calcific deposits in the interior of the opacified hydrophilic IOLs, with a pattern showing the formation of lumps on the surface. The lumps were due to subsurface formation of calcium phosphate crystalline deposits. The crystallite clusters seemed to diffuse from the IOL interior to the surface. We demonstrated the calcification pattern of the hydrophilic IOL (Lentis LS-502-1) with a hydrophobic surface. Although hydrophilic acrylic lenses have a hydrophobic surface, the development of calcification is a possible threat initiating from the hydrophilic subsurface of the IOLs. Copyright © 2016 Elsevier Inc. All rights reserved.

Intraocular pressure measurements in relation to head position and through soft contact lenses: comparison of three portable instruments.

Science.gov (United States)

Klein, Ainat; Shemesh, Gabi; Loewenstein, Anat; Kurtz, Shimon

2011-01-01

to compare the reproducibility of three portable instruments-the Tono-Pen tonometer (Reichert Ophthalmic Instruments, Depew, NY), the Phosphene tonometer (Bausch & Lomb, Rochester, NY), and the TERT (Through Eyelid Russian Tonometer; Rjazan State Instrument Making, Rjazan, Russia)-in the measurement of intraocular pressure (IOP) with and without soft contact lenses and in different head positions. twenty-six eyes of healthy volunteers were examined by the three instruments while the subjects were sitting, recumbent, and hyperextending their heads, and with and without contact lenses. IOP measurements were compared and the effects of head position and presence of contact lenses on the resultant values were analyzed. the average difference between the recumbent and sitting positions was 3.56, 2.68, and 2.62 mm Hg for the Tono-Pen tonometer, Phosphene tonometer, and TERT, respectively. There was an increase of 5.60, 2.78, and 2.63 mm Hg in hyperextension compared to sitting for the Tono-Pen tonometer, Phosphene tonometer, and TERT, respectively. The difference in the IOP values obtained in the presence and absence of therapeutic contact lens for the three instruments in the three positions was between -1.23 and +1.47 mm Hg. IOP measurements of bedridden patients are only slightly higher than those of sitting patients except for the Tono-Pen tonometer in the hyperextension position. The presence of contact lenses does not affect IOP values obtained by the three evaluated instruments.

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.

A comparison of visual outcomes in three different types of monofocal intraocular lenses.

Science.gov (United States)

Shetty, Vijay; Haldipurkar, Suhas S; Gore, Rujuta; Dhamankar, Rita; Paik, Anirban; Setia, Maninder Singh

2015-01-01

To compare the visual outcomes (distance and near) in patients opting for three different types of monofocal intraocular lens (IOL) (Matrix Aurium, AcrySof single piece, and AcrySof IQ lens). The present study is a cross-sectional analysis of secondary clinical data collected from 153 eyes (52 eyes in Matrix Aurium, 48 in AcrySof single piece, and 53 in AcrySof IQ group) undergoing cataract surgery (2011-2012). We compared near vision, distance vision, distance corrected near vision in these three types of lenses on day 15 (±3) post-surgery. About 69% of the eyes in the Matrix Aurium group had good uncorrected distance vision post-surgery; the proportion was 48% and 57% in the AcrySof single piece and AcrySof IQ group (P=0.09). The proportion of eyes with good distance corrected near vision were 38%, 33%, and 15% in the Matrix Aurium, AcrySof single piece, and AcrySof IQ groups respectively (P=0.02). Similarly, The proportion with good "both near and distance vision" were 38%, 33%, and 15% in the Matrix Aurium, AcrySof single piece, and AcrySof IQ groups respectively (P=0.02). It was only the Matrix Aurium group which had significantly better both "distance and near vision" compared with the AcrySof IQ group (odds ratio: 5.87, 95% confidence intervals: 1.68 to 20.56). Matrix Aurium monofocal lenses may be a good option for those patients who desire to have a good near as well as distance vision post-surgery.

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

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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.

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...

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.

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

[IOP measurement through frequent-replacement soft contact lenses].

Science.gov (United States)

Touboul, J

2008-07-01

Intraocular pressure (IOP) can be measured through soft contact lenses with an air-puff tonometer. These measurements seemed accurate for low-power negative lenses. For positive soft contact lenses, IOP is overestimated. The measurement of IOP through a soft contact lens is acceptable in clinical practice only for glaucoma screening. In glaucomatous patients or patients with ocular hypertension, IOP measurements should be performed without a contact lens. The main technique for IOP measurement remains Goldmann applanation tonometry.

Aberration-free intraocular lenses - What does this really mean?

Science.gov (United States)

Langenbucher, Achim; Schröder, Simon; Cayless, Alan; Eppig, Timo

2017-09-01

So-called aberration-free intraocular lenses (IOLs) are well established in modern cataract surgery. Usually, they are designed to perfectly refract a collimated light beam onto the focal point. We show how much aberration can be expected with such an IOL in a convergent light beam such as that found anterior to the human cornea. Additionally, the aberration in a collimated beam is estimated for an IOL that has no aberrations in the convergent beam. The convergent beam is modelled as the pencil of rays corresponding to the spherical wavefront resulting from a typical corneal power of 43m -1 . The IOLs are modelled as infinitely thin phase plates with 20m -1 optical power placed 5mm behind the cornea. Their aberrations are reported in terms of optical path length difference and longitudinal spherical aberration (LSA) of the marginal rays, as well as nominal spherical aberration (SA) calculated based on a Zernike representation of the wavefront-error at the corneal plane within a 6mm aperture. The IOL designed to have no aberrations in a collimated light beam has an optical path length difference of -1.8μm, and LSA of 0.15m -1 in the convergent beam of a typical eye. The corresponding nominal SA is 0.065μm. The IOL designed to have no aberrations in a convergent light beam has an optical path length difference of 1.8μm, and LSA of -0.15m -1 in the collimated beam. An IOL designed to have no aberrations in a collimated light beam will increase the SA of a patient's eye after implantation. Copyright © 2017. Published by Elsevier GmbH.

Photochemical generation of antimicrobial Ag-nanoparticles in intraocular lenses

Science.gov (United States)

Badur, Thorben; Kim, Hee-Cheol; Hampp, Norbert

2017-02-01

The antimicrobial properties of silver (Ag) nanoparticles (NP) have been investigated in depth during the last decades.[1] For cataract treatment minimal invasive surgery has become state-of-the-art. The physicians are still fighting against postoperative inflammations, such as endophthalmitis.[2] We present a novel approach to reduce these postoperative complications by equipping the hydrophilic intraocular lenses (IOL) with a Ag NP depot. As the Ag NP are completely entrapped inside the polymeric IOL no direct contact of the nanoparticles with epithelial cells may occur. Using 1-hydroxybenzotriazole (HOBt) or 7-hydroxycumarine (7HOCum) as photo reduction mediators (PRM) the formation of the Ag NP is accomplished in situ. PRM and Ag nitrate are diffused into the ready made IOL. By means of two-photon-absorption (TPA) photochemistry at λTPA = 532 nm the Ag NP generation is precisely controlled to occur inside the IOL only. At no point NP are directly exposed to the surface.[3] Interesting dependencies between the used PRM and the resulting particle size distribution or the effectiveness of the silver ion reduction inside the polymer matrix are reported. The Ag NP were prepared in the outer area of the IOL not to affect the optical properties of the ophthalmic implant. The amount of Ag ions released was determined and found to be sufficient to effectively reduce the counts of airborne germs. Besides HOBt and 7HOCum we also investigated the photo reductive properties of several other organic reagents, such as benzophenone (BP) and 4-hydroxybenzophenone (4HOBP) for the ability to produce even three-dimensional nanoparticle structures inside a polymer matrix.

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

Gas chromatographic determination with electron capture detection of residual ethylene oxide in intraocular lenses

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Kikuchi, H.; Nakamura, A.; Tsuji, K.

1988-01-01

A sensitive method is described to determine trace quantities of ethylene oxide (EO) in EO-sterilized intraocular lenses (IOLs). An IOL is dipped in ethanol containing 0.25 ppm propylene oxide (PO) in a 4 mL vial, 2 drops of freshly distilled hydrobromic acid is added through a septum, and the mixture is warmed at 50/sup 0/C for 24 h. It is then neutralized by vigorous shaking with sodium bicarbonate, dehydrated with anhydrous sodium sulfate, and filtered. The filtrate is injected into a gas chromatograph with electron-capture detection, and the peak height ratio of ethylene bromohydrin/propylene bromohydrin is measured. EO residue is calculated from the calibration curve obtained through a similar procedure with the standard EO/PO solutions. The limit of determination is 0.04 ..mu..g/lens (ca 2.0 ppm). When EO residue levels were determined for IOLs sampled at 3 different aeration periods after stabilization, the authors found that 9 days of aeration was necessary to meet the US Food and Drug Administration proposed limit for EO residue in IOLs.

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

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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.

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

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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.

Phakic intraocular lenses for the treatment of refractive errors: an evidence-based analysis.

Science.gov (United States)

2009-01-01

The objective of this analysis is to review the effectiveness, safety, and cost-effectiveness of phakic intraocular lenses (pIOLs) for the treatment of myopia, hyperopia, and astigmatism. CONDITION AND TARGET POPULATION REFRACTIVE ERRORS: Refractive errors occur when the eye cannot focus light properly. In myopia (near- or short-sightedness), distant objects appear blurry because the axis of the eye is too long or the cornea is too steep, so light becomes focused in front of the retina. Hyperopia (far sightedness) occurs when light is focused behind the retina causing nearby objects to appear blurry. In astigmatism, blurred or distorted vision occurs when light is focused at two points rather than one due to an irregularly shaped cornea or lens. Refractive errors are common worldwide, but high refractive errors are less common. In the United States, the prevalence of high myopia (≤ -5 D) in people aged 20 to 39, 40 to 59, and 60 years and older is 7.4% (95% confidence interval [CI], 6.5% - 8.3%), 7.8% (95% CI, 6.4% - 8.6%), and 3.1% (95% CI, 2.2% - 3.9%), respectively. The prevalence of high hyperopia (≥ 3 D) is 1.0% (95% CI, .6% - 1.4%), 2.4% (95% CI, 1.7% - 3.0%), and 10.0% (95% CI, 9.1% - 10.9%) for the same age groupings. Finally, the prevalence of astigmatism (≥ 1 D cylinder) is 23.1% (95% CI, 21.6% - 24.5%), 27.6% (95% CI, 25.8% - 29.3%) and 50.1% (48.2% - 52.0%). LOW VISION: According to the Ontario Schedule of Benefits, low visual acuity is defined by a best spectacle corrected visual acuity (BSCVA) of 20/50 (6/15) or less in the better eye and not amenable to further medical and/or surgical treatment. Similarly, the Ontario Assistive Devices Program defines low vision as BSCVA in the better eye in the range of 20/70 or less that cannot be corrected medically, surgically, or with ordinary eyeglasses or contact lenses. Estimates of the prevalence of low vision vary. Using the criteria of BSCVA ranging from 20/70 to 20/160, one study estimated that 35

Comparação da análise da frente de onda e da sensibilidade ao contraste em olhos pseudofácicos com implante de lentes intra-oculares esférica e asférica Wavefront analysis and contrast sensitivity comparison between spheric and aspheric intraocular lenses

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Wilson Takashi Hida

2008-06-01

Full Text Available OBJETIVO: Comparar a análise da frente de onda e a sensibilidade de contraste pós-operatórias em pacientes submetidos à facoemulsificação com implante de lentes intra-oculares esféricas num olho e asféricas no olho contralateral. MÉTODOS: Este estudo prospectivo comparativo, randomizado, duplo-cego, incluiu 32 olhos de 16 pacientes. Uma avaliação oftalmológica completa foi realizada durante as visitas antes e depois da cirurgia (no primeiro, terceiro, sétimo, e nonagésimo dias pós-cirúrgicos, que incluiu acuidade visual, teste de sensibilidade ao contraste, aberrometria. Todos exames (menos aberrometr=ia foram feitos monocularmente com pupilas não dilatadas. Os pacientes foram submetidos a facectomia ultra-sônica convencional com implante de uma lente asférica SN60WF num olho e esférica SN60ATno outro. RESULTADOS: A acuidade visual média com a melhor correção foi -0,146 LogMAR no grupo da lente intra-ocular esférica, e -0.165 logMAR no grupo da lente intra-ocular asférica sob condições fotópicas, -0,003 LogMAR sob condições mesópicas. A sensibilidade ao contraste foi semelhante em ambos os grupos tanto em condições fotópicas e mesópicas. Em relação às aberrações ópticas ocorreu uma diferença significativa nas aberrações totais (1,09 ± 0,56 no grupo asférico e 1,52 ± 1,19 no grupo esférico e no componente esférico das aberrações de alta ordem(0,422 ± 0,202 no grupo asférico e 0,124 ± 0,087 no grupo esférico. CONCLUSÃO: As duas lentes intra-oculares promoveram uma excelente visão em situações de alto contraste, e os olhos implantados com a lente asférica tiveram menos aberrações totais e esféricas que aqueles implantados com a lente esférica.PURPOSE: Compare the wavefront and contrast sensitivity of bilateral pseudophakic patients with aspheric in one eye and spheric intraocular lenses in the other. METHODS: This prospective, comparative, randomized study, double masked, included 32

Subluxation of suture-fixated posterior chamber intraocular lenses a clinicopathologic study.

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Parekh, Parag; Green, W Richard; Stark, Walter J; Akpek, Esen Karamursel

2007-02-01

To report the occurrence of subluxation of suture-fixated posterior chamber (PC) intraocular lenses (IOL) and elucidate the mechanisms involved. Prospective clinicopathologic study. A single 10-0 Prolene suture explanted from a patient who experienced subluxation of his PC-IOL, 11.5 years after placement. Furthermore, multiple 10-0 Prolene sutures and PC-IOLs used for iris fixation were studied as controls. Scanning electron microscopy (SEM) was used to analyze the surface of the explanted suture. In addition, randomly selected 10-0 Prolene sutures cut with Vannas scissors and cut with the positioning holes of a randomly selected PC-IOL identical to that implanted in the patient's eye were examined as controls. Finally, the positioning holes of several randomly selected, iris-fixated PC-IOLs were studied using SEM with particular attention to surface quality and edge finish. Presence of any signs of suture degradation, the character of the cut edge of the suture, as well as the characteristics of the positioning holes of the PC-IOLs. Scanning electron microscopy of the explanted suture revealed sharply cut edges, without significant degradation of the suture, and no intact loop. Scanning electron microscopy of the control suture cut with a PC-IOL demonstrated a similarly cut edge. The positioning holes of the examined PC-IOLs had a sharp edge, and some also had an imperfect finish. We conclude that the surface properties of the positioning holes lead to cutting of the suture, and subsequent subluxation of the PC-IOL.

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

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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.

Intraocular pressure readings obtained through soft contact lenses using four types of tonometer

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Takenaka J

2015-10-01

Full Text Available Joji Takenaka,1 Eriko Kunihara,1 Ulfah Rimayanti,2 Junko Tanaka,3 Makoto Kaneko,4 Yoshiaki Kiuchi1 1Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan; 2Faculty of Medicine and Health Sciences, UIN Alauddin Makassar, South Sulawesi, Indonesia; 3Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan; 4Graduate School of Engineering, Osaka University, Osaka, Japan Purpose: To compare the reliability and accuracy of intraocular pressure (IOP measured while wearing soft contact lenses (SCLs using a non-contact tonometer (NCT, Goldmann applanation tonometer (GAT, iCare rebound tonometer (RBT and the Tono-Pen XL.Methods: Twenty-six healthy subjects were examined. The IOP was measured using NCT, GAT, RBT, and the Tono-Pen XL, while the subjects wore SCLs -5.00 D, -0.50 D and +5.00 D. Bland–Altman plots and a regression analysis were used to compare the IOPs obtained with those instruments and the IOPs of the naked eyes measured using GAT (the standard IOPs in this study.Results: The IOPs obtained by the Tono-Pen XL while the subjects were wearing -5.00 D, -0.50 D, and +5.00 D SCLs were significantly higher than those of the naked eyes obtained using GAT. RBT showed that the IOPs were similar to the GAT standard IOPs under all conditions. The IOPs measured with NCT and GAT while the subjects were wearing -5.00 D and -0.50 D SCLs were similar to the GAT standard IOPs. The IOPs obtained with RBT and NCT while the subjects were wearing -5.00 D and -0.50 D SCLs exhibited a good correlation with the standard IOPs.Conclusion: The NCT and RBT are best when measuring IOP through hydrogel SCLs. Keywords: soft contact lens, intraocular pressure, rebound tonometer, non-contact tonometer

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

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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.

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

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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

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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

Biomicroscopia ultra-sônica na avaliação da posição das lentes intra-oculares em uma técnica de fixação escleral Ultrasound biomicroscopy in the assessment of the intraocular lenses positioning in a transscleral fixation technique

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Raul de Camargo Vianna Filho

2000-10-01

Full Text Available Objetivo: Avaliar pela biomicrospia ultra-sônica (UBM o posicionamento, em relação ao sulco ciliar, das alças de lentes intra-oculares (LIO, em uma técnica de fixação escleral, avaliando-se também se dois pontos de fixação são suficientes para que não haja inclinação da parte óptica. Métodos: Dezesseis olhos afácicos foram submetidos a implante LIO por uma mesma técnica de fixação escleral, realizados por um mesmo cirurgião. Um mês após a cirurgia, o posicionamento das alças das LIO foram avaliados pelo UBM, assim como distâncias entre as LIO e córnea. Os resultados foram submetidos a testes estatísticos. Resultados: Das 32 alças fixadas à esclera, oito estavam localizadas no sulco ciliar e 24 fora deste. Não houve diferença estatística nas distâncias entre LIO e córnea para alças posicionadas no sulco ciliar quando comparadas àquelas localizadas fora do sulco. Isto sugere que, além da distância ao limbo que se transfixa a esclera, outros fatores devem estar associados ao posicionamento da alça no sulco ciliar. As medidas LIO -- córnea realizadas na periferia das LIO às 3, 6, 9, e 12 horas foram semelhantes, mostrando que dois pontos de fixação são suficientes para que a LIO não fique inclinada. Conclusões: Outros fatores (por exemplo o ângulo de abertura do corpo ciliar, além da distância ao limbo na qual se transfixa a esclera, são importantes para o posicionamento das alças no sulco ciliar. Dois pontos de fixação são suficientes para que a LIO não apresente inclinação dentro do olho.Purpose: To assess, through ultrasound biomicroscopy (UBM, the positioning of the intraocular lenses (IOL haptics as related to the ciliary sulcus by using a scleral fixation technique; and to evaluate, as well, if two fixation points are sufficient to avoid tilting of the lenses. Methods: Sixteen aphakic eyes underwent an IOL implan-tation by means of the same scleral fixation technique, performed by the

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.

Late dislocation of in-the-bag intraocular lenses in uveitic eyes: An analysis of management and complications

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Sudha K Ganesh

2017-01-01

Full Text Available Aim: An analysis of late in-the-bag dislocation of intraocular lenses (IOL, in uveitic eyes. Setting: Referral uveitis clinic. Design: Retrospective case series. Materials and Methods: All case records of eyes with chronic uveitis that had phacoemulsification with IOL implantation, at a referral uveitis clinic between February 1997 and January 2015 were retrieved and analyzed. Only those eyes with no documented intraoperative complication and no predisposing risks to IOL dislocation, such as pseudoexfoliation, high myopia, trauma, and prior VR surgery were included in this study. Results: A total of 581 eyes with chronic uveitis underwent phacoemulsification with IOL implantation under steroid cover from February 1997 to December 2015. Out of these 581 eyes, 10 patients (11 eyes had experienced late in-the-bag IOL dislocation (1.89%. All 11 eyes had chronic intermediate uveitis. The mean duration from the time of cataract surgery to IOL dislocation was 11.24 years. 5 out of 11 eyes had pars plana vitrectomy (PPV with IOL removal with 4-point sutured scleral fixated IOL. Two out of 11 eyes had PPV with in-the-bag IOL re-fixation. Out of 11, 2 eyes had PPV with IOL removal only. Remaining 2 eyes of 2 patients did not opt for surgery. Out of 11, 8 eyes had improved vision at last follow-up. Conclusions: In-the-bag dislocation of IOL is a rare late complication in uveitic eyes. With tight perioperative inflammatory control, scleral-fixated posterior chamber intraocular lens or IOL re-fixation are good options of restoring vision in these high-risk eyes.

Staphylococcus epidermidis biofilm formation and structural organization on different types of intraocular lenses under in vitro flow conditions.

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Baillif, Stéphanie; Leduff, Frank; Hartmann, Daniel J; Kodjikian, Laurent

2013-01-01

To compare the adherence and structural organization of Staphylococcus epidermidis biofilm on intraocular lenses (IOLs). IOLs made of 3 different biomaterials [polymethyl methacrylate (PMMA), hydrophilic acrylic or hydrophobic acrylic] were incubated into an S. epidermidis bacterial solution. Scanning electron microscopy was used to count the bound bacteria and to analyze the structural biofilm architecture. After 4-6 h of incubation, adherence was statistically weakest on the hydrophilic acrylic polymer. On the hydrophobic acrylic material, the bacterial cells tended to cover the substratum in a horizontal spread in a continuous monolayer. On the hydrophilic acrylic material or on the PMMA material bacterial cells tended to form only few, small scattered cell clusters. The data suggest that the pattern of S. epidermidis adhesion varies with the IOL biomaterial. Hydrophobic IOLs seem to be more permissive to S. epidermidis adhesion. Copyright © 2013 S. Karger AG, Basel.

Quantum Spin Lenses in Atomic Arrays

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A. W. Glaetzle

2017-09-01

Full Text Available We propose and discuss quantum spin lenses, where quantum states of delocalized spin excitations in an atomic medium are focused in space in a coherent quantum process down to (essentially single atoms. These can be employed to create controlled interactions in a quantum light-matter interface, where photonic qubits stored in an atomic ensemble are mapped to a quantum register represented by single atoms. We propose Hamiltonians for quantum spin lenses as inhomogeneous spin models on lattices, which can be realized with Rydberg atoms in 1D, 2D, and 3D, and with strings of trapped ions. We discuss both linear and nonlinear quantum spin lenses: in a nonlinear lens, repulsive spin-spin interactions lead to focusing dynamics conditional to the number of spin excitations. This allows the mapping of quantum superpositions of delocalized spin excitations to superpositions of spatial spin patterns, which can be addressed by light fields and manipulated. Finally, we propose multifocal quantum spin lenses as a way to generate and distribute entanglement between distant atoms in an atomic lattice array.

A novel full-angle scanning light scattering profiler to quantitatively evaluate forward and backward light scattering from intraocular lenses

International Nuclear Information System (INIS)

Walker, Bennett N.; James, Robert H.; Ilev, Ilko K.; Calogero, Don

2015-01-01

Glare, glistenings, optical defects, dysphotopsia, and poor image quality are a few of the known deficiencies of intraocular lenses (IOLs). All of these optical phenomena are related to light scatter. However, the specific direction that light scatters makes a critical difference between debilitating glare and a slightly noticeable decrease in image quality. Consequently, quantifying the magnitude and direction of scattered light is essential to appropriately evaluate the safety and efficacy of IOLs. In this study, we introduce a full-angle scanning light scattering profiler (SLSP) as a novel approach capable of quantitatively evaluating the light scattering from IOLs with a nearly 360° view. The SLSP method can simulate in situ conditions by controlling the parameters of the light source including angle of incidence. This testing strategy will provide a more effective nonclinical approach for the evaluation of IOL light scatter

A novel full-angle scanning light scattering profiler to quantitatively evaluate forward and backward light scattering from intraocular lenses

Energy Technology Data Exchange (ETDEWEB)

Walker, Bennett N., E-mail: bennett.walker@fda.hhs.gov [Optical Therapeutics and Medical Nanophotonics Laboratory, Office of Science and Engineering Laboratories, U.S. Food and Drug Administration, Silver Spring, Maryland 20993 (United States); Office of Device Evaluation, Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Maryland 20993 (United States); James, Robert H.; Ilev, Ilko K. [Optical Therapeutics and Medical Nanophotonics Laboratory, Office of Science and Engineering Laboratories, U.S. Food and Drug Administration, Silver Spring, Maryland 20993 (United States); Calogero, Don [Office of Device Evaluation, Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Maryland 20993 (United States)

2015-09-15

Glare, glistenings, optical defects, dysphotopsia, and poor image quality are a few of the known deficiencies of intraocular lenses (IOLs). All of these optical phenomena are related to light scatter. However, the specific direction that light scatters makes a critical difference between debilitating glare and a slightly noticeable decrease in image quality. Consequently, quantifying the magnitude and direction of scattered light is essential to appropriately evaluate the safety and efficacy of IOLs. In this study, we introduce a full-angle scanning light scattering profiler (SLSP) as a novel approach capable of quantitatively evaluating the light scattering from IOLs with a nearly 360° view. The SLSP method can simulate in situ conditions by controlling the parameters of the light source including angle of incidence. This testing strategy will provide a more effective nonclinical approach for the evaluation of IOL light scatter.

Intraocular pressure readings obtained through soft contact lenses using four types of tonometer.

Science.gov (United States)

Takenaka, Joji; Kunihara, Eriko; Rimayanti, Ulfah; Tanaka, Junko; Kaneko, Makoto; Kiuchi, Yoshiaki

2015-01-01

To compare the reliability and accuracy of intraocular pressure (IOP) measured while wearing soft contact lenses (SCLs) using a non-contact tonometer (NCT), Goldmann applanation tonometer (GAT), iCare rebound tonometer (RBT) and the Tono-Pen XL. Twenty-six healthy subjects were examined. The IOP was measured using NCT, GAT, RBT, and the Tono-Pen XL, while the subjects wore SCLs -5.00 D, -0.50 D and +5.00 D. Bland-Altman plots and a regression analysis were used to compare the IOPs obtained with those instruments and the IOPs of the naked eyes measured using GAT (the standard IOPs in this study). The IOPs obtained by the Tono-Pen XL while the subjects were wearing -5.00 D, -0.50 D, and +5.00 D SCLs were significantly higher than those of the naked eyes obtained using GAT. RBT showed that the IOPs were similar to the GAT standard IOPs under all conditions. The IOPs measured with NCT and GAT while the subjects were wearing -5.00 D and -0.50 D SCLs were similar to the GAT standard IOPs. The IOPs obtained with RBT and NCT while the subjects were wearing -5.00 D and -0.50 D SCLs exhibited a good correlation with the standard IOPs. The NCT and RBT are best when measuring IOP through hydrogel SCLs.

Intraocular lenses and clinical treatment in paediatric cataract

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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.

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

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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.

Intraocular lens fabrication

Energy Technology Data Exchange (ETDEWEB)

Salazar, Mike A. (Albuquerque, NM); Foreman, Larry R. (Los Alamos, NM)

1997-01-01

This invention describes a method for fabricating an intraocular lens made rom clear Teflon.TM., Mylar.TM., or other thermoplastic material having a thickness of about 0.025 millimeters. These plastic materials are thermoformable and biocompatable with the human eye. The two shaped lenses are bonded together with a variety of procedures which may include thermosetting and solvent based adhesives, laser and impulse welding, and ultrasonic bonding. The fill tube, which is used to inject a refractive filling material is formed with the lens so as not to damage the lens shape. A hypodermic tube may be included inside the fill tube.

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

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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

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

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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.

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 clinical performance between trifocal and bifocal intraocular lenses: A meta-analysis.

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Xu, Zequan; Cao, Danmin; Chen, Xu; Wu, Song; Wang, Xin; Wu, Qiang

2017-01-01

To compare the clinical performance between trifocal and bifocal intraocular lenses in bilateral cataract and/or refractive lens exchange (RLE) surgery. A comprehensive literature search of PubMed, EMBASE, Cochrane Controlled Trials Register and Web of Science was performed through October 2016 to identify randomized, controlled trials (RCTs) and comparative cohort studies. The primary outcomes were uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), defocus curve, spectacle independence, patient satisfaction and contrast sensitivity. The secondary outcomes were residual sphere, spherical equivalent (SE), cylinder and complications. Six RCTs and 2 cohort studies including 568 eyes (278 in the trifocal group and 290 in the bifocal group) were identified. There was a statically significant difference between the two groups in UDVA (WMD: -0.03, 95% CI: -0.05 to -0.01, P = 0.005), but the difference (0.03 log MAR) is not clinically significant. Intermediate visual acuity was better in the trifocal IOL group judging from UIVA and defocus curves. There was a statically significant difference between the two groups in residual cylinder (WMD: 0.11, 95% CI: 0.02 to 0.20, P = 0.02), and subgroup AT Lisa tri 839MP trifocal also showed significant better UNVA than bifocal IOLs (WMD: -0.13, 95% CI: -0.17 to -0.08, Pbetter uncorrected near visual acuity than bifocal IOLs. However, more evidence is needed to compare their spectacle independence, higher satisfaction rate, and photic phenomena.

In vivo chromatic aberration in eyes implanted with intraocular lenses.

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Pérez-Merino, Pablo; Dorronsoro, Carlos; Llorente, Lourdes; Durán, Sonia; Jiménez-Alfaro, Ignacio; Marcos, Susana

2013-04-12

To measure in vivo and objectively the monochromatic aberrations at different wavelengths, and the chromatic difference of focus between green and infrared wavelengths in eyes implanted with two models of intraocular lenses (IOL). EIGHTEEN EYES PARTICIPATED IN THIS STUDY: nine implanted with Tecnis ZB99 1-Piece acrylic IOL and nine implanted with AcrySof SN60WF IOL. A custom-developed laser ray tracing (LRT) aberrometer was used to measure the optical aberrations, at 532 nm and 785 nm wavelengths. The monochromatic wave aberrations were described using a fifth-order Zernike polynomial expansion. The chromatic difference of focus was estimated as the difference between the equivalent spherical errors corresponding to each wavelength. Wave aberration measurements were highly reproducible. Except for the defocus term, no significant differences in high order aberrations (HOA) were found between wavelengths. The average chromatic difference of focus was 0.46 ± 0.15 diopters (D) in the Tecnis group, and 0.75 ± 0.12 D in the AcrySof group, and the difference was statistically significant (P Chromatic difference of focus in the AcrySof group was not statistically significantly different from the Longitudinal chromatic aberration (LCA) previously reported in a phakic population (0.78 ± 0.16 D). The impact of LCA on retinal image quality (measured in terms of Strehl ratio) was drastically reduced when considering HOA and astigmatism in comparison with a diffraction-limited eye, yielding the differences in retinal image quality between Tecnis and AcrySof IOLs not significant. LRT aberrometry at different wavelengths is a reproducible technique to evaluate the chromatic difference of focus objectively in eyes implanted with IOLs. Replacement of the crystalline lens by the IOL did not increase chromatic difference of focus above that of phakic eyes in any of the groups. The AcrySof group showed chromatic difference of focus values very similar to physiological values in

Method for producing an isoplanatic aspheric monofocal intraocular lens, and resul ting lens

OpenAIRE

Barbero, Sergio; Marcos, Susana; Dorronsoro, Carlos; Montejo, Javier; Salazar Salegui, Pedro

2010-01-01

[EN] The invention can be used to obtain isoplanatic aspheric mono focal intraocular lenses in a viewing range of up to 25° (preferably up to 10°). The method comprises the following steps: l. mathematical defmition of an aphakic eye model; 2. mathematical definition of an intraocular lens model; 3. mathematical defmition of the implantation of the lens; 4. mathematical defmition of the merit function; 5. definition of the contour conditions; 6. defmition of a measurement for charact...

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

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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.

Correlating optical bench performance with clinical defocus curves in varifocal and trifocal intraocular lenses.

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Plaza-Puche, Ana B; Alió, Jorge L; MacRae, Scott; Zheleznyak, Len; Sala, Esperanza; Yoon, Geunyoung

2015-05-01

To investigate the correlations existing between a trifocal intraocular lens (IOL) and a varifocal IOL using the "ex vivo" optical bench through-focus image quality analysis and the clinical visual performance in real patients by study of the defocus curves. This prospective, consecutive, nonrandomized, comparative study included a total of 64 eyes of 42 patients. Three groups of eyes were differentiated according to the IOL implanted: 22 eyes implanted with the varifocal Lentis Mplus LS-313 IOL (Oculentis GmbH, Berlin, Germany); 22 eyes implanted with the trifocal FineVision IOL (Physiol, Liege, Belgium), and 20 eyes implanted with the monofocal Acrysof SA60AT IOL (Alcon Laboratories, Inc., Fort Worth, TX). Visual outcomes and defocus curve were evaluated postoperatively. Optical bench through-focus performance was quantified by computing an image quality metric and the cross-correlation coefficient between an unaberrated reference image and captured retinal images from a model eye with a 3.0-mm artificial pupil. Statistically significant differences among defocus curves of different IOLs were detected for the levels of defocus from -4.00 to -1.00 diopters (D) (P < .01). Significant correlations were found between the optical bench image quality metric results and logMAR visual acuity scale in all groups (Lentis Mplus group: r = -0.97, P < .01; FineVision group: r = -0.82, P < .01; Acrys of group: r = -0.99, P < .01). Linear predicting models were obtained. Significant correlations were found between logMAR visual acuity and image quality metric for the multifocal and monofocal IOLs analyzed. This finding enables surgeons to predict visual outcomes from the optical bench analysis. Copyright 2015, SLACK Incorporated.

Intraocular lens fabrication

Energy Technology Data Exchange (ETDEWEB)

Salazar, M.A.; Foreman, L.R.

1997-07-08

This invention describes a method for fabricating an intraocular lens made from clear Teflon{trademark}, Mylar{trademark}, or other thermoplastic material having a thickness of about 0.025 millimeters. These plastic materials are thermoformable and biocompatable with the human eye. The two shaped lenses are bonded together with a variety of procedures which may include thermosetting and solvent based adhesives, laser and impulse welding, and ultrasonic bonding. The fill tube, which is used to inject a refractive filling material is formed with the lens so as not to damage the lens shape. A hypodermic tube may be included inside the fill tube. 13 figs.

Photoprotection and photoreception of intraocular lenses under xenon and white LED illumination.

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Artigas, J M; Navea, A; García-Domene, M C; Artigas, C; Lanzagorta, A

2016-05-01

To analyze the photoprotection and phototransmission that various intraocular lenses (IOLs) provide under the illumination of a xenon (Xe) lamp and white LEDs (light emitting diode). The spectral transmission curves of six representative IOLs were measured using a Perkin-Elmer Lambda 35 UV/VIS spectrometer. Various filtering simulations were performed using a Xe lamp and white LEDs. The spectral emissions of these lamps were measured with an ILT-950 spectroradiometer. The IOLs analyzed primarily show transmission of nearly 100% in the visible spectrum. In the ultraviolet (UV) region, the filters incorporated in the various IOLs did not filter equally, and some of them let an appreciable amount of UV through. The Xe lamp presented a strong emission of ultraviolet A (UVA), and its emission under 300nm was not negligible. The white LED did not present an appreciable emission under 380nm. The cut-off wavelength of most filters is between 380 and 400nm (Physiol Hydriol60C(®), IOLTECH E4T(®), Alcon SA60AT(®), Alcon IQ SN60WF(®)), so that their UV protection is very effective. Nonetheless, the IOL OPHTEC Oculaid(®) contains a filter that, when a Xe lamp is used, lets through up to 20% for 350nm and up to 15% for 300nm, which at this point is ultraviolet B (UVB). The OPHTEC(®) Artisan IOL has a transmission peak below 300nm, which must be taken into account under Xe illumination. White LEDs do not emit energy below 380nm, so no special protection is required in the UV region. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Evaluation of visual quality of spherical and aspherical intraocular lenses by Optical Quality Analysis System

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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.

Losing focus: how lens position and viewing angle affect the function of multifocal lenses in fishes.

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Gagnon, Yakir Luc; Wilby, David; Temple, Shelby Eric

2016-09-01

Light rays of different wavelengths are focused at different distances when they pass through a lens (longitudinal chromatic aberration [LCA]). For animals with color vision this can pose a serious problem, because in order to perceive a sharp image the rays must be focused at the shallow plane of the photoreceptor's outer segments in the retina. A variety of fish and tetrapods have been found to possess multifocal lenses, which correct for LCA by assigning concentric zones to correctly focus specific wavelengths. Each zone receives light from a specific beam entrance position (BEP) (the lateral distance between incoming light and the center of the lens). Any occlusion of incoming light at specific BEPs changes the composition of the wavelengths that are correctly focused on the retina. Here, we calculated the effect of lens position relative to the plane of the iris and light entering the eye at oblique angles on how much of the lens was involved in focusing the image on the retina (measured as the availability of BEPs). We used rotational photography of fish eyes and mathematical modeling to quantify the degree of lens occlusion. We found that, at most lens positions and viewing angles, there was a decrease of BEP availability and in some cases complete absence of some BEPs. Given the implications of these effects on image quality, we postulate that three morphological features (aphakic spaces, curvature of the iris, and intraretinal variability in spectral sensitivity) may, in part, be adaptations to mitigate the loss of spectral image quality in the periphery of the eyes of fishes.

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

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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.

Extended depth of focus contact lenses vs. two commercial multifocals: Part 2. Visual performance after 1 week of lens wear.

Science.gov (United States)

Bakaraju, Ravi C; Tilia, Daniel; Sha, Jennifer; Diec, Jennie; Chung, Jiyoon; Kho, Danny; Delaney, Shona; Munro, Anna; Thomas, Varghese

To compare the visual performance of prototype contact lenses designed via deliberate manipulation of higher-order spherical aberrations to extend-depth-of-focus with two commercial multifocals, after 1 week of lens wear. In a prospective, participant-masked, cross-over, randomized, 1-week dispensing clinical-trial, 43 presbyopes [age: 42-63 years] each wore AIROPTIX Aqua multifocal (AOMF), ACUVUE OASYS for presbyopia (AOP) and extended-depth-of-focus prototypes (EDOF) appropriate to their add requirements. Measurements comprised high-contrast-visual-acuity (HCVA) at 6m, 70cm, 50cm and 40cm; low-contrast-visual-acuity (LCVA) and contrast-sensitivity (CS) at 6m and stereopsis at 40cm. A self-administered questionnaire on a numeric-rating-scale (1-10) assessed subjective visual performance comprising clarity-of-vision and lack-of-ghosting at various distances during day/night-viewing conditions and overall-vision-satisfaction. EDOF was significantly better than AOMF and AOP for HCVA averaged across distances (p≤0.038); significantly worse than AOMF for LCVA (p=0.021) and significantly worse than AOMF for CS in medium and high add-groups (p=0.006). None of these differences were clinically significant (≤2 letters). EDOF was significantly better than AOMF and AOP for mean stereoacuity (36 and 13 seconds-of-arc, respectively: p≤0.05). For clarity-of-vision, EDOF was significantly better than AOP at all distances and AOMF at intermediate and near (p≤0.028). For lack-of-ghosting averaged across distances, EDOF was significantly better than AOP (p<0.001) but not AOMF (p=0.186). EDOF was significantly better than AOMF and AOP for overall-vision-satisfaction (p≤0.024). EDOF provides better intermediate and near vision performance than either AOMF or AOP with no difference for distance vision after 1 week of lens wear. Copyright © 2017 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

Prevention of increased abnormal fundus autofluorescence with blue light-filtering intraocular lenses.

Science.gov (United States)

Nagai, Hiroyuki; Hirano, Yoshio; Yasukawa, Tsutomu; Morita, Hiroshi; Nozaki, Miho; Wolf-Schnurrbusch, Ute; Wolf, Sebastian; Ogura, Yuichiro

2015-09-01

To observe changes in fundus autofluorescence 2 years after implantation of blue light-filtering (yellow-tinted) and ultraviolet light-filtering (colorless) intraocular lenses (IOLs). Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan, and the Department of Ophthalmology, University of Bern, Bern, Switzerland. Prospective comparative observational study. Patients were enrolled who had cataract surgery with implantation of a yellow-tinted or colorless IOL and for whom images were obtained on which the fundus autofluorescence was measurable using the Heidelberg Retina Angiogram 2 postoperatively. The fundus autofluorescence in the images was classified into 8 abnormal patterns based on the classification of the International Fundus Autofluorescence Classification Group, The presence of normal fundus autofluorescence, geographic atrophy, and wet age-related macular degeneration (AMD) also was recorded. The fundus findings at baseline and 2 years postoperatively were compared. Fifty-two eyes with a yellow-tinted IOL and 79 eyes with a colorless IOL were included. Abnormal fundus autofluorescence did not develop or increase in the yellow-tinted IOL group; however, progressive abnormal fundus autofluorescence developed or increased in 12 eyes (15.2%) in the colorless IOL group (P = .0016). New drusen, geographic atrophy, and choroidal neovascularization were observed mainly in the colorless IOL group. The incidence of AMD was statistically significantly higher in the colorless IOL group (P = .042). Two years after cataract surgery, significant differences were seen in the progression of abnormal fundus autofluorescence between the 2 groups. The incidence of AMD was lower in eyes with a yellow-tinted IOL. 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.

Visual outcomes after implantation of a novel refractive toric multifocal intraocular lens

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Talita Shimoda

2014-04-01

Full Text Available Purpose: To assess the postoperative outcomes of a novel toric multifocal in traocular lens (IOL in patients with cataract and corneal astigmatism. Methods: This prospective nonrandomized study included patients with cataract, corneal astigmatism, and a motivation for spectacle independence. In all patients, a Rayner M-flex® T toric IOL was implanted in the capsular bag. Three months after surgery, the distance, intermediate, and near visual acuities; spherical equivalent; residual refractive astigmatism; defocus curve; and contrast sensitivity were evaluated. A patient satisfaction and visual phenomena questionnaire was administered to all patients. Results: Thirty-four eyes of 18 patients were included in this study. Three months after surgery, the mean corrected distance visual acuity (logMAR was 0.00 ± 0.08 at 6 m, 0.20 ± 0.09 at 70 cm, and 0.08 ± 0.11 at 40 cm. Uncorrected distance vision acuity was 20/40 or better in 100% eyes. The preoperative mean refractive cylinder (RC was -2.19 (SD: ± 0.53. After a 3-month follow-up, the average RC was -0.44 D (SD: ± 0.27; p<0.001. Contrast sensitivity levels were high. At the last follow-up, 87.5% patients were spectacle-independent for near, intermediate, and distance vision, and approximately 44% patients reported halos and glare. Conclusion: Toric multifocal IOL implantation in patients with cataract and corneal astigmatism using the Rayner M-flex® T toric IOL was a simple, safe, and accurate option. This technology provides surgeons with a feasible option for meeting patient expectations of an enhanced lifestyle resulting from decreased spectacle dependence.

Long-term outcomes of ciliary sulcus versus capsular bag fixation of intraocular lenses in children: An ultrasound biomicroscopy study.

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Yun-E Zhao

Full Text Available To evaluate the long-term outcomes of ciliary sulcus versus capsular bag fixation of intraocular lenses (IOLs in children after pediatric cataract surgery.IOL was implanted in the ciliary sulcus in 21 eyes of 14 children, and in the capsular bag in 19 eyes of 12 children for the treatment of pediatric cataract in an institutional setting. Ultrasound biomicroscopy (UBM was performed. Main outcome measures included IOL decentration, IOL tilt, anterior chamber depth (ACD, angle-opening distance at 500 μm (AOD500, trabecular-iris angle (TIA, best-corrected visual acuity (BCVA, intraocular pressure (IOP, and incidence of postoperative complications.The mean follow-up period was 6.81 ± 1.82 years. Comparing to the capsular bag fixation group, the ciliary sulcus fixation group had higher vertical IOL decentration, horizontal IOL tilt, and vertical IOL tilt (p = 0.02, 0.01,0.01, respectively, higher incidence of iris-IOL contact and peripheral anterior synechia (p = 0.001, 0.03, respectively, smaller ACD, AOD500, and TIA (p = 0.02, 0.03, 0.04, respectively, higher mean IOP (17.10 ±6.06 mmHg vs.14.15± 4.74 mmHg, p = 0.01, and higher incidence of secondary glaucoma (28.57% vs. 10.53%, p = 0.007.There was no significant difference between the two groups with regard to the BCVA, refractive errors, incidence of myopic shift, nystagmus, strabismus, and visual axis opacity.Ciliary sulcus fixation of IOLs in pediatric eyes may increase IOL malposition and crowding of the anterior segment, and may associate with a higher risk of secondary glaucoma compared to capsular bag fixation of IOLs.

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.

Visual outcome and changes in corneal endothelial cell density following aphakic iris-fixated intraocular lens implantation in pediatric eyes with subluxated lenses.

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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.

Effects of intraocular lenses with different diopters on chromatic aberrations in human eye models.

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Song, Hui; Yuan, Xiaoyong; Tang, Xin

2016-01-11

In this study, the effects of intraocular lenses (IOLs) with different diopters (D) on chromatic aberration were investigated in human eye models, and the influences of the central thickness of IOLs on chromatic aberration were compared. A Liou-Brennan-based IOL eye model was constructed using ZEMAX optical design software. Spherical IOLs with different diopters (AR40e, AMO Company, USA) were implanted; modulation transfer function (MTF) values at 3 mm of pupil diameter and from 0 to out-of-focus blur were collected and graphed. MTF values, measured at 555 nm of monochromatic light under each spatial frequency, were significantly higher than the values measured at 470 to 650 nm of polychromatic light. The influences of chromatic aberration on MTF values decreased with the increase in IOL diopter when the spatial frequency was ≤12 c/d, while increased effects were observed when the spatial frequency was ≥15 c/d. The MTF values of each IOL eye model were significantly lower than the MTF values of the Liou-Brennan eye models when measured at 555 nm of monochromatic light and at 470 to 650 nm of polychromatic light. The MTF values were also found to be increased with the increase in IOL diopter. With higher diopters of IOLs, the central thickness increased accordingly, which could have created increased chromatic aberration and decreased the retinal image quality. To improve the postoperative visual quality, IOLs with lower chromatic aberration should be selected for patients with short axial lengths.

The measurement of intraocular pressure over positive soft contact lenses by rebound tonometry

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Fabrizio Zeri

2016-07-01

Conclusions: 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.

Comparison of Biofilm Formation Capacities of Two Clinical Isolates of Staphylococcus Epidermidis with and without icaA and icaD Genes on Intraocular Lenses

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Sertaç Argun Kıvanç

2017-03-01

Full Text Available Objectives: To compare biofilm formations of two Staphylococcus epidermidis (S. epidermidis isolates with known biofilm formation capacities on four different intraocular lenses (IOL that have not been studied before. Materials and Methods: Two isolates obtained from ocular surfaces and identified in previous studies and stored at -86 °C in 15% glycerol in the microbiology laboratory of the Anadolu University Department of Biology were purified and used in the study. The isolates were S. epidermidis KA 15.8 (ICA+, a known biofilm producer isolate positive for icaA, icaD and bap genes, and S. epidermidis KA 14.5 (ICA-, known as a non-biofilm producer isolate negative for icaA, icaD and bap genes. The biofilm formation capacities of the 2 isolates on 4 different IOLs were compared. Two of the IOLs were acrylic (UD613 [IOL A], Turkey; SA60AT [IOL B], USA, and the other two were polymethyl methacrylate (PMMA (B60130C [IOL C], India; B55125C [IOL D], India. Bacterial enumeration and optical density measurements were done from biofilms that formed on the IOLs. Biofilms were imaged using scanning electron microscopy. Results: Mean bacterial counts on the IOLs were 7.1±0.4 log10 CFU/mL with the ICA+ isolate, and 6.7±0.8 log10 CFU/mL with the ICA- isolate; there were no statistically significant differences. Biofilm formation was lower with acrylic lenses than PMMA lenses with both isolates (p=0.009 and p=0.013. The highest biofilm production was obtained on IOL C (PMMA (p<0.001 and the lowest was obtained on IOL A (hydrophilic acrylic (p<0.001. Conclusion: Bacterial counts after biofilm formation were lower on acrylic lenses, especially hydrophilic acrylic with hydrophobic properties. Further animal and in vivo studies are required to support the findings of this study.

Toric Intraocular Lens Outcomes in Patients With Glaucoma.

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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.

Prismatic displacement effect of progressive multifocal glasses on reaction time and accuracy in elderly people

OpenAIRE

Ellison, Ashton C; Campbell, A John; Robertson, M Clare; Sanderson, Gordon F

2014-01-01

Ashton C Ellison, A John Campbell, M Clare Robertson, Gordon F SandersonDunedin School of Medicine, Department of Medicine, Dunedin, New ZealandBackground: Multifocal glasses (bifocals, trifocals, and progressives) increase the risk of falling in elderly people, but how they do so is unclear. To explain why glasses with progressive addition lenses increase the risk of falls and whether this can be attributed to false projection, this study aimed to 1) map the prismatic displacement of a progr...

Using a slit lamp-mounted digital high-speed camera for dynamic observation of phakic lenses during eye movements: a pilot study

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Leitritz MA

2014-07-01

Full Text Available Martin Alexander Leitritz, Focke Ziemssen, Karl Ulrich Bartz-Schmidt, Bogomil Voykov Centre for Ophthalmology, University Eye Hospital, Eberhard Karls University of Tübingen, Tübingen, Germany Purpose: To evaluate a digital high-speed camera combined with digital morphometry software for dynamic measurements of phakic intraocular lens movements to observe kinetic influences, particularly in fast direction changes and at lateral end points. Materials and methods: A high-speed camera taking 300 frames per second observed movements of eight iris-claw intraocular lenses and two angle-supported intraocular lenses. Standardized saccades were performed by the patients to trigger mass inertia with lens position changes. Freeze images with maximum deviation were used for digital software-based morphometry analysis with ImageJ.Results: Two eyes from each of five patients (median age 32 years, range 28–45 years without findings other than refractive errors were included. The high-speed images showed sufficient usability for further morphometric processing. In the primary eye position, the median decentrations downward and in a lateral direction were -0.32 mm (range -0.69 to 0.024 and 0.175 mm (range -0.37 to 0.45, respectively. Despite the small sample size of asymptomatic patients, we found a considerable amount of lens dislocation. The median distance amplitude during eye movements was 0.158 mm (range 0.02–0.84. There was a slight positive corrlation (r=0.39, P<0.001 between the grade of deviation in the primary position and the distance increase triggered by movements.Conclusion: With the use of a slit lamp-mounted high-speed camera system and morphometry software, observation and objective measurements of iris-claw intraocular lenses and angle-supported intraocular lenses movements seem to be possible. Slight decentration in the primary position might be an indicator of increased lens mobility during kinetic stress during eye movements

The Visual Effects of Intraocular Colored Filters

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Billy R. Hammond

2012-01-01

Full Text Available Modern life is associated with a myriad of visual problems, most notably refractive conditions such as myopia. Human ingenuity has addressed such problems using strategies such as spectacle lenses or surgical correction. There are other visual problems, however, that have been present throughout our evolutionary history and are not as easily solved by simply correcting refractive error. These problems include issues like glare disability and discomfort arising from intraocular scatter, photostress with the associated transient loss in vision that arises from short intense light exposures, or the ability to see objects in the distance through a veil of atmospheric haze. One likely biological solution to these more long-standing problems has been the use of colored intraocular filters. Many species, especially diurnal, incorporate chromophores from numerous sources (e.g., often plant pigments called carotenoids into ocular tissues to improve visual performance outdoors. This review summarizes information on the utility of such filters focusing on chromatic filtering by humans.

[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].

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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.

Laser iridotomy to treat uveitis-glaucoma-hyphema syndrome secondary to reverse pupillary block in sulcus-placed intraocular lenses: Case series.

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Singh, Harmanjit; Modabber, Milad; Safran, Steven G; Ahmed, Iqbal Ike K

2015-10-01

To present cases of uveitis-glaucoma-hyphema (UGH) syndrome due to reverse pupillary block in sulcus-placed posterior chamber intraocular lenses (PC IOLs) that were managed with laser peripheral iridotomy (LPI). Community-based subspecialty clinics. Retrospective interventional case series. A chart review of patients with a sulcus-placed PC IOLs presenting with UGH syndrome and reverse pupillary block with posterior iris bowing as diagnosed by gonioscopy and anterior segment optical coherence tomography was carried out. Laser peripheral iridotomy was performed in the eyes included in the study. The main outcome measure was clinical resolution of UGH syndrome. The study included 6 eyes of 6 patients with a mean age of 59.8 years (range 43.0 to 66.0 years) who presented with unilateral UGH syndrome a mean of 28.7 months (range 0.3 to 84.0 months) after PC IOL implantation. All patients were previously myopic, with 5 (83.3%) having a history of vitrectomy. The mean axial length was 27.0 mm ± 1.4 (SD). An LPI was used to treat the reverse pupillary block with resultant improvement in iris profile and resolution of UGH syndrome in all eyes. The mean intraocular pressure decreased from 30.5 ± 10.0 mm Hg on 0.5 ± 0.8 glaucoma medications to 15.5 ± 3.2 mm Hg postoperatively on 0.7 ± 1.2 medications. The UGH syndrome due to reverse pupillary block occurred after sulcus-placed PC IOLs in susceptible patients, those with axial myopia, and post-vitrectomized eyes. The cases were managed with LPIs. Dr. Ahmed is a consultant to Alcon Laboratories, Inc. and Abbott Medical Optics, Inc. 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.

Reproducibility analysis of measurements with a mechanical semiautomatic eye model for evaluation of intraocular lenses

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Rank, Elisabet; Traxler, Lukas; Bayer, Natascha; Reutterer, Bernd; Lux, Kirsten; Drauschke, Andreas

2014-03-01

Mechanical eye models are used to validate ex vivo the optical quality of intraocular lenses (IOLs). The quality measurement and test instructions for IOLs are defined in the ISO 11979-2. However, it was mentioned in literature that these test instructions could lead to inaccurate measurements in case of some modern IOL designs. Reproducibility of alignment and measurement processes are presented, performed with a semiautomatic mechanical ex vivo eye model based on optical properties published by Liou and Brennan in the scale 1:1. The cornea, the iris aperture and the IOL itself are separately changeable within the eye model. The adjustment of the IOL can be manipulated by automatic decentration and tilt of the IOL in reference to the optical axis of the whole system, which is defined by the connection line of the central point of the artificial cornea and the iris aperture. With the presented measurement setup two quality criteria are measurable: the modulation transfer function (MTF) and the Strehl ratio. First the reproducibility of the alignment process for definition of initial conditions of the lateral position and tilt in reference to the optical axis of the system is investigated. Furthermore, different IOL holders are tested related to the stable holding of the IOL. The measurement is performed by a before-after comparison of the lens position using a typical decentration and tilt tolerance analysis path. Modulation transfer function MTF and Strehl ratio S before and after this tolerance analysis are compared and requirements for lens holder construction are deduced from the presented results.

Subluxation of iris-sutured intraocular lenses and results of a closed chamber technique for repositioning after penetrating keratoplasty.

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Jabbur, Nada S; Akpek, Esen Karamursel; Stark, Walter J

2005-05-01

To describe subluxation of iris-fixated intraocular lenses (IOLs) after penetrating keratoplasty (PK) as a postoperative complication and report the long-term outcomes of a closed-chamber refixation technique used in the management. This was a retrospective, noncomparative interventional case series in which 19 consecutive patient charts with a subluxated iris-fixated IOL after PK were retrospectively reviewed. Fourteen of the patients underwent surgery using a closed-chamber refixation technique. These patients were evaluated for visual outcome and surgical complications associated with the procedure. In 13 patients, postoperative follow-up was available. In all 13 cases, the fixated IOL appeared stable and remained well positioned during a follow-up period of 56 months (range, 6-122). All patients (100%) achieved improved uncorrected visual acuity. The postoperative visual acuity ranged from 20/20 to 20/100 with a mean of 20/40. Vitreous hemorrhage occurred in 1 patient, and an additional patient required a second surgery using the same technique. Both of these patients did well with a final visual acuity of 20/40 and 20/50, respectively. Subluxation of iris-fixated IOL after PK can occur as a postoperative complication. The technique that we herein describe enables secure refixation of subluxated IOLs and yields favorable long-term results.

Switchable Liquid Crystal Contact Lenses for the Correction of Presbyopia

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James Bailey

2018-01-01

Full Text Available Presbyopia is an age-related disorder where the lens of the eye hardens so that focusing on near objects becomes increasingly difficult. This complaint affects everyone over the age of 50. It is becoming progressively more relevant, as the average age of the global population continues to rise. Bifocal or varifocal spectacles are currently the best solution for those that require near and far vision correction. However, many people prefer not to wear spectacles and while multifocal contact lenses are available, they are not widely prescribed and can require significant adaptation by wearers. One possible solution is to use liquid crystal contact lenses that can change focal power by applying a small electric field across the device. However, the design of these contact lenses must be carefully considered as they must be comfortable for the user to wear and able to provide the required change in focal power (usually about +2D. Progress towards different lens designs, which includes lens geometry, liquid crystal choices and suitable alignment modes, are reviewed. Furthermore, we also discuss suitable electrode materials, possible power sources and suggest some methods for switching the lenses between near and far vision correction.

Comparison of visual outcomes after bilateral implantation of extended range of vision and trifocal intraocular lenses.

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Ruiz-Mesa, Ramón; Abengózar-Vela, Antonio; Aramburu, Ana; Ruiz-Santos, María

2017-06-26

To compare visual outcomes after cataract surgery with bilateral implantation of 2 intraocular lenses (IOLs): extended range of vision and trifocal. Each group of this prospective study comprised 40 eyes (20 patients). Phacoemulsification followed by bilateral implantation of a FineVision IOL (group 1) or a Symfony IOL (group 2) was performed. The following outcomes were assessed up to 1 year postoperatively: binocular uncorrected distance visual acuity (UDVA), binocular uncorrected intermediate visual acuity (UIVA) at 60 cm, binocular uncorrected near visual acuity (UNVA) at 40 cm, spherical equivalent (SE) refraction, defocus curves, mesopic and photopic contrast sensitivity, halometry, posterior capsule opacification (PCO), and responses to a patient questionnaire. The mean binocular values in group 1 and group 2, respectively, were SE -0.15 ± 0.25 D and -0.19 ± 0.18 D; UDVA 0.01 ± 0.03 logMAR and 0.01 ± 0.02 logMAR; UIVA 0.11 ± 0.08 logMAR and 0.09 ± 0.08 logMAR; UNVA 0.06 ± 0.07 logMAR and 0.17 ± 0.06 logMAR. Difference in UNVA between IOLs (pvisual outcomes. The FineVision IOL showed better near visual acuity. Predictability of the refractive results and optical performance were excellent; all patients achieved spectacle independence. The 2 IOLs gave similar and good contrast sensitivity in photopic and mesopic conditions and low perception of halos by patients.

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

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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.

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

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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

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

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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

Cauterization technique for suture erosion in transscleralfixation of intraocular lenses

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Xu-Ting Hu

2013-12-01

Full Text Available Transscleral suturing is a commonly applied technique to fix intraocular implants in the sulcus. A major problem after transscleral implantation is suture erosion that normally happens in the late post-surgery period and may result in an increased incidence of endophthalmitis. Here we describe an original cauterization method by using a glass rod to melt the exposed suture end without damaging the suture knot in the sclera to avoid suture exposure in sclera-fixed IOL implantation. This is a simple, quick and effective technique that can be performed without conjunctiva incisions and will help to reduce suture erosion related complications.

Spectacle independence and subjective satisfaction of ReSTOR® multifocal intraocular lens after cataract or presbyopia surgery in two European countries

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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

Influence of material and haptic design on the mechanical stability of intraocular lenses by means of finite-element modeling.

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Remón, Laura; Siedlecki, Damian; Cabeza-Gil, Iulen; Calvo, Begoña

2018-03-01

Intraocular lenses (IOLs) are used in the cataract treatment for surgical replacement of the opacified crystalline lens. Before being implanted they have to pass the strict quality control to guarantee a good biomechanical stability inside the capsular bag, avoiding the rotation, and to provide a good optical quality. The goal of this study was to investigate the influence of the material and haptic design on the behavior of the IOLs under dynamic compression condition. For this purpose, the strain-stress characteristics of the hydrophobic and hydrophilic materials were estimated experimentally. Next, these data were used as the input for a finite-element model (FEM) to analyze the stability of different IOL haptic designs, according to the procedure described by the ISO standards. Finally, the simulations of the effect of IOL tilt and decentration on the optical performance were performed in an eye model using a ray-tracing software. The results suggest the major importance of the haptic design rather than the material on the postoperative behavior of an IOL. FEM appears to be a powerful tool for numerical studies of the biomechanical properties of IOLs and it allows one to help in the design phase to the manufacturers. (2018) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).

VISUAL ACUITY AND CLINICAL REFRACTION FOLLOWING IMPLANTATION OF VARIOUS MULTIFOCAL INTRAOCULAR LENSES

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N. N. Temirov

2015-01-01

Full Text Available Aim. To analyze visual acuity, clinical refraction, and defocusing tolerance after the implantation of monofocal IOL with rotational asymmetric optic (Lentis Mplus 313 MF compared with Acrysof ReSTOR SN6AD1.Materials and methods. Phacoemulsification was performed in a total of 194 patients (288 eyes, i.e., 144 patients (188 eyes with cataract and 50 patients (100 eyes with presbyopia and high ametropia. The patients were divided into two groups. Study group included 132 patients (194 eyes implanted with Lentis Mplus while control group included 62 patients (94 eyes implanted with Acrysof ReSTOR. Uncorrected distance (5 m, intermediate (50‑70 cm, and near (20‑40 cm visual acuity under photopic (85 cd/m2 and mesopic (8 cd/m2 conditions were measured, objective and subjective refractometry were performed, and defocusing tolerance was evaluated.Results. Postoperatively, uncorrected distance and near visual acuity was high while intermediate visual acuity was moderately low. Lentis Mplus patients had better near and intermediate visual acuity under mesopic conditions as compared with Acrysof ReSTOR patients. Emmetropia (target refraction was achieved in 90.2% of study group patients and in 87.2% of control group patients. In patients implanted with Lentis Mplus, refraction was measured by subjective method. Optimal A-constant for Lentis Mplus and Acrysof ReSTOR was 118.0 and 118.6, respectively. Under defocusing, Lentis Mplus patients had better visual acuity than Acrysof ReSTOR patients. This indirectly confirms better intermediate vision.Conclusions. Lentis Mplus provides better vision at various distances that does not almost depend on light levels and induces minimal dysphotopsia. 

Effect of Spherical Aberration on the Optical Quality after Implantation of Two Different Aspherical Intraocular Lenses

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Michael Lasta

2017-01-01

Full Text Available Purpose. To compare the effect of spherical aberration on optical quality in eyes with two different aspherical intraocular lenses. Methods. 120 eyes of 60 patients underwent phacoemulsification. In patients’ eyes, an aberration-free IOL (Aspira-aA; Human Optics or an aberration-correcting aspherical IOL (Tecnis ZCB00; Abott Medical Optics was randomly implanted. After surgery, contrast sensitivity and wavefront measurements as well as tilt and decentration measurements were performed. Results. Contrast sensitivity was significantly higher in eyes with Aspira lens under mesopic conditions with 12 cycles per degree (CPD and under photopic conditions with 18 CPD (p=0.02. Wavefront measurements showed a higher total spherical aberration with a minimal pupil size of 4 mm in the Aspira group (0.05 ± 0.03 than in the Tecnis group (0.03 ± 0.02 (p=0.001. Strehl ratio was higher in eyes with Tecnis (0.28 ± 0.17 with a minimal pupil size larger than 5 mm than that with Aspira (0.16 ± 0.14 (p=0.04. In pupils with a minimum diameter of 4 mm spherical aberration had a significant effect on Strehl ratio, but not in pupils with a diameter less than 4 mm. Conclusions. Optical quality was better in eyes with the aberration-correcting Tecnis IOL when pupils were large. In contrast, this could not be shown in eyes with pupils under 4 mm or larger. This trial is registered with Clinicaltrials.gov NCT03224728.

A stepwise approach for the management of capsular contraction syndrome in hinge-based accommodative intraocular lenses.

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Page, Timothy P; Whitman, Jeffrey

2016-01-01

The aims of this study are to define the various stages of capsular contraction syndrome (CCS) and its effect on refractive error with hinge-based accommodating intraocular lenses (IOLs) and to describe a systematic approach for the management of the different stages of CCS. Hinge-based accommodative IOLs function via flexible hinges that vault the optic forward during accommodation. However, it is the flexibility of the IOL that makes it prone to deformation in the event of CCS. The signs of CCS are identified and described as posterior capsular striae, fibrotic bands across the anterior or posterior capsule, and capsule opacification. Various degrees of CCS may affect hinge-based accommodating IOLs in a spectrum from subtle changes in IOL appearance to significant increases in refractive error and loss of uncorrected visual acuity. The signs of CCS and its effect on IOL position and the resulting changes in refractive error are matched to appropriate treatment plans. A surgeon can avoid CCS and manage the condition if familiar with the early signs of CCS. If CCS is identified, yttrium-aluminum-garnet laser capsulotomy should be considered. If moderate CCS occurs, it may be effectively treated with insertion of a capsular tension ring. If CCS is allowed to progress to advanced stages, an IOL exchange may be necessary. Surgeons should be familiar with the stages of CCS and subsequent interventions. The steps outlined in this article help to guide surgeons in the prevention and management of CCS with hinge-based accommodative IOLs in order to provide improved refractive outcomes for patients.

Microscopic and spectroscopic investigation of an explanted opacified intraocular lens

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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.

Serial corneal endothelial cell loss with lathe-cut and injection-molded posterior chamber intraocular lenses.

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Kraff, M C; Sanders, D R; Lieberman, H L

1983-01-01

We compared endothelial cell loss of patients implanted with lathe-cut posterior chamber lenses and those implanted with injection-molded lenses over a three-year postoperative period. Results were based on more than 2,500 measurements of corneal endothelial density. Although the technique of cataract extraction (anterior chamber phacoemulsification, posterior chamber phacoemulsification, or planned extracapsular extraction) significantly affected cell loss (P less than .01), the type of implant (lathe-cut or injection-molded) did not. Significant continuing endothelial cell loss did not occur during the first three postoperative years with injection-molded lenses. There was, however, a statistically significant 7% to 15% additional cell loss after surgery over the first two to three postoperative years with lathe-cut implants. There have been no cases of corneal endothelial decompensation developing after implantation of injection-molded or lathe-cut lenses. Because a standard field clinical specular microscope was used in this study, cell counting errors cannot be ruled out as a cause of these findings.

New trends in intraocular lens imaging

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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

Comparing the relative peripheral refraction effect of single vision and multifocal contact lenses measured using an autorefractor and an aberrometer: A pilot study.

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Bakaraju, Ravi C; Fedtke, Cathleen; Ehrmann, Klaus; Ho, Arthur

2015-01-01

To compare the contributions of single vision (SVCL) and multifocal contact lenses (MFCL) to the relative peripheral refraction (RPR) profiles obtained via an autorefractor and an aberrometer in a pilot study. Two instruments, Shin-Nippon NVision K5001 (SN) and COAS-HD, were modified to permit open field PR measurements. Two myopic adults (CF, RB) were refracted (cycloplegia) under eight conditions: baseline (no CL); three SVCLs: Focus Dailies(®) (Alcon, USA), PureVision(®) (Bausch & Lomb, USA) and AirOptix(®) (Alcon, USA); and four MFCLs: AirOptix(®) (Alcon, USA), Proclear(®) Distant and Near (Cooper Vision, USA), and PureVision(®) (Bausch & Lomb, USA). CLs had a distance prescription of -2.00D and for MFCLs, a +2.50D Add was selected. Five independent measurements were performed at field angles from -40° to +40° in 10° increments with both instruments. The COAS-HD measures were analyzed at 3mm pupil diameter. Results are reported as a change in the relative PR profile, as refractive power vector components: M, J180, and J45. Overall, at baseline, M, J180 and J45 measures obtained with SN and COAS-HD were considerably different only for field angles ≥±30°, which agreed well with previous studies. With respect to M, this observation held true for most SVCLs with a few exceptions. The J180 measures obtained with COAS-HD were considerably greater in magnitude than those acquired with SN. For SVCLs, the greatest difference was found at -40° for AirOptix SV (ΔCF=3.20D, ΔRB=1.56D) and for MFCLs it was for Proclear Distance at -40° (ΔCF=2.58D, ΔRB=1.39D). The J45 measures obtained with SN were noticeably different to the respective measures with COAS-HD, both in magnitude and sign. The greatest difference was found with AirOptix Multifocal in subject RB at -40°, where the COAS-HD measurement was 1.50D more positive. In some cases, the difference in the RPR profiles observed between subjects appeared to be associated with CL decentration. For most test

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

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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.

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

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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.

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

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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.

Evaluation of optical performance of 4 aspheric toric intraocular lenses using an optical bench system: Influence of pupil size, decentration, and rotation.

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Kim, Min-Ji; Yoo, Young-Sik; Joo, Choun-Ki; Yoon, Geunyoung

2015-10-01

To evaluate the effect of pupil size, degree of intraocular lens (IOL) decentration, and rotation of 4 aspheric toric IOLs on the image quality. Department of Ophthalmology, Seoul St. Mary's Hospital, Seoul, South Korea. Experimental study. Four aspheric toric intraocular lenses (IOLs)-the Precizon (transitional conic toric IOL), AT Torbi 709M (bitoric IOL), SN6AT4 (posterior toric surface IOL), and ZCT225 (anterior toric surface IOL)-were evaluated using the optical bench metrology system. Measurements included changes in spherical aberrations, relative spherical equivalent (SE), and image quality at different pupil diameters and image quality degradation due to decentration and rotation of the IOLs. Change in relative SE with pupil size in aberration-free toric IOLs (transitional conic toric and bitoric IOLs) was greater than in negatively aspheric toric IOLs (posterior toric surface and anterior toric surface IOLs). In contrast, the aberration-free IOLs showed higher contrast than the negatively aspheric IOLs. When IOLs were decentered by 1.0 mm, the contrast reduction rates at 17.6 cycles per degree for the transitional conic toric IOL, bitoric IOL, posterior toric surface IOL, and anterior toric surface IOL were 5.1%, 3.1%, 12.2%, and 15.8%, respectively. Rotation-induced deterioration of contrast to 0.5 required a much higher rotation for the transitional conic toric IOL than for the other 3 IOLs. The transitional conic toric IOL and bitoric IOL provided superior image quality despite pupil size changes and the presence of decentration. The transitional conic toric IOL demonstrated maximum rotation tolerance compared with the other 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.

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

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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.

Moxifloxacin superior to cefuroxime in reducing bacterial adhesion of Staphylococcus epidermidis on hydrophobic intraocular lenses.

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Benbouzid, Fathalah; Kodjikian, Laurent; Hartmann, Daniel; Renaud, François; Baillif, Stéphanie

2016-02-01

To compare the anti-adhesive effect of cefuroxime and moxifloxacin on the primary attachment phase of Staphylococcus epidermidis on hydrophobic acrylic intraocular lenses (IOLs). Forty hydrophobic acrylic IOLs were used. Two groups of IOLs were soaked in a moxifloxacin (Mox-T1: 0.5 mg/0.1 ml) or a cefuroxime (Cef-T1: cefuroxime 1 mg/0.1 ml) solution before incubation in a S. epidermidis bacterial suspension. Two other groups were incubated in the bacterial suspension before antibiotics (Cef-T2 and Mox-T2) were added. The control group (Ctrl) consisted of IOLs incubated in the bacterial suspension. After incubation, IOLs were sonicated and vortexed. The resultant suspension was spread over a nutritive agar plate. Bacterial colonies were counted after 24 hr of incubation. Mean number of colony-forming units per IOL was Cef-T1: 184 × 10(3) (SE: 5.24; SD: 28.21), Cef-T2: 117 × 10(3) (SE: 5.74; SD: 30.37), Mox-T1: 1.27 × 10(3) (SE: 0.12; SD: 0.61), Mox-T2: 25 × 10(3) (SE:1.98; SD: 9.72) and Ctrl: 361 × 10(3) (SE: 26.9; SD: 107.6). The number of adhering bacteria did not vary whether cefuroxime was added before or after IOL incubation in the bacterial suspension (p = 0.132). Moxifloxacin was more effective in reducing the number of adhering bacteria when used before IOL incubation (p < 0.001). Overall for T1 and T2, moxifloxacin was more effective than cefuroxime in reducing bacterial adhesion on IOLs (p < 0.001). Moxifloxacin and cefuroxime significantly reduced S. epidermidis adhesion on hydrophobic acrylic IOLs. The anti-adhesive effect was superior with moxifloxacin. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

[Cause analysis and management of severe dislocated or subluxated intraocular lenses in the capsular bag].

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Wang, Wen-qing; Jia, Li-Li; Lu, Bin; Fang, Jian; Chen, Ying

2006-05-01

To analyze the causes of severe dislocated and subluxated intraocular lenses (IOL) in capsular bag and the relevancy with abnormal capsular constitution. The abnormality of capsular and the position of IOL were retrospectively analyzed by slit lamp and microscope in dilated pupil. Surgeries were performed in all of 31 cases in order to exchange or reposit the dislocated or subluxated lOL. Among 31 cases, there were 20 cases with the dislocated or subluxated IOL in the earlier postoperative period and 11 cases in the later postoperative period. The subluxated IOL in 5 cases (16.1%) were caused by the large rupture of the posterior capsular, and by the rupture of the posterior capsular in 9 cases (29.0%). A upward subluxated IOL developed in one case (3.2%) as the result of small rupture in the equater capsular. The subluxatd IOL in the anterior chamber in two cases (6.5%) was induced by the radial rupture of residual anterior capsular. The size of the IOLs in 2 cases were not matched to the diameter of the capsule bag. The dislocated IOL into the vitreous in 2 cases was caused by the rupture of the superior capsular. The subluxated IOL in 2 cases (6.5%) was caused by the zonal finers rupture due to trauma. The severe disfiguration of the IOL haptic was found in one case. The dislocated IOL in 6 cases (19.4%) was caused by asymmetric capsular shrinkage. A subluxated IOL in one case was resulted from the zonular defects with pseudoexfoliation syndrome. The postoperative corrected visual acuity was 0.5 - 1.0 in 24 eyes, 0.1 - 0.4 in 6 eyes, and 0.05 in one eye. There are several causes for the dislocated or subluxated IOL. The correction of the IOL position should depend on the cause for the dislocated or subluxated IOL.

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.

Tilt, Decentration, and Internal Higher-Order Aberrations of Sutured Posterior-Chamber Intraocular Lenses in Patients with Open Globe Injuries

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Xiangjia Zhu

2017-01-01

Full Text Available Purpose. To evaluate the tilt, decentration, and internal higher-order aberrations (HOAs of sutured posterior-chamber intraocular lenses (IOLs in patients with open globe injuries. Methods. 46 consecutive patients (47 eyes who underwent transsclerally sutured IOL implantation were enrolled in this prospective cohort study. Nineteen eyes had a history of open globe injury. The tilt and decentration of the IOLs and the visual quality were measured 1 month after surgery. Results. The horizontal tilt and decentration of the IOLs in the open-globe-injury group were significantly higher than those in the control group (both P<0.05. In the open-globe-injury group, the horizontal decentration was significantly greater in the limbus-sclera-involved group (n=11 than in the only-cornea-involved group (n=8, P=0.040. The internal coma, 3rd-order, and total HOA values at pupil sizes of 4 mm (P=0.006 and 6 mm (P=0.013 were significantly higher in the open-globe-injury group than in the controls. Consequently, the optical quality data for the modulation transfer function and the Strehl ratio (all P<0.05 were significantly poorer in the open-globe-injury group. Conclusions. Open globe injuries damage the structural integrity of the eyeball, resulting in more-misaligned sutured IOLs and poorer visual quality.

Multifocal Congenital Hemangiopericytoma.

Science.gov (United States)

Robl, Renata; Carvalho, Vânia Oliveira; Abagge, Kerstin Taniguchi; Uber, Marjorie; Lichtvan, Leniza Costa Lima; Werner, Betina; Mehrdad Nadji, Mehrdad

2017-01-01

Congenital hemangiopericytoma (HPC) is a rare mesenchymal tumor with less aggressive behavior and a more favorable prognosis than similar tumors in adults. Multifocal presentation is even less common than isolated HPC and hence its clinical and histologic recognition may be challenging. A newborn infant with multifocal congenital HPC causing severe deformity but with a favorable outcome after chemotherapy and surgical removal is reported. © 2016 Wiley Periodicals, Inc.

Magnifications of Single and Dual Element Accommodative Intraocular Lenses: Paraxial Optics Analysis

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Ale, Jit B; Manns, Fabrice; Ho, Arthur

2010-01-01

Purpose Using an analytical approach of paraxial optics, we evaluated the magnification of a model eye implanted with single-element (1E) and dual-element (2E) translating-optics accommodative intraocular lenses (AIOL) with an objective of understanding key control parameters relevant to their design. Potential clinical implications of the results arising from pseudophakic accommodation were also considered. Methods Lateral and angular magnifications in a pseudophakic model eye were analyzed using the matrix method of paraxial optics. The effects of key control parameters such as direction (forward or backward) and distance (0 to 2 mm) of translation, power combinations of the 2E-AIOL elements (front element power range +20.0 D to +40.0 D), and amplitudes of accommodation (0 to 4 D) were tested. Relative magnification, defined as the ratio of the retinal image size of the accommodated eye to that of unaccommodated phakic (rLM1) or pseudophakic (rLM2) model eyes, was computed to determine how retinal image size changes with pseudophakic accommodation. Results Both lateral and angular magnifications increased with increased power of the front element in 2E-AIOL and amplitude of accommodation. For a 2E-AIOL with front element power of +35 D, rLM1 and rLM2 increased by 17.0% and 16.3%, respectively, per millimetre of forward translation of the element, compared to the magnification at distance focus (unaccommodated). These changes correspond to a change of 9.4% and 6.5% per dioptre of accommodation, respectively. Angular magnification also increased with pseudophakic accommodation. 1E-AIOLs produced consistently less magnification than 2E-AIOLs. Relative retinal image size decreased at a rate of 0.25% with each dioptre of accommodation in the phakic model eye. The position of the image space nodal point shifted away from the retina (towards the cornea) with both phakic and pseudophakic accommodation. Conclusion Power of the mobile element, and amount and direction of

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

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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

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...

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

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

spectacle-independent but the estimate was very uncertain (risk ratio (RR) 8.18; 95% CI 0.47 to 142.62, 1 study, 40 people, very low quality evidence).More cases of posterior capsule opacification (PCO) were seen in accommodative lenses but the effect of the lenses on PCO was uncertain (Peto odds ratio (OR) 2.12; 95% CI 0.45 to 10.02, 91 people, 2 studies, low quality evidence). People in the accommodative lens group were more likely to require laser capsulotomy (Peto OR 7.96; 95% CI 2.49 to 25.45, 2 studies, 60 people, 80 eyes, low quality evidence). Glare was reported less frequently with accommodative lenses but the relative effect of the lenses on glare was uncertain (RR any glare 0.78; 95% CI 0.32 to 1.90, 1 study, 40 people, and RR moderate/severe glare 0.45; 95% CI 0.04 to 4.60, low quality evidence). There is moderate-quality evidence that study participants who received accommodative IOLs had a small gain in near visual acuity after six months. There is some evidence that distance visual acuity with accommodative lenses may be worse after 12 months but due to low quality of evidence and heterogeneity of effect, the evidence for this is not clear-cut. People receiving accommodative lenses had more PCO which may be associated with poorer distance vision. However, the effect of the lenses on PCO was uncertain.Further research is required to improve the understanding of how accommodative IOLs may affect near visual function, and whether they provide any durable gains. Additional trials, with longer follow-up, comparing different accommodative IOLs, multifocal IOLs and monofocal IOLs, would help map out their relative efficacy, and associated late complications. Research is needed on control over capsular fibrosis postimplantation.Risks of bias, heterogeneity of outcome measures and study designs used, and the dominance of one design of accommodative lens in existing trials (the HumanOptics 1CU) mean that these results should be interpreted with caution. They may not be

A stepwise approach for the management of capsular contraction syndrome in hinge-based accommodative intraocular lenses

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Page TP

2016-06-01

Full Text Available Timothy P Page,1 Jeffrey Whitman2 1Department of Ophthalmology, Oakland University William Beaumont School of Medicine, Royal Oak, MI, 2Key-Whitman Eye Center, Dallas, TX, USA Purpose: The aims of this study are to define the various stages of capsular contraction syndrome (CCS and its effect on refractive error with hinge-based accommodating intraocular lenses (IOLs and to describe a systematic approach for the management of the different stages of CCS. Methods: Hinge-based accommodative IOLs function via flexible hinges that vault the optic forward during accommodation. However, it is the flexibility of the IOL that makes it prone to deformation in the event of CCS. The signs of CCS are identified and described as posterior capsular striae, fibrotic bands across the anterior or posterior capsule, and capsule opacification. Various degrees of CCS may affect hinge-based accommodating IOLs in a spectrum from subtle changes in IOL appearance to significant increases in refractive error and loss of uncorrected visual acuity. The signs of CCS and its effect on IOL position and the resulting changes in refractive error are matched to appropriate treatment plans. Results: A surgeon can avoid CCS and manage the condition if familiar with the early signs of CCS. If CCS is identified, yttrium–aluminum–garnet laser capsulotomy should be considered. If moderate CCS occurs, it may be effectively treated with insertion of a capsular tension ring. If CCS is allowed to progress to advanced stages, an IOL exchange may be necessary. Conclusion: Surgeons should be familiar with the stages of CCS and subsequent interventions. The steps outlined in this article help to guide surgeons in the prevention and management of CCS with hinge-based accommodative IOLs in order to provide improved refractive outcomes for patients. Keywords: z-syndrome, pseudophakic tilt, IOL subluxation, CTR, capsular tension ring, capsular fibrosis

The effects of two different types of bandage contact lenses on the healthy canine eye.

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Braus, Barbara Katharina; Riedler, Daniela; Tichy, Alexander; Spergser, Joachim; Schwendenwein, Ilse

2018-02-06

To compare two types of bandage contact lenses on the healthy canine eye. Six healthy Beagles. Two different types of bandage contact lenses (single sized human silicone contact lens 'PureVision 2' (Bausch & Lomb Incorporated, Rochester, NY, USA) and specially designed veterinary hydrogel contact lens 'AcriVet Pat D' (Bausch & Lomb Incorporated) were placed in 12 eyes of healthy Beagle dogs. Retention times and the effects of the lenses regarding irritation of the eye, changes in tear production, impact of contact lenses on tonometric readings, and cytologic and microbiological alterations of the canine eye were investigated. Mean retention times for veterinary hydrogel lenses with special dimensions were significantly shorter (2 days) than for one size human silicon lenses (8.8 days). Irritation scores were overall low for both types of lenses apart from one human lens causing severe irritation and keratoconjunctivitis as a sequel to folding and displacement. Tear production remained stable in human contact lenses. Intraocular pressure readings with a contact lens in place were only slightly altered; the most accurate readings were obtained through a human lens with an applanation tonometer. Cytology revealed a slight, nonsignificant increase in neutrophilic granulocytes with both types of lenses; the microflora did not change significantly. Human silicone lenses have significantly longer retention times and are less expensive than veterinary hydrogel lenses. In regard to irritation, bacterial growth and inflammation, both types of lenses can be recommended for use in canine eyes. © 2018 American College of Veterinary Ophthalmologists.

Intraocular Ossification in the GSP/pe Chicken With Imperfect Albinism.

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Shibuya, K; Kinoshita, K; Mizutani, M; Oshima, A; Yamashita, R; Matsuda, Y

2015-07-01

The eyes of 2 male and 2 female GSP/pe chickens, the imperfect albino strain, were investigated at 52 weeks of age. Aged chickens of the GSP/pe colony became blind with bilateral ocular enlargement and opaque lenses. Affected eyes (bilateral in 2 males and unilateral in 2 females) were hard and difficult to section; histologic specimens were processed after decalcification. A large portion of the posterior chamber was occupied by cancellous bone containing fibrous and cartilaginous foci. Osseous tissues developed adjacent to the choroid, and no retinal pigment epithelium (RPE) was detected between osseous tissues and the choroid. Small segments of degenerate neuronal retina were scattered in the osseous tissue. The irises and ciliary bodies were deformed by osseous tissue, and the lenses had severe cataracts. These observations suggest that the intraocular osseous tissue may be derived from RPE in the hereditary incomplete-albino strain of chickens. © The Author(s) 2014.

Simulation of the Effect of Different Presbyopia-Correcting Intraocular Lenses With Eyes With Previous Laser Refractive Surgery.

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Camps, Vicente J; Miret, Juan J; García, Celia; Tolosa, Angel; Piñero, David P

2018-04-01

To simulate the optical performance of three presbyopia-correcting intraocular lenses (IOLs) implanted in eyes with previous laser refractive surgery. A simulation of the through-focus modulation transfer function (MTF) was performed for three presbyopia-correcting IOLs (Mplus, Oculentis GmbH, Berlin, Germany; Symfony, Johnson & Johnson Vision, Santa Ana, CA; and Mini Well, SIFI S.p.A., Lavinaio, Italy) in one eye with previous myopic LASIK and another with hyperopic LASIK. Real topographic data and the wavefront aberration profile of each IOL obtained with a Hartmann-Shack sensor were used. In the eye with myopic LASIK, all IOLs lost optical quality at near and intermediate distances for 4- and 4.7-mm pupil size. For 3-mm pupil size, the Mini Well IOL showed the best intermediate and near MTF and maintained the far focus independently of the pupil. In the eye with hyperopic LASIK, the Mini Well IOL showed an intermediate, distance, and -4.00-diopter (D) foci for all pupils. The Symfony IOL showed a depth of focus at far and intermediate distance for 3-mm and a focus at -2.50 D in the rest. The Mplus showed a focus of -4.50 and -3.00 D for the 3- and 4-mm pupil, respectively. The Mini Well and Symfony IOLs seem to work better than the Mplus IOL in eyes with previous myopic LASIK. With previous hyperopic LASIK, the Mini Well IOL seems to be able to provide acceptable near, intermediate, and far foci for all pupil sizes. These findings should be confirmed in future clinical studies. [J Refract Surg. 2018;34(4):222-227.]. Copyright 2018, SLACK Incorporated.

[Comparison of surface light scattering of acrylic intraocular lenses made by lathe-cutting and cast-molding methods--long-term observation and experimental study].

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Nishihara, Hitoshi; Ayaki, Masahiko; Watanabe, Tomiko; Ohnishi, Takeo; Kageyama, Toshiyuki; Yaguchi, Shigeo

2004-03-01

To compare the long-term clinical and experimental results of soft acrylic intraocular lenses(IOLs) manufactured by the lathe-cut(LC) method and by the cast-molding(CM) method. This was a retrospective study of 20 patients(22 eyes) who were examined in a 5- and 7-year follow-up study. Sixteen eyes were implanted with polyacrylic IOLs manufactured by the LC method and 6 eyes were implanted with polyacrylic IOLs manufactured by the CM method. Postoperative measurements included best corrected visual acuity, contrast sensitivity, biomicroscopic examination, and Scheimpflug slit-lamp images to evaluate surface light scattering. Scanning electron microscopy and three-dimensional surface analysis were conducted. At 7 years, the mean visual acuity was 1.08 +/- 0.24 (mean +/- standard deviation) in the LC group and 1.22 +/- 0.27 in the CM group. Surface light-seatter was 12.0 +/- 4.0 computer compatible tapes(CCT) in the LC group and 37.4 +/- 5.4 CCT in the CM group. Mean surface roughness was 0.70 +/- 0.07 nm in the LC group and 6.16 +/- 0.97 nm in the CM group. Acrylic IOLs manufactured by the LC method are more stable in long-termuse.

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

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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.

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...

Pigment dispersion syndrome and pigmentary glaucoma after secondary sulcus transscleral fixation of single-piece foldable posterior chamber intraocular lenses in Chinese aphakic patients.

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Tong, Nianting; Liu, Fuling; Zhang, Ting; Wang, Liangyu; Zhou, Zhanyu; Gong, Huimin; Yuan, Fuxiang

2017-05-01

To describe secondary pigment dispersion syndrome (PDS) and pigmentary glaucoma after secondary sulcus transscleral fixation of 1-piece hydrophobic acrylic foldable posterior chamber intraocular lenses (PC IOLs) in aphakic patients in a Chinese population. Department of Ophthalmology, Qingdao Municipal Hospital, Qingdao, China. Retrospective case series. This chart review included eyes that had secondary sulcus transscleral fixation of a 1-piece hydrophobic acrylic foldable PC IOL (Tecnis ZCB00) between March 2011 and March 2014. The patients' demographic data, clinical data, postoperative complications, intervals between initial surgery and the onset of PDS, pigmentary glaucoma occurrences, and findings on slitlamp biomicroscopy, gonioscopy, and ultrasound biomicroscopy (UBM) were recorded. The study comprised 23 consecutive eyes of 21 patients. Seventeen eyes of 16 patients were diagnosed with PDS, and 7 eyes of 6 patients were diagnosed with pigmentary glaucoma. The slitlamp examination and UBM showed that the location between the IOL optic and the posterior surface of the iris was very close. Slitlamp examination of the anterior chamber angle using a gonioscope showed dense pigment deposition on the IOL surfaces. A reverse pupillary block was found in 10 eyes of 9 patients. Other postoperative complications included intraocular hemorrhage, pupillary capture of the IOL optic, IOL tilt, IOL decentration, IOL dislocation, and suture erosion. The 1-piece hydrophobic acrylic foldable PC IOL was not suitable for sulcus transscleral fixation because of a high incidence of PDS and pigmentary glaucoma after surgery in a Chinese population. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

HANGING BY A THREAD: THE LONG-TERM EFFICACY AND SAFETY OF TRANSSCLERAL SUTURED INTRAOCULAR LENSES IN CHILDREN (AN AMERICAN OPHTHALMOLOGICAL SOCIETY THESIS)

Science.gov (United States)

Buckley, Edward G.

2007-01-01

Purpose To evaluate the long-term efficacy, safety, and advisability of using transscleral sutured posterior chamber intraocular lenses (IOLs) in pediatric patients with no capsular support and to determine whether 10-0 polypropylene suture should be used for this purpose. Methods A long-term retrospective interventional case series review of 33 eyes of 26 patients who had a sutured IOL at Duke University Eye Center were evaluated for the intraoperative surgical risks, postoperative visual and refractive outcomes, and the number, type, and severity of the postoperative complications. In addition, a survey of pediatric ophthalmologists’ experience with suture breakage was performed. Results Postoperative visual acuity was significantly improved after surgery (P subluxation of the IOL secondary to spontaneous 10-0 polypropylene suture breakage at 3.5, 8, and 9 years after surgery. A survey of pediatric ophthalmologists revealed 10 similar cases (mean, 5 years after surgery). Conclusion Transscleral fixation of an IOL in a child appears to be a safe and effective procedure provided that the suture material used is stable enough to resist significant degradation over time. Caution should be exercised in the use of 10-0 polypropylene suture to fixate an IOL to the sclera in children, and an alternative material or size should be considered. PMID:18427618

Comparison of clinical performance between trifocal and bifocal intraocular lenses: A meta-analysis.

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Zequan Xu

Full Text Available To compare the clinical performance between trifocal and bifocal intraocular lenses in bilateral cataract and/or refractive lens exchange (RLE surgery.A comprehensive literature search of PubMed, EMBASE, Cochrane Controlled Trials Register and Web of Science was performed through October 2016 to identify randomized, controlled trials (RCTs and comparative cohort studies. The primary outcomes were uncorrected distance visual acuity (UDVA, uncorrected intermediate visual acuity (UIVA, uncorrected near visual acuity (UNVA, defocus curve, spectacle independence, patient satisfaction and contrast sensitivity. The secondary outcomes were residual sphere, spherical equivalent (SE, cylinder and complications.Six RCTs and 2 cohort studies including 568 eyes (278 in the trifocal group and 290 in the bifocal group were identified. There was a statically significant difference between the two groups in UDVA (WMD: -0.03, 95% CI: -0.05 to -0.01, P = 0.005, but the difference (0.03 log MAR is not clinically significant. Intermediate visual acuity was better in the trifocal IOL group judging from UIVA and defocus curves. There was a statically significant difference between the two groups in residual cylinder (WMD: 0.11, 95% CI: 0.02 to 0.20, P = 0.02, and subgroup AT Lisa tri 839MP trifocal also showed significant better UNVA than bifocal IOLs (WMD: -0.13, 95% CI: -0.17 to -0.08, P<0.00001. However, no significant differences were observed in UNVA (WMD: -0.04, 95% CI: -0.11 to 0.02, P = 0.19, spectacle independence (WMD: 1.27, 95% CI: 0.89 to 18.15, P = 0.07, patient satisfaction (WMD: 4.01, 95% CI: 0.07 to 22.72, P = 0.87, residual sphere (WMD: -0.03, 95% CI: -0.18 to 0.13, P = 0.74, SE (WMD: 0.04, 95% CI: -0.09 to 0.16, P = 0.55 or complications (WMD: 2.08, 95% CI: 0.35 to 12.43, P = 0.42.Trifocal IOL technology (especially AT Lisa trifocal 839M trifocal had a clear advantage over bifocal IOLs in intermediate visual acuity, while both trifocal IOLs and

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.

Primary multifocal osseous lymphoma in a child

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Sato, Takashi S.P. [University of Iowa, Carver College of Medicine, Iowa City, IA (United States); Ferguson, Polly J. [University of Iowa, Department of Pediatrics, Iowa City, IA (United States); Khanna, Geetika [Washington University, Mallinckrodt Institute of Radiology, St Louis, MO (United States)

2008-12-15

We report a case of primary multifocal osseous lymphoma in a 6-year-old girl presenting with multifocal osteolytic lesions without systemic symptoms or identifiable non-osseous primary tumor. The differential diagnoses for such a presentation include histiocytosis X, chronic recurrent multifocal osteomyelitis, acute lymphoblastic leukemia, metastatic disease, and primary bone lymphoma. Although non-Hodgkin lymphoma is common in the pediatric population, its presentation as a primary bone tumor, especially with multifocal disease, is extremely rare and is frequently misdiagnosed. We hope that awareness of this entity will help radiologists achieve timely diagnosis and intervention. (orig.)

Comparison of clinical outcomes between limbal relaxing incisions and toric intraocular lenses in eyes with astigmatic corneas

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Giuliano de Oliveira Freitas

2014-01-01

Full Text Available Objective: To compare refractive and vectorial outcomes of limbal relaxing incisions (LRI versus toric intraocular lenses (IOL in the treatment of preexisting corneal astigmatism at the time of phacoemulsification. Methods: This longitudinal observational case series assessed 62 eyes of 31 consecutive cataract patients with preoperative corneal astigmatism between 0.75 and 2.50 diopters in both eyes. Patients were randomly assorted in two groups: one assigned to receive AcrySof Toric™ IOL in both eyes, and another one assigned to have AcrySof Natural™ IOL associated with LRI, also in both eyes. All patients were re-evaluated, postoperatively, at 1, 3 and 6 months, when refractive astigmatism analysis was performed using vectorial methods proposed by Thibos. Variability of outcomes within each group and between groups were assessed and compared. Results: Manifest refractive cylinder, in diopters (D, as means ± standard deviation, in the LRI group for 1-month, 3-month and 6-month re-evalutions were respectively -0.66 ± 0.30; -0.70 ± 0.21 and -0.74 ± 0.26 when compared to -0.58 ± 0.24; -0.63 ± 0.20, and -0.62 ± 0.17 in the toric IOL group. (p value ≥ 0.06. Vectorial analysis evidenced greater astigmatism reduction in the toric IOL group in the 6th postoperative month, when postoperative mean astigmatic power vector was 0.31 D, when compared to 0.37 D in the LRI group (p value = 0.00. Conclusions: A trend of slightly better refractive outcomes favoring toric IOL group was seen, although such a trend was not statistically significant. Vectorial analysis, however, suggests that the use of toric IOL may constitute a more advantageous approach in the treatment of pre-existing corneal astigmatism, simultaneously with phacoemulsification.

[The influence of a new surface treatment of silicone intracoular lenses with fluoralkylsitan on the adherence of endophthalmitic bacteria in vitro

Science.gov (United States)

Kienast, A; Menz, D-H; Dresp, J; Klinger, M; Bunse, A; Ohgke, H; Solbach, W; Laqua, H; Kämmerer, R; Hoerauf, H

2003-10-01

Dynasilan is a fluoroalkylsilan which is able to bind to surface active molecules of intraocular lenses (IOLs), thereby offering a new option for surface modification of silicone lenses. The purpose of this in vitro study was to investigate the influence of this new surface treatment on the adherence of two typical endophthalmitis-inducing bacteria ( Staphylococcus epidermidis, Propionibacterium acnes). A total of 14 Dynasilan-treated and 14 untreated silicone lenses were incubated at 37 degrees C for 24 h in brain heart infusion broth (10(8) CFU/ml) either with Staphylococcus epidermidis or with Propionibacterium acnes for 1 h. Subsequently, the adherent bacteria were resuspended using ultrasonification at 35 kHz for 3 x 45 s. After a dilution series and incubation at 37 degrees C for 24 h or 3 days the colonies were counted. On untreated IOLs incubated with Staphylococcus epidermidis the average number of bacteria was 3.6 x 10(7)/ml, and on treated IOLs the number of counted colonies was reduced to 1.09 x 10(7)/ml. Incubated with Propionibacterium acnes the average number of adherent bacteria on untreated IOLs was 4.75 x 10(4)/ml and on modified IOLs the number was reduced to 2.94 x 10(4)/ml. Dynasilan surface treatment may reduce the adherence of Staphylococcus epidermidis and Propionibacterium acnes on silicone intraocular lenses. Further studies regarding the stability of this treatment, its biocompatibility and influence on lens epithelial cell adhesion are in progress.

MANAGEMENT OF RESIDUAL REFRACTIVE ERROR AFTER CATARACT PHACOEMULSIFICATION. PART 2. INTRAOCULAR APPROACHES

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K. B. Pershin

2017-01-01

Full Text Available The review presents an  analysis  of the  literature  data  on  the  methods of surgical  correction of residual  refractive  error after cataract phacoemulsification. Keratorefractive and intraocular approaches are  considered in details.  A comparison of the  efficacy and  safet y  of different groups   of methods on  the  example  of comparative studies is given.  Historically earlier  keratorefractive methods (laser  vision correction with LASIK and  PRK techniques on intact  eyes,  LASIK after  implantation  of multifocal  IOLs and arcuate keratotomy  after  phaco  are  indicated  for  the  correction of astigmatic refractive  error and  a small  spherical refractive error. Intraocular methods, including the  replacement of the  IOL  and  «piggyback» IOLs implantation  are  used  to  correct a large spherical refractive error. The introduction  of new  technology, the  implantation  of light-adjustable  IOLs, will  expand  the  existing evidence  and provide greater predictabilit y and efficiency of the  method  of correction of residual  refractive error.

Multifocal osteogenic sarcoma in Paget's disease

International Nuclear Information System (INIS)

Vuillemin-Bodaghi, V.; Parlier-Cuau, C.; Laredo, J.D.; Cywiner-Golenzer, C.; Quillard, A.; Kaplan, G.

2000-01-01

The most serious complication of Paget's disease is sarcomatous degeneration of pagetic bone. Multifocal sarcomatous degeneration occurs mainly in polyostotic Paget's disease. Multifocal Paget's sarcoma is uncommon and can arise in any site. We report two cases of synchronous multifocal sarcomatous degeneration. The two patients were elderly women (aged 77 and 86 years, respectively) who developed sarcomatous lesions concomitantly, in the first case report in left ilium, left tibia, and first lumbar vertebra and in the second case report in the skull, right ilium, and sacrum. Whether these cases are due to the simultaneous development of several primaries or to metastases from a single primary remains unclear. (orig.)

Progressive Multifocal Leukoencephalopathy

Science.gov (United States)

... SEARCH Definition Treatment Prognosis Clinical Trials Organizations Publications Definition Progressive multifocal leukoencephalopathy (PML) is a disease of the white matter of the brain, caused by a virus infection ...

Effect of an ultraviolet-filtering intraocular lens on cystoid macular edema

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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.

Biconvex intraocular lenses and Nd:YAG capsulotomy: Experimental comparison of surface damage with different poly(methyl methacrylate) formulations

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Downing, J.E.; Alberhasky, M.T. (Greenview Hospital, Bowling Green, KY (USA))

1990-11-01

Biconvex posterior chamber lenses have optical advantages and decrease the risk of capsular opacification, but they are more likely to be pitted during ND:YAG capsulotomy because of apposition of the lens to the capsule. This study reports the likelihood of surface damage to different formulations of poly(methyl methacrylate) at the energy levels required to open posterior capsules. Molded lenses are more easily damaged than higher molecular weight lathe-cut materials (P less than .01), as expected. However, by keeping energy output low, even injection-molded lenses showed minimal damage, with mean pit size 39 +/- 39 microns at 1 mJ. By using a converging contact lens, low power, and keeping the focus behind the capsule, damage to all materials tested should be clinically insignificant.

Patient-centered and visual quality outcomes of premium cataract surgery: a systematic review.

Science.gov (United States)

Wang, Sophia Y; Stem, Maxwell S; Oren, Gale; Shtein, Roni; Lichter, Paul R

2017-06-26

Over 8 million cataract surgeries are performed in the United States and the European Union annually, with many patients choosing to pay out of pocket for premium options including premium intraocular lens implants (IOLs) or laser-assisted cataract surgery (LACS). This report provides a systematic review evaluating patient-centered and visual quality outcomes comparing standard monofocal IOLs to premium cataract surgery options. PubMed and EMBASE were searched for publications published between January 1, 1980, and September 18, 2016, on multifocal, accommodative, and toric IOLs, monovision, and LACS, which reported on 1) dysphotopsias, 2) contrast sensitivity, 3) spectacle independence, 4) vision-related quality of life or patient satisfaction, and 5) IOL exchange. Multifocal lenses achieved higher rates of spectacle independence compared to monofocal lenses but also had higher reported frequency of dysphotopsia and worse contrast sensitivity, especially with low light or glare. Accommodative lenses were not associated with reduced contrast sensitivity or more dysphotopsia but had only modest improvements in spectacle independence compared to monofocal lenses. Studies of monovision did not target a sufficiently myopic outcome in the near-vision eye to achieve the full potential for spectacle independence. Patients reported high levels of overall satisfaction regardless of implanted IOL. No studies correlated patient-reported outcomes with patient expectations. Studies are needed to thoroughly compare patient-reported outcomes with concomitant patient expectations. In light of the substantial patient costs for premium options, patients and their surgeons will benefit from a better understanding of which surgical options best meet patients' expectations and how those expectations can be impacted by premium versus monofocal-including monovision-options.

[Comparison of four MICS intraocular lenses regarding their rates of neodymium:YAG laser capsulotomy].

Science.gov (United States)

Spyridaki, M; Höh, H

2010-03-01

The aim of this study was to evaluate the incidence of posterior capsule opacification up to 50 months following 1.7-mm bimanual MICS-cataract surgery. Bimanual MICS cataract surgery was performed in 197 eyes (135 patients) via two 1.7-mm corneal incisions. Four MICS acrylic foldable IOLs were implanted: AcriSmart 48S-5, n = 54 (Acritec GmbH, Hennigsdorf, now AT.Smart 48S Carl-Zeiss-Meditec, AG, Jena, Germany), ThinLens UltraChoice 1.0, n = 53 (Technomed GmbH, Baesweiler, Germany), AcriFlex 46, n = 41 und AcriFlex 48 CSE, n = 7 (Acrimed GmbH, Berlin, now: Lentis L-303, Oculentis GmbH, Berlin, Germany) and CareFlex, n = 43 (w2o Medizintechnik AG, Bruchsal, Germany). Statistical analysis was performed using the Kaplan-Meier technique. High levels of completeness of follow-up rates were: ThinLens 96%, CareFlex 100%, AcriSmart 93%, AcriFlex 92%. The capsulotomy rate was 43.13% for ThinLens within a mean/max. follow-up period of 801/1131 days, 34.88% for CareFlex (565/872 days), 40% for AcriSmart (988/1506 days) and 15.91% for AcriFlex (728/975 days). By limiting the follow-up period to a comparable maximum of 850 days for all four IOLs, our capsulotomy rates were as follows: ThinLens 33.33%, CareFlex 32.56 %, AcriSmart 20.0% and AcriFlex 11.36%. MICS IOLs have higher capsulotomy rates than hydrophobic acrylic lenses and sharp-edged silicone lenses. In literature comparisons MICS-IOLs do not exceed the variance levels of capsulotomy rates of PMMA, hydrophilic acrylic and silicone lenses without sharp edges. Cases of decentration or luxation of MICS-IOLs following Neodym:YAG laser capsulotomy were not detected. Capsulotomy frequency with the CareFlex was statistically significantly higher in comparison to the AcriSmart (Log Rank Mantel Cox Test, p = 0.007) and AcriFlex (log rank Mantel Cox test, p = 0.002). Capsulotomy rates observed varied for the four MICS-IOL-types tested. The posterior capsule opacification frequency of the two best MICS-IOLs (AcriFlex, Acri

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

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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.

Preliminary observation of refractive cataract surgery assisted by femtosecond laser

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Xiao-Li Wang

2015-12-01

Full Text Available AIM:To compare the differences of visual acuity and corneal astigmatism postoperatively between conventional refractive cataract surgery and that assisted by femtosecond laser.METHODS:Sixty patients(60 eyeswith age-related cataract and cornea astigmatism were divided into femtosecond group and conventional group randomly or voluntarily. The flat shaft, steep shaft and diopter of corneal astigmatism in patients in femtosecond group were inputted into the online vector calculators to get the location and width of the incision. Then femtosecond laser was used to make corneal releasing incision, the main and auxiliary incision. Phacoemulsification and aspheric multifocal intraocular lens implantation were undergone. Patients in conventional group received full-thickness relaxing incision by cornea paracentesis knife at the steepest meridian axis during phacoemulsification. Then aspheric multifocal intraocular lenses were implanted. Uncorrected distance visual acuity(UCDVA, uncorrected near visual acuity(UCNVAand cornea astigmatism were observed at 1d,1wk and 1mo postoperative. RESULTS:UCVA of patients in both groups was improved after the surgeries. UCDVA and UCNVA of femtosecond group were higher than those of conventional group, while the cornea astigmatism of femtosecond group was lower than that of conventional group.CONCLUSION:Refractile cataract surgery assisted by femtosecond laser canoffer better visual quality than conventional refractive cataract surgery because of lower cornea astigmatism and better visual acuity.

Influência do astigmatismo corneano na acuidade visual final após implante de AcrySof® ReSTOR®: relato de caso Influence of corneal astigmatism in final visual acuity after implantation of AcrySofTM ReSTOR TM: case report

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Ricardo de Carvalho Rocha

2007-12-01

Full Text Available Atualmente tem-se desenvolvido novos tipos de lentes intra-oculares (LIO que objetivam eliminar a presbiopia e o seu uso vem se popularizando. Descreve-se o caso de um paciente com catarata bilateral e irregularidades corneanas e astigmatismo maior que 2 D à topografia, no qual implantou-se a LIO AcrySof® ReSTOR® no olho esquerdo associado à realização de incisões limbares relaxantes para tentar diminuir o astigmatismo corneano observado. A acuidade visual pós-operatória, tanto para perto quanto para longe, ficou abaixo das expectativas, sem melhora à refração e sem uma outra alteração que a justificasse, além das citadas. Após 45 dias, sem melhora da acuidade visual, efetuou-se o explante desta LIO, seguindo-se de implante de uma monofocal, sendo observada melhora da acuidade visual corrigida final. Assim, o presente caso clínico reforça a necessidade de uma correta seleção pré-operatória dos pacientes candidatos ao implante deste tipo de LIO multifocal, atentando inclusive para os dados topográficos.Currently, new types of intraocular lenses have been developed aiming to eliminate presbyopia and the use has become more popular. The authors report the case of a patient with bilateral cataract and corneal irregularities and astigmatism higher than 2D in the corneal topography, in which AcrySofTM ReSTOR TM intraocular lens was implanted in the left eye associated to relaxing limbal incisions trying to reduce corneal astigmatism. The near and distance postoperative visual acuity were worse than expected, with no improvement with refraction. Apparently, no other reason apart from irregular astigmatism/multifocal lens justified the low vision. After 45 days, with no visual acuity improvement, the intraocular lens was explanted and a monofocal one was implanted. The final corrected visual acuity improved. Thus, the present case emphasizes the need of a correct preoperative selection of patients to implant this type of

Drug-induced progressive multifocal leukoencephalopathy

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Vermeer, N S; Straus, S M J M; Mantel-Teeuwisse, A K

2015-01-01

Progressive multifocal leukoencephalopathy (PML) has been identified as a serious adverse drug reaction (ADR) of several immunomodulatory biologicals. In this study, we contrasted the reporting patterns of PML for two biologicals for which the risk was identified at different points in their life......Progressive multifocal leukoencephalopathy (PML) has been identified as a serious adverse drug reaction (ADR) of several immunomodulatory biologicals. In this study, we contrasted the reporting patterns of PML for two biologicals for which the risk was identified at different points...

Controlled release of moxifloxacin from intraocular lenses modified by Ar plasma-assisted grafting with AMPS or SBMA: An in vitro study.

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Pimenta, A F R; Vieira, A P; Colaço, R; Saramago, B; Gil, M H; Coimbra, P; Alves, P; Bozukova, D; Correia, T R; Correia, I J; Guiomar, A J; Serro, A P

2017-08-01

Intraocular lenses (IOLs) present an alternative for extended, local drug delivery in the prevention of post-operative acute endophthalmitis. In the present work, we modified the surface of a hydrophilic acrylic material, used for manufacturing of IOLs, through plasma-assisted grafting copolymerization of 2-acrylamido-2-methylpropane sulfonic acid (AMPS) or [2-(methacryloyloxy)ethyl]dimethyl-(3-sulfopropyl)ammonium hydroxide (SBMA), with the aim of achieving a controlled and effective drug release. The material was loaded with moxifloxacin (MFX), a commonly used antibiotic for endophthalmitis prevention. The characterization of the modified material showed that relevant properties, like swelling capacity, wettability, refractive index and transmittance, were not affected by the surface modification. Concerning the drug release profiles, the most promising result was obtained when AMPS grafting was done in the presence of MFX. This modification led to a higher amount of drug being released for a longer period of time, which is a requirement for the prevention of endophthalmitis. The material was found to be non-cytotoxic for rabbit corneal endothelial cells. In a second step, prototype IOLs were modified with AMPS and loaded with MFX as previously and, after sterilization and storage (30days), they were tested under dynamic conditions, in a microfluidic cell with volume and renovation rate similar to the eye aqueous humour. MFX solutions collected in this assay were tested against Staphylococcus aureus and Staphylococcus epidermidis and the released antibiotic proved to be effective against both bacteria until the 12th day of release. Copyright © 2017 Elsevier B.V. All rights reserved.

Short-term comparison between extended depth-of-focus prototype contact lenses and a commercially-available center-near multifocal.

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Tilia, Daniel; Munro, Anna; Chung, Jiyoon; Sha, Jennifer; Delaney, Shona; Kho, Danny; Thomas, Varghese; Ehrmann, Klaus; Bakaraju, Ravi Chandra

To compare the visual performance of prototype contact lenses which extend depth-of-focus (EDOF) by deliberate manipulation of multiple higher-order spherical aberration terms and a commercially-available center-near lens (AIR OPTIX Aqua Multifocal, AOMF). This was a prospective, cross-over, randomized, single-masked (participant), short-term clinical trial where 52 participants (age 45-70 years) were stratified as low, medium or high presbyopes and wore EDOF and AOMF on different days. Objective measures comprised high and low contrast visual acuity (HCVA/LCVA, logMAR), and contrast sensitivity (log units) at 6m; HCVA at 70cm, 50cm and 40cm and stereopsis (seconds of arc) at 40cm. HCVA at 70cm, 50cm and 40cm were measured as "comfortable acuity" rather than conventional resolution acuity. Subjective measures comprised clarity-of-vision and ghosting at distance, intermediate and near, overall vision satisfaction and ocular comfort (1-10 numeric rating scale) and lens purchase (yes/no response). Statistical analysis included repeated measures ANOVA, paired t-tests and McNemar's test. Significant differences between lens types were independent of strata (p≥0.119). EDOF was significantly better than AOMF for HCVA at 40cm (0.42±0.18 vs. 0.48±0.22, p=0.024), stereopsis (98±88 vs. 141±114, p<0.001), clarity-of-vision at intermediate (8.5±1.6 vs. 7.7±1.9, p=0.006) and near (7.3±2.5 vs. 6.2±2.5, p=0.005), lack-of-ghosting (p=0.012), overall vision satisfaction (7.5±1.7 vs. 6.4±2.2, p<0.001) and ocular comfort (9.0±1.0 vs. 8.3±1.7, p=0.002). Significantly more participants chose to only-purchase EDOF (33% vs. 6%, p=0.003).). There were no significant differences between lens types for any objective measure at 6m or clarity-of-vision at distance (p≥0.356). EDOF provides better intermediate and near vision performance in presbyopes than AOMF with no difference for distance vision during short-term wear. Copyright © 2016 Spanish General Council of Optometry

Change in corneal aberrations after cataract surgery with 2 types of aspherical intraocular lenses.

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Marcos, Susana; Rosales, Patricia; Llorente, Lourdes; Jiménez-Alfaro, Ignacio

2007-02-01

To study the effect of cataract surgery through 3.2 mm superior incisions on corneal aberrations with 2 types of monofocal intraocular lenses (IOLs) with an aspherical design. Instituto de Optica, Consejo Superior de Investigaciones Científicas, and Fundación Jiménez Díaz, Madrid, Spain. Corneal topography of 43 eyes was obtained before and after small corneal incision cataract surgery. Twenty-two eyes had implantation of a Tecnis Z9000 silicone IOL (Advanced Medical Optics) and 21 had implantation of an AcrySof IQ SN60WF acrylic IOL (Alcon Research Labs) using the recommended injector for each IOL type. The intended incision size (3.2 mm) was similar in the 2 groups. Corneal aberrations were estimated using custom-developed algorithms (based on ray tracing) for 10.0 mm and 5.0 mm pupils. Comparisons between preoperative and postoperative measurements and across the groups were made for individual Zernike terms and root-mean-square (RMS) wavefront error. The RMS (excluding tilt and defocus) did not change in the AcrySof IQ group and increased significantly in the Tecnis group with the 10.0 mm and 5.0 mm pupil diameters. Spherical aberration and coma-like terms did not change significantly; however, vertical astigmatism, vertical trefoil, and vertical tetrafoil changed significantly with surgery with the 10.0 mm and 5.0 mm pupil diameters (Porder aberrations consistently showed a superior lobe, resulting from a combination of positive vertical trefoil (Z(3)(-3)) and negative tetrafoil (Z(4)(4)). The mean vertical astigmatism increased by 2.47 microm +/- 1.49 (SD) and 1.74 +/- 1.44 microm, vertical trefoil increased by 1.81 +/- 1.19 microm and 1.20 +/- 1.34 microm, and tetrafoil increased by -1.10 +/- 0.78 microm and -0.89 +/- 0.68 microm in the Tecnis group and AcrySof IQ group, respectively. There were no significant differences between the corneal aberrations in the 2 postoperative groups, although there was a tendency toward more terms or orders changing

Avaliação do desempenho visual da lente intraocular difrativa multifocal - Zeiss AT Lisa 809 MTM

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Lucas Monferrari Monteiro Vianna

2014-04-01

Full Text Available Objetivo: Avaliar a função visual dos pacientes com implante bilateral da LIO multifocal difrativa AT-Lisa 809 MTM por meio dos exames de acuidade visual com e sem correção óptica, curva de sensibilidade ao contraste, curva de desfoco e questionário de qualidade de função visual (VQF39. Métodos: Estudo clínico, prospectivo e de intervenção, que avaliou os resultados de 20 olhos de 10 pacientes, submetidos à facoemulsificação e implante de LIO, entre fevereiro e junho de 2012. Resultados: A ametropia residual média pós-operatória foi de 0,05 ± 0,42 (-0,75 a +1,25 D dioptrias esféricas e -0,30 ± 0,42 (0 a -1,25 D dioptrias cilíndricas. Na curva de desenfoque mono e binocular, a melhor acuidade visual média obtida com 0.00 D de desenfoque (AV de longe. O segundo pico foi obtido com desenfoque de -3,00 D, o que equivale à visão de perto a 33 cm. Entre esses picos, observamos uma perda de desempenho visual, com desenfoque de -2,00 D, que equivale a visão intermediária a 50 cm. A sensibilidade ao contraste foi similar aos relatados na literatura com este tipo de LIO, tanto com quanto sem ofuscamento, e é mostrada em gráficos. O questionário de função visual (VFQ-39 teve valor médio de 91,91 +- 6,82. Conclusão: A LIO multifocal difrativa AT-Lisa 809MTM (Carl Zeiss Meditec Company - Alemanha apresentou resultados condizentes com a literatura quando avaliada pelos exames de acuidade visual com e sem correção óptica, sensibilidade ao contraste, curva de desfoco e questionário de qualidade de função visual (VQF 39.

Multi-focal Vision and Gaze Control Improve Navigation Performance

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Kolja Kuehnlenz

2008-11-01

Full Text Available Multi-focal vision systems comprise cameras with various fields of view and measurement accuracies. This article presents a multi-focal approach to localization and mapping of mobile robots with active vision. An implementation of the novel concept is done considering a humanoid robot navigation scenario where the robot is visually guided through a structured environment with several landmarks. Various embodiments of multi-focal vision systems are investigated and the impact on navigation performance is evaluated in comparison to a conventional mono-focal stereo set-up. The comparative studies clearly show the benefits of multi-focal vision for mobile robot navigation: flexibility to assign the different available sensors optimally in each situation, enhancement of the visible field, higher localization accuracy, and, thus, better task performance, i.e. path following behavior of the mobile robot. It is shown that multi-focal vision may strongly improve navigation performance.

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

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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.

Primary anterior chamber intraocular lens for the treatment of severe crystalline lens subluxation.

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Hoffman, Richard S; Fine, I Howard; Packer, Mark

2009-10-01

Subluxated cataractous and clear lenses are commonly treated by limbal or pars plana lensectomy followed by primary or secondary intraocular lens (IOL) implantation. Adjunctive capsular prosthetic devices have facilitated lens removal and IOL centration in these challenging cases but have also added complexity and potential complications to the procedure. Although crystalline lens extraction may be required to clear the visual axis in mild to moderate lens subluxations, we propose insertion of a primary anterior chamber IOL without lens extraction in severe subluxations when the eye is optically aphakic or can be made functionally aphakic following neodymium:YAG laser zonulysis. Two cases demonstrating this approach are presented.

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

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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

Three-dimensional vectorial multifocal arrays created by pseudo-period encoding

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Zeng, Tingting; Chang, Chenliang; Chen, Zhaozhong; Wang, Hui-Tian; Ding, Jianping

2018-06-01

Multifocal arrays have been attracting considerable attention recently owing to their potential applications in parallel optical tweezers, parallel single-molecule orientation determination, parallel recording and multifocal multiphoton microscopy. However, the generation of vectorial multifocal arrays with a tailorable structure and polarization state remains a great challenge, and reports on multifocal arrays have hitherto been restricted either to scalar focal spots without polarization versatility or to regular arrays with fixed spacing. In this work, we propose a specific pseudo-period encoding technique to create three-dimensional (3D) vectorial multifocal arrays with the ability to manipulate the position, polarization state and intensity of each focal spot. We experimentally validated the flexibility of our approach in the generation of 3D vectorial multiple spots with polarization multiplicity and position tunability.

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

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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.

Desempenho visual dos pacientes pseudofácicos com diferentes lentes intraoculares

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Wilson Takashi Hida

2013-10-01

Full Text Available OBJETIVO: Comparar a performance visual dos pacientes submetidos ao implante das lentes intraoculares multifocais difrativas Tecnis® MF ZM900, Acrysof® Restor® SN60D3, Acrysof® SN60WF e Acrysof® SN60AT. MÉTODOS: Estudo prospectivo comparativo, não randomizado, que incluiu 142 olhos de 71 pacientes com catarata, provenientes do ambulatório de oftalmologia do HC-FMUSP. A avaliação oftalmológica contou com medida da acuidade visual para longa, intermediária e curta distância, sem correção e com a melhor correção óptica, teste de sensibilidade ao contraste, pupilometria e análise de frente de onda por meio do aberrômetro. Todos os exames foram realizados com seis meses de pós-operatório. RESULTADOS: A média de idade dos pacientes foi de 60,7±6,6 anos no grupo Tecnis, 63,1±4,4 anos no grupo Restor e 63,7±4,2 anos no grupo monofocal (SN60AT no olho contralateral SN60WF. A acuidade visual para perto não corrigida e corrigida para longe foi estatisticamente superior nos grupos multifocal Restor e multifocal Tecnis em comparação ao grupo monofocal SN60AT/SN60WF (p<0,001. Não houve diferença estatística entre os grupos na comparação da acuidade visual para longe (p=0,56. A sensibilidade ao contraste fotópica monocular foi estatisticamente inferior nos grupos Restor e Tecnis (p<0,001. A SN60AT apresentou maior aberração esférica comparada a todas as outras lentes (p<0,001. A Tecnis se mostrou com menores valores médios de aberrações esféricas na comparação com a Restor (p<0.001. CONCLUSÃO: A Restor e Tecnis apresentaram melhor acuidade visual para perto do que o grupo monofocal SN60AT/SN60WF. Todas as lentes intraoculares promoveram boa visão para longe. O grupo da Tecnis apresentou melhor sensibilidade de contraste, menos aberrações ópticas e melhor visão intermediária que o grupo Restor.

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

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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.

Sutureless intrascleral intraocular lens fixation with lamellar dissection of scleral tunnel

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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

25G compared with 20G vitrectomy under Resight non-contact wide-angle lenses for Terson syndrome.

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Mao, Xinbang; You, Zhipeng

2017-08-01

The aim of the present study was to compare the effectiveness of 25G vitrectomy to standard 20G vitrectomy for treatment of Terson syndrome under Resight non-contact wide-angle lenses. This was a case-control study of 20 patients with Terson syndrome (study group) that underwent 25G vitrectomy under Resight non-contact wide-angle lenses, with those of 20 matched patients that underwent 20G vitrectomy (control group). Medical records were reviewed from between July 2011 and October 2013. Data included results of the Early Treatment Diabetic Retinopathy Study examination, ophthalmology B-scan ultrasonography and fundus photography. The mean age, follow-up time, the preoperative visual acuity of LogMAR and the preoperative intraocular pressure (IOP) were all comparable in the two groups (all P>0.05). There were statistically significant differences in postoperative visual acuity of LogMAR compared with preoperative visual acuity (Pcontact wide-angle lenses can achieve a significantly shorter operative time and lower post-operative IOP compared with 20G Vitrectomy.

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

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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.

Intraocular pressure reduction and regulation system

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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.

Intraocular (Eye) Melanoma—Health Professional Version

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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.

Inability to perform posterior segment monitoring by scanning laser ophthalmoscopy or optical coherence tomography with some occlusive intraocular lenses in clinical use.

Science.gov (United States)

Yusuf, Imran H; Peirson, Stuart N; Patel, Chetan K

2012-03-01

To evaluate whether occlusive intraocular lenses (IOLs) produced by several manufacturers for clinical use equivalently transmit near-infrared (IR) light for scanning laser ophthalmoscopy (SLO) or optical coherence tomography (OCT) imaging. Nuffield Laboratory of Ophthalmology, Oxford University, United Kingdom. Evaluation of diagnostic test or technology. The study evaluated 6 black IOLs of 2 designs: 3 poly(methyl methacrylate) (PMMA) and 3 iris-claw anterior chamber IOLs. Each IOL was placed between a broad-spectrum white light source and a spectroradiometer to generate transmission spectra. Transmission in the near-IR range was examined using an 850 nm light-emitting diode. Scanning laser ophthalmoscopy or OCT imaging using Spectralis spectral-domain SLO or OCT was attempted through occlusive IOLs in a model eye. Artisan iris-claw and MS 612 PMMA occlusive IOLs totally occluded all wavelengths of light, including in the near IR range in which SLO and OCT imaging systems operate. It was not possible to capture SLO or OCT images through the iris-claw and PMMA occlusive IOLs in a model eye. Results suggest the property of near-IR transmission that permits SLO or OCT imaging through occlusive IOLs is restricted to the Morcher range of occlusive IOLs. Patients with non-near IR transmitting IOLs will not be able to receive detailed posterior segment monitoring with SLO or OCT. This finding may have a significant impact on preoperative occlusive IOL selection and the management of current patients with occlusive IOLs. No 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.

In vivo subjective and objective longitudinal chromatic aberration after bilateral implantation of the same design of hydrophobic and hydrophilic intraocular lenses.

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Vinas, Maria; Dorronsoro, Carlos; Garzón, Nuria; Poyales, Francisco; Marcos, Susana

2015-10-01

To measure the longitudinal chromatic aberration in vivo using psychophysical and wavefront-sensing methods in patients with bilateral implantation of monofocal intraocular lenses (IOLs) of similar aspheric design but different materials (hydrophobic Podeye and hydrophilic Poday). Instituto de Optica, Consejo Superior de Investigaciones Cientificas, Madrid, Spain. Prospective observational study. Measurements were performed with the use of psychophysical (480 to 700 nm) and wavefront-sensing (480 to 950 nm) methods using a custom-developed adaptive optics system. Chromatic difference-of-focus curves were obtained from best-focus data at each wavelength, and the longitudinal chromatic aberration was obtained from the slope of linear regressions to those curves. The longitudinal chromatic aberration from psychophysical measurements was 1.37 diopters (D) ± 0.08 (SD) (hydrophobic) and 1.21 ± 0.08 D (hydrophilic). From wavefront-sensing, the longitudinal chromatic aberration was 0.88 ± 0.07 D and 0.73 ± 0.09 D, respectively. At 480 to 950 nm, the longitudinal chromatic aberration was 1.27 ± 0.09 D (hydrophobic) and 1.02 ± 0.13 D (hydrophilic). The longitudinal chromatic aberration was consistently higher in eyes with the hydrophobic IOL than in eyes with the hydrophilic IOL (a difference of 0.16 D and 0.15 D, respectively). Similar to findings in young phakic eyes, the longitudinal chromatic aberration from the psychophysical method was consistently higher than from wavefront-sensing, by 0.48 D (35.41%) for the hydrophobic IOL and 0.48 D (39.43%) for the hydrophilic IOL. Longitudinal chromatic aberrations were smaller with hydrophilic IOLs than with hydrophobic IOLs of the same design. 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.

Does multifocal papillary micro-carcinoma require radioiodine ablation?

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Punda, A.; Markovic, V.; Eterovic, D.

2015-01-01

Full text of publication follows. Background: the thyroid carcinomas smaller than 1 cm (micro-carcinomas) comprise a significant fraction of papillary carcinomas. Excluding clinical micro-carcinomas, which present as metastatic disease, the micro-carcinomas diagnosed by ultrasound/FNAC or incidentally have very good prognosis. However, whether or not these papillary micro-carcinomas require post-surgical radioiodine ablation remains a matter of debate. Hypothesis: multi-focality is present in majority of clinical papillary micro-carcinomas and this characteristic can be used to identify the subset of non-clinical micro-carcinomas with greater malignant potential. Methods: the data on types of differentiated thyroid carcinomas diagnosed in the period 2008-2011 in the University Hospital Split were collected. Results: there were 359 patients with thyroid carcinoma, 329 (92%) of which had papillary carcinoma. About 61% (202/329) of papillary carcinomas were micro-carcinomas; most of them were diagnosed by ultrasound/FNAC (134/202= 66%), the rest were incidentalomas (48/202=24%) and clinical micro carcinomas (20/202=10%). Sixty percent (12/20) of patients with clinical micro-carcinoma and 23 patients with non-clinical micro-carcinoma (23/182=13%) had multifocal disease. Conclusion: multifocal disease is a frequent characteristic of clinical papillary thyroid micro-carcinomas, suggesting that multi-focality presents an early stage of non-clinical micro-carcinomas with more aggressive behaviour. Thus multifocal, but not uni-focal papillary micro-carcinomas may require radioiodine ablation. (authors)

Do blue-light filtering intraocular lenses affect visual function?

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Lavric, Alenka; Pompe, Manca Tekavcic

2014-11-01

To study different aspects of visual function, macular changes, and subjective differences between the eye with an ultraviolet (UV) and blue-light filtering intraocular lens (IOL) and the fellow eye with a UV-light filtering IOL. Thirty patients (60 eyes) with senile cataract had both cataracts extracted, and an IOL was implanted at least 2 years before clinical evaluation. In one eye, AcrySof SA60AT (a UV-light filtering IOL) was implanted, whereas in the contralateral eye, AcrySof IQ SN60WF (a blue-light filtering IOL) was implanted. Each patient underwent visual acuity testing, color vision testing (Ishihara and Farnsworth-Munsell 100-hue tests), and contrast sensitivity (CS) testing. The macula was evaluated with optical coherence tomography and with clinical examination. Patients were asked if they noted any difference between the implanted IOLs concerning visual impression. Subjective visual quality was evaluated using the National Eye Institute Visual Functioning Questionnaire. There was a borderline statistically significant difference in the mean best-corrected visual acuity (p = 0.05). As regards color vision, no significant changes in Ishihara and Farnsworth-Munsell 100-hue error scores were detected between both eyes (p = 0.48 and p = 0.59, respectively). Analysis of CS showed no significant difference between the groups at any spatial frequency. There were also no statistically significant differences in central macular thickness and total macular volume between the two IOL groups (p = 0.72 and p = 0.61, respectively). In both IOL groups, three eyes developed an epiretinal membrane, and six eyes developed early signs of age-related macular degeneration. This study showed no significant effects of a blue-light filtering IOL on visual acuity and no influence on color perception and CS. After more than 2 years, there were no significant differences in macular changes between the IOL groups. Clinical evidence of the effect of a blue-light filtering IOL on

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

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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.

[Correlation of intraocular pressure variation after visual field examination with 24-hour intraocular pressure variations in primary open-angle glaucoma].

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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.

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

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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

Subaru Weak Lensing Measurements of Four Strong Lensing Clusters: Are Lensing Clusters Over-Concentrated?

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Oguri, Masamune; Hennawi, Joseph F.; Gladders, Michael D.; Dahle, Haakon; Natarajan, Priyamvada; Dalal, Neal; Koester, Benjamin P.; Sharon, Keren; Bayliss, Matthew

2009-01-29

We derive radial mass profiles of four strong lensing selected clusters which show prominent giant arcs (Abell 1703, SDSS J1446+3032, SDSS J1531+3414, and SDSS J2111-0115), by combining detailed strong lens modeling with weak lensing shear measured from deep Subaru Suprime-cam images. Weak lensing signals are detected at high significance for all four clusters, whose redshifts range from z = 0.28 to 0.64. We demonstrate that adding strong lensing information with known arc redshifts significantly improves constraints on the mass density profile, compared to those obtained from weak lensing alone. While the mass profiles are well fitted by the universal form predicted in N-body simulations of the {Lambda}-dominated cold dark matter model, all four clusters appear to be slightly more centrally concentrated (the concentration parameters c{sub vir} {approx} 8) than theoretical predictions, even after accounting for the bias toward higher concentrations inherent in lensing selected samples. Our results are consistent with previous studies which similarly detected a concentration excess, and increases the total number of clusters studied with the combined strong and weak lensing technique to ten. Combining our sample with previous work, we find that clusters with larger Einstein radii are more anomalously concentrated. We also present a detailed model of the lensing cluster Abell 1703 with constraints from multiple image families, and find the dark matter inner density profile to be cuspy with the slope consistent with -1, in agreement with expectations.

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

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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.

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

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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.

Capsule-Fixated Intraocular Lens Implantation in Small Pupil Cases.

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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.

Influence of a new surface modification of intraocular lenses with fluoroalkylsilan on the adherence of endophthalmitis-causing bacteria in vitro.

Science.gov (United States)

Kienast, Antonia; Kämmerer, Regine; Weiss, Claudia; Klinger, Matthias; Menz, Dirk-Henning; Dresp, Joachim; Ohgke, Helge; Solbach, Werner; Laqua, Horst; Hoerauf, Hans

2006-09-01

Dynasilan is a fluoroalkylsilan that is able to interact with surface active centres on intraocular lenses (IOL), offering a new way for surface modification of different IOL materials. The purpose of this in vitro study was to investigate the influence of this new surface modification on the adherence of two typical endophthalmitis causing bacteria (Staphylococcus epidermidis, Propionibacterium acnes). In a pilot experiment, the effect of Dynasilan coating on the adherence of S. epidermidis was tested on glass slides. Forty-two Dynasilan-modified and 42 unmodified IOL (14 PMMA, 14 silicone and 14 hydrogel) were incubated at 37 degrees C in brain heart infusion broth (10(8) CFU/ml) with either S. epidermidis for 24 h or with P. acnes for 1 h. Subsequently, the adherent bacteria were resuspended using ultrasonification at 35 kHz for 3x45 s. After dilution series and incubation at 37 degrees C on Petri dishes for 24 h and 3 days, respectively, the colonies were counted. In the pilot experiment, a markedly lower number of adherent S. epidermidis was observed on Dynasilan-modified glass slides. Of all IOL materials incubated with S. epidermidis, those modified with Dynasilan showed a lower mean number of adherent bacteria (mean 1.37x10(7); SD 2.37x10(7)) than those untreated (2.43x10(7); SD 3.04x10(7)). IOLs incubated with P. acnes showed a significantly lower mean number of adherent bacteria of 2.51x10(4) (SD 2.71x10(4)) on Dynasilan-modified IOLs versus 6.27x10(4) (SD 7.70x10(4)) on untreated IOLs. The presented in vitro results indicate that Dynasilan surface modification is able to reduce the adherence of S. epidermidis and P. acnes on all IOL materials tested. Further studies regarding the stability of this modification and its biocompatibility must be performed.

Ocular surface displacement with and without contact lenses during non-contact tonometry.

Science.gov (United States)

Rimayanti, Ulfah; Kiuchi, Yoshiaki; Uemura, Shohei; Takenaka, Joji; Mochizuki, Hideki; Kaneko, Makoto

2014-01-01

To evaluate the displacement of the central ocular surface during non-contact tonometry with and without soft contact lenses and determine the factors associated with the displacement of the central ocular surface and intraocular pressure (IOP) reading changes caused by wearing soft contact lenses (CLs). One eye each in 21 subjects was studied. The cornea was photographed using a high-speed camera at 5,000 frames/sec during non-contact tonometry without contact lenses (NCL), with -5.0 diopters (D), -0.5 D and +5.0 D CL. The displacement of the ocular surface and the factors affecting displacement at the IOP reading and maximum displacement time were investigated. The IOP readings while wearing +5 D CL were significantly higher than those obtained while wearing -5 D CL. The ocular surface displacement between +5 D CL and other groups were significantly different. A significant positive correlation was found between the ocular surface displacement of subjects at the IOP reading time and the IOP obtained with the non-contact tonometer. A significant negative correlation was found between the ocular surface curvature and the IOP obtained using the non-contact tonometer. The radius of curvature of the ocular surface affected the displacement during the IOP reading and maximum displacement time. Our results indicate that soft contact lens use changes the ocular surface behavior and IOP readings during non-contact tonometry. The radius of curvature of the eye affects the ocular surface displacement and IOP readings in this situation.

Multifocal Epithelial Hyperplasia.

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Agnew, Caitlin; Alexander, Sherene; Prabhu, Neeta

2017-01-15

Multifocal epithelial hyperplasia is a rare disease associated with human papilloma virus types 13 and 32. Diagnosis is based on clinical and histopathological findings, and most lesions are asymptomatic and regress spontaneously with time. The purpose of this paper is to describe a five-year-old girl who presented with multiple intraoral lesions on the buccal mucosa and tongue, which regressed spontaneously in 15 months.

Compensating additional optical power in the central zone of a multifocal contact lens forminimization of the shrinkage error of the shell mold in the injection molding process.

Science.gov (United States)

Vu, Lien T; Chen, Chao-Chang A; Lee, Chia-Cheng; Yu, Chia-Wei

2018-04-20

This study aims to develop a compensating method to minimize the shrinkage error of the shell mold (SM) in the injection molding (IM) process to obtain uniform optical power in the central optical zone of soft axial symmetric multifocal contact lenses (CL). The Z-shrinkage error along the Z axis or axial axis of the anterior SM corresponding to the anterior surface of a dry contact lens in the IM process can be minimized by optimizing IM process parameters and then by compensating for additional (Add) powers in the central zone of the original lens design. First, the shrinkage error is minimized by optimizing three levels of four IM parameters, including mold temperature, injection velocity, packing pressure, and cooling time in 18 IM simulations based on an orthogonal array L 18 (2 1 ×3 4 ). Then, based on the Z-shrinkage error from IM simulation, three new contact lens designs are obtained by increasing the Add power in the central zone of the original multifocal CL design to compensate for the optical power errors. Results obtained from IM process simulations and the optical simulations show that the new CL design with 0.1 D increasing in Add power has the closest shrinkage profile to the original anterior SM profile with percentage of reduction in absolute Z-shrinkage error of 55% and more uniform power in the central zone than in the other two cases. Moreover, actual experiments of IM of SM for casting soft multifocal CLs have been performed. The final product of wet CLs has been completed for the original design and the new design. Results of the optical performance have verified the improvement of the compensated design of CLs. The feasibility of this compensating method has been proven based on the measurement results of the produced soft multifocal CLs of the new design. Results of this study can be further applied to predict or compensate for the total optical power errors of the soft multifocal CLs.

MULTIFOCAL CHOROIDITIS IN DISSEMINATED SPOROTRICHOSIS IN PATIENTS WITH HIV/AIDS.

Science.gov (United States)

Biancardi, Ana L; Freitas, Dayvison F S; Valviesse, Vitor R G de A; Andrade, Hugo B; de Oliveira, Manoel M E; do Valle, Antonio C F; Zancope-Oliveira, Rosely M; Galhardo, Maria C G; Curi, Andre L L

2017-01-01

In this article, the authors describe multifocal choroiditis related to disseminated sporotrichosis in patients with HIV/AIDS. We conducted a retrospective observational study of three patients infected with HIV who presented with disseminated sporotrichosis characterized by cutaneous lesions, multifocal choroiditis, and other manifestations, including osteomyelitis and involvement of the bone marrow, larynx, pharynx, and nasal and oral mucosa. Five eyes of three patients with HIV/AIDS showed multifocal choroiditis related to disseminated sporotrichosis. The CD4 counts ranged from 25 to 53 mm. All patients were asymptomatic visually. The ocular disease was bilateral in two patients. The lesion size ranged from 1/3 to 2 disc diameters. None of the patients had vitritis. Of the 12 lesions, 9 were localized in the posterior pole (Zone 1) and 3 were localized in the mild periphery (Zone 2). Multifocal choroiditis due to disseminated sporotrichosis can occur in profoundly immunosuppressed patients with HIV/AIDS.

Prismatic displacement effect of progressive multifocal glasses on reaction time and accuracy in elderly people.

Science.gov (United States)

Ellison, Ashton C; Campbell, A John; Robertson, M Clare; Sanderson, Gordon F

2014-01-01

Multifocal glasses (bifocals, trifocals, and progressives) increase the risk of falling in elderly people, but how they do so is unclear. To explain why glasses with progressive addition lenses increase the risk of falls and whether this can be attributed to false projection, this study aimed to 1) map the prismatic displacement of a progressive lens, and 2) test whether this displacement impaired reaction time and accuracy. The reaction times of healthy ≥75-year-olds (31 participants) were measured when grasping for a bar and touching a black line. Participants performed each test twice, wearing their progressives and new, matched single vision (distance) glasses in random order. The line and bar targets were positioned according to the maximum and minimum prismatic displacement effect through the progressive lens, mapped using a focimeter. Progressive spectacle lenses have large areas of prismatic displacement in the central visual axis and edges. Reaction time was faster for progressives compared with single vision glasses with a centrally-placed horizontal grab bar (mean difference 101 ms, P=0.011 [repeated measures analysis]) and a horizontal black line placed 300 mm below center (mean difference 80 ms, P=0.007). There was no difference in accuracy between the two types of glasses. Older people appear to adapt to the false projection of progressives in the central visual axis. This adaptation means that swapping to new glasses or a large change in prescription may lead to a fall. Frequently updating glasses may be more beneficial.

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.

Potential contact and intraocular lenses based on hydrophilic/hydrophobic sulfonated syndiotactic polystyrene membranes

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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.

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.

Intraocular lymphoma

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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.

Interactions of Bacteria and Amoebae with Ocular Biomaterials

OpenAIRE

John, Thomas

1991-01-01

The use of biomaterials in periocular and intraocular sites has resulted in some ocular inflammations and infections which can result in vision-threatening ocular disease. This review addresses bacterial interactions with, and adherence to ocular biomaterials such as soft contact lenses, surgical suture materials, and intraocular lenses. In addition, adherence of Acanthamoeba to soft contact lenses is described, and the role of these lenses in the development of Acanthamoeba keratitis is disc...

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

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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.

Comparing the relative peripheral refraction effect of single vision and multifocal contact lenses measured using an autorefractor and an aberrometer: A pilot study

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Ravi C. Bakaraju

2015-07-01

Conclusion: For most test conditions, distinct differences were observed between the RPR measures obtained with the two modified instruments. The differences varied with CL design and centration. Although the pilot study supports the interchangeable use of the two instruments for on- and off-axis refraction in unaided eyes or eyes corrected with low/no spherical aberration; we advocate the use of the COAS-HD over the SN for special purposes like refracting through multifocal CLs.

Multifocal hyperfunctioning thyroid carcinoma without metastases.

Science.gov (United States)

Nishida, Akiko T; Hirano, Shigeru; Asato, Ryo; Tanaka, Shinzo; Kitani, Yoshiharu; Honda, Nobumitsu; Fujiki, Nobuya; Miyata, Kouji; Fukushima, Hideyuki; Ito, Juichi

2008-09-01

Hyperthyroidism due to thyroid carcinoma is rare, and most cases are caused by hyperfunctioning metastatic thyroid carcinoma rather than primary carcinoma. Among primary hyperfunctioning thyroid carcinoma, multifocal thyroid carcinoma is exceedingly rare, with the only one case being reported in the literature. Here, we describe the case of a 62-year-old woman with multifocal functioning thyroid carcinoma. Technetium-99m (99m Tc) scintigraphic imaging showed four hot areas in the thyroid gland. Histopathological examination of all four nodules revealed papillary carcinoma, corresponding to hot areas in the 99m Tc scintigram. DNA sequencing of the thyrotropin receptor (TSH-R) gene from all nodules revealed no mutation, indicating that activation of TSH-R was unlikely in the pathophysiogenesis of hyperfunctioning thyroid carcinoma in the present case.

Image quality comparison of two multifocal IOLs: influence of the pupil.

Science.gov (United States)

García-Domene, Mari Carmen; Felipe, Adelina; Peris-Martínez, Cristina; Navea, Amparo; Artigas, Jose M; Pons, Álvaro M

2015-04-01

To evaluate the effect of pupil size on image quality of a sectorial multifocal intraocular lens (IOL), the Lentis Mplus (Oculentis GmbH, Berlin, Germany), and the Acri.LISA IOL (Carl Zeiss Meditec, Jena, Germany). The authors measured the MTFs of the Lentis Mplus LS-312 IOL and the Acri.LISA 366D IOL with three different sizes of pupil diameters: 3, 4, and 5 mm. The MTF was calculated from the cross-line spread function recorded with the OPAL Vector System (Image Science Ltd., Oxford, UK) by using fast Fourier-transform techniques. In distance focus, the image quality provided by the Lentis Mplus IOL was better than that of the Acri. LISA IOL with all pupil diameters. In near focus, the MTF of the Acri.LISA IOL was better with a 3-mm pupil, but poor with larger pupils. The aberration effect was equal in both IOLs in distance focus, but in near focus and with a 3-mm pupil, the Acri.LISA IOL was less affected by the aberration than the Lentis Mplus IOL. The Lentis Mplus IOL provides better distance image quality than the Acri.LISA IOL, whereas the near image quality of the Acri.LISA IOL is better with small-pupil diameter. The sectorial design makes this IOL more suitable for patients with a pupil diameter greater than 3 mm. Copyright 2015, SLACK Incorporated.

A rare case of a medullary, multifocal lesion in the distal radius

Science.gov (United States)

Aktas, Birol; Ozturan, Burak; Kilic, Bulent; Ozkan, Korhan

2017-01-01

In multifocal findings, the possibility of multifocal osteoid osteomas should be considered and this case helps us to be attentive for the unusual radiographical presentation of osteoid osteoma. PMID:28748099

Multifocal osteosarcoma as second tumor after childhood retinoblastoma

International Nuclear Information System (INIS)

Potepan, P.; Laffranchi, A.; Danesini, G.M.; Spagnoli, I.; Luksch, R.; Sozzi, G.; Testi, A.; Parafioriti, A.; Giardini, R.

1999-01-01

We present a case of multifocal osteosarcoma (MFOS) arising 11.5 years after successful treatment of bilateral retinoblastoma. The clinical, imaging and pathological findings at onset, after therapy, and during follow-up are described. Fluorescent in situ hybridization did not reveal a deletion of the RB-1 retinoblastoma gene, although the presence of an inactivating mutation invisible to this method cannot be ruled out. The MFOS may have been a second multifocal tumor associated with the original retinoblastoma or a post-irradiation sarcoma with extensive metastases. (orig.)

Ocular surface displacement with and without contact lenses during non-contact tonometry.

Directory of Open Access Journals (Sweden)

Ulfah Rimayanti

Full Text Available PURPOSE: To evaluate the displacement of the central ocular surface during non-contact tonometry with and without soft contact lenses and determine the factors associated with the displacement of the central ocular surface and intraocular pressure (IOP reading changes caused by wearing soft contact lenses (CLs. METHODS: One eye each in 21 subjects was studied. The cornea was photographed using a high-speed camera at 5,000 frames/sec during non-contact tonometry without contact lenses (NCL, with -5.0 diopters (D, -0.5 D and +5.0 D CL. The displacement of the ocular surface and the factors affecting displacement at the IOP reading and maximum displacement time were investigated. RESULTS: The IOP readings while wearing +5 D CL were significantly higher than those obtained while wearing -5 D CL. The ocular surface displacement between +5 D CL and other groups were significantly different. A significant positive correlation was found between the ocular surface displacement of subjects at the IOP reading time and the IOP obtained with the non-contact tonometer. A significant negative correlation was found between the ocular surface curvature and the IOP obtained using the non-contact tonometer. The radius of curvature of the ocular surface affected the displacement during the IOP reading and maximum displacement time. CONCLUSIONS: Our results indicate that soft contact lens use changes the ocular surface behavior and IOP readings during non-contact tonometry. The radius of curvature of the eye affects the ocular surface displacement and IOP readings in this situation.

Candida Endophthalmitis After Descemet Stripping Automated Endothelial Keratoplasty With Grafts From Both Eyes of a Donor With Possible Systemic Candidiasis.

Science.gov (United States)

Palioura, Sotiria; Sivaraman, Kavitha; Joag, Madhura; Sise, Adam; Batlle, Juan F; Miller, Darlene; Espana, Edgar M; Amescua, Guillermo; Yoo, Sonia H; Galor, Anat; Karp, Carol L

2018-04-01

To report 2 cases with late postoperative Candida albicans interface keratitis and endophthalmitis after Descemet stripping automated endothelial keratoplasty (DSAEK) with corneal grafts originating from a single donor with a history of presumed pulmonary candidiasis. Two patients underwent uncomplicated DSAEK by 2 corneal surgeons at different surgery centers but with tissue from the same donor and were referred to the Bascom Palmer Eye Institute with multifocal infiltrates at the graft-host cornea interface 6 to 8 weeks later, and anterior chamber cultures that were positive for the same genetic strain of C. albicans. Immediate explantation of DSAEK lenticules and daily intracameral and instrastromal voriconazole and amphotericin injections failed to control the infection. Thus, both patients underwent therapeutic penetrating keratoplasty with intraocular lens explantation, pars plana vitrectomy, and serial postoperative intraocular antifungal injection. Both patients are doing well at 2 years postoperatively with best-corrected vision of 20/20 and 20/30+ with rigid gas permeable lenses. One patient required repeat optical penetrating keratoplasty and glaucoma tube implantation 1 year after the original surgery. Literature review reveals that donor lenticule explantation and intraocular antifungals are often inadequate to control fungal interface keratitis, and a therapeutic graft is commonly needed. Interface fungal keratitis and endophthalmitis due to infected donor corneal tissue is difficult to treat, and both recipients of grafts originating from the same donor are at risk of developing this challenging condition.

Resultados del implante múltiple de lentes intraoculares en la cirugía de catarata en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" Results of the multiple intraocular lenses implantation in the cataract surgery performed at "Ramón Pando Ferrer" Cuban Institute of Ophthalmology

Directory of Open Access Journals (Sweden)

Eric Montero Díaz

2010-06-01

Full Text Available OBJETIVO: Valorar los resultados visuales de los pacientes operados con la técnica de piggy back o implantes múltiples de lentes intraoculares. MÉTODOS: Se realizó un estudio descriptivo retrospectivo de corte transversal en el que se tomaron 32 ojos de 30 pacientes del universo operado de catarata, con la técnica antes descrita, en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer", en el período comprendido entre enero de 2000 hasta diciembre de 2006. Fueron evaluadas algunas variables demográficas, como edad y sexo, así como agudeza visual y refracción preoperatorio y posoperatoria con cristales y sin ellos. Reportamos las complicaciones transquirúrgicas y posquirúrgicas asociadas a las diferentes técnicas quirúrgicas empleadas para la extracción del cristalino. RESULTADOS: La edad promedio obtenida fue mayor de 50 años, y predominó el sexo femenino. Parte de los pacientes tuvieron una agudeza visual corregida superior a 20/40. La complicación más frecuente fue la opacidad de la cápsula posterior y solo en la tercera parte de los pacientes se obtuvo una buena corrección refractiva. CONCLUSIONES: La técnica de piggy back permitió la recuperación de cuatro líneas en la cartilla de Snellen en la agudeza visual corregida, mientras que en la agudeza visual sin corrección solo aumentó en dos líneas. Se encontró igual número de pacientes hipocorregidos y bien corregidos.OBJECTIVE: To asses the visual results of patients operated on by piggy back technique or multiple implantation of intraocular lenses METHODS: A retrospective cross-sectional descriptive study was conducted in 32 eyes from 30 patients operated on from cataract, using the above-mentioned technique, at "Ramon Pando Ferrer" Cuban Institute of Ophthalmology in the period January 2000 through December 2006. Some demographic variables as age and sex as well as visual acuity and preoperative and postoperative refraction with/without lenses were evaluated

Gravitationally Lensed Quasars in Gaia: II. Discovery of 24 Lensed Quasars

Science.gov (United States)

Lemon, Cameron A.; Auger, Matthew W.; McMahon, Richard G.; Ostrovski, Fernanda

2018-04-01

We report the discovery, spectroscopic confirmation and preliminary characterisation of 24 gravitationally lensed quasars identified using Gaia observations. Candidates were selected in the Pan-STARRS footprint with quasar-like WISE colours or as photometric quasars from SDSS, requiring either multiple detections in Gaia or a single Gaia detection near a morphological galaxy. The Pan-STARRS grizY images were modelled for the most promising candidates and 60 candidate systems were followed up with the William Herschel Telescope. 13 of the lenses were discovered as Gaia multiples and 10 as single Gaia detections near galaxies. We also discover 1 lens identified through a quasar emission line in an SDSS galaxy spectrum. The lenses have median image separation 2.13″ and the source redshifts range from 1.06 to 3.36. 4 systems are quadruply-imaged and 20 are doubly-imaged. Deep CFHT data reveal an Einstein ring in one double system. We also report 12 quasar pairs, 10 of which have components at the same redshift and require further follow-up to rule out the lensing hypothesis. We compare the properties of these lenses and other known lenses recovered by our search method to a complete sample of simulated lenses to show the lenses we are missing are mainly those with small separations and higher source redshifts. The initial Gaia data release only catalogues all images of ˜ 30% of known bright lensed quasars, however the improved completeness of Gaia data release 2 will help find all bright lensed quasars on the sky.

A multifocal collimator with circularly distributed focal points for SPECT imaging

International Nuclear Information System (INIS)

Guillemaud, R.; Grangeat, P.

1994-01-01

The authors propose a new circular multifocal collimator which has multiple axial focal points distributed on a transverse circle. This distribution provides a strong focusing at the center of the detector like a cone-beam collimator, with a good sensitivity, and a weak transverse focusing at the periphery, to ensure acquisition of sufficient data, in order to prevent truncation artifacts. For a circular acquisition trajectory, each projection set of the multifocal geometry is equivalent to a virtual cone-beam projection set with a larger detector. Due to this equivalence, the authors derive a first solution for an analytical multifocal reconstruction algorithm: to rebin the projection set from multifocal to cone-beam geometry, then to use a 3D cone-beam reconstruction algorithm. The authors propose to use the Grangeat algorithm in order to deal with a large cone-beam aperture. Finally, the authors present results on simulated data for heart phantom, for a Defrise phantom and for a MTF study. The conclusion is that, from a multifocal projection set, objects are reconstructed without truncation artifacts, with a good precision at their center and with a loss of resolution at the periphery. In addition, the 3D cone-beam artifacts are reduced with the use of the Grangeat algorithm for the reconstruction step

An Unusual Case of Unilateral Multifocal Choroiditis in a Young Male

African Journals Online (AJOL)

Multifocal choroiditis is a vision‑threatening disease causing inflammation at the level of retinal pigment epithelium and outer retina. We present a unique case of unilateral multifocal choroiditis in a young nonmyopic male and its subsequent course. The patient developed visual loss due to the sub‑retinal neovascular ...

[Multifocal Electroretinography in Patients with Poppers Maculopathy].

Science.gov (United States)

Pahlitzsch, Milena; Salchow, Daniel; Rossel, Mirjam; Bergholz, Richard

2017-10-12

Background Maculopathy is a potential side effect of amyl nitrite or "poppers" abuse. It is characterized by a sudden, painless decrease in visual acuity. While the funduscopic changes are subtle, optical coherence tomography shows alterations of the outer retinal layers in the fovea. However, the extent of retinal dysfunction remains poorly understood. Materials/Methods We compared the multifocal electroretinogram of 6 patients with poppers maculopathy to that of a control group consisting of 6 healthy subjects. Response densities and implicit times of N1 and P1 were analyzed. Results Response densities and implicit times of both N1 and P1 were lower in the patients with poppers maculopathy than in the control group, particularly in ring 1 and rings 4 and 5. The only statistically significant finding, however, was a reduced N1 response density of one hexagon in the patient group. No significant differences were found considering the sum response or the averaged rings 1 to 5. Conclusion Compared to a healthy control group, the multifocal electroretinogram of patients with poppers maculopathy shows no relevant impairment. This contrasts the marked effect of the disease on visual acuity. In clinical practice, poppers maculopathy cannot be diagnosed by multifocal electroretinography. Georg Thieme Verlag KG Stuttgart · New York.

Multifocal, chronic osteomyelitis of unknown etiology

International Nuclear Information System (INIS)

Kozlowski, K.; Beluffi, G.; Feltham, C.; James, M.; Nespoli, L.; Tamaela, L.; Pavia Univ.; Municipal Hospital, Nelson; Medical School, Jakarta

1985-01-01

Four cases of multifocal osteomyelitis of unknown origin in childhood are reported. The variable clinical and radiographic appearances of the disease are illustrated and the diagnostic difficulties in the early stages of the disease are stressed. (orig.) [de

Progressive multifocal leukoencephalopathy in transplant recipients

NARCIS (Netherlands)

Mateen, Farrah J.; Muralidharan, RajaNandini; Carone, Marco; van de Beek, Diederik; Harrison, Daniel M.; Aksamit, Allen J.; Gould, Mary S.; Clifford, David B.; Nath, Avindra

2011-01-01

Transplant recipients are at risk of developing progressive multifocal leukoencephalopathy (PML), a rare demyelinating disorder caused by oligodendrocyte destruction by JC virus. Reports of PML following transplantation were found using PubMed Entrez (1958-July 2010). A multicenter, retrospective

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.

Taxonomy of multi-focal nematode image stacks by a CNN based image fusion approach.

Science.gov (United States)

Liu, Min; Wang, Xueping; Zhang, Hongzhong

2018-03-01

In the biomedical field, digital multi-focal images are very important for documentation and communication of specimen data, because the morphological information for a transparent specimen can be captured in form of a stack of high-quality images. Given biomedical image stacks containing multi-focal images, how to efficiently extract effective features from all layers to classify the image stacks is still an open question. We present to use a deep convolutional neural network (CNN) image fusion based multilinear approach for the taxonomy of multi-focal image stacks. A deep CNN based image fusion technique is used to combine relevant information of multi-focal images within a given image stack into a single image, which is more informative and complete than any single image in the given stack. Besides, multi-focal images within a stack are fused along 3 orthogonal directions, and multiple features extracted from the fused images along different directions are combined by canonical correlation analysis (CCA). Because multi-focal image stacks represent the effect of different factors - texture, shape, different instances within the same class and different classes of objects, we embed the deep CNN based image fusion method within a multilinear framework to propose an image fusion based multilinear classifier. The experimental results on nematode multi-focal image stacks demonstrated that the deep CNN image fusion based multilinear classifier can reach a higher classification rate (95.7%) than that by the previous multilinear based approach (88.7%), even we only use the texture feature instead of the combination of texture and shape features as in the previous work. The proposed deep CNN image fusion based multilinear approach shows great potential in building an automated nematode taxonomy system for nematologists. It is effective to classify multi-focal image stacks. Copyright © 2018 Elsevier B.V. All rights reserved.

Heterogeneity of DNA methylation in multifocal prostate cancer.

Science.gov (United States)

Serenaite, Inga; Daniunaite, Kristina; Jankevicius, Feliksas; Laurinavicius, Arvydas; Petroska, Donatas; Lazutka, Juozas R; Jarmalaite, Sonata

2015-01-01

Most prostate cancer (PCa) cases are multifocal, and separate foci display histological and molecular heterogeneity. DNA hypermethylation is a frequent alteration in PCa, but interfocal heterogeneity of these changes has not been extensively investigated. Ten pairs of foci from multifocal PCa and 15 benign prostatic hyperplasia (BPH) samples were obtained from prostatectomy specimens, resulting altogether in 35 samples. Methylation-specific PCR (MSP) was used to evaluate methylation status of nine tumor suppressor genes (TSGs), and a set of selected TSGs was quantitatively analyzed for methylation intensity by pyrosequencing. Promoter sequences of the RASSF1 and ESR1 genes were methylated in all paired PCa foci, and frequent (≥75 %) DNA methylation was detected in RARB, GSTP1, and ABCB1 genes. MSP revealed different methylation status of at least one gene in separate foci in 8 out of 10 multifocal tumors. The mean methylation level of ESR1, GSTP1, RASSF1, and RARB differed between the paired foci of all PCa cases. The intensity of DNA methylation in these TSGs was significantly higher in PCa cases than in BPH (p epigenetic profile of recurrent tumors can be inferred from our data.

Whole body MRI in the diagnosis of chronic recurrent multifocal osteomyelitis.

LENUS (Irish Health Repository)

Kennedy, M T

2012-06-01

Chronic recurrent multifocal osteomyelitis (CRMO) is a diagnosis of exclusion primarily in children and adolescents. As part of the essential criteria for the diagnosis of CRMO, multifocal lesions must be identified. We present the case of an 11-year-old boy with CRMO, whose diagnosis was facilitated by the use of whole body magnetic resonance imaging (WBMR), but not isotope bone scanning.

Multifocal necrotizing fasciitis following Hirshsprung's disease ...

African Journals Online (AJOL)

Multifocal necrotizing fasciitis following Hirshsprung's disease surgery away from the surgical wound site. Ahmed A. Haseeb, Shadi Okasha and Atef Elbarawi. Necrotizing fasciitis (NF) is a life-threatening infection with rapidly progressive necrosis. Escherichia coli is rarely reported as causative agent of type 2 NF.

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.

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.

21 CFR 886.3600 - Intraocular lens.

Science.gov (United States)

2010-04-01

... DEVICES OPHTHALMIC DEVICES Prosthetic Devices § 886.3600 Intraocular lens. (a) Identification. An intraocular lens is a device made of materials such as glass or plastic intended to be implanted to replace the natural lens of an eye. (b) Classification. Class III. (c) Date PMA or notice of completion of a...

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...

Analysis of luminosity distributions of strong lensing galaxies: subtraction of diffuse lensed signal

Science.gov (United States)

Biernaux, J.; Magain, P.; Hauret, C.

2017-08-01

Context. Strong gravitational lensing gives access to the total mass distribution of galaxies. It can unveil a great deal of information about the lenses' dark matter content when combined with the study of the lenses' light profile. However, gravitational lensing galaxies, by definition, appear surrounded by lensed signal, both point-like and diffuse, that is irrelevant to the lens flux. Therefore, the observer is most often restricted to studying the innermost portions of the galaxy, where classical fitting methods show some instabilities. Aims: We aim at subtracting that lensed signal and at characterising some lenses' light profile by computing their shape parameters (half-light radius, ellipticity, and position angle). Our objective is to evaluate the total integrated flux in an aperture the size of the Einstein ring in order to obtain a robust estimate of the quantity of ordinary (luminous) matter in each system. Methods: We are expanding the work we started in a previous paper that consisted in subtracting point-like lensed images and in independently measuring each shape parameter. We improve it by designing a subtraction of the diffuse lensed signal, based only on one simple hypothesis of symmetry. We apply it to the cases where it proves to be necessary. This extra step improves our study of the shape parameters and we refine it even more by upgrading our half-light radius measurement method. We also calculate the impact of our specific image processing on the error bars. Results: The diffuse lensed signal subtraction makes it possible to study a larger portion of relevant galactic flux, as the radius of the fitting region increases by on average 17%. We retrieve new half-light radii values that are on average 11% smaller than in our previous work, although the uncertainties overlap in most cases. This shows that not taking the diffuse lensed signal into account may lead to a significant overestimate of the half-light radius. We are also able to measure

Contactin-1 and Neurofascin-155/-186 Are Not Targets of Auto-Antibodies in Multifocal Motor Neuropathy.

Directory of Open Access Journals (Sweden)

Kathrin Doppler

Full Text Available Multifocal motor neuropathy is an immune mediated disease presenting with multifocal muscle weakness and conduction block. IgM auto-antibodies against the ganglioside GM1 are detectable in about 50% of the patients. Auto-antibodies against the paranodal proteins contactin-1 and neurofascin-155 and the nodal protein neurofascin-186 have been detected in subgroups of patients with chronic inflammatory demyelinating polyneuropathy. Recently, auto-antibodies against neurofascin-186 and gliomedin were described in more than 60% of patients with multifocal motor neuropathy. In the current study, we aimed to validate this finding, using a combination of different assays for auto-antibody detection. In addition we intended to detect further auto-antibodies against paranodal proteins, specifically contactin-1 and neurofascin-155 in multifocal motor neuropathy patients' sera. We analyzed sera of 33 patients with well-characterized multifocal motor neuropathy for IgM or IgG anti-contactin-1, anti-neurofascin-155 or -186 antibodies using enzyme-linked immunosorbent assay, binding assays with transfected human embryonic kidney 293 cells and murine teased fibers. We did not detect any IgM or IgG auto-antibodies against contactin-1, neurofascin-155 or -186 in any of our multifocal motor neuropathy patients. We conclude that auto-antibodies against contactin-1, neurofascin-155 and -186 do not play a relevant role in the pathogenesis in this cohort with multifocal motor neuropathy.

Differences of Longitudinal Chromatic Aberration (LCA) between Eyes with Intraocular Lenses from Different Manufacturers

Science.gov (United States)

Nakajima, Masashi; Hiraoka, Takahiro; Yamamoto, Toshiya; Takagi, Seiu; Hirohara, Yoko; Oshika, Tetsuro

2016-01-01

Several researchers have studied the longitudinal chromatic aberration (LCA) of eyes implanted with an intraocular lens (IOL). We investigated the LCA of eyes implanted with yellow-colored IOLs from three different manufacturers: Alcon Inc., HOYA Corp., and AMO Inc. The number of subjects was 11, 16, and 16, respectively. The LCA of eyes implanted with SN60WF and SN60AT (Alcon Inc.), and with XY-1 (HOYA Corp.), was the same as that of phakic eyes. The LCA of eyes with ZCB00V (AMO Inc.) was smaller than that of phakic eyes. The LCA of eyes implanted with Alcon’s and HOYA’s IOLs, but not the LCA of eyes implanted with AMO’s IOLs, was positively correlated with the powers of the IOLs. We also performed simulations to verify the impacts of LCA on visual performance for 4-mm pupil diameter; the simulations were a polychromatic modulation transfer function (MTF) and a visual Strehl ratio computed on the basis of an optical transfer function (VSOTF). We concluded that the differences between the LCA of different manufacturers do not affect visual performances when some extent of higher-order aberration (HOA) exists. The smaller HOA of AMO IOLs may enhance visual performance. PMID:27258141

Prismatic displacement effect of progressive multifocal glasses on reaction time and accuracy in elderly people

Directory of Open Access Journals (Sweden)

Ellison AC

2014-05-01

Full Text Available Ashton C Ellison, A John Campbell, M Clare Robertson, Gordon F SandersonDunedin School of Medicine, Department of Medicine, Dunedin, New ZealandBackground: Multifocal glasses (bifocals, trifocals, and progressives increase the risk of falling in elderly people, but how they do so is unclear. To explain why glasses with progressive addition lenses increase the risk of falls and whether this can be attributed to false projection, this study aimed to 1 map the prismatic displacement of a progressive lens, and 2 test whether this displacement impaired reaction time and accuracy.Methods: The reaction times of healthy ≥75-year-olds (31 participants were measured when grasping for a bar and touching a black line. Participants performed each test twice, wearing their progressives and new, matched single vision (distance glasses in random order. The line and bar targets were positioned according to the maximum and minimum prismatic displacement effect through the progressive lens, mapped using a focimeter.Results: Progressive spectacle lenses have large areas of prismatic displacement in the central visual axis and edges. Reaction time was faster for progressives compared with single vision glasses with a centrally-placed horizontal grab bar (mean difference 101 ms, P=0.011 [repeated measures analysis] and a horizontal black line placed 300 mm below center (mean difference 80 ms, P=0.007. There was no difference in accuracy between the two types of glasses.Conclusion: Older people appear to adapt to the false projection of progressives in the central visual axis. This adaptation means that swapping to new glasses or a large change in prescription may lead to a fall. Frequently updating glasses may be more beneficial.Keywords: fall prevention, false projection, stored visual spatial information

Outcomes of presbyopia-correcting intraocular lenses after laser in situ keratomileusis.

Science.gov (United States)

Chow, Sharon S W; Chan, Tommy C Y; Ng, Alex L K; Kwok, Alvin K H

2018-03-28

Laser in situ keratomileusis (LASIK) is the most common refractive surgery in young patients, which aims at providing a clear distance vision without the use of spectacles. With time, these patients develop symptomatic cataract, which affects activities of daily living, and to improve visual acuity, intraocular lens (IOL) implantation can be considered. In post-myopic LASIK patients, to allow continuation of spectacle independence, the implantation of presbyopia-correcting IOLs is a suitable option. The purpose of this retrospective case series is to report the visual outcome and quality in post-myopic LASIK eyes after the implantation of AT LISA tri839MP IOL. Twenty eyes of 13 patients with history of myopic LASIK within 20 years underwent phacoemulsification by one single surgeon. All eyes were implanted with AT LISA tri839PMP IOL, and their outcomes were evaluated at 6 months postoperation. The mean postoperative uncorrected distance visual acuity (VA) is 0.28 ± 0.29, while the corrected distance VA is 0.06 ± 0.14. The mean postoperative uncorrected near VA is 0.02 ± 0.05, while the corrected near VA is 0.01 ± 0.02. The mean postoperative manifest refraction spherical equivalent (SE) is - 0.92 ± 0.76D. There is a statistically significant difference between the preoperative and postoperative refraction (p = 0.02), which shows a postoperative myopic shift. There is also a statistically significant difference between the mean targeted SE and postoperative manifest refraction SE (p = 0.00). Only one out of 20 eyes (5%) reported halo and glare symptoms. Ten out of 20 eyes (50%) are able to achieve spectacles independence. In conclusion, in post-myopic LASIK eyes, AT LISA tri839MP provides a good visual outcome at both near and distance, but is more predictable at near than at distance. There is a myopic shift in the postoperative SE. Visual quality is satisfactory and has not been exacerbated. Most patients can remain to be

A common humoral background of intraocular and arterial blood pressure dysregulation.

Science.gov (United States)

Skrzypecki, Janusz; Grabska-Liberek, Iwona; Przybek, Joanna; Ufnal, Marcin

2018-03-01

It has been postulated that intraocular pressure, an important glaucoma risk factor, correlates positively with arterial blood pressure (blood pressure). However, results of experimental and clinical studies are often contradictory. It is hypothesized that, in some hypertensive patients, disturbances in intraocular pressure regulation may depend on biological effects of blood borne hormones underlying a particular type of hypertension, rather than on blood pressure level itself. This review compares the effects of hormones on blood pressure and intraocular pressure, in order to identify a hormonal profile of hypertensive patients with an increased risk of intraocular pressure surge. The PUBMED database was searched to identify pre-clinical and clinical studies investigating the role of angiotensin II, vasopressin, adrenaline, noradrenaline, prostaglandins, and gaseous transmitters in the regulation of blood pressure and intraocular pressure. Studies included in the review suggest that intraocular and blood pressures often follow a different pattern of response to the same hormone. For example, vasopressin increases blood pressure, but decreases intraocular pressure. In contrast, high level of nitric oxide decreases blood pressure, but increases intraocular pressure. Arterial hypertension is associated with altered levels of blood borne hormones. Contradicting results of studies on the relationship between arterial hypertension and intraocular pressure might be partially explained by diverse effects of hormones on arterial and intraocular pressures. Further studies are needed to evaluate if hormonal profiling may help to identify glaucoma-prone patients.

Multifocal tenosynovial giant cell tumors in a child with Noonan syndrome

Energy Technology Data Exchange (ETDEWEB)

Meyers, Arthur B. [Children' s Hospital of Wisconsin, Department of Radiology, Milwaukee, WI (United States); Nemours Children' s Health System/Nemours Children' s Hospital, Department of Radiology, Orlando, FL (United States); Awomolo, Agboola O. [Children' s Hospital of Wisconsin, Department of Radiology, Milwaukee, WI (United States); Szabo, Sara [Medical College of Wisconsin and Children' s Hospital of Wisconsin, Department of Pathology, Milwaukee, WI (United States); Cincinnati Children' s Hospital Medical Center, Division of Pathology and Laboratory Medicine, Cincinnati, OH (United States)

2017-03-15

Noonan syndrome is a genetic disorder with variable expression of distinctive facial features, webbed neck, chest deformity, short stature, cryptorchidism and congenital heart disease. The association of Noonan syndrome and giant cell granulomas of the mandible is widely reported. However, Noonan syndrome may also be associated with single or multifocal tenosynovial giant cell tumors, also referred to as pigmented villonodular synovitis. We report a child with Noonan syndrome, giant cell granulomas of the mandible and synovial and tenosynovial giant cell tumors involving multiple joints and tendon sheaths who was initially misdiagnosed with juvenile idiopathic arthritis. It is important for radiologists to be aware of the association of Noonan syndrome and multifocal giant cell lesions, which can range from the more commonly described giant cell granulomas of the mandible to isolated or multifocal intra- or extra-articular tenosynovial giant cell tumors or a combination of all of these lesions. (orig.)

Multifocal tenosynovial giant cell tumors in a child with Noonan syndrome.

Science.gov (United States)

Meyers, Arthur B; Awomolo, Agboola O; Szabo, Sara

2017-03-01

Noonan syndrome is a genetic disorder with variable expression of distinctive facial features, webbed neck, chest deformity, short stature, cryptorchidism and congenital heart disease. The association of Noonan syndrome and giant cell granulomas of the mandible is widely reported. However, Noonan syndrome may also be associated with single or multifocal tenosynovial giant cell tumors, also referred to as pigmented villonodular synovitis. We report a child with Noonan syndrome, giant cell granulomas of the mandible and synovial and tenosynovial giant cell tumors involving multiple joints and tendon sheaths who was initially misdiagnosed with juvenile idiopathic arthritis. It is important for radiologists to be aware of the association of Noonan syndrome and multifocal giant cell lesions, which can range from the more commonly described giant cell granulomas of the mandible to isolated or multifocal intra- or extra-articular tenosynovial giant cell tumors or a combination of all of these lesions.

Multifocal tenosynovial giant cell tumors in a child with Noonan syndrome

International Nuclear Information System (INIS)

Meyers, Arthur B.; Awomolo, Agboola O.; Szabo, Sara

2017-01-01

Noonan syndrome is a genetic disorder with variable expression of distinctive facial features, webbed neck, chest deformity, short stature, cryptorchidism and congenital heart disease. The association of Noonan syndrome and giant cell granulomas of the mandible is widely reported. However, Noonan syndrome may also be associated with single or multifocal tenosynovial giant cell tumors, also referred to as pigmented villonodular synovitis. We report a child with Noonan syndrome, giant cell granulomas of the mandible and synovial and tenosynovial giant cell tumors involving multiple joints and tendon sheaths who was initially misdiagnosed with juvenile idiopathic arthritis. It is important for radiologists to be aware of the association of Noonan syndrome and multifocal giant cell lesions, which can range from the more commonly described giant cell granulomas of the mandible to isolated or multifocal intra- or extra-articular tenosynovial giant cell tumors or a combination of all of these lesions. (orig.)

Multifocal chronic osteomyelitis of unknown etiology

International Nuclear Information System (INIS)

Kozlowski, K.; Masel, J.; Harbison, S.; Yu, J.; Royal Brisbane Children Hospital; Regional Hospital Bowral

1983-01-01

Five cases of chronic, inflammatory, multifocal bone lesions of unknown etiology are reported. Although bone biopsy confirmed osteomyelitis in each case in none of them were organisms found inspite of an extensive work up. Different clinical course of the disease reflects different aetiology in respective cases. These cases present changing aspects of osteomyelitis emerging since introduction of antibiotics. (orig.)

Acoustic lenses

International Nuclear Information System (INIS)

Kittmer, C.A.

1983-03-01

Acoustic lenses focus ultrasound to produce pencil-like beams with reduced near fields. When fitted to conventional (flat-faced) transducers, such lenses greatly improve the ability to detect and size defects. This paper describes a program developed to design acoustic lenses for use in immersion or contact inspection, using normal or angle beam mode with flat or curved targets. Lens surfaces are circular in geometry to facilitate machining. For normal beam inspection of flat plate, spherical or cylindrical lenses are used. For angle beam or curved surface inspections, a compound lens is required to correct for the extra induced aberration. Such a lens is aspherical with one radius of curvature in the plane of incidence, and a different radius of curvature in the plane perpendicular to the incident plane. The resultant beam profile (i.e., location of the acoustic focus, beam diameter, 6 dB working range) depends on the degree of focusing and the transducer used. The operating frequency and bandwidth can be affected by the instrumentation used. Theoretical and measured beam profiles are in good agreement. Various applications, from zone focusing used for defect sizing in thick plate, to line focusing for pipe weld inspection, are discussed

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.

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.

Additive manufacturing of tunable lenses

Science.gov (United States)

Schlichting, Katja; Novak, Tobias; Heinrich, Andreas

2017-02-01

Individual additive manufacturing of optical systems based on 3D Printing offers varied possibilities in design and usage. In addition to the additive manufacturing procedure, the usage of tunable lenses allows further advantages for intelligent optical systems. Our goal is to bring the advantages of additive manufacturing together with the huge potential of tunable lenses. We produced tunable lenses as a bundle without any further processing steps, like polishing. The lenses were designed and directly printed with a 3D Printer as a package. The design contains the membrane as an optical part as well as the mechanical parts of the lens, like the attachments for the sleeves which contain the oil. The dynamic optical lenses were filled with an oil. The focal length of the lenses changes due to a change of the radius of curvature. This change is caused by changing the pressure in the inside of the lens. In addition to that, we designed lenses with special structures to obtain different areas with an individual optical power. We want to discuss the huge potential of this technology for several applications. Further, an appropriate controlling system is needed. Wéll show the possibilities to control and regulate the optical power of the lenses. The lenses could be used for illumination tasks, and in the future, for individual measurement tasks. The main advantage is the individuality and the possibility to create an individual design which completely fulfills the requirements for any specific application.

A circular multifocal collimator for 3D SPECT imaging

International Nuclear Information System (INIS)

Guillemaud, R.; Grangeat, P.

1993-01-01

In order to improve sensitivity of 3D Single Photon Emission Tomography (SPECT) image, a cone-beam collimator can be used. A new circular multifocal collimator is proposed. The multiple focal points are distributed on a transaxial circle which is the trajectory of the focal points during the circular acquisition. This distribution provides a strong focusing at the center of the detector like a cone-beam collimator, with a good sensitivity, and a weak transaxial focusing at the periphery. A solution for an analytical multifocal reconstruction algorithm has been derived. Grangeat algorithm is proposed to use for this purpose in order to reconstruct with a good sensitivity the region of interest. (R.P.) 3 refs

Multifocal epithelioid hemangioendothelioma of the phalanges of the hand

International Nuclear Information System (INIS)

Bruegel, Melanie; Waldt, Simone; Woertler, Klaus; Rummeny, Ernst J.; Weirich, Gregor

2006-01-01

Epithelioid hemangioendothelioma (EH) of bone is a rare vascular neoplasm characterized by epithelioid endothelial cells and a variable biologic behaviour. The principal sites of occurrence of this osteolytic tumor are the lower extremity and the axial skeleton. Approximately half of the cases present with multifocal disease. The latter feature can be helpful in suggesting the diagnosis of a vascular tumor; on the other hand, it strengthens the need for a skeletal survey or whole-body MRI/CT. We report on the clinical, histologic and radiologic features - including CT and MRI findings - of EH in a case of multifocal disease of the phalanges of the hand, a very uncommon anatomic site of affliction. (orig.)

Research advances on multifocal electroretinogram in primary open angle glaucoma

Directory of Open Access Journals (Sweden)

Feng-Fei Mo

2013-10-01

Full Text Available Primary open angle glaucoma is a chronic and progressive optic neuropathy. It can lead to serious damage of visual impairment, and it is an important eye disease of blindness. Multifocal electroretinogram is a new way to measure visual electrophysiology. It can measure electroretinogram of the whole visual field of many small parts in a relatively short period of time, and it can reflect the function of regional retina. It has an extremely important value for early diagnosis of primary open angle glaucoma. The research advances on multifocal electroretinogram in diagnosing primary open angle glaucoma were summarized in this paper.

Nanofocusing refractive X-ray lenses

Energy Technology Data Exchange (ETDEWEB)

Boye, Pit

2010-02-05

This thesis is concerned with the optimization and development of the production of nanofocusing refractive X-ray lenses. These optics made of either silicon or diamond are well-suited for high resolution X-ray microscopy. The goal of this work is the design of a reproducible manufacturing process which allows the production of silicon lenses with high precision, high quality and high piece number. Furthermore a process for the production of diamond lenses is to be developed and established. In this work, the theoretical basics of X-rays and their interaction with matter are described. Especially, aspects of synchrotron radiation are emphasized. Important in X-ray microscopy are the different optics. The details, advantages and disadvantages, in particular those of refractive lenses are given. To achieve small X-ray beams well beyond the 100 nm range a small focal length is required. This is achieved in refractive lenses by moving to a compact lens design where several single lenses are stacked behind each other. The, so-called nanofocusing refractive lenses (NFLs) have a parabolic cylindrical shape with lateral structure sizes in the micrometer range. NFLs are produced by using micro-machining techniques. These micro-fabrication processes and technologies are introduced. The results of the optimization and the final fabrication process for silicon lenses are presented. Subsequently, two experiments that are exemplary for the use of NFLs, are introduced. The rst one employs a high-resolution scanning fluorescence mapping of a geological sample, and the second one is a coherent x-ray diffraction imaging (CXDI) experiment. CXDI is able to reconstruct the illuminated object from recorded coherent diffraction patterns. In a scanning mode, referred to as ptychography, this method is even able to reconstruct the illumination and the object simultaneously. Especially the reconstructed illumination and the possibility of computed propagation of the wave field along the

Nanofocusing refractive X-ray lenses

International Nuclear Information System (INIS)

Boye, Pit

2010-01-01

This thesis is concerned with the optimization and development of the production of nanofocusing refractive X-ray lenses. These optics made of either silicon or diamond are well-suited for high resolution X-ray microscopy. The goal of this work is the design of a reproducible manufacturing process which allows the production of silicon lenses with high precision, high quality and high piece number. Furthermore a process for the production of diamond lenses is to be developed and established. In this work, the theoretical basics of X-rays and their interaction with matter are described. Especially, aspects of synchrotron radiation are emphasized. Important in X-ray microscopy are the different optics. The details, advantages and disadvantages, in particular those of refractive lenses are given. To achieve small X-ray beams well beyond the 100 nm range a small focal length is required. This is achieved in refractive lenses by moving to a compact lens design where several single lenses are stacked behind each other. The, so-called nanofocusing refractive lenses (NFLs) have a parabolic cylindrical shape with lateral structure sizes in the micrometer range. NFLs are produced by using micro-machining techniques. These micro-fabrication processes and technologies are introduced. The results of the optimization and the final fabrication process for silicon lenses are presented. Subsequently, two experiments that are exemplary for the use of NFLs, are introduced. The rst one employs a high-resolution scanning fluorescence mapping of a geological sample, and the second one is a coherent x-ray diffraction imaging (CXDI) experiment. CXDI is able to reconstruct the illuminated object from recorded coherent diffraction patterns. In a scanning mode, referred to as ptychography, this method is even able to reconstruct the illumination and the object simultaneously. Especially the reconstructed illumination and the possibility of computed propagation of the wave field along the

Multifocal fibrosclerosis: a new case report and review of the literature

Energy Technology Data Exchange (ETDEWEB)

Oguz, Kader Karli; Oguz, Oguzhan; Cila, Aysenur; Oto, Aytekin [Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara (Turkey); Kiratli, Hayyam [Department of Ophthalmology, Faculty of Medicine, Hacettepe University, Ankara (Turkey); Gokoz, Aytac [Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara (Turkey)

2002-05-01

A case of multifocal fibrosclerosis is presented with MR images. Bilateral sclerosing orbital pseudotumor invading cavernous sinuses were the presenting disorder. Magnetic resonance imaging showed involvement of paranasal sinuses bilaterally and multiple supratentorial dural masses. Retroperitoneal fibrosis was associated with the condition. Multifocal involvement should be considered in patients with sclerosing orbital pseudotumor and an imaging approach should be performed on the appropriate clinical condition to document possible coexistence of other disorders including retroperitoneal fibrosis, mediastinal fibrosis, sclerosing cholangitis, and Riedel's thyroiditis (orig.)

Multifocality as a prognostic factor in breast cancer patients registered in Danish Breast Cancer Cooperative Group (DBCG) 1996-2001

DEFF Research Database (Denmark)

Joergensen, L.E.; Gunnarsdottir, K.A.; Lanng, C.

2008-01-01

The purpose of this study was to investigate the prognostic influence of multifocality in breast cancer patients. In a cohort of 7196 patients there were 945 patients with multifocality. We found no prognostic influence of multifocality on overall survival when controlling for known prognostic......, Gunnarsdottir KA, Rasmussen BB, Moeller S, Lanng C. The prognostic influence of multifocality in breast cancer patients. Breast 2004;13:188-193]....... factors. We found a small but significant influence on disease-free survival (HR=1.16 [1.03-1.31]) and a strong correlation between multifocality and known prognostic factors. This was in accordance with an earlier study done on a smaller population and in a different period of time [Pedersen L...

MULTIFOCAL RETINAL INFILTRATES WITH PHLEBITIS AND OPTIC NEUROPATHY IN AN HIV-POSITIVE PEDIATRIC PATIENT.

Science.gov (United States)

Kasi, Sundeep K; Vora, Robin A; Martin, Taliva; Cunningham, Emmett T

2015-01-01

To describe an unusual presentation of bilateral HIV-associated multifocal retinal infiltrates with phlebitis and optic neuropathy in a pediatric patient from Zimbabwe, Africa. Retrospective case report of a 15-year-old boy from Zimbabwe, Africa. The patient was found to have bilateral vitritis, multifocal retinitis with phlebitis, and optic neuropathy in the setting of previously unrecognized HIV infection. Vision improved and the clinical findings resolved after treatment with intravenous corticosteroids and highly active retroviral therapy (HAART). The authors describe the occurrence and treatment of bilateral, HIV-associated multifocal retinal infiltrates with phlebitis and HIV-associated optic neuropathy in a pediatric patient from Zimbabwe, Africa.

Long-Term Visual Prognosis of Peripheral Multifocal Chorioretinitis

NARCIS (Netherlands)

Ossewaarde-van Norel, J; ten Dam-van Loon, NH; de Boer, JH; Rothova, A.

2015-01-01

Purpose To report on the clinical manifestations, complications, and long-term visual prognosis of patients with peripheral multifocal chorioretinitis and to search for predictors for a lower visual outcome. Design Retrospective consecutive observational case series. Methods setting: Institutional.

A Rare Case of Multifocal Prostatic Blue Nevus

Directory of Open Access Journals (Sweden)

Elias J. Farran

2018-01-01

Full Text Available Prostatic blue nevus is a rare benign pathologic diagnosis most commonly diagnosed incidentally on many different types of prostate specimens. Blue nevus is the deposition of stromal melanin characterized by spindle cells within the fibromuscular stroma which stains positive for melanin-specific stains Fontana-Masson and S100 and stains negative for CD68, HMB45, and iron stains. We report the case of a multifocal and bilateral blue nevus in a 52-year-old Hispanic male who presented with an elevated prostate-specific antigen of 4.3 and mild obstructive lower urinary tract symptoms, found by transrectal ultrasound-guided prostate needle biopsy. The biopsy also revealed benign prostatic tissue with postatrophic hyperplasia and chronic inflammation. This is the 35th reported case of prostatic blue nevus and the third to show multifocal blue nevus.

Relation between intraocular pressure and size of transverse sinuses

Energy Technology Data Exchange (ETDEWEB)

Kantarci, Mecit; Onbas, Omer; Alper, Fatih; Okur, Adnan [Atatuerk University, Department of Radiology, Medical Faculty, Erzurum (Turkey); Dane, Senol; Gumustekin, Kenan [Atatuerk University, Department of Physiology, Medical Faculty, Erzurum (Turkey); Aslankurt, Murat [Atatuerk University, Department of Ophtalmatology, Medical Faculty, Erzurum (Turkey); Yazici, Ahmet Taylan [Beyoglu Goez Egitim ve Arastirma Hastanesi, Istanbul (Turkey)

2005-01-01

There are asymmetries in the sizes of transverse sinus and intraocular pressure. The purpose of this study was to investigate possible relationships between the asymmetry of transverse sinuses in TOF MR venography and intraocular pressures of right and left eyes. In this study, subjects were 63 male and 42 female medical school students, aged 18-21 years (mean{+-}SD; 19.72{+-}0.67 years). Subjects with neurological and ophthalmologic disease, particularly dural sinus thrombosis, myopia, trauma and glaucoma, were excluded the study. Subjects were divided into five groups according to the magnitudes of the right- and left-transverse sinuses in MR venography results. There is a functional relation between intraocular pressures of the right and left eyes and asymmetry of the transverse sinus. If the transverse sinus on one side is larger and its venous drainage is greater, the intraocular pressure of the eye on this side is lower. It can be speculated that the transverse sinus size may be associated with pathogenesis of diseases with increased intraocular pressure such as glaucoma. We aim to determine the relation between the size and drainage of transverse sinuses in TOF MR venography and intraocular pressure in patients with open-angle glaucoma in our next study. (orig.)

Relation between intraocular pressure and size of transverse sinuses

International Nuclear Information System (INIS)

Kantarci, Mecit; Onbas, Omer; Alper, Fatih; Okur, Adnan; Dane, Senol; Gumustekin, Kenan; Aslankurt, Murat; Yazici, Ahmet Taylan

2005-01-01

There are asymmetries in the sizes of transverse sinus and intraocular pressure. The purpose of this study was to investigate possible relationships between the asymmetry of transverse sinuses in TOF MR venography and intraocular pressures of right and left eyes. In this study, subjects were 63 male and 42 female medical school students, aged 18-21 years (mean±SD; 19.72±0.67 years). Subjects with neurological and ophthalmologic disease, particularly dural sinus thrombosis, myopia, trauma and glaucoma, were excluded the study. Subjects were divided into five groups according to the magnitudes of the right- and left-transverse sinuses in MR venography results. There is a functional relation between intraocular pressures of the right and left eyes and asymmetry of the transverse sinus. If the transverse sinus on one side is larger and its venous drainage is greater, the intraocular pressure of the eye on this side is lower. It can be speculated that the transverse sinus size may be associated with pathogenesis of diseases with increased intraocular pressure such as glaucoma. We aim to determine the relation between the size and drainage of transverse sinuses in TOF MR venography and intraocular pressure in patients with open-angle glaucoma in our next study. (orig.)

Statistics of gravitational lenses. III. Astrophysical consequences of quasar lensing

International Nuclear Information System (INIS)

Ostriker, J.P.; Vietri, M.

1986-01-01

The method of Schmidt and Green (1983) for calculating the luminosity function of quasars is combined with gravitational-lensing theory to compute expected properties of lensed systems. Multiple quasar images produced by galaxies are of order 0.001 of the observed quasars, with the numbers over the whole sky calculated to be (0.86, 120, 1600) to limiting B magnitudes of (16, 19, 22). The amount of false evolution is small except for an interesting subset of apparently bright, large-redshift objects for which minilensing by starlike objects may be important. Some of the BL Lac objects may be in this category, with the galaxy identified as the parent object really a foreground object within which stars have lensed a background optically violent variable quasar. 24 references

Gravitational lensing

CERN Document Server

Dodelson, Scott

2017-01-01

Gravitational lensing is a consequence of general relativity, where the gravitational force due to a massive object bends the paths of light originating from distant objects lying behind it. Using very little general relativity and no higher level mathematics, this text presents the basics of gravitational lensing, focusing on the equations needed to understand the phenomena. It then applies them to a diverse set of topics, including multiply imaged objects, time delays, extrasolar planets, microlensing, cluster masses, galaxy shape measurements, cosmic shear, and lensing of the cosmic microwave background. This approach allows undergraduate students and others to get quickly up to speed on the basics and the important issues. The text will be especially relevant as large surveys such as LSST and Euclid begin to dominate the astronomical landscape. Designed for a one semester course, it is accessible to anyone with two years of undergraduate physics background.

30 CFR 18.30 - Windows and lenses.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Windows and lenses. 18.30 Section 18.30 Mineral... § 18.30 Windows and lenses. (a) MSHA may waive testing of materials for windows or lenses except headlight lenses. When tested, material for windows or lenses shall meet the test requirements prescribed in...

[Endoscopically controlled optimization of trans-scleral suture fixation of posterior chamber lenses in the ciliary sulcus].

Science.gov (United States)

Althaus, C; Sundmacher, R

1993-08-01

Two technical difficulties have to be overcome in transscleral suture fixation of posterior chamber intraocular lenses (PCL) in the ciliary sulcus: first, exact needle penetration through the sulcus, and second, exact positioning of the PCL haptics in the sulcus. Incongruence of the two may lead to long-term complications by compression or even strangulation of ciliary processes. Intraocular endoscopy was used intraoperatively to visualize the site of needle penetration and the final location of the haptics in patients. It turned out that with our previously described standard techniques the precision was far less than anticipated. Thus, new technical ways had to be sought to improve the precision of positioning. In secondary implantation without perforating keratoplasty we achieved the best results when the needle was passed ab externo before opening the eye and before anterior vitrectomy, taking advantage of a precisely prepared sclerocorneal zone. Passing the needle ab externo in an already hypotonic eyeball gives much less precise results. In combination with perforating keratoplasty with an open-sky approach, needle penetration ab interno is reliable. Correct positioning of the PCL haptics is at least as difficult as correct needle penetration, a fact which up to now has mostly been ignored. In 33 consecutively operated eyes the technique of implantation and PCL design was varied under endoscopical control.(ABSTRACT TRUNCATED AT 250 WORDS)

Scleral Fixation of Posteriorly Dislocated Intraocular Lenses by 23-Gauge Vitrectomy without Anterior Segment Approach

Directory of Open Access Journals (Sweden)

Jeroni Nadal

2015-01-01

Full Text Available Background. To evaluate visual outcomes, corneal changes, intraocular lens (IOL stability, and complications after repositioning posteriorly dislocated IOLs and sulcus fixation with polyester sutures. Design. Prospective consecutive case series. Setting. Institut Universitari Barraquer. Participants. 25 eyes of 25 patients with posteriorly dislocated IOL. Methods. The patients underwent 23-gauge vitrectomy via the sulcus to rescue dislocated IOLs and fix them to the scleral wall with a previously looped nonabsorbable polyester suture. Main Outcome Measures. Best corrected visual acuity (BCVA LogMAR, corneal astigmatism, endothelial cell count, IOL stability, and postoperative complications. Results. Mean follow-up time was 18.8 ± 10.9 months. Mean surgery time was 33 ± 2 minutes. Mean BCVA improved from 0.30 ± 0.48 before surgery to 0.18 ± 0.60 (p=0.015 at 1 month, which persisted to 12 months (0.18 ± 0.60. Neither corneal astigmatism nor endothelial cell count showed alterations 1 year after surgery. Complications included IOL subluxation in 1 eye (4%, vitreous hemorrhage in 2 eyes (8%, transient hypotony in 2 eyes (8%, and cystic macular edema in 1 eye (4%. No patients presented retinal detachment. Conclusion. This surgical technique proved successful in the management of dislocated IOL. Functional results were good and the complications were easily resolved.

Scleral Fixation of Posteriorly Dislocated Intraocular Lenses by 23-Gauge Vitrectomy without Anterior Segment Approach.

Science.gov (United States)

Nadal, Jeroni; Kudsieh, Bachar; Casaroli-Marano, Ricardo P

2015-01-01

Background. To evaluate visual outcomes, corneal changes, intraocular lens (IOL) stability, and complications after repositioning posteriorly dislocated IOLs and sulcus fixation with polyester sutures. Design. Prospective consecutive case series. Setting. Institut Universitari Barraquer. Participants. 25 eyes of 25 patients with posteriorly dislocated IOL. Methods. The patients underwent 23-gauge vitrectomy via the sulcus to rescue dislocated IOLs and fix them to the scleral wall with a previously looped nonabsorbable polyester suture. Main Outcome Measures. Best corrected visual acuity (BCVA) LogMAR, corneal astigmatism, endothelial cell count, IOL stability, and postoperative complications. Results. Mean follow-up time was 18.8 ± 10.9 months. Mean surgery time was 33 ± 2 minutes. Mean BCVA improved from 0.30 ± 0.48 before surgery to 0.18 ± 0.60 (p = 0.015) at 1 month, which persisted to 12 months (0.18 ± 0.60). Neither corneal astigmatism nor endothelial cell count showed alterations 1 year after surgery. Complications included IOL subluxation in 1 eye (4%), vitreous hemorrhage in 2 eyes (8%), transient hypotony in 2 eyes (8%), and cystic macular edema in 1 eye (4%). No patients presented retinal detachment. Conclusion. This surgical technique proved successful in the management of dislocated IOL. Functional results were good and the complications were easily resolved.

Gabor lenses

International Nuclear Information System (INIS)

Mobley, R.M.; Gamml, G.; Maschke, A.W.

1979-01-01

Stable operation of Gabor lenses has been reported by at least three experimental groups. At Brookhaven, several lens designs have been tried since February, 1978 with very good results. The lens concept is simple, operation is less complicated than anticipated, and the focussing strengths attainable make them very attractive alternatives to magnetic focussing for heavy ion beams at low energies. Results obtained with five different configurations are presented. The lenses work well, concern is now with fine details of their beam-optical performance

Acute Retention of Urine Following Intraocular Surgery | Nwosu ...

African Journals Online (AJOL)

Hyperosmolar agents and carbonic anhydrase inhibitors are used to lower the intraocular pressure and thus minimize the chances of vitreous loss during intraocular surgery. However, these agents could precipitate urinary retention. This is a report on two elderly men who had perioperative acute urinary retention following ...

Gravitational lenses and cosmological evolution

International Nuclear Information System (INIS)

Peacock, J.A.

1982-01-01

The effect of gravitational lensing on the apparent cosmological evolution of extragalactic radio sources is investigated. Models for a lens population consisting of galaxies and clusters of galaxies are constructed and used to calculate the distribution of amplification factors caused by lensing. Although many objects at high redshifts are predicted to have flux densities altered by 10 to 20 per cent relative to a homogeneous universe, flux conservation implies that de-amplification is as common as amplification. The effects on cosmological evolution as inferred from source counts and redshift data are thus relatively small; the slope of the counts is not large enough for intrinsically rare lensing events of high amplitude to corrupt observed samples. Lensing effects may be of greater importance for optically selected quasars, where lenses of mass as low as approximately 10 -4 solar mass can cause large amplifications. (author)

Intraocular osseous metaplasia. A clinico-pathological study

OpenAIRE

Vemuganti Geeta; Honavar Santosh; Jalali Subhadra

2002-01-01

Purpose: To evaluate the clinico-pathologic features of intraocular osseous metaplasia. Methods: Pathology specimens of enucleated eyes submitted to the ophthalmic pathology service at a tertiary eye-care referral center between January 1995 and June 1999 were studied for intraocular osseous metaplasia. Specific histopathologic features noted in specimens with osseous metaplasia were the presence of retinal detachment, gliosis, retinal pigment epithelial hyperplasia, drusen, epiretinal membra...

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

Resultados da troca de lente intra-ocular de hidrogel opacificada

Directory of Open Access Journals (Sweden)

Salera Cristina Moreira

2004-01-01

Full Text Available OBJETIVO: Avaliar os resultados da explantação e substituição das lentes intra-oculares (LIO de hidrogel opacificadas. MÉTODOS: Foram analisados retrospectivamente os prontuários de 12 pacientes (15 olhos submetidos à explantação e substituição das lentes intra-oculares de hidrogel opacificadas. RESULTADOS: A opacificação das lentes intra-oculares de hidrogel causou perdas de linhas de visão em 13 olhos (86,7%. A troca das lentes intra-oculares opacificadas promoveu o ganho de linhas de visão em 11 olhos (73,3%. As complicações peroperatórias ocorreram em três olhos (20% e foram as seguintes: perda de óleo de silicone, ruptura total de zônula com perda do saco capsular e ruptura parcial de zônula. Durante a explantação das lentes intra-oculares foi necessária a realização de incisões relaxantes na borda da capsulorrexe anterior em três olhos (20% e em dois olhos (13,3% os hápticos foram cortados sendo retirada somente a zona óptica das lentes intra-oculares. CONCLUSÃO: A cirurgia para explantação e substituição das lentes intra-oculares opacificadas mostrou-se eficaz naqueles pacientes com perdas de linhas de visão (p > 0,05.

BAYESIAN INFERENCE OF CMB GRAVITATIONAL LENSING

Energy Technology Data Exchange (ETDEWEB)

Anderes, Ethan [Department of Statistics, University of California, Davis, CA 95616 (United States); Wandelt, Benjamin D.; Lavaux, Guilhem [Sorbonne Universités, UPMC Univ Paris 06 and CNRS, UMR7095, Institut d’Astrophysique de Paris, F-75014, Paris (France)

2015-08-01

The Planck satellite, along with several ground-based telescopes, has mapped the cosmic microwave background (CMB) at sufficient resolution and signal-to-noise so as to allow a detection of the subtle distortions due to the gravitational influence of the intervening matter distribution. A natural modeling approach is to write a Bayesian hierarchical model for the lensed CMB in terms of the unlensed CMB and the lensing potential. So far there has been no feasible algorithm for inferring the posterior distribution of the lensing potential from the lensed CMB map. We propose a solution that allows efficient Markov Chain Monte Carlo sampling from the joint posterior of the lensing potential and the unlensed CMB map using the Hamiltonian Monte Carlo technique. The main conceptual step in the solution is a re-parameterization of CMB lensing in terms of the lensed CMB and the “inverse lensing” potential. We demonstrate a fast implementation on simulated data, including noise and a sky cut, that uses a further acceleration based on a very mild approximation of the inverse lensing potential. We find that the resulting Markov Chain has short correlation lengths and excellent convergence properties, making it promising for applications to high-resolution CMB data sets in the future.

Importance of intraocular pressure in glaucoma

Science.gov (United States)

Joos, Karen M.

1999-06-01

Glaucoma results in permanent vision loss and affects the peripheral vision initially. It is presented in 22.5 million people worldwide and is the 3rd cause of blindness. Present tonometers are not ideal for intraocular pressure measurements in all eyes. Of concern, PRK and LASIK may result in lower intraocular pressure readings. A challenges now exists for the development of a tonometer which can easily compensate for corneas with many parameters to avoid a future increase in normal-tension glaucoma or glaucoma which is advanced.

Cosmology with weak lensing surveys

International Nuclear Information System (INIS)

Munshi, Dipak; Valageas, Patrick; Waerbeke, Ludovic van; Heavens, Alan

2008-01-01

Weak gravitational lensing is responsible for the shearing and magnification of the images of high-redshift sources due to the presence of intervening matter. The distortions are due to fluctuations in the gravitational potential, and are directly related to the distribution of matter and to the geometry and dynamics of the Universe. As a consequence, weak gravitational lensing offers unique possibilities for probing the Dark Matter and Dark Energy in the Universe. In this review, we summarise the theoretical and observational state of the subject, focussing on the statistical aspects of weak lensing, and consider the prospects for weak lensing surveys in the future. Weak gravitational lensing surveys are complementary to both galaxy surveys and cosmic microwave background (CMB) observations as they probe the unbiased non-linear matter power spectrum at modest redshifts. Most of the cosmological parameters are accurately estimated from CMB and large-scale galaxy surveys, so the focus of attention is shifting to understanding the nature of Dark Matter and Dark Energy. On the theoretical side, recent advances in the use of 3D information of the sources from photometric redshifts promise greater statistical power, and these are further enhanced by the use of statistics beyond two-point quantities such as the power spectrum. The use of 3D information also alleviates difficulties arising from physical effects such as the intrinsic alignment of galaxies, which can mimic weak lensing to some extent. On the observational side, in the next few years weak lensing surveys such as CFHTLS, VST-KIDS and Pan-STARRS, and the planned Dark Energy Survey, will provide the first weak lensing surveys covering very large sky areas and depth. In the long run even more ambitious programmes such as DUNE, the Supernova Anisotropy Probe (SNAP) and Large-aperture Synoptic Survey Telescope (LSST) are planned. Weak lensing of diffuse components such as the CMB and 21 cm emission can also

Cosmology with weak lensing surveys

Energy Technology Data Exchange (ETDEWEB)

Munshi, Dipak [Institute of Astronomy, Madingley Road, Cambridge, CB3 OHA (United Kingdom); Astrophysics Group, Cavendish Laboratory, Madingley Road, Cambridge CB3 OHE (United Kingdom)], E-mail: munshi@ast.cam.ac.uk; Valageas, Patrick [Service de Physique Theorique, CEA Saclay, 91191 Gif-sur-Yvette (France); Waerbeke, Ludovic van [University of British Columbia, Department of Physics and Astronomy, 6224 Agricultural Road, Vancouver, BC V6T 1Z1 (Canada); Heavens, Alan [SUPA - Scottish Universities Physics Alliance, Institute for Astronomy, University of Edinburgh, Blackford Hill, Edinburgh EH9 3HJ (United Kingdom)

2008-06-15

Weak gravitational lensing is responsible for the shearing and magnification of the images of high-redshift sources due to the presence of intervening matter. The distortions are due to fluctuations in the gravitational potential, and are directly related to the distribution of matter and to the geometry and dynamics of the Universe. As a consequence, weak gravitational lensing offers unique possibilities for probing the Dark Matter and Dark Energy in the Universe. In this review, we summarise the theoretical and observational state of the subject, focussing on the statistical aspects of weak lensing, and consider the prospects for weak lensing surveys in the future. Weak gravitational lensing surveys are complementary to both galaxy surveys and cosmic microwave background (CMB) observations as they probe the unbiased non-linear matter power spectrum at modest redshifts. Most of the cosmological parameters are accurately estimated from CMB and large-scale galaxy surveys, so the focus of attention is shifting to understanding the nature of Dark Matter and Dark Energy. On the theoretical side, recent advances in the use of 3D information of the sources from photometric redshifts promise greater statistical power, and these are further enhanced by the use of statistics beyond two-point quantities such as the power spectrum. The use of 3D information also alleviates difficulties arising from physical effects such as the intrinsic alignment of galaxies, which can mimic weak lensing to some extent. On the observational side, in the next few years weak lensing surveys such as CFHTLS, VST-KIDS and Pan-STARRS, and the planned Dark Energy Survey, will provide the first weak lensing surveys covering very large sky areas and depth. In the long run even more ambitious programmes such as DUNE, the Supernova Anisotropy Probe (SNAP) and Large-aperture Synoptic Survey Telescope (LSST) are planned. Weak lensing of diffuse components such as the CMB and 21 cm emission can also

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.

Gravitational lenses

International Nuclear Information System (INIS)

Turner, E.L.

1989-01-01

The author discusses how gravitational lens studies is becoming a major focus of extragalactic astronomy and cosmology. This review is organized into five parts: an overview of the observational situation, a look at the state of theoretical work on lenses, a detailed look at three recently discovered types of lensing phenomena (luminous arcs, radio rings, quasar-galaxy associations), a review of progress on two old problems in lens studies (deriving unique lens mass distribution models, measurements of differential time delays), and an attempt to look into the future of lens studies

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.

Toxic Anterior Segment Syndrome (TASS

Directory of Open Access Journals (Sweden)

Özlem Öner

2011-12-01

Full Text Available Toxic anterior segment syndrome (TASS is a sterile intraocular inflammation caused by noninfectious substances, resulting in extensive toxic damage to the intraocular tissues. Possible etiologic factors of TASS include surgical trauma, bacterial endotoxin, intraocular solutions with inappropriate pH and osmolality, preservatives, denatured ophthalmic viscosurgical devices (OVD, inadequate sterilization, cleaning and rinsing of surgical devices, intraocular lenses, polishing and sterilizing compounds which are related to intraocular lenses. The characteristic signs and symptoms such as blurred vision, corneal edema, hypopyon and nonreactive pupil usually occur 24 hours after the cataract surgery. The differential diagnosis of TASS from infectious endophthalmitis is important. The main treatment for TASS formation is prevention. TASS is a cataract surgery complication that is more commonly seen nowadays. In this article, the possible underlying causes as well as treatment and prevention methods of TASS are summarized. (Turk J Oph thal mol 2011; 41: 407-13

The Increase of Intra-Abdominal Pressure Can Affect Intraocular Pressure

Directory of Open Access Journals (Sweden)

Ilhan Ece

2015-01-01

Full Text Available Objective. This study aims to explore the usage of intraocular pressure measurements as the early indicator of the increase in intra-abdominal pressure. Methods. In this prospective study, 40 patients undergoing elective surgery were included. Patients were divided into four groups of 10 patients. The control group (Group C was not subjected to laparoscopic intervention. Laparoscopic surgery was, respectively, performed with an intra-abdominal pressure of 9, 12, and 15 mmHg in Groups L (low, M (medium, and H (high pressure. Intraocular pressure was measured binocularly in each patient at three different times (before, during, and end of surgery using a contact tonometer. Results. Patients’ gender, age, body mass index (BMI, American Society of Anesthesiology (ASA class, and operative times were not different among the groups. No complications occurred with either the surgery or measurement of intraocular pressure. Intubation was associated with a severe rise in IOP (P<0.05. An increase in intraocular pressure was seen in groups M and H (P<0.05. Conclusion. Intraocular pressure was increased in the groups with an intra-abdominal pressure of 12 mmHg or more. Measuring the intraocular pressure might be a useful method to estimate the intra-abdominal pressure. This trial is registered with NCT02319213.

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

CMB lensing and giant rings

Energy Technology Data Exchange (ETDEWEB)

Rathaus, Ben; Itzhaki, Nissan, E-mail: nitzhaki@post.tau.ac.il, E-mail: ben.rathaus@gmail.com [Raymond and Beverly Sackler Faculty of Exact Sciences, School of Physics and Astronomy, Tel-Aviv University, Ramat-Aviv, 69978 (Israel)

2012-05-01

We study the CMB lensing signature of a pre-inationary particle (PIP), assuming it is responsible for the giant rings anomaly that was found recently in the WMAP data. Simulating Planck-like data we find that generically the CMB lensing signal to noise ratio associated with such a PIP is quite small and it would be difficult to cross correlate the temperature giant rings with the CMB lensing signal. However, if the pre-inationary particle is also responsible for the bulk flow measured from the local large scale structure, which happens to point roughly at the same direction as the giant rings, then the CMB lensing signal to noise ratio is fairly significant.

Planck 2015 results. XV. Gravitational lensing

CERN Document Server

Ade, P.A.R.; Arnaud, M.; Ashdown, M.; Aumont, J.; Baccigalupi, C.; Banday, A.J.; Barreiro, R.B.; Bartlett, J.G.; Bartolo, N.; Basak, S.; Battaner, E.; Benabed, K.; Benoît, A.; Benoit-Lévy, A.; Bernard, J.-P.; Bersanelli, M.; Bielewicz, P.; Bock, J.J.; Bonaldi, A.; Bonavera, L.; Bond, J.R.; Borrill, J.; Bouchet, F.R.; Boulanger, F.; Bucher, M.; Burigana, C.; Butler, R.C.; Calabrese, E.; Cardoso, J.-F.; Catalano, A.; Challinor, A.; Chamballu, A.; Chiang, H.C.; Christensen, P.R.; Church, S.; Clements, D.L.; Colombi, S.; Colombo, L.P.L.; Combet, C.; Couchot, F.; Coulais, A.; Crill, B.P.; Curto, A.; Cuttaia, F.; Danese, L.; Davies, R.D.; Davis, R.J.; de Bernardis, P.; de Rosa, A.; de Zotti, G.; Delabrouille, J.; Désert, F.-X.; Diego, J.M.; Dole, H.; Donzelli, S.; Doré, O.; Douspis, M.; Ducout, A.; Dunkley, J.; Dupac, X.; Efstathiou, G.; Elsner, F.; Enßlin, T.A.; Eriksen, H.K.; Fergusson, J.; Finelli, F.; Forni, O.; Frailis, M.; Fraisse, A.A.; Franceschi, E.; Frejsel, A.; Galeotta, S.; Galli, S.; Ganga, K.; Giard, M.; Giraud-Héraud, Y.; Gjerløw, E.; González-Nuevo, J.; Górski, K.M.; Gratton, S.; Gregorio, A.; Gruppuso, A.; Gudmundsson, J.E.; Hansen, F.K.; Hanson, D.; Harrison, D.L.; Henrot-Versillé, S.; Hernández-Monteagudo, C.; Herranz, D.; Hildebrandt, S.R.; Hivon, E.; Hobson, M.; Holmes, W.A.; Hornstrup, A.; Hovest, W.; Huffenberger, K.M.; Hurier, G.; Jaffe, A.H.; Jaffe, T.R.; Jones, W.C.; Juvela, M.; Keihänen, E.; Keskitalo, R.; Kisner, T.S.; Kneissl, R.; Knoche, J.; Kunz, M.; Kurki-Suonio, H.; Lagache, G.; Lähteenmäki, A.; Lamarre, J.-M.; Lasenby, A.; Lattanzi, M.; Lawrence, C.R.; Leonardi, R.; Lesgourgues, J.; Levrier, F.; Lewis, A.; Liguori, M.; Lilje, P.B.; Linden-Vørnle, M.; López-Caniego, M.; Lubin, P.M.; Macías-Pérez, J.F.; Maggio, G.; Maino, D.; Mandolesi, N.; Mangilli, A.; Maris, M.; Martin, P.G.; Martínez-González, E.; Masi, S.; Matarrese, S.; McGehee, P.; Meinhold, P.R.; Melchiorri, A.; Mendes, L.; Mennella, A.; Migliaccio, M.; Mitra, S.; Miville-Deschênes, M.-A.; Moneti, A.; Montier, L.; Morgante, G.; Mortlock, D.; Moss, A.; Munshi, D.; Murphy, J.A.; Naselsky, P.; Nati, F.; Natoli, P.; Netterfield, C.B.; Nørgaard-Nielsen, H.U.; Noviello, F.; Novikov, D.; Novikov, I.; Oxborrow, C.A.; Paci, F.; Pagano, L.; Pajot, F.; Paoletti, D.; Pasian, F.; Patanchon, G.; Perdereau, O.; Perotto, L.; Perrotta, F.; Pettorino, V.; Piacentini, F.; Piat, M.; Pierpaoli, E.; Pietrobon, D.; Plaszczynski, S.; Pointecouteau, E.; Polenta, G.; Popa, L.; Pratt, G.W.; Prézeau, G.; Prunet, S.; Puget, J.-L.; Rachen, J.P.; Reach, W.T.; Rebolo, R.; Reinecke, M.; Remazeilles, M.; Renault, C.; Renzi, A.; Ristorcelli, I.; Rocha, G.; Rosset, C.; Rossetti, M.; Roudier, G.; Rowan-Robinson, M.; Rubiño-Martín, J.A.; Rusholme, B.; Sandri, M.; Santos, D.; Savelainen, M.; Savini, G.; Scott, D.; Seiffert, M.D.; Shellard, E.P.S.; Spencer, L.D.; Stolyarov, V.; Stompor, R.; Sudiwala, R.; Sunyaev, R.; Sutton, D.; Suur-Uski, A.-S.; Sygnet, J.-F.; Tauber, J.A.; Terenzi, L.; Toffolatti, L.; Tomasi, M.; Tristram, M.; Tucci, M.; Tuovinen, J.; Valenziano, L.; Valiviita, J.; Van Tent, B.; Vielva, P.; Villa, F.; Wade, L.A.; Wandelt, B.D.; Wehus, I.K.; White, M.; Yvon, D.; Zacchei, A.

2016-01-01

We present the most significant measurement of the cosmic microwave background (CMB) lensing potential to date (at a level of 40 sigma), using temperature and polarization data from the Planck 2015 full-mission release. Using a polarization-only estimator we detect lensing at a significance of 5 sigma. We cross-check the accuracy of our measurement using the wide frequency coverage and complementarity of the temperature and polarization measurements. Public products based on this measurement include an estimate of the lensing potential over approximately 70% of the sky, an estimate of the lensing potential power spectrum in bandpowers for the multipole range 40lensing potential power spectrum and that found in the best-fitting LCDM model based on the Planck temperature and polarization power spectra. Using the lensing likelihood alone we obtain a percent-level measurement of ...

Gravitational lensing of quasars

CERN Document Server

Eigenbrod, Alexander

2013-01-01

The universe, in all its richness, diversity and complexity, is populated by a myriad of intriguing celestial objects. Among the most exotic of them are gravitationally lensed quasars. A quasar is an extremely bright nucleus of a galaxy, and when such an object is gravitationally lensed, multiple images of the quasar are produced – this phenomenon of cosmic mirage can provide invaluable insights on burning questions, such as the nature of dark matter and dark energy. After presenting the basics of modern cosmology, the book describes active galactic nuclei, the theory of gravitational lensing, and presents a particular numerical technique to improve the resolution of astronomical data. The book then enters the heart of the subject with the description of important applications of gravitational lensing of quasars, such as the measurement of the famous Hubble constant, the determination of the dark matter distribution in galaxies, and the observation of the mysterious inner parts of quasars with much higher r...

Multifocal peritoneal splenosis in Tc-99m-labeled heat-denatured red blood cell scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Yoon, Min Ki; Hwang, Kyung Hoon; Choe, Won Sick [Gachon University Gil Medical Center, Incheon (Korea, Republic of)

2006-06-15

A 44-year-old man with a past medical history of splenectomy came to hospital because of epigastric pain abdominopelvic computed tomography(CT) showed a soft tissue mass and multifocal variable-sized nodules as well as finding suggestive of cholecystitis. Subsequently, he underwent Tc-99m-labeled heat- denatured red blood cell(RBC) scintigraphy to evaluate the mass and nodules. The scintigraphy confirmed multifocal peritoneal splenosis in the abdominopelvic cavity.

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.

The Clinical and Molecular Characteristics of Adenocarcinoma Presented 
by Multi-focal GGO

Directory of Open Access Journals (Sweden)

Yang SONG

2018-03-01

Full Text Available Due to emphasis on early screening for lung cancer, the detection rate of multiple ground glass opacities (GGOs on computed tomography (CT image increases in recent years, and research on multifocal adenocarcinomas presented by GGOs has been thriving. It is more common in women and non-smokers and has excellent prognosis both in patients with natural history and after surgery. These clinical features suggest that it is likely to be a distinct disease entity. From the perspective of molecular genetics, lesions in the same individual are likely to have distinct clonal features. Therefore, genetic heterogeneity is the most prominent feature of multifocal pulmonary adenocarcinomas with GGOs. The genetic heterogeneity is expected to assist the diagnosis of multifocal pulmonary adenocarcinoma and intrapulmonary metastasis, and also suggests that genetic testing of the GGO lesions is of great therapeutic significance. Some GGO lesions may harvest the similar clonal feature, which provide new evidence for the theory of spread through air spaces (STAS.

[The Clinical and Molecular Characteristics of Adenocarcinoma Presented 
by Multi-focal GGO].

Science.gov (United States)

Song, Yang; Liang, Naixin; Li, Shanqing

2018-03-20

Due to emphasis on early screening for lung cancer, the detection rate of multiple ground glass opacities (GGOs) on computed tomography (CT) image increases in recent years, and research on multifocal adenocarcinomas presented by GGOs has been thriving. It is more common in women and non-smokers and has excellent prognosis both in patients with natural history and after surgery. These clinical features suggest that it is likely to be a distinct disease entity. From the perspective of molecular genetics, lesions in the same individual are likely to have distinct clonal features. Therefore, genetic heterogeneity is the most prominent feature of multifocal pulmonary adenocarcinomas with GGOs. The genetic heterogeneity is expected to assist the diagnosis of multifocal pulmonary adenocarcinoma and intrapulmonary metastasis, and also suggests that genetic testing of the GGO lesions is of great therapeutic significance. Some GGO lesions may harvest the similar clonal feature, which provide new evidence for the theory of spread through air spaces (STAS).
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KINOFORM LENSES - TOWARD NANOMETER RESOLUTION.

Energy Technology Data Exchange (ETDEWEB)

STEIN, A.; EVANS-LUTTERODT, K.; TAYLOR, A.

2004-10-23

While hard x-rays have wavelengths in the nanometer and sub-nanometer range, the ability to focus them is limited by the quality of sources and optics, and not by the wavelength. A few options, including reflective (mirrors), diffractive (zone plates) and refractive (CRL's) are available, each with their own limitations. Here we present our work with kinoform lenses which are refractive lenses with all material causing redundant 2{pi} phase shifts removed to reduce the absorption problems inherently limiting the resolution of refractive lenses. By stacking kinoform lenses together, the effective numerical aperture, and thus the focusing resolution, can be increased. The present status of kinoform lens fabrication and testing at Brookhaven is presented as well as future plans toward achieving nanometer resolution.

The effect of intraocular gas and fluid volumes on intraocular pressure.

Science.gov (United States)

Simone, J N; Whitacre, M M

1990-02-01

Large increases in the intraocular pressure (IOP) of postoperative gas-containing eyes may require the removal of gas or fluid to reduce the IOP to the normal range. Application of the ideal gas law to Friedenwald's equation provides a mathematical model of the relationship between IOP, intraocular gas and fluid volumes, and the coefficient of scleral rigidity. This mathematic model shows that removal of a given volume of gas or fluid produces an identical decrease in IOP and that the more gas an eye contains, the greater the volume reduction necessary to reduce the pressure. Application of the model shows that the effective coefficient of scleral rigidity is low (mean K, 0.0021) in eyes with elevated IOP that have undergone vitrectomy and retinal cryopexy and very low (mean K, 0.0013) in eyes with elevated IOP that have undergone placement of a scleral buckle and band. By using the appropriate mean coefficient of rigidity, the volume of material to be aspirated to produce a given decrease in IOP can be predicted with clinically useful accuracy.

Commercial air travel after intraocular gas injection.

Science.gov (United States)

Houston, Stephen; Graf, Jürgen; Sharkey, James

2012-08-01

Passengers with intraocular gas are at risk of profound visual loss when exposed to reduced absolute pressure within the cabin of a typical commercial airliner. Information provided on the websites of the world's 10 largest airlines offer a considerable range of opinion as to when it might be safe to fly after gas injection. Physicians responsible for clearing pseassengers as 'fit to fly' should be aware modern retinal surgical techniques increasingly employ long-acting gases as vitreous substitutes. The kinetics of long-acting intraocular gases must be considered when deciding how long after surgery it is safe to travel. It is standard practice to advise passengers not to fly in aircraft until the gas is fully resorbed. To achieve this, it may be necessary to delay travel for approximately 2 wk after intraocular injection of sulfur hexafluoride (SF6) and for 6 wk after injection of perfluoropropane (C3F8).

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.

Efectividad de los lentes fáquicos Artisan en la corrección de la alta miopía Effectiveness of Artisan phakic lenses in the correction of high myopia

Directory of Open Access Journals (Sweden)

Yanele Ruiz Rodríguez

2010-12-01

Full Text Available OBJETIVO: Determinar la efectividad de los lentes intraoculares fáquicos Artisan en la corrección de la alta miopía en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" en el período de enero del 2006 a enero del 2009. MÉTODOS: Se realizó un estudio prospectivo, descriptivo. El universo estuvo constituido por el total de ojos (120 a los cuales se les implantó estos lentes. RESULTADOS: Se encontró un componente esférico de 0,5, no astigmatismo inducido y una mejoría de la agudeza visual corregida de 0,9. No se presentaron complicaciones transoperatorias y entre las posoperatorias mediatas predominó la iritis o uveítis (3,4 % así como la atrofia iridiana (5 % entre las tardías. CONCLUSIONES: Los resultados refractivos fueron favorables. Predominaron los pacientes sin complicaciones.OBJECTIVE: To determine the effectiveness of Artisan phakic intraocular lenses in correcting high myopia at "Ramón Pando Ferrer" Cuban Institute of Ophthalmology in January 2006 to January 2009 period. METHODS: A prospective descriptive study was made in which the universe of study was 120 eyes implanted with this type of lenses. RESULTS: Spheral component of 0.5; the induced astigmatism was not found and the corrected visual acuity improvement was 0.9. There were no transoperative complications; the predominant postoperative mediate complications were iritis or uveitis (3.4 % and iridic atrophy (5 % prevailed in the late ones. CONCLUSIONS: The refractive results were favourable. The uncomplicated patients predominated.

Determining the origin of synchronous multifocal bladder cancer by exome sequencing

International Nuclear Information System (INIS)

Acar, Ömer; Özkurt, Ezgi; Demir, Gulfem; Saraç, Hilal; Alkan, Can; Esen, Tarık; Somel, Mehmet; Lack, Nathan A.

2015-01-01

Synchronous multifocal tumours are commonly observed in urothelial carcinomas of the bladder. The origin of these physically independent tumours has been proposed to occur by either intraluminal migration (clonal) or spontaneous transformation of multiple cells by carcinogens (field effect). It is unclear which model is correct, with several studies supporting both hypotheses. A potential cause of this uncertainty may be the small number of genetic mutations previously used to quantify the relationship between these tumours. To better understand the genetic lineage of these tumours we conducted exome sequencing of synchronous multifocal pTa urothelial bladder cancers at a high depth, using multiple samples from three patients. Phylogenetic analysis of high confidence single nucleotide variants (SNV) demonstrated that the sequenced multifocal bladder cancers arose from a clonal origin in all three patients (bootstrap value 100 %). Interestingly, in two patients the most common type of tumour-associated SNVs were cytosine mutations of TpC* dinucleotides (Fisher’s exact test p < 10 −41 ), likely caused by APOBEC-mediated deamination. Incorporating these results into our clonal model, we found that TpC* type mutations occurred 2-5× more often among SNVs on the ancestral branches than in the more recent private branches (p < 10 −4 ) suggesting that TpC* mutations largely occurred early in the development of the tumour. These results demonstrate that synchronous multifocal bladder cancers frequently arise from a clonal origin. Our data also suggests that APOBEC-mediated mutations occur early in the development of the tumour and may be a driver of tumourigenesis in non-muscle invasive urothelial bladder cancer. The online version of this article (doi:10.1186/s12885-015-1859-8) contains supplementary material, which is available to authorized users

Galaxy–Galaxy Weak-lensing Measurements from SDSS. I. Image Processing and Lensing Signals

Energy Technology Data Exchange (ETDEWEB)

Luo, Wentao [Key Laboratory for Research in Galaxies and Cosmology, Shanghai Astronomical Observatory, Nandan Road 80, Shanghai 200030 (China); Yang, Xiaohu; Zhang, Jun; Tweed, Dylan [Department of Physics, Carnegie Mellon University, Pittsburgh, PA 15213 (United States); Fu, Liping; Shu, Chenggang [Shanghai Key Lab for Astrophysics, Shanghai Normal University, 100 Guilin Road, 200234, Shanghai (China); Mo, H. J. [Department of Astronomy, University of Massachusetts, Amherst, MA 01003-9305 (United States); Bosch, Frank C. van den [Department of Astronomy, Yale University, P.O. Box 208101, New Haven, CT 06520-8101 (United States); Li, Ran [Key Laboratory for Computational Astrophysics, Partner Group of the Max Planck Institute for Astrophysics, National Astronomical Observatories, Chinese Academy of Sciences, Beijing, 100012 (China); Li, Nan [Department of Astronomy and Astrophysics, The University of Chicago, 5640 South Ellis Avenue, Chicago, IL 60637 (United States); Liu, Xiangkun; Pan, Chuzhong [Department of Astronomy, Peking University, Beijing 100871 (China); Wang, Yiran [Department of Astronomy, University of Illinois at Urbana-Champaign, 1002 W. Green Street, Urbana, IL 61801 (United States); Radovich, Mario, E-mail: walt@shao.ac.cn, E-mail: xyang@sjtu.edu.cn [INAF-Osservatorio Astronomico di Napoli, via Moiariello 16, I-80131 Napoli (Italy)

2017-02-10

We present our image processing pipeline that corrects the systematics introduced by the point-spread function (PSF). Using this pipeline, we processed Sloan Digital Sky Survey (SDSS) DR7 imaging data in r band and generated a galaxy catalog containing the shape information. Based on our shape measurements of the galaxy images from SDSS DR7, we extract the galaxy–galaxy (GG) lensing signals around foreground spectroscopic galaxies binned in different luminosities and stellar masses. We estimated the systematics, e.g., selection bias, PSF reconstruction bias, PSF dilution bias, shear responsivity bias, and noise rectification bias, which in total is between −9.1% and 20.8% at 2 σ levels. The overall GG lensing signals we measured are in good agreement with Mandelbaum et al. The reduced χ {sup 2} between the two measurements in different luminosity bins are from 0.43 to 0.83. Larger reduced χ {sup 2} from 0.60 to 1.87 are seen for different stellar mass bins, which is mainly caused by the different stellar mass estimator. The results in this paper with higher signal-to-noise ratio are due to the larger survey area than SDSS DR4, confirming that more luminous/massive galaxies bear stronger GG lensing signals. We divide the foreground galaxies into red/blue and star-forming/quenched subsamples and measure their GG lensing signals. We find that, at a specific stellar mass/luminosity, the red/quenched galaxies have stronger GG lensing signals than their counterparts, especially at large radii. These GG lensing signals can be used to probe the galaxy–halo mass relations and their environmental dependences in the halo occupation or conditional luminosity function framework.

Intraocular Inflammation Associated with Ocular Toxoplasmosis : Relationships at Initial Examination

NARCIS (Netherlands)

Dodds, Emilio M.; Holland, Gary N.; Stanford, Miles R.; Yu, Fei; Siu, Willie O.; Shah, Kayur H.; Loon, Ninette Ten Dam-Van; Muccioli, Cristina; Hovakimyan, Anna; Barisani-Asenbauer, Talin

2008-01-01

PURPOSE: To describe characteristics of intraocular inflammation in eyes with active ocular toxoplasmosis and to identify relationships between signs of inflammation, complications (including elevated intraocular pressure [IOP]), other disease features, and host characteristics. DESIGN: Multicenter,

Unusually high incidence of multifocal epithelial hyperplasia in children of the Nahuatl population of Mexico.

Science.gov (United States)

Ledesma-Montes, Constantino; Mendez-Mendoza, Amilcar

2017-01-01

Multifocal epithelial hyperplasia is an uncommon disease of the oral mucosa caused by the human papilloma virus. To study the clinical and pathological findings of multifocal epithelial hyperplasia detected during an oral examination of 343 Mexican Nahuatl children from a single primary school in El Paso de Cupilco, Mexico. A thorough oral examination was performed in all children and clinical data (age, gender, location and number of lesions) were documented and analyzed. Multifocal epithelial hyperplasia was diagnosed in 110 of the 343 children (32.3%). The ages of the children varied from 5 to 15 years, and of these, 56.3% were girls. The lesions were asymptomatic, 0.2 to 3.0 cm in diameter, soft, round to oval, smooth surfaced, sessile papulonodules, similar in colour to that of the surrounding mucosa. The lesions were commonly seen on the buccal mucosa and tongue, and most affected children (85%) had less than 5 lesions. Children in the 7 to 10 years age group were most often affected. Human papillomavirus typing was not done owing to a lack of facilities. There is a high incidence of multifocal epithelial hyperplasia in Nahuatl children with a predilection for females.

Basic characterization of normal multifocal electroretinogram

International Nuclear Information System (INIS)

Fernandez Cherkasova, Lilia; Rojas Rondon, Irene; Castro Perez, Pedro Daniel; Lopez Felipe, Daniel; Santiesteban Freixas, Rosaralis; Mendoza Santiesteban, Carlos E

2008-01-01

A scientific literature review was made on the novel multifocal electroretinogram technique, the involved cell mechanisms and some of the factors modifying its results together with the form of presentation. The basic characteristics of this electrophysiological record obtained from several regions of the retina of normal subjects is important in order to create at a small scale a comparative database to evaluate pathological eye tracing. All this will greatly help in early less invasive electrodiagnosis of localized retinal lesions. (Author)

Microbial adhesion to silicone hydrogel lenses: a review.

Science.gov (United States)

Willcox, Mark D P

2013-01-01

Microbial adhesion to contact lenses is believed to be one of the initiating events in the formation of many corneal infiltrative events, including microbial keratitis, that occur during contact lens wear. The advent of silicone hydrogel lenses has not reduced the incidence of these events. This may partly be related to the ability of microbes to adhere to these lenses. The aim of this study was to review the published literature on microbial adhesion to contact lenses, focusing on adhesion to silicone hydrogel lenses. The literature on microbial adhesion to contact lenses was searched, along with associated literature on adverse events that occur during contact lens wear. Particular reference was paid to the years 1995 through 2012 because this encompasses the time when the first clinical trials of silicone hydrogel lenses were reported, and their commercial availability and the publication of epidemiology studies on adverse events were studied. In vitro studies of bacterial adhesion to unworn silicone hydrogel lens have shown that generally, bacteria adhere to these lenses in greater numbers than to the hydroxyethyl methacrylate-based soft lenses. Lens wear has different effects on microbial adhesion, and this is dependent on the type of lens and microbial species/genera that is studied. Biofilms that can be formed on any lens type tend to protect the bacteria and fungi from the effects on disinfectants. Fungal hyphae can penetrate the surface of most types of lenses. Acanthamoeba adhere in greater numbers to first-generation silicone hydrogel lenses compared with the second-generation or hydroxyethyl methacrylate-based soft lenses. Microbial adhesion to silicone hydrogel lenses occurs and is associated with the production of corneal infiltrative events during lens wear.

Adhesion of Pseudomonas aeruginosa to orthokeratology and alignment lenses.

Science.gov (United States)

Choo, Jennifer D; Holden, Brien A; Papas, Eric B; Willcox, Mark D P

2009-02-01

To determine whether contact lenses designed for orthokeratology (OK) are colonized by greater numbers of bacteria compared with standard (alignment fitted) design rigid gas permeable lenses before and after lens wear. Eighteen 1-year-old cats were randomly fitted with an OK lens in one eye and an alignment fitted (AF) lens in the other eye. Both lenses were made in the same diameter and central thickness and of the same material. Two separate wearing periods of 2 weeks and 6 weeks were used. After each wearing period, lenses were soaked in Pseudomonas aeruginosa (6294 or 6206) for 10 min. The lenses were then reinserted onto their respective corneas for a wearing period of 16 hours after which lenses were collected and remaining adhered bacteria quantified. Unworn control lenses were also soaked and bacteria enumerated for comparison. There were no significant differences in the number of bacteria adherent to unworn AF and OK lenses. Analysis of lenses after wear showed OK lenses retained significantly higher numbers of viable bacteria than AF lenses in all studies. OK lenses retain more bacteria than AF rigid gas permeable lenses after bacteria-loaded overnight lens wear. This may increase the risk for an infection in OK patients should suitable conditions be present. Specific education on the cleaning of OK lenses is essential.

A Rare Multifocal Pattern of Type 2 Autoimmune Pancreatitis with Negative IgG4: A Potential Diagnostic Pitfall That May Mimic Multifocal Pancreatic Adenocarcinoma

Directory of Open Access Journals (Sweden)

Partha Hota

2018-02-01

Full Text Available Autoimmune pancreatitis (AIP is an increasingly recognized form of acute pancreatitis characterized by obstructive jaundice with a rapid and dramatic treatment response to steroid therapy. Recently, AIP has been divided into two distinct phenotypes: lymphoplasmocytic sclerosing pancreatitis AIP (type 1 and idiopathic duct-centric pancreatitis AIP (type 2; each of which have their own distinct demographics, diagnostic criteria, and histopathological features. We report, to the best of our knowledge, the first case of a multifocal pattern of type 2 AIP characterized with both CT and MR imaging. This rare imaging pattern of AIP may mimic the appearance of more worrisome malignant etiologies such as multifocal pancreatic adenocarcinoma or lymphoma, with overlapping imaging characteristics potentially complicating or delaying diagnosis. Therefore, recognition of this atypical pattern of AIP and avoidance of this potential diagnostic pitfall is crucial.

One Episode, Two Lenses

Science.gov (United States)

Drijvers, Paul; Godino, Juan D.; Font, Vicenc; Trouche, Luc

2013-01-01

A deep understanding of students' learning processes is one of the core challenges of research in mathematics education. To achieve this, different theoretical lenses are available. The question is how these different lenses compare and contrast, and how they can be coordinated and combined to provide a more comprehensive view on the topic of…

Multifocal Langerhans cell sarcoma involving epidermis: a case report and review

Directory of Open Access Journals (Sweden)

Wang Changsong

2012-08-01

Full Text Available Abstract Objective To study the clinico-pathological characteristics of Langerhans cell sarcoma (LCS which involving epidermis. Methods A case of primary multifocal LCS was analyzed in histopathology and immunophenotype. Results A 41-year-old man with multifocal cutaneous LCS involving the inguina and waist was reported. Clinical and pathology data were available. Neoplastic cells with markedly malignant cytological features were observed. Tumor cells exhibited irregular shape with abundant and eosinophilic red staining cytoplasm; large, irregular-shaped, showing lobulated or dented nucleus and some cells with a longitudinal nuclear groove and prominent nucleoli. The tumor cells expressed CD1a, Langerin (CD207, S-100 protein, CD68 and vimentin, and did not express pan-T or B cell markers and epithelial markers. The patient died less than 1 year after diagnosis due to local recurrence and metastasis to the lung, despite the administration of local radiation and chemotherapy. Conclusions LCS is a tumor with markedly malignant cytological features that originates from Langerhans cells. Primary multifocal neoplasms involving epidermis is even rare. Accurate diagnosis is based on the histopathological and immunohistochemical of the tumor cells. Virtual slide The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1182345104754765.

Effect of plasma colloid osmotic pressure on intraocular pressure during haemodialysis

OpenAIRE

Tokuyama, T.; Ikeda, T.; Sato, K.

1998-01-01

BACKGROUND—In a previous case report, it was shown that an increase in plasma colloid osmotic pressure induced by the removal of fluid during haemodialysis was instrumental in decreasing intraocular pressure. The relation between changes in intraocular pressure, plasma osmolarity, plasma colloid osmotic pressure, and body weight before and after haemodialysis is evaluated.
METHODS—Intraocular pressure, plasma osmolarity, plasma colloid osmotic pressure, and body weight were evaluated before a...

Indocyanine Green Angiographic and Multifocal Electroretinographic Features in the Diffuse and Regional Form of Bietti′s Crystalline Retinopathy

Institute of Scientific and Technical Information of China (English)

Libin Jiang; Feng Wen; Lezheng Wu; Hong Yan; Shixing Hu

2002-01-01

Prpose: To observe different features of indocyanine green angiography(ICGA) andtifocal electroretinography (ERG) in the diffuse and regional type of Bieti′sc stalline retinopathy (BCR). Thods: ICGA and the multifocal ERG were performed in two cases of the diffuse andregional type of BCR respectively. These data were compared with fluoresceinangiography (FA), standard Ganzfeld ERG, and visual field testing. Results: In the regional case, ICGA revealed reduced perfusion of the choroidalcirculation in the early phase and multiple hypofluorescent spots in the posterior pole in the late phase, due to choriocapillaris filling defect; the extent of choroiocapillaris losswas shown in early phase of ICGA and there were multifocal hyperfluorescent dotssurrounding hypofluorescent spots in late phase in the diffuse case. The multifocal ERGshowed that the central responses were markedly depressed, corresponding to the visualfield defects, while the findings of Ganzfeld ERG were normal in the regional BCR;however, both the multifocal ERG and Ganzfeld ERG were severely subnormal in thediffuse case.Conclusions: The features of ICGA and multifocal ERG are different between the diffuseand regional BCR. In the meantime, the two tools are also useful to differentiate the typeand assess the extentof evolution in BCR.

Solutions for care of silicone hydrogel lenses.

Science.gov (United States)

Willcox, Mark D P

2013-01-01

During wear of contact lenses on a daily wear basis, it is necessary to disinfect the lens overnight before reinserting the lens the next day. The ability of the solutions used for this to disinfect lenses and lens cases is important for safe lens wear. The literature on the disinfecting ability of multipurpose disinfecting solutions (MPDS) commonly used with silicone hydrogel lenses reported during the period 2000 to 2012 is reviewed, as this is the period of time during which these lenses have been commercially available. Particular emphasis is placed on the ability of disinfecting solutions to control colonization of lens cases by microbes and changes in composition and use of the solutions. In addition, the literature is reviewed on ways of minimizing lens case microbial contamination. Maintaining the hygiene of contact lenses and lens cases is important in minimizing various forms of corneal infiltrative events that occur during lens wear. Although lens case contamination is not associated with different lenses, it is determined by use of different MPDS. MPDS that allow more frequent or heavy contamination of cases by Gram-negative bacteria are associated with a higher incidence of corneal infiltrative events. MPDS are now available that contain dual disinfectants. Wiping lens cases with tissues or using lens cases that incorporate silver are associated with reductions in contamination in clinical trials. Similarly, using MPDS to rub and rinse lenses before disinfection may reduce levels of microbes on lenses. The MPDS also contain surfactants that help reduce deposition and denaturation of proteins on lenses. Improvements in MPDS formulations and hygiene practices may help to reduce the incidence of adverse events that are seen during use with silicone hydrogel lenses.

Weak lensing of the Lyman α forest

Science.gov (United States)

Croft, Rupert A. C.; Romeo, Alessandro; Metcalf, R. Benton

2018-06-01

The angular positions of quasars are deflected by the gravitational lensing effect of foreground matter. The Lyman α (Lyα) forest seen in the spectra of these quasars is therefore also lensed. We propose that the signature of weak gravitational lensing of the Lyα forest could be measured using similar techniques that have been applied to the lensed cosmic microwave background (CMB), and which have also been proposed for application to spectral data from 21-cm radio telescopes. As with 21-cm data, the forest has the advantage of spectral information, potentially yielding many lensed `slices' at different redshifts. We perform an illustrative idealized test, generating a high-resolution angular grid of quasars (of order arcminute separation), and lensing the Lyα forest spectra at redshifts z = 2-3 using a foreground density field. We find that standard quadratic estimators can be used to reconstruct images of the foreground mass distribution at z ˜ 1. There currently exists a wealth of Lyα forest data from quasar and galaxy spectral surveys, with smaller sightline separations expected in the future. Lyα forest lensing is sensitive to the foreground mass distribution at redshifts intermediate between CMB lensing and galaxy shear, and avoids the difficulties of shape measurement associated with the latter. With further refinement and application of mass reconstruction techniques, weak gravitational lensing of the high-redshift Lyα forest may become a useful new cosmological probe.

Achromatic X-ray lenses

International Nuclear Information System (INIS)

Umbach, Marion

2009-01-01

This thesis presents first results on the development of achromatic refractive X-ray lenses which can be used for scientific experiments at synchrotron sources. First of all the different requirements for achromatic X-ray lenses have been worked out. There are different types of lenses, one type can be used for monochromatized sources when the energy is scanned while the spot size should be constant. The other type can be used at beamlines providing a broad energy band. By a combination of focusing and defocusing elements we have developed a lens system that strongly reduces the chromatic aberration of a refractive lens in a given energy range. The great challenge in the X-ray case - in contrast to the visible range - the complex refractive index, which is very similar for the possible materials in the X-ray spectrum. For precise studies a numerical code has been developed, which calculates the different rays on their way through the lenses to the detector plane via raytracing. In this numerical code the intensity distribution in the detector plane has been analyzed for a chromatic and the corresponding achromatic system. By optimization routines for the two different fields of applications specific parameter combinations were found. For the experimental verification an achromatic system has been developed, consisting of biconcave SU-8 lenses and biconvex Nickel Fresnel lenses. Their fabrication was based on the LIGA-process, including a further innovative development, namely the fabrication of two different materials on one wafer. In the experiment at the synchrotron source ANKA the energy was varied in a specific energy range in steps of 0.1 keV. The intensity distribution for the different energies was detected at a certain focal length. For the achromatic system a reduction of the chromatic aberration could be clearly shown. Achromatic refractive X-ray lenses, especially for the use at synchrotron sources, have not been developed so far. As a consequence of the

Adherence of Pseudomonas aeruginosa to contact lenses

International Nuclear Information System (INIS)

Miller, M.J.

1988-01-01

The purpose of this research was to examined the interactions of P. aeruginosa with hydrogel contact lenses and other substrata, and characterize adherence to lenses under various physiological and physicochemical conditions. Isolates adhered to polystyrene, glass, and hydrogel lenses. With certain lens types, radiolabeled cells showed decreased adherence with increasing water content of the lenses, however, this correlation with not found for all lenses. Adherence to rigid gas permeable lenses was markedly greater than adherence to hydrogels. Best adherence occurred near pH 7 and at a sodium chloride concentration of 50 mM. Passive adhesion of heat-killed cells to hydrogels was lower than the adherence obtained of viable cells. Adherence to hydrogels was enhanced by mucin, lactoferrin, lysozyme, IgA, bovine serum albumin, and a mixture of these macromolecules. Adherence to coated and uncoated lenses was greater with a daily-wear hydrogel when compared with an extended-wear hydrogel of similar polymer composition. Greater adherence was attributed to a higher concentration of adsorbed macromolecules on the 45% water-content lens in comparison to the 55% water-content lens

Severe pigment dispersion after iris-claw phakic intraocular lens implantation.

Science.gov (United States)

Galvis, Virgilio; Carreño, Néstor I; Tello, Alejandro; Laiton, Andrea N

2017-12-01

A 23-year-old female patient presented 3 months after the implantation of an Artisan® phakic intraocular lens with a severe depigmentation of the iris and peripheral anterior synechiae. Explantation of the intraocular lens and goniosynechialysis were performed. Eleven months after the explantation appearance of the iris significantly improved. There was no loss of lines of corrected distance visual acuity. Severe pigment dispersion after the implantation of an Artisan® phakic intraocular lens may happen and may require explantation of the lens. Iris depigmentation may improve with time.

Severe pigment dispersion after iris-claw phakic intraocular lens implantation

Directory of Open Access Journals (Sweden)

Virgilio Galvis

2017-01-01

Full Text Available A 23-year-old female patient presented 3 months after the implantation of an Artisan® phakic intraocular lens with a severe depigmentation of the iris and peripheral anterior synechiae. Explantation of the intraocular lens and goniosynechialysis were performed. Eleven months after the explantation appearance of the iris significantly improved. There was no loss of lines of corrected distance visual acuity. Severe pigment dispersion after the implantation of an Artisan® phakic intraocular lens may happen and may require explantation of the lens. Iris depigmentation may improve with time.

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

Predictability of uncontrollable multifocal seizures - towards new treatment options

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Lehnertz, Klaus; Dickten, Henning; Porz, Stephan; Helmstaedter, Christoph; Elger, Christian E.

2016-04-01

Drug-resistant, multifocal, non-resectable epilepsies are among the most difficult epileptic disorders to manage. An approach to control previously uncontrollable seizures in epilepsy patients would consist of identifying seizure precursors in critical brain areas combined with delivering a counteracting influence to prevent seizure generation. Predictability of seizures with acceptable levels of sensitivity and specificity, even in an ambulatory setting, has been repeatedly shown, however, in patients with a single seizure focus only. We did a study to assess feasibility of state-of-the-art, electroencephalogram-based seizure-prediction techniques in patients with uncontrollable multifocal seizures. We obtained significant predictive information about upcoming seizures in more than two thirds of patients. Unexpectedly, the emergence of seizure precursors was confined to non-affected brain areas. Our findings clearly indicate that epileptic networks, spanning lobes and hemispheres, underlie generation of seizures. Our proof-of-concept study is an important milestone towards new therapeutic strategies based on seizure-prediction techniques for clinical practice.

Comparison of posterior capsule folds following intracapsular implantation of three types of intraocular lenses with different haptic design

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Ling-Lin Zhang

2018-04-01

Full Text Available AIM: To compare the incidence of posterior capsule folds among different types of intraocular lens(IOLto determine risk factors of posterior capsule folds. METHODS:It was a retrospective study. We collected the cases in which the patients underwent phacoemulsification(PHACOand IOL implantation and at least one of the three types of IOL was implanted, including 2-haptic 3-piece IOLs(HOYA PY60AD, 4-haptic 1-piece IOLs(Bausch & Lomb AO, 2-haptic 1-piece IOLs(AMO Tecnis ZCB00. The posterior capsule folds were measured using slit lamp microscope 2d after the surgery. Information of patient's age, gender, length of ocular axis, intraocular pressure, types of IOL were recorded. Posterior capsule fold risk indicators were identified by using logistic regression analysis. RESULTS: One hundred eighty-seven patients(242 eyeshad been collected, including 80 eyes implanted with HOYA PY60AD IOLs, 81 eyes implanted with Bausch & Lomb AO IOLs, 81 eyes implanted with AMO Tecnis ZCB00 IOLs. The incidence of posterior capsule folds of patients implanted with HOYA PY60AD IOLs was significantly higher than those of patients implanted with AMO Tecnis ZCB00 IOLs(56.3% vs 38.3%, P=0.027. While the incidence of patients implanted with Bausch & Lomb AO IOLs was significantly lower than those of patients implanted with AMO Tecnis ZCB00 IOLs(14.8% vs 38.3%, P=0.001. Multi-factor logistics regression analysis demonstrated that independent risk factors were type of IOLs and length of ocular axis. Compared with AMO Tecnis ZCB00 IOLs, using HOYA PY60AD IOLs increased the risk of posterior capsule folds \\〖P=0.020, OR(95%CI=2.145(1.129,4.073\\〗, while using Bausch & Lomb AO IOLs reduced the risk \\〖P=0.001, OR(95%CI=0.274(0.127, 0.591\\〗. Shorter ocular axis might increase the risk of posterior capsule folds \\〖P=0.012, OR(95%CI=0.669(0.489, 0.915\\〗. CONCLUSION: Haptic design should be an important consideration in IOL design. Compared with AMO Tecnis ZCB00 IOLs

Microbial adherence to cosmetic contact lenses.

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Chan, Ka Yin; Cho, Pauline; Boost, Maureen

2014-08-01

To investigate whether cosmetic contact lenses (CCL) with surface pigments affect microbial adherence. Fifteen brands of CCL were purchased from optical, non-optical retail outlets, and via the Internet. A standardized rub-off test was performed on each CCL (five lenses per brand) to confirm the location of the pigments. The rub-off test comprised gentle rubbing on the surfaces of each CCL with wetted cotton buds for a maximum of 20 rubs per surface. A new set of CCL (five lenses per brand) were incubated in Pseudomonas aeruginosa overnight. Viable counts of adhered bacteria were determined by the number of colony-forming units (CFU) on agar media on each lens. The adherence of P. aeruginosa as well as Staphylococcus aureus and Serratia marcescens to three brands of CCL (A-C) (five lenses per brand) were also compared to their adherences on their clear counterparts. Only two of the 15 brands of CCL tested (brands B and C) had pigments that did not detach with the rub-off test. The remaining 13 brands of CCL all failed the rub-off test and these lenses showed higher P. aeruginosa adherence (8.7 × 10(5)-1.9 × 10(6) CFU/lens). Brands B and C lenses showed at least six times less bacterial adhesion than the other 13 brands. Compared to their clear counterparts, bacterial adherence to brands B and C lenses did not differ significantly, whereas brand A lenses showed significantly higher adherence. Surface pigments on CCL resulted in significantly higher bacterial adherence. Copyright © 2013 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Imaging manifestations of progressive multifocal leukoencephalopathy

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Shah, R.; Bag, A.K.; Chapman, P.R.; Cure, J.K.

2010-01-01

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease caused by reactivation of JC virus in immunosuppressed patients. The diagnosis is usually suggested on imaging and confirmed by cerebrospinal fluid polymerase chain reaction (PCR) for JC virus DNA. In this article, we review the imaging manifestations of PML on computed tomography (CT), magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), MR spectroscopy, single photon-emission computed tomography (SPECT) and positron-emission tomography (PET), and outline the role of imaging in follow-up and prognostication.

Fundus autofluorescence patterns in primary intraocular lymphoma.

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Casady, Megan; Faia, Lisa; Nazemzadeh, Maryam; Nussenblatt, Robert; Chan, Chi-Chao; Sen, H Nida

2014-02-01

To evaluate fundus autofluorescence (FAF) patterns in patients with primary intraocular (vitreoretinal) lymphoma. Records of all patients with primary intraocular lymphoma who underwent FAF imaging at the National Eye Institute were reviewed. Fundus autofluorescence patterns were evaluated with respect to clinical disease status and the findings on fluorescein angiography and spectral-domain optical coherence tomography. There were 18 eyes (10 patients) with primary intraocular lymphoma that underwent FAF imaging. Abnormal autofluorescence in the form of granular hyperautofluorescence and hypoautofluorescence was seen in 11 eyes (61%), and blockage by mass lesion was seen in 2 eyes (11%). All eyes with granular pattern on FAF had active primary intraocular lymphoma at the time of imaging, but there were 5 eyes with unremarkable FAF, which were found to have active lymphoma. The most common pattern on fluorescein angiography was hypofluorescent round spots with a "leopard spot" appearance (43%). These hypofluorescent spots on fluorescein angiography correlated with hyperautofluorescent spots on FAF in 5 eyes (36%) (inversion of FAF). Nodular hyperreflective spots at the level of retinal pigment epithelium on optical coherence tomography were noted in 43% of eyes. The hyperautofluorescent spots on FAF correlated with nodular hyperreflective spots on optical coherence tomography in 6 eyes (43%). Granularity on FAF was associated with active lymphoma in majority of the cases. An inversion of FAF (hyperautofluorescent spots on FAF corresponding to hypofluorescent spots on fluorescein angiography) was observed in less than half of the eyes.

WHAT HAPPENS TO INTRAOCULAR PRESSURE AFTER PERIBULBAR ANAESTHESIA?

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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.

Chest wall resection for multifocal osseous haemangioma.

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Weinandt, Marthe; Legras, Antoine; Mordant, Pierre; Le Pimpec Barthes, Françoise

2016-02-01

Intraosseous haemangioma is a rare and benign primary tumour of the bone. We report the case of a 76-year old woman who presented the exceptional condition of multifocal cavernous haemangiomas involving the spine and the ribs, requiring spinal and chest wall resections to confirm the diagnosis and treat the symptoms. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

N-3 Polyunsaturated Fatty Acids of Marine Origin and Multifocality in Human Breast Cancer.

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Lobna Ouldamer

Full Text Available The microenvironment of breast epithelial tissue may contribute to the clinical expression of breast cancer. Breast epithelial tissue, whether healthy or tumoral, is directly in contact with fat cells, which in turn could influence tumor multifocality. In this pilot study we investigated whether the fatty acid composition of breast adipose tissue differed according to breast cancer focality.Twenty-three consecutive women presenting with non-metastatic breast cancer underwent breast-imaging procedures including Magnetic Resonance Imaging prior to treatment. Breast adipose tissue specimens were collected during breast surgery. We established a biochemical profile of adipose tissue fatty acids by gas chromatography. We assessed whether there were differences according to breast cancer focality.We found that decreased levels in breast adipose tissue of docosahexaenoic and eicosapentaenoic acids, the two main polyunsaturated n-3 fatty acids of marine origin, were associated with multifocality.These differences in lipid content may contribute to mechanisms through which peritumoral adipose tissue fuels breast cancer multifocality.

N-3 Polyunsaturated Fatty Acids of Marine Origin and Multifocality in Human Breast Cancer.

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Ouldamer, Lobna; Goupille, Caroline; Vildé, Anne; Arbion, Flavie; Body, Gilles; Chevalier, Stephan; Cottier, Jean Philippe; Bougnoux, Philippe

2016-01-01

The microenvironment of breast epithelial tissue may contribute to the clinical expression of breast cancer. Breast epithelial tissue, whether healthy or tumoral, is directly in contact with fat cells, which in turn could influence tumor multifocality. In this pilot study we investigated whether the fatty acid composition of breast adipose tissue differed according to breast cancer focality. Twenty-three consecutive women presenting with non-metastatic breast cancer underwent breast-imaging procedures including Magnetic Resonance Imaging prior to treatment. Breast adipose tissue specimens were collected during breast surgery. We established a biochemical profile of adipose tissue fatty acids by gas chromatography. We assessed whether there were differences according to breast cancer focality. We found that decreased levels in breast adipose tissue of docosahexaenoic and eicosapentaenoic acids, the two main polyunsaturated n-3 fatty acids of marine origin, were associated with multifocality. These differences in lipid content may contribute to mechanisms through which peritumoral adipose tissue fuels breast cancer multifocality.

Nonsyndromic Synchronous Multifocal Central Giant Cell Granulomas of the Maxillofacial Region: Report of a Case.

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Anita Munde

2015-04-01

Full Text Available Central giant cell granuloma (CGCG is a benign proliferation of fibroblasts and multinucleated giant cells that almost exclusively occurs in the jaws. It commonly occurs in young adults showing a female predilection in the anterior mandible. Multifocal CGCGs in maxillofacial region are very rare and suggestive of systemic diseases such as hyperparathyroidism, an inherited syndrome such as Noonan-like multiple giant cell lesion syndrome or other disorders. Only 10 cases of multifocal CGCGs in the maxillofacial region without any concomitant systemic disease have been reported in the English literature. Here, we report an unusual case of 36 year-old female presented with non-syndromic synchronous, multifocal CGCGs in the left posterior mandible and left posterior maxilla without any concomitant systemic disease. Relevant literature is reviewed and the incidence, clinical features, radiological features, differential diagnosis and management of CGCGs are discussed.

Visual outcome with the Oculentis Mplus intraocular lens

OpenAIRE

Si-Yuan Liu; Xu Yang

2017-01-01

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 IOL)were 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 ...

Multifocal Synchronous Granular Cell Tumors of the Gastrointestinal Tract

OpenAIRE

Lipkin-Moore, Zachary; Thomas, Rebecca M.; Rothstein, Robin D.

2014-01-01

Granular cell tumors (GCT) are rare and unusual tumors, which are usually benign and asymptomatic. Only 5?10% of cases involve the gastrointestinal tract, most commonly as singular, non-cancerous lesions in the esophagus. We report a rare case of symptomatic, multifocal, synchronous GCT involving the esophagus, stomach, and cecum.

Efeito do filtro de ultravioleta em lentes de contato hidrofílicas de alta hidratação Ultraviolet filter effect on hydrophilic high hydrated contact lenses

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Arlindo José Freire Portes

2008-06-01

Full Text Available A exposição à radiação ultravioleta está relacionada ao aparecimento de patologias oculares como ceratites, cataratas, degenerações maculares ou pterígio. Esta radiação está dividida em 3 tipos de acordo com o seu comprimento de onda: Uv-A (320-400nm, Uv-B (290-320nm e Uv-C (100-290nm. A indústria óptica desenvolveu filtros de ultravioleta para lentes intra-oculares, lentes de contato e lentes de óculos. OBJETIVO: Avaliar a eficácia do filtro de ultravioleta em lentes de contato de alta hidratação. MÉTODOS: Seis grupos de lentes de contato de alta hidratação e de marcas diferentes, contendo 3 unidades novas e iguais foram estudadas, observando-se o percentual de transmissão da energia luminosa de 200 a 400 nm através de um espectofotômetro. RESULTADOS: Os 3 grupos que apresentavam filtro de ultravioleta causaram uma queda abrupta na transmissão da radiação ultravioleta de 400 nm até 340 nm, ocorrendo um aumento na transmissão entre 240 a 300 nm até um nível máximo de 45%. Abaixo de 240 nm e entre 300 e 340 nm, houve um completo bloqueio da transmissão da radiação ultravioleta. Os 3 grupos que não apresentavam filtros de ultravioleta causaram uma queda abrupta na transmissão da radiação ultravioleta abaixo de 240 nm, ocorrendo um bloqueio completo de transmissão abaixo de 220 nm. CONCLUSÃO: As lentes de contato sem filtro Uv testadas não bloquearam com eficácia a radiação Uv-A, B ou C, e as com filtro bloquearam quase totalmente a radiação Uv-B e parcialmente a radiação Uv-A e Uv-C.The exposure to ultraviolet radiation is associated with the beginning of ocular pathologies like keratites, cataract, age-related macular degeneration and pterygium. This radiation is divided in 3 bands according to the wave length: Uv-A (320-400, Uv-B (290-320, Uv-C (100-290. The optic industry developed ultraviolet filters to intraocular lenses, contact lenses and spectacle lenses. PURPOSE: The issue of this work is

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

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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.

Effect of aspherical and yellow tinted intraocular lens on blue-on-yellow perimetry

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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.

Clinical study on the incidence of vancomycin intraocular injection in treatment with suppurative endophthalmitis

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Yi-Qin Duan

2015-05-01

Full Text Available AIM:To estimate the clinical significance of the microculture of humor and vitreous and vancomycin intraocular injection in treatment of suppurative endophthalmitis associated with intraocular foreign bodies.METHODS: Totally 65 patients with penetrating eye trauma and retained intraocular foreign bodies in emergency operation and intraocular injection from January 2012 to September 2014 were regarded as the study group, another 62 patients with penetrating eye trauma and retained intraocular foreign bodies in emergency operation without intraocular injection before August 2011 were regarded as the control group. Aqueous humor and vitreous humor were taken from each patient of the study group and the control group for bacteria and fungus cultivation. The study group was treated with 1mg vancomycin intraocular injection after operation, while the control group was not. RESULTS: The incidence of endophthalmitis in the control group was 16%(10 cases, while in the study group was 3%(2 cases, with significant difference between two groups(x2=6.32, PP>0.05. The positive rate of vitreous humor germiculture in study group was 14%(9 cases, and the incidence of endophthalmitis was 3%. The positive rate of vitreous humor germiculture in control group was 11%(7 casesand the incidence of endophthalmitis was 16%, with significant differences between two groups(PCONCLUSION: Intraocular foreign bodies treated with emergency operation and vancomycin intraocular injections can decrease the incidence of suppurative endophthalmitis and have a good vision prognosis for the second stage of operation.

Intraocular lens alignment from purkinje and Scheimpflug imaging.

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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.

Survey of Intraocular Antibiotics Prophylaxis Practice after Open Globe Injury in China.

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Bingsheng Lou

Full Text Available To elucidate the Chinese practice of intraocular antibiotics administration for prophylaxis after open globe injury.A cross-sectional questionnaire survey was performed online by scanning a Quickmark (QR code with smartphones at the 20th Chinese National Conference of Ocular Trauma in November 2014.A total of 153 (30.6% of all participators at the conference responded. Of the respondents, 20.9% were routinely administered with prophylactic intraocular injection of antibiotics at the conclusion of the primary eye repair, and 56.9% were used only in cases with high risk of endophthalmitis development. The intraocular route of delivery was mainly included with intracameral injection (47.9% and intravitreal injection (42.0%. Cephalosporins (53.8% and vancomycin (42.0% were the main choices of antibiotic agents, followed by fluoroquinolones (24.3%, and aminoglycosides (13.4%. Only 21.9% preferred a combination of two or more two drugs routinely. In addition, significantly more respondents from the referral eye hospital (92.7% replied using intraocular antibiotics injection for prophylaxis compared to those respondents from the primary hospital (69.4% (p = 0.001, Fisher's exact test.Intraocular antibiotics injection for post-traumatic endophthalmitis prophylaxis is widely used in China. However, the choice of antibiotic agents and the intraocular route of delivery vary. A well-designed clinical trial is needed to establish a standardized protocol of intraocular antibiotics administration for post-traumatic endophthalmitis prophylaxis.

EDITORIAL: Focus on Gravitational Lensing

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Jain, Bhuvnesh

2007-11-01

Gravitational lensing emerged as an observational field following the 1979 discovery of a doubly imaged quasar lensed by a foreground galaxy. In the 1980s and '90s dozens of other multiply imaged systems were observed, as well as time delay measurements, weak and strong lensing by galaxies and galaxy clusters, and the discovery of microlensing in our galaxy. The rapid pace of advances has continued into the new century. Lensing is currently one of best techniques for finding and mapping dark matter over a wide range of scales, and also addresses broader cosmological questions such as understanding the nature of dark energy. This focus issue of New Journal of Physics presents a snapshot of current research in some of the exciting areas of lensing. It provides an occasion to look back at the advances of the last decade and ahead to the potential of the coming years. Just about a decade ago, microlensing was discovered through the magnification of stars in our galaxy by invisible objects with masses between that of Jupiter and a tenth the mass of the Sun. Thus a new component of the mass of our galaxy, dubbed MACHOs, was established (though a diffuse, cold dark matter-like component is still needed to make up most of the galaxy mass). More recently, microlensing led to another exciting discovery—of extra-solar planets with masses ranging from about five times that of Earth to that of Neptune. We can expect many more planets to be discovered through ongoing surveys. Microlensing is the best technique for finding Earth mass planets, though it is not as productive overall as other methods and does not allow for follow up observations. Beyond planet hunting, microlensing has enabled us to observe previously inaccessible systems, ranging from the surfaces of other stars to the accretion disks around the black holes powering distant quasars. Galaxies and galaxy clusters at cosmological distances can produce dramatic lensing effects: multiple images of background galaxies

Gauge-invariant formalism of cosmological weak lensing

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Yoo, Jaiyul; Grimm, Nastassia; Mitsou, Ermis; Amara, Adam; Refregier, Alexandre

2018-04-01

We present the gauge-invariant formalism of cosmological weak lensing, accounting for all the relativistic effects due to the scalar, vector, and tensor perturbations at the linear order. While the light propagation is fully described by the geodesic equation, the relation of the photon wavevector to the physical quantities requires the specification of the frames, where they are defined. By constructing the local tetrad bases at the observer and the source positions, we clarify the relation of the weak lensing observables such as the convergence, the shear, and the rotation to the physical size and shape defined in the source rest-frame and the observed angle and redshift measured in the observer rest-frame. Compared to the standard lensing formalism, additional relativistic effects contribute to all the lensing observables. We explicitly verify the gauge-invariance of the lensing observables and compare our results to previous work. In particular, we demonstrate that even in the presence of the vector and tensor perturbations, the physical rotation of the lensing observables vanishes at the linear order, while the tetrad basis rotates along the light propagation compared to a FRW coordinate. Though the latter is often used as a probe of primordial gravitational waves, the rotation of the tetrad basis is indeed not a physical observable. We further clarify its relation to the E-B decomposition in weak lensing. Our formalism provides a transparent and comprehensive perspective of cosmological weak lensing.

Weak lensing and dark energy

International Nuclear Information System (INIS)

Huterer, Dragan

2002-01-01

We study the power of upcoming weak lensing surveys to probe dark energy. Dark energy modifies the distance-redshift relation as well as the matter power spectrum, both of which affect the weak lensing convergence power spectrum. Some dark-energy models predict additional clustering on very large scales, but this probably cannot be detected by weak lensing alone due to cosmic variance. With reasonable prior information on other cosmological parameters, we find that a survey covering 1000 sq deg down to a limiting magnitude of R=27 can impose constraints comparable to those expected from upcoming type Ia supernova and number-count surveys. This result, however, is contingent on the control of both observational and theoretical systematics. Concentrating on the latter, we find that the nonlinear power spectrum of matter perturbations and the redshift distribution of source galaxies both need to be determined accurately in order for weak lensing to achieve its full potential. Finally, we discuss the sensitivity of the three-point statistics to dark energy

Mean intraocular pressure in hypertensive adults

International Nuclear Information System (INIS)

Irum, S.; Malik, A.M.; Saeed, M.

2015-01-01

To determine the mean Intraocular Pressure (IOP) in already diagnosed adult hypertensive patients with different grades of hypertension. Study Design: Cross-sectional descriptive study. Place and Duration of Study: Combined Military Hospital, Lahore, from March 2012 to Aug 2012. Patients and Methods: A total of 178 already diagnosed hypertensive patients were selected. A detailed history of ocular or systemic diseases was taken. Intraocular pressure was measured with help of Goldmann applanation tonometer. Three consecutive readings of IOP of each eye were taken at 30 minutes interval and mean calculated. Blood pressure was recorded in seated position from right upper arm, by mercury sphygmomanometer. Blood pressure measurements were determined by taking the mean value of three systolic and diastolic readings. Results: The results of intraocular pressure (IOP) between various grades of hypertension were determined. There was an increase in mean IOP with rise in blood pressure. The subjects with grade I hypertension showed a mean IOP of 13.95 ± 3.74 mmHg, while grade II and grade III hypertensive subjects had mean IOPs as 18.10 ± 3.32 and 20.21 ± 2.52 mmHg respectively. Conclusion: A higher value of mean IOP was found with increase in systolic and diastolic blood pressures. (author)

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

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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.

Investigations of Galaxy Clusters Using Gravitational Lensing

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Wiesner, Matthew P. [Northern Illinois Univ., DeKalb, IL (United States)

2014-08-01

In this dissertation, we discuss the properties of galaxy clusters that have been determined using strong and weak gravitational lensing. A galaxy cluster is a collection of galaxies that are bound together by the force of gravity, while gravitational lensing is the bending of light by gravity. Strong lensing is the formation of arcs or rings of light surrounding clusters and weak lensing is a change in the apparent shapes of many galaxies. In this work we examine the properties of several samples of galaxy clusters using gravitational lensing. In Chapter 1 we introduce astrophysical theory of galaxy clusters and gravitational lensing. In Chapter 2 we examine evidence from our data that galaxy clusters are more concentrated than cosmology would predict. In Chapter 3 we investigate whether our assumptions about the number of galaxies in our clusters was valid by examining new data. In Chapter 4 we describe a determination of a relationship between mass and number of galaxies in a cluster at higher redshift than has been found before. In Chapter 5 we describe a model of the mass distribution in one of the ten lensing systems discovered by our group at Fermilab. Finally in Chapter 6 we summarize our conclusions.

Instrumental systematics and weak gravitational lensing

International Nuclear Information System (INIS)

Mandelbaum, R.

2015-01-01

We present a pedagogical review of the weak gravitational lensing measurement process and its connection to major scientific questions such as dark matter and dark energy. Then we describe common ways of parametrizing systematic errors and understanding how they affect weak lensing measurements. Finally, we discuss several instrumental systematics and how they fit into this context, and conclude with some future perspective on how progress can be made in understanding the impact of instrumental systematics on weak lensing measurements

The multifocal electroretinogram (mfERG) in the pig

DEFF Research Database (Denmark)

Voss Kyhn, Maria; Kiilgaard, Jens Folke; Lopez, Ana Garcia

2007-01-01

To establish a method allowing multifocal electroretinography (mfERG) recording with simultaneous fundus monitoring on anaesthetized pigs. In addition we characterize the peaks of the porcine mfERG trace, and compare the visual streak area with the optic nerve head, a known non-response area....... Finally we illustrate the feasibility of the method by performing mfERG after an induced laser burn in the visual streak....

A case of osseous scintigraphy showing focuses of multifocal tuberculosis

International Nuclear Information System (INIS)

Faurous-Vanaud, R.; Faurous, P.; Kalfa, G.; Collet, H.; Couty, H.; Artus, J.C.

1997-01-01

Incidence of tuberculosis in developed countries presents in the last years a spectacular boost. However, the osteo-articular system is afflicted by tuberculosis only in a few percent of cases and the multifocal character represents less than 5% of osseous tuberculosis. It is presented here a case of multifocal osseous tuberculosis only to stress its rarity. A woman 28 years old from Djibouti presents since 8 months an asthenia and dorsal pains long thought as psychalgia. The examination has shown a major vertebral stiffness and limitation of right haunch. The radiographs showed a scoliosis centered on D8 with modifications. The biologic data are VS = 90, CRP = 124 and the hemogram is normal. The intradermal reaction (10 U of tuberculin) is phlyctenular. The TDM indicates lytic vertebral extension on D7 - D8, the osseous scintigraphy with MDP - 99 mTc indicates no anomaly in the vascular arrival time; a few minutes after injection: dorsal and upper and of right femur hyperactivity; 2 h after injection: hyper-fixation of D7 to D9 and of the upper end of right femur. The IRM indicates para-vertebral abscess of D7 to D9 with epidural abscess; abscess in the upper part of the loge of right adductors with osseous affliction of the femur's upper end; a bacillary infectious process was a priori evoked. The patient was then placed under quadruple antibiotic-therapy anti-tuberculous care. In case of anomalous multifocal osseous scintigraphy the tuberculous affliction is part of the differential diagnosis, particularly in the immigrant populations or in HIV+ persons

Soft-contact-lenses-induced complications

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Suvajac Gordana

2008-01-01

Full Text Available Background/Aim. Soft contact lenses occupy significant place in ophthalmology, both in the correction of refraction anomalies and in the treatment of many eye diseases. The number of patients that wear soft contact lenses for the purpose of correcting ametropia is constantly increasing. Due to the increasing number of wearers, the percentage of complications that can lead to serious eye damage and serious vision loss is also increasing. The aim of this study was to point out the most common complications related to soft contact lens use. Methods. In the period from 1995−2004 this prospective study included 510 patients wearing soft contact lenses for correcting ametropia. None of the patients wore contact lenses before and none suffered from any system or local diseases that could affected the development of eventual complications. The study took seven years with the patients who wore conventional lenses and three years with those who wore replacement contact lenses. All the necessary ophthalmologic examinations were done (visual acuity, refractokeratometry, the quantity of tear film, biomicroscopic examination of anterior eye segment. All the complications were filmed by video camera. Results. Of all the patients, 19 had blepharitis, 73 suffered from “dry eye”, 57 had conjunctival hyperemia, 12 had conjunctivitis, 34 had gigantopapillary conjunctivitis (GPC, 93 had punctiform epitheliopathy, 20 had corneal infiltration, one patient had keratitis, 91 had corneal vascularisation, and 95 patients had corneal deposits. Conclusion. Both the type and frequency of complications related to soft contact lens use in our group of patients, proved to be significant. Some of this complications (keratitis can significantly damage vision and lead to loss of vision and sometimes can require operative treatment.

Intraocular pressure variations during zygomatic fracture reduction and fixation: a clinical study.

LENUS (Irish Health Repository)

Murray, Dylan J

2012-02-03

BACKGROUND: The reduction of midface fractures has been associated with the rare but devastating complication of blindness. An increase in intraocular pressure is important in the mechanism of blindness in this setting. In this study, the authors assessed the intraocular pressure in patients who underwent zygomatic fracture reduction (with or without fixation). METHODS: Using applanation tonometry, 29 patients underwent intraocular pressure measurements before, during, and after fracture fixation. The contralateral pressures were measured and used as the control. RESULTS: There were 29 patients with a mean age of 35 years, and the mean time to surgery was 5 days. Preoperatively, all patients had normal intraocular pressures and normal visual acuity. All patients underwent a Gillies lift and 18 patients required open reduction and fixation of the frontozygomatic suture (n = 4) or the infraorbital margin (n = 2), and the remainder (n = 12) required fixation of both points. There was no statistically significant increase in the intraocular pressures following the reduction of uncomplicated zygomatic fractures. Statistically significant pressure reductions were noted immediately after reduction and fixation. CONCLUSIONS: The surgical reduction of uncomplicated zygomatic fractures has no adverse effect on the intraocular pressure. It is the authors\\' opinion that adjunctive measures to reduce the pressures are unnecessary.

Topical tissue plasminogen activator appears ineffective for the clearance of intraocular fibrin.

Science.gov (United States)

Zwaan, J; Latimer, W B

1998-06-01

To determine the efficacy of topical tissue plasminogen activator (tPA) for the resolution of postoperative or inflammatory intraocular fibrinous exudates. Each treatment consisted of drops of 1 mg/ml tPA given 9 times 5 minutes apart. Records were reviewed and the results at 24 and 48 hours were recorded. Sixty-two patients had a total of 94 treatments. Fibrin exudates following intraocular surgery in 34 patients were treated 44 times. In 6 patients there was a positive result. Fibrin associated with intraocular infection was treated in 9 patients. None showed clear improvement. Nineteen patients had a total of 34 treatments for poorly controlled intraocular pressure (IOP) after glaucoma surgery. Five patients showed adequate control of the IOP, 12 did not change, and 2 had a questionable improvement. Eleven patients had adequate IOP control after additional treatment. Seven required suture lysis, 2 ab interno bleb revision, and 2 YAG capsulotomy or iridotomy to reduce the IOP to an acceptable level. Within the limits of this retrospective study and taking into account that fibrin may resolve spontaneously, it appears that topical tPA drops are not effective for the liquefaction of intraocular fibrin after surgery or in association with intraocular inflammation. They did not improve IOP control after glaucoma surgery.

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

Advanced pigment dispersion glaucoma secondary to phakic intraocular collamer lens implant

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Clara Ye

2018-06-01

Full Text Available Purpose: 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. Observations: 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. Conclusions and importance: Pigment dispersion glaucoma is a serious adverse outcome after phakic ICL implantation and regular post-operative monitoring may prevent advanced visual field loss. Keywords: Phakic intraocular lens, Intraocular collamer lens, Pigment dispersion, Glaucoma

Chronic multifocal non-bacterial osteomyelitis in hypophosphatasia mimicking malignancy

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Warmuth-Metz Monika

2007-01-01

Full Text Available Abstract Background Hypophosphatasia (HP is characterized by a genetic defect in the tissue-nonspecific alkaline phosphatase (TNSALP gene and predominantly an autosomal recessive trait. HP patients suffer from reduced bone mineralization. Biochemically, elevated concentrations of substrates of TNSALP, including pyridoxal-5'-phosphate and inorganic pyrophosphate occur in serum, tissues and urine. The latter has been associated with chronic inflammation and hyperprostaglandinism. Case presentation We report on 2 affected children presenting with multifocal inflammatory bone lesions mimicking malignancy: A 6 years old girl with short stature had been treated with human growth hormone since 6 months. Then she started to complain about a painful swelling of her left cheek. MRI suggested a malignant bone lesion. Bone biopsy, however, revealed chronic inflammation. A bone scan showed a second rib lesion. Since biopsy was sterile, the descriptive diagnosis of chronic non-bacterial osteomyelitis (CNO was established. The diagnostic tests related to growth failure were repeated and subsequent analyses demonstrated a molecular defect in the TNSALP gene. The second girl (10 years old complained about back pain after she had fallen from her bike. X rays of her spine revealed compressions of 2 thoracic vertebrae. At first these were considered trauma related, however a bone scan did show an additional lesion in the right 4th rib. A biopsy of this rib revealed a sterile lympho- plasmocytoid osteomyelitis suggesting multifocal CNO. Further analyses did show a decreased TNSALP in leukocytes and elevated pyridoxal phosphate in plasma, suggesting a heterozygous carrier status of HP. Conclusion Chronic bone oedema in adult HP and chronic hyper-prostaglandinism in childhood HP do suggest that in some HP patients bone inflammation is present in conjunction with the metabolic defect. Sterile multifocal osteomyelitis could be demonstrated. Non-steroidal anti

Assessment of intraocular foreign bodies by helical-CT multiplanar imaging

International Nuclear Information System (INIS)

Papadopoulos, A.; Fotinos, A.; Maniatis, V.; Kavadias, S.; Michaelides, A.; Avouri, M.; Kalamara, C.; Stringaris, K.

2001-01-01

The aim of this study was to examine the effectiveness of helical CT in the assessment of intraocular foreign bodies, evaluating two protocols with different collimation. We performed helical-CT studies in 30 patients. Fifteen patients were examined with 1.5-mm collimation and the other 15 patients with 3.0-mm collimation. All other imaging parameters were identical in both protocols. Multiplanar images were reconstructed. The examinations were reviewed for presence, localization and size of intraocular foreign bodies. We compare our results with the surgical data. We estimate the required examination time. In the first group (collimation 1.5 mm) an intraorbital foreign body was detected in 8 of 15 patients. In 3 of 8 patients an intraocular foreign body (all were metallic) was detected. In the second group (collimation 3.0 mm) an intraorbital foreign body was detected in 9 of 15 patients. In 8 of 9 patients an intraocular foreign body (all were metallic) was detected. Our results were confirmed by surgery in all cases. Examination time was 36 s in the first group and 18 s in the second group. Computed tomography should be considered the imaging modality of choice in the assessment of metallic intraocular foreign bodies and 3.0-mm collimation is optional, because of reduced examination time and radiation exposure. (orig.)

A novel clinical sign in intraocular tuberculosis: Active chorioretinitis within chorioretinal atrophy

OpenAIRE

Avinash Pathengay; Bhavik Panchal; Himadri Choudhury; Soumyava Basu; Nidhi Relhan; Harry W. Flynn, Jr.

2017-01-01

Purpose: To report a novel clinical sign in patients with intraocular tuberculosis. The current study is an observational consecutive case series of patients diagnosed with intraocular tuberculosis managed at a tertiary eye care centre from June 1, 2012 to December 31, 2015. Observations: The diagnosis of intraocular tuberculosis was made in 6 patients based on ocular features suggestive of tuberculosis along with a positive tuberculin skin testing and chest X-ray consistent with tuberculo...

Case report: multifocal subchondral stress fractures of the femoral heads and tibial condyles in a young military recruit.

Science.gov (United States)

Yoon, Pil Whan; Yoo, Jeong Joon; Yoon, Kang Sup; Kim, Hee Joong

2012-03-01

Subchondral stress fractures of the femoral head may be either of the insufficiency-type with poor quality bone or the fatigue-type with normal quality bone but subject to high repetitive stresses. Unlike osteonecrosis, multiple site involvement rarely has been reported for subchondral stress fractures. We describe a case of multifocal subchondral stress fractures involving femoral heads and medial tibial condyles bilaterally within 2 weeks. A 27-year-old military recruit began having left knee pain after 2 weeks of basic training, without any injury. Subsequently, right knee, right hip, and left hip pain developed sequentially within 2 weeks. The diagnosis of multifocal subchondral stress fracture was confirmed by plain radiographs and MR images. Nonoperative treatment of the subchondral stress fractures of both medial tibial condyles and the left uncollapsed femoral head resulted in resolution of symptoms. The collapsed right femoral head was treated with a fibular strut allograft to restore congruity and healed without further collapse. There has been one case report in which an insufficiency-type subchondral stress fracture of the femoral head and medial femoral condyle occurred within a 2-year interval. Because the incidence of bilateral subchondral stress fractures of the femoral head is low and multifocal involvement has not been reported, multifocal subchondral stress fractures can be confused with multifocal osteonecrosis. Our case shows that subchondral stress fractures can occur in multiple sites almost simultaneously.

Progressive multifocal leukoencephalopathy: new concepts

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Marco A. Lima

2013-09-01

Full Text Available Progressive multifocal leukoencephalopathy (PML is a demyelinating disease of the CNS caused by reactivation of JC virus (JCV in a setting of cellular immunosuppression. Originally, PML was observed in patients with advanced HIV infection, lymphoproliferative disorders and transplant recipients. However, the widespread use of HIV antiretroviral drugs and the new selective immunomodulatory and immunosuppressive medications, such as Rituximab and Natalizumab, has recently modified the epidemiology, clinical presentation and prognosis of PML. Herein, we discuss the new concepts on PML, emphasizing the recent modification in the epidemiology; the impact of new immunomodulatory treatments in the disease, PML-IRIS (Immune reconstitution inflammatory síndrome, new treatment strategies and other JCV related CNS diseases.

Weakly oval electron lense

International Nuclear Information System (INIS)

Daumenov, T.D.; Alizarovskaya, I.M.; Khizirova, M.A.

2001-01-01

The method of the weakly oval electrical field getting generated by the axially-symmetrical field is shown. Such system may be designed with help of the cylindric form coaxial electrodes with the built-in quadrupole duplet. The singularity of the indicated weakly oval lense consists of that it provides the conducting both mechanical and electronic adjustment. Such lense can be useful for elimination of the near-axis astigmatism in the electron-optical system

Lenses matching of compound eye for target positioning

Science.gov (United States)

Guo, Fang; Zheng, Yan Pei; Wang, Keyi

2012-10-01

Compound eye, as a new imaging method with multi-lens for a large field of view, could complete target positioning and detection fastly, especially at close range. Therefore it could be applicated in the fields of military and medical treatment and aviation with vast market potential and development prospect. Yet the compound eye imaging method designed use three layer construction of multiple lens array arranged in a curved surface and refractive lens and imaging sensor of CMOS. In order to simplify process structure and increase the imaging area of every sub-eye, the imaging area of every eye is coved with the whole CMOS. Therefore, for several imaging point of one target, the corresponding lens of every imaging point is unkonown, and thus to identify. So an algorithm was put forward. Firstly, according to the Regular Geometry relationship of several adjacent lenses, data organization of seven lenses with a main lens was built. Subsequently, by the data organization, when one target was caught by several unknown lenses, we search every combined type of the received lenses. And for every combined type, two lenses were selected to combine and were used to calculate one three-dimensional (3D) coordinate of the target. If the 3D coordinates are same to the some combine type of the lenses numbers, in theory, the lenses and the imaging points are matched. So according to error of the 3D coordinates is calculated by the different seven lenses numbers combines, the unknown lenses could be distinguished. The experimental results show that the presented algorithm is feasible and can complete matching task for imaging points and corresponding lenses.

Fatores técnicos intervenientes na realização do exame de eletrorretinograma multifocal (ERGmf Technical factors that influence multifocal electroretinogram (mfERG recording

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Maria Kiyoko Oyamada

2007-08-01

Full Text Available OBJETIVO: Descrever os principais fatores intervenientes observados durante a aquisição e análise do exame de eletrorretinograma multifocal (ERGmf, que afetam o registro gráfico das ondas obtidas e portanto sua análise. MÉTODOS: Análise dos fatores de erro observados durante a aquisição de 100 exames seqüenciais de eletrorretinograma multifocal, realizados com o Reti System da Roland Consult, no período de maio a julho de 2005. Os exames de eletrorretinograma multifocal foram realizados conforme recomendações internacionais, respeitando-se os parâmetros preestabelecidos do equipamento, com 61 elementos, e ângulo visual de 30º. Todos os pacientes foram submetidos à avaliação oftalmológica completa, excluindo-se aqueles com transparência inadequada de meios, córneas planas e os incapazes de visualizar as linhas de fixação. RESULTADOS: Os fatores intervenientes, que poderiam causar erros na interpretação dos resultados obtidos, observados e corrigidos durante a realização dos exames foram: fixação excêntrica, movimentação dos olhos, contração do orbicular, contração da musculatura cervical, não-correção adequada, não-transparência adequada do eletrodo corneano, deslocamento do eletrodo em geral para baixo, descentralização do suporte da lente corretora, distância inadequada paciente-monitor em pacientes com alta ametropia, altura inadequada dos olhos em relação ao centro da tela, ruído na freqüência de 60 HZ (rede elétrica e de campo eletromagnético, impedâncias elevadas. No processamento das ondas, a utilização excessiva de filtros para remoção de ruídos dos registros obtidos, pode interferir na análise dos resultados obtidos. CONCLUSÕES: Cuidados simplesmente observacionais durante a aquisição dos sinais são de importância significativa para a obtenção de registros com boa morfologia e baixo nível de ruído. Permitindo, por meio de sua pronta correção, a análise correta e

Unusual multifocal granulomatous disease caused by actinomycetous bacteria in a nestling Derbyan parrot (Psittacula derbiana).

Science.gov (United States)

Park, F J; Jaensch, S

2009-01-01

A nestling Derbyan parrot (Psittacula derbiana) was presented with unusual subcutaneous swellings of the thigh regions, and poor growth. Histological examination revealed actinomycetous bacteria associated with multifocal systemic granulomas. The clinical and pathological findings of the case are presented, and some relevant aspects of actinomycetous bacterial infections in mammals and birds are discussed. Although granulomatous disease is encountered at times in avian species, the actinomycetous bacteria (Nocardia and Actinomyces spp.) have rarely been reported in association with multifocal granulomatous disease in birds.

High-speed optical signal processing using time lenses

DEFF Research Database (Denmark)

Galili, Michael; Hu, Hao; Guan, Pengyu

2015-01-01

This paper will discuss time lenses and their broad range of applications. A number of recent demonstrations of complex high-speed optical signal processing using time lenses will be outlined with focus on the operating principle.......This paper will discuss time lenses and their broad range of applications. A number of recent demonstrations of complex high-speed optical signal processing using time lenses will be outlined with focus on the operating principle....

Renal Function Outcomes for Multifocal Renal Neoplasms Managed by Radiofrequency Ablation

Energy Technology Data Exchange (ETDEWEB)

Gupta, Pushpender, E-mail: pugupta@wakehealth.edu; Allen, Brian C., E-mail: bcallen2@wakehealth.edu; Chen, Michael Y., E-mail: mchen@wakehealth.edu; Childs, David D., E-mail: dchilds@wakehealth.edu; Kota, Gopi, E-mail: gkota@wakehealth.edu; Zagoria, Ronald J., E-mail: rzagoria@wakehealth.edu [Wake Forest University School of Medicine, Department of Radiology (United States)

2013-10-15

Purpose: To evaluate renal function changes related to radiofrequency ablation (RFA) for the treatment of multifocal renal neoplasms. Methods: This is an institutional review board-approved, Health Insurance Portability and Accountability Act compliant retrospective study of all patients treated with computed tomography guided RFA for multifocal renal neoplasms at one institution. Fifty-seven subjects, mean age 70 (range 37-88) years, underwent RFA of 169 renal neoplasms (average size 2.0 cm). Subjects had between 2 and 8 (mean 2.96) neoplasms ablated. Estimated glomerular filtration rate (eGFR) was measured before and after RFA. Complications related to RFA were recorded. Results: eGFR decreased on average of 4.4 % per tumor treated and 6.7 % per ablation session (average 1.76 tumors treated per session). For subjects with the largest neoplasm measuring >3 cm, eGFR decreased an average of 14.5 % during the course of their treatment. If the largest neoplasm measured 2-3 cm, eGFR decreased an average of 7.7 %, and if the largest neoplasm measured <2 cm, eGFR decreased an average of 3.8 %. Subjects with reduced baseline renal function were more likely to have a greater decline in eGFR after RFA. There was a minor complication rate of 6.3 % (6 of 96 sessions), none of which required treatment, and a major complication rate of 4.2 % (4 of 96 sessions). Conclusion: RFA for the treatment of multifocal renal neoplasms results in mild decline of renal function.

Factors influencing bacterial adhesion to contact lenses.

Science.gov (United States)

Dutta, Debarun; Cole, Nerida; Willcox, Mark

2012-01-01

The process of any contact lens related keratitis generally starts with the adhesion of opportunistic pathogens to contact lens surface. This article focuses on identifying the factors which have been reported to affect bacterial adhesion to contact lenses. Adhesion to lenses differs between various genera/species/strains of bacteria. Pseudomonas aeruginosa, which is the predominant causative organism, adheres in the highest numbers to both hydrogel and silicone hydrogel lenses in vitro. The adhesion of this strain reaches maximum numbers within 1h in most in vitro studies and a biofilm has generally formed within 24 h of cells adhering to the lens surface. Physical and chemical properties of contact lens material affect bacterial adhesion. The water content of hydroxyethylmethacrylate (HEMA)-based lenses and their iconicity affect the ability of bacteria to adhere. The higher hydrophobicity of silicone hydrogel lenses compared to HEMA-based lenses has been implicated in the higher numbers of bacteria that can adhere to their surfaces. Lens wear has different effects on bacterial adhesion, partly due to differences between wearers, responses of bacterial strains and the ability of certain tear film proteins when bound to a lens surface to kill certain types of bacteria.

[Evaluation of accuracy of measuring intraocular pressure by handheld non-contact applanation tonometer].

Science.gov (United States)

Chen, X; Peng, D; Zhou, W; Zhong, Y

1995-06-01

To evaluate the accuracy of measuring intraocular pressure by handheld non-contact applanation tonometer. 58 patients' (113 eyes) intraocular pressure were measured by Keeler, non-contact tonometer and R 900 Goldmann applanation tonometer and the results of measurement of intraocular pressure by the two kinds of tonometers were compared. The mean intraocular pressure measured by non-contact is 16.31 +/- 5.59 mmHg and 17.49 +/- 6.13 mmHg (1 mmHg = 0.1333 kPa) by Goldmann applanation tonometer, respectively. There was no statistical significance to be found (P > 0.05) between the two methods. By linear correlation and regression analysis, a positive correlation was found between the two methods (r = 0.8942, b = 0.8154). The handheld non-contact tonometer has the same accuracy and reliability of measurement of intraocular pressure comparing with Goldmann applanation tonometer, and it can be used in glaucoma clinic and screening.

Dynamics of Fermat potentials in nonperturbative gravitational lensing

International Nuclear Information System (INIS)

Frittelli, Simonetta; Newman, Ezra T.

2002-01-01

We present a framework, based on the null-surface formulation of general relativity, for discussing the dynamics of Fermat potentials for gravitational lensing in a generic situation without approximations of any kind. Additionally, we derive two lens equations: one for the case of thick compact lenses and the other one for lensing by gravitational waves. These equations in principle generalize the astrophysical scheme for lensing by removing the thin-lens approximation while retaining the weak fields

Premature epiphyseal fusion and degenerative arthritis in chronic recurrent multifocal osteomyelitis

International Nuclear Information System (INIS)

Piddo, C.; Reed, M.H.; Black, G.B.

2000-01-01

A 9-year-old boy was diagnosed with chronic recurrent multifocal osteomyelitis affecting multiple sites. During an 8-year follow-up he developed premature closure of a distal radial epiphysis and degenerative changes in the adjacent radiocarpal joint. (orig.)

Nanofocusing Parabolic Refractive X-Ray Lenses

International Nuclear Information System (INIS)

Schroer, C.G.; Kuhlmann, M.; Hunger, U.T.; Guenzler, T.F.; Kurapova, O.; Feste, S.; Lengeler, B.; Drakopoulos, M.; Somogyi, A.; Simionovici, A. S.; Snigirev, A.; Snigireva, I.

2004-01-01

Parabolic refractive x-ray lenses with short focal distance can generate intensive hard x-ray microbeams with lateral extensions in the 100nm range even at short distance from a synchrotron radiation source. We have fabricated planar parabolic lenses made of silicon that have a focal distance in the range of a few millimeters at hard x-ray energies. In a crossed geometry, two lenses were used to generate a microbeam with a lateral size of 330nm by 110nm at 25keV in a distance of 41.8m from the synchrotron radiation source. First microdiffraction and fluorescence microtomography experiments were carried out with these lenses. Using diamond as lens material, microbeams with lateral size down to 20nm and below are conceivable in the energy range from 10 to 100keV

Do swimming goggles limit microbial contamination of contact lenses?

Science.gov (United States)

Wu, Yvonne T; Tran, Jess; Truong, Michelle; Harmis, Najat; Zhu, Hua; Stapleton, Fiona

2011-04-01

Wearing goggles over contact lenses while swimming is often recommended by eye care professionals. Limited data are available to assess this recommendation. The purpose of this study was to examine whether wearing goggles while swimming limits bacterial colonization on contact lenses and whether the type of lens worn affects contamination rates. Twenty-three subjects underwent two swimming sessions at an ocean (salt water) pool (Maroubra beach Rock Pool, Sydney, Australia). Silicone hydrogel (Ciba Focus Night and Day) or hydrogel lenses (Ciba Focus Daily) were inserted into subjects' eyes before 30 min of swimming sessions, and subjects used modified goggles to mimic goggled and non-goggled conditions. At the end of each session, lenses were collected for microbial investigation. Viable bacterial colonies were classified as gram positive and gram negative and enumerated. The level of bacterial colonization on contact lenses between goggled and non-goggled conditions and between the two lens materials were compared. The range of colony forming units recovered from goggled lenses were 0 to 930 compared with 0 to 1210 on non-goggled lenses. The majority of subjects (16/23) had more microorganisms in the non-goggled condition than when wearing goggles (p = 0.03). Gram negative organisms were found in three non-goggled lenses. No significant difference was shown in the number of bacteria isolated from silicone hydrogel and hydrogel lenses (p > 0.6) irrespective of wearing goggles. Water samples had consistently higher numbers of bacterial counts than those adhered to the lenses; however, no association was found between the number of bacteria in the water sample and those found on the contact lenses. Consistently, fewer bacterial colonies were found on the goggled contact lens, thus suggesting goggles offer some protection against bacterial colonization of contact lenses while swimming. These data would support the recommendation encouraging lens wearers to use goggles

Multifocal gastrointestinal stromal tumor (GIST) of the stomach in an 11-year-old girl

International Nuclear Information System (INIS)

Park, Jin; Rubinas, Tara C.; Fordham, Lynn A.; Phillips, J.D.

2006-01-01

A previously healthy 11-year-old girl presented with an 8-month history of anemia and left upper quadrant abdominal pain. US examination demonstrated a 9-cm cystic mass with a fluid-fluid level in the left upper quadrant with unclear organ of origin. Abdominal MR imaging demonstrated a complex cystic mass, likely arising from the stomach. Additional T2 hyperintense submucosal lesions were identified in the gastric wall. Surgical excision confirmed the diagnosis of multifocal gastric gastrointestinal stromal tumor (GIST). MR imaging was helpful in suggesting a gastric origin of the primary mass and in demonstrating multifocal disease within the stomach. (orig.)

Flurbiprofen and intraocular pressure.

Science.gov (United States)

Gieser, D K; Hodapp, E; Goldberg, I; Kass, M A; Becker, B

1981-07-01

Systemic or topical administration of corticosteroids may produce a rise in intraocular pressure (IOP). Nonsteroidal anti-inflammatory drugs (NSAI drugs) are alternate therapy for ocular inflammatory disease. Flurbiprofen, a new NSAI drug, was tested in double-masked fashion to delineate its effect on IOP. Flurbiprofen did not alter IOP in known high corticosteroid responders nor did it block corticosteroid-induced ocular hypertension.

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.

Using Strong Gravitational Lensing to Identify Fossil Group Progenitors

Science.gov (United States)

Johnson, Lucas E.; Irwin, Jimmy A.; White, Raymond E., III; Wong, Ka-Wah; Maksym, W. Peter; Dupke, Renato A.; Miller, Eric D.; Carrasco, Eleazar R.

2018-04-01

Fossil galaxy systems are classically thought to be the end result of galaxy group/cluster evolution, as galaxies experiencing dynamical friction sink to the center of the group potential and merge into a single, giant elliptical that dominates the rest of the members in both mass and luminosity. Most fossil systems discovered lie within z fossil criteria within the look forward time. Since strong gravitational lensing preferentially selects groups merging along the line of sight, or systems with a high mass concentration like fossil systems, we searched the CASSOWARY survey of strong-lensing events with the goal of determining whether lensing systems have any predisposition to being fossil systems or progenitors. We find that ∼13% of lensing groups are identified as traditional fossils while only ∼3% of nonlensing control groups are. We also find that ∼23% of lensing systems are traditional fossil progenitors compared to ∼17% for the control sample. Our findings show that strong-lensing systems are more likely to be fossil/pre-fossil systems than comparable nonlensing systems. Cumulative galaxy luminosity functions of the lensing and nonlensing groups also indicate a possible, fundamental difference between strong-lensing and nonlensing systems’ galaxy populations, with lensing systems housing a greater number of bright galaxies even in the outskirts of groups.

Intraocular Telescopic System Design: Optical and Visual Simulation in a Human Eye Model.

Science.gov (United States)

Zoulinakis, Georgios; Ferrer-Blasco, Teresa

2017-01-01

Purpose. To design an intraocular telescopic system (ITS) for magnifying retinal image and to simulate its optical and visual performance after implantation in a human eye model. Methods. Design and simulation were carried out with a ray-tracing and optical design software. Two different ITS were designed, and their visual performance was simulated using the Liou-Brennan eye model. The difference between the ITS was their lenses' placement in the eye model and their powers. Ray tracing in both centered and decentered situations was carried out for both ITS while visual Strehl ratio (VSOTF) was computed using custom-made MATLAB code. Results. The results show that between 0.4 and 0.8 mm of decentration, the VSOTF does not change much either for far or near target distances. The image projection for these decentrations is in the parafoveal zone, and the quality of the image projected is quite similar. Conclusion. Both systems display similar quality while they differ in size; therefore, the choice between them would need to take into account specific parameters from the patient's eye. Quality does not change too much between 0.4 and 0.8 mm of decentration for either system which gives flexibility to the clinician to adjust decentration to avoid areas of retinal damage.

Separating intrinsic alignment and galaxy-galaxy lensing

International Nuclear Information System (INIS)

Blazek, Jonathan; Seljak, Uroš; Mandelbaum, Rachel; Nakajima, Reiko

2012-01-01

The coherent physical alignment of galaxies is an important systematic for gravitational lensing studies as well as a probe of the physical mechanisms involved in galaxy formation and evolution. We develop a formalism for treating this intrinsic alignment (IA) in the context of galaxy-galaxy lensing and present an improved method for measuring IA contamination, which can arise when sources physically associated with the lens are placed behind the lens due to photometric redshift scatter. We apply the technique to recent Sloan Digital Sky Survey (SDSS) measurements of Luminous Red Galaxy lenses and typical ( ∼ L * ) source galaxies with photometric redshifts selected from the SDSS imaging data. Compared to previous measurements, this method has the advantage of being fully self-consistent in its treatment of the IA and lensing signals, solving for the two simultaneously. We find an IA signal consistent with zero, placing tight constraints on both the magnitude of the IA effect and its potential contamination to the lensing signal. While these constraints depend on source selection and redshift quality, the method can be applied to any measurement that uses photometric redshifts. We obtain a model-independent upper-limit of roughly 10% IA contamination for projected separations of r p ≈ 0.1–10 h −1 Mpc. With more stringent photo-z cuts and reasonable assumptions about the physics of intrinsic alignments, this upper limit is reduced to 1–2%. These limits are well below the statistical error of the current lensing measurements. Our results suggest that IA will not present intractable challenges to the next generation of galaxy-galaxy lensing experiments, and the methods presented here should continue to aid in our understanding of alignment processes and in the removal of IA from the lensing signal

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

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Juan Raúl Hernández Silva

2008-06-01

Full Text Available Un importante eslabón en el progreso alcanzado en la cirugía de cataratas, está fundamentado en el desarrollo industrial paralelo que ha ocurrido durante los últimos años con la introducción de nuevos modelos de lentes intraoculares, como el Rayner 620 H; el perfeccionamiento del instrumental quirúrgico, sistemas de aspiración e irrigación bimanual y bisturí con la medida exacta para colocar el inyector de la lente intraocular. La lente intraocular Rayner 620H significó un gran paso para la facoemulsificación y el control de la opacidad de la cápsula posterior posoperatoria por el diseño peculiar de su óptica y hápticos, que permiten un implante seguro, fácil y una incisión mínima. Se realizó un estudio prospectivo y descriptivo, cuyo universo de estudio fueron 28 ojos con diagnóstico de cataratas a los cuales se les realizó facoemulsificación con implante de lente intraocular Rayner 620 H, en el Centro de Microcirugía Ocular del Instituto Cubano de oftalmología "Ramón Pando Ferrer" en el período comprendido entre junio de 2006 a febrero de 2007. El grupo de edades donde se encontró el de mayor número de pacientes fue en el de más de 60 años. En todos los casos hubo un aumento significativo de la agudeza visual sin corrección y con ella, del preoperatorio al posoperatorio. Hubo un aumento del cilindro queratométrico del preoperatorio al posoperatorio, pero este fue mínimo La pérdida de células endoteliales fue baja del preoperatorio al posoperatorio, respectivamente. No hubo ninguna complicación durante la cirugía ni después de esta. Evaluamos como satisfactoria la efectividad del lente intraocular Rayner 620 H, por el aumento de la agudeza visual del paciente, el bajo astigmatismo inducido, mejoría del campo visual por confrontación, mínima pérdida de células endoteliales, y ausencia de complicaciones y de deslumbramiento posoperatorio en los pacientes.An important link in the advances made by the

Plasma surface modification of rigid contact lenses decreases bacterial adhesion.

Science.gov (United States)

Wang, Yingming; Qian, Xuefeng; Zhang, Xiaofeng; Xia, Wei; Zhong, Lei; Sun, Zhengtai; Xia, Jing

2013-11-01

Contact lens safety is an important topic in clinical studies. Corneal infections usually occur because of the use of bacteria-carrying contact lenses. The current study investigated the impact of plasma surface modification on bacterial adherence to rigid contact lenses made of fluorosilicone acrylate materials. Boston XO and XO2 contact lenses were modified using plasma technology (XO-P and XO2-P groups). Untreated lenses were used as controls. Plasma-treated and control lenses were incubated in solutions containing Staphylococcus aureus or Pseudomonas aeruginosa. MTT colorimetry, colony-forming unit counting method, and scanning electron microscopy were used to measure bacterial adhesion. MTT colorimetry measurements showed that the optical density (OD) values of XO-P and XO2-P were significantly lower than those of XO and XO2, respectively, after incubation with S. aureus (P lenses and to the XO2-P versus XO2 lenses incubated with S. aureus (P lenses incubated with P. aeruginosa (P lenses. Plasma surface modification can significantly decrease bacterial adhesion to fluorosilicone acrylate contact lenses. This study provides important evidence of a unique benefit of plasma technology in contact lens surface modification.

Intraocular pressure in very low birth weight preterm infants and its association with postconceptional age

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Rodrigo L. Lindenmeyer

2012-11-01

Full Text Available OBJECTIVE: To evaluate intraocular pressure in very low birth weight preterm infants and correlate it with postconceptional age. METHODS: The intraocular pressure in a prospective cohort of very low birth weight premature infants (defined as a birth weight <1,500 g and gestational age <32 weeks admitted to Hospital de Clínicas de Porto Alegre , Brazil was evaluated weekly. The evaluated outcome was the variation in the intraocular pressure following changes in the postconceptional age (defined as the gestational age at birth plus the age in weeks at the time of examination in the weeks following preterm birth. Mixed-effects models were used for the statistical analysis to determine the intraocular pressure variation according to postconceptional age, and means and 10th and 90th percentiles were calculated for the intraocular pressure values. RESULTS: Fifty preterm infants with a mean gestational age of 29.7 ± 1.6 weeks and a mean birth weight of 1,127.7 ± 222.7 g were evaluated. The mean intraocular pressure for the entire cohort considering both eyes was 14.9 ± 4.5 mmHg, and 13.5% of all recorded intraocular pressure values were greater than 20 mmHg. The analysis revealed a mean reduction in the intraocular pressure of 0.29 mmHg for each increase in postconceptional age (p = 0.047; 95% CI: -0.58 to -0.0035. The mean intraocular pressure (P10-P90 decreased from 16.3 mmHg (10.5222.16 at 26.3 weeks to 13.1 mmHg (7.28-18.92 at 37.6 weeks of postconceptional age. CONCLUSIONS: The mean intraocular pressure in very low birth weight preterm infants was 14.9 ± 4.5 mmHg. This value decreased 0.29 mmHg per week as the postconceptional age increased.

Intraocular manifestations of mycobacterium tuberculosis: A review of the literature

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Lauren A. Dalvin

2017-05-01

Full Text Available Mycobacterium tuberculosis: is most commonly associated with pulmonary infection. However, tuberculosis (TB can also affect the eye. TB can affect nearly any tissue in the eye, and a high index of suspicion is required for accurate diagnosis, as many of the intraocular manifestations of TB can mimic other, more common diseases. Correct diagnosis is critical because systemic anti-tuberculosis treatment may be required, and vision loss or even loss of the affected eye can occur without proper treatment. Thus, it is important for ophthalmologists and infectious disease specialists to work together to accurately diagnose and treat intraocular TB. This article reports the various known presentations of intraocular TB and reviews important elements of diagnosis and treatment. Keywords: Mycobacterium, Tuberculosis, Choroidal granuloma, Retinal vasculitis

Epithelial Downgrowth after Intraocular Surgery Treated with Intracameral 5-Fluorouracil

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Nina Ni

2015-01-01

Full Text Available Purpose. To present the clinical and histopathologic correlation of two cases of epithelial downgrowth (EDG after prior intraocular surgery. Methods. Observational case reports. Results. We present two cases of EDG occurring after intraocular surgery. In both cases, after two anterior chamber injections of 5-fluorouracil (5FU, the area of EDG initially regressed. In Case 1, a limited area of EDG eventually recurred, and penetrating keratoplasty with cryotherapy was curative. In Case 2, subsequent corneal edema required Descemet-stripping automated endothelial keratoplasty, and the patient remained clinically free of EDG without further treatment. Conclusion. Intracameral 5FU may have a role in the treatment of EDG after intraocular surgery, though its precise utilization and impact remain to be defined.

Multifocal fibrosing thyroiditis: report of 55 cases of a poorly recognized entity.

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Fellegara, Giovanni; Rosai, Juan

2015-03-01

During the course of our consultation activity, we have recognized a peculiar form of thyroiditis in which multiple foci of fibrosis, most of which were associated with reactive atypia of the surrounding follicles, are present. We have referred to this condition, both in our consultation reports and in the third series of A.F.I.P. Fascicle on Tumors of the Thyroid Gland, as "multifocal fibrosing thyroiditis" or (less frequently) "multifocal sclerosing thyroiditis," which are descriptive terms that highlight the benign/inflammatory nature of the process, its multiplicity, and its unknown pathogenesis. The aim of this study is to better define the morphologic features of this process and correlate it with some clinical data. With this purpose, the consultation files of one of the authors (J.R.) were searched for cases coded as multifocal fibrosing thyroiditis or multifocal sclerosing thyroiditis in a 20-year period ranging from January 1989 to December 2009. A total of 55 cases were identified that displayed the above-listed features. There were 51 (93%) female and 4 (7%) male patients (F/M=12.75), with ages ranging between 15 and 71 years (mean age, 47.03 y; median age, 44.5 y). Microscopically, multiple foci of fibrosis were identified in all cases, their number ranging from 2 to 51 per case (mean number, 16), with a mean diameter of 3 mm (range: 0.36 to 15.1 mm). Although heterogenous in shape and size, the individual foci were rather similar to each other in composition, being characterized by a fibrotic poorly cellular center that merged with a cellular peripheral zone. Some of the follicular structures present at the periphery of the scar and-to a lesser extent-those entrapped inside it underwent complex reactive and regenerative (atypical) changes that simulated malignancy. We discuss the differential diagnosis with other benign and malignant thyroid conditions and speculate about its pathogenesis and possible relationship with papillary thyroid microcarcinoma.

Comparison between intraocular pressure spikes with water loading and postural change.

Science.gov (United States)

Chong, Calum Wk; Wang, Sarah B; Jain, Neeranjali S; Bank, Cassandra S; Singh, Ravjit; Bank, Allan; Francis, Ian C; Agar, Ashish

2016-12-01

To compare the agreement between peak intraocular pressures measured through the water drinking test and the supine test, in patients with primary open angle glaucoma. Consecutive, prospective, blinded. Twenty-one patients from the Glaucoma Unit, Prince of Wales Hospital, Sydney, Australia. For the supine test, intraocular pressure was recorded immediately after the patient had lain down and at 20 and 40 min. At the second evaluation, intraocular pressure was measured in each patient after drinking 10 mL/kg body weight of water for the water drinking test. Again, all patients had their intraocular pressure measured at 20 and 40 min (t = 20 and t = 40, respectively). Patients were excluded from the study if they had pre-existing cardiac, renal or pulmonary complications or had concurrent ocular disease or an anatomical abnormality (including angle recession, peripheral anterior synechiae and developmental anomalies of the angle) that may have influenced intraocular pressure. Bland-Altman analysis. Bland-Altman analysis indicated an overall excellent agreement in terms of mean difference between methods (1.0, -1.0 and -0.90 mmHg, at 0, 20 and 40 min, respectively). Further, with the exception of t = 40, all measured time points had 95% confidence intervals within 6.5 mmHg of their mean difference on the Bland-Altman plot. There was close agreement between the intraocular pressure values of the supine test and water drinking test. However, as the water drinking test may be uncomfortable and potentially hazardous, there is potential that the supine test may be a safer and more comfortable alternative. © 2016 Royal Australian and New Zealand College of Ophthalmologists.

Predicting gravitational lensing by stellar remnants

Science.gov (United States)

Harding, Alexander J.; Stefano, R. Di; Lépine, S.; Urama, J.; Pham, D.; Baker, C.

2018-03-01

Gravitational lensing provides a means to measure mass that does not rely on detecting and analysing light from the lens itself. Compact objects are ideal gravitational lenses, because they have relatively large masses and are dim. In this paper, we describe the prospects for predicting lensing events generated by the local population of compact objects, consisting of 250 neutron stars, five black holes, and ≈35 000 white dwarfs. By focusing on a population of nearby compact objects with measured proper motions and known distances from us, we can measure their masses by studying the characteristics of any lensing event they generate. Here, we concentrate on shifts in the position of a background source due to lensing by a foreground compact object. With Hubble Space Telescope, JWST, and Gaia, measurable centroid shifts caused by lensing are relatively frequent occurrences. We find that 30-50 detectable events per decade are expected for white dwarfs. Because relatively few neutron stars and black holes have measured distances and proper motions, it is more difficult to compute realistic rates for them. However, we show that at least one isolated neutron star has likely produced detectable events during the past several decades. This work is particularly relevant to the upcoming data releases by the Gaia mission and also to data that will be collected by JWST. Monitoring predicted microlensing events will not only help to determine the masses of compact objects, but will also potentially discover dim companions to these stellar remnants, including orbiting exoplanets.

Exploring the methods of data analysis in multifocal visual evoked potentials

DEFF Research Database (Denmark)

Malmqvist, Lasse; Santiago de Abreu, Lucimar; Fraser, C.

2016-01-01

Purpose: The multifocal visual evoked potential (mfVEP) provides a topographical assessment of visual function, which has already shown potential for use in patients with glaucoma and multiple sclerosis. However, the variability in mfVEP measurements has limited its broader application. The purpo...

Factors influencing bacterial adhesion to contact lenses

OpenAIRE

Dutta, Debarun; Cole, Nerida; Willcox, Mark

2012-01-01

The process of any contact lens related keratitis generally starts with the adhesion of opportunistic pathogens to contact lens surface. This article focuses on identifying the factors which have been reported to affect bacterial adhesion to contact lenses. Adhesion to lenses differs between various genera/species/strains of bacteria. Pseudomonas aeruginosa, which is the predominant causative organism, adheres in the highest numbers to both hydrogel and silicone hydrogel lenses in vitro. The ...

Lensing reconstruction from a patchwork of polarization maps

International Nuclear Information System (INIS)

Namikawa, Toshiya; Nagata, Ryo

2014-01-01

The lensing signals involved in CMB polarization maps have already been measured with ground-based experiments such as SPTpol and POLARBEAR, and would become important as a probe of cosmological and astrophysical issues in the near future. Sizes of polarization maps from ground-based experiments are, however, limited by contamination of long wavelength modes of observational noise. To further extract the lensing signals, we explore feasibility of measuring lensing signals from a collection of small sky maps each of which is observed separately by a ground-based large telescope, i.e., lensing reconstruction from a patchwork map of large sky coverage organized from small sky patches. We show that, although the B-mode power spectrum obtained from the patchwork map is biased due to baseline uncertainty, bias on the lensing potential would be negligible if the B-mode on scales larger than the blowup scale of 1/f noise is removed in the lensing reconstruction. As examples of cosmological applications, we also show 1) the cross-correlations between the reconstructed lensing potential and full-sky temperature/polarization maps from satellite missions such as PLANCK and LiteBIRD, and 2) the use of the reconstructed potential for delensing B-mode polarization of LiteBIRD observation

A new device to noninvasively estimate the intraocular pressure produced during ocular compression

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Korenfeld MS

2016-01-01

Full Text Available Michael S Korenfeld,1,2 David K Dueker3 1Comprehensive Eye Care, Ltd., 2Department of Ophthalmology and Visual Sciences, Washington University, Washington, MO, USA; 3Hamad Medical Corporation, Doha, Qatar Purpose: To describe a noninvasive instrument that estimates intraocular pressure during episodes of external globe compression and to demonstrate the accuracy and reliability of this device by comparing it to the intraocular pressures simultaneously and manometrically measured in cannulated eyes. Methods: A thin fluid-filled bladder was constructed from flexible and inelastic plastic sheeting and was connected to a pressure transducer with high pressure tubing. The output of the pressure transducer was sent to an amplifier and recorded. This device was validated by measuring induced pressure in the fluid-filled bladder while digital pressure was applied to one surface, and the other surface was placed directly against a human cadaver eye or in vivo pig eye. The human cadaver and in vivo pig eyes were each cannulated to provide a manometric intraocular pressure control. Results: The measurements obtained with the newly described device were within ~5% of simultaneously measured manometric intraocular pressures in both a human cadaver and in vivo pig eye model for a pressure range of ~15–100 mmHg. Conclusion: This novel noninvasive device is useful for estimating the intraocular pressure transients induced during any form of external globe compression; this is a clinical setting where no other devices can be used to estimate intraocular pressure. Keywords: glaucoma, intraocular pressure, tonometer, ocular compression

Pigment dispersion and chronic intraocular pressure elevation after sulcus placement of 3-piece acrylic intraocular lens.

Science.gov (United States)

Almond, M Camille; Wu, Michael C; Chen, Philip P

2009-12-01

A 55-year-old man had phacoemulsification and implantation of a 3-piece acrylic intraocular lens (IOL) (AcrySof MA60AC) in the right eye. One month postoperatively, the intraocular pressure (IOP) was 48 mm Hg and peripheral transillumination defects were noted in the iris circumferentially, with the IOL optic edge visible as a silhouette. Gonioscopy showed dense pigmentation of the trabecular meshwork in the right eye, but in the left eye, only mild trabecular meshwork pigment was seen, along with a concave peripheral iris insertion. At 21 months, the right eye required 3 medications for IOP control. While pigment dispersion has been widely reported after placement of 1-piece acrylic IOLs in the ciliary sulcus, we conclude that in susceptible individuals with a concave peripheral iris insertion, pigment dispersion can occur with sulcus placement of a 3-piece acrylic model despite its thinner optic and angulated haptics.

Precision cosmology with weak gravitational lensing

Science.gov (United States)

Hearin, Andrew P.

In recent years, cosmological science has developed a highly predictive model for the universe on large scales that is in quantitative agreement with a wide range of astronomical observations. While the number and diversity of successes of this model provide great confidence that our general picture of cosmology is correct, numerous puzzles remain. In this dissertation, I analyze the potential of planned and near future galaxy surveys to provide new understanding of several unanswered questions in cosmology, and address some of the leading challenges to this observational program. In particular, I study an emerging technique called cosmic shear, the weak gravitational lensing produced by large scale structure. I focus on developing strategies to optimally use the cosmic shear signal observed in galaxy imaging surveys to uncover the physics of dark energy and the early universe. In chapter 1 I give an overview of a few unsolved mysteries in cosmology and I motivate weak lensing as a cosmological probe. I discuss the use of weak lensing as a test of general relativity in chapter 2 and assess the threat to such tests presented by our uncertainty in the physics of galaxy formation. Interpreting the cosmic shear signal requires knowledge of the redshift distribution of the lensed galaxies. This redshift distribution will be significantly uncertain since it must be determined photometrically. In chapter 3 I investigate the influence of photometric redshift errors on our ability to constrain dark energy models with weak lensing. The ability to study dark energy with cosmic shear is also limited by the imprecision in our understanding of the physics of gravitational collapse. In chapter 4 I present the stringent calibration requirements on this source of uncertainty. I study the potential of weak lensing to resolve a debate over a long-standing anomaly in CMB measurements in chapter 5. Finally, in chapter 6 I summarize my findings and conclude with a brief discussion of my

Upper Extremity Multifocal Neuropathy in a 10-Year-Old Boy Associated With NS6S Disaccharide Antibodies.

Science.gov (United States)

Edelman, Frederick; Naddaf, Elie; Waclawik, Andrew J

2015-06-01

We present a 10-year-old boy with a predominantly motor multifocal neuropathy with demyelinating and axonal changes with sensory involvement, affecting only one upper extremity. Laboratory studies revealed an elevated titer of immunoglobulin M (IgM) antibodies against the NS6S antigen. He responded to treatment with high dose intravenous immunoglobulins. Focal or multifocal immune-mediated neuropathies are not common in children and may be underdiagnosed. © The Author(s) 2014.

Posterior Segment Intraocular Foreign Body: Extraction Surgical Techniques, Timing, and Indications for Vitrectomy

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Dante A. Guevara-Villarreal

2016-01-01

Full Text Available Ocular penetrating injury with Intraocular Foreign Body (IOFB is a common form of ocular injury. Several techniques to remove IOFB have been reported by different authors. The aim of this publication is to review different timing and surgical techniques related to the extraction of IOFB. Material and Methods. A PubMed search on “Extraction of Intraocular Foreign Body,” “Timing for Surgery Intraocular Foreign Body,” and “Surgical Technique Intraocular Foreign Body” was made. Results. Potential advantages of immediate and delayed IOFB removal have been reported with different results. Several techniques to remove IOFB have been reported by different authors with good results. Conclusion. The most important factor at the time to perform IOFB extraction is the experience of the surgeon.

Bacillus cereus panophthalmitis associated with intraocular gas bubble.

Science.gov (United States)

al-Hemidan, A; Byrne-Rhodes, K A; Tabbara, K F

1989-01-01

It has become increasingly apparent that Bacillus cereus can cause a severe and devastating form of endophthalmitis following penetrating trauma by a metallic object. B. cereus is an uncommon aetiological agent in non-clostridial gas-forming infections. The patient studied in this single case report showed evidence of intraocular gas mimicking gas gangrene infection. The physiology of non-clostridial bacteria producing gas from anaerobic metabolic conditions is reviewed. Further intraocular and systemic complications which may be avoided by accurate and early diagnosis and the use of recommended treatment with antibiotics such as clindamycin. Images PMID:2493262

Planck 2015 results: XV. Gravitational lensing

DEFF Research Database (Denmark)

Ade, P. A R; Aghanim, N.; Arnaud, M.

2016-01-01

We present the most significant measurement of the cosmic microwave background (CMB) lensing potential to date (at a level of 40σ), using temperature and polarization data from the Planck 2015 full-mission release. Using a polarization-only estimator, we detect lensing at a significance of 5σ. We...

Bacterial adhesion to unworn and worn silicone hydrogel lenses.

Science.gov (United States)

Vijay, Ajay Kumar; Zhu, Hua; Ozkan, Jerome; Wu, Duojia; Masoudi, Simin; Bandara, Rani; Borazjani, Roya N; Willcox, Mark D P

2012-08-01

The objective of this study was to determine the bacterial adhesion to various silicone hydrogel lens materials and to determine whether lens wear modulated adhesion. Bacterial adhesion (total and viable cells) of Staphylococcus aureus (31, 38, and ATCC 6538) and Pseudomonas aeruginosa (6294, 6206, and GSU-3) to 10 commercially available different unworn and worn silicone hydrogel lenses was measured. Results of adhesion were correlated to polymer and surface properties of contact lenses. S. aureus adhesion to unworn lenses ranged from 2.8 × 10 to 4.4 × 10 colony forming units per lens. The highest adhesion was to lotrafilcon A lenses, and the lowest adhesion was to asmofilcon A lenses. P. aeruginosa adhesion to unworn lenses ranged from 8.9 × 10 to 3.2 × 10 colony forming units per lens. The highest adhesion was to comfilcon A lenses, and the lowest adhesion was to asmofilcon A and balafilcon A lenses. Lens wear altered bacterial adhesion, but the effect was specific to lens and strain type. Adhesion of bacteria, regardless of genera/species or lens wear, was generally correlated with the hydrophobicity of the lens; the less hydrophobic the lens surface, the greater the adhesion. P. aeruginosa adhered in higher numbers to lenses in comparison with S. aureus strains, regardless of the lens type or lens wear. The effect of lens wear was specific to strain and lens. Hydrophobicity of the silicone hydrogel lens surface influenced the adhesion of bacterial cells.

Fimbrolide-coated antimicrobial lenses: their in vitro and in vivo effects.

Science.gov (United States)

Zhu, Hua; Kumar, Ajay; Ozkan, Jerome; Bandara, Rani; Ding, Aidong; Perera, Indrani; Steinberg, Peter; Kumar, Naresh; Lao, William; Griesser, Stefani S; Britcher, Leanne; Griesser, Hans J; Willcox, Mark D P

2008-05-01

To examine the ability of contact lenses coated with fimbrolides, inhibitors of bacterial quorum sensing, to prevent microbial adhesion and their safety during short-term clinical assessment. A fimbrolide was covalently attached to commercially available high Dk contact lenses. Subsequently Pseudomonas aeruginosa, Staphylococcus aureus, Serratia marcescens, or Acanthamoeba sp. were added to the lenses and control uncoated contact lenses. Lenses plus microbes were incubated for 24 h, then washed thoroughly to remove non-adherent microbes. Lenses were macerated and resulting slurry plated onto agar plates. After appropriate incubation, the numbers of colony forming units of bacteria (or numbers of Acanthamoeba trophozoites measured using a hemocytometer) from fimbrolide-coated and uncoated lenses were examined. A Guinea Pig model of lens wear was used to assess the safety of lenses worn on a continuous basis for 1 month. In a separate study, 10 subjects wore fimbrolide-coated lenses for 24 h. The responses of the Guinea Pigs and human volunteers to the lenses were assessed by slit lamp examination. The fimbrolides-coated lenses reduced the adhesion of all bacterial strains tested, with reductions occurring of between 67 and 92%. For Acanthamoeba a reduction of 70% was seen. There were no significant differences in ocular responses to fimbrolide-coated lenses compared with controls in either the 1 month animal model or overnight human trial. Fimbrolide-coated lenses show promise as an antibacterial and anti-acanthamoebal coating on contact lenses and appear to be safe when worn on the eye in an animal model.