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  1. [Intraocular neovascularization].

    PubMed

    Inomata, H; Ishibashi, T; Murata, T; Iwasaki, M; Tahara, A; Hata, K; Yoshida, A; Yoshida, S; Onishi, Y; Murakami, M; Yamamoto, M; Kubota, T; Kawano, Y; Sugai, S; Sakamoto, T; Okada, T; Ishimoto, S; Fujisawa, K; Honda, T; Sakamoto, M; Shigefuji, M; Tsuji, I; Nishioka, K; Ueno, A; Nagatomi, Y

    1997-12-01

    To investigate the mechanism of intraocular neovascularization, we studied how vascular endothelial growth factor (VEGF) and interleukin-8 (IL-8) are expressed in the ocular tissues under hypoxic conditions. Prior to proliferation of vascular endothelial cells resulting in neovascularization, the retinal tissues such as pericytes, retinal glial cells, ganglion cells, and ciliary epithelium react directly to hypoxia expressing VEGF and/or IL-8 and stimulate endothelial cell proliferation in a paracrine manner. We demonstrated that transcription factor activator protein-1 (AP-1) is activated for expression of VEGF messenger ribonuculeic acid (mRNA) and in a similar way nuclear factor kappa B (NF-kappa B) is activated for expression of IL-8 mRNA. However, hypoxia-induced expression of VEGF and/ or IL-8 is only one aspect of the complicated processes in intraocular neovascularization. We hope that further detailed analysis of the mechanism will make it possible to inhibit and treat clinically intraocular neovascularization in the near future. PMID:9436356

  2. Phakic Intraocular Lenses

    MedlinePlus

    ... Implants and Prosthetics Phakic Intraocular Lenses Phakic Intraocular Lenses Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Phakic intraocular lenses are new devices used to correct nearsightedness. These ...

  3. Intraocular radiation blocking

    SciTech Connect

    Finger, P.T.; Ho, T.K.; Fastenberg, D.M.; Hyman, R.A.; Stroh, E.M.; Packer, S.; Perry, H.D. )

    1990-09-01

    Iodine-based liquid radiographic contrast agents were placed in normal and tumor-bearing (Greene strain) rabbit eyes to evaluate their ability to block iodine-125 radiation. This experiment required the procedures of tumor implantation, vitrectomy, air-fluid exchange, and 125I plaque and thermoluminescent dosimetry (TLD) chip implantation. The authors quantified the amount of radiation attenuation provided by intraocularly placed contrast agents with in vivo dosimetry. After intraocular insertion of a blocking agent or sham blocker (saline) insertion, episcleral 125I plaques were placed across the eye from episcleral TLD dosimeters. This showed that radiation attenuation occurred after blocker insertion compared with the saline controls. Then computed tomographic imaging techniques were used to describe the relatively rapid transit time of the aqueous-based iohexol compared with the slow transit time of the oil-like iophendylate. Lastly, seven nontumor-bearing eyes were primarily examined for blocking agent-related ocular toxicity. Although it was noted that iophendylate induced intraocular inflammation and retinal degeneration, all iohexol-treated eyes were similar to the control eyes at 7 and 31 days of follow-up. Although our study suggests that intraocular radiopaque materials can be used to shield normal ocular structures during 125I plaque irradiation, a mechanism to keep these materials from exiting the eye must be devised before clinical application.

  4. Intraocular lens fabrication

    DOEpatents

    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.

  5. Intraocular lens fabrication

    DOEpatents

    Salazar, Mike A.; Foreman, Larry R.

    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.

  6. Laser therapy in intraocular tumors

    NASA Astrophysics Data System (ADS)

    Carstocea, Benone D.; Gafencu, Otilia L.; Apostol, Silvia

    1995-01-01

    Intraocular tumors present special problems of diagnosis and treatment. Diagnostic methods include, in addition to systemic and ophthalmological examinations, ancillary examinations such as transillumination, fluorescein angiography, ultrasonography, radioactive phosphorus uptake test, radiology, computerized tomography, and fine-needle aspiration biopsy with cytological analyses. Previously, enucleation of the involved eye was generally accepted as management of malignant tumors. Improved therapeutic methods such as photocoagulation and better surgical techniques now provide a variety of therapeutical alternatives. This study consists of 21 cases of intraocular tumors that were managed by Argon laser photocoagulation. Four cases were intraocular metastasis and 17 cases were primitive intraocular tumors. Argon laser therapy proved to be totally ineffective for the intraocular metastasis and a very adequate therapy for the primitive tumors. Tumor extirpations (choroidal, cillary body, or iris tumors) using laser lancet proved to be more suitable than classic surgery.

  7. Intraocular pressure reduction and regulation system

    NASA Technical Reports Server (NTRS)

    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.

  8. [Phakic intraocular lenses].

    PubMed

    Kohnen, T; Shajari, M

    2016-06-01

    Refractive surgical procedures are generally divided into additive procedures with, e. g. implantation of an artificial lens and subtractive procedures with ablation of corneal tissue. In this article the current status of phakic intraocular lens (IOL) implantation for correction of refractive errors is reviewed. Phakic IOLs are constructed as angle-supported or iris-fixated anterior chamber lenses and sulcus-fixated posterior chamber lenses. The implantation of phakic IOLs has been demonstrated to be an effective, safe, predictable and stable procedure to correct higher refractive errors. Complications are rare and depend to a large extent on the location. For anterior chamber lenses the main concern is critical endothelial cell loss and for posterior chamber lenses early cataract formation. PMID:27277751

  9. Intraocular pressure reduction and regulation

    NASA Technical Reports Server (NTRS)

    Baehr, E. F.; Mcgannon, W. J.

    1979-01-01

    System designed to reduce intraocular pressure hydraulically to any level desired by physician over set time and in controlled manner has number of uses in ophthalmology. Device may be most immediately useful in treatment of glaucoma.

  10. General Information about Intraocular (Uveal) Melanoma

    MedlinePlus

    ... Intraocular (Uveal) Melanoma Treatment (PDQ®)–Patient Version General Information About Intraocular (Uveal) Melanoma Go to Health Professional ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  11. 21 CFR 886.4270 - Intraocular gas.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Intraocular gas. 886.4270 Section 886.4270 Food... 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...

  12. 21 CFR 886.4270 - Intraocular gas.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Intraocular gas. 886.4270 Section 886.4270 Food... 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...

  13. 21 CFR 886.3600 - Intraocular lens.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Intraocular lens. 886.3600 Section 886.3600 Food... 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...

  14. 21 CFR 886.3600 - Intraocular lens.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Intraocular lens. 886.3600 Section 886.3600 Food... 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...

  15. 21 CFR 886.3600 - Intraocular lens.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Intraocular lens. 886.3600 Section 886.3600 Food... 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...

  16. 21 CFR 886.3600 - Intraocular lens.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Intraocular lens. 886.3600 Section 886.3600 Food... 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...

  17. 21 CFR 886.3600 - Intraocular lens.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Intraocular lens. 886.3600 Section 886.3600 Food... 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...

  18. 21 CFR 886.4270 - Intraocular gas.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Intraocular gas. 886.4270 Section 886.4270 Food... 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...

  19. 21 CFR 886.4275 - Intraocular fluid.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Intraocular fluid. 886.4275 Section 886.4275 Food... 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...

  20. 21 CFR 886.4275 - Intraocular fluid.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Intraocular fluid. 886.4275 Section 886.4275 Food... 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...

  1. 21 CFR 886.4275 - Intraocular fluid.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Intraocular fluid. 886.4275 Section 886.4275 Food... 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...

  2. 21 CFR 886.4275 - Intraocular fluid.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Intraocular fluid. 886.4275 Section 886.4275 Food... 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...

  3. 21 CFR 886.4275 - Intraocular fluid.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Intraocular fluid. 886.4275 Section 886.4275 Food... 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...

  4. 21 CFR 886.4270 - Intraocular gas.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Intraocular gas. 886.4270 Section 886.4270 Food... 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...

  5. 21 CFR 886.4270 - Intraocular gas.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Intraocular gas. 886.4270 Section 886.4270 Food... 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...

  6. The Fyodorov Sputnik intraocular lens.

    PubMed

    Kwitko, M L

    1979-04-01

    The author has implanted 197 Fyodorov intraocular lenses. With careful selection of patients, good surgical judgment, and meticulous surgery, a degree of success can be obtained with this lens, which will equal that of conventional cataract surgery. The surgical technique of implantation will be described. PMID:537770

  7. [Special intra-ocular lenses].

    PubMed

    Jacobi, K W; Nowak, M R; Strobel, J

    1990-01-01

    Intraocular lens (IOL) implantation is the method established worldwide for visual rehabilitation following cataract surgery. IOL's with particular characteristics and/or for special purposes are available for clinical or experimental use. Bifocal and multifocal IOLs have two or more foci for simultaneous far and near vision. The first clinical results are promising. The theoretically expected disadvantages, i.e., reduced contrast sensitivity or reduced visual acuity under reduced contrast conditions, have not yet been found in clinical studies. In cases of age-related macular degeneration, IOLs with a high negative diopter power in the center can be implanted as part of a Galilei telescope. By using high-plus power spectacles, a 2.5x to 4x magnification and a wide field of view can be achieved. Clinical investigation has started recently. Intraocular lenses for the correction of high-grade myopia are being tested by some surgeons. These lenses are made to be implanted in phakic eyes with a clear crystalline lens. Angle-supported and iris-fixated types are under investigation. Longterm results will show the clinical efficacy and safety. Other special intraocular lenses are iris-color lenses and a polymethymethacrylate (PMMA) iris diaphragm. PMID:2083909

  8. Pupillary block glaucoma following intraocular lens implantation.

    PubMed

    Kielar, R A; Stambaugh, J L

    1982-08-01

    Seven cases of pupillary block granuloma occurred in a series of 665 consecutive cases of cataract extraction with insertion of an iris supported intraocular lens, an overall incidence of 1%. The incidence with an iris plane lens was 1.7%, and for all other styles used the incidence was 0.3%. Common factors noted were iris plane intraocular lens and early postoperative complications predisposing to pupillary block. In four of the seven cases, there was a period of normal intraocular pressure followed by elevated intraocular tension with a deep central anterior chamber two weeks to fifteen months following cataract extraction, with subsequent development of corneal edema and typical shallowing of the anterior chamber with iris bombe. Five of seven cases ultimately regained control of intraocular pressure although extensive peripheral anterior synechia were present. No patient ultimately had a visual acuity better than 20/50. PMID:7133608

  9. Transillumination imaging of intraocular tumours.

    PubMed

    Kjersem, Bård; Krohn, Jørgen

    2013-06-01

    The purpose of this paper is to discuss a recently described modification of a standard photo slit lamp system for ocular transillumination, with special emphasis on the light transmission through the eye wall and the photographic technique. Transillumination photography was carried out with the Haag-Streit Photo-Slit Lamp BX 900 (Haag-Streit AG, Koeniz, Switzerland). After having released the background lighting optic fibre cable from its holder, the patient was positioned at the slit lamp, and the fibre tip was gently pressed against the sclera or the cornea of the patient's eye. During about 1/1000 of a second, the eye was illuminated by the flash and the scleral shadow of the tumour was exposed to the camera sensor. The images were of good diagnostic quality, making it easy to outline the tumours and to evaluate the involvement of intraocular structures. None of the examined patients experienced discomfort or negative side effects. The method is recommended in cases where photographic transillumination documentation of intraocular pathologies is considered important. PMID:23641762

  10. IRIS: Integrated Robotic Intraocular Snake*

    PubMed Central

    He, Xingchi; van Geirt, Vincent; Gehlbach, Peter; Taylor, Russell; Iordachita, Iulian

    2015-01-01

    Retinal surgery is one of the most technically challenging surgical disciplines. Many robotic systems have been developed to enhance the surgical capabilities. However, very few of them provide the surgeon the dexterity within the patient’s eye to enable more flexible, more advanced surgical procedures. This paper presents a sub-millimeter intraocular dexterous robot, the Integrated Robotic Intraocular Snake (IRIS). The variable neutral-line mechanism is used to provide very high dexterity with a very small form factor. The IRIS distal dexterous unit is 0.9 mm in diameter and about 3 mm in length. It enables two rotational degrees of freedom at the distal end of the ophthalmic instruments. The analysis on contact mechanics provides a reference for the adjustment of the wire pretension. Redundant actuation is implemented by using one motor for each wire. A motion scaling transmission is developed to overcome the suboptimal resolution of the motors. A scale-up model of the IRIS is built for initial experimental evaluation. Preliminary results show that the scale-up IRIS can provide large range of motion. For given bending angle, the kinematic model can estimate the desired wire translation when the friction is not significant. The first prototype of the actual-scale IRIS is assembled and tested. PMID:26405561

  11. Cytomegalovirus retinitis mimicking intraocular lymphoma.

    PubMed

    Gooi, Patrick; Farmer, James; Hurley, Bernard; Brodbaker, Elliott

    2008-12-01

    We present a case of an unusual retinal infiltrate requiring retinal biopsy for definitive diagnosis. A 62-year-old man with treated lymphoma presented with decreased vision in the right eye associated with a white retinal lesion, which extended inferonasally from an edematous disc. Intraocular lymphoma was considered as a diagnosis; thus, the patient was managed with vitrectomy and retinal biopsy. Cytological analysis of the vitreous aspirate could not rule out a lymphoproliferative disorder. The microbial analysis was negative. Histology of the lesion showed extensive necrosis and large cells with prominent nucleoli. To rule out lymphoma, a battery of immunostains was performed and all were negative. However the limited amount of tissue was exhausted in the process. Subsequently, a hematoxylin and eosin (H/E) slide was destained, on which a CMV immunostain was performed. This revealed positivity in the nuclei and intranuclear inclusions within the large atypical cells. A diagnosis of CMV retinitis was made. Retinal biopsy may provide a definitive diagnosis and direct patient care toward intravenous gancyclovir in the case of CMV or toward radiation and chemotherapy for intraocular lymphoma. When faced with a limited amount of tissue, destaining regular H/E slides is a possible avenue to performing additional immunohistochemical studies. PMID:19668455

  12. Periocular migration of an intraocular lens.

    PubMed

    Jenkins, C

    1992-11-01

    A woman presented with a painful eye 6 weeks after cataract extraction and intraocular lens implantation. In the past she had had a sector iridectomy for iris bombé caused by chronic anterior uveitis. On examination the three central corneal sutures were absent, whilst the medial and lateral sutures had broken and were protruding from the section. The eye was quiet and the section intact. Combined clinical and ultrasound examination failed to locate the intraocular lens. Four months postoperatively, while being fitted for contact lenses for the correction of aphakia, the intraocular lens appeared from the superior fornix. PMID:1477048

  13. Pupillary block after intraocular lens implantation.

    PubMed

    Van Buskirk, E M

    1983-01-01

    Seventeen patients, ranging in age from 40 to 86 years, developed pupillary block detected one week to three years after intraocular lens implantation. Sixteen of the implants were anterior chamber intraocular lenses and one was a posterior chamber intraocular lens. Despite iris bombé that closed the anterior chamber angle, many cases were asymptomatic and were discovered fortuitously during routine postoperative examinations. Laser iridotomy or iridectomy eliminated the pupillary block in all 17 cases, but permanent synechial closure of a portion of the anterior chamber angle persisted in most cases and sometimes required medication or further surgery. One eye eventually lost all light perception. PMID:6849369

  14. Cataract surgery and intraocular pressure.

    PubMed

    Melancia, Diana; Abegão Pinto, Luis; Marques-Neves, Carlos

    2015-01-01

    Cataract surgery is one of the most performed surgeries in the developed world. In addition to its significant impact on visual acuity, phacoemulsification has been hailed as a potential intraocular pressure (IOP)-lowering procedure. While current evidence suggests an overall significant and sustained decrease in IOP to exist after cataract surgery, the specific ocular characteristics that could help predict which patients are likely to benefit from this IOP-lowering effect remain unclear. This definition is important in glaucoma patients if this surgery is to be used in the treatment for this disease. Our review aims to summarize the literature on the subject, depicting possible mechanisms behind this IOP decrease, which type of patients are more likely to benefit from this surgery for IOP-lowering purposes and ultimately help optimizing disease management for the increasing number of patients with concomitant glaucoma and cataract. PMID:25765255

  15. Cataract and keratoconus: minimizing complications in intraocular lens calculations.

    PubMed

    Bozorg, Sara; Pineda, Roberto

    2014-01-01

    Patients with both cataract and keratoconus present unique challenges for the surgeon. Accurate keratometry (K) and axial length (AL) readings may be impossible, and uncertainty is introduced when estimating the corneal power for intraocular lens (IOL) selection. Different options on how to choose an IOL and how to manage irregular astigmatism of a keratoconic patient with cataract have been proposed and are reviewed. The stage of keratoconus and the history of the patient are both critical in determining the strategy used in treatment of cataracts. PMID:25325863

  16. [Intraocular pressure measurement in children].

    PubMed

    Bresson-Dumont, H

    2009-03-01

    Intraocular pressure (IOP) measurement in children is often difficult to perform because younger children are non-compliant and resisting the examination. Normal IOP in children is not well established yet because in the studies reporting about IOP, the instruments used and clinical conditions have varied. Non contact tonometer often overestimates IOP in blinking children and is not always reliable. But all the others measurement techniques use contact (GAT, Perkins, Tono-Pen, ORA, RBT), and are not always suitable and easy-touse. Under general anaesthesia, mean IOP measured with Perkins applanation tonometer is under 8 mmHg before age of 3 months and under 12 mmHg between ages of 6 and 9 months. After, IOP shows an increasing trend with age of 1 mmHg per year up to 12 years. Some studies have proposed as normal pediatric IOP: To=0.71 x age (years) +10, up to age 10. Then, IOP tends to approach adult levels by 12 years of age. However pediatric glaucoma is rare: congenital glaucoma, before age of 3 years, autosomal dominant juvenile glaucoma, with family history of glaucoma and elevated IOP, or secondary glaucoma with special context. Thus, hypertony has to be confirmed by another measurement technique, correlated to central corneal thickness, and clinical examination (optic nerve head and visual field). PMID:19515328

  17. Biopsy techniques for intraocular tumors.

    PubMed

    Rishi, Pukhraj; Dhami, Abhinav; Biswas, Jyotirmay

    2016-06-01

    Biopsy involves the surgical removal of a tissue specimen for histopathologic evaluation. Most intraocular tumors are reliably diagnosed based on the clinical evaluation or with noninvasive diagnostic techniques. However, accurately diagnosing a small percentage of tumors can be challenging. A tissue biopsy is thus needed to establish a definitive diagnosis and plan the requisite treatment. From fine-needle aspiration biopsy (FNAB) to surgical excision, all tissue collection techniques have been studied in the literature. Each technique has its indications and limitations. FNAB has been reported to provide for 88-95% reliable and safe ophthalmic tumor diagnosis and has gained popularity for prognostic purposes and providing eye conserving treatment surgeries. The technique and instrumentation for biopsy vary depending upon the tissue involved (retina, choroid, subretinal space, vitreous, and aqueous), suspected diagnosis, size, location, associated retinal detachment, and clarity of the media. The cytopathologist confers a very important role in diagnosis and their assistance plays a key role in managing and planning the treatment for malignancies. PMID:27488148

  18. Surface Modification of Intraocular Lenses

    PubMed Central

    Huang, Qi; Cheng, George Pak-Man; Chiu, Kin; Wang, Gui-Qin

    2016-01-01

    Objective: This paper aimed to review the current literature on the surface modification of intraocular lenses (IOLs). Data Sources: All articles about surface modification of IOLs published up to 2015 were identified through a literature search on both PubMed and ScienceDirect. Study Selection: The articles on the surface modification of IOLs were included, but those on design modification and surface coating were excluded. Results: Technology of surface modification included plasma, ion beam, layer-by-layer self-assembly, ultraviolet radiation, and ozone. The main molecules introduced into IOLs surface were poly (ethylene glycol), polyhedral oligomeric silsesquioxane, 2-methacryloyloxyethyl phosphorylcholine, TiO2, heparin, F-heparin, titanium, titanium nitride, vinyl pyrrolidone, and inhibitors of cytokines. The surface modification either resulted in a more hydrophobic lens, a more hydrophilic lens, or a lens with a hydrophilic anterior and hydrophobic posterior surface. Advances in research regarding surface modification of IOLs had led to a better biocompatibility in both in vitro and animal experiments. Conclusion: The surface modification is an efficient, convenient, economic and promising method to improve the biocompatibility of IOLs. PMID:26830993

  19. Multifocal intraocular lenses and glare.

    PubMed

    Akutsu, H; Legge, G E; Luebker, A; Lindstrom, R L; Zabel, R W; Kirby, V M

    1993-06-01

    In a previous paper, we reported finding deficits in the contrast sensitivity functions of patients with diffractive multifocal intraocular lenses (IOL's). The results were consistent with optical measurements of the modulation transfer function (MTF) of the IOL. When this MTF is treated as a linear spatial frequency filter, it predicts the existence of a glare effect; contrast threshold for the recognition of target letters should be elevated by a bright, adjacent stimulus. We tested this prediction by measuring contrast thresholds for recognizing 0.2 degrees Sloan letters on a background luminance of 11.2 cd/m2. The letters were presented inside bright (300 cd/m2) annular rings with inner diameters ranging from 0.42 to 1.22 degrees. Thresholds were measured for seven multifocal subjects, age-matched groups of monofocal subjects and phakic-control subjects, and a young group. Multifocal subjects exhibited a greater glare effect than monofocal subjects, and they in turn exhibited a greater effect than phakic-control subjects. The observed glare effect for multifocal subjects was about twice that expected from the spatial filtering property of the multifocal IOL. PMID:8336911

  20. Biopsy techniques for intraocular tumors

    PubMed Central

    Rishi, Pukhraj; Dhami, Abhinav; Biswas, Jyotirmay

    2016-01-01

    Biopsy involves the surgical removal of a tissue specimen for histopathologic evaluation. Most intraocular tumors are reliably diagnosed based on the clinical evaluation or with noninvasive diagnostic techniques. However, accurately diagnosing a small percentage of tumors can be challenging. A tissue biopsy is thus needed to establish a definitive diagnosis and plan the requisite treatment. From fine-needle aspiration biopsy (FNAB) to surgical excision, all tissue collection techniques have been studied in the literature. Each technique has its indications and limitations. FNAB has been reported to provide for 88–95% reliable and safe ophthalmic tumor diagnosis and has gained popularity for prognostic purposes and providing eye conserving treatment surgeries. The technique and instrumentation for biopsy vary depending upon the tissue involved (retina, choroid, subretinal space, vitreous, and aqueous), suspected diagnosis, size, location, associated retinal detachment, and clarity of the media. The cytopathologist confers a very important role in diagnosis and their assistance plays a key role in managing and planning the treatment for malignancies. PMID:27488148

  1. [A morbidity study of intraocular foreign bodies].

    PubMed

    Mocanu, C; Bădescu, S

    1993-01-01

    190 patients presenting intraocular foreign bodies, hospitalized between 1981-1991, are examined. The study of accidents: cases showed a clear prevalence of work accidents--127 cases (66.84%); 86 of these cases occurred in industry (45.26%), the rest of 41 occurred in agriculture (21.58%). The professions most exposed to such accidents are those of locksmith, mechanic in agriculture or automobile industry. The postsurgical evolution and the incidence of complications show that intraocular foreign bodies are wosse-making factors of ocular plagues, because of anatomical structures disorganization, transparency modifications and infectious complications implied, which determined the diminishing of visual acuity in 88.08% of cases. The big percentage of work accidents in the etiology of intraocular foreign bodies emphasize the great importance of foreign the work-protection rules (regarding a especially the wearing of protection glasses) and of introducing of automation in technological processes involving great risks. PMID:8507606

  2. Commercial air travel after intraocular gas injection.

    PubMed

    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). PMID:22872998

  3. 21 CFR 886.4300 - Intraocular lens guide.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Intraocular lens guide. 886.4300 Section 886.4300...) 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...

  4. 21 CFR 886.4300 - Intraocular lens guide.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Intraocular lens guide. 886.4300 Section 886.4300...) 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...

  5. 21 CFR 886.4300 - Intraocular lens guide.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Intraocular lens guide. 886.4300 Section 886.4300...) 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...

  6. 21 CFR 886.4300 - Intraocular lens guide.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Intraocular lens guide. 886.4300 Section 886.4300...) 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...

  7. 21 CFR 886.4300 - Intraocular lens guide.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Intraocular lens guide. 886.4300 Section 886.4300...) 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...

  8. 21 CFR 886.4280 - Intraocular pressure measuring device.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Intraocular pressure measuring device. 886.4280... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4280 Intraocular pressure measuring device. (a) Identification. An intraocular pressure measuring device is a manual or AC-powered...

  9. 21 CFR 886.4280 - Intraocular pressure measuring device.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Intraocular pressure measuring device. 886.4280... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4280 Intraocular pressure measuring device. (a) Identification. An intraocular pressure measuring device is a manual or AC-powered...

  10. 21 CFR 886.4280 - Intraocular pressure measuring device.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Intraocular pressure measuring device. 886.4280... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4280 Intraocular pressure measuring device. (a) Identification. An intraocular pressure measuring device is a manual or AC-powered...

  11. 21 CFR 886.4280 - Intraocular pressure measuring device.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Intraocular pressure measuring device. 886.4280... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4280 Intraocular pressure measuring device. (a) Identification. An intraocular pressure measuring device is a manual or AC-powered...

  12. Importance of intraocular pressure in glaucoma

    NASA Astrophysics Data System (ADS)

    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.

  13. Infant Botulism and Raised Intraocular Pressure.

    PubMed

    Eberly, Matthew D; Uber, Ian; Kieling, Christopher R; Birdsong, Richard H

    2009-11-01

    Infant botulism is an exceedingly rare disease. Because confirmatory laboratory testing is not available for several days after time of presentation, infant botulism remains a clinical diagnosis. The authors demonstrate how raised intraocular pressure may provide an additional clinical clue to making the diagnosis. PMID:19873952

  14. Characterizing intraocular tumors with photoacoustic imaging

    NASA Astrophysics Data System (ADS)

    Xu, Guan; Xue, Yafang; Gursel, Zeynep; Slimani, Naziha; Wang, Xueding; Demirci, Hakan

    2016-03-01

    Intraocular tumors are life-threatening conditions. Long-term mortality from uveal melanoma, which accounts for 80% of primary intraocular tumors, could be as high as 25% depending on the size, ciliary body involvement and extraocular extension. The treatments of intraocular tumors include eye-sparing approaches such as radiotherapy and thermotherapy, and the more aggressive enucleation. The accurate diagnosis of intraocular tumors is thereby critical in the management and follow-up of the patients. The diagnosis of intraocular tumors is usually based on clinical examination with acoustic backscattering based ultrasonography. By analyzing the high frequency fluctuations within the ultrasound (US) signals, microarchitecture information inside the tumor can be characterized. However, US cannot interrogate the histochemical components formulating the microarchitecture. One representative example is the inability of US imaging (and other contemporary imaging modalities as well) in differentiating nevoid and melanoma cells as the two types of cells possesses similar acoustic backscattering properties. Combining optical and US imaging, photoacoustic (PA) measurements encode both the microarchitecture and histochemical component information in biological tissue. This study attempts to characterize ocular tumors by analyzing the high frequency signal components in the multispectral PA images. Ex vivo human eye globes with melanoma and retinoblastoma tumors were scanned using less than 6 mJ per square centimeters laser energy with tunable range of 600-1700 nm. A PA-US parallel imaging system with US probes CL15-7 and L22-14 were used to acquire the high frequency PA signals in real time. Preliminary results show that the proposed method can identify uveal melanoma against retinoblastoma tumors.

  15. Effect of hemodialysis on intraocular lens power calculation.

    PubMed

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

    2016-03-01

    Background To evaluate changes in ocular biometric parameters after hemodialysis (HD) in patients with end-stage renal disease (ESRD). Methods Forty eyes of 40 patients undergoing HD were included in this cross-sectional study. Keratometry (K) readings, white-to-white (WTW) distance, central corneal thickness (CCT), anterior chamber depth (ACD), pupil diameter, lens thickness (LT), axial length (AL), and intraocular lens (IOL) power calculation were measured with Lenstar LS 900 (Haag Streit AG, Koeniz, Switzerland) before and after hemodialysis. Intraocular pressure (IOP) was measured with a non-contact tonometer (Tonopachy NT-530P, Nidek Co., LTD, Tokyo, Japan). Main outcomes were changes in biometric parameters after HD. Reliability of the measurements (intraclass correlation coefficients (ICCs)) and the effect size (Cohen's d) were also calculated. Results Mean difference in AL before and after HD was -0.041 ± 0.022 mm with ICCs > 0.90 (p < 0.001 and Cohen's d = 0.06). Pupil diameter was also significantly different before (4.28 ± 0.81 mm) and after (4.44 ± 0.79 mm) HD with ICCs > 0.90 (p = 0.041 and Cohen's d = 0.20). Hemodialysis had no significant effect on K readings, WTW distance, CCT, ACD, LT, or IOP. Conclusion Axial length and pupil diameter increase after HD with small effect size, while HD does not significantly affect IOL power calculations. PMID:26707804

  16. The Visual Effects of Intraocular Colored Filters

    PubMed Central

    Hammond, Billy R.

    2012-01-01

    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. PMID:24278692

  17. Introduction to the development of intraocular lens

    NASA Astrophysics Data System (ADS)

    Li, Yifan; Peng, Runling; Hu, Shuilan; Wei, Maowei; Chen, Jiabi

    2013-08-01

    In order to cure the cataract disease or injuries in eyes, intraocular lens(IOL) has been studied all the time to replace the crystalline lens in human eyes. Researches on IOL are started early from 19th century, and it develops greatly in the hundreds years after. This article introduces several main kinds of IOLs that appear in the development history of IOL, and raises the double-liquid zoom IOL based on electrowetting, which will be the trend of IOL study.

  18. Case report: intraocular gnathostomiasis in Vietnam.

    PubMed

    Xuan, Le Thi; Rojekittikhun, Wichit; Punpoowong, Benjanee; Trang, Le Nhu; Hien, Tran Vinh

    2002-09-01

    This is the report of the first case of intraocular gnathostomiasis diagnosed in Vietnam. The disease progressed in two months in two distinct phases: in the first phase, the patient had swellings, which appeared at different times and in different locations, on his face--this phase lasted around one month; the second phase was the embedding of the parasite in the vitreous cavity of the right eye and uveitis. Surgical extraction of a living Gnathostoma larva was carried out. Based on morphological, histological criteria, the larva may have been an atypical third-stage of Gnathostoma spinigerum. PMID:12693580

  19. On the retinal toxicity of intraocular glucocorticoids.

    PubMed

    Torriglia, Alicia; Valamanesh, Fatemeh; Behar-Cohen, Francine

    2010-12-15

    Corticosteroids are hormones involved in many physiological responses such as stress, immune modulation, protein catabolism and water homeostasis. The subfamily of glucocorticoids is used systemically in the treatment of inflammatory diseases or allergic reactions. In the eye, glucocorticoides are used to treat macular edema, inflammation and neovascularization. The most commonly used glucocorticoid is triamcinolone acetonide (TA). The pharmaceutical formulation of TA is not adapted for intravitreal administration but has been selected by ophthalmologists because its very low intraocular solubility provides sustained effect. Visual benefits of intraocular TA do not clearly correlate with morpho-anatomical improvements, suggesting potential toxicity. We therefore studied, non-common, but deleterious effects of glucocorticoids on the retina. We found that the intravitreal administration of TA is beneficial in the treatment of neovascularization because it triggers cell death of endothelial cells of neovessels by a caspase-independent mechanism. However, this treatment is toxic for the retina because it induces a non-apoptotic, caspase-independent cell death related to paraptosis, mostly in the retinal pigmented epithelium cells and the Müller cells. PMID:20654583

  20. Intraocular lens power estimation by accurate ray tracing for eyes underwent previous refractive surgeries

    NASA Astrophysics Data System (ADS)

    Yang, Que; Wang, Shanshan; Wang, Kai; Zhang, Chunyu; Zhang, Lu; Meng, Qingyu; Zhu, Qiudong

    2015-08-01

    For normal eyes without history of any ocular surgery, traditional equations for calculating intraocular lens (IOL) power, such as SRK-T, Holladay, Higis, SRK-II, et al., all were relativley accurate. However, for eyes underwent refractive surgeries, such as LASIK, or eyes diagnosed as keratoconus, these equations may cause significant postoperative refractive error, which may cause poor satisfaction after cataract surgery. Although some methods have been carried out to solve this problem, such as Hagis-L equation[1], or using preoperative data (data before LASIK) to estimate K value[2], no precise equations were available for these eyes. Here, we introduced a novel intraocular lens power estimation method by accurate ray tracing with optical design software ZEMAX. Instead of using traditional regression formula, we adopted the exact measured corneal elevation distribution, central corneal thickness, anterior chamber depth, axial length, and estimated effective lens plane as the input parameters. The calculation of intraocular lens power for a patient with keratoconus and another LASIK postoperative patient met very well with their visual capacity after cataract surgery.

  1. A 20-gauge intraocular electromagnetic tip for simplified intraocular foreign-body extraction.

    PubMed

    May, D R; Noll, F G; Munoz, R

    1989-02-01

    A modified tip for the Bronson intraocular electromagnet has been developed. The tip was machined to a 20-gauge cylinder that can be inserted readily into the eye either through an entrance wound or through a pars plana incision. Placement of the tip of the magnet inside the eye allows the foreign body to impact the tip of the magnet rather than the wall of the eye. PMID:2916983

  2. Primary orbital neuroblastoma with intraocular extension

    PubMed Central

    Vallinayagam, Muthukrishnan; Rao, Vasudev Anand; Pandian, Datta Gulnar; Akkara, John Davis; Ganesan, Niruban

    2015-01-01

    Neuroblastoma is an undifferentiated malignancy of primitive neuroblasts. Neuroblastoma is among the most common solid tumors of childhood. Orbital neuroblastoma is typically a metastatic tumor. In this case report, we describe a 2-year-old child with a rapidly progressing orbital tumor. Computed tomography revealed an orbital mass lesion with extraocular and intraocular components. An incisional biopsy was done, and a histopathological examination showed features suggestive of neuroblastoma. Systemic workup including ultrasonography of the abdomen, chest roentgenogram, whole body computed tomography, and bone scintigraphy showed no evidence of systemic involvement. The diagnosis of primary orbital neuroblastoma was made, and the child was subjected to chemotherapy followed by rapid melting of the tumor. Neuroblastoma should be considered in the differential diagnosis of childhood orbital tumors. PMID:26576531

  3. Mechanical properties of intra-ocular lenses

    NASA Astrophysics Data System (ADS)

    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

  4. Intraocular lens employed for cataract surgery

    NASA Astrophysics Data System (ADS)

    Roszkowska, A. M.; Torrisi, L.

    2014-04-01

    The aim of this paper is to illustrate the techniques of cataract surgery with implantation of intraocular lenses and some physical properties of the used materials. The new technology, coupled with extensive experience and the studied cases, permits to increase the standardization and accuracy of the engravings, by reducing the use and handling of surgical instruments inside the eye. At present it is possible to replace the cataract with crystalline lenses based on biopolymers such as PMMA, silicone, acrylic hydrophilic and hydrophobic acrylic. These materials are increasingly able to replace the natural lens and to ensure the fully functional of the eye. The role of femtosecond lasers in cataract surgery, to assist or replace several aspects of the manual cataract surgery, are discussed.

  5. Computational modeling of intraocular gas dynamics.

    PubMed

    Noohi, P; Abdekhodaie, M J; Cheng, Y L

    2015-01-01

    The purpose of this study was to develop a computational model to simulate the dynamics of intraocular gas behavior in pneumatic retinopexy (PR) procedure. The presented model predicted intraocular gas volume at any time and determined the tolerance angle within which a patient can maneuver and still gas completely covers the tear(s). Computational fluid dynamics calculations were conducted to describe PR procedure. The geometrical model was constructed based on the rabbit and human eye dimensions. SF6 in the form of pure and diluted with air was considered as the injected gas. The presented results indicated that the composition of the injected gas affected the gas absorption rate and gas volume. After injection of pure SF6, the bubble expanded to 2.3 times of its initial volume during the first 23 h, but when diluted SF6 was used, no significant expansion was observed. Also, head positioning for the treatment of retinal tear influenced the rate of gas absorption. Moreover, the determined tolerance angle depended on the bubble and tear size. More bubble expansion and smaller retinal tear caused greater tolerance angle. For example, after 23 h, for the tear size of 2 mm the tolerance angle of using pure SF6 is 1.4 times more than that of using diluted SF6 with 80% air. Composition of the injected gas and conditions of the tear in PR may dramatically affect the gas absorption rate and gas volume. Quantifying these effects helps to predict the tolerance angle and improve treatment efficiency. PMID:26682529

  6. Bevacizumab and intraocular tumors: an intriguing paradox

    PubMed Central

    Ly, Long V.; Luyten, Gregorius P.M.; Versluis, Mieke; Grossniklaus, Hans E.; van der Velden, Pieter A.; Jager, Martine J.

    2012-01-01

    Purpose Bevacizumab, a humanized monoclonal antibody to vascular endothelial growth factor-A (VEGF-A), was originally developed as an anti-tumor treatment. In ocular oncology, it is being used to treat macular edema due to radiation retinopathy, but it may also be useful for the treatment of primary uveal melanoma (UM) or its metastases. We determined the effect of bevacizumab on the growth of B16F10 cells inside the eye and on B16F10 and UM cells cultured in vitro. Methods B16F10 melanoma cells were placed into the anterior chamber of the eye of C57Bl/6 mice and tumor growth was monitored after injection of different doses of bevacizumab or mock injection. In addition, the effect of bevacizumab on in vitro growth of B16F10 and human UM cells and on the expression of VEGF-A, GLUT-1, and HIF-1α was evaluated. Results Following intraocular injection of bevacizumab into murine B16 tumor-containing eyes, an acceleration of tumor growth was observed, with the occurrence of anterior chamber hemorrhages. Bevacizumab did not affect proliferation of B16F10 cells in vitro, while it inhibited UM cell proliferation. Expression analysis demonstrated that addition of bevacizumab under hypoxic conditions induced VEGF-A, GLUT-1 and HIF-1α in B16F10 cells as well as in UM cell lines and two of four primary UM tumor cultures. Conclusions In contrast with expectations, intraocular injection of bevacizumab stimulated B16F10 melanoma growth in murine eyes. In vitro exposure of B16 and human UM cells to bevacizumab led to paradoxical VEGF-A upregulation. The use of VEGF inhibitors for treatment of macular edema (due to radiation retinopathy) after irradiation of UM should be considered carefully, because of the possible adverse effects on residual UM cells. PMID:23077404

  7. Computational modeling of intraocular gas dynamics

    NASA Astrophysics Data System (ADS)

    Noohi, P.; Abdekhodaie, M. J.; Cheng, Y. L.

    2015-12-01

    The purpose of this study was to develop a computational model to simulate the dynamics of intraocular gas behavior in pneumatic retinopexy (PR) procedure. The presented model predicted intraocular gas volume at any time and determined the tolerance angle within which a patient can maneuver and still gas completely covers the tear(s). Computational fluid dynamics calculations were conducted to describe PR procedure. The geometrical model was constructed based on the rabbit and human eye dimensions. SF6 in the form of pure and diluted with air was considered as the injected gas. The presented results indicated that the composition of the injected gas affected the gas absorption rate and gas volume. After injection of pure SF6, the bubble expanded to 2.3 times of its initial volume during the first 23 h, but when diluted SF6 was used, no significant expansion was observed. Also, head positioning for the treatment of retinal tear influenced the rate of gas absorption. Moreover, the determined tolerance angle depended on the bubble and tear size. More bubble expansion and smaller retinal tear caused greater tolerance angle. For example, after 23 h, for the tear size of 2 mm the tolerance angle of using pure SF6 is 1.4 times more than that of using diluted SF6 with 80% air. Composition of the injected gas and conditions of the tear in PR may dramatically affect the gas absorption rate and gas volume. Quantifying these effects helps to predict the tolerance angle and improve treatment efficiency.

  8. Mechanisms for vasopressin effects on intraocular pressure in anesthetized rats

    NASA Technical Reports Server (NTRS)

    Balaban, C. D.; Palm, D. E.; Shikher, V.; Searles, R. V.; Keil, L. C.; Severs, W. B.

    1997-01-01

    Continuous intracameral infusions of a balanced salt solution (0.175 microliter min-1) have been reported to raise intraocular pressure (IOP) in anesthetized rats. Palm et al. (1995) previously reported that this effect was attenuated significantly by inclusion of arginine-vasopressin (AVP, 10 ng 0.175 microliter-1) in the infusate. This study used experimental and computer simulation methods to investigate factors underlying these changes in IOP. First, constant intracameral infusions of artificial cerebrospinal fluid (aCSF) at different fixed rates (0.049-0.35 microliter min-1) were used to estimate the outflow resistance. Secondly, IOP responses were measured during an 2 hr intracameral infusion of either aCSF or AVP that was the sum of a small constant component (0.05 microliter min-1) and a larger periodic component (0.25 microliter min-1, cycling for 4 min on, then 4 min off); the mean infusion rate was 0.175 microliter min-1. As shown previously for 0.175 microliter min-1 constant infusions, the periodic aCSF infusion induced a significant rise in IOP that was attenuated by AVP administration. Complex demodulation analysis and the estimated gain parameter of a second order transfer function fit to the periodic responses indicated that outflow resistance increased significantly during the infusions in both aCSF and AVP groups, but that the indices of resistance did not differ significantly between aCSF and AVP infused eyes. This finding implies that changes in outflow resistance do not explain the difference in IOP responses to intracameral aCSF and AVP. The two responses differed significantly, though, in damping factors, such that the aCSF responses were considerably more underdamped than the AVP responses. It is hypothesized that aCSF-induced increase in IOP reflects both (1) a small component reflecting increased outflow resistance and (2) a larger non-resistive component. Since the non-resistive component is insensitive to pretreatment with acetazolamide

  9. Effects of Different Intensities of Exercise on Intraocular Pressure

    ERIC Educational Resources Information Center

    Rowe, Deryl; And Others

    1976-01-01

    The decrease in intraocular pressure during exercise and the first few minutes of recovery is related to a decrease in blood pH and an increase in blood lactate concentration, not to the intensity of the exercise. (MB)

  10. [The neuroanatomical and physiological bases of variations in intraocular pressure].

    PubMed

    Chiquet, C; Denis, P

    2004-09-01

    Intraocular pressure displays a distinct circadian rhythm in animals and humans, with an increase at night and a decrease during the daytime. In animals, the IOP rhythm has been reported to be synchronized by environmental light and to persist in constant darkness, demonstrating a circadian component controlled by an endogenous pacemaker. The structures involved in the rhythmic regulation of intraocular pressure include the suprachiasmatic nucleus, which controls the activity of sympathetic and parasympathetic ocular innervation. These effectors are responsible for controlling the production (beta-adrenergic system) and the outflow (alpha1-adrenergic, parasympathetic system, prostaglandin) of aqueous humor. The production of aqueous humor is under adrenergic control (alpha1- and beta-receptors). Many neuropeptides such as vasoactive intestinal peptide, substance P, and the atrial natriuretic peptide are also involved in the regulation of intraocular pressure. A better understanding of the circadian regulation of intraocular pressure is needed for an appropriate treatment of ocular hypertension and glaucoma. PMID:15314570

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

    MedlinePlus

    ... by: Kierstan Boyd Reviewed by: Elizabeth Yeu MD Mar. 01, 2016 Before intraocular lenses (IOLs) were developed, ... Foods Rich in Vitamin C Help Curb Cataracts Mar 28, 2016 Los Alimentos Ricos en Vitamina C ...

  12. Intraocular lymphoma after cardiac transplantation: magnetic resonance imaging findings.

    PubMed

    Kim, Yi Kyung; Kim, Hyung-Jin; Woo, Kyung In; Kim, Yoon-Duck

    2013-01-01

    We report a case of intraocular lymphoma in a 65-year-old man, 15 months after cardiac transplantation. On Magnetic Resonance (MR) images, the iris and the anterior chamber of the right eye were found to be involved with an enhancing soft-tissue lesion. To our knowledge, this is the first case of post-transplantation intraocular lymphoma evaluated with MR imaging. PMID:23323042

  13. Systemic chemotherapy as a new conservative treatment for intraocular retinoblastoma.

    PubMed

    Yanagisawa, Takaaki

    2004-02-01

    Retinoblastoma is the most common malignant intraocular tumor in childhood. With advances in the methods for early detection of this disease, the survival rate is over 90% in developed countries. The management of intraocular retinoblastoma has gradually changed over the past few decades. Every effort has been made to save life, with the preservation of the eye and sight, if possible. External beam radiotherapy has been a standard treatment for medium and large, or visually threatening, intraocular retinoblastoma, but it markedly increases the risk of cosmetic deformities and secondary cancer in children with germline RB mutations. For the past decade, primary systemic chemotherapy called "chemoreduction" has been employed to avoid radiotherapy and enucleation. This article gives an overview of the results of current trials of primary chemoreduction for intraocular retinoblastoma, and discusses its role and its limitations in conservative treatment. The article also discusses future directions to expand the indications for this treatment. Many children with advanced intraocular retinoblastoma could be spared external beam radiotherapy and enucleation, mostly as a result of chemoreduction and focal methods. Chemoreduction combined with focal treatments will continue to play an important role in the conservative management of children with intraocular retinoblastoma, possibly even in children with advanced disease, with the combined use of multidrug-resistance modulators. PMID:15162821

  14. Noninvasive intraocular pressure monitoring: current insights

    PubMed Central

    De Smedt, Stefan

    2015-01-01

    Glaucoma is the second leading cause of blindness worldwide and intraocular pressure (IOP) is currently its only modifiable risk factor. Peak IOP has for a long time been considered as a major contributor to glaucoma progression, but its effects may depend not only on its magnitude, but also on its time course. The IOP is nowadays considered to be a dynamic parameter with a circadian rhythm and spontaneous changes. The current practice of punctual measuring the IOP during office hours is therefore a suboptimal approach, which does not take into account the natural fluctuation of IOP. Because of its static nature a single IOP measurement in sitting position fails to document the true range of an individual’s IOP, peak IOP, or variation throughout the day. Phasing means monitoring a patient’s IOP during the daytime or over a 24-hour period. This can provide additional information in the management of glaucoma patients. This review focuses on the current insight of non-invasive IOP monitoring as a method of obtaining more complete IOP profiles. Invasive techniques using an implantable sensor are beyond the scope of this review. PMID:26257509

  15. Optical performance test & analysis of intraocular lenses

    NASA Astrophysics Data System (ADS)

    Choi, Junoh

    Cataract is a condition in the eye that if left untreated, could lead to blindness. One of the effective ways to treat cataract is the removal of the cataractous natural crystalline lens and implantation of an artificial lens called an intraocular lens(IOL). The designs of the IOLs have shown improvements over the years to further imitate natural human vision. A need for an objective testing and analysis tool for the latest IOLs grow with the advancements of the IOLs. In this dissertation, I present a system capable of objective test and analysis of the advanced IOLs. The system consists of (1) Model eye into which an IOL can be inserted to mimic conditions of the human eye. (2) Modulation Transfer Function measurement setup capable of through-focus test for depth of field studies and polychromatic test for study of effects of chromatization. (3) Use of Defocus Transfer Function to simulate depth of field characteristic of rotationally symmetric multifocal designs and extension of the function to polychromatic conditions. (4) Several target imaging experiments for comparison of stray light artifacts and simulation using a non-sequential ray trace package.

  16. Update of intraocular lens implantation in children

    PubMed Central

    Al Shamrani, Mohammed; Al Turkmani, Shahira

    2012-01-01

    Cataract is a common problem that affects the vision in children and a major cause of amblyopia in children. However, the management of childhood cataract is tenuous and requires special considerations especially with regard to intraocular lens (IOL) implantation. Age at which an IOL can be implanted is a controversial issue. Implanting an IOL in very young children carries the risk of severe postoperative inflammation and posterior capsule opacification that may need other surgeries and may affect the vision permanently. Accuracy of the calculated IOL power is affected by the short eyes and the steep keratometric values at this age. Furthermore, choosing an appropriate IOL power is not a straight forward decision as future growth of the eye affects the axial length and keratometry readings which may result in an unexpected refractive error as children age. The aim of this review is to cover these issues regarding IOL implantation in children; indications, timing of implantation, types of IOLs, site of implantation and the power calculations. PMID:23961005

  17. UV laser ablation patterns in intraocular lenses

    NASA Astrophysics Data System (ADS)

    Lagiou, D. P.; Evangelatos, Ch.; Apostolopoulos, A.; Spyratou, E.; Bacharis, C.; Makropoulou, M.; Serafetinides, A. A.

    2013-03-01

    The aim of this work is to investigate the effect of UV solid state laser radiation on intraocular lens (IOL) polymer surfaces as an alternative method to conventional surface shaping techniques for IOLs customization. Laser ablation experiments were performed on PMMA plates and commercially available hydrophobic and hydrophilic acrylic IOLs with the 5th harmonic of a Q-switched Nd:YAG laser (λ=213 nm). Circular arrays of holes were drilled on the polymer surface, covering the centre and the peripheries of the IOL. The morphology of the ablated IOL surface was examined with a conventional optical microscope (Leitz GMBH Wetzlar) and with a scanning electron microscope (SEM, Fei - Innova Nanoscope) at various laser parameters. Quantitative measurements of ablation rates were performed with a contact profilometer (Dektak-150), in which a mechanical stylus scanned across the surface of gold-coated IOLs (after SEM imaging) to measure variationsF in surface height. Laser interaction with IOLs depends on optical and mechanical material properties, in addition to laser radiation parameters. The exact ablation mechanism is discussed. Some polymer materials, depending on their properties, are more susceptible to the photothermal mechanism than the photochemical one or vice versa. In summary, every IOL polymer exhibits specific attributes in its interaction with the 5th harmonic of Nd:YAG laser.

  18. Calcification of intraocular implant lens surfaces.

    PubMed

    Wu, Wenju; Guan, Xiangying; Tang, Ruikang; Hook, Daniel; Yan, Wenyan; Grobe, George; Nancollas, George H

    2004-02-17

    Calcification of octacalcium phosphate [Ca8H2(PO4)6 x 5H2O, OCP] on differently packaged "Ultem" and "Surefold" intraocular implant lens surfaces has been studied in vitro in solutions supersaturated with respect to OCP at pH = 7.10 and 37 degrees C. No mineral deposition was observed on the lenses packaged in Ultem vials even after treatment with behenic acid, one of the fatty acids identified on explanted lenses. Following treatment with behenic acid, nucleation of OCP occurred on the lenses from Surefold vials, which incorporate silicone gaskets; induction periods preceding calcification were about 6 h. No mineralization was found on the lenses in vials with other gasket materials, including polytetrafluoroethylene, fluorocarbon elastomer, and polypropylene. The results of this study indicate that both silicone and fatty acids such as behenic acid play important roles in inducing the in vivo calcification of OCP on IOL lenses; all of the lens treatment steps were necessary for nucleation induction. PMID:15803719

  19. Ocular Biocompatibility of Nitinol Intraocular Clips

    PubMed Central

    Velez-Montoya, Raul; Erlanger, Michael

    2012-01-01

    Purpose. To evaluate the tolerance and biocompatibility of a preformed nitinol intraocular clip in an animal model after anterior segment surgery. Methods. Yucatan mini-pigs were used. A 30-gauge prototype injector was used to attach a shape memory nitinol clip to the iris of five pigs. Another five eyes received conventional polypropylene suture with a modified Seipser slip knot. The authors compared the surgical time of each technique. All eyes underwent standard full-field electroretinogram at baseline and 8 weeks after surgery. The animals were euthanized and eyes collected for histologic analysis after 70 days (10 weeks) postsurgery. The corneal thickness, corneal endothelial cell counts, specular microscopy parameters, retina cell counts, and electroretinogram parameters were compared between the groups. A two sample t-test for means and a P value of 0.05 were use for assessing statistical differences between measurements. Results. The injection of the nitinol clip was 15 times faster than conventional suturing. There were no statistical differences between the groups for corneal thickness, endothelial cell counts, specular microscopy parameters, retina cell counts, and electroretinogram measurements. Conclusions. The nitinol clip prototype is well tolerated and showed no evidence of toxicity in the short-term. The injectable delivery system was faster and technically less challenging than conventional suture techniques. PMID:22064995

  20. [Intraocular Pressure Sensor Based on a Contact Lens].

    PubMed

    Guo, Xuhong; Pet, Weihua; Yao, Zhaolin; Chen, Yuanfang; Hu, Xiaohui; Chen, Hongda; Zhu, Jingyuan; Wu, Huijuan

    2016-02-01

    Intraocular pressure detection has a great significance for understanding the status of eye health, prevention and treatment of diseases such as glaucoma. Traditional intraocular pressure detection needs to be held in the hospital. It is not only time-consuming to doctors and patients, but also difficult to achieve 24 hour-continuous detection. Microminiaturization of the intraocular pressure sensor and wearing it as a contact lens, which is convenient, comfortable and noninvasive, can solve this problem because the soft contact lens with an embedded micro fabricated strain gauge allows the measurement of changes in corneal curvature to correlate to variations of intraocular pressure. We fabricated a strain gauge using micro-electron mechanical systems, and integrated with the contact lens made of polydimethylsiloxane (PDMS) using injection molding. The experimental results showed that the sensitivity was 100. 7 µV/µm. When attached to the corneal surface, the average sensitivity of sensor response of intraocular pressure can be 125.8 µV/mm Hg under the ideal condition. PMID:27382734

  1. Effects of 2-alkynyladenosine derivatives on intraocular pressure in rabbits.

    PubMed

    Konno, Takashi; Ohnuma, Shin-ya; Uemoto, Kazuhiro; Uchibori, Takehiro; Nagai, Akihiko; Kogi, Kentaro; Endo, Kazuki; Hosokawa, Tomokazu; Nakahata, Norimichi

    2004-02-23

    We evaluated the activities of 2-alkynyladenosine derivatives, relatively selective adenosine A2 receptor agonists, in the intraocular pressure regulation in rabbits. An adenosine A2 receptor agonist 2-[p-(2-carboxyethyl)phenylethylamino]-5'-N-ethylcarboxamidoadenosine (CGS-21680) decreased intraocular pressure, while another A2 receptor agonist 2-(phenylamino)adenosine transiently increased it. The first group of 2-alkynyladenosine derivatives (1-hexyn-1-yl derivatives) caused a transient increase followed by decrease in intraocular pressure, while the second group (1-octyn-1-yl and 6-cyano-1-hexyn-1-yl derivatives) only decreased it. The second group is also effective in the ocular hypertensive models induced by water-loading and alpha-chymotrypsin. The outflow facility was increased by a 1-octyn-1-yl derivative. Both increase and decrease in intraocular pressure induced by 2-alkynyladenosine derivatives were inhibited by an adenosine A2 receptor antagonist 3,7-dimethyl-1-propargylxanthine, but not by an adenosine A1 receptor antagonist 8-cyclopentyl-1,3-dipropyl xanthine. These findings suggest that 2-alkynyladenosine derivatives may affect intraocular pressure via adenosine A2 receptor, and 2-alkynyladenosine derivative-induced ocular hypotension is due to the increase of outflow facility. PMID:14985053

  2. Change in intraocular pressure during scleral depression

    PubMed Central

    Trevino, Richard; Stewart, Brandi

    2014-01-01

    Purpose Manometric studies have found that intraocular pressure (IOP) rises 116–350 mmHg during scleral depression in surgical settings. No information is available regarding the effect of scleral depression on IOP in routine clinical settings. The aim of this study is to quantify the change in IOP that occurs when scleral depression is performed on normal eyes in a routine clinical setting. Methods A total of 28 eyes from 28 normal subjects were included. Tono-Pen tonometry was performed while scleral depression was performed in each of the two quadrants: superotemporal (ST) and inferonasal (IN). A post-procedure IOP measurement was obtained following each scleral depression examination. Both ST and IN quadrants were tested on all eyes, with the quadrant tested first chosen at random (15 ST, 13 IN). Results The mean IOP during scleral depression was 65.3 mmHg ST and 47.8 mmHg IN, with a maximum recorded IOP of 88 mmHg. The mean change in IOP for the ST quadrant was 51.9 ± 17.3 mmHg and 46.4 ± 16.0 mmHg for the right and left eyes, respectively. The mean change in IOP for the IN quadrant was 45.3 ± 22.7 mmHg and 16.8 ± 15.8 mmHg for the right and left eyes, respectively. Conclusions Scleral depression as performed in a routine office setting produces wide fluctuations in IOP and may impair ocular perfusion. Additional studies are needed to determine the long-term consequences of routine scleral depression. PMID:25444648

  3. Immune Escape Mechanisms of Intraocular Tumors

    PubMed Central

    Niederkorn, Jerry Y.

    2009-01-01

    The notion that the immune system might control the growth of tumors was suggested over 100 years ago by the eminent microbiologist Paul Ehrlich. This concept was refined and expanded by Burnet and Thomas fifty years later with their articulation of the “immune surveillance” hypothesis. In its simplest form, the immune surveillance hypothesis suggests that neoplasms arise spontaneously and express novel antigens that are recognized by the immune system, which either eliminates the tumors or restrains their growth. Within the eye, immune responses are controlled and sometimes profoundly inhibited - a condition known as immune privilege. Immune privilege in the eye is the result of a complex array of anatomical, physiological, and immunoregulatory mechanisms that prevent the induction and expression of many immune responses. Tumors arising in the eye would seem to have an advantage in evading immune surveillance due to ocular immune privilege. Uveal melanoma, the most common and malignant intraocular tumor in adults not only benefits from the immune privilege of the eye, but has adopted many of the mechanisms that contribute to ocular immune privilege as a strategy for protecting uveal melanoma cells once they leave the sanctuary of the eye and are disseminated systemically in the form of metastases. Although the immune system possesses a battery of effector mechanisms designed to rid the body of neoplasms, tumors are capable of rapidly evolving and countering even the most sophisticated immunological effector mechanisms. To date, tumors seem to be winning this arms race, but an increased understanding of these mechanisms should provide insights for designing immunotherapy that was envisioned over half a century ago, but has failed to materialize to date. PMID:19563908

  4. Intraocular Pressure, Ethnicity, and Refractive Error

    PubMed Central

    Manny, Ruth E.; Mitchell, G. Lynn; Cotter, Susan A.; Jones-Jordan, Lisa A.; Kleinstein, Robert N.; Mutti, Donald O.; Twelker, J. Daniel; Zadnik, Karla

    2011-01-01

    Purpose The ethnically-diverse Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study cohort provides a unique opportunity to explore associations among intraocular pressure (IOP), ethnicity, and refractive error while adjusting for potential confounding variables. Methods Mixed linear models were used to examine the effect of age, refractive error (cycloplegic autorefraction), ethnicity, sex, and measurement protocol on IOP (Tono-pen) in 3,777 children, aged 6-14 years at their first CLEERE visit (1995-2009). Children who became myopic during follow-up were used to examine the relationship between time since myopia onset and IOP. Clinically meaningful differences in IOP were preset at > 2 mm Hg. Results IOP differed among refractive error categories with higher IOP in children with low/moderate myopia than those with high hyperopia (differences < 1 mm Hg). There was a statistically significant relationship between age and IOP that depended on ethnicity (interaction p<0.0001) and measurement protocol (interaction p<0.0001). The relationship between sex and IOP depended on measurement protocol (interaction p=0.0004). For children who became myopic during follow-up, the adjusted mean IOP showed a significant decline for only Asian (p=0.024) and White children (p=0.004). As with other statistically significant results, these changes in mean adjusted IOPs from two years before to two years after myopia onset were < 2 mm Hg. Conclusions Small but significant differences in IOP by refractive error category were found in this ethnically diverse cohort of children. Relationships between IOP and age, ethnicity, sex, and measurement protocol were complicated by significant interactions between these parameters. Longitudinal analysis of children before and after myopia onset showed changes in IOP over time that varied by ethnicity. Higher IOPs before and at myopia onset were not present in all ethnic groups, with differences before and after

  5. Aspheric versus Spherical Posterior Chamber Intraocular Lenses

    PubMed Central

    Jafarinasab, Mohammad-Reza; Feizi, Sepehr; Baghi, Ahmad-Reza; Ziaie, Hossein; Yaseri, Mehdi

    2010-01-01

    Purpose To compare spherical aberration and contrast sensitivity function following implantation of four different foldable posterior chamber intraocular lenses (IOLs), namely Sensar, Akreos AO, Tecnis, and AcrySof IQ. Methods In this randomized clinical trial, 68 eyes of 68 patients with senile cataracts underwent phacoemulsification and IOL implantation with Sensar (n=17), Akreos AO (n=17), Tecnis (n=17), or AcrySof IQ (n=17). Uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA), spherical aberration and contrast sensitivity function (CSF) were compared among the study groups, 3 months after surgery. Results There was no significant difference between the study groups in terms of age (P = 0.21). Mean postoperative BSCVA with Sensar, Akreos AO, Tecnis, and AcrySof IQ was 0.15±0.10, 0.12±0.9, 0.08±0.08, and 0.08±0.07 logMAR, respectively (P=0.08). Spherical aberration measured over a 4 mm pupil was significantly higher with Sensar and Akreos AO than the two other IOLs. The difference between Tecnis and AcrySof IQ was significantly in favor of the former IOL. Over a 6 mm pupil, spherical aberrations were comparable with Sensar and Akreos AO, furthermore spherical aberration was also comparable among eyes implanted with Akreos AO, AcrySof IQ, and Tecnis. Sensar yielded significantly inferior results as compared to Acrysof IQ and Tecnis. CSF with Sensar was inferior to the three aspheric IOLs at the majority of spatial frequencies. Tecnis yielded significantly better mesopic CSF at 1.5 and 3 cycles per degree spatial frequencies. Conclusion Tecnis and AcrySof IQ provided significantly better visual function as compared to Sensar and Akreos AO, especially with smaller pupil size. However, this difference diminished with increasing pupil size. PMID:22737364

  6. New trends in intraocular lens imaging

    NASA Astrophysics Data System (ADS)

    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

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

    PubMed Central

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

    2016-01-01

    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 twelve patients, 4) subluxation of the IOL was observed in one patient, and 5) macular edema was found in three eyes. Conclusion 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

  8. Intraocular Gnathostomiasis: Report of a Case and Review of Literature

    PubMed Central

    Pillai, Gopal S.; Kumar, Anil; Radhakrishnan, Natasha; Maniyelil, Jayasree; Shafi, Tufela; Dinesh, Kavitha R.; Karim, Shamsul

    2012-01-01

    Intraocular gnathostomiasis is a rare parasitic infection caused by the third-stage larvae of spiruroid nematode Gnanthostoma spp. seen mostly in tropical and subtropical regions. It is a food-borne zoonosis caused by ingestion of raw or undercooked freshwater fish, amphibians, reptiles, birds, and mammals, all of which are known to harbor advanced third-stage larvae of Gnanthostoma spp. To date, 74 cases of intraocular gnathostomiasis have been reported from 12 different countries. Only four countries have reported more than 10 cases each, and India shares the rare distinction of being one of them, with 14 cases. Surprisingly, not a single case of cutaneous gnanthostomiasis has ever been reported from India. We present one such case of intraocular gnathostomiasis in a 41-year-old male who presented with an actively motile worm attached to the iris, and we review the pertinent literature of all such cases reported from India. PMID:22492146

  9. Evaluation of the motion of surgical instruments during intraocular surgery

    PubMed Central

    Hubschman, J-P; Son, J; Allen, B; Schwartz, S D; Bourges, J-L

    2011-01-01

    Purpose Robot assistance in ocular microsurgery could improve precision, dexterity, save time or prevent complications by task automation, and provide access to ocular surgery in undeserved countries by teleoperation. However, to design robotic devices, the range of motion of surgical instruments needs to be precisely quantified. Methods An electromagnetic tracking system was developed for intraocular surgery in order to quantify the movements of ophthalmic surgeons. Kinematics of surgical steps during phacoemulsification and pars plana vitrectomy procedures were determined by measuring the maximum translation and angular range of motion of intraocular surgical tools in the three planes. Conclusion Important variations in amplitudes of rotation and translation were measured between both hands and between surgical tasks. These parameters may be used to develop a robotic intraocular surgical system or to improve training. PMID:21527954

  10. Intraocular ophthalmic ointment following clear corneal phacoemulsification: Clinical implications.

    PubMed

    Humayun, Muhammad; Gottlieb, Chloe C; Rafuse, Paul E

    2006-12-01

    We report 4 cases of apparent ophthalmic ointment in the anterior chamber after sutureless clear corneal phacoemulsification and posterior chamber intraocular lens implantation. The cases, as well as previous literature, indicate that ointment for topical use can be well tolerated in the eye, although glaucoma and uveitis can be potential negative outcomes. Possible risk factors, some of which may be related to current rates of endophthalmitis after clear corneal cataract surgery, and methods to prevent intraocular ophthalmic ointment after cataract surgery are discussed. PMID:17137997

  11. Development and experimental verification of an intraocular scattering model

    NASA Astrophysics Data System (ADS)

    Jiang, Chong-Jhih; Jhong, Tian-Siang; Chen, Yi-Chun; Sun, Ching-Cherng

    2011-10-01

    An intraocular scattering model was constructed in human eye model and experimentally verified. According to the biometric data, the volumetric scattering in crystalline lens and diffusion at retina fundus were developed. The scattering parameters of cornea, including particle size and obscuration ratio, were varied to make the veiling luminance of the eye model matching the CIE disability glare general formula. By replacing the transparent lens with a cataractous lens, the disability glare curve of cataracts was generated and compared with that of transparent lenses. The MTF of the intraocular scattering model showed nice correspondence with the data measured by a double-pass experiment.

  12. Animal model experimentation using the expansile hydrogel intraocular lens.

    PubMed

    Siepser, S B; Wieland, M

    1991-07-01

    To determine the biocompatibility of the expansile hydrogel intraocular lens, a two-year animal study was undertaken. After phacoemulsification, hydrogel expansile intraocular lenses were implanted in four Dutch-belted rabbit eyes. Slitlamp examinations revealed minimal anterior chamber reaction and lens synechias. Gross pathology and histology demonstrated hyperplastic residual cortex, but confirmed our clinical impression that the lenses were well tolerated. Electron diffraction energy dispersive X-ray microanalysis revealed deposition of aluminum, silicon, magnesium, and calcium, but there was no evidence of matrix penetration. PMID:1895227

  13. Softec HD hydrophilic acrylic intraocular lens: biocompatibility and precision

    PubMed Central

    Espandar, Ladan; Sikder, Shameema; Moshirfar, Majid

    2011-01-01

    Intraocular lens development is driven by higher patient expectations for ideal visual outcomes. The recently US Food and Drug Administration-approved Softec HD™ lens is an aspheric, hydrophilic acrylic intraocular lens (IOL). The hydrophilic design of the lens is optimized to address dysphotopsia while maintaining biocompatibility, optical clarity, resistance to damage, and resistance to biocontamination. Aspheric lenses decrease postoperative spherical aberration. The addition of the Softec lens provides clinicians with another option for IOL placement; however, randomized comparative studies of this lens to others already on the market remain to be completed. PMID:21311658

  14. Coaxially sighted intraocular lens light reflex for centration of the multifocal single piece intraocular lens.

    PubMed

    Melki, Samir A; Harissi-Dagher, Mona

    2011-08-01

    Centration of multifocal Intraocular lenses (IOL) may be critical to ensure optimal function and prevent untoward side effects. Pharmacologic pupillary dilation and constriction may shift the physiologic location of the pupillary center rendering intraoperative positioning of multifocal IOL challenging. Similarly, the anterior capsular center is difficult to pinpoint and may not correspond to either the visual axis or the pupillary center. The visual axis is the only landmark that can be consistently identified prior, during and after cataract surgery. Centering diffractive multifocal IOL on the visual axis may allow more consistent placement and better outcome measures. In the following, we describe a simple technique to center multifocal single piece acrylic IOLs on the visual axis. PMID:21816250

  15. CUSTOM OPTIMIZATION OF INTRAOCULAR LENS ASPHERICITY

    PubMed Central

    Koch, Douglas D.; Wang, Li

    2007-01-01

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

  16. Ultrashort laser ablation of PMMA and intraocular lenses

    NASA Astrophysics Data System (ADS)

    Serafetinides, A. A.; Makropoulou, M.; Fabrikesi, E.; Spyratou, E.; Bacharis, C.; Thomson, R. R.; Kar, A. K.

    2008-10-01

    The use of intraocular lenses (IOLs) is the most promising method to restore vision after cataract surgery. Several new materials, techniques, and patterns have been studied for forming and etching IOLs to improve their optical properties and reduce diffractive aberrations. This study is aimed at investigating the use of ultrashort laser pulses to ablate the surface of PMMA and intraocular lenses, and thus provide an alternative to conventional techniques. Ablation experiments were conducted using various polymer substrates (PMMA samples, hydrophobic acrylic IOL, yellow azo dye doped IOL, and hydrophilic acrylic IOL consist of 25% H2O). The irradiation was performed using 100 fs pulses of 800 nm radiation from a regeneratively amplified Ti:sapphire laser system. We investigated the ablation efficiency and the phenomenology of the ablated patterns by probing the ablation depth using a profilometer. The surface modification was examined using a high resolution optical microscope (IOLs) or atomic force microscope—AFM (PMMA samples). It was found that different polymers exhibited different ablation characteristics, a result that we attribute to the differing optical properties of the materials. In particular, it was observed that the topography of the ablation tracks created on the hydrophilic intraocular lenses was smoother in comparison to those created on the PMMA and hydrophobic lens. The yellow doped hydrophobic intraocular lenses show higher ablation efficiency than undoped hydrophobic acrylic lenses.

  17. Controversies in intraocular lens implantation in pediatric uveitis.

    PubMed

    Phatak, Sumita; Lowder, Careen; Pavesio, Carlos

    2016-12-01

    Cataract is one of the most common and visually debilitating complications of pediatric uveitis. It develops as a consequence of chronic inflammation and steroid use and is seen most often in juvenile idiopathic arthritis (JIA)-associated uveitis. Cataract extraction with intraocular lens (IOL) insertion has been carried out with a measure of success in non-uveitic pediatric eyes, but in cases of uveitis, multiple factors affect the final outcome. Chronic inflammation and its sequelae such as band keratopathy, posterior synechiae, and cyclitic membranes make surgical intervention more challenging and outcome less certain. Postoperative complications like increased inflammation, glaucoma, posterior capsular opacification, retrolental membranes, and hypotony may compromise the visual outcome. Early refractive correction is imperative in pediatric eyes to prevent amblyopia. The use of contact lenses and intraocular lenses in pediatric uveitic eyes were fraught with complications in the past. Surgical interventions such as vitreo-lensectomy followed by contact lens fitting and small incision cataract surgery followed by different types of intraocular lenses have been utilized, and many reports have been published, albeit in small patient groups. This review analyzes and discusses the existing literature on intraocular lens implantation in cases of pediatric uveitic cataract surgery. PMID:27009616

  18. Combined aniridic intraocular lens implantation and vitreoretinal surgery

    PubMed Central

    Mehta, Hijab; Jayadev, Chaitra; Natarajan, S

    2007-01-01

    A 45-year-old man presented with post-traumatic aniridia. We describe the combined surgery done to treat both aniridia and epiretinal membrane simultaneously. A combined aniridia intraocular lens and vitreoretinal surgery was done. The case report highlights the advantage of combined surgery in terms of cost factor and surgical time. PMID:17699956

  19. Telemedicine in the control of intra-ocular pressure.

    PubMed

    Michelson, G; Striebel, W; Prihoda, W; Schmidt, V

    2000-01-01

    Glaucoma is one of the most common causes of blindness in the Western world and a major risk factor is increased intra-ocular pressure. We therefore used telemedicine in its control. Patients measured their intra-ocular pressure several times a day with a portable instrument and the values were then entered into a portable digital assistant. These data were transmitted by a modem to a central server. If the intra-ocular pressure was pathologically high, an email message was automatically sent to the ophthalmologist. The pressure curve, including a statistical analysis, was displayed in an easily readable chart format. Ten patients with glaucoma participated in a trial. Self-tonometry with telemedicine enabled continuous evaluation of the patient by the ophthalmologist. This approach offered the advantage of controlling the treatment remotely. Advantages for the patient were that the measurements were easily done at home under normal conditions, and the patient could control when the measurement and data transmission would be performed. Telemedicine is a cost-effective technique enabling the early diagnosis of pathologically increased intra-ocular pressure. PMID:10793996

  20. Effect of chymase on intraocular pressure in rabbits.

    PubMed

    Konno, Takashi; Maruichi, Midori; Takai, Shinji; Oku, Hidehiro; Sugiyama, Tetsuya; Uchibori, Takehiro; Nagai, Akihiko; Kogi, Kentaro; Ikeda, Tsunehiko; Miyazaki, Mizuo

    2005-11-01

    Chymase is a chymotrypsin-like serine protease that is stored exclusively in the secretory granules of mast cells and converts big endothelins to endothelin-1 (1-31). The aim of this study was to evaluate the effect of chymase on intraocular pressure in rabbits. Chymase injection (3 and 10 mU) resulted in a trend toward increased intraocular pressure and a significant increase in intraocular pressure at a dose of 10 mU compared with the control. A specific chymase inhibitor, Suc-Val-Pro-Phe(P)(OPh)(2), attenuated the ocular hypertension induced by chymase. Endothelin-1 (1-31) also caused ocular hypertension, which was inhibited by a selective endothelin ET(A) receptor antagonist, cyclo(D-Asp-Pro-D-Val-Leu-D-Trp) (BQ-123). Moreover, chymase-induced ocular hypertension was inhibited by BQ-123. These results suggest that chymase influences the regulation of intraocular pressure, and it is likely that the formation of endothelin-1 (1-31) and subsequent activation of endothelin ET(A) receptors are involved in the development of ocular hypertension induced by chymase. PMID:16253233

  1. Intraocular pressure and tear production in five herbivorous wildlife species.

    PubMed

    Ofri, R; Horowitz, I H; Raz, D; Shvartsman, E; Kass, P H

    2002-08-31

    The intraocular pressure and rate of tear production were measured in 18 addax antelopes (Addax nasomaculatus), four impalas (Aepyceros melampus), 11 wide-lipped rhinoceroses (Ceratotherium simum), 10 white-tailed wildebeests (Connochaetes gnou) and seven scimitar-horned oryxes (Oryx dammah). The animals were anaesthetised with an intramuscular injection of etorphine hydrochloride and acepromazine maleate, and the Schirmer tear test I was used to evaluate tear production, and applanation tonometry was used to evaluate the intraocular pressure. The mean (sd) rate of tear production ranged from 17.6 (3.1) mm/minute in the rhinoceros to 28.8 (8.3) mm/minute in the addax. The intraocular pressure ranged from 8.0 (1.2) mmHg in the impala to 32.1 (10.4) mmHg in the rhinoceros. The rate of tear production in the addax and the intraocular pressure in the rhinoceros appear to be the highest values of these variables to have been reported in any species. PMID:12233828

  2. Effects of angiotensin, vasopressin and atrial natriuretic peptide on intraocular pressure in anesthetized rats

    NASA Technical Reports Server (NTRS)

    Palm, D. E.; Shue, S. G.; Keil, L. C.; Balaban, C. D.; Severs, W. B.

    1995-01-01

    The effects of atrial natriuretic peptide (ANP), vasopressin (AVP) and angiotensin (ANG) on blood and intraocular pressures of pentobarbital anesthetized rats were evaluated following intravenous, intracerebroventricular or anterior chamber routes of administration. Central injections did not affect intraocular pressure. Equipressor intravenous infusions of ANG raised, whereas AVP decreased, intraocular pressure. Direct infusions of a balanced salt solution (0.175 microliter/min) raised intraocular pressure between 30 and 60 min. Adding ANG or ANP slightly reduced this solvent effect but AVP was markedly inhibitory. An AVP-V1 receptor antagonist reversed the blunting of the solvent-induced rise by the peptide, indicating receptor specificity. Acetazolamide pretreatment lowered intraocular pressure, but the solvent-induced rise in intraocular pressure and inhibition by AVP still occurred without altering the temporal pattern. Thus, these effects appear unrelated to aqueous humor synthesis rate. The data support the possibility of intraocular pressure regulation by peptides acting from the blood and aqueous humor.

  3. Intraocular lens exchange-removing the optic intact.

    PubMed

    Lee, Matthew Hao; Webster, Diane Lesley

    2016-01-01

    Current practice for intraocular lens (IOL) exchange is to cut the optic of the posterior chamber intraocular lens (PCIOL) prior to removing it. Great care must be taken during this maneuver to avoid a posterior capsular tear. Removing the haptics from the fibrosed capsule can also be hazardous, as it may result in zonular stress and dehiscence. A technique is described for performing foldable (one-piece acrylic) IOL removal without cutting the optic. Careful visco-dissection of the haptics with a low viscosity ophthalmic viscosurgical device (OVD) in the fibrosed peripheral capsular tunnel avoids zonular or capsular stress. Internal wound enlargement permits foldable IOL removal in one piece, whilst preserving a self-sealing sutureless corneal wound. This technique may enhance the safety and efficacy of foldable IOL exchange. PMID:27366699

  4. An Imaging Review of Intra-ocular Calcifications.

    PubMed

    Kachewar, Sushil G; Kulkarni, Devidas S

    2014-01-01

    Intra-ocular calcifications can occur due to a variety of reasons. In cataract, the lovely lens gets calcified and the bright beautiful world becomes dark and dreadful. Cataract comes in various forms like; congenital, traumatic and senile. Asteroid Hyalosis (AH) occurs because of the accumulation of calcium soaps in vitreous of the eyes. Although it is asymptomatic and unilateral, it is seen more often in diabetic patients. Tumours of eye like retinoblastoma and optic nerve meningioma too are known to show calcifications. This review has focussed on imaging appearances of intra-ocular calcifications, a small process in a small organ that nevertheless has a wide impact on the entire organs. PMID:24596775

  5. Intraocular lens exchange-removing the optic intact

    PubMed Central

    Lee, Matthew Hao; Webster, Diane Lesley

    2016-01-01

    Current practice for intraocular lens (IOL) exchange is to cut the optic of the posterior chamber intraocular lens (PCIOL) prior to removing it. Great care must be taken during this maneuver to avoid a posterior capsular tear. Removing the haptics from the fibrosed capsule can also be hazardous, as it may result in zonular stress and dehiscence. A technique is described for performing foldable (one-piece acrylic) IOL removal without cutting the optic. Careful visco-dissection of the haptics with a low viscosity ophthalmic viscosurgical device (OVD) in the fibrosed peripheral capsular tunnel avoids zonular or capsular stress. Internal wound enlargement permits foldable IOL removal in one piece, whilst preserving a self-sealing sutureless corneal wound. This technique may enhance the safety and efficacy of foldable IOL exchange. PMID:27366699

  6. An ultralow power wireless intraocular pressure monitoring system

    NASA Astrophysics Data System (ADS)

    Demeng, Liu; Niansong, Mei; Zhaofeng, Zhang

    2014-10-01

    This paper describes an ultralow power wireless intraocular pressure (IOP) monitoring system that is dedicated to sensing and transferring intraocular pressure of glaucoma patients. Our system is comprised of a capacitive pressure sensor, an application-specific integrated circuit, which is designed on the SMIC 180 nm process, and a dipole antenna. The system is wirelessly powered and demonstrates a power consumption of 7.56 μW at 1.24 V during continuous monitoring, a significant reduction in active power dissipation compared to existing work. The input RF sensitivity is -13 dBm. A significant reduction in input RF sensitivity results from the reduction of mismatch time of the ASK modulation caused by FM0 encoding. The system exhibits an average error of ± 1.5 mmHg in measured pressure. Finally, a complete IOP system is demonstrated in the real biological environment, showing a successful reading of the pressure of an eye.

  7. Intra-ocular pressure normalization technique and equipment

    NASA Technical Reports Server (NTRS)

    Baehr, E. F. (Inventor)

    1979-01-01

    A method and apparatus is described for safely reducing abnormally high intraocular pressure in an eye during a predetermined time interval. This allows maintenance of normal intraocular pressure during glaucoma surgery. A pressure regulator of the spring-biassed diaphragm type is provided with additional bias by a column of liquid. The hypodermic needle can be safely inserted into the anterior chamber of the eye. Liquid is then bled out of the column to reduce the bias on the diaphragm of the pressure regulator and, consequently, the output pressure of the regulator. This lowering pressure of the regulator also occurs in the eye by means of a small second bleed path provided between the pressure regulator and the hypodermic needle.

  8. Determination of heparin on intraocular lens surfaces by ion chromatography.

    PubMed

    Ander, B; Karlsson, A; Ohrlund, A

    2001-05-11

    A sensitive and selective method has been developed for the determination of heparin on heparin coated PMMA, poly(methyl methacrylate), intraocular lenses. Heparin was hydrolysed to glucosamine and glucuronic acid, and the content of glucosamine was determined using ion chromatography with pulsed amperometric detection. In order to verify that a complete hydrolysis was obtained for the heparin on the coated intraocular lenses, electron spectroscopy for chemical analysis (ESCA) was used for analysing traces of sulphur on the lens surfaces. The sensitivity of the method allows quantitative determination of 150 ng of heparin on one individual lens. The new method was compared to a standard spectrophotometric method, measuring the colour intensity of a heparin toluidine blue complex. Correlation between the methods was shown for samples prepared from PMMA lenses coated with different amounts of heparin. PMID:11403462

  9. Endogenous bacterial endophthalmitis masquerading as an intraocular tumor

    PubMed Central

    Salvetti, Anna Paola; Pellegrini, Marco; Bottoni, Ferdinando; Staurenghi, Giovanni

    2015-01-01

    A 40-year-old female patient referred for a possible intraocular tumor was found to have an endogenous bacterial endophthalmitis in her right eye. Fundus examination revealed an amelanotic dome shaped choroidal mass and an exudative retinal detachment. Enhanced Depth Imaging-Optical Coherence Tomography (EDI-OCT), fundus autofluorescence (FAF) and ultrasounds were suggestive of a possible choroidal melanoma. A multimodal imaging approach and a thorough anamnesis were instrumental in establishing the correct diagnosis. PMID:26949365

  10. Intraocular gnathostomiasis: A rare case report from Central India

    PubMed Central

    Rawat, Preeti; Gautam, Manushree; Jain, Nikhila C; Jain, Rajdeep

    2016-01-01

    We report the first case of intraocular gnathostomiasis from Central India. A 29-year-old male from Indore, Madhya Pradesh, presented with pain and redness of the right eye since 1 month. Slit lamp examination revealed anterior uveitis, multiple iris atrophic patches, and a live worm hooked on iris. The worm was removed through a small sclerocorneal tunnel. Microscopy confirmed Gnathostoma spinigerum. The patient was treated with oral albendazole and steroids. The case is reported because of its rarity. PMID:27146938

  11. Intraocular involvement with subretinal pigment epithelium infiltrates by mycosis fungoides.

    PubMed Central

    Erny, B. C.; Egbert, P. R.; Peat, I. M.; Shorrock, K.; Rosenthal, A. R.

    1991-01-01

    We report a case of intraocular mycosis fungoides in a 48-year-old man. The patient presented with decreased visual acuity, white subretinal lesions, and vitritis. Post-mortem histopathology revealed malignant T cell infiltrates consistent with mycosis fungoides in the retina, vitreous, and between the retinal pigment epithelium (RPE) and Bruch's membrane Focal atrophy of the RPE, along with the sub-RPE infiltrates, correlated with the clinically visible fundus lesions. Images PMID:1751471

  12. The dangers of metal-loop intraocular lenses.

    PubMed

    Shepard, D D

    1977-10-01

    The author implanted 500 intraocular lenses (IOLs) during intracapsular surgery. Data from the 60 lenses with metal posterior loops showed a markedly high incidence of complication compared to plastic loops: twice as many overall complications, three times the cystoid mascular edema, three times the rate for subsequent corrective surgical procedures, and 30 times more IOLs had to be removed. IOL manufacturers are advised to abandon metal loops for intracapsular implantation. Polypropylene is suggested as the apparent ideal loop material. PMID:304550

  13. Spontaneous dislocation of intraocular lens as a late complication of uncomplicated cataract surgery: a case series.

    PubMed

    Lam, Hee Hong; Visvaraja, Subrayan

    2012-01-01

    Five patients having uncomplicated phacoemulsification were implanted with CT-Asphina 603P intraocular lenses into the capsular bag. After a few months, three of the patients had haptic flexion anterior to the optic despite minimal capsular fibrosis. One patient had spontaneous dislocation of the intraocular lens into the anterior chamber with only minimal capsular fibrosis. Another patient had one haptic dislocated out of the bag. Late intraocular lens dislocation is also seen in newly designed preloaded intraocular lenses despite the absence of significant capsular fibrosis. Haptic-optic junction design and intraocular lens material play important roles in such complication. A slightly large capsulorhexis might be a deterrent for implantation of this intraocular lens. PMID:21954950

  14. Causes of elevated intraocular pressure following implantation of phakic intraocular lenses for myopia.

    PubMed

    Almalki, Salem; Abubaker, Abdullah; Alsabaani, Nasser A; Edward, Deepak P

    2016-04-01

    The purpose of this study is to present the causes and visual acuity outcomes in patients with elevated intraocular pressure (IOP) following implantable collamer lens (ICL) implantation. A chart review identified patients who developed high IOP at any postoperative examination and a minimum follow-up period of 3 months after ICL implantation. Data are reported out to 6 months postoperatively. Outcome measures included causes of elevated IOP, best-corrected visual acuity (BCVA) at last visit, number of glaucoma medications, other interventions, and glaucomatous damage. Elevated IOP occurred in 58 (10.8 %) of 534 eyes that received ICL. The mean age was 28 ± 7.2 years. The preoperative IOP was 16.3 ± 1.2 mmHg. Elevated IOP most commonly occurred on the first postoperative day (23/58 (39.7 %) eyes) due to retained viscoelastic. This was followed by steroid response in 22/58 (37.9 %) eyes at 2-4 weeks postoperatively. IOP elevation in 6 (10.3 %) eyes was related to high ICL vault and pupillary block, and in 4 (6.9 %) eyes due to synechial angle closure. At last visit, BCVA was 20/40 or better in 56/58 (96.6 %) eyes, and 5/58 (8.6 %) eyes remained on glaucoma medications due to persistent steroid response (2 eyes), synechial angle closure glaucoma (1 eye), and other causes (2 eyes). One eye showed glaucomatous damage. Two eyes with high vault and elevated IOP underwent ICL explantation. There is a moderate risk of transiently developing elevated IOP after ICL implantation. Thorough removal of viscoelastic and use of anti-glaucoma medications during steroid use will reduce the majority of cases with postoperative IOP elevation. PMID:26265323

  15. The preoperative intraocular pressure level predicts the amount of underestimated intraocular pressure after LASIK for myopia

    PubMed Central

    Chihara, E; Takahashi, H; Okazaki, K; Park, M; Tanito, M

    2005-01-01

    Aims: To evaluate the statistical significance of the parameters that affect underestimation of intraocular pressure (IOP) after laser in situ keratomileusis (LASIK) for myopia. Methods: In this prospective case series study, patient age, axial length, preoperative corneal curvature, preoperative central corneal thickness (CCT), preoperative IOP, and ablation depth were studied to determine whether they affect the underestimation of IOP in the right eyes of 100 consecutive patients who underwent LASIK. Results: The preoperative IOP was the most important parameter for an amount of underestimated Goldmann applanation tonometric IOP (GAT) and non-contact tonometric IOP (ncIOP) at 1 month (r = 0.654, p<0.0001, R2 = 0.427, and r = 0.694, p<0.0001, R2 = 0.481, respectively) and 3 months (r = 0.637, p<0.0001, R2 = 0.406, and r = 0.726, p<0.0001, R2 = 0.527, respectively). Patient age was statistically significant for underestimating the GAT at 1 month, and both the ablation depth and CCT were statistically significant parameters for underestimating the ncIOP at 1 month and at 3 months by stepwise multiple regression analysis (F>4.000). However, these parameters had small bivariate correlation coefficients, and were considered as minor parameters. Conclusion: Preoperative IOP is the most important parameter that affects an underestimation of IOP after LASIK for myopia. Eyes with a higher true IOP have a larger underestimation of the IOP after LASIK for myopia. From these results, the importance of the modulus of elasticity on IOP measurements was discussed. PMID:15665345

  16. Sustained Release Intraocular Drug Delivery Devices for Treatment of Uveitis

    PubMed Central

    Haghjou, Nahid; Soheilian, Masoud; Abdekhodaie, Mohammad Jafar

    2011-01-01

    Corticosteroids have been the mainstay of uveitis therapy. When intraocular inflammation is unresponsive to steroids, or steroid related side effects become a concern, steroid-sparing medications may be administered which can be classified into immunosuppressive and immunomodulatory agents. Uveitis treatment can be delivered systemically, topically, periocularly or intraocularly. All of the above mentioned medications can entail significant systemic side effects, particularly if administered for prolonged durations, which may become treatment-limiting. Some medications, particularly hydrophobic compounds, may poorly cross the blood–retinal barrier. Topical medications, which have the least side effects, do not penetrate well into the posterior segment and are unsuitable for posterior uveitis which is often sight-threatening. Intraocular or periocular injections can deliver relatively high doses of drug to the eye with few or no systemic side effects. However, such injections are associated with significant complications and must often be repeated at regular intervals. Compliance with any form of regular medication can be a problem, particularly if its administration is associated with discomfort or if side effects are unpleasant. To overcome the above-mentioned limitations, an increasing number of sustained-release drug delivery devices using different mechanisms and containing a variety of agents have been developed to treat uveitis. This review discusses various current and future sustained-release ophthalmic drug delivery systems for treatment of uveitis. PMID:22454753

  17. Validation of sensor for postoperative positioning with intraocular gas

    PubMed Central

    Brodie, Frank L; Woo, Kelly Y; Balakrishna, Ashwin; Choo, Hyuck; Grubbs, Robert H

    2016-01-01

    Purpose Surgical repair of retinal attachment or macular hole frequently requires intraocular gas. This necessitates specific postoperative positioning to improve outcomes and avoid complications. However, patients struggle with correct positioning. We have developed a novel sensor to detect the position of the gas bubble in the eye and provide feedback to patients in real time. In this paper, we determine the specificity and sensitivity of our sensor in vitro using a model eye. Methods We assessed the reliability of our sensor to detect when a gas bubble has deviated off a model retinal break in a model eye. Various bubble sizes representing the intraocular kinetics of sulfur hexafluoride gas and varying degrees of deviation from the correct position were tested using the sensor attached to a mannequin head with a model eye. Results We recorded 36 data points. The sensor acted appropriately in 33 (91.7%) of them. The sensor triggered the alarm every time the bubble deviated off the break (n=15, sensitivity =100%). However, it triggered the alarm (falsely) 3/21 times when the bubble was correctly positioned over the retinal break (specificity =86%). Conclusion Our device shows excellent sensitivity (100%) and specificity (86%) in detecting whether intraocular gas is tamponading a retinal break in a model eye. PMID:27307698

  18. Development of Microelectromechanical Systems (MEMS) forceps for intraocular surgery

    PubMed Central

    Bhisitkul, R B; Keller, C G

    2005-01-01

    Aim: To develop silicon microforceps for intraocular surgery using Microelectromechanical Systems (MEMS) technology, the application of microchip fabrication techniques for the production of controllable three dimensional devices on the micrometre scale. Methods: Prototype MEMS forceps were designed and manufactured for intraocular surgery. Scanning electron microscopy was used to evaluate device tip construction. Designs using both thermal expansion actuators and conventional mechanical activation were tested in human cadaver eyes and in vivo rabbit eyes to assess functionality in standard vitreoretinal surgery. Results: MEMS forceps were constructed with various tip designs ranging from 100 μm to 2 mm in length. Scanning electron microscopy confirmed accurate construction of micro features such as forceps teeth as small as tens of micrometres. In surgical testing, the silicon forceps tips were effective in surgical manoeuvres, including grasping retinal membranes and excising tissue. The mechanical actuator design on a 20 gauge handle was more operational in the intraocular environment than the thermal expansion actuator design. While handheld operation was possible, the precision of the forceps was best exploited when mounted on a three axis micromanipulator. Conclusion: MEMS microforceps are feasible for conventional vitreoretinal surgery, and offer advances in terms of small scale, operating precision, and construction tolerance. PMID:16299136

  19. Varifocal optics for a novel accommodative intraocular lens

    NASA Astrophysics Data System (ADS)

    Simonov, A. N.; Rombach, M.; Vdovin, G.; Loktev, M.

    2006-01-01

    The development of adaptive optics for the human eye to correct aberrations, to restore accommodation after lens extraction due to cataract and to correct age-related presbyopia have interest of academia and industry. We report on optics for a new accommodative intraocular lens which uses a two-element varifocal Alvarez lens. This lens has two refractive elements with cubic surfaces which, in combination, form a varifocal lens when the elements are shifted relatively to each other perpendicular to the optical path. The accommodative function of the lens will be driven by the ocular ciliary muscle. The refractive elements of the dual-optic intraocular lens are designed to provide a near emmetropic on-axis vision with a >4 dioptre accommodation range. The anterior element has a spherical lens to correct for the overall refraction of the eye, aspheric terms to correct the corneal asphericity and a cubic term as accommodative component; the posterior element has a cubic shaped surface only. The modular transfer function shows that the image on the retina reaches a diffraction limited performance for the on-axis vision in combination with the aspheric correction for aberrations of the cornea. We conclude that the varifocal lens is uniquely suitable for application as an intraocular accommodative lens because of its optical quality and ample accommodative power.

  20. Raised intraocular pressure with topical steroids after trabeculectomy.

    PubMed

    Thomas, R; Jay, J L

    1988-01-01

    A prospective study of 87 eyes of 52 patients with primary open-angle glaucoma showed a significant steroid-induced rise in intraocular pressure in the 4 weeks after trabeculectomy in 23% of eyes. The steroid response rate was lower (17%) in those eyes that had trabeculectomy without a prior trial of medical therapy than in those who had surgery only after failure of medical therapy (36%), but this difference just failed to reach statistical significance. The responders were not significantly different from the non-responders as regards level of intraocular pressure or severity of visual field loss at diagnosis. The frequency of response was lower than that expected in the normal and in the glaucoma population and fell further in the late post-operative period when only 3 of 8 previously responsive eyes submitted to re-challenge with topical steroids showed persisting responsiveness. Topical steroids may be the commonest cause of high intraocular pressure in the first weeks or even days after trabeculectomy. Decisions about long-term supplementary medical therapy should therefore only be taken several weeks after withdrawal of the post-operative steroid drops. PMID:3169586

  1. [The Use of Polymers for Intraocular Lenses in Cataract Surgery].

    PubMed

    Fizia-Orlicz, Anna; Misiuk-Hojło, Marta

    2015-01-01

    According to the World Health Organization, cataract remains the leading cause of the curable visual impairment worldwide. Cataract can only be cured by surgery during which the cloudy lens is replaced with an artificial intraocular lens. It is one of the most common surgeries being performed worldwide. There are age-related, congenital, traumatic and metabolic types of cataract which have been distinguished. Age-related cataract is the most common one and it affects people over 60 with the greatest frequency. In reference to patients whose cornea does not fulfill the requirements for a standard refractive surgery, the number of refractive intraocular lens replacement is increasing. Manufacturers aim to enhance materials in order to minimize surgical complication while increasing the patient’s eyesight. The increase in average lifespan along with patients’ expectations stimulate competition among manufacturers who bring new products and solutions into to the market. There is an augmented demand for premium lenses such as toric, multifocal or accommodating. These lenses bring patients the promise of life without the need for wearing glasses. As far as the main materials used in the production of intraocular lens are concerned, there are hydrophobic, hydrophilic, acrylic and silicone lenses in use. In this paper the author discusses characteristics as well as advantages and disadvantages of the above-mentioned materials. The associated surgical complications and the new areas of development regarding the materials used in lenses manufacturing are also examined. PMID:26994891

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

    PubMed Central

    Kelkar, Aditya; Shah, Rachana; Kelkar, Jai; Kelkar, Shreekant; Arora, Ekta

    2015-01-01

    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. PMID:26327909

  3. Keeping an eye on dialysis: the association of hemodialysis with intraocular hypertension.

    PubMed

    William, Jeffrey H; Gilbert, Aubrey L; Rosas, Sylvia E

    2015-11-01

    Intraocular hypertension is common during hemodialysis. Dialysis disequilibrium syndrome and intraocular hypertension occur via similar pathophysiologic mechanisms. These mechanisms may contribute to the development of glaucoma and cataracts in a patient population already at high risk for ocular abnormalities, given the common risk factors for chronic kidney disease and impaired aqueous humor outflow. We describe a patient with complicated diabetes mellitus, end-stage renal disease, and recent cataract surgery who developed severe intraocular hypertension during hemodialysis. We recommend increased awareness of the symptoms of intraocular hypertension and subsequent ophthalmologic surveillance in order to prevent long-term visual complications. PMID:26042412

  4. Short-term intraocular pressure changes after intravitreal injection of bevacizumab in diabetic retinopathy patients

    PubMed Central

    Farhood, Qasim Kadhim; Twfeeq, Sinan Mohammad

    2014-01-01

    Background This study examined the changes in short-term intraocular pressure (IOP) in a prospective series of patients undergoing intravitreal bevacizumab injection. The aim was to evaluate the frequency and predictive factors related to intraocular pressure (IOP) elevation in patients receiving intravitreal bevacizumab. Patients and methods This study included 52 patients with diabetic retinopathy between 28 to 75 years of age with a mean age of 51 years; 30 (58%) were females, and 22 (42%) were males. All patients received bevacizumab (1.25 mg/0.05 mL) injected intravitreally in a standard fashion between May 2012 to February 2013 in the AL-Jumhoury teaching hospital. IOP was measured at baseline, 5, 10, and 30 minutes after injection using Goldman applanation tonometry. Statistics Data were analyzed using the SPSS v.12.0 for windows. Basic, demographic, and clinical data were analyzed using means, proportions, and appropriate 95% confidence intervals (CIs). Results Most patients (85%) were diagnosed with proliferative diabetic retinopathy, while 15% presented with diabetic macular edema. The mean IOP values at baseline, 5, 10, and 30 minutes after injection were 14.0 mmHg (95% CI 13.4–14.7), 36.1 mmHg (95% CI 33.5–38.6), 25.7 mmHg (95% CI 23.8–27.5), and 15.5 mmHg (95% CI 12.4–16.51), respectively. Regression analysis showed a trend toward phakic patients having higher IOP at 30 minutes. Conclusion Intravitreal injection of bevacizumab is safe with respect to short-term IOP changes, as almost all IOP returned to a safe range (<25 mmHg) within 30 minutes. Elevated IOP 30 minutes after injection only occurs rarely, so routine prophylactic use of anti-glaucoma medication is not indicated. PMID:24707164

  5. Optical bench performance of a novel trifocal intraocular lens compared with a multifocal intraocular lens

    PubMed Central

    Lee, Shinwook; Choi, Myoung; Xu, Zaiwei; Zhao, Zeyu; Alexander, Elsinore; Liu, Yueai

    2016-01-01

    Purpose The purpose of this study is to compare the optical characteristics of the novel PanOptix presbyopia-correcting trifocal intraocular lens (IOL) and the multifocal ReSTOR +3.0 D IOL, through in vitro bench investigations. Methods The optical characteristics of AcrySof® IQ PanOptix™ (PanOptix) and AcrySof® IQ ReSTOR +3.0 D (ReSTOR +3.0 D) IOLs were evaluated by through-focus Badal images, simulated headlight images, and modulation transfer function (MTF) measurements which determine resolution, photic phenomena, and image quality. Through-focus Badal images of an Early Treatment of Diabetic Retinopathy Study chart were recorded at both photopic and mesopic pupil sizes. Simulated headlight images were taken on an MTF bench with a 50-μm pinhole target and a 5.0 mm pupil at the distance focus of the IOL. MTF curves were measured with a 3.0 mm pupil, and spatial frequencies equivalent to 20/40 and 20/20 visual acuities were recorded to illustrate the through-focus MTF curves. Far-, intermediate-, and near-focus MTF values were obtained. Results Bench Badal image testing and MTF measurements showed that PanOptix has a near focus at a distance of 42 cm and an additional intermediate focus at a distance of about 60 cm. The near focus for ReSTOR +3.0 D is at 45 cm. PanOptix and ReSTOR +3.0 D have comparable photopic distances and near MTF values. Additionally, PanOptix provided a substantial continuous range of vision from distance to intermediate and to near compared with ReSTOR +3.0 D. The halo propensity for PanOptix was slightly higher than that for ReSTOR +3.0 D. Conclusion Laboratory-based in vitro simulations showed that PanOptix trifocal IOL has comparable resolution and image quality performance in distance and near foci compared with ReSTOR +3.0 D IOL. PanOptix showed better resolution and image quality performance at the intermediate focus than ReSTOR +3.0 D IOL. PMID:27330273

  6. The Safety, Pharmacokinetics, and Efficacy of Intraocular Celecoxib

    PubMed Central

    Kim, Stephen J.; Toma, Hassanain; Shah, Rohan; Kompella, Uday B.; Vooturi, Sunil K.; Sheng, Jinsong

    2014-01-01

    Purpose. To determine safety, pharmacokinetics, and anti-inflammatory effects of intraocular celecoxib. Methods. The right eye of animals was injected with 1.5, 3, or 6 mg celecoxib prepared in dimethyl sulfoxide (DMSO). Left eyes served as controls and received 0.1 mL DMSO. Electroretinograms (ERG) were obtained at baseline and at 1, 4, and 12 weeks, and eyes were enucleated afterward for histopathologic analysis. For pharmacokinetics, 3 mg celecoxib was injected, and vitreous and retina/choroid drug levels were then analyzed at specific time points. For efficacy, 1 μg lipopolysaccharide was injected to induce inflammation; the right eye was then injected with 3 mg celecoxib (six eyes) or 2 mg triamcinolone acetonide (six eyes) and the left eye with saline. Twenty-four hours later, aqueous fluid was removed, and total leukocyte concentration and prostaglandin E2 (PGE2) concentration were determined. Results. Histologic and ERG studies demonstrated no signs of retinal or optic nerve toxicity. After a single 3-mg injection, vitreous (0.06 μg/mL) and retina/choroid (132.31 μg/g) celecoxib concentrations at 8 weeks exceeded median inhibitory concentration. Treatment with celecoxib and triamcinolone significantly reduced total leukocyte count by 40% (P = 0.02) and 31% (P = 0.01), respectively. Reduction in PGE2 levels paralleled reduction in leukocyte counts (P < 0.05). There was no increase in intraocular pressure, but cataract formation was observed at higher concentrations. Conclusions. Intraocular injection of celecoxib appeared to be nontoxic and demonstrated excellent penetration into the retina/choroid and sustained drug levels out to 8 weeks. Celecoxib demonstrated potent anti-inflammatory effects, but there was an association with cataract formation at higher doses. PMID:24458149

  7. Clinical evaluation of two multifocal intraocular lens implantation patterns

    PubMed Central

    Lin, Hao-Tian; Chen, Wei-Rong; Ding, Zhao-Feng; Chen, Wan; Wu, Chang-Rui

    2012-01-01

    AIM To evaluate the visual outcomes and patient satisfaction of two multifocal intraocular lens implantation patterns, with the decision between the two patterns being guided by the patients' choice of visual zones that best suited their lifestyle, or lifestyle zones. METHODS This is a prospective non-randomized comparative study. The lifestyle zones of 32 consecutive age-related cataract patients (64 eyes) were investigated individually to guide the surgical decision between two multifocal intraocular lens implantation patterns. The first group (MIX) received a combined implantation of a ReZoom NXG1 lens in the dominant eye and a Tecnis ZM900 lens in the other eye. The second group (MATCH) received bilateral ReZoom NXG1 lenses. One year postoperatively, the patients were assessed for binocular uncorrected visual acuity, reading visual acuity, reading speed and depth of focus under different luminance and were surveyed for visual disturbances, satisfaction and complete spectacle independence. RESULTS According to the determination of lifestyle zones, 18 and 14 patients were included in the MIX and MATCH groups, respectively. One year postoperatively, each of the patients exhibited positive visual outcomes and lifestyle satisfaction, although there were still some differences between the two groups. Generally, patients in the MATCH group had better distance visual acuity than those in the MIX group. In contrast, patients in the MIX group had better near visual acuity, better reading acuity and better reading speed than those in the MATCH group. Between the two groups, there was no clear difference in intermediate visual acuity, and the depths of focus between the two groups were approximately equal. The results of the mean NEI-RQL-42 questionnaire score, overall satisfaction, and complete spectacle independence did not differ between the two groups. CONCLUSION Different multifocal intraocular lenses implantation patterns can have differing advantages and

  8. UV solid state laser ablation of intraocular lenses

    NASA Astrophysics Data System (ADS)

    Apostolopoulos, A.; Lagiou, D. P.; Evangelatos, Ch.; Spyratou, E.; Bacharis, C.; Makropoulou, M.; Serafetinides, A. A.

    2013-06-01

    Commercially available intraocular lenses (IOLs) are manufactured from silicone and acrylic, both rigid (e.g. PMMA) and foldable (hydrophobic or hydrophilic acrylic biomaterials), behaving different mechanical and optical properties. Recently, the use of apodizing technology to design new diffractive-refractive multifocals improved the refractive outcome of these intraocular lenses, providing good distant and near vision. There is also a major ongoing effort to refine laser refractive surgery to correct other defects besides conventional refractive errors. Using phakic IOLs to treat high myopia potentially provides better predictability and optical quality than corneal-based refractive surgery. The aim of this work was to investigate the effect of laser ablation on IOL surface shaping, by drilling circular arrays of holes, with a homemade motorized rotation stage, and scattered holes on the polymer surface. In material science, the most popular lasers used for polymer machining are the UV lasers, and, therefore, we tried in this work the 3rd and the 5th harmonic of a Q-switched Nd:YAG laser (λ=355 nm and λ=213 nm respectively). The morphology of the ablated IOL surface was examined with a scanning electron microscope (SEM, Fei - Innova Nanoscope) at various laser parameters. Quantitative measurements were performed with a contact profilometer (Dektak-150), in which a mechanical stylus scanned across the surface of gold-coated IOLs (after SEM imaging) to measure variations in surface height and, finally, the ablation rates were also mathematically simulated for depicting the possible laser ablation mechanism(s). The experimental results and the theoretical modelling of UV laser interaction with polymeric IOLs are discussed in relation with the physical (optical, mechanical and thermal) properties of the material, in addition to laser radiation parameters (laser energy fluence, number of pulses). The qualitative aspects of laser ablation at λ=213 nm reveal a

  9. ["Physical eyes" for evaluating various intraocular lenses for monocular and binocular use].

    PubMed

    Jacobi, K W; Reiner, J

    1993-12-01

    We developed a "physical eye system" to evaluate visual impression after physical implantation of monofocal and multifocal intraocular lenses (IOLs). The system is constructed as two identical astronomical telescopes. The objectives imitate the cornea and behind this cornea the IOL is inserted. The image quality represents exactly the quality of the intraocular lens. PMID:8145490

  10. Extensive facial and orbital infantile hemangiomas associated with high intraocular pressure.

    PubMed

    Shatriah, Ismail; Norazizah, Mohd-Amin; Wan-Hitam, Wan-Hazabbah; Wong, Abd-Rahim; Yunus, Rohaizan; Leo, Seo-Wei

    2013-01-01

    High intraocular pressure is a rare ophthalmic condition associated with infantile hemangiomas that involves the orbit, eyelid, or both. Here, we describe a patient with extensive facial and orbital infantile hemangiomas associated with high intraocular pressure in the affected eye. The prompt management of this challenging condition is essential. PMID:22329437

  11. In situ tumbling of the AcrySof intraocular lens.

    PubMed

    Rao, S K; Leung, A T; Lam, D S; Padmanabhan, P

    2000-02-01

    The small incision through which foldable acrylic intraocular lenses (IOLs) are implanted does not allow easy explantation of the lens in the event of intraoperative complications. Reversal of the IOL optic during insertion, although rare, can predispose to postoperative complications such as pupillary capture of the IOL, capsule bag distension syndrome, and refractive problems. Explanting the IOL can damage it, the cataract wound, or both. We describe a technique of in situ tumbling of the AcrySof IOL to correct reversed-optic implantation that preserves the integrity of the IOL and anterior segment structures. PMID:10683784

  12. Effect of transscleral neodymium: YAG cyclophotocoagulation on intraocular lenses

    SciTech Connect

    Blomquist, P.H.; Gross, R.L.; Koch, D.D. )

    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.

  13. Intraocular implants for the surgical correction of presbyopia

    NASA Astrophysics Data System (ADS)

    Parel, Jean-Marie A.; Rol, Pascal O.; Tahi, Hassan; Manns, Fabrice; Milne, Peter J.; Hamaoui, Marie; Ho, Arthur; Holden, Brien

    2000-06-01

    The surgical techniques proposed to restore accommodation past the onset of presbyopia can be categorized in two classes, those based of scleral expansion and those based on intraocular lens implantation and lens capsule refilling. This paper describes and discusses the different techniques and summarizes the results of clinical and experimental animal trials. Restoration of accommodation has been demonstrated by at least two different teams in non-human senile primates using modifications of the lens capsule refilling technique originally described by Julius Kessler in the late fifties. The advent of recent advances in microsurgery, devices, and injectable polymers are very promising and human clinical trials may soon be envisaged.

  14. Delayed accumulation of lens material behind the foldable intraocular lens.

    PubMed

    Bhattacharjee, Harsha; Bhattacharjee, Kasturi; Bhattacharjee, Pankaj

    2007-01-01

    Foldable acrylic intraocular lenses (IOLs) are known to reduce posterior capsule opacification by preventing migration of lens epithelial cells with its square edge design and its property of tackiness. Studies have reported a mean adhesiveness to posterior capsule more than three times higher for certain acrylic foldable IOLs than polymethyl methacrylate IOLs. The authors would like to report two cases where the force of tackiness was compensated, thereby presenting with delayed accumulation of lens material in the capsular bags behind the IOL with temporary loss of vision. PMID:17951912

  15. Delayed accumulation of lens material behind the foldable intraocular lens

    PubMed Central

    Bhattacharjee, Kasturi; Bhattacharjee, Pankaj

    2007-01-01

    Foldable acrylic intraocular lenses (IOLs) are known to reduce posterior capsule opacification by preventing migration of lens epithelial cells with its square edge design and its property of tackiness. Studies have reported a mean adhesiveness to posterior capsule more than three times higher for certain acrylic foldable IOLs than polymethyl methacrylate IOLs. The authors would like to report two cases where the force of tackiness was compensated, thereby presenting with delayed accumulation of lens material in the capsular bags behind the IOL with temporary loss of vision. PMID:17951912

  16. Accuracy of Intraocular Lens Power Calculation Formulas for Highly Myopic Eyes.

    PubMed

    Zhang, Yichi; Liang, Xiao Ying; Liu, Shu; Lee, Jacky W Y; Bhaskar, Srinivasan; Lam, Dennis S C

    2016-01-01

    Purpose. To evaluate and compare the accuracy of different intraocular lens (IOL) power calculation formulas for eyes with an axial length (AL) greater than 26.00 mm. Methods. This study reviewed 407 eyes of 219 patients with AL longer than 26.0 mm. The refractive prediction errors of IOL power calculation formulas (SRK/T, Haigis, Holladay, Hoffer Q, and Barrett Universal II) using User Group for Laser Interference Biometry (ULIB) constants were evaluated and compared. Results. One hundred seventy-one eyes were enrolled. The Barrett Universal II formula had the lowest mean absolute error (MAE) and SRK/T and Haigis had similar MAE, and the statistical highest MAE were seen with the Holladay and Hoffer Q formulas. The interquartile range of the Barrett Universal II formula was also the lowest among all the formulas. The Barrett Universal II formulas yielded the highest percentage of eyes within ±1.0 D and ±0.5 D of the target refraction in this study (97.24% and 79.56%, resp.). Conclusions. Barrett Universal II formula produced the lowest predictive error and the least variable predictive error compared with the SRK/T, Haigis, Holladay, and Hoffer Q formulas. For high myopic eyes, the Barrett Universal II formula may be a more suitable choice. PMID:27119018

  17. Accuracy of Intraocular Lens Power Calculation Formulas for Highly Myopic Eyes

    PubMed Central

    Zhang, Yichi; Liang, Xiao Ying; Liu, Shu; Lee, Jacky W. Y.; Bhaskar, Srinivasan; Lam, Dennis S. C.

    2016-01-01

    Purpose. To evaluate and compare the accuracy of different intraocular lens (IOL) power calculation formulas for eyes with an axial length (AL) greater than 26.00 mm. Methods. This study reviewed 407 eyes of 219 patients with AL longer than 26.0 mm. The refractive prediction errors of IOL power calculation formulas (SRK/T, Haigis, Holladay, Hoffer Q, and Barrett Universal II) using User Group for Laser Interference Biometry (ULIB) constants were evaluated and compared. Results. One hundred seventy-one eyes were enrolled. The Barrett Universal II formula had the lowest mean absolute error (MAE) and SRK/T and Haigis had similar MAE, and the statistical highest MAE were seen with the Holladay and Hoffer Q formulas. The interquartile range of the Barrett Universal II formula was also the lowest among all the formulas. The Barrett Universal II formulas yielded the highest percentage of eyes within ±1.0 D and ±0.5 D of the target refraction in this study (97.24% and 79.56%, resp.). Conclusions. Barrett Universal II formula produced the lowest predictive error and the least variable predictive error compared with the SRK/T, Haigis, Holladay, and Hoffer Q formulas. For high myopic eyes, the Barrett Universal II formula may be a more suitable choice. PMID:27119018

  18. Regulation of intraocular pressure by soluble and membrane guanylate cyclases and their role in glaucoma

    PubMed Central

    Buys, Emmanuel S.; Potter, Lincoln R.; Pasquale, Louis R.; Ksander, Bruce R.

    2014-01-01

    Glaucoma is a progressive optic neuropathy characterized by visual field defects that ultimately lead to irreversible blindness (Alward, 2000; Anderson et al., 2006). By the year 2020, an estimated 80 million people will have glaucoma, 11 million of which will be bilaterally blind. Primary open-angle glaucoma (POAG) is the most common type of glaucoma. Elevated intraocular pressure (IOP) is currently the only risk factor amenable to treatment. How IOP is regulated and can be modulated remains a topic of active investigation. Available therapies, mostly geared toward lowering IOP, offer incomplete protection, and POAG often goes undetected until irreparable damage has been done, highlighting the need for novel therapeutic approaches, drug targets, and biomarkers (Heijl et al., 2002; Quigley, 2011). In this review, the role of soluble (nitric oxide (NO)-activated) and membrane-bound, natriuretic peptide (NP)-activated guanylate cyclases that generate the secondary signaling molecule cyclic guanosine monophosphate (cGMP) in the regulation of IOP and in the pathophysiology of POAG will be discussed. PMID:24904270

  19. Comparison of Artisan iris-claw intraocular lens implantation and posterior chamber intraocular lens sulcus fixation for aphakic eyes

    PubMed Central

    Teng, He; Zhang, Hong

    2014-01-01

    AIM To compare the efficacy and complications of Artisan iris-claw intraocular lens (IOL) implantation and posterior chamber IOL sulcus fixation for the treatment of aphakic eyes without capsular support after vitrectomy. METHODS A prospective study of 45 cases was conducted. Forty-five eyes without sufficient lens capsule support following pars plana vitrectomy (PPV) combined lens extraction were divided into two groups. Group A: 25 eyes received Artisan iris-claw IOL implantation. Group B: 20 eyes received posterior chamber IOL sulcus fixation. The corrected distance visual acuity (CDVA) and intraocular pressure (IOP), corneal endothelial cell loss rate, surgical time and complications were compared between the two groups. Pigment changes of trabecular meshwork and anterior chamber depths were measured at each time point in Artisan group. RESULTS The mean surgical time of Artisan group was significantly shorter (P<0.05). No statistically significant difference in endothelial cell loss rate was noted between two groups at any time point (P>0.05). CDVA of Artian group was better than that of the sulcus fixation group 1d after surgery (P<0.05) and there was no statistically significant difference 1 and 3mo after surgery (P>0.05). Mean IOP showed no significant differences between groups before and after surgery. The postoperative complications of Artisan group were anterior uveitis, iris depigmentation, pupillary distortion and spontaneous lens dislocation. The complications of sulcus fixation group include choroidal detachment, intraocular haemorrhage, tilt of IOL optic part and retinal detachment. CONCLUSION Secondary Artisan IOL implantation can be performed less invasively and in a shorter surgical time period with earlier visual recovery after surgery compared to transscleral suturing fixation of an IOL. This technique is an effective and safe procedure. It is a promising option for the treatment of aphakic eyes without capsular support after vitrectomy. PMID

  20. Posterior Iris Fixated Intraocular Lens for Pediatric Traumatic Cataract

    PubMed Central

    Kavitha, V.; Balasubramanian, Preethi; Heralgi, Mallikarjun M.

    2016-01-01

    Purpose: To evaluate the postoperative visual outcomes and complications of posterior iris fixated intraocular lens (IFIOL) implantation for pediatric traumatic cataract. Methods: A retrospective clinical audit was performed of all the pediatric traumatic cataract patients who underwent lens removal and iris fixated lens implantation due to inadequate capsular support with or without corneal tear repair between January 2009 and December 2013. Data were collected and analyzed on the preoperative and postoperative visual outcomes and complications. Results: Twenty-five children (25 eyes; 21 males and 4 females) were enrolled with the mean age of 11 ± 4.0 years. There were 72% of eyes that underwent primary cataract removal with IFIOL implantation. Twenty-eight percent of eyes underwent corneal tear repair prior to intraocular lens (IOL) implantation. Preoperative best corrected visual acuity (BCVA) was hand motion in 32% eyes, counting fingers in 24%, and perception of light in 44%. Postoperative BCVA of 0-0.2 logarithm of minimum angle of resolution was reported in the 64% of eyes. One eye developed secondary glaucoma, one eye underwent re-enclavation, and none developed retinal complications. Conclusion: Posterior IFIOL implantation resulted in an improved visual outcome, low incidence of postoperative complications, and is a good alternative to other IOL, in the cases of pediatric traumatic cataract without adequate capsular support. PMID:27162456

  1. Intra-ocular pressure normalization technique and equipment

    NASA Technical Reports Server (NTRS)

    Mcgannon, W. J. (Inventor)

    1980-01-01

    A method and apparatus for safely reducing abnormally high intraocular pressure in an eye during a predetermined time interval is presented. This allows maintenance of normal intraocular pressure during glaucoma surgery. According to the invention, a pressure regulator of the spring biased diaphragm type is provided with additional bias by a column of liquid. The height of the column of liquid is selected such that the pressure at a hypodermic needle connected to the output of the pressure regulator is equal to the measured pressure of the eye. The hypodermic needle can then be safely inserted into the anterior chamber of the eye. Liquid is then bled out of the column to reduce the bias on the diaphragm of the pressure regulator and, consequently, the output pressure of the regulator. This lowering pressure of the regulator also occurs in the eye by means of a small second bleed path provided between the pressure regulator and the hypodermic needle. Alternately, a second hypodermic needle may be inserted into the eye to provide a controlled leak off path for excessive pressure and clouded fluid from the anterior chamber.

  2. Prevention of intraocular pressure rise following intravitreal injection.

    PubMed Central

    Morlet, N; Young, S H

    1993-01-01

    The intraocular pressure change produced by an intravitreal injection of ganciclovir, 2 mg in 0.1 ml, was studied in patients with cytomegalovirus retinitis. Using a Tono-pen XL to measure the intraocular pressure (IOP) of four patients (six eyes) we found the mean pressure immediately following injection was 44.5 mm Hg. Measurements taken on separate occasions after a 30 mm Hg decompression of the eye for 15 minutes before the injection showed a mean IOP of only 20.6 mm Hg after the injection. Mercury bag decompression of the eye significantly reduced the rise in IOP following intravitreal injection (difference in the mean IOP rise = 26.4 mm Hg, df = 54, t = 7.67, p < 0.001). Without ocular decompression before injection, all patients complained of temporary loss of vision, and reflux of the injection solution was frequently observed. Use of ocular decompression also reduced the discomfort of the injection. Throughout the full course of treatment by this means there were no adverse effects on the visual acuity. This technique is recommended to those performing intravitreal injections. Images PMID:8218055

  3. Standardized methods for assessing the imaging quality of intraocular lenses

    NASA Astrophysics Data System (ADS)

    Norrby, N. E. Sverker

    1995-11-01

    The relative merits of three standardized methods for assessing the imaging quality of intraocular lenses are discussed based on theoretical modulation-transfer-function calculations. The standards are ANSI Z80.7 1984 from the American National Standards Institute, now superseded by ANSI Z80.7 1994, and the proposed ISO 11979-2 from the International Organization for Standardization. They entail different test 60% resolution efficiency in air, 70% resolutionefficiency in aqueous humor, and 0.43 modulation at 100 line pairs/mm in a model eye. The ISO working group found that the latter corresponds to 60% resolution efficiency in air in a ring test among eight laboratories on a sample of 39 poly(methyl) methacrylate lenses and four silicone lenses spanning the power (in aqueous humor) range of 10-30 D. In both ANSI Z80.7 1994 and ISO 11979-2, a 60% resolution efficiency in air remains an optional approval limit. It is concluded that the ISO configuration is preferred, because it puts the intraocular lens into the context of the optics of the eye. Note that the ISO standard is tentative and is currently being voted on.

  4. Standardized methods for assessing the imaging quality of intraocular lenses.

    PubMed

    Norrby, N E

    1995-11-01

    The relative merits of three standardized methods for assessing the imaging quality of intraocular lenses are discussed based on theoretical modulation-transfer-function calculations. The standards are ANSI Z80.7 1984 from the American National Standards Institute, now superseded by ANSI Z80.7 1994, and the proposed ISO 11979-2 from the International Organization for Standardization. They entail different test configurations and approval limits, respectively: 60% resolution efficiency in air, 70% resolution efficiency in aqueous humor, and 0.43 modulation at 100 line pairs/mm in a model eye. The ISO working group found that the latter corresponds to 60% resolution efficiency in air in a ring test among eight laboratories on a sample of 39 poly(methyl) methacrylate lenses and four silicone lenses spanning the power (in aqueous humor) range of 10-30 D. In both ANSI Z80.7 1994 and ISO 11979-2, a 60% resolution efficiency in air remains an optional approval limit. It is concluded that the ISO configuration is preferred, because it puts the intraocular lens into the context of the optics of the eye. Note that the ISO standard is tentative and is currently being voted on. PMID:21060604

  5. Case of Primary Intraocular Lymphoma with Extraocular Extension

    PubMed Central

    Kuro, Maki; Matsuyama, Kayako; Matsuoka, Masato; Kosaki, Ryo; Shikata, Nobuaki; Nishimura, Tetsuya; Takahashi, Kanji

    2015-01-01

    Purpose To describe a case of primary intraocular lymphoma (PIOL) with an extension through the sclera that was confirmed to be part of the PIOL by histopathological examinations. Case An 89-year-old woman was referred to a local clinic with a 1-year history of persistent blurred vision in her left eye. After 2 years without aggressive treatments, she had a marked reduction of vision and pain in her left eye. The clinical diagnosis was panophthalmitis, and the eye was enucleated and submitted for histopathological study. Results Light microscope examination showed that atypical lymphocytic cells had infiltrated into both the intraocular and extraocular areas. The anterior chamber angle was blocked by infiltrating tumor cells, which were also detected around the optic nerve. The tumor cells destroyed Bruch's membrane and infiltrated around the perineural and perivascular areas within the sclera. Immunohistochemistry showed that the tumor cells were positive for B-lymphocyte surface antigen (CD20), B-cell antigen receptor complex-associated protein alpha chain (CD79-alpha), and had a high positive rate for anti-Ki-67 antibody. Conclusion The finding in our case indicates that early diagnosis and treatment are important for eyes with PIOL because the tumor can spread and penetrate the sclera and invade extraocular tissues. PMID:27171820

  6. An examination of the hypothesis that intraocular pressure elevation episodes can have prognostic significance in glaucoma suspects.

    PubMed

    McMonnies, Charles

    2015-01-01

    The efficacy of intraocular pressure reduction in retarding the progression of glaucoma has been demonstrated. This review examines the potential for prognostic advantage for glaucoma suspects in reducing their optic nerve head exposure to elevated intraocular pressure associated with activities which have been shown to elevate intraocular pressure. In this observational study, patients examined at the Centre for Eye Health (University of New South Wales) with a diagnosis of glaucoma suspect were surveyed to determine their histories for participation in activities which are known to elevate intraocular pressure. The evidence regarding the pathological significance of these sources of elevation in susceptible patients was examined. Apart from the universality of sleep-related intraocular pressure elevations, the histories from 183 confirmed glaucoma suspects indicate a wide range and variation in frequency of participation in other intraocular pressure elevating activities. A reduction in exposure to elevated intraocular pressure may improve the prognosis for glaucoma suspects. Additional patient specific assessment of the results of this screening could provide an indication of the degree (frequency, intensity level and duration) of exposure to elevated intraocular pressure. Such information may provide the basis for improving a patient's prognosis by helping them to identify opportunities to reduce such exposure to elevated intraocular pressure. Any benefit of reduction of such exposure appears likely to be greater if activities which elevate intraocular pressure are of long duration, occur frequently, occur over a long period of time, and/or involve high levels of intraocular pressure elevation. PMID:25199440

  7. An examination of the hypothesis that intraocular pressure elevation episodes can have prognostic significance in glaucoma suspects

    PubMed Central

    McMonnies, Charles

    2014-01-01

    The efficacy of intraocular pressure reduction in retarding the progression of glaucoma has been demonstrated. This review examines the potential for prognostic advantage for glaucoma suspects in reducing their optic nerve head exposure to elevated intraocular pressure associated with activities which have been shown to elevate intraocular pressure. In this observational study, patients examined at the Centre for Eye Health (University of New South Wales) with a diagnosis of glaucoma suspect were surveyed to determine their histories for participation in activities which are known to elevate intraocular pressure. The evidence regarding the pathological significance of these sources of elevation in susceptible patients was examined. Apart from the universality of sleep-related intraocular pressure elevations, the histories from 183 confirmed glaucoma suspects indicate a wide range and variation in frequency of participation in other intraocular pressure elevating activities. A reduction in exposure to elevated intraocular pressure may improve the prognosis for glaucoma suspects. Additional patient specific assessment of the results of this screening could provide an indication of the degree (frequency, intensity level and duration) of exposure to elevated intraocular pressure. Such information may provide the basis for improving a patient's prognosis by helping them to identify opportunities to reduce such exposure to elevated intraocular pressure. Any benefit of reduction of such exposure appears likely to be greater if activities which elevate intraocular pressure are of long duration, occur frequently, occur over a long period of time, and/or involve high levels of intraocular pressure elevation. PMID:25199440

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

    PubMed Central

    Tan, Junlian; Yang, Yao; Yuan, Zhaohui; Lin, Xiaofeng

    2016-01-01

    Purpose To elucidate the Chinese practice of intraocular antibiotics administration for prophylaxis after open globe injury. Methods 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. Results 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). Conclusions 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. PMID:27275777

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

    PubMed

    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. PMID:15932534

  10. Bacterial Spectrum and Antibiotic Resistance Patterns of Ocular Infection: Differences between External and Intraocular Diseases

    PubMed Central

    Wang, Nan; Yang, Qian; Tan, Yiwei; Lin, Liping; Huang, Qiang; Wu, Kaili

    2015-01-01

    This study aimed to compare the differences of microbial spectrum and antibiotic resistance patterns between external and intraocular bacterial infections in an eye hospital in South China. A total of 737 bacteria isolates from suspected ocular infections were included in this retrospective study covering the period 2010–2013. The organisms cultured from the ocular surface (cornea, conjunctiva) accounted for the majority of the isolates (82.77%, n = 610), followed by the intraocular (aqueous humor, vitreous fluid), which accounted for 17.23% (n = 127). The top three species accounting for the external ocular infections were S. epidermidis (35.25%), P. aeruginosa (8.03%), and S. simulans (4.43%). The top three species for the intraocular infections were S. epidermidis (14.96%), S. hominis (8.66%), and B. subtilis (7.87%). The bacteria from the external ocular surface were more sensitive to neomycin, while those from the intraocular specimens were more sensitive to levofloxacin (P < 0.01). Multidrug resistance was found in 89 bacteria (12.08%), including isolates from both external (13.28%) and intraocular samples (6.30%). The results of this study indicate that the bacteria spectrum of external and intraocular infections is variable in the setting. A high percentage of bacterial organisms were found to be primarily susceptible to neomycin for external infection and levofloxacin for intraocular infection. PMID:26576294

  11. Optical quality of toric intraocular lens implantation in cataract surgery

    PubMed Central

    Xiao, Xian-Wen; Hao, Jing; Zhang, Hong; Tian, Fang

    2015-01-01

    AIM To analyze the optical quality after implantation of toric intraocular lens with optical quality analysis system. METHODS Fifty-two eyes of forty-four patients with regular corneal astigmatism of at least 1.00 D underwent implantation of AcrySof toric intraocular lens, including T3 group 19 eyes, T4 group 18 eyes, T5 group 10 eyes, T6 group 5 eyes. Main outcomes evaluated at 3mo of follow-up, included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), residual refractive cylinder and intraocular lens (IOL) axis rotation. Objective optical quality were measured using optical quality analysis system (OQAS II®, Visiometrics, Spain), included the cutoff frequency of modulation transfer function (MTFcutoff), objective scattering index (OSI), Strehl ratio, optical quality analysis system value (OV) 100%, OV 20% and OV 9% [the optical quality analysis system (OQAS) values at contrasts of 100%, 20%, and 9%]. RESULTS At 3mo postoperative, the mean UDVA and CDVA was 0.18±0.11 and 0.07±0.08 logMAR; the mean residual refractive cylinder was 0.50±0.29 D; the mean toric IOL axis rotation was 3.62±1.76 degrees, the mean MTFcutoff, OSI, Strehl ratio, OV 100%, OV 20% and OV 9% were 22.862±5.584, 1.80±0.84, 0.155±0.038, 0.76±0.18, 0.77±0.19 and 0.78±0.21. The values of UDVA, CDVA, IOL axis rotation, MTFcutoff, OSI, Strehl ratio, OV100%, OV20% and OV9% depending on the power of the cylinder of the implantation were not significantly different (P>0.05), except the residual refractive cylinder (P<0.05). CONCLUSION The optical quality analysis system was useful for characterizing the optical quality of AcrySof toric IOL implantation. Implantation of an AcrySof toric IOL is an effective and safe method to correct corneal astigmatism during cataract surgery. PMID:25709910

  12. Change in Intraocular Pressure During Point-of-Care Ultrasound

    PubMed Central

    Berg, Cameron; Doniger, Stephanie J.; Zaia, Brita; Williams, Sarah R.

    2015-01-01

    Introduction Point-of-care ocular ultrasound (US) is a valuable tool for the evaluation of traumatic ocular injuries. Conventionally, any maneuver that may increase intraocular pressure (IOP) is relatively contraindicated in the setting of globe rupture. Some authors have cautioned against the use of US in these scenarios because of a theoretical concern that an US examination may cause or exacerbate the extrusion of intraocular contents. This study set out to investigate whether ocular US affects IOP. The secondary objective was to validate the intraocular pressure measurements obtained with the Diaton® as compared with standard applanation techniques (the Tono-Pen®). Methods We enrolled a convenience sample of healthy adult volunteers. We obtained the baseline IOP for each patient by using a transpalpebral tonometer. Ocular US was then performed on each subject using a high-frequency linear array transducer, and a second IOP was obtained during the US examination. A third IOP measurement was obtained following the completion of the US examination. To validate transpalpebral measurement, a subset of subjects also underwent traditional transcorneal applanation tonometry prior to the US examination as a baseline measurement. In a subset of 10 patients, we obtained baseline pre-ultrasound IOP measurements with the Diaton® and Tono-Pen®, and then compared them. Results The study included 40 subjects. IOP values during ocular US examination were slightly greater than baseline (average +1.8mmHg, p=0.01). Post-US examination IOP values were not significantly different than baseline (average −0.15mmHg, p=0.42). In a subset of 10 subjects, IOP values were not significantly different between transpalpebral and transcorneal tonometry (average +0.03mmHg, p=0.07). Conclusion In healthy volunteer subjects, point-of-care ocular US causes a small and transient increase in IOP. We also showed no difference between the Diaton® and Tono-Pen® methods of IOP measurement

  13. Tritan colour contrast sensitivity function in refractive multifocal intraocular lenses

    PubMed Central

    Pieh, S.; Hanselmayer, G.; Lackner, B.; Marvan, P.; Grechenig, A.; Weghaupt, H.; Vass, C.; Skorpik, C.

    2001-01-01

    AIMS—To compare tritan colour contrast sensitivity (CCS), without and with glare, in patients with refractive multifocal intraocular lenses (IOLs) and with monofocal intraocular lenses.
METHODS—Tritan CCS was determined (Moorfields Vision System, CH Electronics) in 15 eyes (14 patients, 75.7 (±6.6) years) with a refractive multifocal IOL (Allergan SA 40N) and in 11 eyes (10 patients, 73.7 (±6.4) years) with a monofocal IOL (Allergan SI 40 NB). Measurements were made monocularly under mesopic conditions at a distance of 2 metres from the monitor with best distance refraction plus 0.5 D at 0.5, 1, 3, 6, 11.4, and 22.8 cycles per degree (cpd). The test was then repeated for the multifocal IOLs, adding minus 2.5 D to the best distance refraction to force the patient to use the near focus. Both lenses were also investigated under glare conditions with the same set-up and using the brightness acuity tester (BAT).
RESULTS—The tritan CCS function without glare in multifocal lenses through the distance focus was nearly identical to that through the near focus. The following statistically significant differences were measured: the CCS function without glare for the multifocal lens was worse at 0.5 cpd and 1.0 cpd than that of the monofocal lens. In CCS testing of the multifocal group with glare at 6 cpd, the results through the distance focus were better than the results through the near focus. For the CCS function with glare, the values for the distance focus in the multifocal lens were worse than the values for the monofocal lens at 0.5 cpd and 1 cpd. In CCS testing with glare through the near focus and CCS testing through the monofocal lens, the monofocal lens performed better at 0.5 cpd, 1 cpd, 3 cpd, and 6 cpd.
CONCLUSION—Refractive multifocal intraocular lenses influence tritan CCS function compared to monofocal lenses.

 PMID:11423455

  14. Associations with Intraocular Pressure in a Large Cohort

    PubMed Central

    Chan, Michelle P.Y.; Grossi, Carlota M.; Khawaja, Anthony P.; Yip, Jennifer L.Y.; Khaw, Kay-Tee; Patel, Praveen J.; Khaw, Peng T.; Morgan, James E.; Vernon, Stephen A.; Foster, Paul J.

    2016-01-01

    Purpose To describe the associations of physical and demographic factors with Goldmann-correlated intraocular pressure (IOPg) and corneal-compensated intraocular pressure (IOPcc) in a British cohort. Design Cross-sectional study within the UK Biobank, a large-scale multisite cohort study in the United Kingdom. Participants We included 110 573 participants from the UK Biobank with intraocular pressure (IOP) measurements available. Their mean age was 57 years (range, 40–69 years); 54% were women, and 90% were white. Methods Participants had 1 IOP measurement made on each eye using the Ocular Response Analyzer noncontact tonometer. Linear regression models were used to assess the associations of IOP with physical and demographic factors. Main Outcome Measures The IOPg and IOPcc. Results The mean IOPg was 15.72 mmHg (95% confidence interval [CI], 15.70–15.74 mmHg), and the mean IOPcc was 15.95 mmHg (15.92–15.97 mmHg). After adjusting for covariates, IOPg and IOPcc were both significantly associated with older age, male sex, higher systolic blood pressure (SBP), faster heart rate, greater myopia, self-reported glaucoma, and colder season (all P < 0.001). The strongest determinants of both IOPg and IOPcc were SBP (partial R2: IOPg 2.30%, IOPcc 2.26%), followed by refractive error (IOPg 0.60%, IOPcc 1.04%). The following variables had different directions of association with IOPg and IOPcc: height (−0.77 mmHg/m IOPg; 1.03 mmHg/m IOPcc), smoking (0.19 mmHg IOPg, −0.35 mmHg IOPcc), self-reported diabetes (0.41 mmHg IOPg, −0.05 mmHg IOPcc), and black ethnicity (−0.80 mmHg IOPg, 0.77 mmHg IOPcc). This suggests that height, smoking, diabetes, and ethnicity are related to corneal biomechanical properties. The increase in both IOPg and IOPcc with age was greatest among those of mixed ethnicities, followed by blacks and whites. The same set of covariates explained 7.4% of the variability of IOPcc but only 5.3% of the variability of IOPg. Conclusions This analysis

  15. Intraocular electro-optic lens with ciliary muscle controlled accommodation.

    PubMed

    Doornaert, Dries; Glorieux, Christ; De Gersem, Herbert; Puers, Robert; Spileers, Werner; Blanckaert, Johan

    2013-01-01

    In this paper a concept is proposed of an intraocular lens implant with electro-optic accommodation of a variable-focus hybrid liquid-crystal-based lens. The dioptric strength of the lens is electronically controlled by a signal that is derived from the change of inductance of a sensing coil due to a marker implanted in the nearby contracting or decontracting ciliary muscle. Analytical, numerical and experimental results are reported on the dependency of the frequency of a Colpitts oscillator circuit on the location of a nearby conductive marker. A concept is also reported on the use as an electro-optic lens of a device based on a liquid crystal in planar alignment, which is held between a flat and a curved window coated with optically transparent and electrically conductive layers. PMID:24110406

  16. Shape optimization of an accommodative intra-ocular lens

    NASA Astrophysics Data System (ADS)

    Jouve, François; Hanna, Khalil

    2005-03-01

    Cataract surgery consists in replacing the clouded or opacified crystalline lens by an Intra-Ocular Lens (IOL) having the same mean dioptrical power. Clear vision is then achieved at a given distance and glasses are needed in many situations. A new kind of IOL, potentially accommodative, is proposed. Its design is based on the deep understanding of the accommodation mechanism and on the mathematical modeling and the numerical simulation of the IOL's comportment in vivo. A preliminary version of this IOL is now commercialized by the company HumanOptics under the name '1CU'. In a second phase, shape optimization techniques equipped with strong mechanical and physiological constraints, are used to enhance the IOL performance and build a new design. To cite this article: F. Jouve, K. Hanna, C. R. Mecanique 333 (2005).

  17. Simulation of eye deformation in the measurement of intraocular pressure

    NASA Astrophysics Data System (ADS)

    Khusainov, R. R.; Tsibul'Skii, V. R.; Yakushev, V. L.

    2011-02-01

    The procedure of measuring the intraocular pressure by an optical analyzer is numerically simulated. The cornea and the sclera are considered as axisymmetrically deformable shells of revolution with fixed boundaries; the space between these shells is filled with incompressible fluid. Nonlinear shell theory is used to describe the stressed and strained state of the cornea and sclera. The optical system is calculated from the viewpoint of the geometrical optics. Dependences between the pressure in the air jet and the area of the surface reflecting the light into a photodetector are obtained. The shapes of the regions on the cornea surface are found from which the reflected light falls on the photodetector. First, the light is reflected from the center of the cornea, but then, as the cornea deforms, the light is reflected from its periphery. The numerical results make it possible to better interpret the measurement data.

  18. Ectopic intraocular lens: an unusual complication of cataract surgery.

    PubMed

    Shah, Mehul A; Shah, Shreya A; Aggarwal, Parul M

    2014-06-01

    We wish to report an unusual complication of intraocular lens (IOL) insertion following uneventful phacoemulsification. After successful phacoemulsification surgery, a hydrophobic acrylic IOL was loaded in the injector for insertion into the capsular bag. During insertion, the IOL inadvertently extended into the corneal stromal lamella. The complication was recognized at a late stage, and the foldable acrylic lens was retrieved and reinserted correctly in the bag. The anterior chamber was made viscoelastically taut and was maintained in this state for 10 min, followed by a routine viscoelastic wash and air bubble injection. Cornea was slightly edematous with stromal haze, and the corneal thickness was 908 μm. At the 1-month follow-up visit, the patient's vision was 20/40, the stromal haze had subsided, the corneal thickness was 572 μm, and the patient was comfortable. Though it was unknown complication, following proper management patient recovered satisfactorily. PMID:25005208

  19. [To guard against mistakes in selection of intraocular lenses].

    PubMed

    He, Shou-zhi

    2008-04-01

    Development of different kinds of new intraocular lenses (IOL) provide more selections to meet various clinical requirements, which may plays an active role in making cataract surgery more perfectible. But there are many misunderstandings about how to select the proper IOL. For example, "the expensive one is the best one", "new product is absolutely perfect", and so on. Some surgeons prefer more practice and ignore the summary of the experiences. Someone unilaterally exaggerates some special function of IOL When selecting the IOL, it is a common challenge for us to fully consider the patients needs, and properly manage the relationship between the basic need and special need, and to avoid fanaticism, and provide the best benefits to the patients. PMID:18844010

  20. Safety evaluation of BSS plus in pediatric intraocular surgery.

    PubMed

    Burke, M J; Parks, M M; Calhoun, J H; Diamond, J G; deFaller, J M

    1981-01-01

    An open-label study was conducted to determine the safety of a new intraocular irrigating solution, BSS Plus, when used during pediatric ophthalmic surgery. BBS Plus is a modified glutathione-bicarbonate-Ringer's solution which contains the necessary ions, buffers, and substrates for maintenance of normal cellular metabolism, function, and structural integrity when used as a perfusate during ophthalmic surgical procedures. At three centers, 30 patients undergoing lens aspiration or anterior segment reconstruction using vitrectomy instrumentation were enrolled in this study. Transient postoperative increases in intracellular pressure and internal or external ocular inflammatory signs were seen which were consistent with the trauma produced by the surgical procedure. The solution was judged to be safe when used in these surgical indications. PMID:7264851

  1. Experimental intraocular malignancy: the effect of intracameral perfusion.

    PubMed Central

    Wong, V G; Green, W R; Liu, Y P; Marsden, E R

    1979-01-01

    Transplantable Brown-Pearce carcinoma was adapted successfully in the rabbit anterior chamber. Regression of tumor growth was attained on tri-weekly perfusion of the AC with 10 micromolar of methotrexate. Tumor cyclic nucleotide phosphodiesterase (PDE) and protein activator were found to be markedly depressed during the course of chemotherapy and the PDE cAMP/cGMP ratio was similarly altered. Corroborative light and electron-microscopic studies showed specific alterations of intracellular organelles in relation to MTX and tumor cell death. These findings suggest that metabolic pathways of cyclic nucleotides are important biochemical modulators of neoplastic cells. The method of intraocular perfusion precludes systemic toxic effects and avoids compromising the animals' immunocompetence. Images FIGURE 3 A FIGURE 3 B FIGURE 4 A FIGURE 4 B PMID:232585

  2. [Intraocular metallic crystalline lens for correction of aphakia].

    PubMed

    Aderikhin, I V; Golubchik, V L; Gorban', A I; Kolbin, M N

    1995-01-01

    Technological characteristics of a new in principle intraocular lens (IOL) consisting of a leukosaphire lens and elastic tantalum haptics are presented. The advantages of metallic crystal IOLs are validated: complete chemical and biological inertness, longevity, high transparency, and easy implantation in the capsular sac. Surgical recommendations are offered and highly positive results of clinical trials analyzed (more than 600 implantations followed up for up to 4 years). Metallic crystal IOLs for intracapsular correction of aphakia developed at the S. I. Vavilov All-Russian Research Center and St. Petersburg Division of the Moscow Research and Technological Complex "Ocular Microsurgery" and manufactured by the IOL Joint Stock Company are recommended for wide clinical use. PMID:7483205

  3. Use of the Toric Intraocular Lens for Keratoconus Treatment

    PubMed Central

    Zvornicanin, Jasmin; Cabric, Emir; Jusufovic, Vahid; Musanovic, Zlatko; Zvornicanin, Edita

    2014-01-01

    A 50 year old man presented to Eye clinic University clinical centre Tuzla with bilateral visual impairment. Clinical examination revealed low visual acuity and keratoconus in both eyes, white cataract in right eye and diabetic retinopathy in left eye. Ultrasonography examination was normal. The patient underwent Trypan blue capsule staining, phacoemulsification and implantation of intraocular lens Alcon AcrySof SN60T9 16 D spherical and 6.0 D cylinder power. Phacoemulsification went uneventful and early postoperative recovery was successful. Visual acuity improved to 0,8 and fundus examination revealed background diabetic retinopathy. Postoperative follow up two years after surgery showed no signs of keratoconus progression and visual acuity maintained the same. PMID:24825942

  4. Bionic intraocular lens with variable focus and integrated structure

    NASA Astrophysics Data System (ADS)

    Liang, Dan; Wang, Xuan-Yin; Du, Jia-Wei; Xiang, Ke

    2015-10-01

    This paper proposes a bionic accommodating intraocular lens (IOL) for ophthalmic surgery. The designed lens has a solid-liquid mixed integrated structure, which mainly consists of a support ring, elastic membrane, rigid lens, and optical liquid. The lens focus can be adjusted through the deformation of the lens front surface when compressed. The integrated structure of the IOL is presented, as well as a detailed description of the lens materials and fabrication process. Images under different radial pressures are captured, and the lens deformation process, accommodating range, density, and optical property are analyzed. The designed lens achieves a 14.6 D accommodating range under a radial pressure of 51.4 mN and a 0.24 mm alteration of the lens outer radius. The deformation property of the lens matches well with the characteristic of the eye and shows the potential to help patients fully recover their vision accommodation ability after the cataract surgery.

  5. Survey of the optical quality of intraocular lens implants.

    PubMed

    Grossman, L W; Igel, D A; Faaland, R W

    1991-03-01

    Intraocular lenses (IOLs) from 15 U.S. firms were tested for conformance to the requirements of the American National Standards Institute Z80.7 standard for IOLs. A total of 162 IOLs were tested for resolution, astigmatism, and accuracy of labeled power. Average resolving power was 78% of the diffraction limit, much better than the ANSI minimum requirement which is typically equivalent to 30% of the diffraction limit. This suggests that the ANSI Z80.7 requirement could be significantly tightened with little effect on current production practices. Only one IOL exhibited astigmatism in excess of 0.25 diopter. Differences between measured and labeled power in excess of 0.50 diopter were found in 22 lenses, indicating that accuracy of refractive power may be the most commonly missed optical requirement of the standard. PMID:2040974

  6. Design of a Test Bench for Intraocular Lens Optical Characterization

    NASA Astrophysics Data System (ADS)

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

    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

  7. Cost-Effectiveness of Proton Beam Therapy for Intraocular Melanoma

    PubMed Central

    Moriarty, James P.; Borah, Bijan J.; Foote, Robert L.; Pulido, Jose S.; Shah, Nilay D.

    2015-01-01

    Purpose Proton beam therapy is a commonly accepted treatment for intraocular melanomas, but the literature is lacking in descriptions of patient preferences of clinical outcomes and economic impact. In addition, no economic evaluations have been published regarding the incremental cost-effectiveness of proton beam therapy compared with enucleation or plaque brachytherapy, typical alternative treatments. We, therefore, conducted a cost-utility analysis of these three approaches for the treatment of intraocular melanomas. Materials and Methods A Markov model was constructed. Model parameters were identified from the published literature and publicly available data sources. Cost-effectiveness of each treatment was calculated in 2011 US Dollars per quality-adjusted life-year. Incremental cost-effectiveness ratios were calculated assuming enucleation as reference. One-way sensitivity analyses were conducted on all model parameters. A decision threshold of $50,000/quality-adjusted life-year was used to determine cost-effectiveness. Results Enucleation had the lowest costs and quality-adjusted life-years, and plaque brachytherapy had the highest costs and quality-adjusted life-years. Compared with enucleation, the base-case incremental cost-effectiveness ratios for plaque brachytherapy and proton beam therapy were $77,500/quality-adjusted life-year and $106,100/quality-adjusted life-year, respectively. Results were highly sensitive to multiple parameters. All three treatments were considered optimal, and even dominant, depending on the values used for sensitive parameters. Conclusion Base-case analysis results suggest enucleation to be optimal. However, the optimal choice was not robust to sensitivity analyses and, depending on the assumption, both plaque brachytherapy and proton beam therapy could be considered cost-effective. Future clinical studies should focus on generating further evidence with the greatest parameter uncertainty to inform future cost

  8. Intraocular Lens Fragmentation Using Femtosecond Laser: An In Vitro Study

    PubMed Central

    Bala, Chandra; Shi, Jeffrey; Meades, Kerrie

    2015-01-01

    Purpose: To transect intraocular lenses (IOLs) using a femtosecond laser in cadaveric human eyes. To determine the optimal in vitro settings, to detect and characterize gasses or particles generated during this process. Methods: A femtosecond laser was used to transect hydrophobic and hydrophilic acrylic lenses. The settings required to enable easy separation of the lens fragment were determined. The gasses and particles generated were analysed using gas chromatography mass spectrometer (GC-MS) and total organic carbon analyzer (TOC), respectively. Results: In vitro the IOL fragments easily separated at the lowest commercially available energy setting of 1 μJ, 8-μm spot, and 2-μm line separation. No particles were detected in the 0.5- to 900-μm range. No significant gasses or other organic breakdown by products were detected at this setting. At much higher energy levels 12 μJ (4 × 6 μm spot and line separation) significant pyrolytic products were detected, which could be harmful to the eye. In cadaveric explanted IOL capsule complex the laser pulses could be applied through the capsule to the IOL and successfully fragment the IOL. Conclusion: IOL transection is feasible with femtosecond lasers. Further in vivo animal studies are required to confirm safety. Translational Relevance: In clinical practice there are a number of large intraocular lenses that can be difficult to explant. This in-vitro study examines the possibility of transecting the lasers quickly using femtosecond lasers. If in-vivo studies are successful, then this innovation could help ophthalmic surgeons in IOL explantation. PMID:26101721

  9. Argon laser trabeculoplasty as a means of decreasing intraocular pressure from ''normal'' levels in glaucomatous eyes

    SciTech Connect

    Sharpe, E.D.; Simmons, R.J.

    1985-06-15

    The authors conducted a retrospective study of 67 patients (85 eyes) with severe glaucoma to determine whether argon laser trabeculoplasty could reduce intraocular pressures below the ''normal'' range. All patients had initial intraocular pressures of less than or equal to 19 mm Hg. Success was defined as a decrease in intraocular pressure of at least 20%, no increase in medications, stable visual field, and no subsequent glaucoma surgery. After an average follow-up period of 30 months, treatment was successful in 31 cases. One half of the failures occurred by six months and 11 failures (30%) occurred after 12 months. Sixteen patients were able to decrease their medications. Two patients achieved intraocular pressures between 6 and 9 mm Hg and 20 between 10 and 12 mm Hg.

  10. The Relationship between Corvis ST Tonometry Measured Corneal Parameters and Intraocular Pressure, Corneal Thickness and Corneal Curvature

    PubMed Central

    Asaoka, Ryo; Nakakura, Shunsuke; Tabuchi, Hitoshi; Murata, Hiroshi; Nakao, Yoshitaka; Ihara, Noriko; Rimayanti, Ulfah; Aihara, Makoto; Kiuchi, Yoshiaki

    2015-01-01

    The purpose of the study was to investigate the correlation between Corneal Visualization Scheimpflug Technology (Corvis ST tonometry: CST) parameters and various other ocular parameters, including intraocular pressure (IOP) with Goldmann applanation tonometry. IOP with Goldmann applanation tonometry (IOP-G), central corneal thickness (CCT), axial length (AL), corneal curvature, and CST parameters were measured in 94 eyes of 94 normal subjects. The relationship between ten CST parameters against age, gender, IOP-G, AL, CST-determined CCT and average corneal curvature was investigated using linear modeling. In addition, the relationship between IOP-G versus CST-determined CCT, AL, and other CST parameters was also investigated using linear modeling. Linear modeling showed that the CST measurement ‘A time-1’ is dependent on IOP-G, age, AL, and average corneal curvature; ‘A length-1’ depends on age and average corneal curvature; ‘A velocity-1’ depends on IOP-G and AL; ‘A time-2’ depends on IOP-G, age, and AL; ‘A length-2’ depends on CCT; ‘A velocity-2’ depends on IOP-G, age, AL, CCT, and average corneal curvature; ‘peak distance’ depends on gender; ‘maximum deformation amplitude’ depends on IOP-G, age, and AL. In the optimal model for IOP-G, A time-1, A velocity-1, and highest concavity curvature, but not CCT, were selected as the most important explanatory variables. In conclusion, many CST parameters were not significantly related to CCT, but IOP usually was a significant predictor, suggesting that an adjustment should be made to improve their usefulness for clinical investigations. It was also suggested CST parameters were more influential for IOP-G than CCT and average corneal curvature. PMID:26485129

  11. [An instrument for projecting visual perception by monofocal and bifocal intraocular lenses].

    PubMed

    Reiner, J

    1992-01-01

    With the aid of a simple optical system similar to an astronomical telescope, images of spectacle lenses, contact lenses and intraocular lenses can be projected in front of, onto or into the eye. These optical images function like real lenses and enable their performance to be evaluated. In the case of intraocular lenses, visual perception through monofocal or bifocal lenses and teledioptric systems can be reproduced. PMID:1583844

  12. Transcorneal extrusion of anterior chamber intraocular lenses. A report of three cases.

    PubMed

    McKnight, G T; Richards, S C; Apple, D J; Stanko, M L; O'Morchoe, D J; Solomon, K D

    1987-12-01

    We examined three cases of transcorneal extrusion of anterior chamber intraocular lenses. In each case a preexisting condition (rheumatoid arthritis, glaucoma, and herpes zoster ophthalmicus, respectively) contributed to corneal necrosis and subsequent extrusion of the pseudophakos. The clinicopathologic correlations of this condition are discussed, as well as some causes of corneal decompensation associated with anterior chamber lenses. We emphasize the need for careful evaluation of patients who have preexisting disease before intraocular lens implantation. PMID:3318770

  13. [The progress of studies on intraocular lens implantation in cataract with high myopia].

    PubMed

    Liu, Xue; Wan, Xiuhua

    2015-07-01

    With development of the technology of cataract surgery, combined phacoemulsification and intraocular lens implantation in cataract with high myopia has been widely carried out in clinical treatment. Due to the particularity of high myopia, phacoemulsification in patients with cataract and high myopia is difficult and has recently received a lot of attentions. In this paper, preoperative examinations, the selection of intraocular lenses, surgery methods and surgical complications of cataract surgery in patients with cataract and high myopia are briefly reviewed. PMID:26310259

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

    PubMed Central

    Korenfeld, Michael S; Dueker, David K

    2016-01-01

    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. PMID:26955260

  15. The Increase of Intra-Abdominal Pressure Can Affect Intraocular Pressure

    PubMed Central

    Ece, Ilhan; Vatansev, Celalettin; Kucukkartallar, Tevfik; Tekin, Ahmet; Kartal, Adil; Okka, Mehmet

    2015-01-01

    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. PMID:25648230

  16. Comparison of dose calculation methods for brachytherapy of intraocular tumors

    SciTech Connect

    Rivard, Mark J.; Chiu-Tsao, Sou-Tung; Finger, Paul T.; Meigooni, Ali S.; Melhus, Christopher S.; Mourtada, Firas; Napolitano, Mary E.; Rogers, D. W. O.; Thomson, Rowan M.; Nath, Ravinder

    2011-01-15

    Purpose: To investigate dosimetric differences among several clinical treatment planning systems (TPS) and Monte Carlo (MC) codes for brachytherapy of intraocular tumors using {sup 125}I or {sup 103}Pd plaques, and to evaluate the impact on the prescription dose of the adoption of MC codes and certain versions of a TPS (Plaque Simulator with optional modules). Methods: Three clinical brachytherapy TPS capable of intraocular brachytherapy treatment planning and two MC codes were compared. The TPS investigated were Pinnacle v8.0dp1, BrachyVision v8.1, and Plaque Simulator v5.3.9, all of which use the AAPM TG-43 formalism in water. The Plaque Simulator software can also handle some correction factors from MC simulations. The MC codes used are MCNP5 v1.40 and BrachyDose/EGSnrc. Using these TPS and MC codes, three types of calculations were performed: homogeneous medium with point sources (for the TPS only, using the 1D TG-43 dose calculation formalism); homogeneous medium with line sources (TPS with 2D TG-43 dose calculation formalism and MC codes); and plaque heterogeneity-corrected line sources (Plaque Simulator with modified 2D TG-43 dose calculation formalism and MC codes). Comparisons were made of doses calculated at points-of-interest on the plaque central-axis and at off-axis points of clinical interest within a standardized model of the right eye. Results: For the homogeneous water medium case, agreement was within {approx}2% for the point- and line-source models when comparing between TPS and between TPS and MC codes, respectively. For the heterogeneous medium case, dose differences (as calculated using the MC codes and Plaque Simulator) differ by up to 37% on the central-axis in comparison to the homogeneous water calculations. A prescription dose of 85 Gy at 5 mm depth based on calculations in a homogeneous medium delivers 76 Gy and 67 Gy for specific {sup 125}I and {sup 103}Pd sources, respectively, when accounting for COMS-plaque heterogeneities. For off

  17. Comparison of dose calculation methods for brachytherapy of intraocular tumors

    PubMed Central

    Rivard, Mark J.; Chiu-Tsao, Sou-Tung; Finger, Paul T.; Meigooni, Ali S.; Melhus, Christopher S.; Mourtada, Firas; Napolitano, Mary E.; Rogers, D. W. O.; Thomson, Rowan M.; Nath, Ravinder

    2011-01-01

    Purpose: To investigate dosimetric differences among several clinical treatment planning systems (TPS) and Monte Carlo (MC) codes for brachytherapy of intraocular tumors using 125I or 103Pd plaques, and to evaluate the impact on the prescription dose of the adoption of MC codes and certain versions of a TPS (Plaque Simulator with optional modules). Methods: Three clinical brachytherapy TPS capable of intraocular brachytherapy treatment planning and two MC codes were compared. The TPS investigated were Pinnacle v8.0dp1, BrachyVision v8.1, and Plaque Simulator v5.3.9, all of which use the AAPM TG-43 formalism in water. The Plaque Simulator software can also handle some correction factors from MC simulations. The MC codes used are MCNP5 v1.40 and BrachyDose∕EGSnrc. Using these TPS and MC codes, three types of calculations were performed: homogeneous medium with point sources (for the TPS only, using the 1D TG-43 dose calculation formalism); homogeneous medium with line sources (TPS with 2D TG-43 dose calculation formalism and MC codes); and plaque heterogeneity-corrected line sources (Plaque Simulator with modified 2D TG-43 dose calculation formalism and MC codes). Comparisons were made of doses calculated at points-of-interest on the plaque central-axis and at off-axis points of clinical interest within a standardized model of the right eye. Results: For the homogeneous water medium case, agreement was within ∼2% for the point- and line-source models when comparing between TPS and between TPS and MC codes, respectively. For the heterogeneous medium case, dose differences (as calculated using the MC codes and Plaque Simulator) differ by up to 37% on the central-axis in comparison to the homogeneous water calculations. A prescription dose of 85 Gy at 5 mm depth based on calculations in a homogeneous medium delivers 76 Gy and 67 Gy for specific 125I and 103Pd sources, respectively, when accounting for COMS-plaque heterogeneities. For off-axis points

  18. Functionalised Polysiloxanes as Injectable, In Situ Curable Accommodating Intraocular Lenses

    PubMed Central

    Hao, Xiaojuan; Jeffery, Justine L.; Wilkie, John S.; Meijs, Gordon; Clayton, Anthony; Watling, Jason; Ho, Arthur; Fernandez, Viviana; Acosta, Carolina; Yamamoto, Hideo; Aly, Mohamed G. M.; Parel, Jean-Marie; Hughes, Timothy C.

    2010-01-01

    The aged eye’s ability to change focus (accommodation) may be restored by replacing the hardened natural lens with a soft gel. Functionalised polysiloxane macromonomers, designed for application as an injectable, in situ curable accommodating intraocular lens (A-IOL), were prepared via a two-step synthesis. Prepolymers were synthesised via ring opening polymerisation (ROP) of octamethylcyclotetrasiloxane (D4) and 2,4,6,8-tetramethylcyclotetrasiloxane (D4H) in toluene using trifluoromethanesulfonic acid (TfOH) as catalyst. Hexaethyldisiloxane (HEDS) was used as the end group to control the molecular weight of the prepolymers, which were then converted to macromonomers by hydrosilylation of the SiH groups with allyl methacrylate (AM) to introduce polymerisable groups. The resulting macromonomers had an injectable consistency and thus, were able to be injected into and refill the empty lens capsular bag. The macromonomers also contained a low ratio of polymerisable groups so that they may be cured on demand, in situ, under irradiation of blue light, in the presence of a photo-initiator, to form a soft polysiloxane gel (an intraocular lens) in the eye. The pre-cure viscosity and post-cure modulus of the polysiloxanes, which are crucial factors for an injectable, in situ curable A-IOL application, were controlled by adjusting the end group and D4H concentrations, respectively, in the ROP. The macromonomers were fully cured within 5 minutes under light irradiation, as shown by the rapid change in modulus monitored by photorheology. Ex vivo primate lens stretching experiments on an Ex Vivo Accommodation Simulator (EVAS) showed that the polysiloxane gel refilled lenses achieved over 60% of the accommodation amplitude of the natural lens. An in vivo biocompatibility study in rabbits using the lens refilling (Phaco-Ersatz) procedure demonstrated that the soft gels were biocompatible with the ocular tissue. The polysiloxane macromonomers meet the targeted optical and

  19. Role of TLR5 and flagella in bacillus intraocular infection.

    PubMed

    Parkunan, Salai Madhumathi; Astley, Roger; Callegan, Michelle C

    2014-01-01

    B. cereus possesses flagella which allow the organism to migrate within the eye during a blinding form of intraocular infection called endophthalmitis. Because flagella is a ligand for Toll-like receptor 5 (TLR5), we hypothesized that TLR5 contributed to endophthalmitis pathogenesis. Endophthalmitis was induced in C57BL/6J and TLR5-/- mice by injecting 100 CFU of B. cereus into the mid-vitreous. Eyes were analyzed for intraocular bacterial growth, retinal function, and inflammation by published methods. Purified B. cereus flagellin was also injected into the mid-vitreous of wild type C57BL/6J mice and inflammation was analyzed. TLR5 activation by B. cereus flagellin was also analyzed in vitro. B. cereus grew rapidly and at similar rates in infected eyes of C57BL/6J and TLR5-/- mice. A significant loss in retinal function in both groups of mice was observed at 8 and 12 hours postinfection. Retinal architecture disruption and acute inflammation (neutrophil infiltration and proinflammatory cytokine concentrations) increased and were significant at 8 and 12 hours postinfection. Acute inflammation was comparable in TLR5-/- and C57BL/6J mice. Physiological concentrations of purified B. cereus flagellin caused significant inflammation in C57BL/6J mouse eyes, but not to the extent of that observed during active infection. Purified B. cereus flagellin was a weak agonist for TLR5 in vitro. These results demonstrated that the absence of TLR5 did not have a significant effect on the evolution of B. cereus endophthalmitis. This disparity may be due to sequence differences in important TLR5 binding domains in B. cereus flagellin or the lack of flagellin monomers in the eye to activate TLR5 during infection. Taken together, these results suggest a limited role for flagellin/TLR5 interactions in B. cereus endophthalmitis. Based on this and previous data, the importance of flagella in this disease lies in its contribution to the motility of the organism within the eye during

  20. Tumor vascularity and hematogenous metastasis in experimental murine intraocular melanoma.

    PubMed Central

    Grossniklaus, H E

    1998-01-01

    PURPOSE: The purpose of this study is to test the hypothesis that primary tumor vascularity in a murine model of intraocular melanoma positively correlates with the development and hematogenous spread of metastasis. METHODS: Forty 12-week-old C57BL6 mice were inoculated in either the anterior chamber (AC) or posterior compartment (PC) of 1 eye with 5 x 10(5) cells/microL of Queens tissue culture melanoma cells. The inoculated eye was enucleated at 2 weeks; the mice were sacrificed at 4 weeks postinoculation, and necropsies were performed. The enucleated eyes were examined for histologic and ultrastructural features, including relationship of tumor cells to tumor vascular channels, vascular pattern, and mean vascular density. RESULTS: Melanoma grew and was confined to the eye in 12 of 20 AC eyes and 10 of 20 PC eyes. Histologic and electron microscopic examination showed tumor invasion into vascular channels. Five of 12 AC tumors (42%) and 8 of 10 PC tumors (80%) metastasized. All of the AC tumors, but none of the PC tumors, that distantly metastasized also metastasized to ipsilateral cervical lymph nodes (P = .00535). There was no statistically significant difference of vascular pattern between the melanomas that did and did not metastasize to lungs in the PC group (P = .24), although there was a significant difference in the AC group (P = .02). Tumors with high-grade vascular patterns were more likely to metastasize than tumors with low-grade vascular patterns in the AC group. The mean vascular density positively correlated with the presence and number of metastases in both groups (P = .0000 and P < .001, respectively). There was no statistically significant difference of vascular pattern and mean vascular density for AC versus PC melanoma (P = .97). CONCLUSIONS: The rate of metastasis in this murine intraocular melanoma model positively correlates with primary tumor vascularity. The melanoma metastasizes via invasion of tumor vascular channels. AC melanoma also

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

    PubMed Central

    Lindenmeyer, Rodrigo L.; Farias, Lucas; Mendonça, Taís; Filho, João Borges Fortes; Procianoy, Renato S.; Silveira, Rita C.

    2012-01-01

    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 (10.52–22.16) 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. PMID:23184197

  2. Two remarkable events in the field of intraocular foreign body: (1) The reversal of siderosis bulbi. (2) The spontaneous extrusion of an intraocular copper foreign body.

    PubMed Central

    Welch, R B

    1975-01-01

    Two unusual events concerning intraocular foreign bodies are presented. The first patient had an occult or unsuspected intraocular foreign body. He showed iridoplegia with mydriasis, siderosis iridis, and an intraocular piece of iron lying posteriorly near the retina. The foreign body was removed and the patient regained normal iris color and pupillary activity. His vision remains 20/15 six years postoperatively dispite ensuing retinal detachment one year after removal of the foreign body. The second patient was a young boy injured by a blasting cap explosion. He lost one eye from the injury and had a piece of intraocular brass in his left eye. In spite of the development of chalcosis and a mature cataract the lens gradually shrank in the pupillary space permitting a clear aphakic area and 20/25 vision. The brass fragment migrated forward and inferiorly and was finally extruded under the conjunctiva five years later, where it was removed and chemically analyzed by x-ray diffraction. Images FIGURE 1 A FIGURE 1 B FIGURE 2 FIGURE 3 FIGURE 4 FIGURE 5 FIGURE 6 FIGURE 7 PMID:1108372

  3. Design and fabrication of a microstructured bifocal intraocular lens

    NASA Astrophysics Data System (ADS)

    Stork, Wilhelm; Wagner, Armin; Kreiner, Christine F.; Mueller-Glaser, Klaus-Dieter

    1999-06-01

    Intraocular lenses IOLs allow the vision restoration of cataract patients. However the ability of accommodation is lost after cataract surgery. Multifocal lenses show two or more foci with different refractive powers. Far and near objects can be at focus simultaneously. No additional spectacles are necessary. Bifocal lenses can be fabricated as multizone or as diffractive lenses. Diffractive multifocal lenses show in contrast to multi zone multifocal lenses no change of the brightness ratio for the far and near focus with change of the pupil diameter. Diffractive lenses show a saw tooth like microscopic shape with a geometrical height of the teeth in the order of microns. The lens was fabricated with a mold technique in a flexible silicone material. The molds have been lathed in metal with a ultra precision diamond lathe machine. For the test of the optical performance a MTF-measurement machine was constructed for multifocal lenses. With this machine the imaging quality and the intensity ratio of the two foci were measured. The optical quality of the lens turned out to be diffraction limited. At the University Hospital of Giessen, Germany a first clinical evaluation with 23 patients has been performed and proved for the high quality of the manufactured IOLs.

  4. Star testing: a novel evaluation of intraocular lens optical quality

    PubMed Central

    Mitchell, L; Molteno, A C B; Bevin, T H; Sanderson, G

    2006-01-01

    Background Despite the importance of optical quality of an intraocular lens (IOL) on visual outcomes following cataract surgery, objective data on their optical quality are not readily available, and manufacturing standards are industry regulated. The star test is a classic test of optical quality based on examination of the Airy disc and expanded diffraction rings of a point source of light, used mainly for telescope and microscope objectives. Methods A physical model eye cell allowed star testing of IOLs under conditions similar to the optical environment in which they operate. 18 IOLs were tested and results compared to actual images produced by these lenses in the model eye cell. Quantitative measures of star testing performance were developed. Results The optical performance of the IOLs varied, some performing very poorly. Most lenses (13/17) performed better in reverse orientation, while aberrations induced by the haptics of foldable IOLs were also detected. There was excellent correlation between actual images formed and star testing parameters. Conclusion Star testing IOLs was a novel biomedical application of a centuries old, inexpensive method. A concerning variation of optical quality was found, suggesting IOL optical performance data should be more readily available. Independent, authority mandated IOL optical quality standards should be developed, and results readily available to ophthalmologists. PMID:16622088

  5. Effect of four different intraocular lenses on posterior capsule opacification

    PubMed Central

    Duman, Rahmi; Karel, Fatih; Özyol, Pelin; Ateş, Can

    2015-01-01

    AIM To evaluate the impact of 4 different intraocular lenses (IOLs) on posterior capsule opacification (PCO) by comparing the neodymium: yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy rates. METHODS This retrospective study included 4970 eyes of 4013 cataract patients who underwent phacoemulsification and IOL implantation between January 2000 and January 2008 by the same surgeon at one clinic. Four different IOLs were assessed. The outcome parameter was the incidence of Nd:YAG laser posterior capsulotomies. RESULTS An Nd:YAG laser posterior capsulotomy was performed in 153 (3.07%) of the 4970 eyes. The mean follow-up time was 84mo for all of the IOL groups. The percentage of eyes developing PCO was significantly greater for the acrylic hydrophilic IOLs than for the hydrophobic IOLs, although eyes with acrylic hydrophilic IOLs did not require Nd:YAG laser capsulotomy as soon as eyes with acrylic hydrophobic IOLs. There was no difference between the long-term PCO rates when 1- and 3-piece acrylic hydrophobic IOLs were compared or when IOLs made of the same material but with different haptic angles were compared. CONCLUSION In this study, eyes with acrylic hydrophilic IOLs were more likely to develop PCO than those with acrylic hydrophobic IOLs. The lens design (1-piece versus 3-piece and varying haptic angles) did not affect the PCO rate. PMID:25709920

  6. Intraocular camera for retinal prostheses: Refractive and diffractive lens systems

    NASA Astrophysics Data System (ADS)

    Hauer, Michelle Christine

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

  7. Stem Cells in the Trabecular Meshwork for Regulating Intraocular Pressure.

    PubMed

    Yun, Hongmin; Zhou, Yi; Wills, Andrew; Du, Yiqin

    2016-06-01

    Intraocular pressure (IOP) is still the main treatment target for glaucoma. Outflow resistance mainly exists at the trabecular meshwork (TM) outflow pathway, which is responsible for IOP regulation. Changes of TM cellularity and TM extracellular matrix turnover may play important roles in IOP regulation. In this article, we review basic anatomy and physiology of the outflow pathway and TM stem cell characteristics regarding the location, isolation, identification and function. TM stem cells are localized at the insert region of the TM and are label-retaining in vivo. They can be isolated by side-population cell sorting, cloning culture, or sphere culture. TM stem cells are multipotent with the ability to home to the TM region and differentiate into TM cells in vivo. Other stem cell types, such as adipose-derived stem cells, mesenchymal stem cells and induced pluripotent stem cells have been discovered for TM cell differentiation and TM regeneration. We also review glaucomatous animal models, which are suitable to study stem cell-based therapies for TM regeneration. PMID:27183473

  8. Pharmacotherapy of intraocular pressure: part I. Parasympathomimetic, sympathomimetic and sympatholytics.

    PubMed

    Costagliola, Ciro; dell'Omo, Roberto; Romano, Mario R; Rinaldi, Michele; Zeppa, Lucia; Parmeggiani, Francesco

    2009-11-01

    Elevated intraocular pressure (IOP) has been recognized as the major risk factor for the development of glaucoma and a wide range of options are now available to reduce it: medical treatment, laser, filtering, or cyclodestructive surgery (alone or in combination). All these modalities act by decreasing eye pressure and, thereby, protecting the optic nerve head from a mechanic direct and/or vascular indirect insult. Topical medical therapy represents the first-choice treatment and, in most cases, it effectively controls IOP, avoiding the occurrence of further optic nerve damage. All medications lower IOP in two main ways: decreasing the production of aqueous humour or by increasing its outflow from the eye. Consequently, antiglaucoma drugs either suppress aqueous humour formation (beta-adrenergic antagonists, carbonic anhydrase inhibitors, and alpha-2-adrenergic agonists) or raise aqueous humour outflow throughout the conventional (e.g., pilocarpine) or uveoscleral (prostaglandin FP receptor agonists, and prostamides) route. In addition, fixed and unfixed combinations of antiglaucoma compounds have also been available for patients requiring more than one type of medication. This review, which is part one of two (please see Expert Opinion on Pharmacotherapy 10 (17)) briefly considers the characteristics of sympathomimetic, sympatholytics and parasympathomimetic commonly employed in the medical treatment of glaucoma, mainly the primary open-angle form, focusing the discussion on the clinical evidence supporting the use of these three classes of compound. PMID:19874249

  9. Spontaneous Scleral Perforation of an Anterior Chamber Intraocular Lens

    PubMed Central

    Spierer, Oriel; O'Brien, Terrence P.

    2016-01-01

    A routine eye examination of a 69-year-old man revealed a scleral perforation of one of the haptics of the anterior chamber intraocular lens (AC IOL) which had been implanted many years ago. The patient was asymptomatic with good visual acuity. His history was negative for any trauma, eye rubbing, topical corticosteroid use, or autoimmune disease. The horizontal and vertical white-to-white diameters of the cornea in the right eye were 11.5 and 10.5 mm, respectively. Anterior segment optical coherence tomography showed the anterior chamber length to be 12.28 mm horizontally and 10.63 mm vertically. The patient underwent an IOL exchange, and the length of the explanted AC IOL was measured to be 12 mm. We speculate that the AC IOL, which was vertically aligned, was oversized. This case demonstrates the need for proper sizing and positioning of an AC IOL. In complex cases where AC IOL may be used, measuring the horizontal and vertical lengths of the anterior chamber by anterior segment optical coherence tomography prior to surgery may be useful. PMID:27462251

  10. [Intraocular correction of aphakia in patients after kidney transplantation].

    PubMed

    Bocharov, V E; Ivanov, M N; Gantsovskiĭ, P I

    2004-01-01

    It was for the first time in the ophthalmologic practice that a possibility was demonstrated to ensure relatively high and stable functional results, in a significant number of patients with transplanted kidney (TK), related with different-type cataract extraction and with implantation of a variety of PMMA IOLs, i.e. model of B.A. Alexeev, "Storz" company models made from domestic and foreign-made PMMA and domestic-silicone models (P = 70). It was established that IOL implantation in patients with TK is possible in all cases provided the kidney transplant is compensated for and there are no foci of acute or chronic inflammation in the body. A minimal trauma caused by surgery and the suggested scheme of postoperative management (intramuscular injections of antibiotics and supplementary administration of solutions of poludan, naclof, catachrom and actovegin-gel made alongside with routine instillations) cuts the risk of infectious-and-inflammatory as well as of degenerative-and-dystrophic complications in patients with TK receiving the suppressor therapy. Clinical examinations denoted that the intraocular aphakia correction in patients with TK is a method of choice accelerating the medical and social rehabilitation in the discussed patients' category provided the therapeutic-and-diagnostic as well as preventive measures, as required by their status, are being taken. PMID:15384842

  11. Noninvasive Intraocular Pressure Measurements in Mice by Pneumotonometry

    PubMed Central

    Avila, Marcel Y.; Múnera, Alejandro; Guzmán, Arcadio; Do, Chi Wai; Wang, Zhao; Stone, Richard A.; Civan, Mortimer M.

    2005-01-01

    Purpose To develop a reliable, noninvasive, continuous, and easily implemented system for measuring intraocular pressure (IOP) in mice. Methods Pneumotonometry was adapted for measurement of mouse IOP. Measurements were compared with those obtained with the servo-null micropipette system (SNMS) and with direct anterior chamber cannulation. Heart rate was monitored by the precordial pulse, EKG, or tail pulse in anesthetized mice. The characteristic ocular hypotensive response to mannitol was assessed as an additional validation of the method. Results Measurements of IOP obtained using pneumotonometry agreed closely with values measured by SNMS or by direct cannulation. IOP oscillations were synchronous with the heart rate, with a coherence peak between them of ~2 Hz, equal to the pulse frequency. Hypertonic mannitol reduced IOP from 13.7 ± 0.9 mm Hg by 7.7 ± 0.7 mm Hg after 15 minutes. Conclusions Pneumotonometry is a reliable and noninvasive method for the measurement of IOP in mice and may permit comparisons of IOP to hemodynamic factors. This system is simpler and more adaptable for glaucoma research than previously reported methodologies for measuring IOP in mice. PMID:16123429

  12. Prognostic Factor Analysis of Intraocular Pressure with Neovascular Glaucoma.

    PubMed

    Nakano, Satoko; Nakamuro, Takako; Yokoyama, Katsuhiko; Kiyosaki, Kunihiro; Kubota, Toshiaki

    2016-01-01

    Purpose. To perform multivariate analysis for identifying independent predictors of elevated intraocular pressure (IOP) with neovascular glaucoma (NVG), including antivascular endothelial growth factor (VEGF) intravitreal injections. Methods. We retrospectively reviewed 142 NVG patients (181 eyes) with ischemic retinal diseases [proliferative diabetic retinopathy (PDR) in 134 eyes, retinal vein occlusion (RVO) in 29, and ocular ischemic syndrome in 18]. We analyzed age, gender, initial/final LogMAR VA, initial/final IOP, extent of iris and/or angle neovascularization, treatments, preexisting complications, concurrent medications, and follow-up duration. Results. The mean follow-up duration was 23.8 ± 18.8 months. At the final follow-up, 125 (72.3%) eyes had IOP ≤ 21 mmHg. NVG patients with RVO had a higher degree of angle closure and higher IOP. NVG with PDR had better IOP and LogMAR VA. Angle closure had the greatest impact on final IOP. Greater than 90% of patients treated with trabeculectomy with mitomycin C (LEC) had persistent declines in IOP (≤21 mmHg). Stand-alone and combination anti-VEGF therapies were not associated with improved long-term prognosis of IOP. Conclusions. Angle closure was found to have the greatest effect on NVG-IOP prognosis. When target IOP values are not obtained after adequate PRP with or without anti-VEGF, early LEC may improve the prognosis of IOP. PMID:27579175

  13. Prognostic Factor Analysis of Intraocular Pressure with Neovascular Glaucoma

    PubMed Central

    Nakamuro, Takako; Yokoyama, Katsuhiko; Kiyosaki, Kunihiro

    2016-01-01

    Purpose. To perform multivariate analysis for identifying independent predictors of elevated intraocular pressure (IOP) with neovascular glaucoma (NVG), including antivascular endothelial growth factor (VEGF) intravitreal injections. Methods. We retrospectively reviewed 142 NVG patients (181 eyes) with ischemic retinal diseases [proliferative diabetic retinopathy (PDR) in 134 eyes, retinal vein occlusion (RVO) in 29, and ocular ischemic syndrome in 18]. We analyzed age, gender, initial/final LogMAR VA, initial/final IOP, extent of iris and/or angle neovascularization, treatments, preexisting complications, concurrent medications, and follow-up duration. Results. The mean follow-up duration was 23.8 ± 18.8 months. At the final follow-up, 125 (72.3%) eyes had IOP ≤ 21 mmHg. NVG patients with RVO had a higher degree of angle closure and higher IOP. NVG with PDR had better IOP and LogMAR VA. Angle closure had the greatest impact on final IOP. Greater than 90% of patients treated with trabeculectomy with mitomycin C (LEC) had persistent declines in IOP (≤21 mmHg). Stand-alone and combination anti-VEGF therapies were not associated with improved long-term prognosis of IOP. Conclusions. Angle closure was found to have the greatest effect on NVG-IOP prognosis. When target IOP values are not obtained after adequate PRP with or without anti-VEGF, early LEC may improve the prognosis of IOP. PMID:27579175

  14. Foldable antibacterial acrylic intraocular lenses of high refractive index.

    PubMed

    Parra, F; Vázquez, B; Benito, L; Barcenilla, J; San Román, J

    2009-11-01

    Hydrophilic copolymers with high refractive index and bactericide properties based on quaternary ammonium salts monomers and methacrylates bearing benzothiazole moieties have been developed for application as foldable intraocular lenses. Composition of the systems was adjusted to get materials with optimized flexibility, wettability, and refractive properties. All the materials have been characterized in terms of optical properties, glass transition temperature, water content, and wettability. Water contact values oscillated between 37 and 15% and refractive index values in the wet state between 1.49 and 1.53, depending on composition. Glass transition temperature interval was 63-77 degrees C. Values of surface free energy of the solid ranged from 49 to 54 mN/m, characteristic of IOL hydrogel materials. Bactericide properties of the quaternary ammonium salts methacrylates were higher than that of the benzothiazole derivative, showing inhibition halos as high as 23-25 mm in antibiogram tests against S. epidermidis and P. aeruginosa , strains found in the ocular cavity and responsible for most postsurgical endolphthalmitis. Biocompatibility of the systems was evaluated in cell cultures using human fibroblasts. Cellular viability was higher than 90%, and close to 100% in many cases, for the extracts of selected formulations collected at different periods of time. PMID:19795830

  15. Intraocular Implants for the Treatment of Autoimmune Uveitis

    PubMed Central

    Lee, Darren J.

    2015-01-01

    Uveitis is the third leading cause of blindness in developed countries. Currently, the most widely used treatment of non-infectious uveitis is corticosteroids. Posterior uveitis and macular edema can be treated with intraocular injection of corticosteroids, however, this is problematic in chronic cases because of the need for repeat injections. Another option is systemic immunosuppressive therapies that have their own undesirable side effects. These systemic therapies result in a widespread suppression of the entire immune system, leaving the patient susceptible to infection. Therefore, an effective localized treatment option is preferred. With the recent advances in bioengineering, biodegradable polymers that allow for a slow sustained-release of a medication. These advances have culminated in drug delivery implants that are food and drug administration (FDA) approved for the treatment of non-infectious uveitis. In this review, we discuss the types of ocular implants available and some of the polymers used, implants used for the treatment of non-infectious uveitis, and bioengineered alternatives that are on the horizon. PMID:26264035

  16. Intraocular Lymphoma:Update on Diagnosis and Management

    PubMed Central

    Chan, Chi-Chao; Wallace, Dana J.

    2007-01-01

    Background Primary intraocular lymphoma (PIOL) is a subset of primary central nervous system lymphoma (PCNSL) in which lymphoma cells initially invade the retina, vitreous, or optic nerve head, with or without concomitant CNS involvement. The incidence of this previously rare condition has increased dramatically. Given its nonspecific presentation and aggressive course, PIOL provides a diagnostic and therapeutic challenge. Methods We review the current strategies for diagnosis and treatment of PIOL and present our own experience with PIOL. Results Recent developments in the diagnosis of PIOL include immunohistochemistry, flow cytometry, cytokine evaluation, and molecular analysis. However, definitive diagnosis still requires harvesting of tissue for histopathology. Optimal treatment for PIOL remains unclear. Initial therapeutic regimens should include methotrexate-based chemotherapy and radiotherapy to the brain and eye. In addition, promising results have been seen with intravitreal methotrexate and autologous stem cell transplantation for recurrent and refractory disease. Conclusions Efforts to further determine the immunophenotype and molecular characteristics of PIOL will continue to assist in the diagnosis of PIOL. Future studies are required to determine the role of radiotherapy and optimal local and systemic chemotherapeutic regimens. PMID:15377987

  17. Diagnosis and management of primary intraocular lymphoma: an update

    PubMed Central

    Jahnke, Kristoph; Thiel, Eckhard; Abrey, Lauren E; Neuwelt, Edward A; Korfel, Agnieszka

    2007-01-01

    Despite recent advances in diagnosis and treatment, the prognosis of primary intraocular lymphoma (PIOL) remains poor, and the optimal treatment has yet to be defined. This review presents an overview of the current status of PIOL with a focus on recent advances in diagnosis and treatment. Recent studies show a decreasing time interval from symptom presentation to diagnosis, likely due to increased awareness of the disease and improved diagnostic tools. Advances in the pathologic characterization of PIOL have been made over the past years, and the development of PIOL animal models can offer the opportunity to study aspects of PIOL pathology, pathogenesis and treatment. Regarding treatment of PIOL, recent larger case series favor the use of systemic chemotherapy plus local ocular treatment as first-line management for patients with concomitant PIOL and PCNSL. For patients with isolated PIOL, the current trend focuses on local first-line treatment and early diagnosis of PIOL. Future studies are needed to confirm these trends. Future directions in the management of PIOL should include studies about pathogenesis, prognostic factors, and treatment optimization. In the future, monoclonal antibodies and radioimmunotherapy could prove useful for PIOL treatment. PMID:19668478

  18. Experiment design for through-focus testing of intraocular lenses

    NASA Astrophysics Data System (ADS)

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

    2013-11-01

    Eye models to test intraocular lenses (IOLs) in an optical bench are commonly designed in agreement with the ISO 11979-2 and 11979-9 standard requirements. However, modifications to the ISO eye model have been proposed to test IOLs in conditions closer to real human eye. Wavefront analysis and aberration characterization, wavelength dependence, efficiency, off-axis performance and imaging degradation under certain amount of misalignment can thus be measured in vitro. The main parts of the system to test IOLs are: the illumination system and object test, the eye model including the IOL immersed in a wet cell and a microscope assembled to a sensor that magnifies and captures the aerial image of the object formed by the eye model. A problem concerning the simultaneous variation of defocus and magnification arises when using the microscope to capture out-of-focus images in a through-focus study. Using the eye model, we study the problem of implementing a through-focus measurement of the imaging quality of an IOL. We find a solution based on geometrical optics and compare it with other proposals reported in the literature. The effects on the measurement of the Modulation Transfer Function and the Point Spread Function are predicted. Experimental results are obtained and discussed.

  19. Effect of a tight necktie on intraocular pressure

    PubMed Central

    Teng, C; Gurses-Ozden, R; Liebmann, J M; Tello, C; Ritch, R

    2003-01-01

    Aim: To evaluate the effect of a tight necktie on intraocular pressure (IOP) measurement using Goldmann applanation tonometry. Methods: 40 eyes of 20 normal subjects and 20 open angle glaucoma patients (all male) were enrolled. IOP was measured with an open shirt collar, 3 minutes after placing a tight necktie, and 3 minutes after loosening it. All measurements were made by the same examiner. Results: Mean IOP in normal subjects increased by 2.6 (SD 3.9) mm Hg (p=0.008, paired t test; range −3 to +14 mm Hg) and in glaucoma patients by 1.0 (1.8) mm Hg (p=0.02, paired t test; range −2 to +4.5 mm Hg). In normal subjects, IOP in 12 eyes was increased by ⩾2 mm Hg and in seven eyes by ⩾4 mm Hg. In glaucoma patients, IOP in six eyes was increased by ⩾2 mm Hg and in two eyes by ⩾4 mm Hg. Conclusion: A tight necktie increases IOP in both normal subjects and glaucoma patients and could affect the diagnosis and management of glaucoma. PMID:12881330

  20. Impact factors on intraocular pressure measurements in healthy subjects

    PubMed Central

    Theelen, T; Meulendijks, C F M; Geurts, D E M; van Leeuwen, A; Voet, N B M; Deutman, A F

    2004-01-01

    Aim: To evaluate whether intraocular pressure (IOP) calculation by applanation tonometry is determined more essentially by the subject’s neck position or by neck constriction. Methods: 23 right eyes of 23 healthy subjects (12 male, 11 female) were included. IOP was measured by applanation tonometry with the TonoPen on sitting participants under four different conditions: with open collar upright (A) or with the head in the headrest of a slit lamp (B), with a tight necktie upright (C) or in slit lamp position (D). All measurements with neck constriction were performed 3 minutes after placing the necktie. Results: Mean IOP was 16.9 (SD 2.3) mm Hg (range 11–21 mm Hg) (A), 18.1 (SD 2.2) mm Hg (range 14–22 mm Hg) (B), 17.9 (SD 2.9) mm Hg (range 12–25 mm Hg) (C) and 18.7 (SD 2.7) mm Hg (range 13–24 mm Hg) (D). Mean IOP increased by 1.3 (SD 2.6) mm Hg (p = 0.028, paired t test, range +0.2 to +2.4 mm Hg) if subjects changed position from A to B. There was no statistically significant difference between measurements with or without neck constriction. Conclusion: Applanation tonometry may be inaccurate if performed in slit lamp position. In contrast, tight neckties do not significantly affect IOP evaluation in healthy subjects. PMID:15548801

  1. Aspheric Intraocular Lenses Implantation for Cataract Patients with Extreme Myopia

    PubMed Central

    Miao, Aizhu; Luo, Yi

    2014-01-01

    Objective. To evaluate the postoperative visual quality of cataract patients with extreme myopia after implantation of aspheric intraocular lenses (IOLs). Methods. Thirty-three eyes were enrolled in this prospectivestudy. Eighteen eyes with an axial length longer than 28 mm were included in the extreme myopia group, and the other 15 eyes were included in the nonextreme myopia group. Phacoemulsification and aspheric IOL implantation were performed. Six months after cataract surgery, best-corrected visual acuity (BCVA), contrast sensitivity, and wavefront aberrations were measured, and subjective visual quality was assessed. Results. The BCVA improved significantly after surgery for both groups, and patients in the nonextreme myopia group achieved better postoperative BCVA due to better retinal status of the eyes. The evaluation of contrast sensitivity without glare was the same in both groups, whereas patients in the nonextreme myopia group performed better at intermediate spatial frequencies under glare conditions. The two groups did not show a significant difference in high-order aberrations. With regard to subjective visual quality, the composite scores of both groups did not differ significantly. Conclusions. Aspheric IOLs provided good visual outcomes in cataract patients with extreme myopia. These patients should undergo careful evaluation to determine the maculopathy severity level before surgery. PMID:25006509

  2. Sulcus Fixation of Foldable Intraocular Lenses Guided by Ultrasound Biomicroscopy

    PubMed Central

    Gao, Shasha; Qin, Tingyu; Wang, Shengnan; Lu, Yong

    2015-01-01

    Background. To evaluate the clinical efficacy of suture fixation of foldable intraocular lens (IOL) in ciliary sulcus guided by ultrasound biomicroscopy (UBM). Methods. Thirty-five eyes of 32 cases needing suture fixation of foldable IOL in ciliary sulcus in our hospital were collected and divided into two groups: group A and group B. In group A, UBM was performed on 19 eyes of 17 cases before surgery to locate the projection position of ciliary sulcus in iris surface. In group B, the traditional sulcus fixation of IOL was performed on 16 eyes of 15 cases. The inserting position of needles, the haptics position of IOL and the IOL tilt, and decentration were observed by UBM examination 3 months after the surgery. Meanwhile, the vision and contrast sensitivity were analysed. Results. The differences in inserting position of the needle, the IOL tilt and decentration, the ratio of IOL haptics in sulcus, and uncorrected visual acuity were statistically significant (P < 0.05). The differences in best corrected visual acuity (BCVA) and contrast sensitivity were not statistically significant (P > 0.05). Conclusions. Sulcus fixation of foldable IOL aided by UBM can increase the accuracy of IOL haptics implanted into ciliary sulcus and reduce the IOL tilt and decentration. PMID:26413317

  3. Micro-optical imaging concepts for an intraocular vision aid

    NASA Astrophysics Data System (ADS)

    Eix, Ilos; Stork, Wilhelm; Muller-Glaser, Klaus D.

    2004-03-01

    About 10 million people around the world are suffering from blindness, where the path of light is disturbed due to an opaque, irreversible damaged, and inoperable cornea. Although vision is not given to this group of population, the retina is still intact. To date, there is no artificial implant which is able to replace the natural cornea. The work presented here describes an approach to build and implant a micro-optical and microelectronic system to be used as an intraocular vision aid. By overcoming the disturbed light path, it yields to an improved visual acuity of the patient. The main aspect of this bio-mimetic system is to transfer information representing the patient's field of view to the retina. An image of the field of view is captured in real-time outside the eye. After employing data processing, it is wireless transferred to the implanted part of the vision aid. From there, the information emerging from a micro display is imaged to the retina via a micro-optical system. The limited display resolution available inside the eye and the limited dimensions of the eyeball build the constrains of the optical system. A combination of a spatial light modulator together with an imaging lens system realizes intelligent spatial information distribution schemes onto the retina. This ensures a high outcome of visual acuity in the central region of the retina. Various retinal acuities can be realized. The employment of in-vivo adjustment mechanisms of the focal plane is discussed.

  4. Non-continuous measurement of intraocular pressure in laboratory animals.

    PubMed

    Millar, J Cameron; Pang, Iok-Hou

    2015-12-01

    Glaucoma is a leading cause of blindness, which is treatable but currently incurable. Numerous animal models therefore have both been and continue to be utilized in the study of numerous aspects of this condition. One important facet associated with the use of such models is the ability to accurately and reproducibly measure (by cannulation) or estimate (by tonometry) intraocular pressure (IOP). At this juncture there are several different approaches to IOP measurement in different experimental animal species, and the list continues to grow. We feel therefore that a review of this subject matter is timely and should prove useful to others who wish to perform similar measurements. The general principles underlying various types of tonometric and non-tonometric techniques for non-continuous determination of IOP are considered. There follows discussion of specific details as to how these techniques are applied to experimental animal species involved in the research of this disease. Specific comments regarding anesthesia, circadian rhythm, and animal handling are also included, especially in the case of rodents. Brief consideration is also given to possible future developments. PMID:25933714

  5. Spontaneous Scleral Perforation of an Anterior Chamber Intraocular Lens.

    PubMed

    Spierer, Oriel; O'Brien, Terrence P

    2016-01-01

    A routine eye examination of a 69-year-old man revealed a scleral perforation of one of the haptics of the anterior chamber intraocular lens (AC IOL) which had been implanted many years ago. The patient was asymptomatic with good visual acuity. His history was negative for any trauma, eye rubbing, topical corticosteroid use, or autoimmune disease. The horizontal and vertical white-to-white diameters of the cornea in the right eye were 11.5 and 10.5 mm, respectively. Anterior segment optical coherence tomography showed the anterior chamber length to be 12.28 mm horizontally and 10.63 mm vertically. The patient underwent an IOL exchange, and the length of the explanted AC IOL was measured to be 12 mm. We speculate that the AC IOL, which was vertically aligned, was oversized. This case demonstrates the need for proper sizing and positioning of an AC IOL. In complex cases where AC IOL may be used, measuring the horizontal and vertical lengths of the anterior chamber by anterior segment optical coherence tomography prior to surgery may be useful. PMID:27462251

  6. Toward Automated Intraocular Laser Surgery Using a Handheld Micromanipulator

    PubMed Central

    Yang, Sungwook; MacLachlan, Robert A.; Riviere, Cameron N.

    2014-01-01

    This paper presents a technique for automated intraocular laser surgery using a handheld micromanipulator known as Micron. The novel handheld manipulator enables the automated scanning of a laser probe within a cylinder of 4 mm long and 4 mm in diameter. For the automation, the surface of the retina is reconstructed using a stereomicroscope, and then preplanned targets are placed on the surface. The laser probe is precisely located on the target via visual servoing of the aiming beam, while maintaining a specific distance above the surface. In addition, the system is capable of tracking the surface of the eye in order to compensate for any eye movement introduced during the operation. We compared the performance of the automated scanning using various control thresholds, in order to find the most effective threshold in terms of accuracy and speed. Given the selected threshold, we conducted the handheld operation above a fixed target surface. The average error and execution time are reduced by 63.6% and 28.5%, respectively, compared to the unaided trials. Finally, the automated laser photocoagulation was demonstrated also in an eye phantom, including compensation for the eye movement. PMID:25893135

  7. Determination of the true intraocular pressure and modulus of elasticity of the human cornea in vivo.

    PubMed

    Orssengo, G J; Pye, D C

    1999-05-01

    The purpose of this study was to determine the true intraocular pressure and modulus of elasticity of the human cornea in vivo. The cornea was modeled as a shell, and the equations for the deformations of a shell due to applanating and intraocular pressures were combined to model the behavior of the cornea during applanation tonometry. At certain corneal dimensions called the calibration dimensions, the applanating and intraocular pressures are considered to be equal. This relationship was used to determine the modulus of elasticity of the cornea and the relationship between the applanating and intraocular pressures. The true intraocular pressure (IOPT) was found to be related to Goldmann's applanating pressure (IOPG) as IOPT = IOPG/K, where K is a correction factor. For the calibration corneal thickness of 0.52 mm, the modulus of elasticity E in MPa of the human cornea was found to be related to the true intraocular pressure IOPT in mmHg as E = 0.02291OPT. The generalization of the Imbert-Fick law that takes into account the effect of corneal dimensions and stiffness was found to be given by IOPT = 73.5W/(K A), where W is the applanating weight in gf (gram force) and A is the applanated area in mm2. The calculated true intraocular pressure and modulus of elasticity were found to agree with published experimental results. The mathematical model developed may therefore be used to improve results from applanation tonometry and to estimate the mechanical property of the cornea in vivo. PMID:17883231

  8. Removal of Silicone Oil From Intraocular Lens Using Novel Surgical Materials

    PubMed Central

    Paschalis, Eleftherios I.; Eliott, Dean; Vavvas, Demetrios G.

    2014-01-01

    Purpose To design, fabricate, and evaluate novel materials to remove silicone oil (SiO) droplets from intraocular lenses (IOL) during vitreoretinal surgery. Methods Three different designs were fabricated using soft lithography of polydimethylsiloxane (PDMS), three-dimensional (3D) inverse PDMS fabrication using water dissolvable particles, and atomic layer deposition (ALD) of alumina (Al2O3) on surgical cellulose fibers. Laboratory tests included static and dynamic contact angle (CA) measurements with water and SiO, nondestructive x-ray microcomputer tomography (micro-CT), and microscopy. SiO removal was performed in vitro and ex vivo using implantable IOLs and explanted porcine eyes. Results All designs exhibited enhanced hydrophobicity and oleophilicity. Static CA measurements with water ranged from 131° to 160° and with SiO CA approximately 0° in 120 seconds following exposure. Nondestructive x-ray analysis of the 3D PDMS showed presence of interconnected polydispersed porosity of 100 to 300 μm in diameter. SiO removal from IOLs was achieved in vitro and ex vivo using standard 20-G vitrectomy instrumentation. Conclusion Removal of SiO from IOLs can be achieved using materials with lower surface energy than that of the IOLs. This can be achieved using appropriate surface chemistry and surface topography. Three designs, with enhanced hydrophobic properties, were fabricated and tested in vitro and ex vivo. All materials remove SiO within an aqueous environment. Preliminary ex vivo results were very promising, opening new possibilities for SiO removal in vitreoretinal surgeries. Translational Relevance This is the first report of an instrument that can lead to successful removal of SiO from the surface of IOL. In addition to the use of this instrument/material in medicine it can also be used in the industry, for example, retrieval of oil spills from bodies of water. PMID:25237593

  9. Intraocular pressure and glaucoma: Is physical exercise beneficial or a risk?

    PubMed

    McMonnies, Charles William

    2016-01-01

    Intraocular pressure may become elevated with muscle exertion, changes in body position and increased respiratory volumes, especially when Valsalva manoeuver mechanisms are involved. All of these factors may be present during physical exercise, especially if hydration levels are increased. This review examines the evidence for intraocular pressure changes during and after physical exercise. Intraocular pressure elevation may result in a reduction in ocular perfusion pressure with the associated possibility of mechanical and/or ischaemic damage to the optic nerve head. A key consideration is the possibility that, rather than being beneficial for patients who are susceptible to glaucomatous pathology, any intraocular pressure elevation could be detrimental. Lower intraocular pressure after exercise may result from its elevation causing accelerated aqueous outflow during exercise. Also examined is the possibility that people who have lower frailty are more likely to exercise as well as less likely to have or develop glaucoma. Consequently, lower prevalence of glaucoma would be expected among people who exercise. The evidence base for this topic is deficient and would be greatly improved by the availability of tonometry assessment during dynamic exercise, more studies which control for hydration levels, and methods for assessing the potential general health benefits of exercise against any possibility of exacerbated glaucomatous pathology for individual patients who are susceptible to such changes. PMID:26794458

  10. Comparative intraocular penetration of topical and injected cefuroxime.

    PubMed Central

    Jenkins, C D; Tuft, S J; Sheraidah, G; McHugh, D A; Buckley, R J

    1996-01-01

    AIMS: The choice of a prophylactic antibiotic for cataract surgery is dependent on its antibacterial activity and tissue penetration. The influence of the route and timing of administration of cefuroxime on its intraocular concentrations was examined. METHODS: 120 patients were recruited before cataract surgery into a prospective trial to compare the anterior chamber concentration of cefuroxime at a fixed time after administration by three routes. In a further 110 patients, the interval before sampling was varied in order to permit an examination of the kinetics of penetration. In another 10 patients, cefuroxime was given topically at the completion of surgery to assess the effect of a corneal wound on aqueous penetration. Cefuroxime concentrations were measured by high performance liquid chromatography on 0.2 ml samples of aqueous aspirated from the anterior chamber. Mean aqueous concentrations of cefuroxime for each group were compared using Student's t test. RESULTS: After 25 mg cefuroxime, mean aqueous concentrations increased in the order forniceal (< 0.1 microgram/ml) < topical (0.18 microgram/ml) < subconjunctival (2.31 microgram/ml) when sampled 12-24 minutes after administration. Aqueous concentrations of cefuroxime reached a peak between 80 and 110 minutes after both forniceal and peribulbar injection but were still rising at this time after subconjunctival injection. Topical application of 12.5 mg cefuroxime to eyes with a 10 mm corneal wound resulted in a mean aqueous concentration of 9.34 micrograms/ml. CONCLUSION: In the intact eye, only sub-conjunctival injection resulted in clinically significant aqueous concentrations of cefuroxime (> 1 microgram/ml) between 12 and 24 minutes after administration. For all routes, maximal aqueous concentrations were delayed by at least 80 minutes from administration. In the presence of a corneal wound, high aqueous levels of cefuroxime were rapidly attained after topical application. PMID:8949709

  11. Bevacizumab therapy normalizes the pathological intraocular environment beyond neutralizing VEGF

    PubMed Central

    Rogojina, Anna T.; Chalam, K.V.

    2010-01-01

    Purpose Vascular endothelial growth factor (VEGF) plays a key role in neovascularization by stimulating the proliferation and migration of vascular endothelial cells. The anti-VEGF therapy bevacizumab acts by binding to VEGF and preventing its effects. However, this linear interaction represents only a partial view of the pathobiology of neovascular diseases and the anti-VEGF treatment. To obtain an integrated view of the processes involved in VEGF-related ocular pathologies, we applied a systems approach and investigated whether intravitreal bevacizumab injections have a global effect in normalizing the ocular physiology perturbed by the disease. Methods We analyzed 90 analytes representing various pathophysiological processes in aqueous humor. The samples were obtained from eight patients receiving intravitreal bevacizumab injections for various ocular VEGF-related conditions. The samples were obtained before and after the injection and were analyzed using microbead technology developed by Luminex xMAP. Results Forty-three analytes were detected above the sensitivity of the assay both in pre- and post-injection samples. Of these, normal values of 41 analytes were known and these analytes were further analyzed. The detected analytes included relevant markers such as VEGF, C reactive protein, glutathione, and cytokines. We identified 24 markers that were perturbed more than 1.5 fold in diseased samples (pre-injection) compared to normal levels. The levels of perturbed analytes were compared in post-treatment samples. The results demonstrated an unequivocal trend toward normalization in post-treatment samples. Conclusions Our results show intraocular bevacizumab injections change the perturbed physiologic environment of the eye toward normalization. Its effects reached beyond neutralizing VEGF. The results also demonstrate that large-scale analysis of the aqueous, using a systems approach, could provide useful insight regarding ocular diseases, their

  12. Retreatments after multifocal intraocular lens implantation: an analysis

    PubMed Central

    Gundersen, Kjell Gunnar; Makari, Sarah; Ostenstad, Steffen; Potvin, Rick

    2016-01-01

    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. PMID:27041983

  13. Nanosponge-Mediated Drug Delivery Lowers Intraocular Pressure

    PubMed Central

    Lambert, Wendi S.; Carlson, Brian J.; van der Ende, Alice E.; Shih, Grace; Dobish, Julia N.; Calkins, David J.; Harth, Eva

    2015-01-01

    Purpose We examined the efficacy of an extended-release drug delivery system, nanosponge (NS) encapsulated compounds, administered intravitreally to lower intraocular pressure (IOP) in mice. Methods Bilateral ocular hypertension was induced in mice by injecting microbeads into the anterior chamber. Hypertensive mice received NS loaded with ocular hypotensive drugs via intravitreal injection and IOP was monitored. Retinal deposition and retinal ganglion cell (RGC) uptake of Neuro-DiO were examined following intravitreal injection of Neuro-DiO-NS using confocal microscopy. Results Brimonidine-loaded NS lowered IOP 12% to 30% for up to 6 days (P < 0.02), whereas travoprost-NS lowered IOP 19% to 29% for up to 4 days (P < 0.02) compared to saline injection. Three bimatoprost NS were tested: a 400-nm NS and two 700-nm NS with amorphous (A-NS) or amorphous/crystalline (AC-NS) crosslinkers. A single injection of 400 nm NS lowered IOP 24% to 33% for up to 17 days compared to saline, while A-NS and AC-NS lowered IOP 22% to 32% and 18% to 26%, respectively, for up to 32 days (P < 0.046). Over time retinal deposition of Neuro-DiO increased from 19% to 71%; Neuro-DiO released from NS was internalized by RGCs. Conclusions A single injection of NS can effectively deliver ocular hypotensive drugs in a linear and continuous manner for up to 32 days. Also, NS may be effective at targeting RGCs, the neurons that degenerate in glaucoma. Translational Relevance Patient compliance is a major issue in glaucoma. The use of NS to deliver a controlled, sustained release of therapeutics could drastically reduce the number of patients that progress to vision loss in this disease. PMID:25599009

  14. Comparison Between Digital and Manual Marking for Toric Intraocular Lenses

    PubMed Central

    Elhofi, Abdel Hamid; Helaly, Hany Ahmed

    2015-01-01

    Abstract To compare the clinical outcome of digital and manual marking for toric intraocular lens (IOL) alignment. This is a prospective clinical study that included 60 eyes of 60 patients undergoing cataract surgery with coexisting corneal astigmatism more than 1 diopter (D). The eyes were randomly assigned to either digital image guidance using VERION digital marker (Alcon Laboratories, Ft. Worth, TX) or manual slitlamp-assisted preoperative marking using pendulum-attached marker. Tecnis toric IOL (Abbott Medical Optics, Inc, Santa Ana, CA) was implanted in all cases. The mean postoperative uncorrected distance visual acuity (UCDVA) for the digital-marking group was 0.12 + 0.12 logMAR, and for the manual-marking group was 0.18 + 0.14 logMAR (P = 0.104). The mean deviation from targeted induced astigmatism (TIA) for the first group was 0.10 + 0.08 D and for the second group was 0.20 + 0.14 D (P = 0.001). The mean postoperative toric IOL misalignment measured by the slitlamp was 2.4° + 1.96° for the first group and was 4.33° + 2.72° for the second group (P = 0.003). Accurate alignment of the toric IOL is important to achieve the desired astigmatism correction. VERION system has the advantage of preoperative planning and intraoperative digital guidance of the toric IOL alignment. The use of VERION system resulted in less postoperative deviation from TIA and showed less postoperative toric IOL misalignment than using manual-marking technique. PMID:26402830

  15. Driving time modulates accommodative response and intraocular pressure.

    PubMed

    Vera, Jesús; Diaz-Piedra, Carolina; Jiménez, Raimundo; Morales, José M; Catena, Andrés; Cardenas, David; Di Stasi, Leandro L

    2016-10-01

    Driving is a task mainly reliant on the visual system. Most of the time, while driving, our eyes are constantly focusing and refocusing between the road and the dashboard or near and far traffic. Thus, prolonged driving time should produce visual fatigue. Here, for the first time, we investigated the effects of driving time, a common inducer of driver fatigue, on two ocular parameters: the accommodative response (AR) and the intraocular pressure (IOP). A pre/post-test design has been used to assess the impact of driving time on both indices. Twelve participants (out of 17 recruited) completed the study (5 women, 24.42±2.84years old). The participants were healthy and active drivers with no visual impairment or pathology. They drove for 2h in a virtual driving environment. We assessed AR and IOP before and after the driving session, and also collected subjective measures of arousal and fatigue. We found that IOP and AR decreased (i.e., the accommodative lag increased) after the driving session (p=0.03 and p<0.001, respectively). Moreover, the nearest distances tested (20cm, 25cm, and 33cm) induced the highest decreases in AR (corrected p-values<0.05). Consistent with these findings, the subjective levels of arousal decreased and levels of fatigue increased after the driving session (all p-values<0.001). These results represent an innovative step towards an objective, valid, and reliable assessment of fatigue-impaired driving based on visual fatigue signs. PMID:27235337

  16. Blood Pressure Modifies Retinal Susceptibility to Intraocular Pressure Elevation

    PubMed Central

    He, Zheng; Nguyen, Christine T. O.; Armitage, James A.; Vingrys, Algis J.; Bui, Bang V.

    2012-01-01

    Primary open angle glaucoma affects more than 67 million people. Elevated intraocular pressure (IOP) is a risk factor for glaucoma and may reduce nutrient availability by decreasing ocular perfusion pressure (OPP). An interaction between arterial blood pressure and IOP determines OPP; but the exact contribution that these factors have for retinal function is not fully understood. Here we sought to determine how acute modifications of arterial pressure will affect the susceptibility of neuronal function and blood flow to IOP challenge. Anaesthetized (ketamine:xylazine) Long-Evan rats with low (∼60 mmHg, sodium nitroprusside infusion), moderate (∼100 mmHg, saline), or high levels (∼160 mmHg, angiotensin II) of mean arterial pressure (MAP, n = 5–10 per group) were subjected to IOP challenge (10–120 mmHg, 5 mmHg steps every 3 minutes). Electroretinograms were measured at each IOP step to assess bipolar cell (b-wave) and inner retinal function (scotopic threshold response or STR). Ocular blood flow was measured using laser-Doppler flowmetry in groups with similar MAP level and the same IOP challenge protocol. Both b-wave and STR amplitudes decreased with IOP elevation. Retinal function was less susceptible to IOP challenge when MAP was high, whereas the converse was true for low MAP. Consistent with the effects on retinal function, higher IOP was needed to attenuated ocular blood flow in animals with higher MAP. The susceptibility of retinal function to IOP challenge can be ameliorated by acute high BP, and exacerbated by low BP. This is partially mediated by modifications in ocular blood flow. PMID:22359566

  17. Increased Intraocular Pressure and Hyperglycemic Level in Diabetic Patients

    PubMed Central

    Hymowitz, Maggie B.; Chang, Donny; Feinberg, Edward B.; Roy, Sayon

    2016-01-01

    Purpose To determine whether hyperglycemic levels as determined from high hemoglobin A1c (HbA1c) levels influence intraocular pressure (IOP) in patients with non-proliferative diabetic retinopathy (NPDR). Methods A retrospective chart review was performed on subjects with a diagnosis of NPDR and a corresponding HbA1c level measured within 90 days before or after an IOP measurement over a two-year period. Exclusion criteria included a diagnosis of glaucoma or treatment with IOP lowering medications or oral or topical steroids. Results Using 14.5mmHg as a baseline mean value for IOP, 42 subjects had an IOP < 14.5mmHg and mean HbA1c of 8.1±1.1, while 72 subjects had an IOP ≥ 14.5mmHg and a mean HbA1c of 9.0±2.1. Although there was an overlap in the confidence intervals, a significant difference (P = 0.01) in the mean HbA1c level was observed in regression analysis between the two groups. Importantly, diabetic subjects with elevated HbA1c levels rarely (<1%) exhibited reduced IOP levels. Conclusions Diabetic subjects with elevated HbA1c levels exhibited significantly higher IOPs compared to those with lower HbA1c levels. Findings from this study indicate an association between hyperglycemia and elevated IOP and that poor glycemic control may contribute to increased IOP levels in long-term diabetic patients. PMID:27002725

  18. Energy Efficiency of a New Trifocal Intraocular Lens

    NASA Astrophysics Data System (ADS)

    Vega, F.; Alba-Bueno, F.; Millán, M. S.

    2014-01-01

    The light distribution among the far, intermediate and near foci of a new trifocal intraocular lens (IOL) is experimentally determined, as a function of the pupil size, from image analysis. The concept of focus energy efficiency is introduced because, in addition to the theoretical diffraction efficiency of the focus, it accounts for other factors that are naturally presented in the human eye such as the level of spherical aberration (SA) upon the IOL, light scattering at the diffractive steps or the depth of focus. The trifocal IOL is tested in-vitro in two eye models: the aberration-free ISO model, and a so called modified-ISO one that uses an artificial cornea with positive spherical SA in instead. The SA upon the IOL is measured with a Hartmann-Shack sensor and compared to the values of theoretical eye models. The results show, for large pupils, a notorious reduction of the energy efficiency of the far and near foci of the trifocal IOL due to two facts: the level of SA upon the IOL is larger than the value the lens is able to compensate for and there is significant light scattering at the diffractive steps. On the other hand, the energy efficiency of the intermediate focus for small pupils is enhanced by the contribution of the extended depth of focus of the near and far foci. Thus, while IOLs manufacturers tend to provide just the theoretical diffraction efficiency of the foci to show which would be the performance of the lens in terms of light distribution among the foci, our results put into evidence that this is better described by using the energy efficiency of the foci.

  19. Handheld Automated Microsurgical Instrumentation for Intraocular Laser Surgery

    PubMed Central

    Yang, Sungwook; Lobes, Louis A.; Martel, Joseph N.; Riviere, Cameron N.

    2016-01-01

    Background and Objective Laser photocoagulation is a mainstay or adjuvant treatment for a variety of common retinal diseases. Automated laser photocoagulation during intraocular surgery has not yet been established. The authors introduce an automated laser photocoagulation system for intraocular surgery, based on a novel handheld instrument. The goals of the system are to enhance accuracy and efficiency and improve safety. Materials and Methods Triple-ring patterns are introduced as a typical arrangement for the treatment of proliferative retinopathy and registered to a preoperative fundus image. In total, 32 target locations are specified along the circumferences of three rings having diameters of 1, 2, and 3 mm, with a burn spacing of 600 μm. Given the initial system calibration, the retinal surface is reconstructed using stereo vision, and the targets specified on the preoperative image are registered with the control system. During automated operation, the laser probe attached to the manipulator of the active handheld instrument is deflected as needed via visual servoing in order to correct the error between the aiming beam and a specified target, regardless of any erroneous handle motion by the surgeon. A constant distance of the laser probe from the retinal surface is maintained in order to yield consistent size of burns and ensure safety during operation. Real-time tracking of anatomical features enables compensation for any movement of the eye. A graphical overlay system within operating microscope provides the surgeon with guidance cues for automated operation. Two retinal surgeons performed automated and manual trials in an artificial model of the eye, with each trial repeated three times. For the automated trials, various targeting thresholds (50–200 μm) were used to automatically trigger laser firing. In manual operation, fixed repetition rates were used, with frequencies of 1.0–2.5 Hz. The power of the 532 nm laser was set at 3.0 W with a

  20. Higher intraocular pressure is associated with leukoaraiosis among middle-aged and elderly Koreans without glaucoma or dementia

    PubMed Central

    Park, B-J; Kim, J-K; Lee, Y-J

    2014-01-01

    Aim Leukoaraiosis and high intraocular pressure are strongly associated with cardiovascular disease, vascular angiopathy, and geriatric syndrome. Until now, little is known about the relationship between intraocular pressure and leukoaraiosis in its preclinical stage. The aim of this study was to evaluate the association between intraocular pressure and leukoaraiosis among middle-aged and elderly Koreans without glaucoma or dementia. Methods We examined the relationship of intraocular pressure with leukoaraiosis at a preclinical stage in 753 Korean adults (474 men, 279 women; mean age 57.8±6.6 years). A multiple logistic regression analysis was performed in order to determine whether intraocular pressure is an independent determinant for leukoaraiosis. Results The overall prevalence of leukoaraiosis was 7.3%. Mean ocular pressure (±SD) was significantly higher in the leukoaraiosis group than the control group (14.3±2.9 and 13.5±2.9, respectively; P=0.028). In multiple logistic regression analysis, the odds ratio for leukoaraiosis was 1.18 (95% confidence interval: 1.06–1.31) for each 1 mm Hg increase in intraocular pressure. Conclusion Intraocular pressure was found to be independently and positively associated with leukoaraiosis. This finding indicates that higher intraocular pressure may be a useful additional measure in assessing the risk of leukoaraiosis in the clinical setting. PMID:24675583

  1. Anti-tubercular therapy for intraocular tuberculosis: A systematic review and meta-analysis.

    PubMed

    Kee, Ae Ra; Gonzalez-Lopez, Julio J; Al-Hity, Aws; Gupta, Bhaskar; Lee, Cecilia S; Gunasekeran, Dinesh Visva; Jayabalan, Nirmal; Grant, Robert; Kon, Onn Min; Gupta, Vishali; Westcott, Mark; Pavesio, Carlos; Agrawal, Rupesh

    2016-01-01

    Intraocular tuberculosis remains a diagnostic and management conundrum for both ophthalmologists and pulmonologists. We analyze the efficacy and safety of anti-tubercular therapy (ATT) in patients with intraocular tuberculosis and factors associated with favorable outcome. Twenty-eight studies are included in this review, with a total of 1,917 patients. Nonrecurrence of inflammation was observed in pooled estimate of 84% of ATT-treated patients (95% CI 79-89). There was minimal difference in the outcome between patients treated with ATT alone (85% successful outcome; 95% CI 25-100) and those with concomitant systemic corticosteroid (82%; 95% CI 73-90). The use of ATT may be of benefit to patients with suspected intraocular tuberculosis; however, this conclusion is limited by the lack of control group analysis and standardized recruitment and treatment protocols. We propose further prospective studies to better establish the efficacy of ATT and ascertain the factors associated with favorable treatment outcomes. PMID:26970263

  2. [Refraction after Implantation of Multifocal and Presbyopia-Correcting Intraocular Lenses].

    PubMed

    Kretz, F T A; Linz, K; Mueller, M; Gerl, M; Koss, M J; Gerl, R H; Auffarth, G U

    2015-08-01

    Nowadays, further developments in the field of intraocular lenses offer a higher level of spectacle independence for our patients. As light gets scattered on different focal points a wider range of defocus is created. This greater defocus area makes it more difficult for us to determine the objective or subjective refraction. This contribution is concerned with the difficulties of measuring visual acuity in different intraocular lens designs and different measurement distances. Measuring refraction after implantation of a multifocal intraocular lens is a complex procedure and the experience of the examiner plays a crucial role. Retinoscopy, keratometry and the defocus curve are reliable methods for testing, while the auto refractometer, bichromatic testing and the cross-cylinder have limitations. PMID:25927177

  3. STS-41 crewmembers conduct DSO 0472 Intraocular Pressure on OV-103's middeck

    NASA Technical Reports Server (NTRS)

    1990-01-01

    STS-41 crewmembers conduct Detailed Supplementary Objective (DSO) 0472 Intraocular Pressure on the middeck of Discovery, Orbiter Vehicle (OV) 103. Mission Specialist (MS) William M. Shepherd rests his head on the stowed treadmill while Pilot Robert D. Cabana, holding Shepherd's eye open, prepares to measure Shepherd's intraocular pressure using a tono pen (in his right hand). Objectives include: establishing a database of changes in intraocular pressures that can be used to evaluate crew health; validating ten degree head down bedrest as a model for cephalad fluid shifts in microgravity; facilitating the interpretation of data by providing a quantative measure of microgravity induced cephalad fluid shifts; and validating the tono pen as an effective tool for diagnostic and scientific data collection.

  4. Laser-triggered intraocular implant to induce photodynamic therapy for posterior capsule opacification prevention.

    PubMed

    Zhang, Zhaoguo; Huang, Wenyong; Lei, Ming; He, Yuanfeng; Yan, Mina; Zhang, Xuefei; Zhao, Chunshun

    2016-02-10

    Posterior capsule opacification (PCO) is one of the main reasons for loss of vision again after cataract surgery. In this study, intraocular lenses were modified with indocyanine green (ICG) and sealed up with PLGA to form long-term intraocular implants (ICG-IOL). When triggered by laser, ICG-IOL would induce photodynamic therapy (PDT). In-vitro cell viability assay and scratch wound healing assay demonstrated that ICG-IOL could effectively inhibit HLEpiC proliferation and migration without causing damage to the cells far away from it. Laser attenuation test indicated that ICG-IOL could be applied in vivo. In-vivo pharmacodynamics and safety study showed that ICG-IOL could significantly prevent the occurrence of PCO and was safe for intraocular normal tissue. All these results suggested that ICG-IOL would be a very promising candidate for PCO prevention. PMID:26456263

  5. Intraocular Pressure Regulation: Findings of Pulse-Dependent Trabecular Meshwork Motion Lead to Unifying Concepts of Intraocular Pressure Homeostasis

    PubMed Central

    2014-01-01

    Abstract Intraocular pressure (IOP) is the only treatable risk factor in glaucoma, one of the world's leading causes of blindness. Mechanisms that maintain IOP within a normal range have been poorly understood in contrast to intrinsic mechanisms that regulate systemic blood pressure. Vessel walls experience continuous pulse-induced cyclic pressure and flow. Pressure-dependent wall stress and flow-dependent shear stress provide sensory signals that initiate mechanotransduction responses. The responses optimize vessel wall elasticity, compliance and lumen size, providing a feedback loop to maintain intrinsic pressure homeostasis. Aqueous humor is part of a vascular circulatory loop, being secreted into the anterior chamber of the eye from the vasculature, then returning to the vasculature by passing through the trabecular meshwork (TM), a uniquely modified vessel wall interposed between the anterior chamber and a vascular sinus called Schlemm's canal (SC). Since pressure in circulatory loops elsewhere is modulated by cyclic stresses, one might predict similar pressure modulation in the aqueous outflow system. Recent laboratory evidence in fact demonstrates that cyclic IOP changes alter aqueous outflow while increasing cellularity and contractility of TM cells. Cyclic changes also lead to alterations in gene expression, changes in cytoskeletal networks and modulation of signal transduction. A new technology, phase-based optical coherence tomography, demonstrates in vivo pulse-dependent TM motion like that elsewhere in the vasculature. Recognition of pulse-dependent TM motion provides a linkage to well-characterized mechanisms that provide pressure homeostasis in the systemic vasculature. The linkage may permit unifying concepts of pressure control and provide new insights into IOP homeostatic mechanisms. PMID:24359130

  6. Correlation between Intraocular Pressure Fluctuation with Postural Change and Postoperative Intraocular Pressure in Relation to the Time Course after Trabeculectomy

    PubMed Central

    Tenkumo, Kaori; Nitta, Eri; Sato, Shino

    2014-01-01

    Background. To investigate the correlation between intraocular pressure (IOP) fluctuation with postural change and IOP in relation to the time course after trabeculectomy. Methods. A total of 29 patients who had previously undergone primary trabeculectomy with mitomycin C were examined. IOP was obtained at 1, 2, 3, 6, and 12 months and then every 6 months postoperatively. Results. The postural IOP difference before surgery was 3.0 ± 1.8 mmHg, which was reduced to 0.9 ± 1.1 mmHg at 1 month, 1.0 ± 1.0 mmHg at 2 months, 1.3 ± 2.0 mmHg at 3 months, 1.3 ± 1.4 mmHg at 6 months, 1.4 ± 1.5 mmHg at 12 months, and 1.1 ± 0.7 mmHg at 18 months after trabeculectomy (P < 0.01 each visit). The filtering surgery failed in 7 out of 29 eyes. Postural IOP changes were less than 3 mmHg in those patients who did not require needle revision at every visit. However, in patients who did require needle revision, the increase in the posture-induced IOP was greater than 3 mmHg prior to the increase in the sitting position IOP. Conclusions. Assessment of postural IOP changes after trabeculectomy might be potentially useful for predicting IOP changes after trabeculectomy. PMID:25136454

  7. Comparison of visual outcomes after implantation of diffractive trifocal toric intraocular lens and a diffractive apodized bifocal toric intraocular lens

    PubMed Central

    Gundersen, Kjell Gunnar; Potvin, Rick

    2016-01-01

    Purpose The aim of this study was to compare a new diffractive trifocal toric lens with an apodized diffractive bifocal toric lens in terms of refractive and visual acuity (VA) outcomes, including low-contrast VA (LCVA), as well as the patient’s visual function 3 months after implantation. Patients and methods This is a randomized prospective study involving bilateral implantation of a trifocal toric or a bifocal toric lens. At 3 months postoperatively, the subject’s vision was tested both uncorrected and with his/her best distance correction at: distance (4 m), intermediate (63 cm), and near (40 cm). Binocular defocus curves were measured with no correction and with the subject’s best distance correction in place. Quality of vision was measured using the National Eye Institute Visual Function Questionnaire. Results A total of 22 patients were enrolled (eleven in each group). There was no statistically significant difference in the absolute change in measured rotation between 1 month and 3 months postoperatively between the two intraocular lens (IOL) groups (P=0.98). At 3 months, the postoperative refraction and distance VA by eye were similar between groups. There was no statistically significant difference in the measured LCVA between groups (P=0.39). The defocus curve showed that at 67 cm, the trifocal toric lens had statistically significantly better VA when compared to the bifocal toric lens. There were no statistically significant differences by group for any of the National Eye Institute Visual Function Questionnaire scores (P>0.26 in all cases). Conclusion The trifocal toric IOL improved the intermediate vision without negatively impacting visual function and distance, near, or low-contrast VA when compared to a bifocal toric IOL. The toric component of the trifocal lens effectively reduced astigmatism and provided good rotational stability. PMID:27051269

  8. New two-point scleral-fixation technique for foldable intraocular lenses with four hollow haptics.

    PubMed

    Liu, He-Ting; Jiang, Zheng-Xuan; Tao, Li-Ming

    2016-01-01

    The study was to report a new two-point scleral-fixation technique for foldable intraocular lenses with four haptics. Lenses were slid into the anterior chamber from a 2.8 mm corneal incision and fixed under two sclera flaps at two opposite points. The postoperative best-corrected visual acuities (BCVAs) of all patients were significantly better than their preoperative BCVA. The results demonstrate that two-point, scleral fixations of foldable, intraocular lenses might be practicable and effective. PMID:27158623

  9. New two-point scleral-fixation technique for foldable intraocular lenses with four hollow haptics

    PubMed Central

    Liu, He-Ting; Jiang, Zheng-Xuan; Tao, Li-Ming

    2016-01-01

    The study was to report a new two-point scleral-fixation technique for foldable intraocular lenses with four haptics. Lenses were slid into the anterior chamber from a 2.8 mm corneal incision and fixed under two sclera flaps at two opposite points. The postoperative best-corrected visual acuities (BCVAs) of all patients were significantly better than their preoperative BCVA. The results demonstrate that two-point, scleral fixations of foldable, intraocular lenses might be practicable and effective. PMID:27158623

  10. Apparatus and method for non-contact, acoustic resonance determination of intraocular pressure

    DOEpatents

    Sinha, Dipen N.; Wray, William O.

    1994-01-01

    Apparatus and method for measuring intraocular pressure changes in an eye under investigation by detection of vibrational resonances therein. An ultrasonic transducer operating at its resonant frequency is amplitude modulated and swept over a range of audio frequencies in which human eyes will resonate. The output therefrom is focused onto the eye under investigation, and the resonant vibrations of the eye observed using a fiber-optic reflection vibration sensor. Since the resonant frequency of the eye is dependent on the pressure therein, changes in intraocular pressure may readily be determined after a baseline pressure is established.

  11. Intraocular/Intracranial pressure mismatch hypothesis for visual impairment syndrome in space.

    PubMed

    Zhang, Li-Fan; Hargens, Alan R

    2014-01-01

    Visual impairment intracranial pressure syndrome (VIIP) is considered a major risk for future human spaceflight. Loss of hydrostatic pressure gradients in vascular and cerebrospinal fluid systems due to the removal of gravity associated with subsequent intracranial and intraocular fluid shifts and the resulting intraocular/intracranial pressure mismatch might be important etiology factors causingVIIP syndrome. Acclimation changes in the ocular and cerebral circulation and the two fluid systems during chronic microgravity exposure and their underlying mechanisms need further elucidation. Relevant findings may help to validate the pressure differential hypothesis for VlIP syndrome and to evaluate whether a gravity based countermeasure is needed. PMID:24479265

  12. Fulminant Panuveitis following Iris Suture Fixation of Posterior Chamber Intraocular Lens

    PubMed Central

    Mansour, Ahmad M.; Awwad, Shady T.

    2013-01-01

    We present a case of fulminant panuveitis following iris suture fixation of a posterior chamber intraocular lens. We hypothesize that the zonular dehiscence allowed the inflammatory cells in the anterior compartment to gain access to the posterior segment mimicking endophthalmitis or toxic anterior segment syndrome. Also certain bulky lens designs, like the current Rayner hydrophilic acrylic lens, are difficult to manipulate and hold in the optic capture position, and hence the iris fixation of these lenses can be traumatic and lengthy. It is advised to exchange such lenses with 3-piece intraocular lenses that are easy to fixate. PMID:23476849

  13. Apparatus and method for non-contact, acoustic resonance determination of intraocular pressure

    DOEpatents

    Sinha, D.N.; Wray, W.O.

    1994-12-27

    The apparatus and method for measuring intraocular pressure changes in an eye under investigation by detection of vibrational resonances therein. An ultrasonic transducer operating at its resonant frequency is amplitude modulated and swept over a range of audio frequencies in which human eyes will resonate. The output therefrom is focused onto the eye under investigation, and the resonant vibrations of the eye observed using a fiber-optic reflection vibration sensor. Since the resonant frequency of the eye is dependent on the pressure therein, changes in intraocular pressure may readily be determined after a baseline pressure is established. 3 figures.

  14. Iris-claw, retropupillary-fixated, aphakic intraocular lens implantation for traumatic aphakia following penetrating keratoplasty

    PubMed Central

    Anbari, Anas A.

    2015-01-01

    Summary We report the correction of aphakia using an iris-claw, aphakic intraocular lens (IOL) fixated in a retropupillary location in a 17-year-old young man who suffered blunt trauma to his eye 5 months after penetrating keratoplasty (PKP). There were no intraoperative complications. At 21 months after implantation, the patient’s uncorrected distance visual acuity was 20/28; his corrected distance visual acuity was 20/22, with +0.50 −3.00 × 155. Intraocular pressure was normal, and endothelial cell count was 1798 cells/mm2.

  15. Symbolic algebra approach to the calculation of intraocular lens power following cataract surgery

    NASA Astrophysics Data System (ADS)

    Hjelmstad, David P.; Sayegh, Samir I.

    2013-03-01

    We present a symbolic approach based on matrix methods that allows for the analysis and computation of intraocular lens power following cataract surgery. We extend the basic matrix approach corresponding to paraxial optics to include astigmatism and other aberrations. The symbolic approach allows for a refined analysis of the potential sources of errors ("refractive surprises"). We demonstrate the computation of lens powers including toric lenses that correct for both defocus (myopia, hyperopia) and astigmatism. A specific implementation in Mathematica allows an elegant and powerful method for the design and analysis of these intraocular lenses.

  16. Intraocular pressure-lowering combination therapies with prostaglandin analogues.

    PubMed

    Aptel, Florent; Chiquet, Christophe; Romanet, Jean-Paul

    2012-07-01

    Intraocular pressure (IOP) reduction is currently the only therapeutic approach demonstrated to preserve visual function in patients with glaucoma. The first line of glaucoma treatment consists of topical IOP-lowering medications, usually initiated as monotherapy. A significant proportion of patients require more than one medication to reach a target IOP at which optic nerve damage will not progress. As prostaglandin analogues (PGAs) are the most effective class for reducing IOP, one of the other commonly used classes (β-adrenoceptor antagonist [β-blocker], carbonic anhydrase inhibitor or α(2)-adrenoceptor agonist) is frequently combined with a PGA. In the last decade, the use of fixed combinations containing two medications in a single bottle has steadily increased. Fixed combinations have the potential to simplify the dosing regimen, increase patient adherence, avoid the washout effect of the second drop on the first medication instilled, decrease exposure to preservatives and, sometimes, reduce the cost of treatment. Clinical trials have evaluated PGA-based fixed combinations versus unfixed combinations (individual components administered concomitantly) or versus individual monotherapies; however, any advantage that the fixed combinations may have in terms of IOP-lowering efficacy is still debated. For these reasons, the PGA-based fixed combinations are not approved by regulatory authorities in some countries, such as the US. We review the published studies evaluating the efficacy and tolerability of the IOP-lowering unfixed and fixed combination therapies with PGAs. Regarding unfixed combinations, the review shows that α(2)-adrenergic agonists-PGA and carbonic anhydrase inhibitor-PGA combinations seem to be at least as effective at reducing IOP as the β-blocker-PGA combinations. As for the fixed combinations, the review shows that the three PGA-timolol fixed combinations are more effective than their component medications used separately as monotherapy and

  17. [Postoperative opacification of posterior chamber intraocular lenses - a review].

    PubMed

    Schmidbauer, J M; Werner, L; Apple, D J; Pandey, S K; Izak, A M; Trivedi, R H; Macky, T A; Auffarth, G U; Peng, Q; Arthur, S N; Escobar-Gomez, M; Ma, L; Vargas, L G

    2001-09-01

    Postoperative opacification of intraocular lenses (IOLs) is a very unpleasant complication for the ophthalmic surgeon and the patient. We report on our experiences with opacification of different foldable IOL designs and rigid poly (methyl methacrylate) (PMMA) posterior chamber lenses.1. Snowflake degeneration of PMMA IOLs: This condition is an unanticipated and surprising late postoperative finding 8 to 15 years after implantation. In our opinion, this complication is probably not related to the PMMA biomaterial itself, but rather it appears to represent a manufacturing problem that has affected a selected, albeit large number of lenses manufactured in the 1980s-mid 1990s.2. Degeneration of UV absorber material and calcium deposits within the optic of hydrophilic IOLs: Two years postoperatively degenerations of UV absorber material and calcium deposits within the optic of single piece hydrophilic acrylic lenses SC60B-OUV manufactured by MDR (Medical developmental research Inc. Clearwater FL, USA) can occur. Although the precise mechanism is not fully known, it was assumed that these opacifications are due to premature aging of the UV blocking agent incorporated in the lens biomaterial and calcification.3. Calcification on the surface of the Bausch & Lomb Hydroviewtrade mark IOLs: Twelve to 15 months postoperatively granular surface calcifications in Hydroviewtrade mark IOLs occured. The mechanism is not fully understood. According to Bausch and Lomb studies, part of the components of the packaging contained silicone, which may have come off the packaging onto the lens optic, where it then appears to be a catalyst for calcium precipitation. The manufacturer has correlated a change in packaging with the appearance of the opacification. The manufacturer now believes that this problem has been solved. However, final verification will require a careful 1 - 2 years clinical study.4. Glistenings in the hydrophobic acrylic AcrySoftrade mark IOLs: The time frame of

  18. Phakic Intraocular Lenses for the Treatment of Refractive Errors

    PubMed Central

    2009-01-01

    Executive Summary Objective 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. Clinical Need: 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

  19. Central corneal thickness and intraocular pressure in premature infants.

    PubMed

    Sekeroglu, Mehmet Ali; Hekimoglu, Emre; Petricli, İkbal Seza; Karakaya, Jale; Ozcan, Beyza; Yucel, Husniye; Kavurt, Aysen Sumru; Bas, Ahmet Yagmur

    2015-12-01

    To evaluate the central corneal thickness (CCT) and intraocular pressure (IOP) of premature infants and to document correlation of them with gestational age, chronological age, and birth weight of infants. Using a hand-held applanation tonometer and a portable pachymeter, IOP and CCT of 170 premature infants were measured just before initial retinopathy of prematurity screening examination and re-measured 4 weeks after the first visit. The CCT and IOP were positively correlated during the first (r = 0.616, p < 0.001) and second (r = 0.564, p < 0.001) visits. The mean CCT at first and second visits were 568.1 ± 22.1 (527-628) and 561.6 ± 21.4 (520-619) µm, consecutively (p < 0.001). Gestational age, chronological age and birth weight of infants were found to be negatively correlated with CCT at first (r = -0.751, p < 0.001; r = -0.745, p < 0.001; r = -0.581, p < 0.001, consecutively) and second (r = -0.729, p < 0.001; r = -0.729, p < 0.001; r = -0.555, p < 0.001, consecutively) visits. The mean IOP at first and second visits were 14.1 ± 1.9 (11-19) and 13.7 ± 1.7 (11-18) mmHg, consecutively (p < 0.001). Gestational age, chronological age, and birth weight of infants were found to be negatively correlated with IOP at first (r = -0.724, p < 0.001; r = -0.715, p < 0.001; r = -0.558, p < 0.001, consecutively) and second (r = -0.704, p < 0.001; r = -0.703, p < 0.001; r = -0.518, p < 0.001, consecutively) visits. CCT and IOP of the premature infants with a smaller gestational age were found to be higher (p < 0.001 for both). Premature infants with smaller gestational age have higher CCT and IOP values when compared to older infants. These values tend to become lower 4 weeks after the first examination as infants become older. The CCT and IOP were positively correlated with each other and both were negatively correlated with gestational age, chronological age, and birth weight during first and second visits. PMID:26286757

  20. Drug loading of foldable commercial intraocular lenses using supercritical impregnation.

    PubMed

    Bouledjouidja, A; Masmoudi, Y; Sergent, M; Trivedi, V; Meniai, A; Badens, E

    2016-03-16

    The drug delivery through intraocular lenses (IOLs) allows the combination of cataract surgery act and postoperative treatment in a single procedure. In order to prepare such systems, "clean" supercritical CO2 processes are studied for loading commercial IOLs with ophthalmic drugs. Ciprofloxacin (CIP, an antibiotic) and dexamethasone 21-phosphate disodium (DXP, an anti-inflammatory drug) were impregnated into foldable IOLs made from poly-2-hydroxyethyl methacrylate (P-HEMA). A first pre-treatment step was conducted in order to remove absorbed conditioning physiological solution. Supercritical impregnations were then performed by varying the experimental conditions. In order to obtain transparent IOLs and avoid the appearance of undesirable foaming, it was necessary to couple slow pressurization and depressurization phases during supercritical treatments. The impregnation yields were determined through drug release studies. For both drugs, release studies show deep and reproducible impregnation for different diopters. For the system P-HEMA/CIP, a series of impregnations was performed to delimit the experimental range at two pressures (80 and 200 bar) in the presence or absence of ethanol as a co-solvent for two diopters (+5.0 D and +21.0 D). Increase in pressure in the absence of a co-solvent resulted in improved CIP impregnation. The addition of ethanol (5 mol%) produced impregnation yields comparable to those obtained at 200 bar without co-solvent. A response surface methodology based on experimental designs was used to study the influence of operating conditions on impregnation of IOLs (+21.0 D) in the absence of co-solvent. Two input variables with 5 levels each were considered; the pressure (80-200 bar) and the impregnation duration (30-240 min). CIP impregnation yields ranging between 0.92 and 3.83 μg CIP/mg IOL were obtained from these experiments and response surface indicated the pressure as a key factor in the process. The DXP impregnation in P-HEMA was

  1. Reference intervals for intraocular pressure measured by rebound tonometry in ten raptor species and factors affecting the intraocular pressure.

    PubMed

    Reuter, Anne; Müller, Kerstin; Arndt, Gisela; Eule, Johanna Corinna

    2011-09-01

    Intraocular pressure (IOP) was measured with the TonoVet rebound tonometer in 10 raptor species, and possible factors affecting IOP were investigated. A complete ophthalmic examination was performed, and IOP was assessed in 2 positions, upright and dorsal recumbency, in 237 birds belonging to the families Accipitridae, Falconidae, Strigidae, and Tytonidae. Mean IOP values of healthy eyes were calculated for each species, and differences between families, species, age, sex, left and right eye, as well as the 2 body positions were evaluated. Physiologic fluctuations of IOP were assessed by measuring IOP serially for 5 days at the same time of day in 15 birds of 3 species. Results showed IOP values varied by family and species, with the following mean IOP values (mm Hg +/- SD) determined: white-tailed sea eagle (Haliaeetus albicilla), 26.9 +/- 5.8; red kite (Milvus milvus), 13.0 +/- 5.5; northern goshawk (Accipiter gentilis), 18.3 +/- 3.8; Eurasian sparrowhawk (Accipiter nisus), 15.5 +/- 2.5; common buzzard (Buteo buteo), 26.9 +/- 7.0; common kestrel (Falco tinnunculus), 9.8 +/- 2.5; peregrine falcon, (Falco peregrinus), 12.7 +/- 5.8; tawny owl (Strix aluco), 9.4 +/- 4.1; long-eared owl (Asio otus), 7.8 +/- 3.2; and barn owl (Tyto alba), 10.8 +/- 3.8. No significant differences were found between sexes or between left and right eyes. In goshawks, common buzzards, and common kestrels, mean IOP was significantly lower in juvenile birds than it was in adult birds. Mean IOP differed significantly by body position in tawny owls (P = .01) and common buzzards (P = .04). By measuring IOP over several days, mean physiologic variations of +/- 2 mm Hg were detected. Differences in IOP between species and age groups should be considered when interpreting tonometric results. Physiologic fluctuations of IOP may occur and should not be misinterpreted. These results show that rebound tonometry is a useful diagnostic tool in measuring IOP in birds of prey because it provides rapid

  2. Laser ablation and high precision patterning of biomaterials and intraocular lenses

    NASA Astrophysics Data System (ADS)

    Serafetinides, A. A.; Spyratou, E.; Makropoulou, M.

    2010-10-01

    The use of intraocular lenses (IOL) is the most promising method for restoring excellent vision in cataract surgery. In addition, multifocal intraocular lenses for good distant and near vision are investigated. Several new materials, techniques and patterns are studied for the formation and etching of intraocular lenses in order to improve their optical properties and reduce the diffractive aberrations. As pulsed laser ablation is well established as a universal tool for surface processing of organic polymer materials, this study was focused in using laser ablation with short and ultra short laser pulses for surface modification of PMMA and intraocular lenses, instead of using other conventional techniques. The main advantage of using very short laser pulses, e.g. of ns, ps or fs duration, is that heat diffusion into the polymer material is negligible. As a result high precision patterning of the sample, without thermal damage of the surroundings, becomes possible. In this study, laser ablation was performed using commercially available hydrophobic acrylic IOLs, hydrophilic acrylic IOLs, and PMMA IOLs, with various diopters. We investigated the ablation efficiency and the phenomenology of the etched patterns by testing the ablation rate, versus laser energy fluence, at several wavelengths and the surface modification with atomic force microscopy (AFM), or scanning electron microscopy (SEM). The irradiated polymers have different optical properties, at the applied wavelengths, and therefore, present different ablation behaviour and morphology of the laser ablated crater walls and surrounding surfaces. The experimental results, some theoretical assumptions for mathematical modeling of the relevant ablation mechanisms are discussed.

  3. Two cases of primary intraocular lymphoma: fine needle aspiration diagnosis and intravitreal methotrexate treatment.

    PubMed

    Zhao, Tantai; Li, Yunqin; Tang, Luosheng; Wei, Xin; Zhu, Xiaohua

    2011-02-01

    We described clinical process of two cases of intraocular lymphoma in aspects of early diagnosis by fine needle aspiration (FNA) and biopsy and treatment by intravitreal methotrexate (MTX). Two patients were suspected to have primary intraocular lymphoma (PIOL) with geographic yellow-white infiltrates and vitreous opacity. FNA confirmed malignant intraocular lymphoma in one patient and failed in the other patient due to complication of vitreous hemorrhage. Subsequent vitreous biopsy confirmed malignant intraocular lymphoma in the other patient. Both patients were treated by intravitreal methotrexate. In case 1 the tumor had complete remission and follow-up of 12 months had not found any signs of recurrence. In case 2 the patient died of brain metastasis 22 months after the ocular biopsy. Our findings demonstrate that although cytological examination of vitrectomy specimens remains the gold standard in diagnosis of PIOL, examination of FNA and biopsy increases the reliability of early diagnosing or excluding a PIOL. Individualized intravitreal methotrexate can be used to effectively treat PIOL. More effective integrated program treating primary central nervous system lymphoma/PIOL is worthy of looking forward to. PMID:21336740

  4. Fifty-year follow-up and Strampelli anterior chamber intraocular lens

    PubMed Central

    Oakley, Carmen L.; Nigro, Matthew A.; Vote, Brendan J.

    2015-01-01

    The Strampelli anterior chamber intraocular lens was created in 1953, and was primarily used to treat myopia and aphakia. Due to the positioning of the lens, it was associated with a number of complications, and was later modified to decrease the rate of significant complications, including endothelial cell loss. This paper describes a 62-year-old man, who has had a Strampelli intraocular lens (IOL) in situ for 52 years, with relatively few complications. The case provides a framework for reflection on the significant advances in the development of IOLs since the Strampelli era. The Strampelli anterior chamber intraocular lens was created in 1953, and was primarily used to treat myopia and aphakia. Due to the positioning of the lens, it was associated with a number of complications, and was later modified to decrease the rate of significant complications, including endothelial cell loss. This paper describes a 62-year-old man, who has had a Strampelli intraocular lens (IOL) in situ for 52 years, with relatively few complications. The case provides a framework for reflection on the significant advances in the development of IOLs since the Strampelli era.

  5. Intravitreal injection of anti-VEGF and diagnosis of primary intraocular central nervous system lymphoma.

    PubMed

    Gambrelle, J; Missotten, G; Delhoum, S; Desjardins, L

    2013-05-01

    We report a case of primary intraocular central nervous system (CNS) lymphoma in a patient previously treated with intravitreal anti-vascular endothelial growth factor (VEGF) injections for age-related macular degeneration (AMD). An 88-year-old woman, with past medical history significant for bilateral age-related macular degeneration (AMD) treated with intravitreal ranibizumab injections for 1 year, was referred to our department for bilateral vitritis diagnosed 10 days after the last anti-VEGF injection. A complete uveitis work-up including aqueous humour analysis, brain MRI and vitreous biopsy enabled us to confirm the diagnosis of primary intraocular CNS lymphoma. To the best of our knowledge, this is the first report of the diagnosis of primary intraocular CNS lymphoma in a patient treated with anti-VEGF for AMD. The differential diagnosis of vitritis in elderly patients is relatively broad. Endophthalmitis and uveitis have been described after anti-VEGF injections. In such a situation, there is actually a risk of missing the diagnosis of intraocular lymphoma in the mistaken belief that the observed vitritis may be a reaction to administered anti-VEGFs. If no direct time-relationship with the anti-VEGF injections can be found, a classic vitritis work-up should be performed. Our observation suggests that ranibizumab, at the dosage used for AMD, does not impede the spread of CNS lymphoma in the eye nor interfere with cytological diagnosis. PMID:23306179

  6. Deformable Surface Accommodating Intraocular Lens: Second Generation Prototype Design Methodology and Testing

    PubMed Central

    McCafferty, Sean J.; Schwiegerling, Jim T.

    2015-01-01

    Purpose: Present an analysis methodology for developing and evaluating accommodating intraocular lenses incorporating a deformable interface. Methods: The next generation design of extruded gel interface intraocular lens is presented. A prototype based upon similar previously in vivo proven design was tested with measurements of actuation force, lens power, interface contour, optical transfer function, and visual Strehl ratio. Prototype verified mathematical models were used to optimize optical and mechanical design parameters to maximize the image quality and minimize the required force to accommodate. Results: The prototype lens produced adequate image quality with the available physiologic accommodating force. The iterative mathematical modeling based upon the prototype yielded maximized optical and mechanical performance through maximum allowable gel thickness to extrusion diameter ratio, maximum feasible refractive index change at the interface, and minimum gel material properties in Poisson's ratio and Young's modulus. Conclusions: The design prototype performed well. It operated within the physiologic constraints of the human eye including the force available for full accommodative amplitude using the eye's natural focusing feedback, while maintaining image quality in the space available. The parameters that optimized optical and mechanical performance were delineated as those, which minimize both asphericity and actuation pressure. The design parameters outlined herein can be used as a template to maximize the performance of a deformable interface intraocular lens. Translational Relevance: The article combines a multidisciplinary basic science approach from biomechanics, optical science, and ophthalmology to optimize an intraocular lens design suitable for preliminary animal trials. PMID:25938005

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

    PubMed Central

    Unsal, Ugur; Baser, Gonen

    2016-01-01

    Purpose. To compare near, intermediate, and distance vision and quality of vision, when refractive rotational multifocal intraocular lenses with 3.0 diopters or diffractive multifocal intraocular lenses with 2.5 diopters near addition are implanted. Methods. 41 eyes of 41 patients in whom rotational +3.0 diopters near addition IOLs were implanted and 30 eyes of 30 patients in whom diffractive +2.5 diopters near addition IOLs were implanted after cataract surgery were reviewed. Uncorrected and corrected distance visual acuity, intermediate visual acuity, near visual acuity, and patient satisfaction were evaluated 6 months later. Results. The corrected and uncorrected distance visual acuity were the same between both groups (p = 0.50 and p = 0.509, resp.). The uncorrected intermediate and corrected intermediate and near vision acuities were better in the +2.5 near vision added intraocular lens implanted group (p = 0.049, p = 0.005, and p = 0.001, resp.) and the uncorrected near vision acuity was better in the +3.0 near vision added intraocular lens implanted group (p = 0.001). The patient satisfactions of both groups were similar. Conclusion. The +2.5 diopters near addition could be a better choice in younger patients with more distance and intermediate visual requirements (driving, outdoor activities), whereas the + 3.0 diopters should be considered for patients with more near vision correction (reading). PMID:27340560

  8. A case of presumed acute retinal necrosis after intraocular foreign body injury.

    PubMed

    Park, Sung Who; Byon, Ik Soo; Park, Hyun Jun; Lee, Ji Eun; Oum, Boo Sup

    2013-01-01

    The aim of this study was to report a case of acute retinal necrosis (ARN) after intraocular foreign body removal. A 32-year-old male presented with visual loss in the left eye. He was hit by an iron fragment while he was hammering. An intraocular foreign body was found with corneal laceration and traumatic cataract. On the day he was injured, primary closure of the laceration, lensectomy, and vitrectomy were performed, and the foreign body was removed. The day after the operation, there was no sign of retinal detachment or retinitis. Two days after the operation, retinal necrosis and accompanying vitreous inflammation were noted in the far periphery. On day 3, the necrosis spread circumferentially and inflammation became more distinct. ARN was presumed and intravenous acyclovir was administered. The necrotic areas were reduced 2 days later, and were resolved in 1 month. The final visual acuity in his left eye was 20/20 after implantation of an intraocular lens. This case is the first report of ARN after penetrating injury and an intraocular foreign body. ARN may develop after open-globe injury. PMID:23658473

  9. Novel Intraocular Therapy in Non-infectious Uveitis of the Posterior Segment of the Eye

    PubMed Central

    Mikhail, Michael; Sallam, Ahmed

    2013-01-01

    This article reviews the new clinically relevant data regarding the intraocular treatment of non-infectious uveitis. Triamcinolone acetonide is the most commonly used intravitreal corticosteroid for treatment of uveitis and uveitic macular oedema. The drug is available at low cost but it is associated with a high risk of raised intraocular pressure (IOP) and cataract and is not licensed for intraocular use. Dexamethasone implant (Ozurdex®) appears to have a better safety profile, and a slightly long-lasting effect than triamcinolone acetonide. Fluocinolone acetonide implant (Retisert®) implant allows the release of corticosteroids at a constant rate over a 3-year period, but it requires surgical placement and its use is associated with a very high risk of cataracts and raised intraocular pressure. Iluvien® is another fluocinolone acetonide implant that could represent a more convenient treatment option for such cases in the future as it can be inserted into the vitreous cavity through 25-gauge injector system in an outpatient setting. To circumvent the risks associated with corticosteroids use, non-corticosteroids related therapeutics including intravitreal methotrexate; anti-vascular endothelial growth factor treatments and intravitreal sirolimus have been recently developed. PMID:24822232

  10. Bilateral anterior chamber intraocular lenses dislocation in a patient with habitual eye rubbing.

    PubMed

    Poh, E P; Fariza, N Nor; Mariam, I

    2005-08-01

    A 61-year-old Chinese man presented with bilateral posteriorly dislocated anterior chamber intraocular lenses (AC IOLs) one year after successful vitrectomy, removal of bilateral dislocated mature cataractous lenses and AC IOLs implantation. A thorough clinical evaluation revealed habitual eye rubbing as the only possible cause. PMID:16379196