Sample records for intraocular relativo al

  1. 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 ...

  2. Intraocular pressure and ocular biometric parameters changes in migraine.

    PubMed

    Koban, Yaran; Ozlece, Hatice Kose; Bilgin, Gorkem; Koc, Mustafa; Cagatay, Halil Huseyin; Durgunlu, Emre I; Burcu, Ayse

    2016-05-31

    The aim of this study was to assess the intraocular pressure and ocular biometric parameters in migraine patients during acute migraine attacks and compare them with painless period and healthy controls using a new optical biometer AL-Scan. In this prospective, case-control study, the axial length, corneal curvature radius, anterior chamber depth, central corneal thickness, and pupil size of 40 migraine patients during acute migraine attacks and painless period and 40 age- and sex-matched healthy subjects were measured using a AL-Scan optical biometer (Nidek Co., Gamagori, Japan). All patients underwent a complete ophthalmic examination before the measurements. IOP and biometer measurements were taken at the same time of day (10:00-12:00) in order to minimize the effects of diurnal variation. There was not a statistically significant difference in intraocular pressure between the migraine patients during acute migraine attacks (15.07 mmHg), painless period (14.10 mmHg), and the controls (15,73 ± 0,81). Also, the ocular biometric parameters did not significantly vary during the acute migraine attacks. Further studies are needed to evaluate the etiopathologic relationship between intraocular pressure and ocular biometric parameters and acute migraine attack.

  3. Comparative Efficacy of the New Optical Biometer on Intraocular Lens Power Calculation (AL-Scan versus IOLMaster).

    PubMed

    Ha, Ahnul; Wee, Won Ryang; Kim, Mee Kum

    2018-05-15

    To evaluate the agreement in axial length (AL), keratometry, and anterior chamber depth measurements between AL-Scan and IOLMaster biometers and to compare the efficacy of the AL-Scan on intraocular lens (IOL) power calculations and refractive outcomes with those obtained by the IOLMaster. Medical records of 48 eyes from 48 patients who underwent uneventful phacoemulsification and IOL insertion were retrospectively reviewed. One of the two types of monofocal aspheric IOLs were implanted (Tecnis ZCB00 [Tecnis, n = 34] or CT Asphina 509M [Asphina, n = 14]). Two different partial coherence interferometers measured and compared AL, keratometry (2.4 mm), anterior chamber depth, and IOL power calculations with SRK/T, Hoffer Q, Holladay2, and Haigis formulas. The difference between expected and actual final refractive error was compared as refractive mean error (ME), refractive mean absolute error (MAE), and median absolute error (MedAE). AL measured by the AL-Scan was shorter than that measured by the IOLMaster (p = 0.029). The IOL power of Tecnis did not differ between the four formulas; however, the Asphina measurement calculated using Hoffer Q for the AL-Scan was lower (0.28 diopters, p = 0.015) than that calculated by the IOLMaster. There were no statistically significant differences between the calculations by MAE and MedAE for the four formulas in either IOL. In SRK/T, ME in Tecnis-inserted eyes measured by AL-Scan showed a tendency toward myopia (p = 0.032). Measurement by AL-Scan provides reliable biometry data and power calculations compared to the IOLMaster; however, refractive outcomes of Tecnis-inserted eyes by AL-Scan calculated using SRK/T can show a slight myopic tendency. © 2018 The Korean Ophthalmological Society.

  4. 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.

  5. Intraocular (Eye) Melanoma—Health Professional Version

    Cancer.gov

    Intraocular (uveal) melanoma of the uveal tract (iris, ciliary body, and choroid), though rare, is the most common primary intraocular malignancy in adults. Find evidence-based information on intraocular melanoma treatment.

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

    PubMed

    Noro, Takahiko; Nakamoto, Kenji; Sato, Makoto; Yasuda, Noriko; Ito, Yoshinori; Ogawa, Shumpei; Nakano, Tadashi; Tsuneoka, Hiroshi

    2014-10-01

    We retrospectively examined intraocular pressure variations after visual field examination in primary open angle glaucoma (POAG), together with its influencing factors and its association with 24-hour intraocular pressure variations. Subjects were 94 eyes (52 POAG patients) subjected to measurements of 24-hour intraocular pressure and of changes in intraocular pressure after visual field examination using a Humphrey Visual Field Analyzer. Subjects were classified into three groups according to the magnitude of variation (large, intermediate and small), and 24-hour intraocular pressure variations were compared among the three groups. Factors influencing intraocular pressure variations after visual field examination and those associated with the large variation group were investigated. Average intraocular pressure variation after visual field examination was -0.28 ± 1.90 (range - 6.0(-) + 5.0) mmHg. No significant influencing factors were identified. The intraocular pressure at 3 a.m. was significantly higher in the large variation group than other two groups (p < 0.001). Central corneal thickness was correlated with the large variation group (odds ratio = 1.04; 95% confidence interval, 1.01-1.07 ; p = 0.02). No particular tendencies in intraocular pressure variations were found after visual field examination. Increases in intraocular pressure during the night might be associated with large intraocular pressure variations after visual field examination.

  7. Genetics of Primary Intraocular Tumors

    PubMed Central

    Nagarkatti-Gude, Nisha; Wang, Yujuan; Ali, Mohammad Javed; Honavar, Santosh G.; Jager, Martine J.; Chan, Chi-Chao

    2012-01-01

    Primary intraocular neoplasms are tumors that originate within the eye. The most common malignant primary intraocular tumor in adults is uveal melanoma and the second is primary intraocular lymphoma or vitreoretinal (intraocular) lymphoma. The most common malignant intraocular tumor in children is retinoblastoma. Genetics plays a vital role in the diagnosis and detection of ocular tumors. In uveal melanoma, monosomy 3 is the most common genetic alteration and somatic mutations of BAP1, a tumor suppressor gene, have been reported in nearly 50% of primary uveal melanomas. The retinoblastoma gene RB1 is the prototype tumor suppressor gene—mutations in RB1 alleles lead to inactivated RB protein and the development of retinoblastoma. Immunoglobulin heavy chain (IgH) or T-cell receptor (TCR) gene rearrangement is observed in B-cell or T-cell primary vitreoretinal lymphoma, respectively. Other factors related to the genetics of these three common malignancies in the eye are discussed and reviewed. PMID:22834783

  8. 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 replace...

  9. [New trends of customizing intraocular lens choice].

    PubMed

    He, Shou-zhi

    2006-05-01

    Definition and basic principle of customizing intraocular lens choice are described. The importance of the choicing intraocular lens for individual patient is illustrated. The review emphasizes that it is surgeon's responsibility to choice the appropriate intraocular lens for the best postoperative outcome and patient's satisfaction.

  10. Intraocular (Eye) Melanoma—Patient Version

    Cancer.gov

    Intraocular (uveal) melanoma is a rare cancer that forms in the eye. It usually has no early signs or symptoms. As with melanoma of the skin, risk factors include having fair skin and light-colored eyes. Start here to find information on intraocular melanoma treatment.

  11. 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 direct...

  12. [Intraocular osteosarcoma in a dog].

    PubMed

    Wiesner, L; Schröder, S; Gralla, S; Goeck, D; Kramer, M; Ondreka, N

    2014-01-01

    The present case describes the diagnostic and therapeutic procedure of a dog with an intraocular osteosarcoma. According to the results of the diagnostic imaging studies, the tentative diagnosis of an intraocular neoplasm with perforation of the globe and orbital invasion of the tumour was made and an orbital exenteration was performed. The histopathological diagnosis of the extracted organ implied an intraocular, extraskeletal osteosarcoma. Seventy-seven days later the patient displayed an acute paraparesis. Clinical and diagnostic reevaluation using magnetic resonance imaging (MRI) was performed and the dog was euthanized at the owner's request. By means of MRI and necropsy, an additional axial osteosarcoma of the 6th lumbar vertebra and a malignant melanoma of the right tonsil were diagnosed.

  13. 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.

  14. Intraocular cysts of toxoplasma gondii in patients with necrotizing retinitis following periocular/intraocular triamcinolone injection.

    PubMed

    Nijhawan, Raje; Bansal, Reema; Gupta, Nalini; Beke, Nikhil; Kulkarni, Pandurang; Gupta, Amod

    2013-10-01

    To report the detection of Toxoplasma gondii cysts in intraocular aspirates of patients with necrotizing retinitis following periocular/intraocular corticosteroid injection. Case report. Two patients (2 eyes) with widespread necrotizing retinitis in a steroid-exposed eye posed a diagnostic challenge and underwent pars plana vitrectomy (PPV). Intraocular samples (vitreous fluid, retinal tissue, and subretinal aspirate in case 1, and vitreous fluid in case 2) were subjected to cytological examination. The subretinal aspirate (case 1) revealed encysted bradyzoites of Toxoplasma gondii. Vitreous fluid (case 2) tested positive for anti-toxoplasma antibodies and the smear showed encysted forms of Toxoplasma gondii on cytology. CONCLUSION. Toxoplasma gondii cysts were detected in eyes with necrotizing retinitis that developed secondary to injudicious use of corticosteroids.

  15. Scleral and intraocular amoebic dissemination in Acanthamoeba keratitis.

    PubMed

    Arnalich-Montiel, Francisco; Jaumandreu, Laia; Leal, Marina; Valladares, Basilio; Lorenzo-Morales, Jacob

    2013-12-01

    To review an Acanthamoeba keratitis case series for the documented extracorneal spread of the amoeba. A retrospective review of an observational case series from a single institution. Three patients with 4 instances of microbiologically confirmed extracorneal amoebic spread were identified. Patient 1 had nodular scleritis after undergoing penetrating keratoplasty and was treated successfully with double freeze-thaw cryotherapy; patient 2 had intraocular dissemination of the amoeba detected in a retrocorneal membrane; and patient 3 had, after undergoing tectonic keratoplasty, intraocular dissemination of the amoeba that was treated successfully with intraocular and systemic voriconazole and, afterwards, a nodular scleritis treated with double freeze-thaw cryotherapy and a large-diameter corneal graft to treat corneal recurrence. Acanthamoeba can migrate to the sclera or to the intraocular tissues in some instances, such as in long-standing disease or in penetrating keratoplasty. A prompt biopsy for microbiological analysis and early treatment are required, if this is suspected. Voriconazole can be effective for intraocular invasion when used orally and intraocularly. Scleral involvement might require a surgical approach with double freeze-thaw cryotherapy to treat the localized disease.

  16. Intraocular inflammation in autoimmune diseases.

    PubMed

    Pras, Eran; Neumann, Ron; Zandman-Goddard, Gisele; Levy, Yair; Assia, Ehud I; Shoenfeld, Yehuda; Langevitz, Pnina

    2004-12-01

    The uveal tract represents the vascular organ of the eye. In addition to providing most of the blood supply to the intraocular structures, it acts as a conduit for immune cells, particularly lymphocytes, to enter the eye. Consequently, the uveal tract is represented in many intraocular inflammatory processes. Uveitis is probably a misnomer unless antigens within the uvea are the direct targets of the inflammatory process. A better term of the condition is "intraocular inflammation" (IOI). To review the presence of IOI in autoimmune diseases, the immunopathogenic mechanisms leading to disease, and treatment. We reviewed the English medical literature by using MEDLINE (1984-2003) employing the terms "uveitis," "intraocular inflammation," and "autoimmune diseases." An underlying autoimmune disease was identified in up to 40% of patients with IOI, and included spondyloarthropathies, Behcets disease, sarcoidosis, juvenile chronic arthritis, Vogt-Koyanagi-Harada syndrome (an inflammatory syndrome including uveitis with dermatologic and neurologic manifestations), immune recovery syndrome, and uveitis with tubulointerstitial disease. The immunopathogenesis of IOI involves enhanced T-cell response. Recently, guidelines for the use of immunosuppressive drugs for inflammatory eye disease were established and include: corticosteroids, azathioprine, methotrexate, mycophenolate mofetil, cyclosporine, tacrolimus, cyclophosphamide, and chlorambucil. New therapies with limited experience include the tumor necrosis factor alpha inhibitors, interferon alfa, monoclonal antibodies against lymphocyte surface antigens, intravenous immunoglobulin (IVIG), and the intraocular delivery of immunosuppressive agents. An underlying autoimmune disease was identified in up to 40% of patients with IOI. Immunosuppressive drugs, biologic agents, and IVIG are employed for the treatment of IOI in autoimmune diseases.

  17. 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.

  18. 21 CFR 886.4270 - Intraocular gas.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4270 Intraocular gas. (a) Identification. An intraocular gas is a device consisting of a gaseous fluid intended to be introduced into the eye to place pressure... required. As of May 28, 1976, an approval under section 515 of the act is required before this device may...

  19. Processes for manufacturing multifocal diffractive-refractive intraocular lenses

    NASA Astrophysics Data System (ADS)

    Iskakov, I. A.

    2017-09-01

    Manufacturing methods and design features of modern diffractive-refractive intraocular lenses are discussed. The implantation of multifocal intraocular lenses is the most optimal method of restoring the accommodative ability of the eye after removal of the natural lens. Diffractive-refractive intraocular lenses are the most widely used implantable multifocal lenses worldwide. Existing methods for manufacturing such lenses implement various design solutions to provide the best vision function after surgery. The wide variety of available diffractive-refractive intraocular lens designs reflects the demand for this method of vision correction in clinical practice and the importance of further applied research and development of new technologies for designing improved lens models.

  20. INTRAOCULAR LENS SCAFFOLD TO PREVENT INTRAOCULAR FOREIGN BODY SLIPPAGE.

    PubMed

    Agarwal, Amar; Ashok Kumar, Dhivya; Agarwal, Athiya

    2017-01-01

    To report the application of intraocular lens (IOL) scaffold technique in intraocular foreign body (IOFB) removal. Patient with IOFB in posterior segment is included. The IOFB is retrieved from the posterior segment (pars plana vitrectomy and exteriorization of the IOFB from the retinal surface using an intravitreal forceps via the posterior capsulotomy) and placed on the iris. A three-piece posterior chamber IOL is placed in the sulcus via the clear corneal incision. IOFB is then removed from the anterior chamber over the IOL by forceps. Metallic IOFB of 4 mm × 3 mm has been retrieved by IOL scaffold technique after rescuing it from the posterior segment. There has been no drop or slip of IOFB in the vitreous during removal. Posterior chamber IOL served as scaffold during IOFB removal from anterior chamber. The IOL scaffold maneuver has shown to prevent slippage by acting as a barrier between the IOFB and the vitreous.

  1. Piggyback intraocular lens implantation to correct pseudophakic refractive error after segmental multifocal intraocular lens implantation.

    PubMed

    Venter, Jan A; Oberholster, Andre; Schallhorn, Steven C; Pelouskova, Martina

    2014-04-01

    To evaluate refractive and visual outcomes of secondary piggyback intraocular lens implantation in patients diagnosed as having residual ametropia following segmental multifocal lens implantation. Data of 80 pseudophakic eyes with ametropia that underwent Sulcoflex aspheric 653L intraocular lens implantation (Rayner Intraocular Lenses Ltd., East Sussex, United Kingdom) to correct residual refractive error were analyzed. All eyes previously had in-the-bag zonal refractive multifocal intraocular lens implantation (Lentis Mplus MF30, models LS-312 and LS-313; Oculentis GmbH, Berlin, Germany) and required residual refractive error correction. Outcome measurements included uncorrected distance visual acuity, corrected distance visual acuity, uncorrected near visual acuity, distance-corrected near visual acuity, manifest refraction, and complications. One-year data are presented in this study. The mean spherical equivalent ranged from -1.75 to +3.25 diopters (D) preoperatively (mean: +0.58 ± 1.15 D) and reduced to -1.25 to +0.50 D (mean: -0.14 ± 0.28 D; P < .01). Postoperatively, 93.8% of eyes were within ±0.50 D and 98.8% were within ±1.00 D of emmetropia. The mean uncorrected distance visual acuity improved significantly from 0.28 ± 0.16 to 0.01 ± 0.10 logMAR and 78.8% of eyes achieved 6/6 (Snellen 20/20) or better postoperatively. The mean uncorrected near visual acuity changed from 0.43 ± 0.28 to 0.19 ± 0.15 logMAR. There was no significant change in corrected distance visual acuity or distance-corrected near visual acuity. No serious intraoperative or postoperative complications requiring secondary intraocular lens removal occurred. Sulcoflex lenses proved to be a predictable and safe option for correcting residual refractive error in patients diagnosed as having pseudophakia. Copyright 2014, SLACK Incorporated.

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

    PubMed

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

    2018-03-01

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

  3. Bilateral intraocular calcification in necrotizing cytomegalovirus retinitis.

    PubMed

    Tuncer, Samuray; Oray, Merih; Yildirim, Yeliz; Camcioglu, Yildiz; Tugal-Tutkun, Ilknur

    2014-10-01

    We report a unique case of bilateral intraocular calcification due to necrotizing cytomegalovirus (CMV) retinitis associated with congenital CMV infection. A 7-month-old boy with a history of congenital CMV infection showed bilateral intraocular calcific plaques on computed tomography (CT) and ultrasonography. We reviewed the patient's medical files for the purpose of this report. The patient had a prior medical history of hospitalization for fever and swelling in the neck at 3 months of age. Systemic findings (anemia, neutropenia, hepatosplenomegaly, and reactive lymphadenomegaly) in association with a low CD4 count, high blood CMV viral load, and positivity for urine CMV DNA by polymerase chain reaction led to the diagnosis of bone marrow suppression and congenital CMV infection. At 7 months, he developed horizontal nystagmus and bilateral leukocoria over 20 days. Cranial CT and ultrasonography revealed bilateral intraocular calcific plaques and the patient was referred to rule out retinoblastoma. Fundoscopy was consistent with bilateral hemorrhagic, necrotizing CMV retinitis. Significant resolution of the retinal infiltrations occurred 2 weeks after initiation of systemic treatment with ganciclovir. Intraocular calcification may be a sign of active CMV retinitis. To our knowledge this is the first report of bilateral intraocular calcification serving as the presenting clinical manifestation of necrotizing CMV retinitis.

  4. 21 CFR 886.4300 - Intraocular lens guide.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  5. Scanning electron microscopic and histologic evaluation of the AcrySof SA30AL acrylic intraocular lens. Manufacturing quality and morphology in the capsular bag.

    PubMed

    Escobar-Gomez, Marcela; Apple, David J; Vargas, Luis G; Werner, Liliana; Arthur, Stella N; Pandey, Suresh K; Izak, Andrea M; Schmidbauer, Josef M

    2003-01-01

    To evaluate the properties of the AcrySof(R) SA30AL (Alcon Laboratories, Inc.) single-piece foldable posterior chamber intraocular lens (IOL). Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA. Two nonimplanted clinical-quality AcrySof IOLs were examined by gross, light, and scanning electron microscopy (SEM). In addition, 2 eyes implanted with this IOL obtained post-mortem, the first such eyes accessioned in our laboratory and the first described to date, were examined using the Miyake-Apple posterior photographic technique and by histologic sections. Scanning electron microscopy of the SA30AL IOL showed excellent surface finish. The edge of the optic was square (truncated) and had a matte (velvet or ground-glass) appearance, a feature that may minimize edge glare and other visual phenomena. A well-fabricated square or truncated optic edge was demonstrated. Miyake-Apple analysis revealed that the SA30AL IOL showed appropriate fit and configuration within the capsular bag. Histologic correlation of the IOL's square edge and its relation to the capsular bag and adjacent Soemmering's ring were noted. The AcrySof SA30AL IOL is a well-fabricated lens that situates well in the capsular bag. The truncated optic and its relationship to adjacent structures show a morphological profile that has been shown to be highly efficacious in reducing the rate of posterior capsule opacification.

  6. The intraocular pressure response to dehydration: a pilot study.

    PubMed

    Hunt, Andrew P; Feigl, Beatrix; Stewart, Ian B

    2012-05-01

    The aim of this study was to determine the intraocular pressure response to differing levels of dehydration. Seven males participated in 90 min of treadmill walking (5 km h(-1) and 1% grade) in both temperate (22 °C) and hot (43 °C) conditions. At baseline and 30 min intervals intraocular pressure, nude body mass, body temperature and heart rate were recorded. Statistically significant interactions (p < 0.05) were observed for intraocular pressure (hot condition: baseline 17.0 ± 2.9, 30 min 15.6 ± 3.5, 60 min 14.5 ± 3.7 and 90 min 13.6 ± 2.9 mmHg; temperate condition: baseline 16.8 ± 2.7, 30 min 16.5 ± 2.6, 60 min 15.8 ± 2.5 and 90 min 15.7 ± 1.8 mmHg) and body mass loss (hot condition: 30 min -1.07 ± 0.35, 60 min -2.17 ± 0.55 and 90 min -3.13 ± 0.74%; temperate condition: 30 min -0.15 ± 0.11, 60 min -0.47 ± 0.18 and 90 min -0.78 ± 0.25%). Significant linear regressions (p < 0.05) were observed for intraocular pressure and body mass loss (adjusted r(2) = 0.24) and intraocular pressure change and body mass loss (adjusted r(2) = 0.51). In conclusion, intraocular pressure was progressively reduced during a period of exercise causing dehydration, but remained relatively stable when hydration was maintained. The present study revealed a moderate relationship between dehydration (body mass loss) and intraocular pressure change.

  7. Effects of hyperbaric exposure on eyes with intraocular gas bubbles.

    PubMed

    Jackman, S V; Thompson, J T

    1995-01-01

    Air travel is known to be potentially hazardous for patients with intraocular gas bubbles, and the external pressure changes associated with hyperbaric oxygen therapy and scuba diving could be similarly dangerous. Rabbits with a perfluoropropane/air gas mixture filling approximately 60% of the vitreous cavity of the right eye were exposed to 3 different hyperbaric pressure profiles to an equivalent depth of 33 feet. The first group were a control group and were not exposed to hyperbaric pressures. The second group remained at an equivalent depth of 33 feet for 30 minutes, and the third group remained at 33 feet for 1 minute. Both groups ascended to normal atmospheric pressure at a rate of 1 foot per minute. The fourth group remained at 33 feet for 1 minute and then ascended at a rate of 0.2 feet per minute. In all eyes with an intraocular gas bubble, intraocular pressure dropped to zero when the atmospheric pressure was increased, and rose to more than 50 mmHg when the atmospheric pressure was returned to normal. Pressures in excess of 50 mmHg were sustained for 10 minutes or longer in each rabbit exposed to one of the hyperbaric profiles. No significant intraocular pressure changes were observed in eyes without an intraocular gas bubble or eyes not exposed to hyperbaric pressure. Marked elevation in intraocular pressure occurs as a result of hyperbaric exposure in eyes with an intraocular gas bubble. Hyperbaric exposure is therefore not advisable for patients with intraocular gas bubbles.

  8. Evaluating the Biostability of Yellow and Clear Intraocular Lenses with a System Simulating Natural Intraocular Environment

    PubMed Central

    Hayashi, Rijo; Hayashi, Shimmin; Arai, Kiyomi; Yoshida, Shinichirou; Chikuda, Makoto; Machida, Shigeki

    2016-01-01

    Purpose Blue light–filtering intraocular lenses (IOLs) are thought to protect the retina from blue light damage after cataract surgery, and the implantation of yellow-tinted IOLs has been commonly used in cataract surgery. To our knowledge, this is the first investigation measuring the long-term biostability of yellow-tinted IOLs using an in vitro system simulating natural intraocular environment. Methods Six hydrophobic acrylic IOLs, three clear IOLs, and three yellow-tinted IOLs were included in the study. Each yellow-tinted IOL was a matching counterpart of a clear IOL, with the only difference being the lens color. The IOLs were kept in conditions replicating the intraocular environment using a perfusion culture system for 7 months. Resolution, light transmittance rate, and the modulation transfer function (MTF) were measured before and after culturing. Surface roughness of the anterior and posterior surfaces was also measured. Results After culturing for 7 months, there were no changes in the resolution, the light transmittance rate, and MTF. The surface roughness of the anterior and posterior surfaces increased after culturing; however, this increase was clinically insignificant. There were no differences in surface roughness between the clear and yellow-tinted IOLs, either before or after culturing. Conclusions A novel in vitro system replicating intraocular environment was used to investigate the biostability of yellow-tinted IOLs. The surface roughness showed no clinically significant increase after culturing for 7 months. Translational Relevance This system is useful for evaluating the biostability of IOLs. PMID:27933221

  9. Intraocular (Eye) Melanoma Treatment (PDQ®)—Health Professional Version

    Cancer.gov

    Intraocular (uveal) melanoma treatment options include observation, surgery, radiation therapy, and transpupillary thermotherapy. Get detailed information about the diagnosis and treatment of newly diagnosed and recurrent intraocular melanoma in this summary for clinicians.

  10. 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.

  11. Solid intraocular xanthogranuloma in three Miniature Schnauzer dogs.

    PubMed

    Zarfoss, Mitzi K; Dubielzig, Richard R

    2007-01-01

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

  12. Water Drinking Test: Intraocular Pressure Changes after Tube Surgery and Trabeculectomy

    PubMed Central

    Razeghinejad, Mohammad Reza; Tajbakhsh, Zahra; Nowroozzadeh, Mohammad Hossein; Masoumpour, Masoumeh

    2017-01-01

    Purpose: To study the effects of filtration surgeries (tube and trabeculectomy) on changes in intraocular pressure after a water-drinking test. Methods: In this prospective, non-randomized, comparative clinical study, 30 patients who had tube surgery and 30 age- and sex-matched trabeculectomy patients underwent a water-drinking test. Only one eye of each patient was included. The baseline intraocular pressure was ≤21 mmHg in all enrolled eyes with or without adjunctive topical medications. After the water-drinking test, the intraocular pressure was measured and recorded at 15, 30, 45, and 60 minutes and the results were compared between the two groups. Results: In both groups, intraocular pressure significantly increased from baseline at all measured time-points (P < 0.001). In the trabeculectomy group, the average intraocular pressure increased from 14.8 ± 2.9 to 18.8 ± 4.7 mmHg at 30 minutes, but decreased at 60 min (18.0 ± 5.2 mmHg). In the Tube group, intraocular pressure increased incrementally until the last measurement (14.2 ± 3.9, 18.8 ± 5.6, and 19.7 ± 6.0 mmHg at baseline, 30, and 60 minutes, respectively). The end-pressure difference (intraocular pressure at 60 minutes vs. baseline) was significantly greater in the tube group (5.6 ± 3.6 mmHg; 41% change) than in the trabeculectomy group (3.2 ± 4.7; 23% change; P = 0.03). Conclusion: Intraocular pressure significantly increased after the water-drinking test in both the groups. Intraocular pressure started to decline 30 minutes after the water-drinking test in the trabeculectomy group, while it continued to increase up to 60 minutes in the Tube group. This finding may have implications regarding the efficacy or safety of the procedures in advanced glaucoma patients. PMID:29090048

  13. Water Drinking Test: Intraocular Pressure Changes after Tube Surgery and Trabeculectomy.

    PubMed

    Razeghinejad, Mohammad Reza; Tajbakhsh, Zahra; Nowroozzadeh, Mohammad Hossein; Masoumpour, Masoumeh

    2017-01-01

    To study the effects of filtration surgeries (tube and trabeculectomy) on changes in intraocular pressure after a water-drinking test. In this prospective, non-randomized, comparative clinical study, 30 patients who had tube surgery and 30 age- and sex-matched trabeculectomy patients underwent a water-drinking test. Only one eye of each patient was included. The baseline intraocular pressure was ≤21 mmHg in all enrolled eyes with or without adjunctive topical medications. After the water-drinking test, the intraocular pressure was measured and recorded at 15, 30, 45, and 60 minutes and the results were compared between the two groups. In both groups, intraocular pressure significantly increased from baseline at all measured time-points ( P < 0.001). In the trabeculectomy group, the average intraocular pressure increased from 14.8 ± 2.9 to 18.8 ± 4.7 mmHg at 30 minutes, but decreased at 60 min (18.0 ± 5.2 mmHg). In the Tube group, intraocular pressure increased incrementally until the last measurement (14.2 ± 3.9, 18.8 ± 5.6, and 19.7 ± 6.0 mmHg at baseline, 30, and 60 minutes, respectively). The end-pressure difference (intraocular pressure at 60 minutes vs. baseline) was significantly greater in the tube group (5.6 ± 3.6 mmHg; 41% change) than in the trabeculectomy group (3.2 ± 4.7; 23% change; P = 0.03). Intraocular pressure significantly increased after the water-drinking test in both the groups. Intraocular pressure started to decline 30 minutes after the water-drinking test in the trabeculectomy group, while it continued to increase up to 60 minutes in the Tube group. This finding may have implications regarding the efficacy or safety of the procedures in advanced glaucoma patients.

  14. Immunology of intraocular tumors.

    PubMed

    Niederkorn, Jerry Y; Wang, Shixuan

    2005-02-01

    The immune surveillance hypothesis was introduced over 30 years ago and proposed that neoplasms express novel antigens that subjected them to immune detection and elimination. In order for immune surveillance to be effective in controlling neoplasms, two requirements must be satisfied: 1) the tumor must arise in a body site that permits the induction the full array of immune responses and 2) the immune elements generated must have unfettered access to the tumor and be able to express their entire range of effector functions at the tumor site. The unique immunologic and anatomic features of the eye prevent the induction and expression of conventional immunity--a phenomenon known as 'immune privilege'. Although ocular immune privilege represents a theoretical obstacle to immune surveillance, some highly immunogenic intraocular tumors can circumvent immune privilege and undergo immune rejection. Uveal melanoma is the most common intraocular malignancy in adults, yet it occurs with a frequency that is no higher than neoplasms arising in conventional bodies. The presence of either tumor-infiltrating lymphocytes (TIL) or tumor-infiltrating macrophages (TIM) is associated with poor prognosis in uveal melanoma patients and suggests that some immune responses to intraocular tumors might exacerbate, rather than mitigate, tumor progression. Although counterintuitive, this proposition is consistent with the 'immune stimulation' hypothesis of tumor progression offered by Richmond Prehn over thirty years ago. It remains to be ascertained if immune stimulation affects the malignancy of ocular tumors, but it represents an intriguing explanation for the paradoxes of uveal melanoma.

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

    PubMed

    Simone, J N; Whitacre, M M

    1990-02-01

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

  16. 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).

  17. [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.

  18. Intraocular osteosarcoma in a dog.

    PubMed

    van de Sandt, R R O M; Boevé, M H; Stades, F C; Kik, M J L; Kirpensteijn, J

    2004-07-01

    A 10-year-old German shepherd dog was presented with unilateral uveitis and hyphaema. Treatment was unsuccessful and the eye was enucleated. Intraocular osteosarcoma was diagnosed by histological examination.

  19. Noninvasive photoacoustic detecting intraocular foreign bodies with an annular transducer array.

    PubMed

    Yang, Diwu; Zeng, Lvming; Pan, Changning; Zhao, Xuehui; Ji, Xuanrong

    2013-01-14

    We present a fast photoacoustic imaging system based on an annular transducer array for detection of intraocular foreign bodies. An eight-channel data acquisition system is applied to capture the photoacoustic signals using multiplexing and the total time of data acquisition and transferring is within 3 s. A limited-view filtered back projection algorithm is used to reconstruct the photoacoustic images. Experimental models of intraocular metal and glass foreign bodies were constructed on ex vivo pig's eyes and clear photoacoustic images of intraocular foreign bodies were obtained. Experimental results demonstrate the photoacoustic imaging system holds the potential for in clinic detecting the intraocular foreign bodies.

  20. Toric Intraocular Lens Outcomes in Patients With Glaucoma.

    PubMed

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

    2015-06-01

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

  1. In vitro oxygen sensing using intraocular microrobots.

    PubMed

    Ergeneman, Olgaç; Chatzipirpiridis, George; Pokki, Juho; Marín-Suárez, Marta; Sotiriou, Georgios A; Medina-Rodríguez, Santiago; Sánchez, Jorge F Fernández; Fernández-Gutiérrez, Alberto; Pané, Salvador; Nelson, Bradley J

    2012-11-01

    We present a luminescence oxygen sensor integrated with a wireless intraocular microrobot for minimally-invasive diagnosis. This microrobot can be accurately controlled in the intraocular cavity by applying magnetic fields. The microrobot consists of a magnetic body susceptible to magnetic fields and a sensor coating. This coating embodies Pt(II) octaethylporphine (PtOEP) dyes as the luminescence material and polystyrene as a supporting matrix, and it can be wirelessly excited and read out by optical means. The sensor works based on quenching of luminescence in the presence of oxygen. The excitation and emission spectrum, response time, and oxygen sensitivity of the sensor were characterized using a spectrometer. A custom device was designed and built to use this sensor for intraocular measurements with the microrobot. Due to the intrinsic nature of luminescence lifetimes, a frequency-domain lifetime measurement approach was used. An alternative sensor design with increased performance was demonstrated by using poly(styrene-co-maleic anhydride) (PS-MA) and PtOEP nanospheres.

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

    PubMed

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

    2017-12-01

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

  3. Population-based Incidence of Intraocular Lens Exchange in Olmsted County, Minnesota.

    PubMed

    Bothun, Erick D; Cavalcante, Lilian C B; Hodge, David O; Patel, Sanjay V

    2018-03-01

    To determine the population-based incidence of pseudophakic intraocular lens exchange in Olmsted County, Minnesota. Retrospective review of a population-based cohort. Patients undergoing pseudophakic intraocular lens exchange in Olmsted County, Minnesota, between January 1, 1986 and December 31, 2016 were identified from the Rochester Epidemiology Project medical record linkage system. Indications and outcomes were determined, and the incidence rate was calculated as cases per 1 000 000 person-years. Poisson regression analysis was used to assess changes in incidence over time, and the cumulative probability of needing a lens exchange was estimated by Kaplan-Meier analysis. Eighty cases of intraocular lens exchange were identified, yielding an overall age- and sex-adjusted incidence rate of 28.4 per million (confidence interval [CI], 22.1-34.7), which increased over the study period (P = .04). The 30-year cumulative probability of intraocular lens exchange among patients undergoing cataract surgery was 1.5% (CI, 0.6%-2.4%), increasing at a relatively constant rate. Dislocated lenses accounted for 72.5% of lens exchanges. Unplanned refractive outcome of primary cataract surgery and uveitis-glaucoma-hyphema syndrome from squared-edged haptics emerged as newer indications for intraocular lens exchange. The population-based incidence of pseudophakic intraocular lens exchange has increased over the last 30 years, and can be explained by the increase in incidence rate of cataract surgery over the same period. Surgeons should be aware of emerging indications of intraocular lens exchange, which reflect changes in lens design and increasing expectations of refractive outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. 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.

  5. Fundus autofluorescence patterns in primary intraocular lymphoma.

    PubMed

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

    2014-02-01

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

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

    PubMed

    Lou, Bingsheng; Lin, Lixia; Tan, Junlian; Yang, Yao; Yuan, Zhaohui; Lin, Xiaofeng

    2016-01-01

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

  7. 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.

  8. Epigenetics, microbiota, and intraocular inflammation: New paradigms of immune regulation in the eye.

    PubMed

    Wen, Xiaofeng; Hu, Xiao; Miao, Li; Ge, Xiaofei; Deng, Yuhua; Bible, Paul W; Wei, Lai

    2018-05-01

    Sight threatening immune responses that damage the eye characterize intraocular inflammatory diseases. These diseases including uveitis and age-related macular degeneration are worryingly common and quality of life shattering. Genetic studies in past decades significantly advanced our understanding of the etiology of these devastating diseases. Unfortunately, patient genetics alone failed to adequately explain disease origin, susceptibility, and progression. Non-genetic factors such as the epigenetic regulation of ocular diseases and the environmental factors triggering intraocular inflammation offer new insight into intraocular inflammatory disorders. Importantly, mounting evidence is signaling that dysbiosis of human microbiota leads to rapid epigenomic reprograming of host cells and results in the onset of many diseases. In this review, we discuss how epigenetic mechanisms and microbiota may cooperate to initiate and perpetuate ocular inflammation. Lastly, we propose that the discovery of intraocular microbiota presents a significant shift in thought affecting current approaches to the diagnosis, treatment, and prevention of intraocular inflammatory diseases such as uveitis and age-related macular degeneration. The geographical and genetic background difference in both disease presentation and genetic association of intraocular inflammatory diseases may be due to the variation of intraocular microbiota. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Occurrence of intraocular air bubbles during intravitreal injections for retinopathy of prematurity.

    PubMed

    Sukgen, Emine Alyamac; Gunay, Murat; Kocluk, Yusuf

    2017-02-01

    This study aims to present five cases with retinopathy of prematurity (ROP) who were found to have intraocular air bubbles after intravitreal injection (IVI) treatment. The medical records of 148 infants who underwent IVI for ROP were retrospectively reviewed and the ones who demonstrated post-injection intraocular air bubble formation were recruited. Of the 148 patients (31 babies received ranibizumab, 20 babies received aflibercept, 97 babies received bevacizumab), five were found to have intraocular air bubbles right after the IVI. Two infants received intravitreal ranibizumab and three received intravitreal bevacizumab injections. Although intraocular pressure increased temporarily, no intraocular sterile or infective reactions were observed in the postoperative period. The air bubble was found to resorb spontaneously within 72 h. The occurrence rate of the intravitreal air bubbles in our series was 3.37 % despite previously not been reported in the literature. Due to the intravitreal air injection risk, it is important to be more careful while preparing the intravitreal medication before treatment in premature babies.

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

    PubMed

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

    2010-11-11

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

  11. PENETRATING OCULAR INJURY WITH RETAINED INTRAOCULAR FOREIGN BODY FROM DRYWALL.

    PubMed

    Syed, Reema; Kim, Sung-Hye; Palacio, Agustina; Nunery, William R; Schaal, Shlomit

    2018-03-23

    To present a case of open globe injury and retained intraocular foreign body secondary to drywall. Interventional case report. A 21-year-old man presented with corneal laceration, iris defect, and vitreous hemorrhage after hammering drywall. Computed tomography scan was negative for intraocular foreign body, but a drywall intraretinal foreign body was found on 25-gauge vitrectomy. Intraoperative findings and 6-month follow-up are presented. Intraocular foreign body must always be suspected in all cases of penetrating ocular trauma. Although magnetic resonance imaging is ideal in diagnosing nonmetallic foreign bodies, computed tomography scan with Hounsfield units should be used in an emergency setting.

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

    PubMed

    Zwaan, J; Latimer, W B

    1998-06-01

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

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

    PubMed

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

    2012-03-01

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

  14. 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.

  15. Frontoethmoidal mucocele associated with bilateral increased intraocular pressure and proptosis.

    PubMed

    Chandra, Aman; Lim, Mingyann; Scott, Elizabeth; Morsman, David

    2007-02-01

    We describe the case of a 53-year-old man presenting with bilateral proptosis and raised intraocular pressure. Computed tomography imaging revealed these signs to be secondary to a frontoethmoidal mucocele with bilateral orbital invasion. Bilateral increased intraocular pressure is unusual in cases of frontoethmoidal mucoceles, but prompt imaging and treatment can prevent permanent visual loss.

  16. Reproducibility of intraocular pressure peak and fluctuation of the water-drinking test.

    PubMed

    Hatanaka, Marcelo; Alencar, Luciana M; De Moraes, Carlos G; Susanna, Remo

    2013-01-01

    The water-drinking test has been used as a stress test to evaluate the drainage system of the eye. However, in order to be clinically applicable,a test must provide reproducible results with consistent measurements. This study was performed to verify the reproducibility of intraocular pressure peaks and fluctuation detected during the water-drinking test in patients with ocular hypertension and open-angle glaucoma. A prospective analysis of patients in a tertiary care unit for glaucoma treatment. Twenty-four ocular hypertension and 64 open-angle glaucoma patients not under treatment. The water-drinking test was performed in 2 consecutive days by the same examiners in patients not under treatment. Reproducibility was assessed using the intraclass correlation coefficient. Peak and fluctuation of intraocular pressure obtained with the water-drinking test were analysed for reproducibility. Eighty-eight eyes from 24 ocular hypertension and 64 open-angle glaucoma patients not under treatment were evaluated. Test and retest intraocular pressure peak values were 28.38 ± 4.64 and 28.38 ± 4.56 mmHg, respectively (P = 1.00). Test and retest intraocular pressure fluctuation values were 5.75 ± 3.9 and 4.99 ± 2.7 mmHg, respectively (P = 0.06). Based on intraclass coefficient, reproducibility was excellent for peak intraocular pressure (intraclass correlation coefficient = 0.79) and fair for intraocular pressure fluctuation (intraclass correlation coefficient = 0.37). Intraocular pressure peaks detected during the water-drinking test presented excellent reproducibility, whereas the reproducibility of fluctuation was considered fair. © 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.

  17. Flurbiprofen and intraocular pressure.

    PubMed

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

    1981-07-01

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

  18. 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.

  19. [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. Georg Thieme Verlag KG Stuttgart · New York.

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

    PubMed

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

    2016-12-01

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

  1. 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.

  2. Diurnal variations in axial length, choroidal thickness, intraocular pressure, and ocular biometrics.

    PubMed

    Chakraborty, Ranjay; Read, Scott A; Collins, Michael J

    2011-07-11

    To investigate the pattern of diurnal variations in axial length (AL), choroidal thickness, intraocular pressure (IOP), and ocular biometrics over 2 consecutive days. Measurements of ocular biometrics and IOP were collected for 30 young adult subjects (15 myopes, 15 emmetropes) at 10 different times over 2 consecutive days. Five sets of measurements were collected each day at approximately 3-hour intervals, with the first measurement taken at ~9 AM and final measurement at ~9 PM. AL underwent significant diurnal variation (P < 0.0001) that was consistently observed across the 2 measurement days. The longest AL was typically observed at the second measurement session (mean time, 12:26) and the shortest AL at the final session of each day (mean time, 21:06). The mean diurnal change in AL was 0.032 ± 0.018 mm. Choroidal thickness underwent significant diurnal variation (mean change, 0.029 ± 0.016 mm; P < 0.001) and varied approximately in antiphase to the AL changes. Significant diurnal variations were also found in vitreous chamber depth (VCD; mean change, 0.06 ± 0.029 mm; P < 0.0001) and IOP (mean change, 3.54 ± 0.84 mm Hg; P < 0.0001). A positive association was found between the variations of AL and IOP (r(2) = 0.17, P < 0.0001) and AL and VCD (r(2) = 0.31, P < 0.0001) and a negative association between AL and choroidal thickness (r(2) = 0.13, P < 0.0001). There were no significant differences in the magnitude and timing of diurnal variations associated with refractive error. Significant diurnal variations in AL, choroidal thickness, and IOP were consistently observed over 2 consecutive days of testing.

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

    PubMed

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

    2009-12-01

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

  4. Metastatic intraocular hemangiopericytoma in a dog.

    PubMed

    Pucket, Jonathan D; Allbaugh, Rachel A; Higginbotham, Mary L; Rankin, Amy J; Teixeira, Leandro

    2017-01-01

    A 10-year-old Labrador Retriever who had been undergoing therapy for a recurrent hemangiopericytoma of the right flank presented to the Kansas State University Ophthalmology service for evaluation of a painful left eye. Examination revealed secondary glaucoma and irreversible blindness of the affected eye and multifocal chorioretinal lesions in the fellow eye. Therapeutic and diagnostic enucleation of the left eye was performed and histopathologic examination demonstrated the presence of a presumed metastatic spindle cell sarcoma. Further immunohistochemical staining confirmed the intraocular neoplasia to be metastatic spread from the previously removed flank mass. Rapid progression in size and number of chorioretinal lesions in the right eye was noted in the post-operative period until the patient was euthanized one month after surgery. This case report is the first to document intraocular metastasis of hemangiopericytoma in a veterinary patient.

  5. Metastatic intraocular hemangiopericytoma in a dog

    PubMed Central

    Pucket, Jonathan D.; Allbaugh, Rachel A.; Higginbotham, Mary L.; Rankin, Amy J.; Teixeira, Leandro

    2017-01-01

    A 10-year-old Labrador Retriever who had been undergoing therapy for a recurrent hemangiopericytoma of the right flank presented to the Kansas State University Ophthalmology service for evaluation of a painful left eye. Examination revealed secondary glaucoma and irreversible blindness of the affected eye and multifocal chorioretinal lesions in the fellow eye. Therapeutic and diagnostic enucleation of the left eye was performed and histopathologic examination demonstrated the presence of a presumed metastatic spindle cell sarcoma. Further immunohistochemical staining confirmed the intraocular neoplasia to be metastatic spread from the previously removed flank mass. Rapid progression in size and number of chorioretinal lesions in the right eye was noted in the post-operative period until the patient was euthanized one month after surgery. This case report is the first to document intraocular metastasis of hemangiopericytoma in a veterinary patient. PMID:28652979

  6. Influence of macular pigment optical density spatial distribution on intraocular scatter.

    PubMed

    Putnam, Christopher M; Bland, Pauline J; Bassi, Carl J

    This study evaluated the summed measures of macular pigment optical density (MPOD) spatial distribution and their effects on intraocular scatter using a commercially available device (C-Quant, Oculus, USA). A customized heterochromatic flicker photometer (cHFP) device was used to measure MPOD spatial distribution across the central 16° using a 1° stimulus. MPOD was calculated as a discrete measure and summed measures across the central 1°, 3.3°, 10° and 16° diameters. Intraocular scatter was determined as a mean of 5 trials in which reliability and repeatability measures were met using the C-Quant. MPOD spatial distribution maps were constructed and the effects of both discrete and summed values on intraocular scatter were examined. Spatial mapping identified mean values for discrete MPOD [0.32 (s.d.=0.08)], MPOD summed across central 1° [0.37 (s.d.=0.11)], MPOD summed across central 3.3° [0.85 (s.d.=0.20)], MPOD summed across central 10° [1.60 (s.d.=0.35)] and MPOD summed across central 16° [1.78 (s.d.=0.39)]. Mean intraocular scatter was 0.83 (s.d.=0.16) log units. While there were consistent trends for an inverse relationship between MPOD and scatter, these relationships were not statistically significant. Correlations between the highest and lowest quartiles of MPOD within the central 1° were near significance. While there was an overall trend of decreased intraocular forward scatter with increased MPOD consistent with selective short wavelength visible light attenuation, neither discrete nor summed values of MPOD significantly influence intraocular scatter as measured by the C-Quant device. Published by Elsevier España, S.L.U.

  7. An Intraocular Camera for Retinal Prostheses: Restoring Sight to the Blind

    NASA Astrophysics Data System (ADS)

    Stiles, Noelle R. B.; McIntosh, Benjamin P.; Nasiatka, Patrick J.; Hauer, Michelle C.; Weiland, James D.; Humayun, Mark S.; Tanguay, Armand R., Jr.

    Implantation of an intraocular retinal prosthesis represents one possible approach to the restoration of sight in those with minimal light perception due to photoreceptor degenerating diseases such as retinitis pigmentosa and age-related macular degeneration. In such an intraocular retinal prosthesis, a microstimulator array attached to the retina is used to electrically stimulate still-viable retinal ganglion cells that transmit retinotopic image information to the visual cortex by means of the optic nerve, thereby creating an image percept. We describe herein an intraocular camera that is designed to be implanted in the crystalline lens sac and connected to the microstimulator array. Replacement of an extraocular (head-mounted) camera with the intraocular camera restores the natural coupling of head and eye motion associated with foveation, thereby enhancing visual acquisition, navigation, and mobility tasks. This research is in no small part inspired by the unique scientific style and research methodologies that many of us have learned from Prof. Richard K. Chang of Yale University, and is included herein as an example of the extent and breadth of his impact and legacy.

  8. Intraocular laser surgical probe for membrane disruption by laser-induced breakdown.

    PubMed

    Hammer, D X; Noojin, G D; Thomas, R J; Clary, C E; Rockwell, B A; Toth, C A; Roach, W P

    1997-03-01

    A fiber probe has been designed as a surgical aid to cut intraocular membranes with laser-induced breakdown as the mechanism. The design of the intraocular laser surgical probe is discussed. A preliminary retinal damage distance has been calculated with breakdown threshold, spot size, and shielding measurements. Collateral mechanical-damage effects caused by shock wave and cavitation are discussed.

  9. Intraocular (Uveal) Melanoma Symptoms, Tests, Prognosis, and Stages (PDQ®)—Patient Version

    Cancer.gov

    Intraocular melanoma is a rare cancer that forms from cells that make melanin in the eye. It is the most common eye cancer in adults and may not cause early signs or symptoms. Find out risk factors, tests to diagnose, prognosis, and staging for intraocular melanoma.

  10. Intraocular extramedullary plasmacytoma in a cat.

    PubMed

    Michau, Tammy Miller; Proulx, David R; Rushton, Steven D; Olivry, Thierry; Dunston, Stanley M; Gilger, Brian C; Davidson, Michael G

    2003-06-01

    An 8-year-old, castrated male Domestic Short-haired cat was referred for evaluation of a possible intraocular neoplasm following previous ocular trauma. The eye was blind, and uveitis and an iridal mass were noted on examination. An enucleation was performed and the mandibular lymph node excised. Histopathologic examination revealed neoplastic proliferation of plasma cells in the iris and lymph node. No other evidence of disseminated disease was detected. This is the first case reported of an intraocular extramedullary plasmacytoma in the cat. The variation in clinical manifestations and potential association with multiple myeloma are not known at this time. Disseminated metastasis from a primary plasmacytoma of the uveal tract could also involve the bone marrow and be indistinguishable from multiple myeloma. Early enucleation, as in trauma-associated sarcomas, may be indicated to prevent metastasis. Periodic systemic evaluation for evidence of multiple myeloma should be performed.

  11. Near-infrared transillumination photography of intraocular tumours.

    PubMed

    Krohn, Jørgen; Ulltang, Erlend; Kjersem, Bård

    2013-10-01

    To present a technique for near-infrared transillumination imaging of intraocular tumours based on the modifications of a conventional digital slit lamp camera system. The Haag-Streit Photo-Slit Lamp BX 900 (Haag-Streit AG) was used for transillumination photography by gently pressing the tip of the background illumination cable against the surface of the patient's eye. Thus the light from the flash unit was transmitted into the eye, leading to improved illumination and image resolution. The modification for near-infrared photography was done by replacing the original camera with a Canon EOS 30D (Canon Inc) converted by Advanced Camera Services Ltd. In this camera, the infrared blocking filter was exchanged for a 720 nm long-pass filter, so that the near-infrared part of the spectrum was recorded by the sensor. The technique was applied in eight patients: three with anterior choroidal melanoma, three with ciliary body melanoma and two with ocular pigment alterations. The good diagnostic quality of the photographs made it possible to evaluate the exact location and extent of the lesions in relation to pigmented intraocular landmarks such as the ora serrata and ciliary body. The photographic procedure did not lead to any complications. We recommend near-infrared transillumination photography as a supplementary diagnostic tool for the evaluation and documentation of anteriorly located intraocular tumours.

  12. Ocular onchocerciasis in the Yanomami communities from Brazilian Amazon: effects on intraocular pressure.

    PubMed

    Herzog-Neto, Guilherme; Jaegger, Karen; Nascimento, Erika S do; Marchon-Silva, Verônica; Banic, Dalma M; Maia-Herzog, Marilza

    2014-01-01

    To determine the influence of onchocercal eye disease on the intraocular pressure of the Yanomami Tribe Aratha-ú of Roraima State, Brazil, considered endemic for onchocerciasis, a total of 86 patients were submitted to an ophthalmologic exam that included external examination, slit lamp examination, intraocular pressure measurement, and a fundus ophthalmoscope examination. A high prevalence of onchocerciasis-related eye lesions was encountered in 68.6% of the patients. Punctate keratitis and microfilariae in the anterior chamber were found in ∼28%. The mean of intraocular eye pressure found was 10.47 mm of Hg.

  13. Intraocular gnathostomiasis: report of a case and review of literature.

    PubMed

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

    2012-04-01

    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.

  14. Two cases of intraocular infection with Alaria mesocercaria (Trematoda)

    PubMed

    McDonald, H R; Kazacos, K R; Schatz, H; Johnson, R N

    1994-04-15

    We encountered two cases of human intraocular infection with mesocercariae of Alaria (Trematoda), involving unrelated Asian men who had unilateral decreased vision. Both patients had pigmentary tracks in the retina, areas of active or healed retinitis, or both, and other signs of diffuse unilateral subacute neuroretinitis. Similar, nonnematode worms were seen in the patients' retinas and vitreous, respectively, several years after apparent infection. The worm in Case 1 was analyzed from projected fundus photographs and diagnosed as an Alaria mesocercaria on the basis of its shape, size (500 x 150 microns), and movement; it was successfully killed with laser. The worm in Case 2 was removed surgically from the vitreous and identified as A. mesocercaria, 555 x 190 microns, most likely A. americana. The probable source of infection in the patients was ingestion, in local restaurants, of undercooked frogs' legs containing A. mesocercaria. In addition to causing prolonged intraocular infection, A. mesocercaria was found to be a cause of diffuse unilateral subacute neuroretinitis, a condition previously attributed only to intraocular nematode larvae.

  15. The influence of oxybuprocaine (Novesine) on the intraocular pressure.

    PubMed

    Leys, M; van Rij, G; de Heer, L J

    1986-01-15

    Patients with raised intraocular pressure often have lower tension during hospital admissions than on out-patient measurement, even though the therapy is the same. A prospective study on 18 volunteers and 10 glaucoma patients was set up to find out whether oxybuprocaine eyedrops or repeated applanation tonometry could have anything to do with this. The tension was measured at least 3 times a day with the non-contact tonometer (NCT). In the case of the volunteers oxybuprocaine was instilled into the eye 3 times a day for one week. In the case of the patients the tension in one eye was measured with the Goldmann tonometer on several days after the application of oxybuprocaine drops. No reduction in intraocular pressure was found during the observation period, nor was there an obvious difference between the test eyes and the control eyes. In hospital, patients had at 11 o'clock in the morning intraocular pressure which was on the average 2.2 +/- 1.5 mmHg lower than that measured at out-patient checks, in spite of receiving the same therapy.

  16. Intraocular Pressure Increases After Intraarticular Knee Injection With Triamcinolone but Not Hyaluronic Acid.

    PubMed

    Taliaferro, Kevin; Crawford, Alexander; Jabara, Justin; Lynch, Jonathan; Jung, Edward; Zvirbulis, Raimonds; Banka, Trevor

    2018-07-01

    Intraarticular steroid injections are a common first-line therapy for severe osteoarthritis, which affects an estimated 27 million people in the United States. Although topical, oral, intranasal, and inhalational steroids are known to increase intraocular pressure in some patients, the effect of intraarticular steroid injections on intraocular pressure has not been investigated, to the best of our knowledge. If elevated intraocular pressure is sustained for long periods of time or is of sufficient magnitude acutely, permanent loss of the visual field can occur. How does intraocular pressure change 1 week after an intraarticular knee injection either with triamcinolone acetonide or hyaluronic acid? A nonrandomized, nonblinded prospective cohort study was conducted at an outpatient, ambulatory orthopaedic clinic. This study compared intraocular pressure elevation before and 1 week after intraarticular knee injection of triamcinolone acetonide versus hyaluronic acid for management of primary osteoarthritis of the knee. Patients self-selected to be injected in their knee with either triamcinolone acetonide or hyaluronic acid before being informed of the study. The primary endpoint was intraocular pressure elevation of ≥ 7 mm Hg 1 week after injection. This cutoff is determined as the minimum significant pressure change in the ophthalmology literature recognized as an intermediate responder to steroids. Intraocular pressure was measured using a handheld Tono-Pen® applanation device. This device is frequently used in intraocular pressure measurement in clinical and research settings; 10 sequential measurements are obtained and averaged with a confidence interval. Only measurements with a 95% confidence interval were used. Over a 6-month period, a total of 96 patients were approached to enroll in the study. Sixty-two patients out of 96 approached (65%) agreed. Thirty-one (50%) were injected with triamcinolone and 31 (50%) were injected with hyaluronic acid. Patients

  17. 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.

  18. Central Corneal Thickness and its Relationship to Intra-Ocular and Epidmiological Determinants.

    PubMed

    Tayyab, Ali; Masrur, Amena; Afzal, Farooq; Iqbal, Fyza; Naseem, Kamran

    2016-06-01

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

  19. The interaction between intracranial pressure, intraocular pressure and lamina cribrosal compression in glaucoma.

    PubMed

    McMonnies, Charles W

    2016-05-01

    This review examines some of the biomechanical consequences associated with the opposing intraocular and intracranial forces. These forces compress the lamina cribrosa and are a potential source of glaucomatous pathology. A difference between them creates a displacement force on the lamina cribrosa. Increasing intraocular pressure and/or decreasing intracranial pressure will increase the trans-lamina cribrosa pressure difference and the risk of its posterior displacement, canal expansion and the formation of pathological cupping. Both intraocular pressure and intracranial pressure can be elevated during a Valsalva manoeuvre with associated increases in both anterior and posterior lamina cribrosa loading as well as its compression. Any resulting thinning of or damage to the lamina cribrosa and/or retinal ganglion cell axons and/or astrocyte and glial cells attached to the matrix of the lamina cribrosa and/or reduction in blood flow to the lamina cribrosa may contribute to glaucomatous neuropathy. Thinning of the lamina cribrosa reduces its stiffness and increases the risk of its posterior displacement. Optic nerve head posterior displacement warrants medical or surgical lowering of intraocular pressure; however, compared to intraocular pressure, the trans-lamina cribrosa pressure difference may be more important in pressure-related pathology of the optic nerve head region. Similarly important could be increased compression loading of the lamina cribrosa. Reducing participation in activities which elevate intraocular and intracranial pressure will decrease lamina cribrosa compression exposure and may contribute to glaucoma management and may have prognostic significance for glaucoma suspects. © 2016 The Authors. Clinical and Experimental Optometry © 2016 Optometry Australia.

  20. Intraocular foreign-body hazard during vitrectomy.

    PubMed

    Bovino, J A; Marcus, D F

    1982-03-01

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

  1. 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.

  2. Ocular Onchocerciasis in the Yanomami Communities from Brazilian Amazon: Effects on Intraocular Pressure

    PubMed Central

    Herzog-Neto, Guilherme; Jaegger, Karen; do Nascimento, Erika S.; Marchon-Silva, Verônica; Banic, Dalma M.; Maia-Herzog, Marilza

    2014-01-01

    To determine the influence of onchocercal eye disease on the intraocular pressure of the Yanomami Tribe Aratha-ú of Roraima State, Brazil, considered endemic for onchocerciasis, a total of 86 patients were submitted to an ophthalmologic exam that included external examination, slit lamp examination, intraocular pressure measurement, and a fundus ophthalmoscope examination. A high prevalence of onchocerciasis-related eye lesions was encountered in 68.6% of the patients. Punctate keratitis and microfilariae in the anterior chamber were found in ∼28%. The mean of intraocular eye pressure found was 10.47 mm of Hg. PMID:24297812

  3. Intraocular lenses in age-related macular degeneration.

    PubMed

    Grzybowski, Andrzej; Wasinska-Borowiec, Weronika; Alio, Jorge L; Amat-Peral, Pedro; Tabernero, Juan

    2017-09-01

    The aim of this work is to review the lenses, assessing their advantages and disadvantages. We describe a total of seven types of intraocular lenses (IOLs) recommended for age-related macular degeneration (AMD). We used the PubMed web platform to search for implantable devices in various stages of AMD. We searched for both prospective and retrospective studies and also case reports. Clinical results in AMD patients have been described for a total of seven types of IOLs recommended for AMD: an implantable miniature telescope (IMT), IOL-VIP System, Lipshitz macular implant (LMI), sulcus-implanted Lipshitz macular implant, LMI-SI, Fresnel Prism Intraocular Lens, iolAMD and Scharioth Macula Lens. We conclude that to objectively ascertain the effectiveness and safety of these lenses, further independent clinical studies with longer follow-up data are necessary prior to the general use of these optical devices.

  4. An intraocular micro light-emitting diode device for endo-illumination during pars plana vitrectomy.

    PubMed

    Koelbl, Philipp S; Lingenfelder, Christian; Spraul, Christoph W; Kampmeier, Juergen; Koch, Frank Hj; Kim, Yong Keun; Hessling, Martin

    2018-03-01

    Development of a new, fiber-free, single-use endo-illuminator for pars plana vitrectomy as a replacement for fiber-based systems with external light sources. The hand-guided intraocularly placed white micro light-emitting diode is evaluated for its illumination properties and potential photochemical and thermal hazards. A micro light-emitting diode was used to develop a single-use intraocular illumination system. The light-source-on-tip device was implemented in a prototype with 23G trocar compatible outer diameter of 0.6 mm. The experimental testing was performed on porcine eyes. All calculations of possible photochemical and thermal hazards during the application of the intraocular micro light-emitting diode were calculated according to DIN EN ISO 15007-2: 2014. The endo-illuminator generated a homogeneous and bright illumination of the intraocular space. The color impression was physiologic and natural. Contrary to initial apprehension, the possible risk caused by inserting a light-emitting diode into the intraocular vitreous was much smaller when compared to conventional fiber-based illumination systems. The photochemical and thermal hazards allowed a continuous exposure time to the retina of at least 4.7 h. This first intraocular light source showed that a light-emitting diode can be introduced into the eye. The system can be built as single-use illumination system. This light-source-on-tip light-emitting diode-endo-illumination combines a chandelier wide-angle illumination with an adjustable endo-illuminator.

  5. Relationship of the actual thick intraocular lens optic to the thin lens equivalent.

    PubMed

    Holladay, J T; Maverick, K J

    1998-09-01

    To theoretically derive and empirically validate the relationship between the actual thick intraocular lens and the thin lens equivalent. Included in the study were 12 consecutive adult patients ranging in age from 54 to 84 years (mean +/- SD, 73.5 +/- 9.4 years) with best-corrected visual acuity better than 20/40 in each eye. Each patient had bilateral intraocular lens implants of the same style, placed in the same location (bag or sulcus) by the same surgeon. Preoperatively, axial length, keratometry, refraction, and vertex distance were measured. Postoperatively, keratometry, refraction, vertex distance, and the distance from the vertex of the cornea to the anterior vertex of the intraocular lens (AV(PC1)) were measured. Alternatively, the distance (AV(PC1)) was then back-calculated from the vergence formula used for intraocular lens power calculations. The average (+/-SD) of the absolute difference in the two methods was 0.23 +/- 0.18 mm, which would translate to approximately 0.46 diopters. There was no statistical difference between the measured and calculated values; the Pearson product-moment correlation coefficient from linear regression was 0.85 (r2 = .72, F = 56). The average intereye difference was -0.030 mm (SD, 0.141 mm; SEM, 0.043 mm) using the measurement method and +0.124 mm (SD, 0.412 mm; SEM, 0.124 mm) using the calculation method. The relationship between the actual thick intraocular lens and the thin lens equivalent has been determined theoretically and demonstrated empirically. This validation provides the manufacturer and surgeon additional confidence and utility for lens constants used in intraocular lens power calculations.

  6. 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 and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL... the natural lens of an eye. (b) Classification. Class III. (c) Date PMA or notice of completion of a...

  7. [Hormonal homeostasis and intraocular pressure in chronic emotional stress caused by influences acting on the amygdala].

    PubMed

    Isakova, L S; Danilov, G E; Egorkina, S B; Butolin, E G

    1989-01-01

    Changes in intraocular pressure, eye hydrodynamics and the amount of hypophyseal, thyroid, adrenal and pancreatic hormones were studied during continuous stimulation of amygdaloid complex or after administration of angiotensin II into the structure in rabbits. The effects involved changes in hormonal homeostasis and elevation of intraocular pressure due to a hypersecretion of intraocular fluid. The administration of angiotensin II during the amygdala stimulation enhanced the changes.

  8. 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.

  9. Assessment of subjective intraocular forward scattering and quality of vision after posterior chamber phakic intraocular lens with a central hole (Hole ICL) implantation.

    PubMed

    Iijima, Ayaka; Shimizu, Kimiya; Yamagishi, Mayumi; Kobashi, Hidenaga; Igarashi, Akihito; Kamiya, Kazutaka

    2016-12-01

    To evaluate the subjective intraocular forward scattering and quality of vision after posterior chamber phakic intraocular lens with a central hole (Hole ICL, STAAR Surgical) implantation. We prospectively examined 29 eyes of 29 consecutive patients (15 men and 14 women; ages, 37.2 ± 8.8 years) undergoing Hole ICL implantation. We assessed the values of the logarithmic straylight value [log (s)] using a straylight meter (C-Quant ™ , Oculus) preoperatively and 3 months postoperatively. The patients completed a questionnaire detailing symptoms on a quantitative grading scale (National Eye Institute Refractive Error Quality of Life Instrument-42; NEI RQL-42) 3 months postoperatively. We compared the preoperative and postoperative values of the log(s) and evaluated the correlation of these values with patient subjective symptoms. The mean log(s) was not significantly changed, from 1.07 ± 0.20 preoperatively, to 1.06 ± 0.17 postoperatively (Wilcoxon signed-rank test, p = 0.641). There was a significant correlation between the preoperative and postoperative log(s) (Spearman's correlation coefficient r = 0.695, p < 0.001). The postoperative log(s) was significantly associated with the scores of glare in the questionnaire (Spearman's correlation coefficient r = -0.575, p = 0.017). According to our experience, Hole ICL implantation does not induce a significant additional change in the subjective intraocular forward scattering. The symptom of glare after Hole ICL implantation was significantly correlated with the postoperative intraocular forward scattering in relation to the preoperative one. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  10. Wavefront shaping to correct intraocular scattering

    NASA Astrophysics Data System (ADS)

    Artal, Pablo; Arias, Augusto; Fernández, Enrique

    2018-02-01

    Cataracts is a common ocular pathology that increases the amount of intraocular scattering. It degrades the quality of vision by both blur and contrast reduction of the retinal images. In this work, we propose a non-invasive method, based on wavefront shaping (WS), to minimize cataract effects. For the experimental demonstration of the method, a liquid crystal on silicon (LCoS) spatial light modulator was used for both reproduction and reduction of the realistic cataracts effects. The LCoS area was separated in two halves conjugated with the eye's pupil by a telescope with unitary magnification. Thus, while the phase maps that induced programmable amounts of intraocular scattering (related to cataract severity) were displayed in a one half of the LCoS, sequentially testing wavefronts were displayed in the second one. Results of the imaging improvements were visually evaluated by subjects with no known ocular pathology seeing through the instrument. The diffracted intensity of exit pupil is analyzed for the feedback of the implemented algorithms in search for the optimum wavefront. Numerical and experimental results of the imaging improvements are presented and discussed.

  11. Intraocular pressure and retinal vascular changes during transient exposure to microgravity.

    PubMed

    Mader, T H; Gibson, C R; Caputo, M; Hunter, N; Taylor, G; Charles, J; Meehan, R T

    1993-03-15

    We measured intraocular pressures and retinal vascular diameters from 11 subjects during 20 seconds of microgravity produced by parabolic flight on board a KC-135 aircraft. Intraocular pressures increased 58% during parabolic flight compared to baseline values (19 +/- 1 mm Hg vs 12 +/- 1 mm Hg, respectively; P < .001). A 4% reduction in the caliber of retinal arteries was also noted during microgravity, but this change did not achieve statistical significance (7.8 +/- 0.3 pixels at zerogravity vs 8.1 +/- 0.3 pixels at 1g; P = .07). The increase in intraocular pressure and trend of arteries to constrict are thought to result from cephalad shifts in intravascular and extravascular body fluids as a result of the absence of the 1g hydrostatic gradient. The results of our study confirm that this fluid shift and its effects on the eye occur rapidly, within 20 seconds of exposure to microgravity.

  12. [Intraocular pressure after ND: YAG laser capsulotomy in pseudophakic patients with glaucoma].

    PubMed

    Sesar, Antonio; Petric, Irena; Sesar, Ivanka; Lacmnovic-Loncar, Valentina; Jurisić, Darija; Tomić, Zeljka; Mandić, Zdravko

    2006-01-01

    The aim of the study was to analyze changes in intraocular pressure after Nd: YAG laser capsulotomy in pseudophakic patients with glaucoma. Intraocular pressure was recorded before, and 1 and 3 hours after YAG laser capsulotomy in 69 pseudophakic patients with glaucoma. Twenty eight patients received no therapy before capsulotomy, 21 patients received topical brimonidine 0.2%, and 20 patients received topical dorzolamide 2% 1 hour before laser capsulotomy. All patients received topical tropicamide 1% and tetracaine 0.5%. Nd: YAG laser posterior capsulotomy was performed using inverted-U technique to make a 3-4 mm diameter capsulotomy. After capsulotomy, all eyes received topical fluorometholone for 10 days. A pressure rise was greater in patients without any therapy before YAG laser capsulotomy. Eight patients with glaucoma showed intraocular pressure rise of 5 mm Hg, and 2 patients pressure rise of 10 mm Hg after laser capsulotomy. A reduction of intraocular pressure rise was found in patients who received dorzolamide 2% or brimonidine 0.2%, only 1 patient in each group developed a pressure rise of 5 mm Hg. In all patients a significant pressure rise developed within the first hour. It is difficult to compare different studies due to different techniques of cataract surgery and different intraocular lense material and design. Barnes showed that 6 of 29 (21%) developed a pressure rise of 5 mm Hg, and 1 of 29 (3%) patients a pressure rise of 10 mm Hg. In our study, 29% of patients had a pressure rise of > or =5 mm Hg, and 7% of patients had a rise of > or =10 mm Hg after laser capsulotomy. These results may be associated with a large proportion of extracapsular cataract extraction (71%) versus phacoemulsification (29%) in our patients. Pretreatment with dorzolamide 2% or brimonidine 0.2% reduce the intraocular pressure rise after Nd: YAG laser capsulotomy in pseudophakic patients with glaucoma.

  13. Concurrent clinical intraocular findings in horses with depigmented punctate chorioretinal foci.

    PubMed

    Mathes, Rachel L; Burdette, Erin L; Moore, Phillip A; Myrna, Kathern E

    2012-03-01

    To report concurrent clinical intraocular findings in horses with depigmented punctate chorioretinal foci and to document any correlation with equine recurrent uveitis (ERU). Records of 131 horses (241 eyes) examined at the University of Georgia Veterinary Teaching hospital from 2001 to 2010 were reviewed with either clinically normal fundi or depigmented punctate chorioretinal foci in the absence of other fundic pathology. Data collected included patient signalment, concurrent clinical ocular findings and follow-up information. Sex, presence of no other intraocular findings, presence of ERU, presence of cataracts, and presence of vitreal disease were compared between normal and foci groups using chi-squared analysis. Age and length of follow-up time were compared using a student's t-test. Ninety-one horses (167 eyes) with chorioretinal foci and forty horses (74 eyes) with clinically normal ocular fundi were examined. Fifty-eight (64%) horses with chorioretinal foci and 20 (50%) horses with clinically normal fundi had a normal intraocular examination. There was no significant difference in any of the criteria examined between groups. Horses with depigmented punctate chorioretinal foci, in the absence of other fundic pathology, are not more likely to have intraocular disease or ERU than horses with clinically normal ocular fundi. These findings suggest that depigmented punctate fundic foci in horses are not indicative of or associated with ERU. © 2011 American College of Veterinary Ophthalmologists.

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

    PubMed

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

    2012-01-01

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

  15. Environmental and Genetic Factors Explain Differences in Intraocular Scattering.

    PubMed

    Benito, Antonio; Hervella, Lucía; Tabernero, Juan; Pennos, Alexandros; Ginis, Harilaos; Sánchez-Romera, Juan F; Ordoñana, Juan R; Ruiz-Sánchez, Marcos; Marín, José M; Artal, Pablo

    2016-01-01

    To study the relative impact of genetic and environmental factors on the variability of intraocular scattering within a classical twin study. A total of 64 twin pairs, 32 monozygotic (MZ) (mean age: 54.9 ± 6.3 years) and 32 dizygotic (DZ) (mean age: 56.4 ± 7.0 years), were measured after a complete ophthalmologic exam had been performed to exclude all ocular pathologies that increase intraocular scatter as cataracts. Intraocular scattering was evaluated by using two different techniques based on a straylight parameter log(S) estimation: a compact optical instrument based in the principle of optical integration and a psychophysical measurement. Intraclass correlation coefficients (ICC) were used as descriptive statistics of twin resemblance, and genetic models were fitted to estimate heritability. No statistically significant difference was found for MZ and DZ groups for age (P = 0.203), best-corrected visual acuity (P = 0.626), cataract gradation (P = 0.701), sex (P = 0.941), optical log(S) (P = 0.386), or psychophysical log(S) (P = 0.568), with only a minor difference in equivalent sphere (P = 0.008). Intraclass correlation coefficients between siblings were similar for scatter parameters: 0.676 in MZ and 0.471 in DZ twins for optical log(S); 0.533 in MZ twins and 0.475 in DZ twins for psychophysical log(S). For equivalent sphere, ICCs were 0.767 in MZ and 0.228 in DZ twins. Conservative estimates of heritability for the measured scattering parameters were 0.39 and 0.20, respectively. Correlations of intraocular scatter (straylight) parameters in the groups of identical and nonidentical twins were similar. Heritability estimates were of limited magnitude, suggesting that genetic and environmental factors determine the variance of ocular straylight in healthy middle-aged adults.

  16. Stability of Adrenaline in Irrigating Solution for Intraocular Surgery.

    PubMed

    Shibata, Yuuka; Kimura, Yasuhiro; Taogoshi, Takanori; Matsuo, Hiroaki; Kihira, Kenji

    2016-01-01

    Intraocular irrigating solution containing 1 µg/mL adrenaline is widely used during cataract surgery to maintain pupil dilation. Prepared intraocular irrigating solutions are recommended for use within 6 h. After the irrigating solution is admistered for dilution, the adrenaline may become oxidized, and this may result in a decrease in its biological activity. However, the stability of adrenaline in intraocular irrigating solution is not fully understood. The aim of this study was to evaluate the stability of adrenaline in clinically used irrigating solutions of varying pH. Six hours after mixing, the adrenaline percentages remaining were 90.6%±3.7 (pH 7.2), 91.1%±2.2 (pH 7.5), and 65.2%±2.8 (pH 8.0) of the initial concentration. One hour after mixing, the percentages remaining were 97.6%±2.0 (pH 7.2), 97.4%±2.7 (pH 7.5), and 95.6%±3.3 (pH 8.0). The degradation was especially remarkable and time dependent in the solution at pH 8.0. These results indicate that the concentration of adrenaline is decreased after preparation. Moreover, we investigated the influence of sodium bisulfite on adrenaline stability in irrigating solution. The percentage adrenaline remaining at 6 h after mixing in irrigating solution (pH 8.0) containing sodium bisulfite at 0.5 µg/mL (concentration in irrigating solution) or at 500 µg/mL (concentration in the undiluted adrenaline preparation) were 57.5 and 97.3%, respectively. Therefore, the low concentration of sodium bisulfite in the irrigating solution may be a cause of the adrenaline loss. In conclusion, intraocular irrigation solution with adrenaline should be prepared just prior to its use in surgery.

  17. Intraocular robotic interventional surgical system (IRISS): Mechanical design, evaluation, and master-slave manipulation.

    PubMed

    Wilson, Jason T; Gerber, Matthew J; Prince, Stephen W; Chen, Cheng-Wei; Schwartz, Steven D; Hubschman, Jean-Pierre; Tsao, Tsu-Chin

    2018-02-01

    Since the advent of robotic-assisted surgery, the value of using robotic systems to assist in surgical procedures has been repeatedly demonstrated. However, existing technologies are unable to perform complete, multi-step procedures from start to finish. Many intraocular surgical steps continue to be manually performed. An intraocular robotic interventional surgical system (IRISS) capable of performing various intraocular surgical procedures was designed, fabricated, and evaluated. Methods were developed to evaluate the performance of the remote centers of motion (RCMs) using a stereo-camera setup and to assess the accuracy and precision of positioning the tool tip using an optical coherence tomography (OCT) system. The IRISS can simultaneously manipulate multiple surgical instruments, change between mounted tools using an onboard tool-change mechanism, and visualize the otherwise invisible RCMs to facilitate alignment of the RCM to the surgical incision. The accuracy of positioning the tool tip was measured to be 0.205±0.003 mm. The IRISS was evaluated by trained surgeons in a remote surgical theatre using post-mortem pig eyes and shown to be effective in completing many key steps in a variety of intraocular surgical procedures as well as being capable of performing an entire cataract extraction from start to finish. The IRISS represents a necessary step towards fully automated intraocular surgery and demonstrated accurate and precise master-slave manipulation for cataract removal and-through visual feedback-retinal vein cannulation. Copyright © 2017 John Wiley & Sons, Ltd.

  18. 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

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

    PubMed Central

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

    2017-01-01

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

  20. Repeated intraocular crystallization of ganciclovir in one eye after bilateral intravitreal injections: a case report.

    PubMed

    Iu, Lawrence P L; Fan, Michelle C Y; Lam, Wai-Ching; Wong, Ian Y H

    2018-02-09

    Cytomegalovirus (CMV) retinitis is an opportunistic infection that primarily affects immunocompromised individuals. Intravitreal ganciclovir injection monotherapy or in combination with systemic anti-CMV therapy are effective treatments for CMV retinitis. Crystallization of ganciclovir after intravitreal injection is extremely rare. Only two cases had been reported in literature. Crystallization in only one eye after bilateral injections had not been reported before. We hereby report a case of intraocular ganciclovir crystallization in one eye after bilateral intravitreal injections, and repeated crystallization in the same eye after repeated injections. A 79-year-old patient had bilateral cytomegalovirus retinitis and received bilateral intravitreal ganciclovir injections of 2.5 mg in 0.05 ml sterile water. Fundus examination after injection showed formation of needle-shaped, golden-yellow crystals in the vitreous of right eye but not in left eye. The crystals dissolved spontaneously. Repeated bilateral intravitreal ganciclovir injections 4 days later resulted in repeated crystallization of ganciclovir in right eye but not in left eye. The crystals dissolved spontaneously and completely after 5 minutes. Visual acuity remained unchanged and intraocular pressure was normal. Intraocular ganciclovir crystallization could occur after intravitreal injections. It is important to perform fundus examination after injection. The crystals may dissolve rapidly and vitrectomy may not be necessary. Our case suggested intraocular ganciclovir crystallization is an idiosyncratic phenomenon, subjects to distinctive intraocular environment which could be different between two eyes of the same patient. The susceptible intraocular environment could be persistent leading to repeated crystallization.

  1. The safety of intraocular methotrexate in silicone-filled eyes.

    PubMed

    Hardwig, Paul W; Pulido, Jose S; Bakri, Sophie J

    2008-10-01

    Intraocular methotrexate has been safely used in eyes with primary CNS lymphoma (PCNSL), and in eyes with uveitis and proliferative diabetic retinopathy. Dosing in silicone-filled eyes was reduced from a standard 400 microg intravitreal injection due to concerns of toxicity. The present study reports the visual results of non-PCNSL, silicone-filled eyes treated with intravitreal methotrexate using cumulative dosages ranging from 200 microg to 1,200 microg. In this retrospective case series, all patients with silicone-filled eyes who received intraocular methotrexate were included. Patients were observed with serial ophthalmic examinations. Best-corrected visual acuity was measured by Snellen acuity. Pretreatment acuities were compared to those obtained at last follow-up. The cohort included 12 patients (13 eyes) with disease other than PCNSL. The cumulative dose of intraocular methotrexate in any one patient ranged from 200 microg to 1,200 microg. Mean follow-up was 9 months (median, 10 months; range, 2 weeks to 16 months). Best-corrected vision at last follow-up was either stable or improved from pretreatment acuity in 12 of 13 eyes. Preservation of acuity in 12 of 13 study eyes suggests that intravitreal methotrexate in a cumulative dose of up to 1,200 microg is safe in silicone-filled eyes.

  2. Bartonella and intraocular inflammation: a series of cases and review of literature

    PubMed Central

    Kalogeropoulos, Chris; Koumpoulis, Ioannis; Mentis, Andreas; Pappa, Chrisavgi; Zafeiropoulos, Paraskevas; Aspiotis, Miltiadis

    2011-01-01

    Purpose: To present various forms of uveitis and/or retinal vasculitis attributed to Bartonella infection and review the impact of this microorganism in patients with uveitis. Methods: Retrospective case series study. Review of clinical records of patients diagnosed with Bartonella henselae and Bartonella quintana intraocular inflammation from 2001 to 2010 in the Ocular Inflammation Department of the University Eye Clinic, Ioannina, Greece. Presentation of epidemiological and clinical data concerning Bartonella infection was provided by the international literature. Results: Eight patients with the diagnosis of Bartonella henselae and two patients with B. quintana intraocular inflammation were identified. Since four patients experienced bilateral involvement, the affected eyes totaled 14. The mean age was 36.6 years (range 12–62). Uveitic clinical entities that we found included intermediate uveitis in seven eyes (50%), vitritis in two eyes (14.2%), neuroretinitis in one eye (7.1%), focal retinochoroiditis in one eye (7.1%), branch retinal vein occlusion (BRVO) due to vasculitis in one eye (7.1%), disc edema with peripapillary serous retinal detachment in one eye (7.1%), and iridocyclitis in one eye (7.1%). Most of the patients (70%) did not experience systemic symptoms preceding the intraocular inflammation. Antimicrobial treatment was efficient in all cases with the exception of the case with neuroretinitis complicated by anterior ischemic optic neuropathy and tubulointerstitial nephritis. Conclusion: Intraocular involvement caused not only by B. henselae but also by B. quintana is being diagnosed with increasing frequency. A high index of suspicion is needed because the spectrum of Bartonella intraocular inflammation is very large. In our study the most common clinical entity was intermediate uveitis. PMID:21750616

  3. Intraocular biopsy using special forceps: a new instrument and refined surgical technique.

    PubMed

    Akgul, Harun; Otterbach, Friedrich; Bornfeld, Norbert; Jurklies, Bernhard

    2011-01-01

    The aim was to investigate the Essen biopsy forceps as a new instrument and surgical approach for biopsy of intraocular tumours. Biopsy is indicated for assessment of any uncertain intraocular process or confirmation for presumed diagnosis before treatment. There is increasing interest for further genetic and immunocytological information in order to characterise the neoplasm, especially grading and prognosis of micrometastasis in uveal melanoma. The authors have developed a new surgical technique using special intraocular biopsy forceps. Twenty patients with uncertain intraocular subretinal tumour underwent biopsies carried out using the special Essen biopsy forceps. Biopsies were obtained through sutureless 23-gauge three-port vitrectomy. A small retinotomy tumour specimen was taken by the forceps branches. For further processing, the specimens were flushed out into a sterile tube and then sent to pathologists. The prebioptical tumour had a mean thickness of 3.48 mm (1.1 to 9.8 mm). In all cases (n=20) biopsies (0.3-2.1 mm in size) were obtained, in 19 cases (95%) allowing precise histological and immunohistochemical typing of the lesions following cytoblock embedding. Uveal melanoma was diagnosed in 50% (n=10), choroidal metastasis in 15% (n=3) and choroidal naevus in 15% (n=3); other diagnoses (n=3) included choroidal haemangioma, B cell lymphoma and old subretinal haemorrhage. Apart from three patients with temporary punctual bleeding on the surface, there were no intra- and postoperative complications. Biopsy using special forceps is a promising new approach and precise surgical procedure. Especially for small intraocular tumours, this technique has the advantage in providing enough tissue for improved histological examination and presenting a low risk for complications.

  4. A case of scleritis associated rheumatoid arthritis accompanying an intraocular elevated lesion.

    PubMed

    Kobayashi, Takatoshi; Takai, Nanae; Tada, Rei; Shoda, Hiromi; Kida, Teruyo; Ikeda, Tsunehiko; Ozaki, Takurou; Makino, Shigeki

    2018-05-30

    Scleritis and/or uveitis sometimes accompanies patients who suffer from rheumatoid arthritis. However, few studies have reported scleritis and/or uveitis accompanying a fundus elevated lesion, such as an intraocular tumor. In this study, we report a case of rheumatoid uveitis associated with an intraocular elevated lesion. A 66-year-old female visited another eye clinic and was diagnosed as bilateral anterior uveitis, and was prescribed steroid eye drops for treatment. She had previously been diagnosed as rheumatoid arthritis at the age of 30 years. Due to vitreous opacity that appeared in her right eye, we increased the instillation of steroid eye drops and the amount of oral prednisolone. Although the inflammation had improved, anterior uveitis relapsed, and an intraocular whitish elevated lesion resembling an intraocular tumor at the superior nasal retina appeared. We speculated this lesion to be a granuloma complicated with rheumatoid arthritis. Thus, we increased the amount of prednisolone administration, and the lesion began to shrink and ultimately fully disappeared. We strongly believe that our case's lesion was a subretinal granuloma related with rheumatoid arthritis, as it disappeared by increased corticosteroid treatment. Our findings show that we should consider rheumatoid arthritis in a differential diagnosis of such types of fundus elevated lesions.

  5. Corn silk aqueous extracts and intraocular pressure of systemic and non-systemic hypertensive subjects.

    PubMed

    George, Gladys O; Idu, Faustina K

    2015-03-01

    Hypotensive properties have been attributed to the stigma/style of Zea mays L (corn silk). Although the effect of corn silk extract on blood pressure has been documented in animal studies, we are not aware of any study on its effect on human blood pressure and intraocular pressure. A randomised study was carried out on the effect of water only, masked doses of corn silk aqueous extract (60, 130, 192.5 and 260 mg/kg body weight) on intraocular pressure and blood pressure of 20 systemic and 20 non-systemic hypertensive subjects. Intraocular pressure and blood pressure were measured at baseline and every hour for eight hours after administering water or a masked dose of corn silk aqueous extract. Each dose was administered at two-week intervals to each subject in the two study groups. The results showed that the last three doses of corn silk aqueous extract gave a statistically significant reduction (p < 0.001) in mean intraocular pressure and blood pressure within eight hours of administration. The peak effect on intraocular pressure was observed after four hours and this was preceded by the peak effect on blood pressure, which occurred after three hours of administration. The hypotensive effect was dose-dependent in the two groups. Corn silk aqueous extract has a lowering effect on intraocular pressure in systemic and non-systemic hypertensive subjects. This may have resulted from the fall in blood pressure that is due to potassium-induced natriuresis and diuresis caused by the high potassium content in the high doses of the corn silk extract. © 2015 The Authors. Clinical and Experimental Optometry © 2015 Optometry Australia.

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

    PubMed Central

    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. PMID:26970263

  7. The role of pili in Bacillus cereus intraocular infection.

    PubMed

    Callegan, Michelle C; Parkunan, Salai Madhumathi; Randall, C Blake; Coburn, Phillip S; Miller, Frederick C; LaGrow, Austin L; Astley, Roger A; Land, Craig; Oh, So-Young; Schneewind, Olaf

    2017-06-01

    Bacterial endophthalmitis is a potentially blinding intraocular infection. The bacterium Bacillus cereus causes a devastating form of this disease which progresses rapidly, resulting in significant inflammation and loss of vision within a few days. The outer surface of B. cereus incites the intraocular inflammatory response, likely through interactions with innate immune receptors such as TLRs. This study analyzed the role of B. cereus pili, adhesion appendages located on the bacterial surface, in experimental endophthalmitis. To test the hypothesis that the presence of pili contributed to intraocular inflammation and virulence, we analyzed the progress of experimental endophthalmitis in mouse eyes infected with wild type B. cereus (ATCC 14579) or its isogenic pilus-deficient mutant (ΔbcpA-srtD-bcpB or ΔPil). One hundred CFU were injected into the mid-vitreous of one eye of each mouse. Infections were analyzed by quantifying intraocular bacilli and retinal function loss, and by histology from 0 to 12 h postinfection. In vitro growth and hemolytic phenotypes of the infecting strains were also compared. There was no difference in hemolytic activity (1:8 titer), motility, or in vitro growth (p > 0.05, every 2 h, 0-18 h) between wild type B. cereus and the ΔPil mutant. However, infected eyes contained greater numbers of wild type B. cereus than ΔPil during the infection course (p ≤ 0.05, 3-12 h). Eyes infected with wild type B. cereus experienced greater losses in retinal function than eyes infected with the ΔPil mutant, but the differences were not always significant. Eyes infected with ΔPil or wild type B. cereus achieved similar degrees of severe inflammation. The results indicated that the intraocular growth of pilus-deficient B. cereus may have been better controlled, leading to a trend of greater retinal function in eyes infected with the pilus-deficient strain. Although this difference was not enough to significantly alter the severity

  8. Effects of corneal thickness on the intraocular penetration of travoprost 0.004%

    PubMed Central

    Martinez-de-la-Casa, J M; Rayward, O; Saenz-Frances, F; Santos-Bueso, E; Mendez-Hernandez, C; Herrero-Vanrell, R; Garcia-Feijoo, J; Garcia-Sanchez, J

    2012-01-01

    Purpose To determine whether the intraocular penetration of travoprost 0.004% is affected by central corneal thickness. Methods Sixty-four patients who were scheduled for cataract surgery without any other ophthalmologic pathology of significance were enroled in this study. At 120 min before surgery, one drop of travoprost 0.004% was instilled in the eye to be operated on. At the start of surgery, a sample of aqueous humour was extracted to subsequently determine its AL-5848 concentration. These concentrations were compared among three groups of patients established according to central corneal thickness measurements obtained by ultrasound pachymetry. Results Mean AL-5848 concentrations were 3.27±2.03 ng/ml in Group I (CCT<511 microns), 3.27±2.44 ng/ml in Group II (CCT≥511 and ≤574 microns), and 2.73±2.15 ng/ml in Group III (CCT>574 microns), indicating no significant differences among the groups. Conclusions We were unable to demonstrate the greater or lesser penetration of travoprost depending on corneal thickness, which could explain differences in patient responses to this drug. PMID:22562189

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

    NASA Image and Video Library

    1990-10-10

    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.

  10. EX VIVO MODEL FOR THE CHARACTERIZATION AND IDENTIFICATION OF DRYWALL INTRAOCULAR FOREIGN BODIES ON COMPUTED TOMOGRAPHY.

    PubMed

    Syed, Reema; Kim, Sung-Hye; Palacio, Agustina; Nunery, William R; Schaal, Shlomit

    2017-06-06

    The study was inspired after the authors encountered a patient with a penetrating globe injury due to drywall, who had retained intraocular drywall foreign body. Computed tomography (CT) was read as normal in this patient. Open globe injury with drywall has never been reported previously in the literature and there are no previous studies describing its radiographic features. The case report is described in detail elsewhere. This was an experimental study. An ex vivo model of 15 porcine eyes with 1 mm to 5 mm fragments of implanted drywall, 2 vitreous only samples with drywall and 3 control eyes were used. Eyes and vitreous samples were CT scanned on Days 0, 1, and 3 postimplantation. Computed ocular images were analyzed by masked observers. Size and radiodensity of intraocular drywall were measured using Hounsfield units (HUs) over time. Intraocular drywall was hyperdense on CT. All sizes studied were detectable on Day 0 of scanning. Mean intraocular drywall foreign body density was 171 ± 52 Hounsfield units (70-237) depending on fragment size. Intraocular drywall foreign body decreased in size whereas Hounsfield unit intensity increased over time. Drywall dissolves in the eye and becomes denser over time as air in the drywall is replaced by fluid. This study identified Hounsfield Units specific to intraocular drywall foreign body over time.

  11. MicroRNA profiling in intraocular medulloepitheliomas.

    PubMed

    Edward, Deepak P; Alkatan, Hind; Rafiq, Qundeel; Eberhart, Charles; Al Mesfer, Saleh; Ghazi, Nicola; Al Safieh, Leen; Kondkar, Altaf A; Abu Amero, Khaled K

    2015-01-01

    To study the differential expression of microRNA (miRNA) profiles between intraocular medulloepithelioma (ME) and normal control tissue (CT). Total RNA was extracted from formalin fixed paraffin embedded (FFPE) intraocular ME (n=7) and from age matched ciliary body controls (n=8). The clinical history and phenotype was recorded. MiRNA profiles were determined using the Affymetrix GeneChip miRNA Arrays analyzed using expression console 1.3 software. Validation of significantly dysregulated miRNA was confirmed by quantitative real-time PCR. The web-based DNA Intelligent Analysis (DIANA)-miRPath v2.0 was used to perform enrichment analysis of differentially expressed (DE) miRNA gene targets in Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway. The pathologic evaluation revealed one benign (benign non-teratoid, n=1) and six malignant tumors (malignant teratoid, n=2; malignant non-teratoid, n = 4). A total of 88 miRNAs were upregulated and 43 miRNAs were downregulated significantly (P<0.05) in the tumor specimens. Many of these significantly dysregulated miRNAs were known to play various roles in carcinogenesis and tumor behavior. RT-PCR validated three significantly upregulated miRNAs and three significantly downregulated miRNAs namely miR-217, miR-216a, miR-216b, miR-146a, miR-509-3p and miR-211. Many DE miRNAs that were significant in ME tumors showed dysregulation in retinoblastoma, glioblastoma, and precursor, normal and reactive human cartilage. Enriched pathway analysis suggested a significant association of upregulated miRNAs with 15 pathways involved in prion disease and several types of cancer. The pathways involving significantly downregulated miRNAs included the toll-like receptor (TLR) (p<4.36E-16) and Nuclear Factor kappa B (NF-κB) signaling pathways (p<9.00E-06). We report significantly dysregulated miRNAs in intraocular ME tumors, which exhibited abnormal profiles in other cancers as well such as retinoblastoma and glioblastoma. Pathway analysis of

  12. Intraocular Gnathostoma spinigerum. Clinicopathologic study of two cases with review of literature.

    PubMed

    Biswas, J; Gopal, L; Sharma, T; Badrinath, S S

    1994-01-01

    Live intraocular nematode is a rare occurrence that is mostly reported in Southeast Asian countries. Common nematodes that are seen live in the eye are microfilaria, Gnathostoma, and Angiostrongylus. Approximately 12 cases of intraocular gnathostomiasis have been reported in the literature. Two cases of intraocular gnathostoma, removed by vitrectomy in the first case and by paracentesis in the second case, are reported. Morphologic study of the parasites in wet preparation was performed under dissecting microscope and fixed in Karnovosky's fixative. Light microscopic and scanning electron microscopic studies were also performed. The first patient had anterior uveitis, multiple iris holes, and dense vitreous haze with fibrous proliferation over the optic disc. On resolution of the vitreous haze, a live worm was seen in the vitreous cavity. The second patient had anterior uveitis with secondary glaucoma, multiple iris holes, mild vitritis, and focal subretinal haemorrhage with subretinal tracts. Four days later a live worm was seen in the anterior chamber and removed. Microscopic study of the parasites from both patients revealed typical head bulb with four circumferential rows of hooklets, and fine cuticular spines were seen on the surface of the body. Iris holes, uveitis, and subretinal haemorrhage with subretinal tract can be characteristic features of intraocular gnathostomiasis. Identification of this parasite can be made by typical features, which can be identified on light and scanning electron microscopic study.

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

    PubMed

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

    2018-06-01

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

  14. Bilateral phacoemulsification and intraocular lens implantation in a great horned owl.

    PubMed

    Carter, Renee T; Murphy, Christopher J; Stuhr, Charles M; Diehl, Kathryn A

    2007-02-15

    A great horned owl of estimated age < 1 year that was captured by wildlife rehabilitators was evaluated because of suspected cataracts. Nuclear and incomplete cortical cataracts were evident in both eyes. Ocular ultrasonography revealed no evidence of retinal detachment, and electroretinography revealed normal retinal function. For visual rehabilitation, cataract surgery was planned and intraocular lens design was determined on the basis of values obtained from the schematic eye, which is a mathematical model representing a normal eye for a species. Cataract surgery and intraocular lens placement were performed in both eyes. After surgery, refraction was within -0.75 diopters in the right eye and -0.25 diopters in the left eye. Visual rehabilitation was evident on the basis of improved tracking and feeding behavior, and the owl was eventually released into the wild. In raptors with substantial visual compromise, euthanasia or placement in a teaching facility is a typical outcome because release of such a bird is unacceptable. Successful intraocular lens implantation for visual rehabilitation and successful release into the wild are achievable.

  15. [Association between two different types of strangling and intraocular pressure variation in jiu-jitsu athletes].

    PubMed

    Scarpi, Marinho Jorge; Conte, Marcelo; Rossin, Reginaldo Alexandre; Skubs, Renato; Lenk, Rudolf Eberhard; Brant, Rodrigo

    2009-01-01

    To verify the association between two different types of strangling with intraocular pressure variation in jiu-jitsu athletes. An observational study was performed on 9 athletes of jiu-jitsu, with at least 6 month of training, male, aged 20 to 30 years, without any physical and eyeball lesions. Associations between intraocular pressure and Cross Choke from the guard strangling (E1), and E2 - Cross Choke from mount strangling were gotten. Intraocular pressure was determined by using Perkins tonometer, at first in the absence of physical exercise over the last 24 hours and after each strangling. Then it was carried out the intraocular pressure measure at each 3 minutes, during 12 minutes of exercise recovery (R1, R2, R3, and R4) keeping the athletes lied down. Statistical analysis was done using ANOVA test and Bonferroni post-test. Meaningful reduction of both eyes intraocular pressure occurred at the E2 situation comparing to the E1 situation at all exercise recovery measures: R1 (OD: 8.22 +/- 1.39 vs.11.33 +/- 2.00 / OE: 8.55 +/- 1.23 vs. 11.88 +/- 1.90), R2 (OD: 8.44 +/- 1.87 vs.10.22 +/- 2.53 / OE: 9.00 +/- 1.80 vs. 10.44 +/- 2.35), R3 (OD: 8.44 +/- 1.74 vs.9.78 +/- 2.54 / OE: 8.55 +/- 1.42 vs. 10.33 +/- 1.93) all with p<0,01 e R4 (OD: 8.88 +/- 2.08 vs.9.55 +/- 2.87 / OE: 9.11 +/- 1.53 vs. 10.44 +/- 2.18) with p<0.05. Meaningful IOP reduction (p<0.05) was observed at the R1 moment of E2 strangling (OD: 10.77 +/- 1.92 vs.8.22 +/- 1.39 / OE: 11.44 +/- 1.94 vs. 8.55 +/- 1.23). There is association between intraocular pressure and jiu-jitsu strangling exercises, with intraocular pressure reduction.

  16. Using continuous intraoperative optical coherence tomography measurements of the aphakic eye for intraocular lens power calculation.

    PubMed

    Hirnschall, Nino; Norrby, Sverker; Weber, Maria; Maedel, Sophie; Amir-Asgari, Sahand; Findl, Oliver

    2015-01-01

    To include intraoperative measurements of the anterior lens capsule of the aphakic eye into the intraocular lens power calculation (IPC) process and to compare the refractive outcome with conventional IPC formulae. In this prospective study, a prototype operating microscope with an integrated continuous optical coherence tomography (OCT) device (Visante attached to OPMI VISU 200, Carl Zeiss Meditec AG, Germany) was used to measure the anterior lens capsule position after implanting a capsular tension ring (CTR). Optical biometry (intraocular lens (IOL) Master 500) and ACMaster measurements (Carl Zeiss Meditec AG, Germany) were performed before surgery. Autorefraction and subjective refraction were performed 3 months after surgery. Conventional IPC formulae were compared with a new intraoperatively measured anterior chamber depth (ACD) (ACDIntraOP) partial least squares regression (PLSR) model for prediction of the postoperative refractive outcome. In total, 70 eyes of 70 patients were included. Mean axial eye length (AL) was 23.3 mm (range: 20.6-29.5 mm). Predictive power of the intraoperative measurements was found to be slightly better compared to conventional IOL power calculations. Refractive error dependency on AL for Holladay I, HofferQ, SRK/T, Haigis and ACDintraOP PLSR was r(2)=-0.42 (p<0.0001), r(2)=-0.5 (p<0.0001), r(2)=-0.34 (p=0.010), r(2)=-0.28 (p=0.049) and r(2)<0.001 (p=0.866), respectively, ACDIntraOP measurements help to better predict the refractive outcome and could be useful, if implemented in fourth-generation IPC formulae. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Intraocular osseous metaplasia. A clinico-pathological study.

    PubMed

    Vemuganti, Geeta K; Honavar, Santosh G; Jalali, Subhadra

    2002-09-01

    To evaluate the clinico-pathologic features of intraocular osseous metaplasia. Pathology specimens of enucleated eyes submitted to the ophthalmic pathology service at a tertiary eye-care referral center between January 1995 and June 1999 were studied for intraocular osseous metaplasia. Specific histopathologic features noted in specimens with osseous metaplasia were the presence of retinal detachment, gliosis, retinal pigment epithelial hyperplasia, drusen, epiretinal membrane, fibrovascular proliferation and inflammation. Immunohistochemistry using monoclonal antibody against glial fibrillary acidic protein was performed to assess the glial component within the membranes and the proliferative vitreoretinal mass. Clinical records were reviewed and correlated with histopathologic findings. Osseous metaplasiaS was noted in 8 of 151 (5.2%) eyes examined. Clinical diagnosis in these was phthisis bulbi, staphyloma, absolute glaucoma and microphthalmos. Enucleation was performed for relief of symptoms (in painful blind eyes) or for cosmesis, and in an eye inciting sympathetic ophthalmia. Retinal detachment, gliosis and retinal pigment epithelial hyperplasia were noted in all the cases. Drusen with calcification or ossification (5 of 8), fibrovascular proliferation in the vitreous (5 of 8) and active inflammation (4 of 8) were the other associated histologic features. Location of ossification was subretinal in 3 cases, preretinal (ora serrata) in 1 case and in both locations in 4 cases. The eyes with subretinal osseous metaplasia had associated calcified drusen, while preretinal ossification was seen within the fibrovascular membranes. Chronic retinal detachment, hyperplasia and transdifferentiation of retinal pigment epithelium appear to be a few of the prerequisites for intraocular osseous metaplasia. Ossification can occur at isolated subretinal and preretinal locations or can involve both. Though a larger study is required to postulate the chronology of events, in

  18. Intraocular gnathostomiasis from coastal part of Maharashtra.

    PubMed

    Sujata, Dharmshale N; Renu, Bharadwaj S

    2013-01-01

    Intraocular infestation by live Gnathostoma spinigerum is a rare occurrence in humans. Most of the published reports are from South-East Asia. We report a case of ocular gnathostomiasis from Western Maharashtra, where the worm was removed live from the anterior chamber of the left eye. Identification of the worm was confirmed by light microscopy.

  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. Copyright © 2010 Elsevier Inc. All rights reserved.

  20. 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. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Intraocular gnathostomiasis from coastal part of Maharashtra

    PubMed Central

    Sujata, Dharmshale N; Renu, Bharadwaj S

    2013-01-01

    Intraocular infestation by live Gnathostoma spinigerum is a rare occurrence in humans. Most of the published reports are from South-East Asia. We report a case of ocular gnathostomiasis from Western Maharashtra, where the worm was removed live from the anterior chamber of the left eye. Identification of the worm was confirmed by light microscopy. PMID:23961449

  2. Iris-Claw Intraocular Lens and Scleral-Fixated Posterior Chamber Intraocular Lens Implantations in Correcting Aphakia: A Meta-Analysis.

    PubMed

    Jing, Wu; Guanlu, Liang; Qianyin, Zheng; Shuyi, Li; Fengying, He; Jian, Liu; Wen, Xu

    2017-07-01

    A meta-analysis to compare iris-claw intraocular lens (IC-IOL) and scleral-fixated posterior chamber intraocular lens (SF-PCIOL) implantations in correcting aphakia without sufficient capsular support. Eligible studies were collected through PubMed, Web of Science, Embase, and the Cochrane library. The pooled relative risks (RR), pooled standardized mean difference (SMD), and their 95% confidence interval of the eligible studies were then calculated. Seven studies met our inclusion criteria, involving 232 and 158 eyes in IC-IOL and SF-PCIOL groups, respectively. The pooled SMD of the mean postoperative corrected distance visual acuity (CDVA) (logMAR) was -0.25. The pooled RR of the eyes achieving 20/40 or better postoperatively was 1.16. The pooled SMD of the surgical time was -2.97. The pooled RR of the surgical complications was 0.86. The pooled RR of IOL dislocation, retinal detachment (RD), and cystoid macular edema (CME) between the two groups were 0.22, 0.63, and 0.64. Implantation of IC-IOL has a more simple procedure and shorter learning curve than SF-PCIOL implantation in correcting aphakia without sufficient capsular support.

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

    PubMed

    McCafferty, Sean J; Schwiegerling, Jim T

    2015-04-01

    Present an analysis methodology for developing and evaluating accommodating intraocular lenses incorporating a deformable interface. 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. 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. 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. 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.

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

    PubMed

    Hemkeppler, E; Böhm, M; Kohnen, T

    2018-05-29

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

  5. 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)

  6. Ray-tracing analysis of intraocular lens power in situ.

    PubMed

    Olsen, Thomas; Funding, Mikkel

    2012-04-01

    To describe a method for back-solving the power of an intraocular lens (IOL) in situ based on laser biometry and ray-tracing analysis of the pseudophakic eye. University Eye Clinic, Aarhus Hospital, Aarhus, Denmark. Evaluation of diagnostic test or technology. This study comprised pseudophakic eyes with an IOL power ranging from -2.00 to +36.00 diopters (D). Preoperatively, the corneal radius was measured with conventional autokeratometry and the axial length (AL) with optical biometry. After surgery, the position of the IOL was recorded using laser interferometry. Based on the postoperative refraction and the biometric measurements, a ray-tracing analysis was performed back-solving for the power of the IOL in situ. The analysis was performed assuming pupil diameters from 0.0 to 8.0 mm with and without correction for the Stiles-Crawford effect. The study evaluated 767 pseudophakic eyes (583 patients). Assuming a 3.0 mm pupil, the mean prediction error between the labeled and the calculated IOL power (± 1 standard deviation [SD]) was -0.26 D ± 0.65 (SD) (range -2.4 to +1.8 D). The prediction error showed no bias with IOL power or with AL. The calculated IOL power depended on the assumed pupil size and the Stiles-Crawford effect. However, the latter had a modulatory effect on the prediction error for large pupil diameters (>5.0 mm) only. The optics of the pseudophakic eye can be accurately described using exact ray tracing and modern biometric techniques. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  7. Delayed presentation of retained acrylic intraocular lens (IOL) fragment after uncomplicated cataract surgery.

    PubMed

    Capitena, Cara E; Gamett, Kevin; Pantcheva, Mina B

    2016-10-01

    To report a case of delayed presentation of a severed acrylic single-piece intraocular lens (IOL) haptic fragment causing corneal edema after uneventful phacoemulsification surgery. An 85-year-old male presented with inferior corneal decompensation six months after a reportedly uneventful phacoemulsification in his left eye. A distal haptic fragment of an acrylic single-piece posterior chamber intraocular lens was found in the inferior anterior chamber angle. Intraoperative examination revealed that the dislocated fragment originated from the temporal haptic, the remainder of which was adherent to the anterior surface of the capsular bag. The clipped edge of the haptic fragment showed a clean, flat surface, suggesting it was severed by a sharp object. The findings were considered consistent with cutting of the fragment during implantation presumably from improper lens loading, improper implantation technique, or defective implantation devices. This is the first case report of a foldable acrylic intraocular lens severed during routine uncomplicated cataract surgery that was not noted at the time of the surgery or in the immediate postoperative period. Delayed presentation of severed IOL fragments should be considered in cases of late onset corneal edema post-operatively, when other causes have been ruled out. Careful implantation technique and thorough examination of the intraocular lens after implantation to assess for lens damage intraoperatively is essential to avoid such rare complications.

  8. 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

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

    PubMed Central

    2012-01-01

    Background The implementation of capitated payment has driven medical institutions through developing balance billing for medical services. By exploring the patients’ decision-making factors on different self-pay items, a reference for the pricing and sales strategy for the related products can be formed. The major purposes of this study were to analyze the determinants of preoperative selection and postoperative satisfaction with implantation of different types of intraocular lenses in cataract surgery. Methods This cross-sectional study consisted of 127 patients that were 50 years of age and older, and who had phacoemulsification with intraocular lens implantation in both eyes. Data were collected by using a structured questionnaire. The following parameters were measured: access to medical care, attitude towards receiving medical products at one’s own expense, overall patient satisfaction and postoperative visual clarity. Results The results showed that the patient’s gender, educational level and economic status influenced the type of intraocular lens chosen. Patients in the insurance group cared about access to medical care, and patients in the balance billing group cared about product differentiation. ANOVA results showed no statistically significant differences in the overall satisfaction of the patients among the groups with different types of intraocular lenses. Patients that received cataract surgery with implantation of multifocal intraocular lenses had better vision when trying to view smaller objects and when looking at objects under strong light. Conclusions Manufacturers should increase the number of differences between their products, and health care providers can then recommend the appropriate intraocular lens in accordance with the needs or demands of their patients, and also by keeping in mind the financial constraints of their patients. PMID:23107001

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

    PubMed

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

    2012-10-29

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

  11. 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.

  12. Comparison of visual outcomes after bilateral implantation of a diffractive trifocal intraocular lens and blended implantation of an extended depth of focus intraocular lens with a diffractive bifocal intraocular lens

    PubMed Central

    de Medeiros, André Lins; de Araújo Rolim, André Gustavo; Motta, Antonio Francisco Pimenta; Ventura, Bruna Vieira; Vilar, César; Chaves, Mário Augusto Pereira Dias; Carricondo, Pedro Carlos; Hida, Wilson Takashi

    2017-01-01

    Purpose The purpose of this study was to compare the visual outcomes and subjective visual quality between bilateral implantation of a diffractive trifocal intraocular lens, Alcon Acrysof IQ® PanOptix® TNFT00 (group A), and blended implantation of an extended depth of focus lens, J&J Tecnis Symfony® ZXR00 with a diffractive bifocal intraocular lens, J&J Vision Tecnis® ZMB00 (group B). Methods This prospective, nonrandomized, consecutive, comparative study included the assessment of 40 eyes in 20 patients implanted with multifocal intraocular lens. Exclusion criteria were existence of any corneal, retina, or optic nerve disease, previous eye surgery, illiteracy, previous refractive surgery, high axial myopia, expected postoperative corneal astigmatism of >1.00 cylindrical diopter (D), and intraoperative or postoperative complications. Binocular visual acuity was tested in all cases. Ophthalmological evaluation included the measurement of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), and uncorrected intermediate visual acuity (UIVA), with the analysis of contrast sensitivity (CS), and visual defocus curve. Results Postoperative UDVA was 0.01 and −0.096 logMAR (p<0.01) in groups A and B, respectively; postoperative CDVA was −0.07 and −0.16 logMAR (p<0.01) in groups A and B, respectively; UIVA was 0.14 and 0.20 logMAR (p<0.01) in groups A and B, respectively; UNVA was −0.03 and 0.11 logMAR (p<0.01) in groups A and B, respectively. Under photopic conditions group B had better CS at low frequencies with and without glare. Conclusion Both groups promoted good quality of vision for long, intermediate, and short distances. Group B exhibited a better performance for very short distances and for intermediate and long distances ≥−1.50 D of vergence. Group A exhibited a better performance for UIVA at 60 cm and for UNVA at 40 cm. PMID:29138533

  13. [Correction of aphakia with the implantation of the retropupillary iris clip intraocular artificial lens].

    PubMed

    Szabó, Antal; Papp, András; Borbándy, Ágnes; D Géhl, Zsuzsanna; Nagy, Zoltán Zsolt; Resch, Miklós

    2017-01-01

    The correction of aphakia might be a challenge for the surgeon. The aim of this study is to describe the authors' experience with the implantation of the retropupillary iris clip intraocular lens. Patients between January 2014 and December 2015 were included in the retrospective study. Retropupillary implantation of iris clip intraocular lens VRSA 54 (AMO Advanced Medical Optics, USA) was performed in all cases. The minimum follow up period was three months. The stability of the intraocular lens and the intraoperative and postoperative complications and the visual acuity were evaluated. During this time period 11 cases (1 female, 10 males) were included in the study. The mean age at the time of the implantation was 57.7 years (between 25-74 years). In 4 cases the iris clip lens was implanted during the first intervention, in 7 cases during the secondary procedure. In all cases the lens was fixated onto the iris posteriorly. The best corrected visual acuity before the iris clip implantation was 0.43 (0.1-1.0) and postoperatively at the time of the follow up 0.49 (0.04-1.0). With the use of the retropupillary implanted iris clip intraocular lens all of the patients could have been rehabilitated without major complications. Orv. Hetil., 2017, 158(1), 20-24.

  14. 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.

  15. 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.

  16. The effect of vitrectomy with silicone oil tamponade on intraocular pressure and anterior chamber morphology.

    PubMed

    Suic, S P; Sikić, J

    2001-01-01

    We measured the tamponading effect of silicone oil, saline and air after vitrectomy, on intraocular pressure and aqueous humor outflow in 85 patients with highly proliferative retina and vitreous changes. Silicone oil as retinal tamponading agent after vitrectomy was used in 45 patients, and saline or air in 39 patients. The mean intraocular pressure measured at one month after treatment was greatly elevated in patients with silicone oil tamponade as compared to those with saline or air tamponade. At 6 and 12 months examinations, mean intraocular pressures were compared in these two groups of patients. Gonioscopy revealed silicone oil emulsification and presence of emulsified bubbles in the anterior chamber in 22.22% of patients, and narrowing of the chamber angle in several patients with silicone oil tamponade. Intraocular pressure elevation following vitrectomy with silicone oil tamponade was found to be of transient rather than permanent nature, since it regressed after silicone oil removal. This transient elevation was due to silicone oil tendency to emulsify. Silicone oil bubbles changed the morphology of the anterior chamber angle and fine trabecular structures by creating a barrier to aqueous humor outflow.

  17. Effect of marihuana on intraocular and blood pressure in glaucoma.

    PubMed

    Merritt, J C; Crawford, W J; Alexander, P C; Anduze, A L; Gelbart, S S

    1980-03-01

    Marihuana inhalation was accompanied by increased heart rate and decreased intraocular and blood pressure in 18 subjects with heterogenous glaucomas. The hypotensive effects appeared in 60 to 90 minutes as the decrease in intraocular pressure (IOP) appeared to follow the decrease in blood pressure. In addition to any local effect, the mechanism of lowered to any local effect, the mechanism of lowered IOP may also involve the decreased pressure perfusing the ciliary body vasculature as a result of the peripheral vasodilatory properties of marihuana. Postural hypotension, tachycardia, palpitations, and alterations in mental status occurred with such frequency as to mitigate against the routine used in the general glaucoma population. Our data indicate that further research should be directed to local means of delivering the ocular hypotensive cannabinoid to the glaucomatous eye.

  18. Ultrastructural evaluation of explanted opacified Hydroview (H60M) intraocular lenses

    PubMed Central

    Cartwright, Nathaniel E Knox; Mayer, Eric J; McDonald, Brendan M; Skinner, Andrew; Salter, Chris J; Tole, Derek M; Sparrow, John M; Dick, Andrew D; Group, The Bristol IOL Study; Ferguson, David J P

    2007-01-01

    Aim To describe the ultrastructural appearance of explanted opacified Hydroview H60M intraocular lenses. Methods 14 explanted lenses were examined by scanning electron microscopy, and their appearance compared with a non‐implanted H60M lens from the same time period. Wavelength‐dispersive x ray spectroscopy (WDX) was performed on two opacified lenses. Results Subsurface deposits were seen in all explanted opacified lenses. These deposits broke only onto the surface of more densely opacified lenses. WDX confirmed that the deposits contained both calcium and phosphorous, consistent with their being calcium apatite. Conclusion These findings challenge the widely accepted opinion that H60M intraocular lens opacification begins on the surface of the optic. PMID:16987894

  19. History and development of the apodized diffractive intraocular lens.

    PubMed

    Davison, James A; Simpson, Michael J

    2006-05-01

    The ReSTOR intraocular lens presents a unique apodized diffractive design within a refractive foldable acrylic optic, which makes an unprecedented level of mulifocal optical performance available. We describe the history and principles of diffractive optics used in the development of this refractive-diffractive IOL.

  20. Robot-assisted intraocular surgery: development of the IRISS and feasibility studies in an animal model

    PubMed Central

    Rahimy, E; Wilson, J; Tsao, T-C; Schwartz, S; Hubschman, J-P

    2013-01-01

    Purpose The aim of this study is to develop a novel robotic surgical platform, the IRISS (Intraocular Robotic Interventional and Surgical System), capable of performing both anterior and posterior segment intraocular surgery, and assess its performance in terms of range of motion, speed of motion, accuracy, and overall capacities. Patients and methods To test the feasibility of performing ‘bimanual' intraocular surgical tasks using the IRISS, we defined four steps out of typical anterior (phacoemulsification) and posterior (pars plana vitrectomy (PPV)) segment surgery. Selected phacoemulsification steps included construction of a continuous curvilinear capsulorhexis and cortex removal in infusion–aspiration (I/A) mode. Vitrectomy steps consisted of performing a core PPV, followed by aspiration of the posterior hyaloid with the vitreous cutter to induce a posterior vitreous detachment (PVD) assisted with triamcinolone, and simulation of the microcannulation of a temporal retinal vein. For each evaluation, the duration and the successful completion of the task with or without complications or involuntary events was assessed. Results Intraocular procedures were successfully performed on 16 porcine eyes. Four eyes underwent creation of a round, curvilinear anterior capsulorhexis without radialization. Four eyes had I/A of lens cortical material completed without posterior capsular tear. Four eyes completed 23-gauge PPV followed by successful PVD induction without any complications. Finally, simulation of microcannulation of a temporal retinal vein was successfully achieved in four eyes without any retinal tears/perforations noted. Conclusion Robotic-assisted intraocular surgery with the IRISS may be technically feasible in humans. Further studies are pending to improve this particular surgical platform. PMID:23722720

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

    PubMed

    Alió, Jorge L; Plaza-Puche, Ana B; Javaloy, Jaime; Ayala, María José; Vega-Estrada, Alfredo

    2013-04-01

    To compare the visual and intraocular optical quality outcomes with different designs of the refractive rotationally asymmetric multifocal intraocular lens (MFIOL) (Lentis Mplus; Oculentis GmbH, Berlin, Germany) with or without capsular tension ring (CTR) implantation. One hundred thirty-five consecutive eyes of 78 patients with cataract (ages 36 to 82 years) were divided into three groups: 43 eyes implanted with the C-Loop haptic design without CTR (C-Loop haptic only group); 47 eyes implanted with the C-Loop haptic design with CTR (C-Loop haptic with CTR group); and 45 eyes implanted with the plate-haptic design (plate-haptic group). Visual acuity, contrast sensitivity, defocus curve, and ocular and intraocular optical quality were evaluated at 3 months postoperatively. Significant differences in the postoperative sphere were found (P = .01), with a more myopic postoperative refraction for the C-Loop haptic only group. No significant differences were detected in photopic and scotopic contrast sensitivity among groups (P ⩾ .05). Significantly better visual acuities were present in the C-Loop haptic with CTR group for the defocus levels of -2.0, -1.5, -1.0, and -0.50 D (P ⩽.03). Statistically significant differences among groups were found in total intraocular root mean square (RMS), high-order intraocular RMS, and intraocular coma-like RMS aberrations (P ⩽.04), with lower values from the plate-haptic group. The plate-haptic design and the C-Loop haptic design with CTR implantation both allow good visual rehabilitation. However, better refractive predictability and intraocular optical quality was obtained with the plate-haptic design without CTR implantation. The plate-haptic design seems to be a better design to support rotational asymmetric MFIOL optics. Copyright 2013, SLACK Incorporated.

  2. Suturing technique for scleral fixation of toric intraocular lens in the traumatic aphakic eye with corneal astigmatism.

    PubMed

    Pan, Qintuo; Yang, Zhengwei; Chen, Xiaomeng; Wei, Wenlong; Ke, Zhisheng; Chen, Ding; Huang, Fang; Cai, Junyong; Zhao, Zhenquan

    2018-04-01

    To describe the clinical outcomes of traumatic aphakic eyes with corneal astigmatism after using a novel technique for toric intraocular lens suture fixation. In total, 12 eyes of 12 patients who underwent a new scleral suture fixation technique of one-piece toric intraocular lens (SN6AT series, Alcon Inc., TX, USA) were included in our retrospective study. Preoperative patient status, postoperative visual acuity and refractive outcomes, postoperative intraocular lens rotation, tilt, decentration, and complications were analyzed. The mean follow-up was 11.6 ± 1.0 months. The mean preoperative best-corrected visual acuity was 0.55 ± 0.32 in the logarithm of minimum angle of resolution equivalent; the postoperative best-corrected visual acuity was 0.45 ± 0.34. The mean preoperative total corneal astigmatism was 2.51 ± 1.67 D. The mean postoperative residual astigmatism was 0.77 ± 0.54 D. The mean intraocular lens rotation was 3.33° ± 1.37° (range, 1°-6°). The mean intraocular lens tilt in horizontal direction was 3.64° ± 1.02° (range, 2.6°-6.3°) and in vertical direction it was 3.19° ± 1.07 ° (range, 1.6°-5.2°). The mean intraocular lens decentration in horizontal direction was 0.14 ± 0.03 mm (range, 0.089-0.192 mm) and in vertical direction it was 0.15 ± 0.02 mm (range, 0.113-0.181 mm). One patient had mild vitreous hemorrhage and two other patients had high postoperative residual sphere and astigmatism, respectively. But no other serious complications were observed. Scleral suture fixation of foldable toric intraocular lens to correct corneal astigmatism can be a safe and effective alternative technique to manage traumatic aphakic eyes that lack adequate capsular support.

  3. Suction-based grasping tool for removal of regular- and irregular-shaped intraocular foreign bodies.

    PubMed

    Erlanger, Michael S; Velez-Montoya, Raul; Mackenzie, Douglas; Olson, Jeffrey L

    2013-01-01

    To describe a suction-based grasping tool for the surgical removal of irregular-shaped and nonferromagnetic intraocular foreign bodies. A surgical tool with suction capabilities, consisting of a stainless steel shaft with a plastic handle and a customizable and interchangeable suction tip, was designed in order to better engage and manipulate irregular-shaped in-traocular foreign bodies of various sizes and physical properties. The maximal suction force and surgical capabilities were assessed in the laboratory and on a cadaveric eye vitrectomy model. The suction force of the water-tight seal between the intraocular foreign body and the suction tip was estimated to be approximately 40 MN. During an open-sky vitrectomy in a porcine model, the device was successful in engaging and firmly securing foreign bodies of different sizes and shapes. The suction-based grasping tool enables removal of irregular-shaped and nonferromagnetic foreign bodies. Copyright 2013, SLACK Incorporated.

  4. 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.

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

    PubMed

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

    2017-11-01

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

  6. Combining primary and piggyback intraocular lenses to treat extreme myopic astigmatism in stable keratoconus following cataract surgery.

    PubMed

    Goh, Yi Wei; Misra, Stuti; Patel, Dipika V; McGhee, Charles N J

    2013-03-01

    The majority of those with keratoconus can maximise visual acuity with spectacle or contact lens correction as they age; however, as subjects enter their sixties, cataracts may supervene and contact lens tolerance diminishes with consequent reduction in visual acuity. Following cataract extraction, the complex refractive error associated with keratoconus may not be readily corrected by an intraocular lens alone. This report highlights the planned implantation of a primary posterior chamber toric intraocular lens with a secondary piggyback, sulcus-based, intraocular lens in advanced but stable keratoconus with extreme myopic astigmatism and cataract. © 2013 The Authors. Clinical and Experimental Optometry © 2013 Optometrists Association Australia.

  7. Socioeconomic and psychological impact of treatment for unilateral intraocular retinoblastoma.

    PubMed

    Soliman, S E; Dimaras, H; Souka, A A; Ashry, M H; Gallie, B L

    2015-06-01

    To identify the socioeconomic and psychosocial impacts of clinical treatment decisions for advanced unilateral intraocular retinoblastoma. Retrospective observational case series. institutional study at Alexandria Main University Hospital. records of 66 unilateral retinoblastoma cases treated from May 2005 to May 2013 were retrospectively reviewed. Sixty cases were eligible (International Intraocular Retinoblastoma Classification [IIRC] group C, D or E). two treatment groups were compared: enucleation vs. salvage treatment. Salvage treatment eyes were further subdivided based on IIRC group. Six socioeconomic parameters (financial burden, financial impact, psychological, social, medical and tumor impacts) were scored. Parameter scores ranged from 0 to 3, for overall score range 0 (no adverse impact) to 18 (severe adverse impact). derived Socioeconomic scores were correlated with treatment and outcomes. The enucleation group (28 eyes) had a median overall Socioeconomic score of 4/18, significantly lower than the salvage treatment group (32 eyes), median score 11/18 (P<0.01). Socioeconomic score varied with IIRC group. Attempted eye salvage failed in 25 children, due to uncontrolled tumor (44%) and socioeconomic impact of cumulative therapies (56%). Treatment duration and Socioeconomic score were higher for the 5 children in the salvage treatment group who developed metastatic disease compared to those without metastasis (P<0.01). The socioeconomic and psychosocial impacts of attempted ocular salvage for unilateral intraocular retinoblastoma are severe, in comparison to primary enucleation. Primary enucleation is a good treatment for unilateral retinoblastoma. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  8. The Advanced Glaucoma Intervention Study (AGIS): 7. The relationship between control of intraocular pressure and visual field deterioration.The AGIS Investigators.

    PubMed

    2000-10-01

    To investigate the association between control of intraocular pressure after surgical intervention for glaucoma and visual field deterioration. In the Advanced Glaucoma Intervention Study, eyes were randomly assigned to one of two sequences of glaucoma surgery, one beginning with argon laser trabeculoplasty and the other trabeculectomy. In the present article we examine the relationship between intraocular pressure and progression of visual field damage over 6 or more years of follow-up. In the first analysis, designated Predictive Analysis, we categorize 738 eyes into three groups based on intraocular pressure determinations over the first three 6-month follow-up visits. In the second analysis, designated Associative Analysis, we categorize 586 eyes into four groups based on the percent of 6-month visits over the first 6 follow-up years in which eyes presented with intraocular pressure less than 18 mm Hg. The outcome measure in both analyses is change from baseline in follow-up visual field defect score (range, 0 to 20 units). In the Predictive Analysis, eyes with early average intraocular pressure greater than 17.5 mm Hg had an estimated worsening during subsequent follow-up that was 1 unit of visual field defect score greater than eyes with average intraocular pressure less than 14 mm Hg (P =.002). This amount of worsening was greater at 7 years (1.89 units; P <.001) than at 2 years (0.64 units; P =.071). In the Associative Analysis, eyes with 100% of visits with intraocular pressure less than 18 mm Hg over 6 years had mean changes from baseline in visual field defect score close to zero during follow-up, whereas eyes with less than 50% of visits with intraocular pressure less than 18 mm Hg had an estimated worsening over follow-up of 0.63 units of visual field defect score (P =.083). This amount of worsening was greater at 7 years (1.93 units; P <.001) than at 2 years (0.25 units; P =.572). In both analyses low intraocular pressure is associated with reduced

  9. Intraocular scattering compensation in retinal imaging

    PubMed Central

    Christaras, Dimitrios; Ginis, Harilaos; Pennos, Alexandros; Artal, Pablo

    2016-01-01

    Intraocular scattering affects fundus imaging in a similar way that affects vision; it causes a decrease in contrast which depends on both the intrinsic scattering of the eye but also on the dynamic range of the image. Consequently, in cases where the absolute intensity in the fundus image is important, scattering can lead to a wrong estimation. In this paper, a setup capable of acquiring fundus images and estimating objectively intraocular scattering was built, and the acquired images were then used for scattering compensation in fundus imaging. The method consists of two parts: first, reconstruct the individual’s wide-angle Point Spread Function (PSF) at a specific wavelength to be used within an enhancement algorithm on an acquired fundus image to compensate for scattering. As a proof of concept, a single pass measurement with a scatter filter was carried out first and the complete algorithm of the PSF reconstruction and the scattering compensation was applied. The advantage of the single pass test is that one can compare the reconstructed image with the original one and see the validity, thus testing the efficiency of the method. Following the test, the algorithm was applied in actual fundus images in human eyes and the effect on the contrast of the image before and after the compensation was compared. The comparison showed that depending on the wavelength, contrast can be reduced by 8.6% under certain conditions. PMID:27867710

  10. Neodymium:YAG laser cutting of intraocular lens haptics.

    PubMed

    Gorn, R A; Steinert, R F

    1985-11-01

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

  11. Risk for eye splash injury during administration of intraocular injections: a study of retina specialists and fellows.

    PubMed

    Bourla, Dan H; Wirthlin, Robert S; Bourla, Nirit; Gupta, Anurag; Stanescu-Segall, Dinu; Schwartz, Steven D; Axer-Siegel, Ruth

    2007-06-01

    To evaluate the use of eye protection and frequency of eye splash events during intraocular injections as well as infection risk awareness among retina specialists and fellows in training. In a prospective survey of practicing retina specialists and retina fellows, frequency of use and type of eye protection employed during intraocular injections, frequency of eye splash occurrences, description of the eye splash event, number of procedures performed, and awareness of transconjunctival infection risk were investigated. Sixty-four ophthalmologists responded to the questionnaire: 40 retina fellows and 24 retina specialists. The response rate was 100%. Twenty-five percent of the fellows and 33.3% of the specialists reported using eye protection, including corrective glasses, during all intraocular injections. Two of the retina fellows and none of the specialists used special forms of eye protection. Retina fellows had a mean +/- SD of 2.1 +/- 1.3 years experience and the specialists had a mean +/- SD of 10.4 +/- 6.7 years experience in performing intraocular injections. The mean number of injections +/- SD performed by the fellows and specialists was 23 +/- 14.6 and 35 +/- 11.9 per month, respectively. Twelve conjunctival or corneal splash occurrences were reported by six fellows and two retina specialists. Eleven splash events occurred due to reflux of fluid during administration of subconjunctival anesthetic injection, and one event occurred during an anterior chamber tap. Splash events were significantly more likely to occur during procedures performed by fellows, with a relative risk of 8.4 for unprotected procedures (P< 0.001, Fisher exact test). Most (87.5%) of the participants were aware of the risk for transconjunctival viral infection. Special eye protection is seldom used during administration of intraocular injections. Although the risk for eye splash during administration of subconjunctival anesthetic before intraocular injections is relatively small

  12. Intraocular 6-hydroxydopamine prevents the persistent estrus induced by continuous light.

    PubMed

    Shimizu, K; Hokano, M

    1985-01-15

    Following the intraocular injection of 6-hydroxydopamine, which can destroy the retinal dopaminergic neurons, female rats showed a normal estrous cycle in LD 12:12 but not a persistent estrus in continuous light.

  13. Extended depth of focus intraocular lens: Chromatic performance

    PubMed Central

    Millán, Maria S.; Vega, Fidel

    2017-01-01

    We describe a first-and-second-diffractive-order intraocular lens ((1st,2nd)DIOL) within the class of hybrid refractive-diffractive designs for intraocular lenses (IOLs) and analyse its properties of focus extension and compensation of longitudinal chromatic aberration (LCA), particularly for lenses with low addition. Power, energy efficiency and their wavelength dependence are extended from monofocal IOL and conventional bifocal zeroth-and-first-diffractive-order IOL ((0th,1st)DIOL) to (1st,2nd)DIOL of low addition. Compensation of LCA is experimentally assessed in optical bench through the through-focus energy efficiency of three Tecnis IOLs with red, green and blue illuminations: ZA9003 (monofocal), ZKB00 (bifocal (0th,1st)DIOL with + 2.75 D add) and Symfony ZXR00. We prove Tecnis Symfony ZXR00 IOL can be considered an example of (1st,2nd)DIOL design of low addition, with LCA compensation in both the distance and intermediate foci, whereas the bifocal (0th,1st)DIOL does not compensate in the distance focus. However, the energy efficiency of (1st,2nd)DIOL for wavelengths other than the design wavelength is markedly more asymmetric. PMID:28966865

  14. Postoperative inflammatory reactions to intraocular lense sterilized with ethylene-oxide.

    PubMed

    Stark, W J; Rosenblum, P; Maumenee, A E; Cowan, C L

    1980-05-01

    Postoperative inflammatory complications after intraocular lens implantation have increased since we have been using lenses manufactured by American companies and sterilized with ethylene-oxide, as compared with lenses from European companies sterilized by sodium hydroxide. The possible sources of this complication are discussed.

  15. Intraocular pressure-lowering effect of oral paracetamol and its in vitro corneal penetration properties

    PubMed Central

    Mohamed, Nabiel; Meyer, David

    2013-01-01

    Background Several studies have confirmed the ability of cannabinoids to reduce intraocular pressure. Experimental data recently demonstrated unequivocally that the analgesic effect of paracetamol is due to its indirect action on cannabinoid receptors. The question then arises as to whether paracetamol can reduce intraocular pressure via its effect on intraocular cannabinoid receptors. Methods A 2-week, prospective, randomized, controlled, single-center, parallel-group pilot study was carried out to determine the efficacy and safety of paracetamol 1 g orally administered every 6 hours in adult patients with primary or secondary open angle glaucoma as compared with topical levobunolol 0.5% twice a day. Patient well-being was closely monitored throughout the study and focused on hepatic safety in accordance with Drug-Induced Liver Injury Network criteria. The in vitro diffusion kinetics of acetaminophen in a phosphate-buffered solution in rabbit and human corneas was also investigated, with the view to a topical application. Results Eighteen adult patients were enrolled in the study, with nine in the topical levobunolol group and nine in the oral paracetamol group. In the levobunolol group, the mean reduction in intraocular pressure at day 7 was 7.5 mmHg (P < 0.008) and at day 14 was 9.1 mmHg (P < 0.005), from a mean baseline intraocular pressure of 29.6 mmHg. The corresponding figures for the paracetamol group were 8.8 mmHg (P < 0.0004) at day 7 and 6.5 mmHg (P < 0.004) at day 14, from a mean baseline intraocular pressure of 29.4 mmHg. Both study regimens were well tolerated. No serious treatment-related adverse events were reported in either of the treatment groups. Liver function tests, systolic/diastolic blood pressure, or heart rate remained unchanged in both groups during the 2 weeks of the study. In the laboratory study, paracetamol 1 mg/mL in phosphate-buffered solution (pH 7.4) showed acceptable flux rates. Steady-state levels were achieved within 12 hours

  16. Visual performance after the implantation of a new trifocal intraocular lens

    PubMed Central

    Vryghem, Jérôme C; Heireman, Steven

    2013-01-01

    Purpose To evaluate the subjective and objective visual results after the implantation of a new trifocal diffractive intraocular lens. Methods A new trifocal diffractive intraocular lens was designed combining two superimposed diffractive profiles: one with +1.75 diopters (D) addition for intermediate vision and the other with +3.50 D addition for near vision. Fifty eyes of 25 patients that were operated on by one surgeon are included in this study. The uncorrected and best distance-corrected monocular and binocular, near, intermediate, and distance visual acuities, contrast sensitivity, and defocus curves were measured 6 months postoperatively. In addition to the standard clinical follow-up, a questionnaire evaluating individual satisfaction and quality of life was submitted to the patients. Results The mean age of patients at the time of surgery was 70 ± 10 years. The mean uncorrected and corrected monocular distance visual acuity (VA) were LogMAR 0.06 ± 0.10 and LogMAR 0.00 ± 0.08, respectively. The outcomes for the binocular uncorrected distance visual acuity were almost the same (LogMAR −0.04 ± 0.09). LogMAR −010 ± 0.15 and 0.02 ± 0.06 were measured for the binocular uncorrected intermediate and near VA, respectively. The distance-corrected visual acuity was maintained in mesopic conditions. The contrast sensitivity was similar to that obtained after implantation of a bifocal intraocular lens and did not decrease in mesopic conditions. The binocular defocus curve confirms good VA even in the intermediate distance range, with a moderate decrease of less than LogMAR 0.2 at −1.5 D, with respect to the best distance VA at 0 D defocus. Patient satisfaction was high. No discrepancy between the objective and subjective outcomes was evidenced. Conclusion The introduction of a third focus in diffractive multifocal intraocular lenses improves the intermediate vision with minimal visual discomfort for the patient. PMID:24124348

  17. Intermediate-term and long-term outcome of piggyback drainage: connecting glaucoma drainage device to a device in-situ for improved intraocular pressure control.

    PubMed

    Dervan, Edward; Lee, Edward; Giubilato, Antonio; Khanam, Tina; Maghsoudlou, Panayiotis; Morgan, William H

    2017-11-01

    This study provides results of a treatment option for patients with failed primary glaucoma drainage device. The study aimed to describe and evaluate the long-term intraocular pressure control and complications of a new technique joining a second glaucoma drainage device directly to an existing glaucoma drainage device termed 'piggyback drainage'. This is a retrospective, interventional cohort study. Eighteen eyes of 17 patients who underwent piggyback drainage between 2004 and 2013 inclusive have been studied. All patients had prior glaucoma drainage device with uncontrolled intraocular pressure. The piggyback technique involved suturing a Baerveldt (250 or 350 mm) or Molteno3 glaucoma drainage device to an unused scleral quadrant and connecting the silicone tube to the primary plate bleb. Failure of intraocular pressure control defined as an intraocular pressure greater than 21 mmHg on maximal therapy on two separate occasions or further intervention to control intraocular pressure. The intraocular pressure was controlled in seven eyes (39%) at last follow-up with a mean follow-up time of 74.2 months. The mean preoperative intraocular pressure was 27.1 mmHg (95% confidence interval 23.8-30.3) compared with 18.4 mmHg (95% confidence interval 13.9-22.8) at last follow-up. The mean time to failure was 57.1 months (95% confidence interval 32.2-82), and the mean time to further surgery was 72.3 months (95% confidence interval 49.9-94.7). Lower preoperative intraocular pressure was associated with longer duration of intraocular pressure control (P = 0.048). If the intraocular pressure was controlled over 2 years, it continued to be controlled over the long term. Two eyes (11%) experienced corneal decompensation. Piggyback drainage represents a viable surgical alternative for the treatment of patients with severe glaucoma with failing primary glaucoma drainage device, particularly in those at high risk of corneal decompensation. © 2017 Royal Australian and New Zealand

  18. Human Intraocular Filariasis Caused by Dirofilaria sp. Nematode, Brazil

    PubMed Central

    Diniz, Daniel G.; Dantas-Torres, Filipe; Casiraghi, Maurizio; de Almeida, Izabela N.F.; de Almeida, Luciana N.F.; Nascimento dos Santos, Jeannie; Furtado, Adriano Penha; Sobrinho, Edmundo F. de Almeida; Bain, Odile

    2011-01-01

    A case of human intraocular dirofilariasis is reported from northern Brazil. The nematode was morphologically and phylogenetically related to Dirofilaria immitis but distinct from reference sequences, including those of D. immitis infesting dogs in the same area. A zoonotic Dirofilaria species infesting wild mammals in Brazil and its implications are discussed. PMID:21529396

  19. Branch retinal artery occlusion post-penetrating globe injury with intraocular foreign body.

    PubMed

    Nagpal, Manish; Chaudhary, Pranita; Jain, Ashish

    2018-01-01

    Intraocular foreign body (IOFB) in cases of penetrating eye injury accounts for an important indication of vitreoretinal intervention following ocular trauma. Vascular occlusion as a complication of IOFB is rare. Here we present a case of a 34-year-old male with post-traumatic cataract and an intraocular metallic foreign body (IOFB) lodged in the superficial layers of the retina inferotemporal to the disc, causing an inferotemporal branch retinal artery occlusion. The case was managed by lensectomy with pars plana vitrectomy and IOFB removal followed by a second procedure of secondary IOL implantation. Final best-corrected visual acuity improved to 6/24. This case highlights an unusual sequelae following penetrating ocular trauma.

  20. A new surgical technique using steel suture for trans-scleral fixation of posterior chamber intraocular lenses

    PubMed Central

    Ram, Jagat; Gupta, Nishant; Chaudhary, Manish; Verma, Neelam

    2013-01-01

    Background: A new emerging complication of trans-scleral fixation of posterior chamber (PC) intraocular lens (IOL) with polypropylene suture is high rates of spontaneous dislocation of the IOL due to disintegration or breakage of suture. Materials: We report a new surgical technique of trans-scleral fixation of posterior chamber intraocular lens (SF PCIOL) with steel suture to eliminate the complication of dislocation of IOL fixed with polypropylene suture in one adult and a child. Results: We successfully achieved stable fixation and good centration of IOL after SF PCIOL with steel suture in these patient having inadequate posterior capsular support. Both eyes achieved best corrected visual acuity 20/40 at 18 months follow-up. Conclusions: Steel suture is a viable option for trans-scleral fixation of posterior chamber intraocular lens. PMID:23619504

  1. Development of fibrin-free intraocular lens with photochemical surface modification

    NASA Astrophysics Data System (ADS)

    Sato, Yuji; Tanizawa, Katsuya; Anai, Hiroyuki; Sato, Nobuhiro; Sato, Yuki; Ajiki, Tooru; Parel, Jean-Marie; Murahara, Masataka

    2004-07-01

    Having substituted the hydrophilic and hydrophobic groups alternately on the soft acrylic resin intraocular lens (IOL) surface by using an ArF excimer laser and a Xe2 excimer lamp, we have developed the IOL that is free from fibrin. Acrylic resin or PMMA lens has been used as an intraocular lens for 50 years. However, protein and fat are stuck onto the IOL surface after a long implantation, which opacifies the surface (after-cataract). Thus, we designed the micro domain structures of hydrophilic and hydrophobic groups on the IOL surface for fibrin-free. Firstly, the IOL was irradiated with the Xe2 excimer lamp in the presence of perfluoropolyether in order to make it hydrophobic. By this photochemical reaction, the CF3 functional groups were substituted on the IOL surface. Secondly, the ArF laser was projected on the IOL through the mask pattern in reduced size in the presence of water in order to be hydrophilic. With the photochemical reaction, the OH groups were substituted at the part exposed. The fibrin adsorption test of the modified IOL surface was carried out with FT-IR; which revealed that the fibrin-sticking rate of the treated sample has decreased by 23% compared with that of the non-treated sample. As a result, the fibrin-free IOL has been made by modifying the surface of the IOL to have the micro domain structures of the hydrophilic and hydrophobic groups that are arrayed alternately. In conclusion, the ideal intraocular lens has been demonstrated.

  2. Role of light and the circadian clock in the rhythmic oscillation of intraocular pressure: Studies in VPAC2 receptor and PACAP deficient mice.

    PubMed

    Fahrenkrug, Jan; Georg, Birgitte; Hannibal, Jens; Jørgensen, Henrik Løvendahl

    2018-04-01

    The intraocular pressure of mice displays a daily rhythmicity being highest during the dark period. The present study was performed to elucidate the role of the circadian clock and light in the diurnal and the circadian variations in intraocular pressure in mice, by using animals with disrupted clock function (VPAC2 receptor knockout mice) or impaired light information to the clock (PACAP knockout mice). In wildtype mice, intraocular pressure measured under light/dark conditions showed a statistically significant 24 h sinusoidal rhythm with nadir during the light phase and peak during the dark phase. After transfer of the wildtype mice into constant darkness, the intraocular pressure increased, but the rhythmic changes in intraocular pressure continued with a pattern identical to that obtained during the light/dark cycle. The intraocular pressure in VPAC2 receptor deficient mice during light/dark conditions also showed a sinusoidal pattern with significant changes as a function of a 24 h cycle. However, transfer of the VPAC2 receptor knockout mice into constant darkness completely abolished the rhythmic changes in intraocular pressure. The intraocular pressure in PACAP deficient mice oscillated significantly during both 24 h light and darkness and during constant darkness. During LD conditions, the amplitude of PACAP deficient was significantly lower compared to wildtype mice, resulting in higher daytime and lower nighttime values. In conclusion, by studying the VPAC2 receptor knockout mouse which lacks circadian control and the PACAP knockout mouse which displays impaired light signaling, we provided evidence that the daily intraocular pressure rhythms are primarily generated by the circadian master clock and to a lesser extent by environmental light and darkness. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. The Relationship between Anterior Chamber Depth, Axial Length and Intraocular Lens Power among Candidates for Cataract Surgery.

    PubMed

    Sedaghat, Mohammad Reza; Azimi, Ali; Arasteh, Peyman; Tehranian, Naghmeh; Bamdad, Shahram

    2016-10-01

    Basic anatomical parameters in ophthalmology are variable in different countries according to ethnic groups, genetics and some environmental factors. The aim of this study was to determine the relationship between axial length (AL), anterior chamber depth (ACD) and intraocular lens power (IOL) in a referral center from eastern Iran among patients who had cataract surgery, in comparison to studies from other regions of the world. In a cross-sectional retrospective study from 2011 to 2013, the records of 698 cataract patients referring to Khatam Al Anbia general hospital in Mashhad, Iran were evaluated. We divided patients, based on their AL and ACD, into three separate groups and compared their results. The SPSS software was used for data analysis. The Chi-Square test and the Independent-samples t-test were used to compare qualitative and quantitative data between two groups, respectively. The Kendall and the Pearson product-moment correlation tests were used to assess the relationship between AL and ACD. The linear Regression model was used to obtain a mathematical model to estimate ACD, using AL, age and sex. Among individuals who had normal AL (between 22-24.5mm), there was a positive correlation between AL and ACD (p<0.001, r=0.17), however, among individuals with short (AL<22mm) or long sightedness (AL>24.5mm), no significant correlation was detected. We also found that older people have shorter AL (p=0.001 and r=-0.287). Men have an average longer AL (23.7±2.4mm vs. 22.9±2.1mm; p<0.001) and deeper ACD compared to women (2.93±0.45mm vs. 2.82±0.42mm, p=0.002). Our findings were mostly similar to previous literature from other regions of the world and although some anatomical variations may exist regarding ophthalmic anatomy, factors like race and geographical area have little effect on the relationship between ACD, AL and IOL power calculation, furthermore our results support the use of third and fourth generation formulas for IOL power calculation.

  4. 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

  5. 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

  6. 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.

  7. Optimizing outcomes with multifocal intraocular lenses

    PubMed Central

    Sachdev, Gitansha Shreyas; Sachdev, Mahipal

    2017-01-01

    Modern day cataract surgery is evolving from a visual restorative to a refractive procedure. The advent of multifocal intraocular lenses (MFIOLs) allows greater spectacle independence and increased quality of life postoperatively. Since the inception in 1980s, MFIOLs have undergone various technical advancements including trifocal and extended depth of vision implants more recently. A thorough preoperative workup including the patients’ visual needs and inherent ocular anatomy allows us to achieve superior outcomes. This review offers a comprehensive overview of the various types of MFIOLs and principles of optimizing outcomes through a comprehensive preoperative screening and management of postoperative complications. PMID:29208809

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

    PubMed

    Schmidinger, G; Pemp, B; Werner, L

    2013-11-01

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

  9. Outcomes of 23- and 25-gauge transconjunctival sutureless vitrectomies for dislocated intraocular lenses.

    PubMed

    Bajgai, Priya; Tigari, Basavraj; Singh, Ramandeep

    2017-10-04

    To compare the outcome of 23-gauge as compared with 25-gauge transconjunctival sutureless vitrectomy (TSV) in the management of dislocated intraocular lenses (IOLs). Retrospective, non-consecutive, comparative, interventional case series. Patients with dislocated intraocular lens who underwent sutureless PPV using either 23-gauge or 25-gauge instruments. The patients who presented with a dislocated IOL, underwent TSV with repositioning of the intraocular lens, either in the sulcus or scleral-fixated sutured/glued. Of the total 61 eyes, 33 (54.09%) underwent 23-gauge TSV and 28 (45.90%) underwent 25-gauge TSV. The mean logMAR BCVA at baseline and 6 months after surgery was 0.8 and 0.46 in the 23-gauge group, and 0.82 and 0.47 in the 25-gauge group. There was no significant difference in logMAR BCVA values between the two groups at any time point of time during the follow-up. The mean postoperative IOP on postoperative day 1 was 14.76 ± 5.4 in 23-gauge group and 17.57 ± 7.9 in the 25-gauge group (p = 0.10). Retinal break was noticed intraoperatively in two cases in 23-gauge group and in three cases in 25-gauge group (p = 0.509). Postoperative complications included IOL decentration in one case of 23-gauge vitrectomy and two cases in 25-gauge group (p = 0.5), cystoid macular edema in four patients in 23-gauge group and six cases of 25-gauge group (p = 0.3) and retinal detachment in one case in each group (p = 0.9). 25-gauge appears to be as safe and as effective as 23-gauge TSV in the management of dislocated intraocular lenses.

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

    PubMed

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

    2016-04-01

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

  11. The Effect of Altitude on Intraocular Pressure in Vitrectomized Eyes with Sulfur Hexafluoride Tamponade by the Friedenwald Method: Rabbit Animal Model

    PubMed Central

    Fromow-Guerra, Jans; Solís-Vivanco, Adriana; Perez-Reguera, Adriana; Quiroz-Mercado, Hugo; Meza-de Regil, Armando; Papa-Oliva, Gabriela; Morales-Cantón, Virgilio

    2016-01-01

    The aim of this study is to assess the change in intraocular pressure after a road trip, in eyes with different levels of filling with gas tamponade. Five rabbit eyes were subject to pars plana vitrectomy and gas tamponade (filling percentage: 25%, 50%, and 100% of nonexpansile SF6, 100% saline solution, and 100% room air). A sixth eye was injected with 0.35 cc of undiluted SF6 without vitrectomy. Guided by global positioning system, they were driven to the highest point of the highway connecting Mexico City with Puebla city and back, stopping every 300 m to assess intraocular pressure. The rabbit's scleral rigidity and estimation for human eyes were done by using the Friedenwald nomogram. Maximum altitude was 3209 m (Δ949 m). There were significant differences in intraocular pressure on the rabbit eyes filled with SF6 at 100%, 50%, 25%, and 100% room air. Per every 100 m of altitude rise, the intraocular pressure increased by 1.53, 1.0046, 0.971, and 0.97 mmHg, respectively. Using the human Friedenwald rigidity coefficient, the human eye estimate for intraocular pressure change was 2.1, 1.8, 1.4, and 1.1 mmHg per every 100 m of attitude rise. Altitude changes have a significant impact on intraocular pressure. The final effect depends on the percentage of vitreous cavity fill and scleral rigidity. PMID:27957500

  12. The Effect of Altitude on Intraocular Pressure in Vitrectomized Eyes with Sulfur Hexafluoride Tamponade by the Friedenwald Method: Rabbit Animal Model.

    PubMed

    Fromow-Guerra, Jans; Solís-Vivanco, Adriana; Velez-Montoya, Raul; Perez-Reguera, Adriana; Quiroz-Mercado, Hugo; Meza-de Regil, Armando; Papa-Oliva, Gabriela; Morales-Cantón, Virgilio

    2016-01-01

    The aim of this study is to assess the change in intraocular pressure after a road trip, in eyes with different levels of filling with gas tamponade. Five rabbit eyes were subject to pars plana vitrectomy and gas tamponade (filling percentage: 25%, 50%, and 100% of nonexpansile SF 6 , 100% saline solution, and 100% room air). A sixth eye was injected with 0.35 cc of undiluted SF 6 without vitrectomy. Guided by global positioning system, they were driven to the highest point of the highway connecting Mexico City with Puebla city and back, stopping every 300 m to assess intraocular pressure. The rabbit's scleral rigidity and estimation for human eyes were done by using the Friedenwald nomogram. Maximum altitude was 3209 m (Δ949 m). There were significant differences in intraocular pressure on the rabbit eyes filled with SF 6 at 100%, 50%, 25%, and 100% room air. Per every 100 m of altitude rise, the intraocular pressure increased by 1.53, 1.0046, 0.971, and 0.97 mmHg, respectively. Using the human Friedenwald rigidity coefficient, the human eye estimate for intraocular pressure change was 2.1, 1.8, 1.4, and 1.1 mmHg per every 100 m of attitude rise. Altitude changes have a significant impact on intraocular pressure. The final effect depends on the percentage of vitreous cavity fill and scleral rigidity.

  13. Review and update of intraocular therapy in noninfectious uveitis.

    PubMed

    Sallam, Ahmed; Taylor, Simon R J; Lightman, Sue

    2011-11-01

    To review new clinically relevant data regarding the intraocular treatment of noninfectious uveitis. Triamcinolone acetonide, the most commonly used intravitreal corticosteroid for treatment of uveitis and uveitic macular oedema has a limited duration of action and is associated with a high risk of corticosteroid-induced intraocular pressure (IOP) rise and cataract. Recent advances have led to the development of sustained-release corticosteroid devices using different corticosteroids such as dexamethasone and fluocinolone acetonide. Treatment options for patients who have previously exhibited corticosteroid hypertensive response have also expanded through the use of new noncorticosteroid intravitreal therapeutics such as methotrexate and antivascular endothelial growth factor (anti-VEGF) agents. Ozurdex dexamethasone implant appears to have a better safety profile, and a slightly long-lasting effect than triamcinolone acetonide. The Retisert implant allows the release of corticosteroids at a constant rate for 2.5 years, but it requires surgical placement and its use is associated with a very high risk of cataract and requirement for IOP-lowering surgery. For patients who are steroid responders, methotrexate may offer a better alternative to corticosteroid treatment than anti-VEGF agents, but controlled trials are required to confirm this.

  14. SURGICAL OUTCOME OF SIMULTANEOUS INTRAOCULAR LENS RESCUE AND SUTURELESS INTRASCLERAL TUNNEL FIXATION OF DISLOCATED INTRAOCULAR LENSES.

    PubMed

    Kim, Min; Lee, Dong H; Koh, Hyoung J; Lee, Sung C; Kim, Sung S

    2015-07-01

    To report short-term surgical outcomes of single-stage simultaneous rescue and sutureless intrascleral fixation of dislocated intraocular lens (IOLs). Sixteen eyes of 16 patients who underwent simultaneous rescue and intrascleral fixation of dislocated 3-piece IOLs were retrospectively evaluated. Partial thickness limbal-based scleral flaps (2.0 × 2.0 mm) were created, and a 22-gauge round needle was used to create a sclerotomy at 1.5 mm from the limbus under the previously created scleral flap, and a 23-gauge trans pars plana vitrectomy was performed. Bimanual maneuvers using two 23-gauge end-grasping forceps under chandelier illumination and a wide-angle viewing system enabled 1 step rescue of IOLs from the posterior vitreous cavity with 1 hand and simultaneous haptic externalization through sclerotomy with the other hand. An externalized haptic was placed into the 3-mm intrascleral tunnel created using a bent 26-gauge needle. Fibrin glue was used to fixate haptics and close the scleral flaps. Intraocular lenses were successfully rescued and sclera-fixated through intrascleral tunnels in all 16 eyes (mean age, 56.56 ± 19.89 years). The mean preoperative logarithm of the minimum angle of resolution best-corrected visual acuity was 0.92 ± 0.68, and this significantly improved at 6 months to 0.289 ± 0.36 (P = 0.003). During the follow-up period (10.1 ± 3.21 months), no significant change of endothelial cell count or central foveal thickness was noted postoperatively (P = 0.203 and P = 0.979, respectively). There were no significant postoperative complications such as IOL dislocation, IOL decentration, retinal detachment, endophthalmitis, or postoperative hypotony. Simultaneous rescue and sutureless intrascleral haptic fixation of dislocated 3-piece IOLs using bimanual maneuvers is an effective, safe, and minimally invasive surgical method to rescue and fixate the dislocated IOL without further explant.

  15. Towards a Completely Implantable, Light-Sensitive Intraocular Retinal Prosthesis

    DTIC Science & Technology

    2001-10-25

    electronic retinal prosthesis is under development to treat retinitis pigmentosa and age-related macular degeneration, two presently incurable...34Preservation of the inner retina in retinitis pigmentosa . A morphometric analysis," Arch Ophthalmol, vol. 115, no. 4, pp. 511-515, Apr.1997...Towards a completely implantable, light-sensitive intraocular retinal prosthesis. M.S. Humayun, J.D. Weiland, B. Justus1, C. Merrit1, J. Whalen, D

  16. Intraocular Lens Use in an Astronaut During Long Duration Spaceflight.

    PubMed

    Mader, Thomas H; Gibson, C Robert; Schmid, Josef F; Lipsky, William; Sargsyan, Ashot E; Garcia, Kathleen; Williams, Jeffrey N

    2018-01-01

    The purpose of this paper is to report the first use of an intraocular lens (IOL) in an astronaut during long duration spaceflight (LDSF). An astronaut developed a unilateral cataract and underwent phacoemulsification with insertion of an acrylic IOL. Approximately 15 mo later he flew on a Soyuz spacecraft to the International Space Station (ISS), where he successfully completed a 6-mo mission. Ocular examination, including ultrasound (US), was performed before, during, and after his mission and he was questioned regarding visual changes during each portion of his flight. We documented no change in IOL position during his space mission. This astronaut reported excellent and stable vision during liftoff, entry into microgravity (MG), 6 mo on the ISS, descent, and landing. Our results suggest that modern IOLs are stable, effective, and well tolerated during LDSF.Mader TH, Gibson CR, Schmid JF, Lipsky W, Sargsyan AE, Garcia K, Williams JN. Intraocular lens use in an astronaut during long duration spaceflight. Aerosp Med Hum Perform. 2018; 89(1):63-65.

  17. Diagnosis of intraocular lymphosarcoma in a dog by use of a polymerase chain reaction assay for antigen receptor rearrangement.

    PubMed

    Pate, Diana O; Gilger, Brian C; Suter, Steven E; Clode, Alison B

    2011-03-01

    A 12-year-old castrated male mixed-breed dog was evaluated because of blepharospasm and blindness affecting both eyes. During examination and diagnostic testing of the dog, fine-needle aspirates of splenic nodules were examined microscopically and stage Vb multicentric large-cell lymphosarcoma was identified. Aqueocentesis was performed, and sample analysis revealed intraocular lymphosarcoma; B-cell neoplasia was confirmed by use of a PCR assay for antigen receptor rearrangement (PARR) performed on samples of aqueous humor. Secondary uveitis and glaucoma were detected bilaterally in addition to chronic superficial corneal ulcerations in the left eye. Treatment for abdominal and intraocular lymphosarcoma involving administration of vincristine, l-asparaginase, cyclophosphamide, doxorubicin, and prednisone was initiated. Secondary uveitis and glaucoma were controlled with topical treatment; however, the corneal ulceration did not resolve. Seven weeks following diagnosis, the dog died as a result of complications related to systemic neoplasia and chemotherapy. In the dog of this report, intraocular lymphosarcoma was diagnosed via PARR performed on samples of aqueous humor. Moreover, the immunophenotype of the neoplastic cells was determined by use of that diagnostic technique. Because secondary uveitis is a common finding in dogs and cats with systemic lymphosarcoma, intraocular lymphosarcoma should be considered as a differential diagnosis; furthermore, investigation (eg, PARR performed on aqueous humor samples) to identify the presence of intraocular lymphosarcoma is warranted, thereby allowing targeted interventions to be considered in management of those patients.

  18. Evidence for a GPR18 Role in Diurnal Regulation of Intraocular Pressure

    PubMed Central

    Miller, Sally; Leishman, Emma; Oehler, Olivia; Daily, Laura; Murataeva, Natalia; Wager-Miller, Jim; Bradshaw, Heather; Straiker, Alex

    2016-01-01

    Purpose The diurnal cycling of intraocular pressure (IOP) was first described in humans more than a century ago. This cycling is preserved in other species. The physiologic underpinning of this diurnal variation in IOP remains a mystery, even though elevated pressure is indicated in most forms of glaucoma, a common cause of blindness. Once identified, the system that underlies diurnal variation would represent a natural target for therapeutic intervention. Methods Using normotensive mice, we measured the regulation of ocular lipid species by the enzymes fatty acid amide hydrolase (FAAH) and N-arachidonoyl phosphatidylethanolamine phospholipase (NAPE-PLD), mRNA expression of these enzymes, and their functional role in diurnal regulation of IOP. Results We now report that NAPE-PLD and FAAH mice do not exhibit a diurnal cycling of IOP. These enzymes produce and break down acylethanolamines, including the endogenous cannabinoid anandamide. The diurnal lipid profile in mice shows that levels of most N-acyl ethanolamines and, intriguingly, N-arachidonoyl glycine (NAGly), decline at night: NAGly is a metabolite of arachidonoyl ethanolamine and a potent agonist at GPR18 that lowers intraocular pressure. The GPR18 blocker O1918 raises IOP during the day when pressure is low, but not at night. Quantitative PCR analysis shows that FAAH mRNA levels rise with pressure, suggesting that FAAH mediates the changes in pressure. Conclusions Our results support FAAH-dependent NAGly action at GPR18 as the physiologic basis of the diurnal variation of intraocular pressure in mice. PMID:27893106

  19. Eye growth in the second decade of life: implications for the implantation of a multifocal intraocular lens.

    PubMed

    Wilson, M Edward; Trivedi, Rupal H; Burger, Berdine M

    2009-12-01

    There is a growing interest in multifocal intraocular lens (IOL) implantation in children because they lose accommodation when a cataract is removed. Many have assumed that very little, if any, eye growth occurs in the second decade of life. Multifocal IOL implantation requires precise biometry to arrive at the correct IOL power for spectacle independence. If the eye grows and the refraction becomes myopic, spectacle dependence may return. Therefore, knowing when the eye has completed its growth is critical to the decision of when to implant a multifocal IOL. Ninety-eight eyes were analyzed retrospectively. Each had at least two axial length (AL) measurements using immersion A-scan ultrasound in the second decade of life. Globe AL was 23.36 +/- 1.52 mm at initial measurement and 23.89 +/- 1.64 mm at last measurement. Measurement data show variable growth throughout the second decade of life. Based on our data, a theoretical patient was constructed with an AL at age 10 of 23.11 mm, who would need an IOL power of 21.5 for emmetropia. That same patient would have an AL of 23.76 mm (IOL power of 19.5) at age 15 and 24.41 mm (IOL power of 17.5) at age 20. That is a 4-diopter change in the IOL power need. Axial eye growth continues throughout the second decade of life, at least to age 20. These data have important implications for the use of multifocal IOLs in the preteen and teenage years.

  20. Pharmacokinetics and efficacy of intraocular flurbiprofen.

    PubMed

    Blazaki, S; Tsika, C; Tzatzarakis, M; Naoumidi, E; Tsatsakis, A; Tsatsanis, C; Tsilimbaris, Miltiadis K

    2017-12-01

    Intravitreal delivery of non-steroidal anti-inflammatory drugs could be an effective way to treat macular edema caused by posterior segment inflammation. In this study, we evaluated the intravitreal bioavailability and anti-inflammatory efficacy of flurbiprofen in rabbit eyes. For pharmacokinetics, 0.1 ml of 7.66 mg/ml flurbiprofen solution was injected intravitreally and vitreous drug levels were analyzed at specific time points using LC-MS technique. For efficacy, 100 ng lipopolysaccharide of E.coli was injected intravitreally in rabbits to induce inflammation. The animals were separated in three groups and received intraocular flurbiprofen, dexamethasone and PBS to serve as control. Complete ocular examination and total cell count in aqueous fluid were determined to evaluate the extent of inflammation. Eyes were then enucleated for histopathology analysis. The efficacy in the uveitis model was determined by clinical signs of inflammation, total leukocyte count and histology findings. No adverse events were observed during pharmacokinetic assessment. No signs of inflammation, hemorrhage or retina detachment were detected. The recovery of flurbiprofen from vitreous samples was 92.6%. The half-life of flurbiprofen was estimated to be 1.92 h with an elimination constant rate (K) of 0.36. Treatment with intraocular injections of flurbiprofen and dexamethasone significantly reduced total leukocyte count in a manner comparable to dexamethasone [reduction of 96.84% (p < 0.05) and 97.44% (p < 0.05), respectively]. Histologic studies demonstrated significantly less signs of ocular inflammation after flurbiprofen injection compared to control eyes. Flurbiprofen is effective in suppressing inflammation in this experimental uveitis model. In our experimental setting, intravitreal flurbiprofen seem to have a therapeutic result comparable to dexamethasone. However, the half-life of the drug remains short, necessitating further research to prolong its presence in the

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

    PubMed

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

    2005-11-10

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

  2. Rotationally asymmetric multifocal IOL implantation with and without capsular tension ring: refractive and visual outcomes and intraocular optical performance.

    PubMed

    Alió, Jorge L; Plaza-Puche, Ana B; Piñero, David P

    2012-04-01

    To ascertain whether the refractive, visual, and intraocular optical quality outcomes of a rotationally asymmetric multifocal intraocular lens (IOL) are enhanced by the use of a capsular tension ring. Ninety consecutive eyes from 53 patients (age range: 36 to 82 years) were divided into two groups: the no ring group comprised 43 eyes implanted with the multifocal rotationally asymmetric Lentis Mplus LS-312 (Oculentis GmbH) without a capsular tension ring; and the ring group comprised 47 eyes with the same IOL with a capsular tension ring. Distance and near visual acuity and refractive outcomes were evaluated pre- and postoperatively. Contrast sensitivity, intraocular aberrations, and defocus curve were evaluated postoperatively. Significant postoperative differences between groups were found in sphere, spherical equivalent refraction, and near addition (P<.02). Regarding defocus curve, significantly better visual acuity was present in eyes with the capsular tension ring for intermediate vision conditions (P<.05). Intraocular aberrometry did not differ significantly between groups (P<.09). Refractive predictability and intermediate visual outcomes with the Lentis Mplus LS-312 IOL improved significantly when implanted in combination with a capsular tension ring. Copyright 2012, SLACK Incorporated.

  3. [Spectral transmission in blue filter intraocular lenses].

    PubMed

    Schrage, N

    2012-02-01

    There is uncertainty in ophthalmology concerning the quality and spectral transmission of light of so-called blue filter intraocular lenses (IOL). Clinical users have noticed that such IOL's appear to have different color intensities. The discussion on medical changes by means of such IOL's is dependent on the real light transmission of these IOL's. To add some objective data we compared these IOL's by systematic transmission measurements and observed technical differences of diffraction and geometry as well as transmission differences. The result gives objective indications that differences between blue filter IOL's from different manufacturers are important and are detailed in this paper.

  4. Intraocular pressure, ultrasonographic and echobiometric findings of juvenile Yacare caiman (Caiman yacare) eye.

    PubMed

    Ruiz, Thaís; Campos, Wilma N S; Peres, Thalita P S; Gonçalves, Gentil F; Ferraz, Rosa H S; Néspoli, Pedro E B; Sousa, Valéria R F; Ribeiro, Alexandre P

    2015-01-01

    The aim was to determine the intraocular pressure (IOP), the ultrasonographic and echobiometric findings in the eyes of juvenile Yacare caiman (Caiman yacare). Twenty-two healthy caimans from a breeding farm in Brazilian Pantanal. Intraocular pressure was measured under physical restraint and topical anesthesia by applanation tonometry. Five individual measurements of each eye were recorded by the same examiner. B-mode ultrasonography was performed with a 10-MHz linear transducer, and the anterior chamber depth, lens thickness, vitreous depth, and axial globe length were measured. Unpaired and paired t-tests were used to assess data. Pearson's test was used to assess correlations between IOP and ocular structures (P < 0.05). Mean ± SD IOP of the 44 eyes studied was 9.56 ± 2.69 mmHg, (range 5.4-15.6 mmHg). IOP did not differ significantly between right and left eyes or between genders (P > 0.05). Echobiometric measurements did not differ significantly between eyes and genders (P > 0.05). Intraocular structures measured in male and female subjects were, respectively, 2.61 ± 0.13 and 2.55 ± 0.18 mm for anterior chamber depth, 7.60 ± 0.17 and 7.54 ± 0.20 mm for lens thickness, 6.83 ± 0.20 and 6.90 ± 0.22 mm for vitreous chamber depth, and 17.55 ± 0.25 and 17.54 ± 0.29 mm for axial globe length. Correlations were not observed (P > 0.05). Reference values of tonometry and distances of intraocular structures of Yacare caiman were described. IOP did not correlate with echobiometric measurements in this crocodilian. The ultrasonographic appearance was similar to other domestic and wild species. © 2014 American College of Veterinary Ophthalmologists.

  5. Corneal biomechanical parameters and intraocular pressure: the effect of topical anesthesia

    PubMed Central

    Ogbuehi, Kelechi C

    2012-01-01

    Background The intraocular pressures and biomechanical parameters measured by the ocular response analyzer make the analyzer a useful tool for the diagnosis and management of anterior segment disease. This observational study was designed to investigate the effect of topical anesthesia on the parameters measured by the ocular response analyzer: corneal hysteresis, corneal resistance factor, Goldmann-correlated intraocular pressure (IOPg), and corneal-compensated intraocular pressure (IOPcc). Methods Two sets of measurements were made for 78 eyes of 39 subjects, approximately 1 week apart. In session 1, each eye of each subject was randomized into one of three groups: polyvinyl alcohol (0.5%), tetracaine hydrochloride (0.5%), or oxybuprocaine hydrochloride (0.4%). In session 2, eyes that were in the polyvinyl alcohol group in session 1 were assigned to the tetracaine group, those in the tetracaine group in session 1 were assigned to oxybuprocaine group, and those in the oxybuprocaine group in session 1 were assigned to the polyvinyl alcohol group. For both sessions, each subject first had his or her central corneal thickness assessed with a specular microscope, followed by measurements of intraocular pressure and corneal biomechanical parameters with the Ocular Response Analyzer. All measurements were repeated for 2 minutes and 5 minutes following the instillation of either polyvinyl alcohol, tetracaine, or oxybuprocaine. The level of statistical significance was 0.05. Results Polyvinyl alcohol, tetracaine hydrochloride, and oxybuprocaine hydrochloride had no statistically significant (P > 0.05) effect on any of the biomechanical parameters of the cornea. There was no statistically significant effect on either IOPg (P > 0.05) or IOPcc (P > 0.05) 2 minutes after the eye drops were instilled in either session. Five minutes after the eye drops were instilled, polyvinyl alcohol showed no statistically significant effect on either IOPg (P > 0.05) or IOPcc (P > 0.05) in

  6. Corneal biomechanical parameters and intraocular pressure: the effect of topical anesthesia.

    PubMed

    Ogbuehi, Kelechi C

    2012-01-01

    The intraocular pressures and biomechanical parameters measured by the ocular response analyzer make the analyzer a useful tool for the diagnosis and management of anterior segment disease. This observational study was designed to investigate the effect of topical anesthesia on the parameters measured by the ocular response analyzer: corneal hysteresis, corneal resistance factor, Goldmann-correlated intraocular pressure (IOPg), and corneal-compensated intraocular pressure (IOPcc). Two sets of measurements were made for 78 eyes of 39 subjects, approximately 1 week apart. In session 1, each eye of each subject was randomized into one of three groups: polyvinyl alcohol (0.5%), tetracaine hydrochloride (0.5%), or oxybuprocaine hydrochloride (0.4%). In session 2, eyes that were in the polyvinyl alcohol group in session 1 were assigned to the tetracaine group, those in the tetracaine group in session 1 were assigned to oxybuprocaine group, and those in the oxybuprocaine group in session 1 were assigned to the polyvinyl alcohol group. For both sessions, each subject first had his or her central corneal thickness assessed with a specular microscope, followed by measurements of intraocular pressure and corneal biomechanical parameters with the Ocular Response Analyzer. All measurements were repeated for 2 minutes and 5 minutes following the instillation of either polyvinyl alcohol, tetracaine, or oxybuprocaine. The level of statistical significance was 0.05. Polyvinyl alcohol, tetracaine hydrochloride, and oxybuprocaine hydrochloride had no statistically significant (P > 0.05) effect on any of the biomechanical parameters of the cornea. There was no statistically significant effect on either IOPg (P > 0.05) or IOPcc (P > 0.05) 2 minutes after the eye drops were instilled in either session. Five minutes after the eye drops were instilled, polyvinyl alcohol showed no statistically significant effect on either IOPg (P > 0.05) or IOPcc (P > 0.05) in either session

  7. Changes in choroidal thickness following trabeculectomy and its correlation with the decline in intraocular pressure.

    PubMed

    Silva, Diana; Lopes, Ana Sofia; Henriques, Susana; Lisboa, Maria; Pinto, Sara; Trancoso Vaz, Fernando; Prieto, Isabel

    2018-04-16

    Evaluate whether there are significant changes in choroidal thickness following trabeculectomy, and how they relate do the decline in intraocular pressure. This was a prospective evaluation of 28 eyes who underwent Moorfields modified trabeculectomy. The choroidal thickness was measured via OCT with enhanced depth imaging, before surgery and 1 day, 1 week and 1 month after surgery. Measurements were taken at the fovea, 1000 µm temporal to the fovea and 1000 µm nasal to the fovea. The relationship between choroidal thickness and intraocular pressure was statistically evaluated. The mean intraocular pressure before surgery was 25.07 ± 4.64 mmHg; 8.57 ± 3.62 mmHg after 1 day; 10.36 ± 4.39 mmHg after 1 week and 13.71 ± 5.13 mmHg after 1 month. Mean choroidal thickness increased after trabeculectomy with maximal values at 1 week. The largest increase was found at the fovea, with an average before surgery of 253.54 ± 62.01 µm; 286.75 ± 64.20 µm at 1 day, 286.36 ± 63.14 µm at 1 week and 271.00 ± 60.31 µm at 1 month. Increase in choroidal thickness was significant 1 day and 1 week after surgery in the foveal (p = 0.012, p = 0.007) and temporal (p = 0.040, p = 0.000) locations and 1 week postoperatively on the nasal location (p = 0.016). None of them were significant at 1 month after surgery. Preoperative IOP and choroidal thickness were correlated at all macular locations (ρ = 0.449-0.525, p = 0.004-0.016) yet no correlation was found between increase in choroidal thickness and decline in intraocular pressure in the postoperative period. Choroidal thickness appears to increase temporarily after trabeculectomy and these changes were not correlated with the decline in intraocular pressure. Further research is required to fully understand this phenomenon.

  8. Validation of the ocular trauma score for intraocular foreign bodies in deadly weapon-related open-globe injuries.

    PubMed

    Unal, Melih H; Aydin, Ali; Sonmez, Murat; Ayata, Ali; Ersanli, Dilaver

    2008-01-01

    To evaluate the prognostic value of the Ocular Trauma Score (OTS) in cases of deadly weapon-related open-globe injuries with intraocular foreign bodies. A retrospective, interventional case series included 20 eyes of 20 patients who had deadly weapon-related open-globe injuries with intraocular foreign bodies. The OTS was calculated for each patient by adding the determined numbers of OTS variables at presentation (initial visual acuity, rupture, endophthalmitis, perforating injury, retinal detachment, and afferent pupillary defect). Patients were categorized based on their score (category 1 through 5). Final visual acuities in the OTS categories were calculated and compared to those in OTS study group. No statistically significant difference was found between the categorical distributions of the study patients and those in the OTS study group. No patient in the study was in category 5. The OTS, which was designed to predict visual outcomes of general ocular trauma, may also provide reliable information about the prognosis of deadly weapon-related open-globe injuries with intraocular foreign bodies.

  9. Cataract, phacoemulsification and intraocular pressure: Is the anterior segment anatomy the missing piece of the puzzle?

    PubMed

    Masis Solano, Marisse; Lin, Shan C

    2018-01-29

    Cataract extraction is a safe and effective surgery that has a lowering effect on the intraocular pressure. The specific mechanisms for this effect are still unclear. A direct inflammatory effect on the trabecular meshwork, alteration of the blood aqueous barrier, changes in the ciliary body and mechanical changes of the anterior segment anatomy are the key to understand cataract surgery and it's effects on aqueous humor dynamics. Additionally, with the advent of AS OCT, changes in the anterior segment of the eye have been studied and several parameters (such as lens vault, angle opening distance and anterior chamber depth) have been identified as predictors of intraocular pressure change. In eyes with narrow angles there is a greater drop in intraocular pressure after cataract surgery and it is correlated with parameters related to anterior chamber space. It is safe to affirm that cataract surgery is an important part of the modern glaucoma treatment and evidence should be analyzed as part of a bigger picture in order to more accurately understand its clinical relevance. Copyright © 2018. Published by Elsevier Ltd.

  10. Lessons learned: wrong intraocular lens.

    PubMed

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

    2012-10-01

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

  11. Effects on Periocular Tissues after Proton Beam Radiation Therapy for Intraocular Tumors

    PubMed Central

    2018-01-01

    Background To present our experience on orbital and periorbital tissue changes after proton beam radiation therapy (PBRT) in patients with intraocular tumors, apart from treatment outcomes and disease control. Methods Medical records of 6 patients with intraocular tumors who had been treated with PBRT and referred to oculoplasty clinics of two medical centers (Seoul National University Hospital and Seoul Metropolitan Government-Seoul National University Boramae Medical Center) from October 2007 to September 2014 were retrospectively reviewed. The types of adverse effects associated with PBRT, their management, and progression were analyzed. In anophthalmic patients who eventually underwent enucleation after PBRT due to disease progression, orbital volume (OV) was assessed from magnetic resonance (MR) images using the Pinnacle3 program. Results Among the six patients with PBRT history, three had uveal melanoma, and three children had retinoblastoma. Two eyes were treated with PBRT only, while the other four eyes ultimately underwent enucleation. Two eyes with PBRT only suffered from radiation dermatitis and intractable epiphora due to canaliculitis or punctal obstruction. All four anophthalmic patients showed severe enophthalmic features with periorbital hollowness. OV analysis showed that the difference between both orbits was less than 0.1 cm before enucleation, but increased to more than 2 cm3 after enucleation. Conclusion PBRT for intraocular tumors can induce various orbital and periorbital tissue changes. More specifically, when enucleation is performed after PBRT due to disease progression, significant enophthalmos and OV decrease can develop and can cause poor facial cosmesis as treatment sequelae. PMID:29651818

  12. From Reading Stones, Glasses and Contact Lenses to Intraocular Lenses & Ophthalmic Lasers--A Short Overview over the History of Visual Aids.

    PubMed

    Scholtz, Sibylle K; Auffarth, Gerd U

    2012-01-01

    Alhazen, ibn al-Haytham, (965 Basra - c. 1040 in Cairo) was a Muslim polymath who made significant contributions to the principles of optics, being the first to recognize the optical effect by transparent objects in the 11th century. His insights led to a fundamental revolution, enabling older presbyopic persons to read again. Today many more options are available to help visually impaired people correct their sight defects. This article will give an historical overview of the sight aids which are available today and will describe the very first beginnings of the development of the "reading stone" or "glasses". Further, it will also give a chronological overview of more modern techniques, e.g., intraocular lenses, contact lenses and the options of refractive surgery.

  13. Comparison of 20% sulfur hexafluoride with air for intraocular tamponade in Descemet membrane endothelial keratoplasty (DMEK).

    PubMed

    Botsford, Benjamin; Vedana, Gustavo; Cope, Leslie; Yiu, Samuel C; Jun, Albert S

    2016-01-01

    To compare the effect of 20% sulfur hexafluoride (SF6) with that of air on graft detachment rates for intraocular tamponade in Descemet membrane endothelial keratoplasty (DMEK). Forty-two eyes of patients who underwent DMEK by a single surgeon (A.S.J.) at Wilmer Eye Institute between January 2012 and 2014 were identified; 21 received air for intraocular tamponade and the next consecutive 21 received SF6. The main outcome measure was the graft detachment rate; univariate and multivariate analyses were performed. The graft detachment rate was 67% in the air group and 19% in the SF6 group (p<0.05). No complete graft detachments occurred, and all partial detachments underwent intervention with injection of intraocular air. The percentages of eyes with 20/25 or better vision were not different between the groups (67% vs. 71%). Univariate analysis showed significantly higher detachment rates with air tamponade (OR, 8.50; p<0.005) and larger donor graft size (OR, 14.96; p<0.05). Multivariate analysis with gas but not graft size included showed that gas was an independent statistically significant predictor of outcome (OR, 6.65; p<0.05). When graft size was included as a covariate, gas was no longer a statistically significant predictor of detachment but maintained OR of 7.81 (p=0.063) similar to the results of univariate and multivariate analyses without graft size. In comparison with air, graft detachment rates for intraocular tamponade in DMEK were significantly reduced by 20% SF6.

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

    PubMed

    Jürgens, Ignasi; Rey, Amanda

    2015-01-01

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

  15. LONG-TERM INTRAOCULAR PRESSURE AFTER UNCOMPLICATED PARS PLANA VITRECTOMY FOR IDIOPATHIC EPIRETINAL MEMBRANE.

    PubMed

    Tognetto, Daniele; Pastore, Marco R; Cirigliano, Gabriella; DʼAloisio, Rossella; Borelli, Massimo; De Giacinto, Chiara

    2017-11-16

    To investigate long-term intraocular pressure trends after uncomplicated pars plana vitrectomy for idiopathic epiretinal membrane. Three hundred and sixty-eight eyes of 368 consecutive patients were enrolled. Changes in intraocular pressure 1, 3, 6, and 12 months after surgery and during the final follow-up visit were evaluated in vitrectomized eyes and nonvitrectomized fellow eyes. The median follow-up period was 36 months (range 12-92 months). Longitudinal data analysis evidenced a 2.5-mmHg (2.2 mmHg; 2.7 mmHg, 95% confidence interval) statistically significant difference in intraocular pressure 30 days after surgery between treated and fellow untreated eyes, gradually recovering to a not significant 0.2-mmHg (-0.1 mmHg; 0.4 mmHg, 95% confidence interval) difference within 26 months. The incidence of late-onset ocular hypertension was 5.7% (21 over 347, 2%; 12%, 95% confidence interval) without difference between the treated eyes and the group control. No significant difference in the incidence of late-onset ocular hypertension and sex, lens status, or gauge of vitrectomy instruments was detected. Only patient's age was significantly higher (mean difference 4.2 years; 0.1-8.0 years, Monte Carlo, 95% confidence interval) in those who developed late-onset ocular hypertension in the vitrectomized eye. Uncomplicated pars plana vitrectomy for idiopathic epiretinal membrane seems not to increase the risk of late-onset ocular hypertension or open-angle glaucoma development.

  16. 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.

  17. Intraocular pressure measurements after conductive keratoplasty.

    PubMed

    Kymionis, George D; Naoumidi, Tatiana L; Aslanides, Ioannis M; Kumar, Vinod; Astyrakakis, Nikolaos I; Tsilimbaris, Miltiadis; Pallikaris, Ioannis G

    2005-01-01

    To determine the possible impact of conductive keratoplasty (CK) on intraocular pressure (IOP) measurements. A prospective, single-center, noncomparative interventional case series was performed. Baseline and postoperative IOPs were measured by Goldmann applanation tonometry in 32 eyes of 18 patients who underwent CK for hyperopia correction. Mean follow-up was 11.9 months (range: 8 to 18 months). After CK, a statistically significant decrease in the measured IOP was observed (before CK: 14.22+/-1.64 vs after CK: 12.66+/-2.21, P<.001). The change in IOP readings postoperatively was not correlated with age, sex, keratometric readings, or attempted correction. Despite the limitations due to the small number of patients enrolled in this study, the applanation tonometer appears to underestimate the true IOP after CK.

  18. Assessment of intraocular measurements in neonatal foals and association with gender, laterality, and body weight: a clinical study.

    PubMed

    Valentini, Simona; Castagnetti, Carolina; Musella, Vincenzo; Spinella, Giuseppe

    2014-01-01

    Objective of this study was to describe intraocular measurements in newly born foals (1-7 days of age) and assess the association between globe measurements and gender, laterality, and body weight. B-scan ultrasonographic biometry was performed on both eyes of 22 healthy foals (44 eyes) ages 1-7 days using a 10-MHz transducer. Intraocular measurements (anterior chamber depth, central lens thickness, vitreous chamber depth, axial globe length, longitudinal globe length, lens poles distance) were carried out using the ultrasound internal calipers. The influence of gender (male or female), laterality (right or left eye), and body weight ("light" <48 kg; "heavy" ≥48 kg) on ocular measurements was analysed by the Student t test. Values of P<0.05 were accepted as significant for all analyses. Mean anterior chamber depth was 2.2±0.5 mm (Standard Deviation); central lens thickness was 9.9±0.8 mm; vitreous chamber depth was 15.5±1.1 mm; axial globe length was 27.6±1.6 mm; longitudinal globe length was 35.8±1.2 mm, and lens poles distance was 16.4±1.0 mm. Intraocular measurements were not influenced by gender, laterality nor body weight. This study provides reference values for intraocular measurements in neonatal foals and may be useful in the diagnosis and treatment of congenital and acquired pathologies involving the globe.

  19. Peripapillary Schisis in Glaucoma Patients With Narrow Angles and Increased Intraocular Pressure

    PubMed Central

    Kahook, Malik Y.; Noecker, Robert J.; Ishikawa, Hiroshi; Wollstein, Gadi; Kagemann, Larry; Wojtkowski, Maciej; Duker, Jay S.; Srinivasan, Vivek J.; Fujimoto, James G.; Schuman, Joel S.

    2007-01-01

    PURPOSE To describe two cases of peripapillary retinal schisis in patients with glaucoma without evidence of optic nerve pits, pseudopits, or X-linked retinoschisis. DESIGN Two observational case reports and literature review. METHODS Imaging of the peripapillary nerve fiber layer and schisis cavities was completed in two patients, and one patient was followed over time. RESULTS The first patient, diagnosed with narrow angle glaucoma, was noted to have peripapillary schisis in the right eye with matching changes on visual field and optical coherence tomographic (OCT) results. Follow-up examination revealed that the schisis disappeared in the right eye while appearing in the left. The findings were verified with high-speed ultra-high-resolution OCT performed in both eyes. The second case involved a patient with anatomically narrow angles, high intraocular pressure (IOP), and peripapillary schisis extending into the macula. CONCLUSIONS Peripapillary retinoschisis may represent a unique sequelae of intraocular fluctuations in patients with uncontrolled glaucoma. Further studies are needed to better understand this disease process. PMID:17386284

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

    PubMed

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

    2016-02-01

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

  1. The influence of intraocular pressure and air jet pressure on corneal contactless tonometry tests.

    PubMed

    Simonini, Irene; Pandolfi, Anna

    2016-05-01

    The air puff is a dynamic contactless tonometer test used in ophthalmology clinical practice to assess the biomechanical properties of the human cornea and the intraocular pressure due to the filling fluids of the eye. The test is controversial, since the dynamic response of the cornea is governed by the interaction of several factors which cannot be discerned within a single measurement. In this study we describe a numerical model of the air puff tests, and perform a parametric analysis on the major action parameters (jet pressure and intraocular pressure) to assess their relevance on the mechanical response of a patient-specific cornea. The particular cornea considered here has been treated with laser reprofiling to correct myopia, and the parametric study has been conducted on both the preoperative and postoperative geometries. The material properties of the cornea have been obtained by means of an identification procedure that compares the static biomechanical response of preoperative and postoperative corneas under the physiological IOP. The parametric study on the intraocular pressure suggests that the displacement of the cornea׳s apex can be a reliable indicator for tonometry, and the one on the air jet pressure predicts the outcomes of two or more distinct measurements on the same cornea, which can be used in inverse procedures to estimate the material properties of the tissue. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Asymptomatic snowflake degeneration in a polymethyl methacrylate (PMMA) intraocular lens implant.

    PubMed

    Tan, Lee T; Shuttleworth, Garry N

    2008-01-01

    Snowflake degeneration is a late complication of polymethyl methacrylate (PMMA) intraocular lens implants. We report a case of asymptomatic advanced snowflake opacification presenting 13 years after implantation who maintained a visual acuity of 6/6. This report serves to illustrate the variability of the clinical effects of snowflake degeneration, which do not necessarily correlate with slit-lamp appearances.

  3. Bilateral cataract extraction with posterior chamber intraocular lens implantation simultaneous in pediatric cataracts.

    PubMed

    Caça, Ihsan; Sakalar, Yildirim Bayezit; Ari, Seyhmus; Alakus, Fuat; Dogan, Eyüp

    2008-01-01

    We evaluated the results of simultaneous bilateral cataract extraction with intraocular lens (IOL) inplantation 32 pediatric cataract patients. Simultaneous cataract extraction and posterior capsulotomy with anterior vitrectomy and IOL implantation is an effective and safe procedure in bilateral pediatric cataracts treatment.

  4. Glue-assisted intrascleral fixation of posterior chamber intraocular lens

    PubMed Central

    Narang, Priya; Narang, Samir

    2013-01-01

    Purpose: To analyze the visual outcome of patients undergoing glue-assisted intrascleral fixation of posterior chamber intraocular lens (IOL) in the absence of posterior capsular support. Materials and Methods: This retrospective study analyzes 25 eyes which underwent IOL implantation by the glued intrascleral fixation technique. The pre and post-operative uncorrected visual acuity (UCVA), pre and post-operative best corrected visual acuity (BCVA), intraocular pressure (IOP), IOL position, anterior chamber reaction and central macular thickness were assessed and recorded. Immediate and late post-operative complications were also recorded. Results: A total of 25 eyes of 22 patients were reviewed and analyzed over a period of one year. All eyes had a foldable three-piece IOL implanted. About 84% of the eyes had a gain of one or more lines, 12% had no gain, and 4% had a fall of three lines of BCVA on Snellen's visual chart, which was attributed to cystoid macular edema (CME). Postoperatively, there was a significant improvement in the UCVA (P < 0.05) and in the BCVA (P < 0.05). Postoperative complications included decentration in one case and vitritis with chronic macular edema in another case. Optical coherence tomography (OCT) demonstrated well placed IOL with no tilt. Conclusion: Although the results of one year follow-up of glued intrascleral fixation are promising, long term studies are recommended. PMID:23685487

  5. Time course of optical quality and intraocular scattering after refractive lenticule extraction.

    PubMed

    Kamiya, Kazutaka; Shimizu, Kimiya; Igarashi, Akihito; Kobashi, Hidenaga

    2013-01-01

    To assess the time course of optical quality and intraocular scattering in relation to visual acuity after femtosecond lenticule extraction (FLEx) for the correction of myopia. This study evaluated 36 eyes of 36 patients with spherical equivalents of -4.38±1.53 D [mean ± standard deviation] who underwent FLEx. Before surgery, and 1 week and 1, 3 and 6 months after surgery, we assessed the modulation transfer function (MTF) cutoff frequency, Strehl ratio, objective scattering index (OSI), and OQAS values (OVs), using a double-pass instrument. We also investigated the relationship of the OSI with corrected distance visual acuity (CDVA) preoperatively and postoperatively. The mean changes in MTF cutoff frequency, Strehl ratio, OSI, OV100%, OV20%, and OV9% preoperatively and 6 months postoperatively were -5.51 ± 15.01, -0.03 ± 0.07, 0.35 ± 0.83, -0.17 ± 0.48, -0.14 ± 0.38, and -0.09 ± 0.22, respectively. We found no significant preoperative correlation between the OSI and logMAR CDVA (Spearman rank correlation coefficient r = 0.068, p = 0.69), and modest, but significant correlations 1 week and 1, 3, and 6 months postoperatively (r = 0.572, r = 0.562, r = 0.542, r = 0.540, p<0.001, respectively). FLEx induced a transient decrease in optical quality in association with an increase in intraocular scattering in the early postoperative period, possibly due to mild interface haze formation, but gradually recovered with time. It is suggested that this transient degradation in optical quality related to an increase in the intraocular scattering may result in a slight delay of CDVA recovery in the early postoperative period.

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

    PubMed Central

    Lin, Siying; Gupta, Bhaskar; Rossiter, Jonathan

    2016-01-01

    Minimally invasive glaucoma surgery is a developing area that has the potential to replace traditional glaucoma surgery, with its known risk profile, but at present there are no randomised controlled data to validate its use. We report on a case where sequential bilateral combined ab interno trabeculotomy and lens extraction surgery was performed on a 45-year-old woman with combined uveitic and chronic narrow angle raised intraocular pressure. Maximal medical management alone could not control the intraocular pressure. At 12-month follow-up, the patient had achieved stable intraocular pressure in both eyes on a combination of topical ocular antiglaucomatous and steroid therapies. This case demonstrates the effectiveness of trabecular meshwork ablation via ab interno trabeculotomy in a case of complex mixed mechanism glaucoma. PMID:26833953

  7. STS-44 crewmembers conduct DSO 472, Intraocular Pressure, on OV-104's middeck

    NASA Image and Video Library

    1991-12-01

    STS044-04-001 (24 Nov-1 Dec 1991) --- Astronauts F. Story Musgrave (right) and Mario Runco, Jr., mission specialists, team up for one of the biomedical Detailed Supplementary Objective (DSO) test on the eight-day flight, this one involving intraocular pressure.

  8. Genome-wide association study of intraocular pressure identifies the GLCCI1/ICA1 region as a glaucoma susceptibility locus

    PubMed Central

    Strange, Amy; Bellenguez, Céline; Sim, Xueling; Luben, Robert; Hysi, Pirro G.; Ramdas, Wishal D.; van Koolwijk, Leonieke M.E.; Freeman, Colin; Pirinen, Matti; Su, Zhan; Band, Gavin; Pearson, Richard; Vukcevic, Damjan; Langford, Cordelia; Deloukas, Panos; Hunt, Sarah; Gray, Emma; Dronov, Serge; Potter, Simon C.; Tashakkori-Ghanbaria, Avazeh; Edkins, Sarah; Bumpstead, Suzannah J.; Blackwell, Jenefer M.; Bramon, Elvira; Brown, Matthew A.; Casas, Juan P.; Corvin, Aiden; Duncanson, Audrey; Jankowski, Janusz A.Z.; Markus, Hugh S.; Mathew, Christopher G.; Palmer, Colin N.A.; Plomin, Robert; Rautanen, Anna; Sawcer, Stephen J.; Trembath, Richard C.; Wood, Nicholas W.; Barroso, Ines; Peltonen, Leena; Healey, Paul; McGuffin, Peter; Topouzis, Fotis; Klaver, Caroline C.W.; van Duijn, Cornelia M.; Mackey, David A.; Young, Terri L.; Hammond, Christopher J.; Khaw, Kay-Tee; Wareham, Nick; Wang, Jie Jin; Wong, Tien Y.; Foster, Paul J.; Mitchell, Paul; Spencer, Chris C.A.; Donnelly, Peter; Viswanathan, Ananth C.

    2013-01-01

    To discover quantitative trait loci for intraocular pressure, a major risk factor for glaucoma and the only modifiable one, we performed a genome-wide association study on a discovery cohort of 2175 individuals from Sydney, Australia. We found a novel association between intraocular pressure and a common variant at 7p21 near to GLCCI1 and ICA1. The findings in this region were confirmed through two UK replication cohorts totalling 4866 individuals (rs59072263, Pcombined = 1.10 × 10−8). A copy of the G allele at this SNP is associated with an increase in mean IOP of 0.45 mmHg (95%CI = 0.30–0.61 mmHg). These results lend support to the implication of vesicle trafficking and glucocorticoid inducibility pathways in the determination of intraocular pressure and in the pathogenesis of primary open-angle glaucoma. PMID:23836780

  9. 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

  10. Assessment of Intraocular Measurements in Neonatal Foals and Association with Gender, Laterality, and Body Weight: A Clinical Study

    PubMed Central

    Valentini, Simona; Castagnetti, Carolina; Musella, Vincenzo; Spinella, Giuseppe

    2014-01-01

    Objective of this study was to describe intraocular measurements in newly born foals (1–7 days of age) and assess the association between globe measurements and gender, laterality, and body weight. B-scan ultrasonographic biometry was performed on both eyes of 22 healthy foals (44 eyes) ages 1–7 days using a 10-MHz transducer. Intraocular measurements (anterior chamber depth, central lens thickness, vitreous chamber depth, axial globe length, longitudinal globe length, lens poles distance) were carried out using the ultrasound internal calipers. The influence of gender (male or female), laterality (right or left eye), and body weight (“light” <48 kg; “heavy” ≥48 kg) on ocular measurements was analysed by the Student t test. Values of P<0.05 were accepted as significant for all analyses. Mean anterior chamber depth was 2.2±0.5 mm (Standard Deviation); central lens thickness was 9.9±0.8 mm; vitreous chamber depth was 15.5±1.1 mm; axial globe length was 27.6±1.6 mm; longitudinal globe length was 35.8±1.2 mm, and lens poles distance was 16.4±1.0 mm. Intraocular measurements were not influenced by gender, laterality nor body weight. This study provides reference values for intraocular measurements in neonatal foals and may be useful in the diagnosis and treatment of congenital and acquired pathologies involving the globe. PMID:25296286

  11. [To exercise caution in developing intraocular lens exchange].

    PubMed

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

    2018-05-11

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

  12. Severe South American Ocular Toxoplasmosis Is Associated with Decreased Ifn-γ/Il-17a and Increased Il-6/Il-13 Intraocular Levels

    PubMed Central

    de-la-Torre, Alejandra; Sauer, Arnaud; Pfaff, Alexander W.; Bourcier, Tristan; Brunet, Julie; Speeg-Schatz, Claude; Ballonzoli, Laurent; Villard, Odile; Ajzenberg, Daniel; Sundar, Natarajan; Grigg, Michael E.

    2013-01-01

    In a cross sectional study, 19 French and 23 Colombian cases of confirmed active ocular toxoplasmosis (OT) were evaluated. The objective was to compare clinical, parasitological and immunological responses and relate them to the infecting strains. A complete ocular examination was performed in each patient. The infecting strain was characterized by genotyping when intraocular Toxoplasma DNA was detectable, as well as by peptide-specific serotyping for each patient. To characterize the immune response, we assessed Toxoplasma protein recognition patterns by intraocular antibodies and the intraocular profile of cytokines, chemokines and growth factors. Significant differences were found for size of active lesions, unilateral macular involvement, unilateral visual impairment, vitreous inflammation, synechiae, and vasculitis, with higher values observed throughout for Colombian patients. Multilocus PCR-DNA sequence genotyping was only successful in three Colombian patients revealing one type I and two atypical strains. The Colombian OT patients possessed heterogeneous atypical serotypes whereas the French were uniformly reactive to type II strain peptides. The protein patterns recognized by intraocular antibodies and the cytokine patterns were strikingly different between the two populations. Intraocular IFN-γ and IL-17 expression was lower, while higher levels of IL-13 and IL-6 were detected in aqueous humor of Colombian patients. Our results are consistent with the hypothesis that South American strains may cause more severe OT due to an inhibition of the protective effect of IFN-γ. PMID:24278490

  13. Optic nerve head blood flow response to reduced ocular perfusion pressure by alteration of either the blood pressure or intraocular pressure.

    PubMed

    Wang, Lin; Cull, Grant A; Fortune, Brad

    2015-04-01

    To test the hypothesis that blood flow autoregulation in the optic nerve head has less reserve to maintain normal blood flow in the face of blood pressure-induced ocular perfusion pressure decrease than a similar magnitude intraocular pressure-induced ocular perfusion pressure decrease. Twelve normal non-human primates were anesthetized by continuous intravenous infusion of pentobarbital. Optic nerve blood flow was monitored by laser speckle flowgraphy. In the first group of animals (n = 6), the experimental eye intraocular pressure was maintained at 10 mmHg using a saline reservoir connected to the anterior chamber. The blood pressure was gradually reduced by a slow injection of pentobarbital. In the second group (n = 6), the intraocular pressure was slowly increased from 10 mmHg to 50 mmHg by raising the reservoir. In both experimental groups, optic nerve head blood flow was measured continuously. The blood pressure and intraocular pressure were simultaneously recorded in all experiments. The optic nerve head blood flow showed significant difference between the two groups (p = 0.021, repeat measures analysis of variance). It declined significantly more in the blood pressure group compared to the intraocular pressure group when the ocular perfusion pressure was reduced to 35 mmHg (p < 0.045) and below. There was also a significant interaction between blood flow changes and the ocular perfusion pressure treatment (p = 0.004, adjusted Greenhouse & Geisser univariate test), indicating the gradually enlarged blood flow difference between the two groups was due to the ocular perfusion pressure decrease. The results show that optic nerve head blood flow is more susceptible to an ocular perfusion pressure decrease induced by lowering the blood pressure compared with that induced by increasing the intraocular pressure. This blood flow autoregulation capacity vulnerability to low blood pressure may provide experimental evidence related to the

  14. Evaluation of a new soft tipped injector for the implantation of foldable intraocular lenses.

    PubMed

    Kleinmann, Guy; Apple, David J

    2007-08-01

    To evaluate the R-INJ-04 soft-tipped injector, a new injector with an integral round nozzle manufactured by Rayner Intraocular Lenses, England. 16 Rayner C-flex intraocular lenses (IOLs; Rayner Intraocular lenses, England) ranging between +10 and +30 D (2 for each power) were tested. An ophthalmic viscoelastic device (Healon, AMO, Santa Ana, California, USA) was applied to the injectors. The IOLs were loaded according to the company injector's instructions for use and were injected into a Petri dish. After the injection, all the IOLs and nozzles were evaluated by gross (macroscopic) and microscopic analyses and photographed under a light microscope. One lens of each power and the cartridge used for the implantation were then sent for further analysis by scanning electron microscopy (SEM). The rest of the IOLs were tested for power and modulation transfer function (MTF). All the injections were successful. No damage to the IOLs or to the injectors was found by gross examination, light microscopy and SEM. No deposits were found on the IOL optical surfaces or haptics. Power and MTF analysis showed a close match with the original measurements. Our results suggest that the R-INJ-04 soft-tipped injector is safe for the implantation of the C-flex IOL with power range from 10 to 30 D. No structural damage to the IOLs or to the injectors was found, and the lens power and light transmission properties were not damaged in any way by the injection process.

  15. Intraocular straylight and contrast sensitivity after contralateral wavefront-guided LASIK and wavefront-guided PRK for myopia.

    PubMed

    Barreto, Jackson; Barboni, Mirella T S; Feitosa-Santana, Claudia; Sato, João R; Bechara, Samir J; Ventura, Dora F; Alves, Milton Ruiz

    2010-08-01

    To compare intraocular straylight measurements and contrast sensitivity after wavefront-guided LASIK (WFG LASIK) in one eye and wavefront-guided photorefractive keratectomy (WFG PRK) in the fellow eye for myopia and myopic astigmatism correction. A prospective, randomized study of 22 eyes of 11 patients who underwent simultaneous WFG LASIK and WFG PRK (contralateral eye). Both groups were treated with the NIDEK Advanced Vision Excimer Laser System, and a microkeratome was used for flap creation in the WFG LASIK group. High and low contrast visual acuity, wavefront analysis, contrast sensitivity, and retinal straylight measurements were performed preoperatively and at 3, 6, and 12 months postoperatively. A third-generation straylight meter, C-Quant (Oculus Optikgeräte GmbH), was used for measuring intraocular straylight. Twelve months postoperatively, mean uncorrected distance visual acuity was -0.06 +/- 0.07 logMAR in the WFG LASIK group and -0.10 +/- 0.10 logMAR in the WFG PRK group. Mean preoperative intraocular straylight was 0.94 +/- 0.12 logs for the WFG LASIK group and 0.96 +/- 0.11 logs for the WFG PRK group. After 12 months, the mean straylight value was 1.01 +/- 0.1 log s for the WFG LASIK group and 0.97 +/- 0.12 log s for the WFG PRK group. No difference was found between techniques after 12 months (P = .306). No significant difference in photopic and mesopic contrast sensitivity between groups was noted. Intraocular straylight showed no statistically significant increase 1 year after WFG LASIK and WFG PRK. Higher order aberrations increased significantly after surgery for both groups. Nevertheless, WFG LASIK and WFG PRK yielded excellent visual acuity and contrast sensitivity performance without significant differences between techniques.

  16. Comparison of clinical outcomes of iris fixation and scleral fixation as treatment for intraocular lens dislocation.

    PubMed

    Kim, Kyeong Hwan; Kim, Wan Soo

    2015-09-01

    To compare the efficacy and safety of iris fixation with scleral fixation in surgical repositioning of dislocated intraocular lenses (IOLs). Retrospective, consecutive, comparative interventional case series. setting: Referral hospital. Seventy-eight consecutive patients who underwent surgical repositioning of dislocated intraocular lenses using suturing to the sclera or iris. Forty-four eyes of 44 patients underwent scleral fixation and 35 eyes of 34 patients underwent iris fixation of dislocated intraocular lenses. Visual acuity, refractive stability, operation time, and perioperative complications, including recurrence of IOL dislocation. Corrected distance visual acuity (CDVA) improved significantly 1 month postoperatively in both groups (P < .01 each), and remained stable for 12 months. One week postoperatively, however, CDVA improved significantly in the scleral fixation (P = .040) but not in the iris fixation (P = .058) group. The amount of refractive error significantly diminished 1 day after surgery (P = .028 in the scleral fixation and P = .046 in the iris fixation group). For the astigmatic components, Jackson crossed cylinders equivalent to conventional cylinders of positive power at axes of 0 degrees (J0) and 45 degrees (J45), J45 differed significantly in the scleral fixation and iris fixation groups (P = .009), whereas J0 was similar (P > .05). Operation time was significantly shorter (P = .0007), while immediate postoperative inflammation was significantly more severe (P = .001), in the iris fixation than in the scleral fixation group. Recurrence rates were similar (P > .05), but the mean time to recurrence was significantly shorter in the iris fixation than in the scleral fixation group (P = .031). Iris fixation and scleral fixation techniques had similar efficacy in the repositioning of dislocated intraocular lenses. Although operation time was shorter for iris fixation, it had several disadvantages, including induced astigmatism

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

    PubMed

    Lin, Siying; Gupta, Bhaskar; Rossiter, Jonathan

    2016-02-01

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

  18. Intraocular methotrexate can induce extended remission in some patients in noninfectious uveitis.

    PubMed

    Taylor, Simon R J; Banker, Alay; Schlaen, Ariel; Couto, Cristobal; Matthe, Egbert; Joshi, Lavnish; Menezo, Victor; Nguyen, Ethan; Tomkins-Netzer, Oren; Bar, Asaf; Morarji, Jiten; McCluskey, Peter; Lightman, Sue

    2013-01-01

    To assess the outcomes of the intravitreal administration of methotrexate in uveitis. Multicenter, retrospective interventional case series of patients with noninfectious uveitis. Thirty-eight eyes of 30 patients were enrolled, including a total of 54 intravitreal injections of methotrexate at a dose of 400 µg in 0.1 mL. The primary outcome measure was visual acuity. Secondary outcome measures included control of intraocular inflammation and cystoid macular edema, time to relapse, development of adverse events, and levels of systemic corticosteroid and immunosuppressive therapy. Methotrexate proved effective in controlling intraocular inflammation and improving vision in 30 of 38 eyes (79%). The side effect profile was good, with no reported serious ocular adverse events and only one patient having an intraocular pressure of >21 mmHg. Of the 30 eyes that responded to treatment, 8 relapsed, but 22 (73%) entered an extended period of remission, with the Kaplan-Meier estimate of median time to relapse for the whole group being 17 months. The eight eyes that relapsed were reinjected and all responded to treatment. One eye relapsed at 3 months, but 7 eyes again entered extended remission. Of the 14 patients on systemic therapy at the start of the study, 8 (57%) were able to significantly reduce this following intravitreal methotrexate injection. In patients with uveitis and uveitic cystoid macular edema, intravitreal MTX can effectively improve visual acuity and reduce cystoid macular edema and, in some patients, allows the reduction of immunosuppressive therapy. Some patients relapse at 3 to 4 months, but a large proportion (73%) enter an extended period of remission of up to 18 months. This larger study extends the results obtained from previous smaller studies suggesting the viability of intravitreal methotrexate as a treatment option in uveitis.

  19. Fractured Anterior Chamber Intraocular Lens (ACIOL) Complicating Nd: YAG Laser for Peripheral Iridotomy.

    PubMed

    Farah, Edgard; Koutsandrea, Chryssanthi; Papaefthimiou, Ioannis; Papaconstantinou, Dimitris; Georgalas, Ilias

    2013-01-01

    Laser peripheral iridotomy is the procedure of choice for the treatment of angle-closure glaucoma caused by relative or absolute pupillary block. Nd: YAG laser iridotomy has been reported to have several complications such as Iris bleeding, hyphema, transient IOP elevation, intraocular inflammation, choroidal, retinal detachment and vitreous hemorrhage. We report a case of a 74 year old lady on anticoagulant treatment who developed pupillary block and angle closure glaucoma after cataract surgery and anterior chamber intraocular lens (ACIOL) insertion complicated with intraoperative bleeding. The patient was treated with Nd: YAG laser iridotomy , however, the ACIOL was inadvertently fractured after a single shot of laser and it had to be replaced. Although the incidence is rare. Ophthalmologists and Opticians should be aware that an ACIOL may be fractured even after a single Nd:YAG laser shot and avoid to perform it close to the ACIOL. Pretreatment counseling should include this rare complication.

  20. The synthetic cannabinoid WIN55212-2 decreases the intraocular pressure in human glaucoma resistant to conventional therapies.

    PubMed

    Porcella, A; Maxia, C; Gessa, G L; Pani, L

    2001-01-01

    The search for new ocular hypotensive agents represents a frontier of current eye research because blindness due to optic neuropathy occurs insidiously in 10% of all patients affected by glaucoma. Cannabinoids have been proposed to lower intraocular pressure by either central or peripheral effects but a specific mechanism for this action has never been elucidated. We recently demonstrated the presence of the central cannabinoid receptor (CB(1)) mRNA and protein in the human ciliary body. In the present study we show that the synthetic CB(1) receptor agonist, WIN 55212--2, applied topically at doses of 25 or 50 microg (n = 8), decreases the intraocular pressure of human glaucoma resistant to conventional therapies within the first 30 min (15 +/- 0.5% and 23 +/- 0.9%, respectively). A maximal reduction of 20 +/- 0.7% and 31 +/- 0.6%, respectively, is reached in the first 60 min. These data confirm that CB(1) receptors have direct involvement in the regulation of human intraocular pressure, and suggest that, among various classes of promising antiglaucoma agents, synthetic CB(1) receptor agonists should deserve further research and clinical development.

  1. Correlation of visual performance with quality of life and intraocular aberrometric profile in patients implanted with rotationally asymmetric multifocal IOLs.

    PubMed

    Ramón, María L; Piñero, David P; Pérez-Cambrodí, Rafael J

    2012-02-01

    To examine the visual performance of a rotationally asymmetric multifocal intraocular lens (IOL) by correlating the defocus curve of the IOL-implanted eye with the intraocular aberrometric profile and impact on the quality of life. A prospective, consecutive, case series study including 26 eyes from 13 patients aged between 50 and 83 years (mean: 65.54±7.59 years) was conducted. All patients underwent bilateral cataract surgery with implantation of a rotationally asymmetric multifocal IOL (Lentis Mplus LS-312 MF30, Oculentis GmbH). Distance and near visual acuity outcomes, intraocular aberrations, defocus curve, and quality of life (assessed using the National Eye Institute Visual Functioning Questionnaire-25) were evaluated postoperatively (mean follow-up: 6.42±2.24 months). A significant improvement in distance visual acuity was found postoperatively (P<.01). Mean postoperative logMAR distance-corrected near visual acuity was 0.19±0.12 (∼20/30). Corrected distance visual acuity and near visual acuity of 20/20 or better were achieved by 30.8% and 7.7% of eyes, respectively. Of all eyes, 96.2% had a postoperative addition between 0 and 1.00 diopter (D). The defocus curve showed two peaks of maximum visual acuity (0 and 3.00 D of defocus), with an acceptable range of intermediate vision. LogMAR visual acuity corresponding to near defocus was directly correlated with some higher order intraocular aberrations (r⩾0.44, P⩽.04). Some difficulties evaluated with the quality of life test correlated directly with near and intermediate visual acuity (r⩾0.50, P⩽.01). The Lentis Mplus multifocal IOL provides good distance, intermediate, and near visual outcomes; however, the induced intraocular aberrometric profile may limit the potential visual benefit. Copyright 2012, SLACK Incorporated.

  2. [Possibility of 3D Printing in Ophthalmology - First Experiences by Stereotactic Radiosurgery Planning Scheme of Intraocular Tumor].

    PubMed

    Furdová, A; Furdová, Ad; Thurzo, A; Šramka, M; Chorvát, M; Králik, G

    Nowadays 3D printing allows us to create physical objects on the basis of digital data. Thanks to its rapid development the use enormously increased in medicine too. Its creations facilitate surgical planning processes, education and research in context of organ transplantation, individualization prostheses, breast forms, and others.Our article describes the wide range of applied 3D printing technology possibilities in ophthalmology. It is focusing on innovative implementation of eye tumors treatment planning in stereotactic radiosurgery irradiation.We analyze our first experience with 3D printing model of the eye in intraocular tumor planning stereotactic radiosurgery. 3D printing, model, Fused Deposition Modelling, stereotactic radiosurgery, prostheses, intraocular tumor.

  3. The effect of increased intra-abdominal pressure on orbital subarachnoid space width and intraocular pressure.

    PubMed

    Liu, Su-Meng; Wang, Ning-Li; Zuo, Zhen-Tao; Chen, Wei-Wei; Yang, Di-Ya; Li, Zhen; Cao, Yi-Wen

    2018-02-01

    In accordance with the trans-lamina cribrosa pressure difference theory, decreasing the trans-lamina cribrosa pressure difference can relieve glaucomatous optic neuropathy. Increased intracranial pressure can also reduce optic nerve damage in glaucoma patients, and a safe, effective and noninvasive way to achieve this is by increasing the intra-abdominal pressure. The purpose of this study was to observe the changes in orbital subarachnoid space width and intraocular pressure at elevated intra-abdominal pressure. An inflatable abdominal belt was tied to each of 15 healthy volunteers, aged 22-30 years (12 females and 3 males), at the navel level, without applying pressure to the abdomen, before they laid in the magnetic resonance imaging machine. The baseline orbital subarachnoid space width around the optic nerve was measured by magnetic resonance imaging at 1, 3, 9, and 15 mm behind the globe. The abdominal belt was inflated to increase the pressure to 40 mmHg (1 mmHg = 0.133 kPa), then the orbital subarachnoid space width was measured every 10 minutes for 2 hours. After removal of the pressure, the measurement was repeated 10 and 20 minutes later. In a separate trial, the intraocular pressure was measured for all the subjects at the same time points, before, during and after elevated intra-abdominal pressure. Results showed that the baseline mean orbital subarachnoid space width was 0.88 ± 0.1 mm (range: 0.77-1.05 mm), 0.77 ± 0.11 mm (range: 0.60-0.94 mm), 0.70 ± 0.08 mm (range: 0.62-0.80 mm), and 0.68 ± 0.08 mm (range: 0.57-0.77 mm) at 1, 3, 9, and 15 mm behind the globe, respectively. During the elevated intra-abdominal pressure, the orbital subarachnoid space width increased from the baseline and dilation of the optic nerve sheath was significant at 1, 3 and 9 mm behind the globe. After decompression of the abdominal pressure, the orbital subarachnoid space width normalized and returned to the baseline value. There was no significant difference in the

  4. Influence of corneal thickness on the intraocular pressure readings for Maklakoff's tonometer of different weight

    NASA Astrophysics Data System (ADS)

    Franus, D. V.

    2018-05-01

    Research is conducted into variation in the stress-strain state of the corneoscleral shell of the human eye under loading by a flat base stamp of varying weight. A three-dimensional finite-element model of the contact problem of loading of the corneoscleral shell in the ANSYS program package is presented. Cornea and sclera are modeled as conjugated transversely isotropic spherical shells. The cornea is modeled as a multilayer shell with variable thickness in which all modeled layers have their own individual elastic properties. The research deals with the numerical calculation of the diameter of the contact zone between the shell and the stamp. Values of correction coefficients for intraocular pressure are obtained depending on the thickness of the corneal shell in its center, allowing the true intraocular pressure to be determined more accurately.

  5. Effect of latanoprost/timolol and dorzolamide/tiomolol on intraocular pressure after phacoemulsification surgery

    PubMed Central

    Erdogan, Haydar; Ozec, Ayse Vural; Caner, Cengiz; Toker, Mustafa Ilker; Arici, Mustafa Kemal; Topalkara, Aysen

    2011-01-01

    AIM To evalaute the effect of fixed-combination latanoprost 0.005%/timolol maleate 0.5% and dorzolamide hydrochloride 2%/timolol maleate 0.5% on postoperative intraocular pressure after phacoemulsification cataract surgery. METHODS This study is a prospective, randomized, double-masked and placebo-controlled. The study included 90 eyes of 90 patients which were scheduled to have phacoemulsification surgery. Patients were randomly assigned preoperatively to 1 of 3 groups (30 eyes of 30 patients). Two hour before surgery, the patients received one drop latanoprost/timolol (group 1), dorzolamide/timolol (group 2) and placebo (group 3, control group). The IOPs were measured at preoperative and postoperative 4, 8, and 24 hours. RESULTS The preoperative mean intraocular pressure was not statistically significant between both drug groups and control group. In group 1 and 2, the postoperative mean IOP [group1: (14.03±3.15)mmHg and group 2: (14.16±4.43)mmHg] at 24 hours were significantly lower than the control group [(16.93±3.70)mmHg, (P<0.05)]. In addition, the postoperative mean IOP of group 1 [(14.90±3.69)mmHg] at 8 hours was significantly lower than the control group [(17.70±3.89)mmHg, (P<0.05)], but there was no significant difference between group 2 [(16.16±5.23)mmHg] and control group at 8 hours (P>0.05). CONCLUSION When compared with placebo, the use of preoperative fixed combination of latanoprost/timolol and dorzolamide/timolol is an effective method for preventing intraocular pressure elevation in 24 hours after phacoemulsification surgery, but did not completely prevent IOP spikes. PMID:22553640

  6. Diurnal Alterations of Refraction, Anterior Segment Biometrics, and Intraocular Pressure in Long-Time Dehydration due to Religious Fasting.

    PubMed

    Baser, Gonen; Cengiz, Hakan; Uyar, Murat; Seker Un, Emine

    2016-01-01

    To investigate the effects of dehydration due to fasting on diurnal changes of intraocular pressure, anterior segment biometrics, and refraction. The intraocular pressures, anterior segment biometrics (axial length: AL; Central corneal thickness: CCT; Lens thickness: LT; Anterior chamber depth: ACD), and refractive measurements of 30 eyes of 15 fasting healthy male volunteers were recorded at 8:00 in the morning and 17:00 in the evening in the Ramadan of 2013 and two months later. The results were compared and the statistical analyses were performed using the Rstudio software version 0.98.501. The variables were investigated using visual (histograms, probability plots) and analytical methods (Kolmogorov-Smirnov/Shapiro-Wilk test) to determine whether or not they were normally distributed. The refractive values remained stable in the fasting as well as in the control period (p = 0.384). The axial length measured slightly shorter in the fasting period (p = 0.001). The corneal thickness presented a diurnal variation, in which the cornea measured thinner in the evening. The difference between the fasting and control period was not statistically significant (p = 0.359). The major differences were observed in the anterior chamber depth and IOP. The ACD was shallower in the evening during the fasting period, where it was deeper in the control period. The diurnal IOP difference was greater in the fasting period than the control period. Both were statistically significant (p = 0.001). The LT remained unchanged in both periods. The major difference was shown in the anterior chamber shallowing in the evening hours and IOP. Our study contributes the hypothesis that the posterior segment of the eye is more responsible for the axial length alterations and normovolemia has a more dominant influence on diurnal IOP changes.

  7. Delayed intraocular foreign body removal without endophthalmitis during Operations Iraqi Freedom and Enduring Freedom.

    PubMed

    Colyer, Marcus H; Weber, Eric D; Weichel, Eric D; Dick, John S B; Bower, Kraig S; Ward, Thomas P; Haller, Julia A

    2007-08-01

    To report the long-term follow-up results of intraocular foreign body (IOFB) removal at Walter Reed Army Medical Center during Operation Iraqi Freedom and Operation Enduring Freedom from February 2003 through November 2005 and to determine the prognostic factors for visual outcome in this patient population. Retrospective, noncomparative, interventional case series. Seventy-nine eyes of 70 United States military soldiers deployed in support of operations Iraqi Freedom and Enduring Freedom sustained IOFB injuries and subsequently were treated at the Walter Reed Army Medical Center with a minimum of 6 months of follow-up. The principal procedure performed was 20-gauge 3-port vitrectomy with IOFB removal through limbal or pars plana incision. Final visual acuity, rate of proliferative vitreoretinopathy, rate of endophthalmitis. Average patient age was 27 years, with an average of 331 days of postoperative follow-up. Average IOFB size was 3.7 mm (range, 0.1-20 mm). Median time to IOFB removal was 21 days (mean, 38 days; range, 2-661 days). Mean preoperative visual acuity was 20/400 (1.36 logarithm of mean angle of resolution [logMAR] units) and mean final visual acuity was 20/120 (0.75 logMAR). Of the patients, 53.4% achieved visual acuity of 20/40 or better, whereas 77.5% achieved visual acuity of better than 20/200. There were no cases of endophthalmitis (0/79 eyes; 95% confidence interval, 0%-3.1%), siderosis bulbi, or sympathetic ophthalmia. Among the eyes, 10.3% evolved to no light perception or had been enucleated by the 6-month follow-up visit. Poor visual outcome correlated with extensive intraocular injury (P<0.032). Seventeen of 79 eyes (21%) experienced proliferative vitreoretinopathy. Proliferative vitreoretinopathy correlated with poor initial vision (hand movements or worse; P = 0.035) and extensive intraocular injury (P<0.001). Timing of vitrectomy did not correlate with visual outcome. The most common systemic antibiotic administered was levofloxacin

  8. [Implantation of intraocular lenses in the ciliary sulcus].

    PubMed

    Schulze, S; Bertelmann, T; Sekundo, W

    2014-04-01

    Implantation of an intraocular lens (IOL) into the ciliary sulcus is the second most common implantation site after the regular capsular bag (in the bag) placement of an IOL. Although mainly not primarily intended, it is very often used in both complicated cataract surgery and secondary implantation due to IOL dislocation or aphakia. In most cases stable positioning is possible, especially when using optic capture techniques. A variety of difficulties can occur with sulcus implantation depending on the anatomical and surgical conditions present at the time of implantation. The most anterior position of the sulcus lense has to be considered for calculation of the refractive power of the IOL.

  9. Intra-Ocular Pressure Measurement in a Patient with a Thin, Thick or Abnormal Cornea.

    PubMed

    Clement, Colin I; Parker, Douglas G A; Goldberg, Ivan

    2016-01-01

    Accurate measurement of intra-ocular pressure is a fundamental component of the ocular examination. The most common method of measuring IOP is by Goldmann applanation tonometry, the accuracy of which is influenced by the thickness and biomechanical properties of the cornea. Algorithms devised to correct for corneal thickness to estimate IOP oversimplify the effects of corneal biomechanics. The viscous and elastic properties of the cornea influence IOP measurements in unpredictable ways, a finding borne out in studies of patients with inherently abnormal and surgically altered corneal biomechanics. Dynamic contour tonometry, rebound tonometry and the ocular response analyzer provide useful alternatives to GAT in patients with abnormal corneas, such as those who have undergone laser vision correction or keratoplasty. This article reviews the various methods of intra-ocular pressure measurement available to the clinician and the ways in which their utility is influenced by variations in corneal thickness and biomechanics.

  10. Multifocal intraocular lenses: Types, outcomes, complications and how to solve them

    PubMed Central

    Salerno, Liberdade C.; Tiveron, Mauro C.; Alió, Jorge L.

    2017-01-01

    The multifocal intraocular lenses (IOLs) available are often able to restore visual function and allow spectacle independence after their implantation with great levels of patient satisfaction. The factors associated with the postoperatory success include the careful selection of the patient, the knowledge about the IOLs’ design, and their visual performance added to the proper surgical technique and management of possible complications as demonstrated by the evidence available. PMID:29296549

  11. Effects of intraocular injection of a low concentration of zinc on the rat retina.

    PubMed

    Nakamichi, N; Chidlow, G; Osborne, N N

    2003-10-01

    The main aim of this study was to investigate whether intraocular injection of low concentrations of zinc (no greater than 10 microM) aid the survival of ganglion cells in the rat retina after excitotoxic (NMDA) and ischemia/reperfusion injuries. We also determined whether low amounts of zinc cause any detectable retinal toxicity. Intraocular injection of NMDA caused substantial reductions in the mRNA levels of the ganglion cell-specific markers Thy-1 and neurofilament light (NF-L). Co-injection of 0.1 or 1 nmol zinc neither diminished nor exacerbated the effect of NMDA on the levels of these mRNAs. Likewise, ischemia/reperfusion caused significant decreases in the levels of Thy-1 and NF-L mRNAs and in the b-wave amplitude of the electroretinogram. These effects were not counteracted by injection of zinc. Intraocular injection of NMDA caused marked toxicological effects in retinal glial cells, including upregulations of cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), glial fibrial acidic protein (GFAP), basic fibroblast growth factor (FGF-2) and ciliary neurotrophic factor (CNTF). Interestingly, injection of 1 nmol zinc caused no changes in the levels of COX-2 and iNOS, yet produced similar, although quantitatively less pronounced, changes in FGF-2, GFAP and CNTF. The upregulations of FGF-2 and CNTF suggest that increasing zinc intake may benefit injured retinal neurons. However, this was not found to be the case in the present studies, perhaps due to the acute nature of the injury paradigms utilised.

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

    PubMed

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

    2015-05-01

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

  13. Clinical outcome and higher order aberrations after bilateral implantation of an extended depth of focus intraocular lens.

    PubMed

    Pilger, Daniel; Homburg, David; Brockmann, Tobias; Torun, Necip; Bertelmann, Eckart; von Sonnleithner, Christoph

    2018-04-01

    The purpose of this study was to assess the clinical outcome after a bilateral implantation of an extended depth of focus intraocular lens in comparison to a monofocal intraocular lens. Department of Ophthalmology, Charité-Medical University Berlin, Germany. A total of 60 eyes of 30 patients were enrolled in this prospective, single-center study. The cataract patients underwent phacoemulsification with bilateral implantation of a TECNIS ® Symfony (Abbott Medical Optics, Santa Ana, CA, USA, 15 patients) or a TECNIS Monofocal ZCB00 (Abbott Medical Optics, Santa Ana, CA, USA, 15 patients). Postoperative evaluations were performed after 1 and 3 months, including visual acuities at far, intermediate, and near distance. Mesopic, scotopic vision, and contrast sensitivity were investigated. Aberrometry was performed using an iTrace aberrometer with a pupil scan size of 5.0 mm. After 3 months, the TECNIS Symfony group reached an uncorrected visual acuity at far distance of -0.02 logMAR compared to -0.06 logMAR in the TECNIS Monofocal group ( p = 0.03). Regarding the uncorrected vision at intermediate and near distance the following values were obtained: intermediate visual acuity -0.13 versus 0.0 logMAR (TECNIS Symfony vs TECNIS Monofocal, p = 0.001) and near visual acuity 0.11 versus 0.26 logMAR (TECNIS Symfony vs TECNIS Monofocal, p = 0.001). Low-contrast visual acuities were 0.27 versus 0.20 logMar (TECNIS Symfony vs TECNIS Monofocal, p = 0.023). The TECNIS Symfony intraocular lens can be considered an appropriate alternative to multifocal intraocular lenses because of good visual results at far, intermediate, and near distance as well as in low-contrast vision.

  14. Biometry and intraocular lens power calculation results with a new optical biometry device: comparison with the gold standard.

    PubMed

    Kaswin, Godefroy; Rousseau, Antoine; Mgarrech, Mohamed; Barreau, Emmanuel; Labetoulle, Marc

    2014-04-01

    To evaluate the agreement in axial length (AL), keratometry (K), anterior chamber depth (ACD) measurements; intraocular lens (IOL) power calculations; and predictability using a new partial coherence interferometry (PCI) optical biometer (AL-Scan) and a reference (gold standard) PCI optical biometer (IOLMaster 500). Service d'Ophtalmologie, Hopital Bicêtre, APHP Université, Paris, France. Evaluation of a diagnostic device. One eye of consecutive patients scheduled for cataract surgery was measured. Biometry was performed with the new biometer and the reference biometer. Comparisons were performed for AL, average K at 2.4 mm, ACD, IOL power calculations with the Haigis and SRK/T formulas, and postoperative predictability of the devices. A P value less than 0.05 was statistically significant. The study enrolled 50 patients (mean age 72.6 years±4.2 SEM). There was a good correlation between biometers for AL, K, and ACD measurements (r=0.999, r=0.933, and r=0.701, respectively) and between IOL power calculation with the Haigis formula (r=0.972) and the SRK/T formula (r=0.981). The mean absolute error (MAE) in IOL power prediction was 0.42±0.08 diopter (D) with the new biometer and 0.44±0.08 D with the reference biometer. The MAE was 0.20 D with the Haigis formula and 0.19 with the SRK/T formula (P=.36). The new PCI biometer provided valid measurements compared with the current gold standard, indicating that the new device can be used for IOL power calculations for routine cataract surgery. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  15. Effects of silibinin hemisuccinate on the intraocular pressure in normotensive rabbits.

    PubMed

    Mohammed, Haider M; Abdulrazzaq, Munaf H; Hussain, Saad A

    2007-09-01

    To evaluate the effects of silibinin hemisuccinate on the normal intraocular pressure (IOP) in rabbits. This study took place in the Department of Pharmacology and Toxicology, College of Pharmacy, University of Baghdad during the period from January to June 2005. Twenty-five New Zealand white rabbits weighing 1.5-2.5 kg were used in this study. The effects of corneal instillation of various concentrations of silibinin hemisuccinate (0.5%, 0.75% and 1%) dissolved in arachis oil, on the normal intraocular pressure in rabbits were evaluated using indentation tonometry; in addition to the possible modulation of normal IOP-recovery time after intravenous infusion of 20% sodium chloride solution. The results showed that within 30 minutes of application, silibinin in various concentrations significantly reduces IOP in comparison to baseline values (p<0.05), with greater reduction being achieved with 0.75%. The effect of IOP reduction lasts 2-3 hours and proportionate to the concentration used. Moreover, remarkable delay in IOP recovery was observed after instillation of silibinin compared with the vehicle treated (arachis oil) animals, indicating interference with aqueous humor formation. The results obtained in this study provide experimental evidences for the effectiveness of silibinin in the reduction of IOP and possible modulation of its regulatory mechanisms.

  16. 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

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

    PubMed

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

    2013-12-01

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

  18. Magnetically adjustable intraocular lens.

    PubMed

    Matthews, Michael Wayne; Eggleston, Harry Conrad; Pekarek, Steven D; Hilmas, Greg Eugene

    2003-11-01

    To provide a noninvasive, magnetic adjustment mechanism to the repeatedly and reversibly adjustable, variable-focus intraocular lens (IOL). University of Missouri-Rolla, Rolla, and Eggleston Adjustable Lens, St. Louis, Missouri, USA. Mechanically adjustable IOLs have been fabricated and tested. Samarium and cobalt rare-earth magnets have been incorporated into the poly(methyl methacrylate) (PMMA) optic of these adjustable lenses. The stability of samarium and cobalt in the PMMA matrix was examined with leaching studies. Operational force testing of the magnetic optics with emphasis on the rotational forces of adjustment was done. Prototype optics incorporating rare-earth magnetic inserts were consistently produced. After 32 days in solution, samarium and cobalt concentration reached a maximum of 5 ppm. Operational force measurements indicate that successful adjustments of this lens can be made using external magnetic fields with rotational torques in excess of 0.6 ounce inch produced. Actual lenses were remotely adjusted using magnetic fields. The magnetically adjustable version of this IOL is a viable and promising means of handling the common issues of postoperative refractive errors without the requirement of additional surgery. The repeatedly adjustable mechanism of this lens also holds promise for the developing eyes of pediatric patients and the changing needs of all patients.

  19. FBG-based sensorized light pipe for robotic intraocular illumination facilitates bimanual retinal microsurgery.

    PubMed

    Horise, Yuki; He, Xingchi; Gehlbach, Peter; Taylor, Russell; Iordachita, Iulian

    2015-01-01

    In retinal surgery, microsurgical instruments such as micro forceps, scissors and picks are inserted through the eye wall via sclerotomies. A handheld intraocular light source is typically used to visualize the tools during the procedure. Retinal surgery requires precise and stable tool maneuvers as the surgical targets are micro scale, fragile and critical to function. Retinal surgeons typically control an active surgical tool with one hand and an illumination source with the other. In this paper, we present a "smart" light pipe that enables true bimanual surgery via utilization of an active, robot-assisted source of targeted illumination. The novel sensorized smart light pipe measures the contact force between the sclerotomy and its own shaft, thereby accommodating the motion of the patient's eye. Forces at the point of contact with the sclera are detected by fiber Bragg grating (FBG) sensors on the light pipe. Our calibration and validation results demonstrate reliable measurement of the contact force as well as location of the sclerotomy. Preliminary experiments have been conducted to functionally evaluate robotic intraocular illumination.

  20. Laser flare photometry: a noninvasive, objective, and quantitative method to measure intraocular inflammation.

    PubMed

    Tugal-Tutkun, Ilknur; Herbort, Carl P

    2010-10-01

    Aqueous flare and cells are the two inflammatory parameters of anterior chamber inflammation resulting from disruption of the blood-ocular barriers. When examined with the slit lamp, measurement of intraocular inflammation remains subjective with considerable intra- and interobserver variations. Laser flare cell photometry is an objective quantitative method that enables accurate measurement of these parameters with very high reproducibility. Laser flare photometry allows detection of subclinical alterations in the blood-ocular barriers, identifying subtle pathological changes that could not have been recorded otherwise. With the use of this method, it has been possible to compare the effect of different surgical techniques, surgical adjuncts, and anti-inflammatory medications on intraocular inflammation. Clinical studies of uveitis patients have shown that flare measurements by laser flare photometry allowed precise monitoring of well-defined uveitic entities and prediction of disease relapse. Relationships of laser flare photometry values with complications of uveitis and visual loss further indicate that flare measurement by laser flare photometry should be included in the routine follow-up of patients with uveitis.

  1. Early aggressive intraocular pressure lowering, target intraocular pressure, and a novel concept for glaucoma care.

    PubMed

    Singh, Kuldev; Shrivastava, Anurag

    2008-11-01

    Early diagnosis of glaucomatous optic nerve damage offers the potential for early treatment which may prevent vision loss from this neurodegenerative disease. Even in patients who do not begin early treatment, early diagnosis allows for better monitoring of disease at a stage where the stakes are lower relative to later stages of the disease. For these reasons, early diagnosis of glaucomatous optic nerve disease is desirable and opens the door for appropriately aggressive therapy. The target intraocular pressure (IOP) concept is widely employed by glaucoma practitioners. Although there have been no randomized clinical trials or other high-quality studies showing the benefits of setting a target IOP versus not using this approach, there is ample evidence that lowering IOP slows glaucoma progression and, in general, lower is better, regardless of disease stage and baseline IOP level. We propose an alternative approach to managing glaucoma without the use of the target IOP concept and suggest that this market IOP concept should be compared with the target IOP approach in an appropriately powered comparative clinical trial.

  2. CXCL1, but not IL-6, significantly impacts intraocular inflammation during infection

    PubMed Central

    Parkunan, Salai Madhumathi; Randall, C. Blake; Astley, Roger A.; Furtado, Glaucia C.; Lira, Sergio A.; Callegan, Michelle C.

    2016-01-01

    During intraocular bacterial infections, the primary innate responders are neutrophils, which may cause bystander damage to the retina or perturb the clarity of the visual axis. We hypothesized that cytokine IL-6 and chemokine CXCL1 contributed to rapid neutrophil recruitment during Bacillus cereus endophthalmitis, a severe form of intraocular infection that is characterized by explosive inflammation and retinal damage that often leads to rapid vision loss. To test this hypothesis, we compared endophthalmitis pathogenesis in C57BL/6J, IL-6−/−, and CXCL1−/− mice. Bacterial growth in eyes of CXCL1−/−, IL-6−/−, and C67BL/6J mice was similar. Retinal function retention was greater in eyes of IL-6−/− and CXCL1−/− mice compared with that of C57BL/6J, despite these eyes having similar bacterial burdens. Neutrophil influx into eyes of CXCL1−/− mice was reduced to a greater degree compared with that of eyes of IL6−/− mice. Histology confirmed significantly less inflammation in eyes of CXCL1−/− mice, but similar degrees of inflammation in IL6−/− and C57BL/6J eyes. Because inflammation was reduced in eyes of infected CXCL1−/− mice, we tested the efficacy of anti-CXCL1 in B. cereus endophthalmitis. Retinal function was retained to a greater degree and there was less overall inflammation in eyes treated with anti-CXCL1, which suggested that anti-CXCL1 may have therapeutic efficacy in limiting inflammation during B. cereus endophthalmitis. Taken together, our results indicate that absence of IL-6 did not affect overall pathogenesis of endophthalmitis. In contrast, absence of CXCL1, in CXCL1−/− mice or after anti-CXCL1 treatment, led to an improved clinical outcome. Our findings suggest a potential benefit in targeting CXCL1 to control inflammation during B. cereus and perhaps other types of intraocular infections. PMID:27286792

  3. CXCL1, but not IL-6, significantly impacts intraocular inflammation during infection.

    PubMed

    Parkunan, Salai Madhumathi; Randall, C Blake; Astley, Roger A; Furtado, Glaucia C; Lira, Sergio A; Callegan, Michelle C

    2016-11-01

    During intraocular bacterial infections, the primary innate responders are neutrophils, which may cause bystander damage to the retina or perturb the clarity of the visual axis. We hypothesized that cytokine IL-6 and chemokine CXCL1 contributed to rapid neutrophil recruitment during Bacillus cereus endophthalmitis, a severe form of intraocular infection that is characterized by explosive inflammation and retinal damage that often leads to rapid vision loss. To test this hypothesis, we compared endophthalmitis pathogenesis in C57BL/6J, IL-6 -/- , and CXCL1 -/- mice. Bacterial growth in eyes of CXCL1 -/- , IL-6 -/- , and C67BL/6J mice was similar. Retinal function retention was greater in eyes of IL-6 -/- and CXCL1 -/- mice compared with that of C57BL/6J, despite these eyes having similar bacterial burdens. Neutrophil influx into eyes of CXCL1 -/- mice was reduced to a greater degree compared with that of eyes of IL6 -/- mice. Histology confirmed significantly less inflammation in eyes of CXCL1 -/- mice, but similar degrees of inflammation in IL6 -/- and C57BL/6J eyes. Because inflammation was reduced in eyes of infected CXCL1 -/- mice, we tested the efficacy of anti-CXCL1 in B. cereus endophthalmitis. Retinal function was retained to a greater degree and there was less overall inflammation in eyes treated with anti-CXCL1, which suggested that anti-CXCL1 may have therapeutic efficacy in limiting inflammation during B. cereus endophthalmitis. Taken together, our results indicate that absence of IL-6 did not affect overall pathogenesis of endophthalmitis. In contrast, absence of CXCL1, in CXCL1 -/- mice or after anti-CXCL1 treatment, led to an improved clinical outcome. Our findings suggest a potential benefit in targeting CXCL1 to control inflammation during B. cereus and perhaps other types of intraocular infections. © Society for Leukocyte Biology.

  4. Intraocular Pressure Response to Moderate Exercise during 30-Min Recovery.

    PubMed

    Najmanova, Eliska; Pluhacek, Frantisek; Botek, Michal

    2016-03-01

    The aim of the study was to evaluate intraocular pressure (IOP) before and after moderate exercise in normal healthy individuals with defined physical exertion. The second aim of this investigation was to determine the correlation between resting IOP (IOPr) and its change induced by exercise as well as the relationship between resting heart rate (HRr) and changes in IOP after exercise. Forty-one healthy volunteers between the ages of 19 and 25 years were recruited for the study. First, the resting (reference) values IOPr and HRr were measured after 30 min of resting time. Volunteers consequently performed 30 min of exercise on a bicycle ergometer. Intraocular pressure was remeasured immediately after the end of exercise (the relevant IOP change was denoted as ΔIOP0) and subsequently repeated 5, 10, 20, and 30 min after exercise. A significant decrease in IOP compared with the resting value (post hoc Tukey honest significant difference test) was found immediately after exercise (p = 2 × 10) and 5 and 10 min after exercise (p = 2 × 10 and p = 3 × 10). Significant relationships were found between the change in IOP (ΔIOP0) and baseline IOP (IOPr) and between the baseline resting heart rate (HRr) and the change in IOP (ΔIOP0). There was a significant IOP-lowering effect, which was persistent for 10 min after 30 min of exercise. The IOP change was dependent on the initial IOP reading and initial HR.

  5. Combining zonal refractive and diffractive aspheric multifocal intraocular lenses.

    PubMed

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

    2012-03-01

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

  6. Intraocular pressure variation following retrobulbar anaesthesia among the different sex, age and ethnic groups in Malaysia.

    PubMed

    Lee, F N; Kong, V Y; Lee, G P; Ho, K H; Choon, S C; Hoh, H B

    1999-12-01

    A total of 114 patients (48 Chinese, 34 Malay and 32 Indian) undergoing extracapsular cataract extraction (ECCE) with intraocular lens implantation, were enrolled. All were given 3 ml of local anaesthetic (combination of equal amounts of lignocaine 2% and bupivacaine 0.5%) using retrobulbar technique. Intraocular pressure (IOP) was measured at different time intervals; before, immediately after and 5 minutes after injection with Honan balloon compression. Mean IOP increased by 5.0 mmHg immediately after injection (p < 0.001) and reduced to baseline level after 5 minutes of external compression. Although there were no statistical difference in terms of IOP variation between sex and age groups, Chinese patients demonstrated the highest IOP rise following retrobulbar anaesthesia. This is the first study to demonstrate the influence of race in the IOP response with Chinese subjects having the highest IOP rise.

  7. Corneal biomechanical changes in diabetes mellitus and their influence on intraocular pressure measurements.

    PubMed

    Sahin, Afsun; Bayer, Atilla; Ozge, Gökhan; Mumcuoğlu, Tarkan

    2009-10-01

    To investigate possible corneal biomechanical changes in patients with diabetes mellitus and understand the influence of such changes on intraocular pressure measurements. The study group was composed of 120 eyes from 61 healthy control subjects and 81 eyes from 43 diabetic subjects. IOP was measured first with an ocular response analyzer (ORA) and subsequently with a Goldmann applanation tonometer (GAT). Central corneal thickness (CCT) was measured with an ultrasonic pachymeter attached to the ORA. Axial length (AL), anterior chamber depth (ACD), and keratometry readings were acquired with partial coherence laser interferometry during the same visit before all IOP and CCT determinations were made. Corneal hysteresis (CH) was found to be significantly lower in diabetic patients when compared with healthy control subjects (9.51 +/- 1.82 mm Hg vs. 10.41 +/- 1.66 mm Hg, P < 0.0001). There was no significant difference in terms of corneal resistance factor (CRF; P = 0.8). Mean CCT, GAT IOP, Goldmann-correlated IOP (IOPg), and corneal-compensated IOP (IOPcc) were significantly higher in diabetic patients than in healthy control subjects (P = 0.01 for CCT, P < 0.0001 for GAT IOP, IOPg, and IOPcc). Diabetes affects corneal biomechanics and results in lower CH values than those in healthy control subjects, which may cause clinically relevant high IOP measurements independent of CCT.

  8. Sectioning a luxated intraocular lens inside the vitreous cavity.

    PubMed

    Vilaplana, Daniel; Pazos, Marta

    2013-07-01

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

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

    PubMed

    Baumeister, M

    2014-10-01

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

  10. Central amaurosis induced by an intraocular, posttraumatic fibrosarcoma in a cat.

    PubMed

    Barrett, P M; Merideth, R E; Alarcon, F L

    1995-01-01

    A 12-year-old, castrated male, domestic shorthair cat with a previous penetrating trauma to the left globe which progressed to a phthisical eye presented for acute blindness. Ophthalmic examination and electroretinography of the right eye were found to be normal. Following euthanasia, gross and microscopic examinations were completed. A left intraocular, posttraumatic fibrosarcoma with extension to the optic nerve and chiasm and induced right optic nerve fiber degeneration at the optic chiasm with necrosis leading to central amaurosis were diagnosed.

  11. Spectral properties of common intraocular lens (IOL) types

    NASA Astrophysics Data System (ADS)

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

    1999-06-01

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

  12. Comparison of axial length, anterior chamber depth and intraocular lens power between IOLMaster and ultrasound in normal, long and short eyes.

    PubMed

    Dong, Jing; Zhang, Yaqin; Zhang, Haining; Jia, Zhijie; Zhang, Suhua; Wang, Xiaogang

    2018-01-01

    To compare the axial length (AL), anterior chamber depth (ACD) and intraocular lens power (IOLP) of IOLMaster and Ultrasound in normal, long and short eyes. Seventy-four normal eyes (≥ 22 mm and ≤ 25 mm), 74 long eyes (> 25 mm) and 78 short eyes (< 22 mm) underwent AL and ACD measurements with both devices in the order of IOLMaster followed by Ultrasound. The IOLP were calculated using a free online LADAS IOL formula calculator. The difference in AL and IOLP between IOLMaster and Ultrasound was statistically significant when all three groups were combined. The difference in ACD between IOLMaster and Ultrasound was statistically significant in the normal group (P<0.001) and short eye group (P<0.001) but not the long eye group (P = 0.465). For the IOLP difference between IOLMaster and Ultrasound in the normal group, the percentage of IOLP differences <|0.5|D, ≥|0.5|D<|0.75|D, ≥|0.75|D<|1.0|D, and ≥|1.0|D were 90.5%, 8.1%, 1.4% and 0%, respectively. For the long eye group, they were 90.5%, 5.4%, 4.1% and 0%, respectively. For the short eye group, they were 61.5%, 23.1%, 10.3%, and 5.1%, respectively. IOLMaster and Ultrasound have statistically significant differences in AL measurements and IOLP (using LADAS formula) for normal, long eye and short eye. The two instruments agree regarding ACD measurements for the long eye group, but differ for the normal and short eye groups. Moreover, the high percentage of IOLP differences greater than |0.5|D in the short eye group is noteworthy.

  13. Baseline Intraocular Pressure Is Associated with Subjective Sensitivity to Physical Exertion in Young Males

    ERIC Educational Resources Information Center

    Vera, Jesús; Jiménez, Raimundo; García, José Antonio; Perales, José Cesar; Cárdenas, David

    2018-01-01

    Purpose: The purposes of this study were to (a) investigate the effect of physical effort (cycling for 60 min at 60 ± 5% of individually computed reserve heart-rate capacity), combined with 2 different levels of cognitive demand (2-back, oddball), on intraocular pressure (IOP) and subjective judgments of perceived exertion (ratings of perceived…

  14. Analysis of patients with good uncorrected distance and near vision after monofocal intraocular lens implantation.

    PubMed

    Nanavaty, Mayank A; Vasavada, Abhay R; Patel, Anil S; Raj, Shetal M; Desai, Tejas H

    2006-07-01

    To analyze factors contributing to uncorrected visual acuity of at least 6/12 for distance and at least J4 for near (pseudoaccommodation) after monofocal intraocular lens (IOL) implantation. Iladevi Cataract and IOL Research Center, Ahmedabad, India. In a case-controlled study of 30 eyes (30 patients) that had phacoemulsification, those with pseudoaccommodation were assigned to cases and 30 eyes (30 patients) without pseudoaccommodation were designated as controls. Controls were matched by identical best corrected visual acuity, age, and postoperative duration. Subjective refraction was done with retinoscopy. Factors analyzed included corneal astigmatism, pupil size, axial IOL movement, amplitude of accommodation, axial length (AL), and age. Corneal astigmatism was noted on topography and interpreted as against the rule (ATR) (180 +/- 15 degrees), with the rule (WTR) (90 +/- 15 degrees), and oblique (OB) (45/135 +/- 30 degrees). Pupil size was noted on topographic display and AL and anterior chamber depth (ACD) on immersion A-scan. The axial IOL movement was calculated as the difference in ACD after instillation of cyclopentolate 1% (Cyclopent) and subsequently pilocarpine nitrate 2% (Carpinol) at separate visits, and amplitude of accommodation was measured with static and dynamic retinoscopy. Multivariate logistic regression and odds ratio with 95% confidence intervals were determined. Mean spherical equivalent was -0.45 +/- 0.63 diopter (D) in cases and -0.35 +/- 0.83 D (P = .61) in controls. Multivariate logistic regression in cases versus controls: corneal astigmatism (ATR versus WTR and OB collectively): 10.19 [1.8,57.44], P = .009; pupil size: 0.45 [0.07,2.71], P = .38; axial IOL movement: 1.39 [0.51,0.77], P = .514; amplitude of accommodation: 2.95 [0.93,9.3], P = .065; AL: 0.55 [0.29,1.02], P = .058; and age: 0.98 [0.5,1.95], P = .963. The study suggests a significant role of ATR corneal astigmatism in good uncorrected distance and near vision after

  15. 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

  16. Comparison of Visual Quality after Implantation of Big Bag and Akreos Adapt Intraocular Lenses in Patients with High Myopia.

    PubMed

    Ma, Shengsheng; Zheng, Dongjian; Lin, Ling; Meng, Fanjian; Yuan, Yonggang

    2015-03-01

    To compare vision quality following phacoemulsification cataract extraction and implantation of a Big Bag or Akreos Adapt intraocular lens (IOL) in patients diagnosed with high myopia complicated with cataract. This was a randomized prospective control study. The patients with high myopia. complicated with cataract, with axial length ≥ 28 mm, and corneal astigmatism ≤ 1D were enrolled and randomly divided into the Big Bag and Akreos Adapt IOL groups. All patients underwent phacoemulsification cataract extraction and lens implantation. At 3 months after surgery, intraocular high-order aberration was measured by a Tracey-iTrace wavefront aberrometer at a pupil diameter of 5 mm in an absolutely dark room and statistically compared between two groups. The images of the anterior segment of eyes were photographed with a Scheimpflug camera using Penta-cam three-dimensional anterior segment analyzer. The tilt and decentration of the IOL were calculated by Image-pro plus 6.0 imaging analysis software and statistically compared between two groups. In total, 127 patients (127 eyes), including 52 males and 75 females, were enrolled in this study. The total high-order aberration and coma in the Akreos Adapt group (59 eyes) were significantly higher compared with those in the Big Bag (P < 0.05). The clover and spherical aberration did not differ between the two groups (P > 0.05). The horizontal and vertical decentration were significantly smaller in the Big Bag lens group than in the Akreos Adapt group (both P < 0.05), whereas the tilt of IOL did not significantly differ between the two groups (P > 0.05). Both Big Bag and Akreos Adapt IOLs possess relatively good intraocular stability implanted in patients with high myopia. Compared with the Akreos Adapt IOL, the Big Bag IOL presents with smaller intraocular high-order aberration. Coma is the major difference between the two groups.

  17. Prevalence and factors predictive of intraocular fungal infection in patients with fungemia at an academic urban tertiary care center

    PubMed Central

    Geraymovych, Elena; Conduff, Joseph H; Braich, Puneet S; Leffler, Christopher T; Brar, Vikram S

    2015-01-01

    Objective To report the prevalence and to identify factors predictive of intraocular infection in patients with fungemia receiving prophylactic antifungal therapy. Methods A retrospective review of patients who received prophylactic antifungal therapy and a dilated fundus examination at an academic urban tertiary care center from 2000 to 2007. Basic demographic information, fungal species grown, antifungal agent(s) used, number of positive blood culture specimens, visual acuity, visual symptoms, and known risks of disseminated candidiasis were noted. Logistic regression analysis was used to determine the factors significantly associated with intraocular fungal infection. Results A total of 132 patients with positive fungemia culture were requested to have ophthalmology consults. The prevalence of ocular infection was 6.9% (N=9). All nine patients were infected with Candida species. Undergoing gastrointestinal (GI) surgery within the prior 6 months was significantly related to developing intraocular infection, with an odds ratio of 18.5 (95% confidence interval, 15.1–24.3; P=0.002). Having ≥3 positive fungal blood cultures was also a significant risk factor, with an odds ratio of 2.6 (95% confidence interval, 1.8–3.7; P=0.03). Among 40 patients having GI surgery, eight (20.0%) had intraocular fungal disease, compared with one of 92 patients (1.1%) not having GI surgery. Among 125 patients with a negative baseline examination result, two of 32 patients (6.3%), who had recent GI surgery, subsequently developed fungal ocular disease, compared with 0 of 93 patients (0%), who did not have recent GI surgery. Conclusion Recent GI surgery and higher numbers of positive fungal blood culture specimens may be predictive of candida ocular infections. Normal baseline fundoscopy examination results in patients with such risks may require repeat evaluations to detect delayed manifestations. PMID:26491246

  18. Prevalence and factors predictive of intraocular fungal infection in patients with fungemia at an academic urban tertiary care center.

    PubMed

    Geraymovych, Elena; Conduff, Joseph H; Braich, Puneet S; Leffler, Christopher T; Brar, Vikram S

    2015-01-01

    To report the prevalence and to identify factors predictive of intraocular infection in patients with fungemia receiving prophylactic antifungal therapy. A retrospective review of patients who received prophylactic antifungal therapy and a dilated fundus examination at an academic urban tertiary care center from 2000 to 2007. Basic demographic information, fungal species grown, antifungal agent(s) used, number of positive blood culture specimens, visual acuity, visual symptoms, and known risks of disseminated candidiasis were noted. Logistic regression analysis was used to determine the factors significantly associated with intraocular fungal infection. A total of 132 patients with positive fungemia culture were requested to have ophthalmology consults. The prevalence of ocular infection was 6.9% (N=9). All nine patients were infected with Candida species. Undergoing gastrointestinal (GI) surgery within the prior 6 months was significantly related to developing intraocular infection, with an odds ratio of 18.5 (95% confidence interval, 15.1-24.3; P=0.002). Having ≥3 positive fungal blood cultures was also a significant risk factor, with an odds ratio of 2.6 (95% confidence interval, 1.8-3.7; P=0.03). Among 40 patients having GI surgery, eight (20.0%) had intraocular fungal disease, compared with one of 92 patients (1.1%) not having GI surgery. Among 125 patients with a negative baseline examination result, two of 32 patients (6.3%), who had recent GI surgery, subsequently developed fungal ocular disease, compared with 0 of 93 patients (0%), who did not have recent GI surgery. Recent GI surgery and higher numbers of positive fungal blood culture specimens may be predictive of candida ocular infections. Normal baseline fundoscopy examination results in patients with such risks may require repeat evaluations to detect delayed manifestations.

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

    PubMed Central

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

    2018-01-01

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

  20. Evaluation of Pharmacologic Agents to Suppress Intraocular Cellular Proliferation Following Trauma

    DTIC Science & Technology

    1986-07-01

    Tracttonal Detachment* aniawl op uVeitis agent-- -- 1 (1-4) or control 1 wk 2 wk 4 wk 6 wk 12 wk Gross Lama* Imadi to Injaetica or drug 61 1 D S L C R F...BIBLIOGRAPHY 1. Mimura Y: The effect of colchicine treatment on ocular lesions in Behcet’s disease. Ophthalmol Jpn 26:902-908, 1985. 2. Brown W O... Treatment of intraocular proliferation with intravitreal injection of triamcinolone acetonide. Am J Ophthalmol 90:810, 1980. 9. Trese MT, Spitznas M

  1. Technology needs for the development of the accommodative intraocular lens

    NASA Astrophysics Data System (ADS)

    Nishi, Okihiro

    2010-02-01

    Refilling the lens capsule while preserving capsular integrity offers the potential to restore ocular accommodation. There are two persisting problems in capsular bag refilling for possible clinical application: Leakage of the injectable material through the capsular opening and capsular opacification. Numerous attempts for solving these cardinal problems have not been proven to be clinically applicable. Recently, we developed a novel capsular bag refilling procedure using a novel accommodative intraocular lens that serves as an optic as well as a plug for sealing the capsular opening. The procedure and the results of monkey experiments will be presented.

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

    PubMed

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

    2016-01-01

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

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

    PubMed

    Alió, Jorge L; Plaza-Puche, Ana B; Javaloy, Jaime; Ayala, María José

    2012-02-01

    To compare the visual outcomes and intraocular optical quality observed postoperatively in patients implanted with a rotationally asymmetric multifocal intraocular lens (IOL) and an apodized diffractive multifocal IOL. Seventy-four consecutive eyes of 40 cataract patients (age range: 36 to 79 years) were divided into two groups: zonal refractive group, 39 eyes implanted with a rotationally asymmetric multifocal IOL (Lentis Mplus LS-312 IOL, Oculentis GmbH); and diffractive group, 35 eyes implanted with an apodized diffractive multifocal IOL (ReSTOR SN6AD3, Alcon Laboratories Inc). Distance and near visual acuity outcomes, contrast sensitivity, intraocular optical quality, and defocus curves were evaluated during 3-month follow-up. Calculation of the intraocular aberrations was performed by subtracting corneal aberrations from total ocular aberrations. Uncorrected near visual acuity and distance-corrected near visual acuity were better in the diffractive group than in the zonal refractive group (P=.01), whereas intermediate visual acuity (defocus +1.00 and +1.50 diopters) was better in the zonal refractive group. Photopic contrast sensitivity was significantly better in the zonal refractive group (P=.04). Wavefront aberrations (total, higher order, tilt, primary coma) were significantly higher in the zonal refractive group than in the diffractive group (P=.02). Both multifocal IOLs are able to successfully restore visual function after cataract surgery. The zonal refractive multifocal IOL provides better results in contrast sensitivity and intermediate vision, whereas the diffractive multifocal IOL provides better near vision at a closer distance. Copyright 2012, SLACK Incorporated.

  4. Comparative intraocular penetration of 4 fluoroquinolones after topical instillation.

    PubMed

    Chung, Jae Lim; Lim, Eun Hye; Song, Sang Wroul; Kim, Byung Yeop; Lee, Joon H; Mah, Francis S; Seo, Kyoung Yul

    2013-07-01

    To compare the intraocular penetration of 4 fluoroquinolone eye drops after topical instillation into rabbit eyes. The tested drugs were levofloxacin 1.5% (LVFX), gatifloxacin 0.3%, moxifloxacin 0.5% (MFLX), and besifloxacin 0.6% (BFLX). Forty-eight New Zealand white rabbits were randomly assigned into 2 groups. For group 1 (40 rabbits, 80 eyes), single instillation was performed, and tissue samples were acquired after 0.5, 1, 2, 4, and 6 hours. For group 2 (8 rabbits, 16 eyes), repeated instillation was performed (4 times, every 15 minutes), and tissues were acquired 1 hour after the fourth instillation. The drug concentrations in ocular tissues (cornea, aqueous, conjunctiva, and trisected vitreous) were analyzed with high-performance liquid chromatography. The AUC 0-6 h (area under the curve, in microgram.hour/gram) in group 1 and the mean concentration (in micrograms/gram) in group 2 for LVFX, gatifloxacin 0.3%, MFLX, and BFLX, respectively, were 22.97, 6.44, 13.54, and 3.29 and 22.60, 6.99, 13.69, and 1.91 in cornea; 5.66, 1.43, 3.38, and 0.42 and 5.52, 1.29, 2.47, and 0.19 in aqueous humor; 2.33, 0.91, 2.17, and 9.83 and 4.51, 0.78, 1.48, and 2.09 in bulbar conjunctiva; 0.243, 0.051, 0.134, and 0.018 and 0.182, 0.055, 0.122, and 0.015 in anterior vitreous; none of the drugs achieved enough concentration in equatorial and posterior vitreous. Repeated instillation resulted in approximately 2.1 times greater penetration than single instillation. LVFX and MFLX demonstrated good intraocular penetration particularly in cornea, aqueous humor, and anterior vitreous, and they may be considered the penetrative fluoroquinolones. BFLX showed high concentration in bulbar conjunctiva and may be considered the retentive fluoroquinolone.

  5. Vertical fixation with fibrin glue-assisted secondary posterior chamber intraocular lens implantation in a case of surgical aphakia

    PubMed Central

    Ladi, Jeevan S; Shah, Nitant A

    2013-01-01

    We report the first case of vertical fixation by fibrin glue-assisted secondary posterior chamber intraocular lens implantation in a case of surgical aphakia. Advantages of vertical fixation are discussed. PMID:23514650

  6. Studies on a novel doughnut-shaped minitablet for intraocular drug delivery.

    PubMed

    Choonara, Yahya E; Pillay, Viness; Carmichael, Trevor; Danckwerts, Michael P

    2007-12-28

    The objective of this study was to evaluate the effect of 2 independent formulation variables on the drug release from a novel doughnut-shaped minitablet (DSMT) in order to optimize formulations for intraocular drug delivery. Formulations were based on a 3(2) full-factorial design. The 2 independent variables were the concentration of Resomer (% wt/wt) and the type of Resomer grade (RG502, RG503, and RG504), respectively. The evaluated response was the drug release rate constant computed from a referenced marketed product and in vitro drug release data obtained at pH 7.4 in simulated vitreous humor. DSMT devices were prepared containing either of 2 model drugs, ganciclovir or foscarnet, using a Manesty F3 tableting press fitted with a novel central-rod, punch, and die setup. Dissolution data revealed biphasic drug release behavior with 55% to 60% drug released over 120 days. The inherent viscosity of the various Resomer grades and the concentration were significant to achieve optimum release rate constants. Using the resultant statistical relationships with the release rate constant as a response, the optimum formulation predicted for devices formulated with foscarnet was 70% wt/wt of Resomer RG504, while 92% wt/wt of Resomer RG503 was ideal for devices formulated with ganciclovir. The results of this study revealed that the full-factorial design was a suitable tool to predict an optimized formulation for prolonged intraocular drug delivery.

  7. Occult intraocular trauma: evaluation of the eye in an austere environment.

    PubMed

    Sweet, Patrick H

    2013-03-01

    Physicians deployed to austere environments often encounter the challenge of needing to make clinical decisions based upon rudimentary history and physical examination. These skills, however, can be difficult for many to rely on, with the many subtleties of examining the eye, when they are normally accustomed to relying on sophisticated modalities to establish diagnosis. This case is a model for evaluating eye trauma in an austere or hostile environment. A 25-year-old male U.S. Marine was fired upon at a Mexican Army checkpoint where he sustained glass shrapnel injuries, the most serious being to his right eye. He was taken from a detention facility to a Mexican hospital, where he was evaluated and given the diagnosis of corneal laceration. Twelve hours later, a U.S. Navy physician arrived to evaluate the patient; he was allowed limited access to the patient. His ophthalmologic examination revealed a closed corneal laceration on the right eye, worse than 20/800 vision, absent red reflex, and obscured funduscopic examination. These findings made it impossible to rule out globe penetration. The patient was released 48 h later to a U.S. Naval Hospital, where intraocular foreign bodies were confirmed by imaging and he was taken to emergency surgery. This case illustrates that even under austere conditions, a focused history and evaluation can reveal the likelihood of occult intraocular foreign body, thereby triaging the patient for emergency surgery. Published by Elsevier Inc.

  8. Alcaligenes xylosoxidans endophthalmitis following phacoemulsification and intraocular lens implantation.

    PubMed

    Robert, Pierre-Yves; Chainier, Delphine; Garnier, Fabien; Ploy, Marie-Cécile; Parneix, Pierre; Adenis, Jean-Paul; Martin, Christian

    2008-01-01

    Five consecutive cases of endophthalmitis that developed after cataract extraction by a single surgeon using the same operating room during one morning session are described. Following preoperative topical administration of ciprofloxacin, surgery consisted of phacoemulsification with peristaltic pump and fluid venting, polymethylmethacrylate intraocular lens implantation, and corneal suture. No complications occurred during surgery. All five patients developed endophthalmitis caused by infection with Alcaligenes xylosoxidans in less than 24 hours. Pulsed-field gel electrophoresis was used to prove similarity between strains. Bacterial inquiry on contamination of the operating room environment revealed massive colonization of phacoemulsifier irrigation channels by Pseudomonas fluorescens bacteria from an unestablished source. Four of the five patients ultimately recovered visual acuity better than 20/60.

  9. Repeat sample intraocular pressure variance in induced and naturally ocular hypertensive monkeys.

    PubMed

    Dawson, William W; Dawson, Judyth C; Hope, George M; Brooks, Dennis E; Percicot, Christine L

    2005-12-01

    To compare repeat-sample means variance of laser induced ocular hypertension (OH) in rhesus monkeys with the repeat-sample mean variance of natural OH in age-range matched monkeys of similar and dissimilar pedigrees. Multiple monocular, retrospective, intraocular pressure (IOP) measures were recorded repeatedly during a short sampling interval (SSI, 1-5 months) and a long sampling interval (LSI, 6-36 months). There were 5-13 eyes in each SSI and LSI subgroup. Each interval contained subgroups from the Florida with natural hypertension (NHT), induced hypertension (IHT1) Florida monkeys, unrelated (Strasbourg, France) induced hypertensives (IHT2), and Florida age-range matched controls (C). Repeat-sample individual variance means and related IOPs were analyzed by a parametric analysis of variance (ANOV) and results compared to non-parametric Kruskal-Wallis ANOV. As designed, all group intraocular pressure distributions were significantly different (P < or = 0.009) except for the two (Florida/Strasbourg) induced OH groups. A parametric 2 x 4 design ANOV for mean variance showed large significant effects due to treatment group and sampling interval. Similar results were produced by the nonparametric ANOV. Induced OH sample variance (LSI) was 43x the natural OH sample variance-mean. The same relationship for the SSI was 12x. Laser induced ocular hypertension in rhesus monkeys produces large IOP repeat-sample variance mean results compared to controls and natural OH.

  10. [Pay attention to the application of the international intraocular retinoblastoma classification and sequential multiple modality treatment].

    PubMed

    Fan, X Q

    2017-08-11

    Retinoblastoma (RB) is the most common intraocular malignancy in childhood. It may seriously affect vision, and even threaten the life. The early diagnosis rate of RB in China remains low, and the majority of patients are at late phase with high rates of enucleation and mortality. The International Intraocular Retinoblastoma Classification and TNM staging system are guidances for therapeutic choices and bases for prognosis evaluation. Based on the sequential multi-method treatment modality, chemotherapy combined with local therapy is the mainstream in dealing with RB, which may maximize the results of eye saving and even vision retaining. New therapeutic techniques including supra-selective ophthalmic artery interventional chemotherapy and intravitreal chemotherapy can further improve the efficacy of treatment, especially the eye salvage rate. The overall level of RB treatment should be improved by promoting the international staging, new therapeutic techniques, and the sequential multiple modality treatment. (Chin J Ophthalmol, 2017, 53: 561 - 565) .

  11. Scedosporium prolificans Keratouveitis in Association with a Contact Lens Retained Intraocularly over a Long Term

    PubMed Central

    Arthur, Stella; Steed, Lisa L.; Apple, David J.; Peng, Qun; Howard, Gene; Escobar-Gomez, Marcela

    2001-01-01

    Scedosporium prolificans is a soil saprophyte that is associated with a large variety of infectious processes and with respiratory colonization in immunocompetent and immunocompromised patients. We report the first described case of S. prolificans keratouveitis associated with the intraocular long-term retention of a contact lens in a 76-year-old female patient. PMID:11724890

  12. Immediate effect of intravitreal injection of bevacizumab on intraocular pressure

    PubMed Central

    Lemos-Reis, Ricardo; Moreira-Gonçalves, Nuno; Melo, António B; Carneiro, Ângela M; Falcão-Reis, Fernando M

    2014-01-01

    Purpose To investigate the immediate effect of intravitreal injection of bevacizumab on intraocular pressure (IOP). Methods This was a prospective and nonrandomized study. A total of 291 eyes with macular edema or active choroidal neovascularization were submitted to a single 1.25 mg (0.05 mL) bevacizumab intravitreal injection. Intraocular pressure was measured with an Icare® tonometer immediately before and after injection in a seated position. The presence of subconjunctival reflux was recorded. The fellow eye served as the control. Results Mean preoperative IOP was 18.0±5.9 mmHg in the treated eye versus 16.9±6.0 mmHg in the fellow eye. Mean postoperative IOP was 42.1±14.5 mmHg in the treated eye versus 17.5±6.0 mmHg in the fellow eye. The IOP variation was statistically significant in both cases and controls (P<0.001 and P=0.003, respectively), and this increase was higher in cases than in controls (P<0.001). Postoperative IOPs higher than 50 mmHg were achieved in 32.0% of the eyes. Subconjunctival reflux was present in 21.3% and determined a lower IOP rise (P<0.001). Tested variables (glaucoma, phakic status, and sex) did not have a statistically significant effect on IOP rise or subconjunctival reflux. Conclusion IOP increases with intravitreal bevacizumab injection, reaching 50 mmHg or more in about one third of patients. A higher IOP is expected if no subconjunctival reflux occurs. The baseline IOP does not influence the incidence of subconjunctival reflux. The clinical relevance of these facts has yet to be clarified. PMID:25092962

  13. Effect of Topical Calcium Channel Blockers on Intraocular Pressure in Steroid-induced Glaucoma.

    PubMed

    Ganekal, Sunil; Dorairaj, Syril; Jhanji, Vishal; Kudlu, Krishnaprasad

    2014-01-01

    To evaluate the effect of 0.125% verapamil and 0.5% diltiazem eye drops on intraocular pressure (IOP) in steroid-induced glaucoma in rabbit eyes. A total of 18 rabbits with steroid-induced glaucoma were divided into three groups (A, B and C; n = 6 each). Right eyes in groups A, B and C received 0.5% diltiazem, 0.125% verapamil and 0.5% timolol eye drops twice daily for 12 days, respectively; whereas, left eyes received distilled water. IOP was measured with Tono-pen XL at baseline, day 4, day 8, and day 12 of treatment. Both 0.5% diltiazem and 0.125% verapamil eye drops significantly reduced IOP compared to control eyes (p < 0.05). Reduction of IOP by 0.5% diltiazem, 0.125% verapamil eye drops were comparable to 0.5% timolol. No surface toxicity or systemic side effects were noted during the study period. Calcium channel blockers, verapamil, and diltia-zem significantly reduced IOP in rabbiteyes. This group of drugs may have a potential role in treatment of glaucoma How to cite this article: Ganekal S, Dorairaj S, Jhanji V, Kudlu K. Effect of Topical Calcium Channel Blockers on Intraocular Pressure in Steroid-induced Glaucoma. J Current Glau Prac 2014;8(1):15-19.

  14. Reduced intraocular pressure after cataract surgery in patients with narrow angles and chronic angle-closure glaucoma.

    PubMed

    Brown, Reay H; Zhong, Le; Whitman, Allison L; Lynch, Mary G; Kilgo, Patrick D; Hovis, Kristen L

    2014-10-01

    To evaluate the effect of cataract surgery on intraocular pressure (IOP) in patients with narrow angles and chronic angle-closure glaucoma (ACG) and to determine whether the change in IOP was correlated with the preoperative pressure, axial length (AL), and anterior chamber depth (ACD). Private practice, Atlanta, Georgia, USA. Retrospective case series. Charts of patients with narrow angles or chronic ACG who had cataract surgery were reviewed. All eyes had previous laser iridotomies. Data recorded included preoperative and postoperative IOP, AL, and ACD. The preoperative IOP was used to stratify eyes into 4 groups. The charts of 56 patients (83 eyes) were reviewed. The mean reduction IOP in all eyes was 3.28 mm Hg (18%), with 88% having a decrease in IOP. There was a significant correlation between preoperative IOP and the magnitude of IOP reduction (r = 0.68, P < .001). The mean decrease in IOP was 5.3 mm Hg in eyes with a preoperative IOP above 20 mm Hg, 4.6 mm Hg in the over 18 to 20 mm Hg group, 2.5 mm Hg in the over 15 to 18 mm Hg group, and 1.4 mm Hg in the 15 mm Hg or less group. The mean follow-up was 3.0 years ± 2.3 (SD). Cataract surgery reduced IOP in patients with narrow angles and chronic ACG. The magnitude of reduction was highly correlated with preoperative IOP and weakly correlated with ACD. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  15. [Research on antibodies anti toxoplasma gondii in intraocular fluids (Aqueous and vitreous humor) from patients with ocular toxoplasmosis, in the City of Belém, Pará State].

    PubMed

    Carmo, Ediclei Lima do; Almeida, Edmundo Frota; Bichara, Cléa Nazaré; Póvoa, Marinete Marins

    2005-01-01

    Tests were performed for antibodies IgG, IgM and IgA anti-Toxoplasma gondii antibodies in serum and intraocular fluids (Aqueous and vitreous humor) from patients with ocular toxoplasmosis. By the results obtained, it was verified that intraocular IgG and IgA anti-Toxoplasma gondii antibodies can be important markers for the diagnosis of ocular toxoplasmosis.

  16. Laser-assisted marking for toric intraocular lens alignment.

    PubMed

    Dick, H Burkhard; Schultz, Tim

    2016-01-01

    We describe a technique of 3-dimensional spectral-domain optical coherence tomography-controlled laser-assisted corneal marking for toric intraocular lens implantation. To facilitate accurate alignment, the technique creates 2 perpendicular intrastromal incisions (width 0.75 mm) using an image-guided femtosecond laser. This was performed in a case series comprising 10 eyes of 10 patients. No posterior corneal perforation or epithelial alterations occurred. The incisions were plainly visible under the operating microscope, and no optical phenomena were reported 6 weeks after surgery. Laser-assisted marking can be performed safely and has the potential to enable precise axis marking. Dr. Dick is a paid consultant to Abbott Medical Optics, Inc. Dr. Schultz has no financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  17. Role of intraocular Leptospira infections in the pathogenesis of Equine Recurrent Uveitis in the Southern United States

    USDA-ARS?s Scientific Manuscript database

    To investigate the role of intraocular leptospiral infections in horses with Equine Recurrent Uveitis (ERU) in the southern United States, blood and ocular fluid samples were collected from horses with a history and ocular findings consistent with ERU. Samples were also obtained from control horses ...

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

    PubMed

    Mainster, Martin A; Turner, Patricia L

    2010-04-01

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

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

    PubMed

    Olsen, Thomas

    2007-02-01

    This study aimed to demonstrate how the level of accuracy in intraocular lens (IOL) power calculation can be improved with optical biometry using partial optical coherence interferometry (PCI) (Zeiss IOLMaster) and current anterior chamber depth (ACD) prediction algorithms. Intraocular lens power in 461 consecutive cataract operations was calculated using both PCI and ultrasound and the accuracy of the results of each technique were compared. To illustrate the importance of ACD prediction per se, predictions were calculated using both a recently published 5-variable method and the Haigis 2-variable method and the results compared. All calculations were optimized in retrospect to account for systematic errors, including IOL constants and other off-set errors. The average absolute IOL prediction error (observed minus expected refraction) was 0.65 dioptres with ultrasound and 0.43 D with PCI using the 5-variable ACD prediction method (p < 0.00001). The number of predictions within +/- 0.5 D, +/- 1.0 D and +/- 2.0 D of the expected outcome was 62.5%, 92.4% and 99.9% with PCI, compared with 45.5%, 77.3% and 98.4% with ultrasound, respectively (p < 0.00001). The 2-variable ACD method resulted in an average error in PCI predictions of 0.46 D, which was significantly higher than the error in the 5-variable method (p < 0.001). The accuracy of IOL power calculation can be significantly improved using calibrated axial length readings obtained with PCI and modern IOL power calculation formulas incorporating the latest generation ACD prediction algorithms.

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

    PubMed

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

    1986-11-01

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

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

    PubMed

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

    2002-01-01

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

  2. Effect of oral administration of carprofen on intraocular pressure in normal dogs.

    PubMed

    Meekins, J M; Overton, T L; Rankin, A J; Roush, J K

    2016-08-01

    The aim of this study was to determine the effect of oral administration of carprofen on intraocular pressure in normal dogs. Twelve young adult beagle dogs were randomly assigned to treatment (n = 6) or control (n = 6) groups. After an 11-day acclimation period, the treatment group received approximately 2.2 mg/kg carprofen per os every 12 h for 7 days, and the control group received a placebo gel capsule containing no drug per os every 12 h for 7 days. Intraocular pressure (IOP) was measured by a rebound tonometer at three time points per day (8 am, 2 pm, and 8 pm) during the acclimation (days 1-11) and treatment (days 12-18) phases and for 48 h (days 19-20) after the completion of treatment. There was no statistically significant change in IOP for either eye in the dogs receiving oral carprofen during the treatment phase (days 12-18). After day 4, no significant daily IOP changes were seen in control group dogs. Carprofen administered orally every 12 h for 7 days had no effect on IOP in normal beagle dogs. An acclimation period to frequent IOP measurements of at least 5 days is necessary to establish baseline IOP values and minimize possible anxiety-related effects on IOP measurements. © 2016 John Wiley & Sons Ltd.

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

    PubMed

    Kohnen, Thomas; Kook, Daniel

    2009-08-01

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

  4. Light scatter on the surface of AcrySof intraocular lenses: part I. Analysis of lenses retrieved from pseudophakic postmortem human eyes.

    PubMed

    Yaguchi, Shigeo; Nishihara, Hitoshi; Kambhiranond, Waraporn; Stanley, Daniel; Apple, David J

    2008-01-01

    To investigate the cause of light scatter measured on the surface of AcrySof intraocular lenses (Alcon Laboratories, Inc., Fort Worth, TX) retrieved from pseudophakic postmortem human eyes. Ten intraocular lenses (Alcon AcrySofModel MA60BM) were retrieved postmortem and analyzed for light scatter before and after removal of surface-bound biofilms. Six of the 10 lenses exhibited light scatter that was clearly above baseline levels. In these 6 lenses, both peak and average pixel density were reduced by approximately 80% after surface cleaning. The current study demonstrates that a coating deposited in vivo on the lens surface is responsible for the light scatter observed when incident light is applied.

  5. Eye retraction and rotation during Corvis ST 'air puff' intraocular pressure measurement and its quantitative analysis.

    PubMed

    Boszczyk, Agnieszka; Kasprzak, Henryk; Jóźwik, Agnieszka

    2017-05-01

    The aim of this study was to analyse the indentation and deformation of the corneal surface, as well as eye retraction, which occur during air puff intraocular pressure (IOP) measurement. A group of 10 subjects was examined using a non-contact Corvis ST tonometer, which records image sequences of corneas deformed by an air puff. Obtained images were processed numerically in order to extract information about corneal deformation, indentation and eyeball retraction. The time dependency of the apex deformation/eye retraction ratio and the curve of dependency between apex indentation and eye retraction take characteristic shapes for individual subjects. It was noticed that the eye globes tend to rotate towards the nose in response to the air blast during measurement. This means that the eye globe not only displaces but also rotates during retraction. Some new parameters describing the shape of this curve are introduced. Our data show that intraocular pressure and amplitude of corneal indentation are inversely related (r 8  = -0.83, P = 0.0029), but the correlation between intraocular pressure and amplitude of eye retraction is low and not significant (r 8  = -0.24, P = 0.51). The curves describing corneal behaviour during air puff tonometry were determined and show that the eye globe rotates towards the nose during measurement. In addition, eye retraction amplitudes may be related to elastic or viscoelastic properties of deeper structures in the eye or behind the eye and this should be further investigated. Many of the proposed new parameters present comparable or even higher repeatability than the standard parameters provided by the Corvis ST. © 2017 The Authors Ophthalmic & Physiological Optics © 2017 The College of Optometrists.

  6. An evaluation of novel vital dyes for intraocular surgery.

    PubMed

    Haritoglou, Christos; Yu, Alice; Freyer, Wolfgang; Priglinger, Siegfried G; Alge, Claudia; Eibl, Kirsten; May, Christian A; Welge-Luessen, Ulrich; Kampik, Anselm

    2005-09-01

    To evaluate systematically the staining characteristics and safety of potential new dyes for intraocular surgery. Six dyes were included in the investigation: light green SF (LGSF) yellowish, E68, bromophenol blue (BPB), Chicago blue (CB), rhodamine 6G, rhodulinblau-basic 3 (RDB-B3). All dyes were dissolved and diluted in a balanced saline saline solution. The light-absorbing properties of each dye were measured at a concentration of 0.05% between 200 and 1000 nm. Staining characteristics were examined by staining lens capsule tissue and epiretinal membranes (ERMs), removed intraoperatively, with dye concentrations of 1.0%, 0.5%, 0.2%, and 0.05%. Enucleated porcine eyes (postmortem time, 9 hours) were also stained. Dye-related toxicity was evaluated by a colorimetric test (MTT) measuring the inhibition of retinal pigment epithelium (RPE) cell proliferation (ARPE-19 and primary human RPE cells, passages 3-6). Cell viability was also quantified based on a two-color fluorescence cell-viability assay. Dyes were investigated in concentrations of 0.2% and 0.02%. All dyes investigated in this study stained human lens capsules, removed intraoperatively; ERMs, peeled during macular pucker surgery; and enucleated porcine eyes, depending on the concentration applied. The long-wavelength absorption maximum of the dyes was within the range of 527 to 655 nm at concentrations of 0.05%. Rhodamine G6 and RDB-B3 showed adverse effects on ARPE-19 cell proliferation at a concentration of 0.2% and were excluded from further investigation in primary RPE cells. The remaining four dyes showed no toxic effect on ARPE-19 and primary RPE cell proliferation at concentrations of 0.2% and 0.02%. Cell viability was affected by LGSF yellowish (0.2%) and CB (0.2% and 0.02%). Two dyes (E68 and BPB) showed no relevant toxicity in vitro. The systematic evaluation of dyes for intraocular use seems mandatory. In this study four dyes were identified with effective staining characteristics, with two of

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

    PubMed

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

    2002-01-01

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

  8. Intraocular levels of methotrexate after oral low-dose treatment in chronic uveitis.

    PubMed

    Puchta, Joachim; Hattenbach, Lars-Olof; Baatz, Holger

    2005-01-01

    To determine the intraocular levels of methotrexate in low-dose treatment of noninfectious uveitis. One day after oral administration, the methotrexate level was measured in the aqueous humor and serum of a patient with noninfectious uveitis, who underwent cataract surgery. A fluorescence polarization immunoassay was used for determination. After oral administration, methotrexate was only measurable in aqueous humor but not in serum. In uveitis, orally administered low-dose methotrexate reaches detectable levels in aqueous humor, even in the absence of detectable levels in serum. Copyright (c) 2005 S. Karger AG, Basel.

  9. Aplicación de la metodología Molecular de Orbitales de Defecto Cuántico (MQDO) al cálculo de intensidades vibrónicas y vidas medias de niveles vibracionales

    NASA Astrophysics Data System (ADS)

    María Velasco Sanz, Ana

    Desde que se formuló, en 1996, la metodología Molecular de Orbitales de Defecto Cuántico (MQDO) [1], se han obtenido datos de calidad relativos a intensidades de bandas electrónicas que implican estados Rydberg para una gran variedad de sistemas moleculares [2]. Animados por los buenos resultados obtenidos, recientemente hemos abordado el estudio de transiciones vibrónicas, es decir aquellas que ocurren entre estados vibracionales que pertenecen a distintos estados Rydberg electrónicos. Como prototipo adecuado para nuestros propósitos hemos elegido la molécula de NO, importante en la química de la atmósfera, y para la cual existen en la bibliografía datos experimentales de calidad suficiente para contrastar la validez de nuestros resultados. En concreto, hemos calculado las fuerzas de oscilador y coeficientes de Einstein para transiciones electrónicas y vibrónicas de las principales bandas del NO, al igual que vidas medias radiativas de niveles vibracionales de dicha molécula. Las propiedades estudiadas son esenciales para la comprensión de los aspectos teóricos de los procesos físicos básicos relativos a la dispersión electrónica en moléculas heteronucleares con capas abiertas. Además, valores fiables de probabilidades de transición moleculares tienen importantes aplicaciones en Astrofísica, en la modelización de procesos fotodinámicos moleculares, etc., al igual que para evaluar más profundamente la validez de nuestra metodología teórica.

  10. Combined keratoplasty, cataract extraction, and intraocular lens implantation after corneolenticular laceration in children.

    PubMed

    Vajpayee, R B; Angra, S K; Honavar, S G

    1994-04-15

    Over a period of two years we performed combined penetrating keratoplasty, cataract extraction, and intraocular lens implantation in seven children between the ages of 2 and 12 years old. The interval between trauma and the surgery varied from six weeks to six months (3.5 +/- 1.6 months, mean +/- SD). All of the patients had undergone primary repair of corneal perforation. Fresh corneas preserved in McCarey-Kaufman medium were used. The graft size was 7.5 mm with 0.5 mm disparity. Posterior chamber polymethylmethacrylate C-loop lenses were used in all cases. The surgeon's average postkeratoplasty keratometry was used in the calculation of intraocular lens power. The follow-up period ranged from nine to 36 months (18 +/- 9.1 months, mean +/- SD). Six grafts remained clear at the final follow-up. The visual acuity ranged from 20/40 to 20/200 with final astigmatism ranging from 0.5 diopter to 2.0 diopters. One patient developed a retinal detachment 12 months after surgery, which was successfully reattached. One patient, who had preoperative corneal vascularization, had graft rejection, which was treated medically. Our limited series suggests that the triple ocular procedure is a good choice for the treatment of corneolenticular trauma in children. The proper postoperative treatment includes vigorous antiamblyopia therapy and Nd:YAG laser treatment of after-cataracts.

  11. Incidence of Intraocular Pressure Elevation following Intravitreal Ranibizumab (Lucentis) for Age-related Macular Degeneration.

    PubMed

    Reis, Gustavo Msm; Grigg, John; Chua, Brian; Lee, Anne; Lim, Ridia; Higgins, Ralph; Martins, Alessandra; Goldberg, Ivan; Clement, Colin I

    2017-01-01

    The aim of this article is to evaluate the rate of patients developing sustained elevated intraocular pressure (IOP) after ranibizumab (Lucentis) intravitreal (IVT) injections. This is a retrospective study. Charts of 192 consecutive patients receiving Lucentis for age-related macular degeneration (AMD) were retrospectively reviewed. We enrolled patients with at least two IOP measurements between injections. Elevated IOP was defined as >21 mm Hg with an increase of at least 20% from baseline. Noninjected contralateral eyes of the same patient cohort were used as control. Primary outcome was defined as elevated IOP. Secondary outcomes were presence and type of glaucoma, number of injections, and time to IOP elevation. Elevated IOP occurred at a significantly higher rate in eyes receiving IVT ranibizumab (7.47%; n = 9) compared with control (0.93%; n = 1). Patients with preexisting glaucoma or ocular hypertension (OHT) were more likely to develop elevated IOP after IVT ranibizumab injection. Intravitreal ranibizumab injections are associated with sustained IOP elevation in some eyes. Reis GMSM, Grigg J, Chua B, Lee A, Lim R, Higgins R, Martins A, Goldberg I, Clement CI. The Incidence of Intraocular Pressure Elevation following Intravitreal Ranibizumab (Lucentis) for Age-related Macular Degeneration. J Curr Glaucoma Pract 2017;11(1):3-7.

  12. [The problems of cataract surgery and intraocular correction: Russian school achievements and modern trends].

    PubMed

    Maliugin, B E; Linnik, L F; Egorova, E V; Kopaeva, V G; Tolchinskaia, A I

    2007-01-01

    The development of the safest and, at the same time, efficient methods of cataract surgery, is not only a topical task of medical science and practice, but also, taking the demographic situation into account, a solution to a social problem. The article describes the main achievements of academician S. N. Fyodorov's school in the field of cataract surgery with intraocular lense (IOL) implantation. Special attention is paid to the key components of cataract extraction technique named "small incision surgery", which is based upon the use of ultrasmall surgical approaches with self-sealing ability and no need for suturing. The main advantages and disadvantages of various types of cataract lense fragmentation, including ultrasound emulsification, mechanic and hydraulic fragmentation, and laser destruction, are described. Topical issues concerning cataract extraction technique under the conditions of complicating ophthalmopathology including the weakness of ciliary zonule system, high-degree myopia, glaucoma, pseudoexfoliative syndrome, small pupil, past injuries and eye surgery, are outlined. The paper also reflects a new qualitative step in the development of intraocular aphakia correction technique under modern conditions. Basic requirements to design parameters and IOL materials are determined from the position of reestablishing the accommodative function and fine visual functions. Ways of IOL design improvement are described especially for their application in non-standard and complicated cases.

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

    PubMed

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

    1993-04-01

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

  14. A 6 1/2-years survey of intraocular and intraorbital foreign bodies in the North-west Frontier Province, Pakistan.

    PubMed Central

    Khan, M. D.; Kundi, N.; Mohammed, Z.; Nazeer, A. F.

    1987-01-01

    A survey of 198 patients (210 eyes) with intraocular or intraorbital foreign bodies is presented. Most were males between 16 and 30 years of age, and 6.1% of cases were bilateral. The commonest cause was a flying particle while using a hand hammer, followed by fragments of bomb and mine blasts. Intraorbital foreign bodies occurred in 78 eyes and intraocular foreign bodies in 132 eyes. Irreparable damage caused 13 eyes (6.2%) to be enucleated. Ten eyes developed severe endophthalmitis or panophthalmitis requiring evisceration. One hundred and thirty-four (63.8%) foreign bodies were removed, and 76 (36.2%) foreign bodies could not be removed. The causes of non-removal, the various complications, and the pattern of foreign bodies in the eye or orbit in Pakistan are discussed and compared with those of other regions. PMID:3663566

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

    PubMed

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

    2015-10-01

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

  16. Assessment of Intraocular and Systemic Vasculature Pressure Parameters in Simulated Microgravity with Thigh Cuff Countermeasure

    NASA Technical Reports Server (NTRS)

    Huang, Alex S.; Balasubramanian, Siva; Tepelus, Tudor; Sadda, Jaya; Sadda, Srinivas; Stenger, Michael B.; Lee, Stuart M. C.; Laurie, Steve S.; Liu, John; Macias, Brandon R.

    2017-01-01

    Changes in vision have been well documented among astronauts during and after long-duration space flight. One hypothesis is that the space flight induced headward fluid alters posterior ocular pressure and volume and may contribute to visual acuity decrements. Therefore, we evaluated venoconstrictive thigh cuffs as a potential countermeasure to the headward fluid shift-induced effects on intraocular pressure (IOP) and cephalic vascular pressure and volumes.

  17. Immunological Characterization of Intraocular Lymphoid Follicles in a Spontaneous Recurrent Uveitis Model.

    PubMed

    Kleinwort, Kristina J H; Amann, Barbara; Hauck, Stefanie M; Feederle, Regina; Sekundo, Walter; Deeg, Cornelia A

    2016-08-01

    Recently, formation of tertiary lymphoid structures was demonstrated and further characterized in the R161H mouse model of spontaneous autoimmune uveitis. In the horse model of spontaneous recurrent uveitis, intraocular lymphoid follicle formation is highly characteristic, and found in all stages and scores of disease, but in depth analyses of immunologic features of these structures are lacking to date. Paraffin-embedded eye sections of cases with equine spontaneous recurrent uveitis (ERU) were characterized with immunohistochemistry to gain insight into the distribution, localization, and signaling of immune cells in intraocular tertiary lymphoid tissues. Ectopic lymphoid tissues were located preferentially in the iris, ciliary body, and retina at the ora serrata of horses with naturally-occurring ERU. The majority of cells in the tertiary lymphoid follicles were T cells with a scattered distribution of B cells and PNA+ cells interspersed. A fraction of T cells was additionally positive for memory cell marker CD45RO. Almost all cells coexpressed CD166, a molecule associated with activation and transmigration of T cells into inflamed tissues. Several transcription factors that govern immune cell responses were detectable in the tertiary lymphoid follicles, among them Zap70, TFIIB, GATA3, and IRF4. A high expression of the phosphorylated signal transducers and activators of transcription (STAT) proteins 1 and 5 were found at the margin of the structures. Cellular composition and structural organization of these inflammation-associated tertiary lymphoid tissue structures and the expression of markers of matured T and B cells point to highly organized adaptive immune responses in these follicles in spontaneous recurrent uveitis.

  18. 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

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

    PubMed

    Gunenc, Uzeyir; Kocak, Nilufer; Ozturk, A Taylan; Arikan, Gul

    2014-08-01

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

  20. Regulation of intraocular pressure in mice: structural analysis of dopaminergic and serotonergic systems in response to cabergoline.

    PubMed

    Platania, Chiara Bianca Maria; Leggio, Gian Marco; Drago, Filippo; Salomone, Salvatore; Bucolo, Claudio

    2013-11-01

    Elevated intraocular pressure (IOP) is the main recognized risk factor of glaucoma. To investigate the contribution of dopaminergic and serotonergic systems in IOP regulation, we used cabergoline, a mixed dopamine and serotonin agonist, in C57BL/6J WT and dopamine D₃ receptor knock-out (D₃R⁻/⁻) mice with normal eye pressure or steroid-induced ocular hypertension. Furthermore, we studied the structural basis of the cabergoline-mediated activation of the dopaminergic and serotonergic systems by molecular modeling. Topical application of cabergoline, significantly decreased, in a dose-dependent manner, the intraocular pressure in WT mice, both in an ocular normotensive group (-9, -5 and -2 mmHg with 5%, 1%, and 0.1%, respectively) and an ocular hypertensive group, with a prolonged effect in this latter group. No change of intraocular pressure was observed after topical application of cabergoline in D₃R⁻/⁻ mice. We modeled and optimized, with molecular dynamics, structures of hD₃, h5HT(1A) and h5HT(2A-C) receptors; thereafter we carried out molecular docking of cabergoline. Docking revealed that binding of cabergoline into D₃ and 5HT(1A) receptors is associated with a better desolvation energy in comparison to 5HT(2A-C) binding. In conclusion, the present study support the hypothesis that dopaminergic system is pivotal to regulate IOP and that D₃R represents an intriguing target in the treatment of glaucoma. Furthermore, the structure-based computational approach adopted in this study is able to build and refine structure models of homologous dopaminergic and serotonergic receptors that may be of interest for structure-based drug discovery of ligands, with dopaminergic selectivity or with multi-pharmacological profile, potentially useful to treat optic neuropathies. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Survey of ophthalmic anterior segment findings and intraocular pressure in 95 North American box turtles (Terrapene spp.).

    PubMed

    Espinheira Gomes, Filipe; Brandão, João; Sumner, Julia; Kearney, Michael; Freitas, Inês; Johnson, James; Cutler, Daniel; Nevarez, Javier

    2016-03-01

    To describe the ophthalmic biomicroscopy findings and intraocular pressures (IOP) in a captive population of box turtles and to determine whether a relationship exists between body morphometrics or health status and IOP. Hundred and three box turtles (69 Gulf coast, 24 three-toed, one ornate, one eastern, and eight unidentified) were triaged into three different color-coded groups: green (healthy), yellow (abnormal physical examination with no need for immediate care), and red (immediate care required). Both eyes were evaluated by rebound tonometry and slit-lamp biomicroscopy. Body weight and morphometric data were recorded. Intraocular pressures measurements were available for 190 eyes, slit-lamp biomicroscopy was available for 170 eyes, and morphometric data were available for 81 turtles. IOP in Gulf coast turtles (138 eyes) was 6.7 ± 1.4 mmHg OU. IOP in three-toed turtles (48 eyes) was 8.3 ± 1.5 mmHg OU, which was significantly higher than in Gulf coast turtles (P < 0.0001). No significant IOP differences were noted between genders in both subspecies (P = 0.768). There was a correlation between IOP and health status in three-toed turtles only. There was a mild negative correlation between morphometrics and IOP in Gulf coast and three-toed turtles. Fifteen of 87 turtles had unilateral corneal or lenticular opacities; 3/87 had bilateral corneal or lenticular disease; and 3/87 had adnexal abnormalities. Different subspecies of box turtles have different normal intraocular pressures as measured by rebound tonometry, which was influenced by the animals' health status in one subspecies. Some morphometric parameters were found to be associated with IOP. Box turtles are often affected with ophthalmic abnormalities of unknown clinical significance. © 2015 American College of Veterinary Ophthalmologists.

  2. In Vitro and In Vivo Sustained Zero-Order Delivery of Rapamycin (Sirolimus) From a Biodegradable Intraocular Device.

    PubMed

    Lance, Kevin D; Good, Samuel D; Mendes, Thaís S; Ishikiriyama, Mynna; Chew, Patrick; Estes, Laurel S; Yamada, Kazuhito; Mudumba, Sri; Bhisitkul, Robert B; Desai, Tejal A

    2015-11-01

    We created implantable intraocular devices capable of constant and continuous rapamycin release on the scale of months to years. Polycaprolactone (PCL) thin films were used to encapsulate rapamycin to create implantable and biodegradable intraocular devices. Different film devices were studied by modifying the size, thickness, and porosity of the PCL films. In vitro release of rapamycin was observed to be constant (zero-order) through 14 weeks of study. Release rates were tunable by altering PCL film porosity and thickness. In vivo release of rapamycin was observed out through 16 weeks with concentrations in the retina-choroid in the therapeutic range. Rapamycin concentration in the blood was below the lower limit of quantification. The drug remaining in the device was chemically stable in vitro and in vivo, and was sufficient to last for upwards of 2 years of total release. The mechanism of release is related to the dissolution kinetics of crystalline rapamycin. Microporous PCL thin film devices demonstrate good ocular compatibility and the ability to release rapamycin locally to the eye over the course of many weeks.

  3. In Vitro and In Vivo Sustained Zero-Order Delivery of Rapamycin (Sirolimus) From a Biodegradable Intraocular Device

    PubMed Central

    Lance, Kevin D.; Good, Samuel D.; Mendes, Thaís S.; Ishikiriyama, Mynna; Chew, Patrick; Estes, Laurel S.; Yamada, Kazuhito; Mudumba, Sri; Bhisitkul, Robert B.; Desai, Tejal A.

    2015-01-01

    Purpose We created implantable intraocular devices capable of constant and continuous rapamycin release on the scale of months to years. Methods Polycaprolactone (PCL) thin films were used to encapsulate rapamycin to create implantable and biodegradable intraocular devices. Different film devices were studied by modifying the size, thickness, and porosity of the PCL films. Results In vitro release of rapamycin was observed to be constant (zero-order) through 14 weeks of study. Release rates were tunable by altering PCL film porosity and thickness. In vivo release of rapamycin was observed out through 16 weeks with concentrations in the retina–choroid in the therapeutic range. Rapamycin concentration in the blood was below the lower limit of quantification. The drug remaining in the device was chemically stable in vitro and in vivo, and was sufficient to last for upwards of 2 years of total release. The mechanism of release is related to the dissolution kinetics of crystalline rapamycin. Conclusions Microporous PCL thin film devices demonstrate good ocular compatibility and the ability to release rapamycin locally to the eye over the course of many weeks. PMID:26559479

  4. Design and evaluation of an intraocular B-scan OCT-guided 36-gauge needle

    NASA Astrophysics Data System (ADS)

    Shen, Jin H.; Joos, Karen M.

    2015-03-01

    Optical coherence tomography imaging is widely used in ophthalmology and optometry clinics for diagnosing retinal disorders. External microscope-mounted OCT operating room systems have imaged retinal changes immediately following surgical manipulations. However, the goal is to image critical surgical maneuvers in real time. External microscope-mounted OCT systems have some limitations with problems tracking constantly moving intraocular surgical instruments, and formation of absolute shadows by the metallic surgical instruments upon the underlying tissues of interest. An intraocular OCT-imaging probe was developed to resolve these problems. A disposable 25-gauge probe tip extended beyond the handpiece, with a 36-gauge needle welded to a disposable tip with its end extending an additional 3.5 mm. A sealed 0.35 mm diameter GRIN lens protected the fiber scanner and focused the scanning beam at a 3 to 4 mm distance. The OCT engine was a very high-resolution spectral-domain optical coherence tomography (SDOCT) system (870 nm, Bioptigen, Inc. Durham, NC) which produced 2000 A-scan lines per B-scan image at a frequency of 5 Hz with the fiber optic oscillations matched to this frequency. Real-time imaging of the needle tip as it touched infrared paper was performed. The B-scan OCT-needle was capable of real-time performance and imaging of the phantom material. In the future, the B-scan OCT-guided needle will be used to perform sub-retinal injections.

  5. Hydrophilic acrylic intraocular lens as a drug-delivery system for fourth-generation fluoroquinolones.

    PubMed

    Kleinmann, Guy; Apple, David J; Chew, Jesse; Hunter, Brian; Stevens, Scott; Larson, Scott; Mamalis, Nick; Olson, Randall J

    2006-10-01

    To evaluate the ability and safety of a hydrophilic acrylic intraocular lens (IOL) as a drug-delivery system for commercially available gatifloxacin and moxifloxacin. David J. Apple, MD, Laboratories for Ophthalmic Research, John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, Utah, USA. Thirty rabbits were divided into 2 similar groups. In Group A (15 rabbits, 30 eyes), hydrophilic acrylic IOLs (C-flex, Rayner Intraocular Lenses, Ltd.) presoaked for 24 hours in commercially available solutions of gatifloxacin 3 mg/mL or moxifloxacin 5 mg/mL were implanted after evacuation of the crystalline lens. Group B (15 rabbits, 30 eyes) had topical preoperative and postoperative cataract prophylaxis with gatifloxacin 3 mg/mL or moxifloxacin 5 mg/mL; IOLs that were not presoaked were also implanted after evacuation of the crystalline lenses. In both groups, aqueous humor samples were taken 4, 8, or 12 hours after IOL implantation (5 eyes at each time point) to determine the antibiotic concentrations. Clinical examinations were performed 24 hours postoperatively. The antibiotic concentrations in Group A (presoaked IOLs) were statistically significantly higher than those in Group B (topical) for both antibiotics in all postoperative samples except moxifloxacin at 12 hours. In both groups, there was no statistically significant difference between the concentrations of the 2 antibiotics. No eye showed signs of clinical toxicity. Results show the C-flex IOL is a safe and effective drug-delivery system for fourth-generation fluoroquinolones.

  6. Positional and rotational stability of the toric phakic intraocular lens under high +Gz environments.

    PubMed

    Tan, Marcus C L; Nah, Gerard K M

    2012-02-01

    Phakic intraocular lens (PIOL) implantation is a surgical option for correction of refractive errors. PIOLs can be use to correct myopia, hyperopia, and astigmatism. It is a surgical option available to patients in addition to methods such as laser cornea refractive surgery, e.g., laser assisted in-situ keratomileusis (LASIK) and photo-refractive keratectomy (PRK). Visian implantable collamer lens (ICL) are posterior chamber lenses which are surgically positioned in a phakic eye in the sulcus between the iris diaphragm and the natural crystalline lens. This case report describes the stability of Visian toric ICL in a candidate with bilateral implants under high +Gz force exposure in a human centrifuge trainer. The subject was sequentially exposed to three incremental +Gz profiles of +5 Gz, +7 Gz, and +9 Gz. Pre- and post-+Gz exposure, ophthalmic examination revealed no ICL displacement, implant touch or induced cataract, or change in refractive error. The rotational stability of the toric implants was also demonstrated by identical subjective refractions in both eyes taken pre- and post-+Gz, exposure. A search of the literature did not reveal any published articles on intraocular stability of ICL in the +Gz environment. This case report suggests that ICL may be considered an alternative to laser refractive surgery for patients subjected to a high +G, environment such as military aviators.

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

    PubMed

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

    2014-07-01

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

  8. Intra-ocular lens optical changes resulting from the loading of dexamethasone.

    PubMed

    Artigas, José M; García-Domene, M Carmen; Navea, Amparo; Botella, Pablo; Fernández, Eduardo

    2017-10-01

    To study the optical changes on hydrogel-silicone intraocular lenses (IOLs) resulting from loading them with dexamethasone. We used prototype hydrogel(pHEMA)-silicone IOLs and loaded the matrices with an anti-inflammatory drug (dexamethasone). The optical properties we analyzed experimentally were a) modulation transfer function (MTF); b) spectral transmission; c) diopter power. These determinations were performed on drug-loaded IOLs, IOLs that had released the drug, and IOLs that had not been drug-loaded. Loading a hydrogel-silicone IOL with dexamethasone results in impairment of its optical qualities, in particular its MTF and spectral transmission, but not dioptric power. However, once the drug has been released, it almost recovers its initial optical properties.

  9. Intra-ocular lens optical changes resulting from the loading of dexamethasone

    PubMed Central

    Artigas, José M.; García-Domene, M. Carmen; Navea, Amparo; Botella, Pablo; Fernández, Eduardo

    2017-01-01

    To study the optical changes on hydrogel-silicone intraocular lenses (IOLs) resulting from loading them with dexamethasone. We used prototype hydrogel(pHEMA)-silicone IOLs and loaded the matrices with an anti-inflammatory drug (dexamethasone). The optical properties we analyzed experimentally were a) modulation transfer function (MTF); b) spectral transmission; c) diopter power. These determinations were performed on drug-loaded IOLs, IOLs that had released the drug, and IOLs that had not been drug-loaded. Loading a hydrogel-silicone IOL with dexamethasone results in impairment of its optical qualities, in particular its MTF and spectral transmission, but not dioptric power. However, once the drug has been released, it almost recovers its initial optical properties. PMID:29082089

  10. 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

  11. 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

  12. 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

  13. Injectable suture device for intraocular lens fixation.

    PubMed

    Smith, Jesse M; Erlanger, Michael; Olson, Jeffrey L

    2015-12-01

    We describe a surgical technique for scleral fixation of a posterior chamber intraocular lens (PC IOL) using a 24-gauge injectable polypropylene suture delivery system. A 3-piece PC IOL is inserted into the anterior chamber of the eye. Two sclerotomies are made 1.5 mm posterior to the limbus using a microvitreoretinal blade. The 24-gauge injector delivers a preformed suture loop into the eye with the double-armed needles still external to the eye. Each polypropylene IOL haptic is directed through the loop using microforceps. The suture loop is tightened around the haptic, and the attached needles are used to fixate the IOL to the sclera and close the sclerotomies simultaneously. This technique has been used in an ex vivo porcine eye and in an aphakic patient. In the latter, the IOL was quickly fixated to the sclera and maintained a stable position postoperatively. Dr. Olson has a patent pending for the device described in this article. No other author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  14. Intraocular pressure in the smallest primate aging model: the gray mouse lemur.

    PubMed

    Dubicanac, Marko; Joly, Marine; Strüve, Julia; Nolte, Ingo; Mestre-Francés, Nadine; Verdier, Jean-Michel; Zimmermann, Elke

    2018-05-01

    The aim of this study was to assess the practicability of common tonometers used in veterinary medicine for rapid intraocular pressure (IOP) screening, to calibrate IOP values gained by the tonometers, and to define a reference IOP value for the healthy eye in a new primate model for aging research, the gray mouse lemur. TonoVet ® and the TonoPen ™ measurements were calibrated manometrically in healthy enucleated eyes of mouse lemurs euthanized for veterinary reasons. For comparison of the practicability of both tonometers as a rapid IOP assessment tool for living mouse lemurs, the IOP of 24 eyes of 12 animals held in the hand was measured. To define a standard reference value for IOP in mouse lemurs, 258 healthy animals were measured using the TonoVet ® . Intraocular pressure measurements for the TonoVet ® can be corrected using the formula: y = 0.981 + (1.962*TonoVet ® value), and those for the TonoPen ™ using that of y = 5.38 + (1.426*TonoPen ™ value). The calibrated IOP for a healthy mouse lemur eye was 20.3 ± 2.8 mmHg. The TonoVet ® showed advantages in practicability, for example, small corneal contact area, short and painless corneal contact, shortened total time spent on investigation, as well as the more accurate measured values. IOP measurements of healthy mouse lemur eyes were not affected by age, sex, eye side, or colony. Tonometry using TonoVet ® is the more practicable assessment tool for IOP measurement of the tiny eyes of living mouse lemurs. Pathological deviations can be identified based on the described reference value. © 2016 American College of Veterinary Ophthalmologists.

  15. High Refractive Index Polysiloxane as Injectable, In Situ Curable Accommodating Intraocular Lens

    PubMed Central

    Hao, Xiaojuan; Jeffery, Justine L.; Le, Tam P.T.; McFarland, Gail; Johnson, Graham; Mulder, Roger J.; Garrett, Qian; Manns, Fabrice; Nankivil, Derek; Arrieta, Esdras; Ho, Arthur; Parel, Jean-Marie; Hughes, Timothy C.

    2012-01-01

    Functionalised siloxane macromonomers, with properties designed for application as an injectable, in situ curable accommodating intraocular lens (A-IOL), were prepared via reequilibration of a phenyl group-containing polysiloxane of very high molecular weight with octamethylcyclotetrasiloxane (D4) and 2,4,6,8-tetra(n-propyl-3-methacrylate)-2,4,6,8-tetramethylcyclotetrasiloxane (D4AM) in toluene using trifluoromethanesulfonic acid as a catalyst. Hexaethyldisiloxane was used as an end group to control the molecular weight of the polymer. The generated polymers had a consistency suitable for injection into the empty lens capsule. The polymers contained a low ratio of polymerisable groups so that, in the presence of a photo-initiator, they could be cured on demand in situ within 5 minutes under irradiation of blue light to form an intraocular lens within the lens capsule. All resulting polysiloxane soft gels had a low elastic modulus and thus should be able to restore accommodation. The pre-cure viscosity and post-cure modulus of the generated polysiloxanes were controlled by the end group and D4AM concentrations respectively in the re-equilibration reactions. The refractive index could be precisely controlled by adjusting the aromatic ratio in the polymer to suit such application as an artificial lens. Lens stretching experiments with both human and non-human primate cadaver lenses of different ages refilled with polysiloxane polymers provided a significant increase in amplitude of accommodation (up to 4 D more than that of the respective natural lens). Both in vitro cytotoxicity study using L929 cell lines and in vivo biocompatibility study in rabbit models demonstrated the non-cytotoxicity and ocular biocompatibility of the polymer. PMID:22594975

  16. Adjunctive steroid therapy versus antibiotics alone for acute endophthalmitis after intraocular procedure.

    PubMed

    Kim, Carole H; Chen, Monica F; Coleman, Anne L

    2017-02-22

    Endophthalmitis refers to severe infection within the eye that involves the aqueous humor or vitreous humor, or both, and threatens vision. Most cases of endophthalmitis are exogenous (i.e. due to inoculation of organisms from an outside source), and most exogenous endophthalmitis is acute and occurs after an intraocular procedure. The mainstay of treatment is emergent administration of broad-spectrum intravitreous antibiotics. Due to their anti-inflammatory effects, steroids in conjunction with antibiotics have been proposed to be beneficial in endophthalmitis management. To assess the effects of antibiotics combined with steroids versus antibiotics alone for the treatment of acute endophthalmitis following intraocular surgery or intravitreous injection. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 11), MEDLINE Ovid (1946 to 8 December 2016), Embase Ovid (1980 to 8 December 2016), LILACS (Latin American and Caribbean Health Sciences Literature Database) (1982 to 8 December 2016), the ISRCTN registry (www.isrctn.com/editAdvancedSearch); searched 8 December 2016, ClinicalTrials.gov (www.clinicaltrials.gov); searched 8 December 2016, and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched 8 December 2016. We did not use any date or language restrictions in the electronic searches for trials. We included randomized controlled trials comparing the effectiveness of adjunctive steroids with antibiotics alone in the management of acute, clinically diagnosed endophthalmitis following intraocular surgery or intravitreous injection. We excluded trials with participants with endogenous endophthalmitis unless outcomes were reported by source of infection. We imposed no restrictions on the method or order of administration, dose, frequency, or duration of antibiotics and steroids. Two review authors independently screened the

  17. Adjunctive steroid therapy versus antibiotics alone for acute endophthalmitis after intraocular procedure

    PubMed Central

    Kim, Carole H; Chen, Monica F; Coleman, Anne L

    2017-01-01

    Background Endophthalmitis refers to severe infection within the eye that involves the aqueous humor or vitreous humor, or both, and threatens vision. Most cases of endophthalmitis are exogenous (i.e. due to inoculation of organisms from an outside source), and most exogenous endophthalmitis is acute and occurs after an intraocular procedure. The mainstay of treatment is emergent administration of broad-spectrum intravitreous antibiotics. Due to their anti-inflammatory effects, steroids in conjunction with antibiotics have been proposed to be beneficial in endophthalmitis management. Objectives To assess the effects of antibiotics combined with steroids versus antibiotics alone for the treatment of acute endophthalmitis following intraocular surgery or intravitreous injection. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 11), MEDLINE Ovid (1946 to 8 December 2016), Embase Ovid (1980 to 8 December 2016), LILACS (Latin American and Caribbean Health Sciences Literature Database) (1982 to 8 December 2016), the ISRCTN registry (www.isrctn.com/editAdvancedSearch); searched 8 December 2016, ClinicalTrials.gov (www.clinicaltrials.gov); searched 8 December 2016, and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched 8 December 2016. We did not use any date or language restrictions in the electronic searches for trials. Selection criteria We included randomized controlled trials comparing the effectiveness of adjunctive steroids with antibiotics alone in the management of acute, clinically diagnosed endophthalmitis following intraocular surgery or intravitreous injection. We excluded trials with participants with endogenous endophthalmitis unless outcomes were reported by source of infection. We imposed no restrictions on the method or order of administration, dose, frequency, or duration of antibiotics and

  18. Quantitative assessment of corneal vibrations during intraocular pressure measurement with the air-puff method in patients with keratoconus.

    PubMed

    Koprowski, Robert; Ambrósio, Renato

    2015-11-01

    One of the current methods for measuring intraocular pressure is the air-puff method. A tonometer which uses this method is the Corvis device. With the ultra-high-speed (UHS) Scheimpflug camera, it is also possible to observe corneal deformation during measurement. The use of modern image analysis and processing methods allows for analysis of higher harmonics of corneal deflection above 100 Hz. 493 eyes of healthy subjects and 279 eyes of patients with keratoconus were used in the measurements. For each eye, 140 corneal deformation images were recorded during intraocular pressure measurement. Each image was recorded every 230 µs and had a resolution of 200 × 576 pixels. A new, original algorithm for image analysis and processing has been proposed. It enables to separate the eyeball reaction as well as low-frequency and high-frequency corneal deformations from the eye response to an air puff. Furthermore, a method for classification of healthy subjects and patients with keratoconus based on decision trees has been proposed. The obtained results confirm the possibility to distinguish between patients with keratoconus and healthy subjects. The features used in this classification are directly related to corneal vibrations. They are only available in the proposed software and provide specificity of 98%, sensitivity-85%, and accuracy-92%. This confirms the usefulness of the proposed method in this type of classification that uses corneal vibrations during intraocular pressure measurement with the Corvis tonometer. With the new proposed algorithm for image analysis and processing allowing for the separation of individual features from a corneal deformation image, it is possible to: automatically measure corneal vibrations in a few characteristic points of the cornea, obtain fully repeatable measurement of vibrations for the same registered sequence of images and measure vibration parameters for large inter-individual variability in patients. Copyright © 2015 Elsevier

  19. Influence of the effective lens position, as predicted by axial length and keratometry, on the near add power of multifocal intraocular lenses.

    PubMed

    Savini, Giacomo; Hoffer, Kenneth J; Lombardo, Marco; Serrao, Sebastiano; Schiano-Lomoriello, Domenico; Ducoli, Pietro

    2016-01-01

    To calculate the near focal distance of different multifocal intraocular lenses (IOLs) as a function of the 2 parameters that are measured before cataract surgery; that is, axial length (AL) and refractive corneal power (keratometry [K]). GB Bietti Foundation IRCCS, Rome, Italy. Noninterventional theoretical study. The IOL power for emmetropia was first calculated in an eye model with the AL ranging from 20 to 30 mm and K from 38 to 48 diopters (D). Then, the predicted myopic refraction for any given IOL add power (from +1.5 to +4.0 D) was calculated, and from this value the near focal distance was obtained. Calculations were also performed for the average eye (K = 43.81 D; AL = 23.65 mm). The near focal distance increased with increasing values of K and AL for each near power add. The near focal distance ranged between 53 cm and 72 cm (21 inches and 28 inches) for a multifocal IOL with +2.50 D, between 44 cm and 60 cm (17 inches and 24 inches) for a multifocal IOL with +3.00 D add, and between 33 cm and 44 cm (13 inches and 18 inches) for a multifocal IOL with +4.00 D add. In the average eye, the near focal distance ranges between 36 cm (near add power = 4.00 D) and 99 cm (near add power = 1.5 D). Longer eyes with steeper corneas showed the longest near focal distance and could experience more difficulties in focusing near objects after surgery. The opposite was true for short hyperopic eyes. Dr. Hoffer receives licensing fees for the commercial use of the registered trademark Hoffer from all biometry manufacturers using the Hoffer Q formula to ensure that it is programmed correctly and book royalties from Slack, Inc., for the textbook IOL Power. None of the authors has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  20. Comparison of Visual Performance of Multifocal Intraocular Lenses with Same Material Monofocal Intraocular Lenses

    PubMed Central

    Yamauchi, Tomofusa; Tabuchi, Hitoshi; Takase, Kosuke; Ohsugi, Hideharu; Ohara, Zaigen; Kiuchi, Yoshiaki

    2013-01-01

    Purpose To compare the visual performance of multifocal intraocular lenses (IOLs) and monofocal IOLs made of the same material. Methods The subjects included patients implanted with either Tecnis® monofocal IOLs (ZA9003 or ZCB00) or Tecnis® multifocal IOLs (ZMA00 or ZMB00) bilaterally. We conducted a retrospective study comparing the two types of IOLs. The multifocal group included 46 patients who were implanted with Tecnis® multifocal IOLs bilaterally. The monofocal group was an age- and sex-matched control group, and included 85 patients who were implanted with Tecnis® monofocal IOLs bilaterally. Lens opacity grading, the radius of corneal curvature, corneal astigmatism, axial length and the refractive status were measured preoperatively. Pupil size, ocular aberrometry, distance, intermediate and near visual acuity, contrast sensitivity with and without glare and the responses to a quality-of-vision questionnaire were evaluated pre- and postoperatively. Results The uncorrected near visual acuity was significantly better in the multifocal group, whereas both the corrected intermediate and near visual acuity were better in the monofocal group. Contrast sensitivity (with and without glare) was significantly better in the monofocal group. The rate of spectacle dependency was significantly lower in the multifocal group. There were no significant differences between the two groups regarding most items of the postoperative quality-of-vision questionnaire (VFQ-25), with the exception that the patients in the monofocal group reported fewer problems with nighttime driving. Conclusions The multifocal IOLs used in this study reduced spectacle dependency more so than monofocal IOLs and did not compromise the subjective visual function, with the exception of nighttime driving. PMID:23840836

  1. Induction of antibody response in the oral cavity of dogs following intraocular (eye drop) immunization with Porphyromonas gingivalis cell lysate incorporated in pH-sensitive fusogenic polymer-modified liposomes.

    PubMed

    Shimizu, Yosuke; Iwasaki, Tadashi; Tajima, Tomoko; Yuba, Eiji; Kono, Kenji; Watarai, Shinobu

    2017-02-14

    Induction of mucosal immune responses against Porphyromonas gingivalis within the oral cavity of dogs was studied by immunizing with pH-sensitive fusogenic polymer (MGluPG)-modified liposome-associated cell lysate. Dogs immunized with P. gingivalis cell lysate-containing MGluPG-modified liposomes by intraocular (eye drop) route displayed significant levels of P. gingivalis cell lysate-specific serum IgG and IgA as well as mucosal IgA antibodies in saliva secretion. Serum and salivary antibodies generated by intraocularly immunized with MGluPG-modified liposome-associated P. gingivalis cell lysate revealed a significant aggregation activity against P. gingivalis, whereas serum and saliva from dogs receiving MGluPG-modified liposomes unentrapping P. gingivalis cell lysate did not show the aggregation activity against P. gingivalis. Furthermore, P. gingivalis-specific antibodies in saliva of immunized dogs inhibited the adherence of P. gingivalis to cultured HeLa cells. More importantly, salivary antibodies induced by intraocular immunization with P. gingivalis cell lysate-containing MGluPG-modified liposomes significantly inhibited the coaggregation of P. gingivalis with Actinomyces naeslundii and the cell damage activity of P. gingivalis against FaDu cells, an oral epithelial cell. These results suggest that intraocularly administered P. gingivalis cell lysate-containing MGluPG-modified liposomes should be an effective mucosal vaccine against P. gingivalis infection in dogs and may be an important tool for the prevention of periodontitis.

  2. Short-Term Moderately Elevated Intraocular Pressure Is Associated With Elevated Scotopic Electroretinogram Responses

    PubMed Central

    Choh, Vivian; Gurdita, Akshay; Tan, Bingyao; Prasad, Ratna C.; Bizheva, Kostadinka; Joos, Karen M.

    2016-01-01

    Purpose Moderately elevated intraocular pressure (IOP) is a risk factor for open-angle glaucoma. Some patients suffer glaucoma despite clinically measured normal IOPs. Fluctuations in IOP may have a significant role since IOPs are higher during sleep and inversion activities. Controlled transient elevations of IOPs in rats over time lead to optic nerve structural changes that are similar to the early changes observed in constant chronic models of glaucoma. Because early intervention decreases glaucoma progression, this study was done to determine if early physiological changes to the retina could be detected with noninvasive electrophysiological and optical imaging tests during moderately elevated IOP. Methods Intraocular pressures were raised to moderately high levels (35 mm Hg) in one eye of Sprague-Dawley rats while the other (control) eye was untreated. One group of rats underwent scotopic threshold response (STR) and electroretinogram (ERG) testing, while another 3 groups underwent optical coherence tomography (OCT) imaging, Western blot, or histologic evaluation. Results The amplitudes of the STR and ERG responses in eyes with moderately elevated IOPs were enhanced compared to the values before IOP elevation, and compared to untreated contralateral eyes. Structural changes to the optic nerve also occurred during IOP elevation. Conclusions Although ischemic IOP elevations are well-known to globally reduce components of the scotopic ERG, acute elevation in rats to levels often observed in untreated glaucoma patients caused an increase in these parameters. Further exploration of these phenomena may be helpful in better understanding the mechanisms mediating early retinal changes during fluctuating or chronically elevated IOP. PMID:27100161

  3. Short-Term Intraocular Pressure Rise during Locally Induced Force by Ophthalmologic Surgery Applications.

    PubMed

    Koelbl, Philipp Simon; Werner, Jens Ulrich; Enders, Christian; Lingenfelder, Christian; Koch, Frank H J; Hessling, Martin

    2018-05-31

    Surgical or diagnostic procedures are often accompanied by a short-term increase in intraocular pressure (IOP). A short-term increase in IOP can occur during refractive procedures, vitreoretinal surgery, transillumination, photocoagulation, or cryocoagulation. A porcine eye model was chosen (n = 89) to compile comparable study data and to de termine correlations between the force induced and the resulting intraocular pressure while excluding the effect of surgeons. The IOP was measured in the anterior chamber. IOP changes were induced by applying an external force and measured when using a cannula, trocar, and cryocoagulation (n = 32), and correlations between force and resulting IOP were assessed (n = 57). A correlation was noted between the force induced and the IOP increase, which showed a linear dependency. The insertion of a 29-G cannula caused a mean ΔIOP value of 49.1 ± 2.9 mm Hg and an external force of 0.76 N, and that of a 23-G trocar 344.4 ± 5.9 mm Hg and 6.09 N, respectively. The rise in IOP during a simulated cryocoagulation reached values between 57.3 ± 14.8 mm Hg (cryoprobe tip diameter: 0.9 mm) and 130.3 ± 2.9 mm Hg (cryoprobe tip diameter: 7.0 mm). The values of the forces applied can be converted into the resulting IOP based on the specific action. Surgical or diagnostic procedures should, therefore, be evaluated with regard to preexisting pathologies, such as glaucoma. © 2018 S. Karger AG, Basel.

  4. Predictive factors for photic phenomena after refractive, rotationally asymmetric, multifocal intraocular lens implantation

    PubMed Central

    Tchah, Hungwon; Nam, Kiyeun; Yoo, Aeri

    2017-01-01

    AIM To investigate the independent factors associated with photic phenomena in patients implanted with refractive, rotationally asymmetric, multifocal intraocular lenses (MIOLs). METHODS Thirty-four eyes of 34 patients who underwent unilateral cataract surgery, followed by implantation of rotationally asymmetric MIOLs were included. Distance and near visual acuity outcomes, intraocular aberrations, preferred reading distances, preoperative and postoperative refractive errors, mesopic and photopic pupil diameters, and the mesopic and photopic kappa angles were assessed. Patients were also administered a satisfaction survey. Photic phenomena were graded by questionnaire. Independent-related factors were identified by correlation and bivariate logistic regression analyses. RESULTS The distance from the photopic to the mesopic pupil center (pupil center shift) was significantly associated with glare/halo symptoms [odds ratio (OR)=2.065, 95% confidence interval (CI)=0.916-4.679, P=0.006] and night vision problems (OR=1.832, 95% CI=0.721-2.158, P=0.007). The preoperative photopic angle kappa was significantly associated with glare/halo symptoms (OR=2.155, 95% CI=1.065-4.362, P=0.041). The photopic angle kappa was also significantly associated with glare/halo symptoms (OR=2.155, 95% CI=1.065-4.362, P=0.041) and with night vision problems (OR=1.832, 95% CI=0.721-2.158, P=0.007) in patients implanted with rotationally asymmetric MIOLs. CONCLUSION A large pupil center shift and misalignment between the visual and pupillary axis (angle kappa) may play a role in the occurrence of photic phenomena after implantation of rotationally asymmetric MIOLs. PMID:28251083

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

    PubMed Central

    Vilar, César; Hida, Wilson Takashi; de Medeiros, André Lins; Magalhães, Klayny Rafaella Pereira; de Moraes Tzelikis, Patrick Frensel; Chaves, Mario Augusto Pereira Dias; Motta, Antônio Francisco Pimenta; Carricondo, Pedro Carlos; Alves, Milton Ruiz; Nosé, Walton

    2017-01-01

    Purpose To compare visual outcomes and performance between bilateral implantation of a diffractive trifocal intraocular lens (IOL) Acrysof®PanOptix® TFNT00 and blended implantation of two different near add power bifocal IOLs: Acrysof® Restor® SV25T0 in dominant eye and Acrysof® Restor® SN6AD1 in the nondominant eye. Methods This prospective, nonrandomized, consecutive and comparative study assessed 20 patients (40 eyes) who had bilateral cataract surgery performed using the IOLs described. Patients were divided into groups, bilateral trifocal implant and blended implant. Evaluation included measurement of binocular uncorrected and corrected distance visual acuity at 4 m (UDVA, CDVA) and uncorrected intermediate (60 cm) and near (at 40 cm) visual acuity; contrast sensitivity (CS) and visual defocus curve. Results Postoperative CDVA comparison showed no statistical significance between groups. UDVA was significantly better in the trifocal groups. Under photopic conditions, the trifocal group had better CS in higher frequencies with and without glare. The binocular defocus curve demonstrated a trifocal behavior in both groups, with the bilateral trifocal group exhibiting better performance for intermediate vision. Conclusion Both lens combinations were able to provide good near, intermediate and distance vision, with the trifocal group showing significantly better performance at intermediate distances and better CS under photopic conditions. PMID:28814826

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

    PubMed

    Stevens, Scott; Werner, Liliana; Mamalis, Nick

    2007-01-01

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

  7. The Impact of Adherence and Instillation Proficiency of Topical Glaucoma Medications on Intraocular Pressure

    PubMed Central

    Shibeshi, Workineh; T. Giorgis, Abeba; Asgedom, Solomon Weldegebreal

    2017-01-01

    Background The possible sequel of poorly controlled intraocular pressure (IOP) includes treatment failure, unnecessary medication use, and economic burden on patients with glaucoma. Objective To assess the impact of adherence and instillation technique on IOP control. Methods A cross-sectional study was conducted on 359 glaucoma patients in Menelik II Hospital from June 1 to July 31, 2015. After conducting a Q-Q analysis, multiple binary logistic analyses, linear regression analyses, and two-tailed paired t-test were conducted to compare IOP in the baseline versus current measurements. Results Intraocular pressure was controlled in 59.6% of the patients and was relatively well controlled during the study period (mean (M) = 17.911 mmHg, standard deviation (S) = 0.323) compared to the baseline (M = 20.866 mmHg, S = 0.383, t (358) = −6.70, p < 0.0001). A unit increase in the administration technique score resulted in a 0.272 mmHg decrease in IOP (p = 0.03). Moreover, primary angle-closure glaucoma (adjusted odds ratio (AOR) = 0.347, 95% confidence interval (CI): 0.144–0.836) and two medications (AOR = 1.869, 95% CI: 1.259–9.379) were factors affecting IOP. Conclusion Good instillation technique of the medications was correlated with a reduction in IOP. Consequently, regular assessment of the instillation technique and IOP should be done for better management of the disease. PMID:29104803

  8. The Impact of Adherence and Instillation Proficiency of Topical Glaucoma Medications on Intraocular Pressure.

    PubMed

    Atey, Tesfay Mehari; Shibeshi, Workineh; T Giorgis, Abeba; Asgedom, Solomon Weldegebreal

    2017-01-01

    The possible sequel of poorly controlled intraocular pressure (IOP) includes treatment failure, unnecessary medication use, and economic burden on patients with glaucoma. To assess the impact of adherence and instillation technique on IOP control. A cross-sectional study was conducted on 359 glaucoma patients in Menelik II Hospital from June 1 to July 31, 2015. After conducting a Q-Q analysis, multiple binary logistic analyses, linear regression analyses, and two-tailed paired t-test were conducted to compare IOP in the baseline versus current measurements. Intraocular pressure was controlled in 59.6% of the patients and was relatively well controlled during the study period (mean ( M ) = 17.911 mmHg, standard deviation ( S ) = 0.323) compared to the baseline ( M = 20.866 mmHg, S = 0.383, t (358) = -6.70, p < 0.0001). A unit increase in the administration technique score resulted in a 0.272 mmHg decrease in IOP ( p = 0.03). Moreover, primary angle-closure glaucoma (adjusted odds ratio (AOR) = 0.347, 95% confidence interval (CI): 0.144-0.836) and two medications (AOR = 1.869, 95% CI: 1.259-9.379) were factors affecting IOP. Good instillation technique of the medications was correlated with a reduction in IOP. Consequently, regular assessment of the instillation technique and IOP should be done for better management of the disease.

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

    NASA Astrophysics Data System (ADS)

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

    2010-10-01

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

  10. Dynamic changes of the intraocular pressure and the pressure of cerebrospinal fluid in nonglaucomatous neurological patients.

    PubMed

    González-Camarena, Pedro Iván; San-Juan, Daniel; González-Olhovich, Irene; Rodríguez-Arévalo, David; Lozano-Elizondo, David; Trenado, Carlos; Anschel, David J

    2017-03-01

    To describe the dynamic changes of the intraocular pressure (IOP) and intracranial pressure (ICP) with normal or pathological values (intracranial hypertension) in nonglaucomatous neurological patients during lumbar punction (LP). Case-control study, prospective measurement of tonometry in both groups referred for LP. Intraocular pressure, ICP and translaminar pressure difference (TPD) were compared pre- and post-LP. Thirty-six patients (72 eyes) with mean age of 38.5 (16-64) years and BMI of 26.81 kg/m 2 were analysed. The initial mean ICP was 12.81 (± 6.6) mmHg. The mean TPD before and after the LP was 1.48 mmHg and 0.65 mmHg, respectively. The mean IOP of both eyes decreased to 0.8 mmHg post-LP in patients with pathological ICP (p = 0.0193) and normal ICP (p = 0.006). We found a statistically significant decrease of the IOP post-LP compared to the pre-LP in both groups, being higher in patients with pathological ICP. There were no significant differences of the IOP in patients with normal versus pathological ICP pre-LP/post-LP; neither was found a correlation between ICP and IOP. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  11. [Long-term results of posterior chamber phakic intraocular lens implantation for correction of high ametropia].

    PubMed

    Le Loir, M; Cochener, B

    2012-06-01

    To assess efficacy, stability and safety of posterior chamber phakic intraocular lens implantation with STAAR Visian ICL for correction of high ametropia, with a mean follow-up of 5 years (3.5-10 years). Ninety eyes of 53 highly ametropic patients (45 myopia, ten hyperopia and 35 with mixed astigmatism) were included in a retrospective single-surgeon study, using primarily the V4 ICL model (87 eyes). We studied pre- and postoperative refractive efficacy, endothelial cell density, crystalline lens opacification and intraocular clearances within the various compartments of the eye. Mean uncorrected visual acuity was 0.77 at the 12th postoperative month; 17 of 90 eyes required adjunctive photoablation for residual astigmatism. Forty-eight percent of eyes gained at least one line of best corrected visual acuity. After implantation, the decrease in endothelial cell density remained stable at 0.69%/year, and 91% of eyes showed no opacification of the crystalline lens. Mean endothelium-ICL and ICL-crystalline lens distances were 2.41 mm and 0.52 mm respectively. Overall patient satisfaction achieved was 96% at 36 months postoperatively. These results demonstrate efficacy, stability and safety of the ICL V4 phakic IOL for the correction of high ametropia. Long-term follow-up did not show a significant increase in cataract formation in implanted eyes. Copyright © 2012. Published by Elsevier Masson SAS.

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

    PubMed

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

    2013-03-01

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

  13. Capsule-Fixated Intraocular Lens Implantation in Small Pupil Cases.

    PubMed

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

    2017-08-01

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

  14. Comparison of AL-Scan and IOLMaster 500 Partial Coherence Interferometry Optical Biometers.

    PubMed

    Hoffer, Kenneth J; Savini, Giacomo

    2016-10-01

    To investigate agreement between the ocular biometry measurements provided by a newer optical biometer, the AL-Scan (Nidek Co, Ltd., Gamagori, Japan) and those provided by the IOLMaster 500 (Carl Zeiss Meditec, Jena Germany), which are both based on partial coherence interferometry. Axial length, corneal power, and anterior chamber depth (corneal epithelium to lens) were measured in 86 eyes of 86 patients scheduled for cataract surgery using both biometers. All values were analyzed using a paired t test, the Pearson product moment correlation coefficient (r), and Bland-Altman plots. The mean axial length values of both instruments were exactly the same (23.46 ± 0.99 mm) for both) and showed excellent agreement and correlation. On the contrary, the AL-Scan measured a steeper mean corneal power by 0.08 diopters (D) at the 2.4-mm zone but by only 0.03 D at the 3.3-mm zone, only the former being statistically significant. The AL-Scan measured a deeper anterior chamber depth by 0.13 mm, which was statistically significant (P < .001). Agreement between the two units was good. However, the small but statistically significant difference in corneal power (at the IOLMaster-comparable 2.4-mm zone) and in the anterior chamber depth measurement make lens constant optimization necessary when calculating the intraocular lens power by means of theoretical formulas. [J Refract Surg. 2016;32(10):694-698.]. Copyright 2016, SLACK Incorporated.

  15. Scleral fixation of one piece intraocular lens by injector implantation

    PubMed Central

    Can, Ertuğrul; Başaran, Reşat; Gül, Adem; Birinci, Hakkı

    2014-01-01

    Aim of Study: With an ab-interno technique of transscleral suturing of current one-piece posterior chamber intraocular lenses (PC IOLs) by injector implantation in the absence of capsular support, we aimed to demonstrate the possibility of the implantation of one-piece acrylic PC IOLs that might be produced in the future for only scleral fixation through small clear corneal incision. Materials and Methods: Case report and literature review. Results: This procedure has been performed in eight aphakic eyes with four different types of IOLs. Good centration was achieved with minimal technical effort. All patients had well-centered and stable lenses postoperatively during 9-18 months follow-up. Conclusion: We managed to decrease the risks of surgical trauma and intricate surgical maneuvers requirement. With this technique, excessive fluid leakage and consecutive hypotony can be minimized. PMID:25230961

  16. Femtosecond laser–assisted cataract surgery in vitrectomized eye with posterior chamber phakic intraocular lens

    PubMed Central

    Anisimova, Natalia; Malyugin, Boris; Arbisser, Lisa B.; Sobolev, Nikolay

    2017-01-01

    Summary We describe a case of femtosecond laser–assisted cataract surgery (FLACS) in an eye with multiple comorbidities, including retinal detachment surgery, high myopia, posterior chamber phakic intraocular lens (PC pIOL) and residual, emulsified, silicone oil located in the anterior chamber. FLACS was affected by the optical blockage, but the incomplete capsular tear was recoverable. The case suggests that silicone oil bubbles concentrated at the dome of the posterior corneal surface, along with the PC pIOL optic edges and scars after corneal astigmatic relaxing incisions can lead to incomplete anterior capsulotomy. PMID:28924422

  17. Study of the effect of distance and misalignment between magnetically coupled coils for wireless power transfer in intraocular pressure measurement.

    PubMed

    Rendon-Nava, Adrian E; Díaz-Méndez, J Alejandro; Nino-de-Rivera, Luis; Calleja-Arriaga, Wilfrido; Gil-Carrasco, Felix; Díaz-Alonso, Daniela

    2014-01-01

    An analysis of the effect of distance and alignment between two magnetically coupled coils for wireless power transfer in intraocular pressure measurement is presented. For measurement purposes, a system was fabricated consisting of an external device, which is a Maxwell-Wien bridge circuit variation, in charge of transferring energy to a biomedical implant and reading data from it. The biomedical implant is an RLC tank circuit, encapsulated by a polyimide coating. Power transfer was done by magnetic induction coupling method, by placing one of the inductors of the Maxwell-Wien bridge circuit and the inductor of the implant in close proximity. The Maxwell-Wien bridge circuit was biased with a 10 MHz sinusoidal signal. The analysis presented in this paper proves that wireless transmission of power for intraocular pressure measurement is feasible with the measurement system proposed. In order to have a proper inductive coupling link, special care must be taken when placing the two coils in proximity to avoid misalignment between them.

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

    NASA Astrophysics Data System (ADS)

    Plylar, Helen Bond

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

  19. Evaluation of the quality of generic polymethylmethacrylate intraocular lenses marketed in India.

    PubMed

    Combe, R; Watkins, R; Brian, G

    2001-04-01

    To determine the quality of single-piece, allpolymethylmethacrylate (PMMA) Intraocular lenses (IOLs) from eght generic manufacturers marketing their product in India. This assessment of quality was made with respect to compliance with internationa standards for the manufacture of IOLs, specifically those parameters most likely to affect patient postoperat ve visual acuity and the long-term biocompatibility of the implanted lens. Ten IOLs from each of eight manufacturers were purchased randomly from commercial retail outlets in India. Each IOL, in a masked fashion, had its physical dimensions, optical performance and cosmetic appearance assessed, using the methods prescribed in ISO 11979-2 and 11979-3. Validation of manufacturing process controls were determined by statistical process contro techniques. Four IOLs from each manufacturer were also tested for the presence of unpolymerized PMMA using gas chromatography. Only lenses from two IOL manufacturers complied with the optical and mechanical standards. All other manufacturers' lenses failed one or more of these tests. Intraocular lenses from only two producers met with surface quality and bulk homogeneity standards. All others exhibited defects such as surface contamination and scratches, poor polishing, and chipped or rough positioning holes. Lenses from two producers exhibited high levels of methylmethacrylate monomer (MMA). Non-clinical grade PMMA starting material may have been used in the manufacture of IOLs by some producers. Critical manufacturing defects occurred in the IOLs from five of the eight producers tested. Only one manufacturer's IOLs met all specifications, and on statistical analysis demonstrated good manufacturing process contro with respect to the properties tested. With the widespread acceptance of IOL implantation in developing countries, such as India, it is essential that in the rush to make this the norm, the quality of implants used not be overlooked.

  20. Management of dislocated intraocular lenses with iris suture.

    PubMed

    Faria, Mun Y; Ferreira, Nuno P; Canastro, Mario

    2017-01-19

    Subluxated or malpositioned intraocular lenses (IOLs) and inadequate capsular support is a challenge for every ophthalmic surgeon. Iris suture of an IOL seems to be an easy technique for the management of dislocated 3-piece IOL, allowing the IOL to be placed behind the iris, far from the trabecular meshwork and corneal endothelium. The purpose of this study is to assess the results of pars plana vitrectomy (PPV) and iris suture of dislocated 3-piece acrylic IOLs. In this retrospective, nonrandomized, interventional case consecutive study, of a total of 103 dislocated IOLs, 36 eyes were considered for analysis. All 36 eyes had subluxated or totally luxated 3-piece IOL and underwent iris suture at the Ophthalmology Department of Santa Maria Hospital-North Lisbon Hospital Center, Portugal, from January 2011 until November 2015. All patients underwent 3-port 23-G PPV. The optic zone of the dislocated IOL was placed anterior to the iris with the haptics behind, in the posterior chamber. Haptics were sutured to iris followed by placement of the optics behind iris plane. Postoperative measures included best-corrected visual acuity (BCVA), IOL position, intraocular pressure, pigment dispersion, clinical signs of endothelial cell loss, and development of macular edema. A total of 36 eyes of 36 patients were included. All underwent successful iris fixation of dislocated 3-piece IOL. Mean overall follow-up was 15.9 months (range 3-58 months). At presentation, 16 eyes (44.4%) had a luxated IOL and 20 eyes (55.6%) a subluxated IOL. As underlying cause, 17 eyes (47.2%) had a history of complicated cataract surgery, 5 eyes (13.9%) had a traumatic dislocation of the IOL, and 6 eyes (16.7%) had a previous vitreoretinal surgery. A total of 8 eyes (22.2%) had late spontaneous IOL dislocation after uneventful cataract surgery. The mean preoperative BCVA was 1.09 ± 0.70 logarithm of the minimal angle of resolution (logMAR) units and mean postoperative BCVA was 0.48 ± 0.58 of log

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

    PubMed

    Nuzzi, Raffaele; Monteu, Francesca; Tridico, Federico

    2017-01-01

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

  2. Engineering hurdles in contact and intraocular lens lathe design: the view ahead

    NASA Astrophysics Data System (ADS)

    Bradley, Norman D.; Keller, John R.; Ball, Gary A.

    1994-05-01

    Current trends in and intraocular lens design suggest ever- increasing demand for aspheric lens geometries - multisurface and/or toric surfaces - in a variety of new materials. As computer numeric controls (CNC) lathes and mills continue to evolve with he ophthalmic market, engineering hurdles present themselves to designers: Can hardware based upon single-point diamond turning accommodate the demands of software-driven designs? What are the limits of CNC resolution and repeatability in high-throughput production? What are the controlling factors in lathed, polish-free surface production? Emerging technologies in the lathed biomedical optics field are discussed along with their limitations, including refined diamond tooling, vibrational control, automation, and advanced motion control systems.

  3. The effects of Helicobacter pylori infection on intraocular pressure in anterior uveitis

    PubMed Central

    Kim, J M; Park, K H; Choi, M J; Ha, M M; Sohn, Y H; Kim, H K; Caprioli, J

    2012-01-01

    Purpose We investigated the influence of H. pylori infection on intraocular pressure (IOP) in anterior uveitis patients to clarify whether H. pylori infection is related to high IOP in anterior uveitis. Methods In this prospective study, 165 Korean anterior uveitis patients were examined. All patients underwent serological analysis to identify the cause of uveitis, including the presence of H. pylori infection by enzyme-linked immunosorbent assay. Serological values were compared between patients with and without high IOP. Results Seropositivity for H. pylori was 69.70% of patients with high IOP and 38.38% of patients with normal IOP (P<0.01). Conclusion This study suggests that H. pylori infection is associated with high IOP in anterior uveitis. PMID:23154495

  4. Image-guided intraocular injection using multimodality optical coherence tomography and fluorescence confocal scanning laser ophthalmoscopy in rodent ophthalmological models

    NASA Astrophysics Data System (ADS)

    Terrones, Benjamin D.; Benavides, Oscar R.; Leeburg, Kelsey C.; Mehanathan, Sankarathi B.; Levine, Edward M.; Tao, Yuankai K.

    2018-02-01

    Intraocular injections are routinely performed for delivery of anti-VEGF and anti-inflammatory therapies in humans. While these injections are also performed in mice to develop novel models of ophthalmic diseases and screen novel therapeutics, the injection location and volume are not well-controlled and reproducible. We overcome limitations of conventional injections methods by developing a multimodality, long working distance, non-contact optical coherence tomography (OCT) and fluorescence confocal scanning laser ophthalmoscopy (cSLO) system for retinal imaging before and after injections. Our OCT+cSLO system combines a custom-built spectraldomain OCT engine (875+/-85 nm) with 125 kHz line-rate with a modified commercial cSLO with a maximum frame-rate of 30 fps (512 x 512 pix.). The system was designed for an overlapping OCT+cSLO field-of-view of 1.1 mm with a 7.76 mm working distance to the pupil. cSLO excitation light sources and filters were optimized for simultaneous GFP and tdTomato imaging. Lateral resolution was 3.02 µm for OCT and 2.74 μm for cSLO. Intravitreal injections of 5%, 10%, and 20% intralipid with Alex Fluor 488 were manually injected intraocularly in C57BL/6 mice. Post-injection imaging showed structural changes associated with retinal puncture, including the injection track, a retinal elevation, and detachment of the posterior hyaloid. OCT enables quantitative analysis of injection location and volumes whereas complementary cSLO improves specificity for identifying fluorescently labeled injected compounds and transgenic cells. The long working distance of our non-contact OCT+cSLO system is uniquely-suited for concurrent imaging with intraocular injections and may be applied for imaging of ophthalmic surgical dynamics and real-time image-guided injections.

  5. Iris-claw versus posterior chamber fixation intraocular lens implantation in pediatric traumatic cataract☆

    PubMed Central

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

    2016-01-01

    Aim: This study aims to compare visual outcomes and complications of iris-fixated (claw) intraocular lens (IFIOL) implantation with those of posterior chamber intraocular lens (PCIOL) implantation in children with traumatic cataract. Settings and design: Retrospective observational clinical audit. Materials and methods: A total of 50 pediatric traumatic cataract cases that underwent lens removal and IOL implantation (IFIOL or PCIOL) with or without corneal or corneoscleral tear repair between January 2009 and December 2013 were analyzed. After meeting the eligibility criteria, their pre- and postoperative visual outcomes and complication rates were recorded. Data were analyzed descriptively. Results: Out of 50 children, IFIOL and PCIOL implantations were performed in one eye of each of 25 children. Their mean age was 11 ± 4 years (range 4–18 years). Primary (cataract removal with lens implantation) and secondary (corneal tear repair followed by cataract removal with lens implantation) procedures were performed in 19 (76%) and six (24%) children in the IFIOL group and in 21 (84%) and four (16%) children in the PCIOL group, respectively. There was an improvement in best corrected visual acuity postimplantation in both the IFIOL and the PCIOL group, and no significant difference in the logarithm of the minimum angle of resolution of best corrected visual acuity was observed between the two groups over 36 months. Only three eyes in the IFIOL group developed complications: one eye developed secondary glaucoma, one disenclavation of IOL haptic, and one cystoid macular edema. Conclusion: Both IFIOL and PCIOL implantations have good visual outcomes and minimal postoperative complications; therefore, IFIOL can be used as an alternative to PCIOL in children with traumatic cataract with inadequate capsular support. PMID:29018714

  6. Intraoperative assessment of intraocular pressure in vitrectomized air-filled and fluid-filled eyes.

    PubMed

    Moon, Chan Hee; Choi, Kyung Seek; Rhee, Mi Ri; Lee, Sung Jin

    2013-11-01

    To ascertain the difference of intraocular pressure (IOP) measurement between vitrectomized air-filled and fluid-filled eyes. Thirty-one eyes of 31 consecutive patients who underwent conventional vitrectomy and intraocular gas tamponade were assessed. After vitrectomy, IOP of the fluid-filled eyes was measured by Tono-Pen. Thereafter, fluid-air exchange was performed, and IOP of the air-filled eyes was measured again. The IOP within each fluid- and air-filled eye was varied by selecting settings on the vitrectomy system, from 10 to 50 mmHg with 5-mmHg increments. Postoperatively, IOP was assessed by both Tono-Pen and Goldmann applanation tonometry (GAT). Linear and nonlinear regression analyses were conducted between intraoperatively measured Tono-Pen readings and actual IOPs. Bland-Altman plot was used to assess the agreements between postoperatively measured Tono-Pen readings and GAT readings. The discrepancy between Tono-Pen readings and actual IOP in fluid-filled eyes was not significant, except for the profound high pressures over 45 mmHg. However, Tono-Pen readings in air-filled eyes were significantly lower than actual IOPs in all ranges, and Tono-Pen increasingly underestimates IOP at higher levels. Intraoperative Tono-Pen readings were correlated significantly with actual IOP and a quadratic equation evidenced the best fit (R(2) = 0.996). Postoperatively, difference of the measurements between Tono-Pen and GAT was not significant. Tono-Pen and GAT significantly underestimate actual IOP in air-filled eyes. It should be considered that actual IOP would be greater than the measured IOP in gas-filled eyes, even though the IOP is measured as normal. © 2013 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  7. Intraocular and extraocular cameras for retinal prostheses: Effects of foveation by means of visual prosthesis simulation

    NASA Astrophysics Data System (ADS)

    McIntosh, Benjamin Patrick

    Blindness due to Age-Related Macular Degeneration and Retinitis Pigmentosa is unfortunately both widespread and largely incurable. Advances in visual prostheses that can restore functional vision in those afflicted by these diseases have evolved rapidly from new areas of research in ophthalmology and biomedical engineering. This thesis is focused on further advancing the state-of-the-art of both visual prostheses and implantable biomedical devices. A novel real-time system with a high performance head-mounted display is described that enables enhanced realistic simulation of intraocular retinal prostheses. A set of visual psychophysics experiments is presented using the visual prosthesis simulator that quantify, in several ways, the benefit of foveation afforded by an eye-pointed camera (such as an eye-tracked extraocular camera or an implantable intraocular camera) as compared with a head-pointed camera. A visual search experiment demonstrates a significant improvement in the time to locate a target on a screen when using an eye-pointed camera. A reach and grasp experiment demonstrates a 20% to 70% improvement in time to grasp an object when using an eye-pointed camera, with the improvement maximized when the percept is blurred. A navigation and mobility experiment shows a 10% faster walking speed and a 50% better ability to avoid obstacles when using an eye-pointed camera. Improvements to implantable biomedical devices are also described, including the design and testing of VLSI-integrable positive mobile ion contamination sensors and humidity sensors that can validate the hermeticity of biomedical device packages encapsulated by hermetic coatings, and can provide early warning of leaks or contamination that may jeopardize the implant. The positive mobile ion contamination sensors are shown to be sensitive to externally applied contamination. A model is proposed to describe sensitivity as a function of device geometry, and verified experimentally. Guidelines are

  8. Biomechanical properties of crystalline lens as a function of intraocular pressure assessed noninvasively by optical coherence elastography

    NASA Astrophysics Data System (ADS)

    Wu, Chen; Aglyamov, Salavat R.; Liu, Chih-Hao; Han, Zhaolong; Singh, Manmohan; Larin, Kirill V.

    2017-02-01

    Many ocular diseases such as glaucoma and uveitis can lead to the elevation of intraocular pressure (IOP). Previous research implies a link between elevated IOP and lens disease. However, the relationship between IOP elevation and biomechanical properties of the crystalline lens has not been directly studied yet. In this work, we investigated the biomechanical properties of porcine lens as a function of IOP by acoustic radiation force optical coherence elastography.

  9. Capsular Outcomes After Pediatric Cataract Surgery Without Intraocular Lens Implantation

    PubMed Central

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

    2016-01-01

    Abstract The objective of this study was to investigate capsular outcomes 12 months after pediatric cataract surgery without intraocular lens implantation via qualitative classification and quantitative measurement. This study is a cross-sectional study that was approved by the institutional review board of Zhongshan Ophthalmic Center of Sun Yat-sen University in Guangzhou, China. Digital coaxial retro-illumination photographs of 329 aphakic pediatric eyes were obtained 12 months after pediatric cataract surgery without intraocular lens implantation. Capsule digital coaxial retro-illumination photographs were divided as follows: anterior capsule opening area (ACOA), posterior capsule opening area (PCOA), and posterior capsule opening opacity (PCOO). Capsular outcomes were qualitatively classified into 3 types based on the PCOO: Type I—capsule with mild opacification but no invasion into the capsule opening; Type II—capsule with moderate opacification accompanied by contraction of the ACOA and invasion to the occluding part of the PCOA; and Type III—capsule with severe opacification accompanied by total occlusion of the PCOA. Software was developed to quantitatively measure the ACOA, PCOA, and PCOO using standardized DCRPs. The relationships between the accurate intraoperative anterior and posterior capsulorhexis sizes and the qualitative capsular types were statistically analyzed. The DCRPs of 315 aphakic eyes (95.8%) of 191 children were included. Capsular outcomes were classified into 3 types: Type I—120 eyes (38.1%); Type II—157 eyes (49.8%); Type III—38 eyes (12.1%). The scores of the capsular outcomes were negatively correlated with intraoperative anterior capsulorhexis size (R = −0.572, P < 0.001), but no significant correlation with intraoperative posterior capsulorhexis size (R = −0.16, P = 0.122) was observed. The ACOA significantly decreased from Type I to Type II to Type III, the PCOA increased in size from Type I to Type

  10. 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

  11. Pseudo retinitis pigmentosa in a case of missed intraocular foreign body.

    PubMed

    Temkar, Shreyas; Mukhija, Ritika; Venkatesh, Pradeep; Chawla, Rohan

    2017-07-31

    A 35-year-old man presented with history of painless, progressive loss of vision in the left eye for the past 7 years. There was history of trauma to the same eye with an iron object 7 years prior. Fundus examination revealed pigmentary retinopathy (unilateral advanced retinitis pigmentosa (RP)-like picture). X-ray orbits were suspicious of retained intraocular foreign body (IOFB). CT orbits confirmed the presence of IOFB. Electroretinogram revealed depressed responses. Right eye examination was within normal limits. A diagnosis of siderosis bulbi with unilateral pseudo RP-like fundus was made. No surgical intervention was planned for IOFB in view of poor visual prognosis. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Simple technique to measure toric intraocular lens alignment and stability using a smartphone.

    PubMed

    Teichman, Joshua C; Baig, Kashif; Ahmed, Iqbal Ike K

    2014-12-01

    Toric intraocular lenses (IOLs) are commonly implanted to correct corneal astigmatism at the time of cataract surgery. Their use requires preoperative calculation of the axis of implantation and postoperative measurement to determine whether the IOL has been implanted with the proper orientation. Moreover, toric IOL alignment stability over time is important for the patient and for the longitudinal evaluation of toric IOLs. We present a simple, inexpensive, and precise method to measure the toric IOL axis using a camera-enabled cellular phone (iPhone 5S) and computer software (ImageJ). Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  13. High intraocular pressure produces learning and memory impairments in rats.

    PubMed

    Yuan, Yuxiang; Chen, Zhiqi; Li, Lu; Li, Xing; Xia, Qian; Zhang, Hong; Duan, Qiming; Zhao, Yin

    2017-11-15

    Primary open angle glaucoma (POAG) is a leading cause of irreversible blindness worldwide. Previous MRI studies have revealed that POAG can be associated with alterations in hippocampal function. Thus, the aim of this study was to investigate a relationship between chronic high intraocular pressure (IOP) and hippocampal changes in a rat model. We used behavioural tests to assess learning and memory ability, and additionally investigated the hippocampal expression of pathological amyloid beta (Aβ), phospho-tau, and related pathway proteins. Chronic high IOP impaired learning and memory in rats and concurrently increased Aβ and phospho-tau expression in the hippocampus by altering the activation of different kinase (GSK-3β, BACE1) and phosphatase (PP2A) proteins in the hippocampus. This study provides novel evidence for the relationship between high IOP and hippocampal alterations, especially in the context of learning and memory. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Safety of medium-chain triglycerides used as an intraocular tamponading agent in an experimental vitrectomy model rabbit.

    PubMed

    Auriol, Sylvain; Mahieu, Laurence; Brousset, Pierre; Malecaze, François; Mathis, Véronique

    2013-01-01

    To evaluate safety of medium-chain triglycerides used as a possible intraocular tamponading agent. A 20-gauge pars plana vitrectomy was performed in the right eye of 28 rabbits. An ophthalmologic examination was performed every week until rabbits were killed. At days 7, 30, 60, and 90, rabbits were killed and the treated eyes were examined macroscopically and prepared for histologic examination. Principal outcome was retinal toxicity evaluated by light and electron microscopy, and secondary outcomes were the presence of medium-chain triglyceride emulsification, inflammatory reactions, and the development of cataract. Histologic examination did not reveal any retinal toxicity. Two cases of moderate emulsification were observed, but in these cases, emulsification was caused by the perioperative injection of the agent and did not increase during the postoperative period. We noted 13 cases of inflammatory reaction in vitreous cavity and no case of inflammatory reaction in anterior chamber. Two eyes developed cataract as a result of perioperative trauma to the lens with the vitreous cutter and not secondary to the presence of medium-chain triglycerides in the vitreous cavity. Medium-chain triglycerides did not induce morphologic evidence of retinal toxicity. The results suggest that medium-chain triglycerides could be a promising alternative intraocular tamponading agent for the treatment of retinal detachments.

  15. Comparison of decentration and tilt between one piece and three piece polymethyl methacrylate intraocular lenses

    PubMed Central

    Hayashi, K.; Hayashi, H.; Nakao, F.; Hayashi, F.

    1998-01-01

    BACKGROUND—The extent of the decentration and tilt was prospectively compared between one piece polymethyl methacrylate (PMMA) and three piece PMMA intraocular lenses (IOLs) which were implanted in the capsular bag after performing continuous curvilinear capsulorhexis.
METHODS—91 patients underwent a one piece PMMA IOL implantation in one eye as well as the implantation of the three piece PMMA IOL with polyvinylidene fluoride loops in the opposite eye. The length of the lens decentration and the angle of the tilt were quantitated using the anterior eye segment analysis system (EAS-1000) at 1 week as well as 1, 3, and 6 months postoperatively.
RESULTS—The mean length of the decentration in the one piece IOL was smaller than that in the three piece IOL at 1 week (p=0.0092), 1 month (p=0.0044), 3 months (p=0.0069), and 6 months (p=0.0010) postoperatively. However, no significant difference was found in the degree of the tilt between the two types of IOLs throughout the observation periods.
CONCLUSION—These results clarified that the one piece PMMA IOL with rigid PMMA haptics implanted in the capsular bag provides a better centration than the three piece PMMA IOL with flexible haptics, whereas the tilt was the same between the two types of IOLs.

 Keywords: intraocular lens; decentration; tilt; continuous curvilinear capsulorhexis PMID:9640193

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

    PubMed

    Fouda, Sameh Mosaad; Al Aswad, Mahmoud A; Ibrahim, Basem M; Bori, Ashraf; Mattout, Hala K

    2016-12-01

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

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

    PubMed

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

    2017-11-08

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

  18. Intraocular lens design for treating high myopia based on individual eye model

    NASA Astrophysics Data System (ADS)

    Wang, Yang; Wang, Zhaoqi; Wang, Yan; Zuo, Tong

    2007-02-01

    In this research, we firstly design the phakic intraocular lens (PIOL) based on individual eye model with optical design software ZEMAX. The individual PIOL is designed to correct the defocus and astigmatism, and then we compare the PIOL power calculated from the individual eye model with that from the experiential formula. Close values of PIOL power are obtained between the individual eye model and the formula, but the suggested method has more accuracy with more functions. The impact of PIOL decentration on human eye is evaluated, including rotation decentration, flat axis decentration, steep axis decentration and axial movement of PIOL, which is impossible with traditional method. To control the PIOL decentration errors, we give the limit values of PIOL decentration for the specific eye in this study.

  19. Effect of ophthalmic solution components on acrylic intraocular lenses.

    PubMed

    Ayaki, Masahiko; Nishihara, Hitoshi; Yaguchi, Shigeo; Koide, Ryohei

    2007-01-01

    To investigate the effect of ophthalmic solution components on the surface of acrylic intraocular lenses (IOLs). Department of Opthalmology, Showa University School of Medicine. Measurement of the contact angles of ophthalmic solutions on 3 acrylic IOLs was performed. The solutions were diclofenac sodium (Diclod), bromfenac sodium (Bronuck), betamethasone phosphate (Rinderon), dibekacin sulfate (Panimycin), polysorbate 80 (Tween 20), benzalkonium chloride, chlorobutanol, methylparahydroxybenzoate, and propylparahydroxybenzoate. The IOLs were incubated at 35 degrees C for 2 weeks in undiluted ophthalmic solutions and in 1:10 dilutions of ophthalmic solution components. The IOLs were sectioned and observed by scanning electron microscopy. The contact angle of Diclod and Bronuck solutions was the smallest. The contact angle of Rinderon and Panimycin was similar to that of distilled water. Scanning electron microscopy examination of IOLs incubated in ophthalmic solution components showed intralenticular changes. The IOLs immersed in ophthalmic solutions did not show any change, even after extended incubation. The chemical components of ophthalmic solutions, such as surfactants and solvents, permeate acrylic IOLs, suggesting the potential for long-term adverse effects of eyedrops in pseudophakic eyes.

  20. Temporal multiplexing to simulate multifocal intraocular lenses: theoretical considerations

    PubMed Central

    Akondi, Vyas; Dorronsoro, Carlos; Gambra, Enrique; Marcos, Susana

    2017-01-01

    Fast tunable lenses allow an effective design of a portable simultaneous vision simulator (SimVis) of multifocal corrections. A novel method of evaluating the temporal profile of a tunable lens in simulating different multifocal intraocular lenses (M-IOLs) is presented. The proposed method involves the characteristic fitting of the through-focus (TF) optical quality of the multifocal component of a given M-IOL to a linear combination of TF optical quality of monofocal lenses viable with a tunable lens. Three different types of M-IOL designs are tested, namely: segmented refractive, diffractive and refractive extended depth of focus. The metric used for the optical evaluation of the temporal profile is the visual Strehl (VS) ratio. It is shown that the time profiles generated with the VS ratio as a metric in SimVis resulted in TF VS ratio and TF simulated images that closely matched the TF VS ratio and TF simulated images predicted with the M-IOL. The effects of temporal sampling, varying pupil size, monochromatic aberrations, longitudinal chromatic aberrations and temporal dynamics on SimVis are discussed. PMID:28717577

  1. The vascular basis of the positional influence of the intraocular pressure.

    PubMed

    Krieglstein, G K; Waller, W K; Leydhecker, W

    1978-05-02

    By measuring intraocular pressure in different body positions from 60 degrees semiupright to 30 degrees head down, a nonlinear relationship between IOP increase and body position was confirmed. IOP postural response in individual subjects was roughly correlated to ophthalmic arterial pressure and to the episcleral venous pressure postural response. In one series of subjects, the episcleral venous pressure increments due to posture wa; parallel to the applanation-indentation disparity in the same individual eyes. Differential tonometry with applanation or indentation procedures under blind conditions gave significantly low indentation readings. It is concluded that IOP postural response depends on arterial and venous vascular changes when subjects move from an erect to a horizontal body position. Blood expulsion from the choroid by indentation tonometry might be the reason that this tonometric procedure does not measure IOP changes based on vascular changes.

  2. Voltage-controlled IPMC actuators for accommodating intra-ocular lens systems

    NASA Astrophysics Data System (ADS)

    Horiuchi, Tetsuya; Mihashi, Toshifumi; Fujikado, Takashi; Oshika, Tetsuro; Asaka, Kinji

    2017-04-01

    An ion polymer-metal composite (IPMC) actuator has unique performance characteristics that were applied in this study for use within the eye. Cataracts are a common eye disease causing clouding of the lens. To treat cataracts, surgeons replace clouded lenses with intraocular lenses (IOLs). However, patients who receive this treatment must still wear reading glasses for tasks requiring close-up vision. We suggest a new voltage-controlled accommodating IOL consisting of an IPMC actuator to change the lens’ focus. We examined the relationship between the displacement performance of an IPMC actuator and the accommodating range of the IOL using in vitro experiments. We show that this system has an accommodating range of approximately 1.15 D under an applied voltage of ±1.2 V. By Lagrange interpolation, we estimate that with an IPMC actuator displacement of 0.14 mm, we can achieve a refractive power of 4 D, which is equivalent to the accommodating range of a 40 year old person.

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

    PubMed

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

    2017-09-01

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

  4. The importance of quantitative measurement methods for uveitis: laser flare photometry endorsed in Europe while neglected in Japan where the technology measuring quantitatively intraocular inflammation was developed.

    PubMed

    Herbort, Carl P; Tugal-Tutkun, Ilknur

    2017-06-01

    Laser flare photometry (LFP) is an objective and quantitative method to measure intraocular inflammation. The LFP technology was developed in Japan and has been commercially available since 1990. The aim of this work was to review the application of LFP in uveitis practice in Europe compared to Japan where the technology was born. We reviewed PubMed articles published on LFP and uveitis. Although LFP has been largely integrated in routine uveitis practice in Europe, it has been comparatively neglected in Japan and still has not received FDA approval in the USA. As LFP is the only method that provides a precise measure of intraocular inflammation, it should be used as a gold standard in uveitis centres worldwide.

  5. [Evaluation of Postoperative Astigmatism Correction and Postoperative Rotational Stability of Two Toric Intraocular Lenses].

    PubMed

    Grohlich, M; Miháltz, K; Lasta, M; Weingessel, B; Vécsei-Marlovits, V

    2017-06-01

    Background The aim of this retrospective study was to evaluate the rotational stability and the refractive outcome of two different toric IOLs. Methods This study included 41 eyes with corneal astigmatism greater than 1.5 diopters (D). All patients underwent surgery in the Department of Ophthalmology at Hietzing Hospital between 2010 and 2013. The study lenses were the Alcon AcrySof IQ Toric IOL and the Abbott Tecnis Toric Aspheric IOL. Measurements of corneal topography and aberrations were performed with the HOYA iTrace™. Determination of visual acuity was performed with ETDRS charts. Optical aberrations were represented by Zernike coefficients, and optical quality was assessed with the Strehl ratio. Results Mean rotation was 4.92° (standard deviation: ± 4.10°) in the Alcon group and 4.31° (± 4.59°) in the Abbott group. No significant difference was observed between the two toric intraocular lenses. Rotational stability was comparable to results from other studies. Astigmatism correction was visualised with a power-vector analysis, which demonstrated similar results in both lenses and a clear success of astigmatism correction. No statistically significant differences were found in residual refractive astigmatism, which was 0.85 ± 0.48 D in the Alcon group and 1.09 ± 0.66 in the Tecnis group. No significant difference between the two groups was found in the Strehl ratio. Conclusion Implantation of toric intraocular lenses (Alcon + Abbott) in patients with regular astigmatism is an effective and safe method, which should be offered to patients. Both the Tecnis and the AcrySof toric IOLs similarly reduced ocular astigmatism. Georg Thieme Verlag KG Stuttgart · New York.

  6. Intraocular Pressure Control after Trabeculectomy, Phacotrabeculectomy and Phacoemulsification in a Hispanic Population.

    PubMed

    L Jung, Jennifer; Isida-Llerandi, Cristina G; Lazcano-Gomez, Gabriel; SooHoo, Jeffrey R; Kahook, Malik Y

    2014-01-01

    To compare the efficacy of different surgical strategies for intraocular pressure (IOP) control in Hispanic glaucoma patients with and without visually significant cataracts. Comparative retrospective consecutive case series. The charts of 153 consecutive patients with primary open angle glaucoma who underwent either trabeculectomy alone (n = 51), phacotrabeculectomy (n = 51), or phacoemulsification alone (n = 51) were reviewed to compare IOP control, the number of glaucoma medications required postoperatively, and the inci dence of surgical complications. Preoperative IOP was 17.5 ± 5.2 mm Hg in the trabe-culectomy group, 15.4 ± 4.5 mm Hg in the phacotrabeculectomy group and 13.9 ± 2.9 mm Hg in the phacoemulsification group (p < 0.001 for all comparisons). Mean IOP reduction from baseline was 4.2 ± 6.9 (24.6%) for the trabeculectomy group, 2.9 ± 5.0 (20.8%) for the phacotrabeculectomy group, and 0.9 ± 3.4 (6.5%) for the phacoemulsification group (p = 0.009). The number of IOP-lowering medications required postoperatively decreased significantly in all three groups (p = 0.001). The rate of early and late postoperative complications was similar between the trabeculectomy and phacotrabeculectomy groups and less for the phacoemulsification group. Trabeculectomy and phacotrabeculectomy are both viable surgical options for managing open angle glau coma. Both resulted in similar rates of success, IOP reduction, decrease in use of IOP-lowering medications and post operative complication rates. Phacoemulsification alone had a lower success rate and greater need for postoperative IOP-lowering medications compared to trabeculectomy alone or phacotrabeculectomy. Phacoemulsification alone may be a reasonable option for patients with visually significant cataract and lower baseline IOP. How to cite this article: Jung JL, Isida-Llerandi CG, Lazcano-Gomez G, SooHoo JR, Kahook MY. Intraocular Pressure Control after Trabeculectomy, Phacotrabeculectomy and Phaco

  7. Intraocular Pressure Control after Trabeculectomy, Phacotrabeculectomy and Phacoemulsification in a Hispanic Population

    PubMed Central

    L Jung, Jennifer; Isida-Llerandi, Cristina G; Lazcano-Gomez, Gabriel; SooHoo, Jeffrey R

    2014-01-01

    ABSTRACT Purpose: To compare the efficacy of different surgical strategies for intraocular pressure (IOP) control in Hispanic glaucoma patients with and without visually significant cataracts. Design: Comparative retrospective consecutive case series. Methods: The charts of 153 consecutive patients with primary open angle glaucoma who underwent either trabeculectomy alone (n = 51), phacotrabeculectomy (n = 51), or phacoemulsification alone (n = 51) were reviewed to compare IOP control, the number of glaucoma medications required postoperatively, and the inci dence of surgical complications. Results: Preoperative IOP was 17.5 ± 5.2 mm Hg in the trabe-culectomy group, 15.4 ± 4.5 mm Hg in the phacotrabeculectomy group and 13.9 ± 2.9 mm Hg in the phacoemulsification group (p < 0.001 for all comparisons). Mean IOP reduction from baseline was 4.2 ± 6.9 (24.6%) for the trabeculectomy group, 2.9 ± 5.0 (20.8%) for the phacotrabeculectomy group, and 0.9 ± 3.4 (6.5%) for the phacoemulsification group (p = 0.009). The number of IOP-lowering medications required postoperatively decreased significantly in all three groups (p = 0.001). The rate of early and late postoperative complications was similar between the trabeculectomy and phacotrabeculectomy groups and less for the phacoemulsification group. Conclusion: Trabeculectomy and phacotrabeculectomy are both viable surgical options for managing open angle glau coma. Both resulted in similar rates of success, IOP reduction, decrease in use of IOP-lowering medications and post operative complication rates. Phacoemulsification alone had a lower success rate and greater need for postoperative IOP-lowering medications compared to trabeculectomy alone or phacotrabeculectomy. Phacoemulsification alone may be a reasonable option for patients with visually significant cataract and lower baseline IOP. How to cite this article: Jung JL, Isida-Llerandi CG, Lazcano-Gomez G, SooHoo JR, Kahook MY. Intraocular Pressure Control after

  8. Haemodynamic stability during general anaesthesia for intra-ocular surgery: the effect of topical oxybuprocaine.

    PubMed

    Lytle, J; Thomas, N F

    1992-07-01

    Local anaesthesia is frequently used in combination with light general anaesthesia to reduce the reflex responses to surgical stimulation. This combination has not previously been evaluated for intra-ocular surgery. During cataract extraction under general anaesthesia, the effect of topical anaesthesia with oxybuprocaine 0.4% on the pressor response was compared with normal saline in a control group. The simple technique of instilling local anaesthetic drops into the conjunctival sac blocked the pain pathway sufficiently to prevent the pressor response to surgical stimulation (p less than 0.001). Higher inspired concentrations of enflurane were required in the control group to achieve and maintain haemodynamic stability (p less than 0.001).

  9. Subjective Visual Performance and Objective Optical Quality With Intraocular Lens Glistening and Surface Light Scattering.

    PubMed

    Luo, Furong; Bao, Xuan; Qin, Yingyan; Hou, Min; Wu, Mingxing

    2018-06-01

    To evaluate the long-term effect of glistenings and surface light scattering of intraocular lenses (IOLs) on visual and optical performance after cataract surgery. Pseudophakic eyes that underwent standard phacoemulsification and two types of hydrophobic acrylic spherical IOL implantation without complications for at least 5 years were included in this retrospective study. Participants were divided into the glistenings, surface light scattering, and control groups according to the current condition of the IOLs. Then participants received a follow-up examination including uncorrected and corrected distance visual acuity (UDVA and CDVA), contrast sensitivity, straylight, and intraocular higher order aberrations, as well as point spread function (PSF) and modulation transfer function (MTF). A total of 140 eyes were included in the study. UDVA, CDVA, and glare sensitivity were not significantly different among the three groups (P > .05). However, compared with the control group, the IOLs of the glistenings and surface light scattering groups were associated with significantly lower contrast sensitivity under no glare conditions. Furthermore, eye with glistenings exhibited the highest straylight value (P < .05), whereas no difference was found between the surface light scattering and control groups. In contrast to the control group, the spherical aberration increased and the mean values of PSF and MTF decreased in the glistenings and surface light scattering groups. Both glistenings and surface light scattering tend to impair subjective visual performance, such as contrast sensitivity, and potentially affect objective optical quality, including straylight, spherical aberration, PSF, and MTF. [J Refract Surg. 2018;34(6):372-378.]. Copyright 2018, SLACK Incorporated.

  10. Descemet membrane endothelial keratoplasty in cases with existing scleral-sutured and iris-sutured intraocular lenses

    PubMed Central

    2014-01-01

    Background To report two cases of Descemet Membrane Endothelial Keratoplasty (DMEK) in patients with existing scleral-fixated and iris-fixated intraocular lenses (sf-IOL and if-IOL, respectively). Case presentation DMEK procedures were performed on a 49-year-old woman with a pre-existing sf-IOL (case 1) and a 69-year-old woman with a pre-existing if-IOL (case 2) in order to treat secondary corneal edema due to pseudophakic bullous keratopathy. Visual acuity, refractive error, intraocular pressure, slit lamp examination, pachymetry measurements and endothelial cell density (ECD) were considered and repeated during follow-ups. Both cases had no intraoperative complications. At postoperative day 1 graft centration and complete attachment were noted. The IOL positions were unchanged in comparison to their preoperative positions. In case 1, visual acuity improved from 1/15 at 1 meter preoperative to 20/200 within one week and to 20/63 within 12 weeks of follow up. In case 2, visual acuity improved from counting fingers at 1 meter preoperative to 20/200 within one week and to 20/100 within 12 weeks of follow-up. In case 2 a partial graft dislocation was observed at postoperative day twenty. Complete graft re-apposition was achieved by rebubbling procedure performed with intracameral air injection. Conclusions DMEK surgery in the treatment of pseudophakic bullous keratopathy in the presence of sf-IOL and if-IOL can successfully be performed. These eyes are at increased risk of IOL dislocation into the vitreous cavity during DMEK surgery. PMID:24443809

  11. Capsular bag opacification after experimental implantation of a new accommodating intraocular lens in rabbit eyes.

    PubMed

    Werner, Liliana; Pandey, Suresh K; Izak, Andrea M; Vargas, Luis G; Trivedi, Rupal H; Apple, David J; Mamalis, Nick

    2004-05-01

    To evaluate the development of capsular bag opacification in rabbit eyes after implantation of an intraocular lens (IOL) designed to minimize contact between the anterior capsule and the IOL and ensure expansion of the capsular bag. David J. Apple, MD Laboratories for Ophthalmic Devices Research, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. Ten New Zealand white rabbits had a study IOL (new accommodating silicone IOL [Synchrony, Visiogen, Inc.]) implanted in 1 eye and a control IOL (1-piece plate silicone IOL with large fixation holes) implanted in the other eye. Intraocular lens position, anterior capsule opacification (ACO), and posterior capsule opacification (PCO) were qualitatively assessed using slitlamp retroillumination photographs of the dilated eyes. Anterior capsule opacification and PCO were graded on a 0 to 4 scale after the eyes were enucleated (Miyake-Apple posterior and anterior views after excision of the cornea and iris). The eyes were also evaluated histopathologically. The rate of ACO and PCO was significantly higher in the control group. Fibrosis and ACO were almost absent in the study group; the control group exhibited extensive capsulorhexis contraction, including capsulorhexis occlusion. Postoperative IOL dislocation into the anterior chamber and pupillary block syndrome were observed in some eyes in the study group. The special design features associated with the study IOL appeared to help prevent PCO. Complications in the study group were probably caused by the increased posterior vitreous pressure in rabbit eyes compared to human eyes and the relatively large size of the study IOL relative to the anterior segment of rabbit eyes.

  12. Intracapsular lensectomy and sulcus intraocular lens fixation in dogs with primary lens luxation or subluxation.

    PubMed

    Stuhr, Charles M; Schilke, Hillary K; Forte, Christina

    2009-01-01

    To evaluate the postoperative results of lensectomy and sulcus intraocular lens fixation (SIOLF) via an ab interno approach in dogs with progressive lens subluxation or early luxation. Retrospective study. Twenty eyes from 19 dogs presented to the Animal Eye Clinic for lens luxation or subluxation between 1999 and 2006. Medical records were reviewed to evaluate preoperative lens position, vision status, intraocular pressure (IOP), and whether surgery was performed on an emergent or elective nature. Lensectomy and SIOLF were performed and postoperative status including vision, glaucoma, and retinal detachment was assessed. Average age was 8.6 years (range 4-14 years) and 55% (11/20) were terriers. Patients were followed a mean of 29.2 months (range 1-92 months) after surgery. Retinal detachment or secondary glaucoma was observed in 1 of 20 (5%) and 5 of 20 (20%) eyes, respectively, with 1 of 20 (5%) exhibiting both. Mean preoperative IOP was 16 mmHg and preoperative lens position was equally divided between luxated and subluxated lenses. Surgery was performed more frequently as an elective procedure (18/20; 90%) due to normalized IOP vs. an emergency procedure (2/20; 10%). Vision was retained in 70% (14/20) of eyes with a mean time to vision loss of 41 months in the remaining eyes due to glaucoma, retinal detachment, or retinal degeneration. Complications of glaucoma and retinal detachment after SIOLF in this study were less when compared with previously reported incidence rates in the literature for lensectomy alone which may reflect improved patient selection.

  13. [Implantation of a sulcus-fixated toric additive intraocular lens in a case of high astigmatism after a triple procedure].

    PubMed

    Linz, K; Auffarth, G U; Kretz, F T A

    2014-08-01

    Residual refractive errors, especially high-grade astigmatism after penetrating keratoplasty, often lead to a significant loss of vision. If high anismetropia could not be corrected with glasses or contact lenses, different kinds of surgical procedures are available for visual rehabilitation (intraocular lens exchange, astigmatic keratotomy, Excimer laser treatment, intrastromal corneal ring segment implantation and additive intraocular lens implantation). Toric add-on IOLs are especially designed for sulcus implantation and correcting high astigmatism in pseudophakic eyes. All toric IOLs are individually manufactured according to subjective refraction and biometry. Depending on the underlying manufacturer high-grade astigmatism can be corrected with a cylindrical power up to + 30.0 D. A 74-year-old patient presented with endothelial decompensation and an uncorrected distance visual acuity (UDVA) of 1.0 logMAR for penetrating keratoplasty on the right eye due to a Fuchs endothelial dystrophy. Postoperatively, the uncorrected distance visual acuity improved to 0.8 logMAR, with pinhole correction to 0.5 logMAR. After removing the sutures a high and irregular corneal astigmatism of 21.0 D was found. The corrected distance visual acuity (CDVA) with a refraction of + 5.5 D sph, - 21.0 D cyl 90° was 0.24 logMAR. Therefore an individually manufactured toric additive intraocular lens of + 25.0 D cylindrical and - 18.0 D spherical power for sulcus implantation was chosen and implanted uneventfully. Eight months after surgery refractive astigmatism was reduced significantly to - 0.75 D with an UDVA of 0.08 logMAR and a CDVA of 0.02 logMAR. During the 8-months follow-up period the additive IOL remained centered and no IOL rotation could be observed. Toric add-on IOLs are a safe and successful method for reducing high astigmatism and anisometropia after penetrating keratoplasty. One of the main advantages is the reversibility of the procedure by an explantation of

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

    PubMed

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

    2009-09-01

    To investigate quantitative changes of the anterior segment configuration after clear corneal incision phacoemulsification and foldable intraocular lens (IOL) implantation with slit-lamp-adapted optical coherence tomography (SL-OCT). In prospective consecutive case series, clear corneal incision phacoemulsification and foldable intraocular lens implantation were performed in 44 eyes of 40 patients. The changes of the anterior segment configuration were performed by SL-OCT before and 1 day, 1 week, 2 weeks and 1 month after surgery. SPSS 16.0 software was used to analyze statistical difference. For all patients, the central corneal thickness (CCT) and the incisional corneal thickness (ICT) increased significantly 1 day after surgery (CCT increased 99.59 microm, ICT increased 234.57 microm; P = 0.490). At 1 month, the CCT almost had returned to baseline, but the ICT had been thicker about 19.25 microm than baseline(P = 0.001). The measurements of ACD, AOD500, AOD750, TISA500, TISA750 also increased significantly 1 day after surgery. Although the ACD had no changes within 2 weeks (all P < 0.05), it had been not stable. The changes of the width of the anterior chamber had been stable in the early period after surgery (all P > 0.05). The SL-OCT could impersonality and quantificationally evaluate the anterior segment changes induced by cataract surgery.

  15. Effect of Hemifacial Spasm on Intraocular Pressure Measurement.

    PubMed

    Cicik, Erdogan; Yildirim, Rengin; Arici, Ceyhun; Dikkaya, Funda; Arslan, Osman Sevki

    2018-01-01

    To evaluate the effect of hemifacial spasm (HFS) on intraocular pressure (IOP) measurement. Twenty-four consecutive patients with HFS and 25 age- and gender-matched randomly selected eyes of healthy volunteers underwent corneal pachymetry and IOP measurements using Goldmann applanation tonometer (GAT) and noncontact tonometer (NCT). IOP measurements were performed before (during HFS) and 2 weeks after Botox injections in HFS patients and in healthy volunteers without Botox injections. There was no statistical difference between involved eye side and uninvolved eye side of HFS patients in measured central corneal thickness. Similarly, no difference was found between involved eye side of HFS patients and controls. There were no statistically significant differences comparing IOP values before treatment and levels measured at 2 weeks of Botox injections, either with GAT ( p = 0.33, 0.11) or NCT ( p = 0.80, 0.43) devices in the involved eyes and uninvolved eyes of patients with HFS, respectively. There were also no significant differences in these parameters (GAT ( p = 0.63) and NCT ( p = 0.54)) in controls. Contractions in facial muscles may not lead to significant increase in IOP in HFS patients. This result may help clinical decision making in the treatment of glaucoma patients with HFS. This trial is registered with NCT03390803.

  16. Pomalidomide and Dexamethasone in Treating Patients With Relapsed or Refractory Primary Central Nervous System Lymphoma or Newly Diagnosed or Relapsed or Refractory Intraocular Lymphoma

    ClinicalTrials.gov

    2017-08-28

    B-Cell Lymphoma, Unclassifiable, With Features Intermediate Between Diffuse Large B-Cell Lymphoma and Burkitt Lymphoma; Central Nervous System Lymphoma; Intraocular Lymphoma; Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System; Recurrent Adult Diffuse Large Cell Lymphoma; Retinal Lymphoma

  17. Postoperative Refractive Errors Following Pediatric Cataract Extraction with Intraocular Lens Implantation.

    PubMed

    Indaram, Maanasa; VanderVeen, Deborah K

    2018-01-01

    Advances in surgical techniques allow implantation of intraocular lenses (IOL) with cataract extraction, even in young children. However, there are several challenges unique to the pediatric population that result in greater degrees of postoperative refractive error compared to adults. Literature review of the techniques and outcomes of pediatric cataract surgery with IOL implantation. Pediatric cataract surgery is associated with several sources of postoperative refractive error. These include planned refractive error based on age or fellow eye status, loss of accommodation, and unexpected refractive errors due to inaccuracies in biometry technique, use of IOL power formulas based on adult normative values, and late refractive changes due to unpredictable eye growth. Several factors can preclude the achievement of optimal refractive status following pediatric cataract extraction with IOL implantation. There is a need for new technology to reduce postoperative refractive surprises and address refractive adjustment in a growing eye.

  18. Near-point string: Simple method to demonstrate anticipated near point for multifocal and accommodating intraocular lenses.

    PubMed

    George, Monica C; Lazer, Zane P; George, David S

    2016-05-01

    We present a technique that uses a near-point string to demonstrate the anticipated near point of multifocal and accommodating intraocular lenses (IOLs). Beads are placed on the string at distances corresponding to the near points for diffractive and accommodating IOLs. The string is held up to the patient's eye to demonstrate where each of the IOLs is likely to provide the best near vision. None of the authors has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

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

    PubMed

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

    2017-06-14

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

  20. 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

  1. Mobility experiments with microrobots for minimally invasive intraocular surgery.

    PubMed

    Ullrich, Franziska; Bergeles, Christos; Pokki, Juho; Ergeneman, Olgac; Erni, Sandro; Chatzipirpiridis, George; Pané, Salvador; Framme, Carsten; Nelson, Bradley J

    2013-04-23

    To investigate microrobots as an assistive tool for minimally invasive intraocular surgery and to demonstrate mobility and controllability inside the living rabbit eye. A system for wireless magnetic control of untethered microrobots was developed. Mobility and controllability of a microrobot are examined in different media, specifically vitreous, balanced salt solution (BSS), and silicone oil. This is demonstrated through ex vivo and in vivo animal experiments. The developed electromagnetic system enables precise control of magnetic microrobots over a workspace that covers the posterior eye segment. The system allows for rotation and translation of the microrobot in different media (vitreous, BSS, silicone oil) inside the eye. Intravitreal introduction of untethered mobile microrobots can enable sutureless and precise ophthalmic procedures. Ex vivo and in vivo experiments demonstrate that microrobots can be manipulated inside the eye. Potential applications are targeted drug delivery for maculopathies such as AMD, intravenous deployment of anticoagulation agents for retinal vein occlusion (RVO), and mechanical applications, such as manipulation of epiretinal membrane peeling (ERM). The technology has the potential to reduce the invasiveness of ophthalmic surgery and assist in the treatment of a variety of ophthalmic diseases.

  2. Effect of topical anesthetics on intraocular pressure and pachymetry.

    PubMed

    Montero, J A; Ruiz-Moreno, J M; Fernandez-Munoz, M; Rodriguez-Palacios, M I

    2008-01-01

    The determination of intraocular pressure (IOP) by noncontact tonometry (NCT) has been reported to be affected by central corneal thickness (CCT) and by the instillation of topical anesthetics. In order to determine the influence of topical anesthetics on CCT and IOP measured by NCT, 80 eyes from 49 patients were examined before and after the instillation of topical anesthetics. Average age was 55.3 years (SD 18.4, range 18 to 93). Twenty-eight patients were female and 21 were male. Average basal IOP was 16.1 mmHg (SD 5.2, range 8 to 35.3). IOP was 14.8 mmHg (SD 4.6, 7.4 to 32.4) (p=0.0005, Student t test for paired data) 5 minutes after topical anesthetics instillation. CCT averaged 541 micronm (SD 32, range 482 to 604) before topical anesthetic drops and 541 micronm (SD 32, 490 to 607, p=0.89, Student t test for paired data) 5 minutes after topical anesthetics instillation. The study confirms that the instillation of topical anesthetics causes a reduction in IOP. These changes do not seem to be associated with changes in CCT.

  3. Biodegradable chitosan and polylactic acid-based intraocular micro-implant for sustained release of methotrexate into vitreous: analysis of pharmacokinetics and toxicity in rabbit eyes.

    PubMed

    Manna, Soumyarwit; Banerjee, Rupak K; Augsburger, James J; Al-Rjoub, Marwan F; Donnell, Anna; Correa, Zelia M

    2015-08-01

    The purpose of this study was to evaluate the pharmacokinetics and toxicity of a chitosan (CS) and polylactic acid (PLA) based methotrexate (MTX) intravitreal micro-implant in an animal model using rabbit eyes. CS- and PLA-based micro-implants containing 400 μg of MTX were fabricated using lyophilization and dip-coating techniques. The micro-implants were surgically implanted in the vitreous of eight New Zealand rabbits employing minimally invasive technique. The PLA-coated CS-MTX micro-implant was inserted in the right eye and the placebo micro-implant in the left eye of each rabbit. Two rabbits were euthanized at each pre-determined time point post-implantation (days 5, 12, 19, and 33) for pharmacokinetics and histopathology evaluation. A therapeutic concentration of MTX (0.1-1.0 μM) in the vitreous was detected in the rabbit eyes studied for 33 days. The MTX release from the coated micro-implants followed a first order kinetics (R (2) ~ 0.88), implying that MTX release depends on the concentration of MTX in the micro-implant. Histopathological analysis of the enucleated eyes failed to show any signs of infection or tissue toxicity in any of the specimens. The PLA-coated CS-MTX micro-implants were able to deliver therapeutic release of MTX for a period of more than 1 month without detectable toxicity in a rabbit model. The micro-implants can be further investigated as a prospective alternative to current treatment protocols of repeated intravitreal MTX injections in intraocular disorders such as primary intraocular lymphoma, and selected cases of non-microbial intraocular inflammation.

  4. Baseline Intraocular Pressure Is Associated With Subjective Sensitivity to Physical Exertion in Young Males.

    PubMed

    Vera, Jesús; Jiménez, Raimundo; García, José Antonio; Perales, José Cesar; Cárdenas, David

    2018-03-01

    The purposes of this study were to (a) investigate the effect of physical effort (cycling for 60 min at 60 ± 5% of individually computed reserve heart-rate capacity), combined with 2 different levels of cognitive demand (2-back, oddball), on intraocular pressure (IOP) and subjective judgments of perceived exertion (ratings of perceived exertion [RPE]), affect (Affective Valence subscale of the Self-Assessment Manikin [SAM]), and mental workload (National Aeronautics and Space Administration Task Load Index [NASA-TLX]); and (b) ascertain whether baseline IOP, measured before exercise, is associated with individual differences in subjective assessments of effort and affective response during exercise. Seventeen participants (M age = 23.28 ± 2.37 years) performed 2 physical/cognitive dual tasks, matched in physical demand but with different mental requirements (2-back, oddball). We assessed IOP before exercise, after 2 min of active recovery, and after 15 min of passive recovery, and we also collected RPE and SAM measures during the sessions (28 measurement points). We used NASA-TLX and cognitive performance as checks of the mental manipulation. (a) Intraocular pressure increased after concomitant physical/mental effort, with the effect reaching statistical significance after the 2-back task (p = .002, d = 0.35) but not after the oddball condition (p = .092, d = 0.29). (b) Baseline IOP was associated with subjective sensitivity to effort and showed statistical significance for the oddball condition (p = .03, ƞ p 2  = .622) but not for the 2-back task (F < 1). Results suggest a relationship between IOP and physical/cognitive effort, which could have implications for the management of glaucoma. Additionally, a rapid measure of IOP could be used as a marker of individual effort sensitivity in applied settings.

  5. Comparison of astigmatism correction using either peripheral corneal relaxing incisions or toric intraocular lenses.

    PubMed

    Muftuoglu, Ilkay Kilic; Aydin Akova, Yonca; Aksoy, Sibel; Unsal, Erkan

    2016-01-01

    To compare the efficacy and short-term stability of toric intraocular lenses (tIOL) and peripheral cornea relaxing incisions (PCRI) during phacoemulsification. Patients with preexisting corneal astigmatism had cataract surgery either with tIOL (AcrySof Toric) (39 eyes of 35 patients) or standard intraocular lens (AcrySof) + PCRIs (38 eyes of 33 patients). Patients were retrospectively evaluated for manifest refraction, corneal topography, and uncorrected and corrected visual acuities preoperatively and at postoperative 1 and 6 months. The Alpins vectorial method was used to analyze the target induced astigmatism (TIA) and surgically induced astigmatism (SIA), magnitude of error (the difference between the magnitude of SIA and TIA) (ME), and correction index. Mean preoperative corneal astigmatism was 2.21 ± 1.32 D in the tIOL group and 2.24 ± 0.96 D in the PCRI group; the difference was not significant. The decrease in astigmatism was significant in both groups at last follow-up (64% tIOL group, 32% PCRI group, p<0.01, Wilcoxon signed rank test). The mean remaining refractive astigmatism was significantly higher in the PCRI group than in the tIOL group at 1-month (1.42 ± 1.22, 0.89 ± 0.68, respectively) and 6-month follow-ups (1.75 ± 1.37 D, 0.92 ± 0.72, respectively) (p<0.01). The mean ME was significantly lower (-0.35 versus -0.88) with a higher correction index (0.96 versus 0.56) in the tIOL group at 6 months postoperatively. Both tIOL implantation and using PCRI were effective methods to reduce preoperative astigmatism at the time of the cataract surgery. However, tIOLs provided better remaining astigmatism with a more stable refraction than PCRI.

  6. Iris-fixated phakic intraocular lens implantation after retinal detachment surgery: long-term clinical results.

    PubMed

    Chung, Jin Kwon; Kim, Jin Kook; Lee, Jae Bum; Lee, Sung Jin

    2013-10-01

    To assess the efficacy and safety of iris-fixated phakic intraocular lens (pIOL) implantation to correct myopia in eyes with previous retinal detachment (RD) surgery. Department of Ophthalmology, Soonchunhyang University College of Medicine, Seoul, South Korea. Retrospective case series. Patients having pIOL implantation in both eyes were enrolled. Eyes that had scleral buckling or encircling (RD group) and healthy fellow eyes (non-RD group) were evaluated over a 6-year follow-up. The corrected distance visual acuity (CDVA), endothelial cell density (ECD), intraoperative complications, and long-term complications were safety outcomes. Uncorrected distance visual acuity (UDVA), predictability, and stability of refraction were efficacy outcomes. The study comprised 34 eyes (17 patients). The mean postoperative CDVA and ECD were not significantly different between groups, and no patient lost CDVA. The rate of transient intraocular pressure spike was significantly higher in the RD group (P=.043). After 3 years and 6 years, the mean postoperative UDVA was 0.06 logMAR ± 0.09 (SD) and 0.08 ± 0.10 logMAR, respectively, in the RD group and 0.04 ± 0.08 logMAR and 0.04 ± 0.09 logMAR, respectively, in the non-RD group (P=.518 and P=.478, respectively). The rate of eyes within ±0.50 diopter of the desired refraction and the postoperative refraction was not significantly different between groups. No eye had vitreoretinal changes requiring secondary surgical intervention. Iris-fixated pIOL implantation corrected the myopic refractive error in patients who had scleral buckling or encircling surgery for RD with a high degree of efficacy, safety, and long-term stability. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  7. The effect of the corneal epithelium on the intraocular penetration of fluoroquinolone ophthalmic solution.

    PubMed

    Fukuda, Masamichi; Inoue, Amane; Sasaki, Kazuyuki; Takahashi, Nobuo

    2004-01-01

    Pharmacokinetic studies of antibacterial agents for infectious eye diseases have usually been performed on normal rabbit eyes. In this study, the intraocular penetration of fluoroquinolone ophthalmic solutions was determined in normal rabbit eyes and in rabbit eyes that had the corneal epithelium intentionally removed. We determined the intraocular penetration of ofloxacin (OFLX), levofloxacin (LVFX), and norfloxacin (NFLX), fluoroquinolone ophthalmic solutions that are already on the market and undergoing clinical studies, by injecting 50 microl of each solution into the cul-de-sacs of rabbit eyes three times at 15-min intervals. The drug concentration at 10, 30, 60, 120, and 240 min after final instillation was determined by high-performance liquid chromatography. The maximum concentration in the aqueous humor of normal rabbit eyes was 2.09 +/- 1.56 microg/ml (60 min, OFLX), 2.57 +/- 1.00 microg/ml (30 min, LVFX), and 0.42 +/- 0.12 microg/ml (120 min, NFLX). The drug concentration in the aqueous humor of eyes with intentionally removed corneal epithelium was 12.50 +/- 5.62 microg/ml (30 min, OFLX), 9.02 +/- 2.45 microg/ml (60 min, LVFX), and 8.54 +/- 5.17 microg/ml (30 min, NFLX). The drug penetration of the eye drops into eyes with removed corneal epithelium was around 6 times (OFLX), 3.5 times (LVFX), and 20 times (NFLX) higher than the penetration into the eye with normal cornea. Among the pharmacokinetic parameters of the three ophthalmic solutions according to the one-compartment model, the maximum concentration in the aqueous and the area under the concentration-time curve in the aqueous tended to be higher in the eyes with intentionally removed corneal epithelia than in those with normal corneas.

  8. Better Visual Outcome by Intraocular Lens Ejection in Geriatric Patients with Ruptured Ocular Injuries

    PubMed Central

    Sugita, Tadasu; Tsunekawa, Taichi; Matsuura, Toshiyuki; Takayama, Kei; Yamamoto, Kentaro; Kachi, Shu; Ito, Yasuki; Ueno, Shinji; Nonobe, Norie; Kataoka, Keiko; Suzumura, Ayana; Iwase, Takeshi; Terasaki, Hiroko

    2017-01-01

    Ocular trauma is one of the leading causes of visual impairment worldwide. Because of the popularity of cataract surgeries, aged individuals with ocular trauma commonly have a surgical wound in their eyes. The purpose of this study was to evaluate the visual outcome of cases that were coincident with intraocular lens (IOL) ejection in the eyes with ruptured open-globe ocular injuries. Consecutive patients with open-globe ocular injuries were first reviewed. Patients’ characteristics, corrected distance visual acuities (CDVAs) over 3 years after the trauma, causes of injuries, traumatic wound patterns, and coexistence of retinal detachment were examined. The relationships between poor CDVA and the other factors, including the complications of crystalline lens and IOL ejection, were examined. A total of 105 eyes/patients [43 eyes with rupture, 33 with penetrating, 28 with intraocular foreign body (IOFB), and 1 with perforating injuries] were included. Rupture injuries were common in aged patients and were mostly caused by falls, whereas penetrating and IOFB injuries were common in young male patients. CDVAs of the eyes with rupture injuries were significantly worse than those of the eyes with penetrating or IOFB injuries. CDVA from more than 50% of the ruptured eyes resulted in no light perception or light perception to 20/500. CDVA of the ruptured eyes complicated by crystalline lens ejection was significantly worse than that of those complicated by IOL ejection. The wounds of the ruptured eyes complicated by IOL ejection were mainly located at the superior corneoscleral limbus, whereas those of the eyes complicated by crystalline lens ejection were located at the posterior sclera. There were significant correlations between poor CDVA and retinal detachment and crystalline lens ejection. These results proposed a new trend in the ocular injuries that commonly occur in aged patients; history of cataract surgery might affect the final visual outcome after open

  9. Intraocular pressure is sensitive to cumulative and instantaneous mental workload.

    PubMed

    Vera, Jesús; Jiménez, Raimundo; García, José Antonio; Cárdenas, David

    2017-04-01

    We used a repeated-measures design to assess the impact of mental-task complexity on intraocular pressure (IOP). Fourteen participants performed three continuous 11-min blocks of a mental-workload task (3-back) and an oddball version of this task. Also, heart-rate variability (HRV), cognitive-performance scores, and subjective measure of mental load (NASA-TLX) were determined. IOP was taken before each block and afterwards as well as after recovery from mental tasks. We found that IOP increased during heavy mental workloads (p < 0.01). Consistent with this finding, the autonomic control (HRV) and the cognitive performance were significantly lower (p < 0.045, and p < 0.01, respectively), and the NASA-TLX scores were higher during the 3-back task (p < 0.01). We conclude that IOP is sensitive to mental workload, and it could provide a novel neuroergonomic tool to assess mental workload. Our study highlights a potential association between IOP and the nervous system's state of activation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Open globe injury with an interesting intra-ocular foreign body

    PubMed Central

    Gill, Ekjyot; Shulman, Matthew; Schechet, Sid; Grumbine, Lawson

    2017-01-01

    Introduction: Cases of penetrating ocular trauma due to osseous material are limited, so reported incidents are valuable in determining outcomes and proper treatment courses. Case description: We report a case of an open globe injury of the left eye with an intraocular foreign body occurring after a firework exploded in the hand of a 22-year-old man. The patient presented with light perception vision in the injured eye with a full-thickness limbal laceration and dense hyphema obscuring fundoscopy. CT scan revealed a hyperdense foreign body juxtaposed to the lens. Immediate surgical intervention to repair the globe rupture revealed a defect in the anterior capsule and small, white objects in the posterior chamber that were promptly removed. Pathologic investigation determined these fragments to be cortical bone likely from the patient’s phalanges. Results and discussion: There was no evidence of endophthalmitis or keratitis from time of injury to the five-month follow-up, suggesting that the risk of infection may be low and therefore it may be reasonable to manage these injuries with a period of observation. PMID:28706770

  11. Intracranial and Intraocular Pressure at the Lamina Cribrosa: Gradient Effects.

    PubMed

    Jóhannesson, Gauti; Eklund, Anders; Lindén, Christina

    2018-04-12

    A pressure difference between the intraocular and intracranial compartments at the site of the lamina cribrosa has been hypothesized to have a pathophysiological role in several optic nerve head diseases. This paper reviews the current literature on the translamina cribrosa pressure difference (TLCPD), the associated pressure gradient, and its potential pathophysiological role, as well as the methodology to assess TLCPD. For normal-tension glaucoma (NTG), initial studies indicated low intracranial pressure (ICP) while recent findings indicate that a reduced ICP is not mandatory. Data from studies on the elevated TLCPD as a pathophysiological factor of NTG are equivocal. From the identification of potential postural effects on the cerebrospinal fluid (CSF) communication between the intracranial and retrolaminar space, we hypothesize that the missing link could be a dysfunction of an occlusion mechanism of the optic nerve sheath around the optic nerve. In upright posture, this could cause an elevated TLCPD even with normal ICP and we suggest that this should be investigated as a pathophysiological component in NTG patients.

  12. 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.

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

    PubMed Central

    Yun, Hongmin; Zhou, Yi; Wills, Andrew

    2016-01-01

    Abstract 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

  14. Correlation Between Biomechanical Responses of Posterior Sclera and IOP Elevations During Micro Intraocular Volume Change

    PubMed Central

    Morris, Hugh J.; Tang, Junhua; Cruz Perez, Benjamin; Pan, Xueliang; Hart, Richard T.; Weber, Paul A.; Liu, Jun

    2013-01-01

    Purpose. This study tested the hypothesis that intraocular pressure (IOP) elevations, induced by controlled increase of intraocular volume, are correlated with the biomechanical responses of the posterior sclera. Methods. Porcine globes were tested within 48 hours postmortem. The first group of globes (n = 11) was infused with 15 μL of phosphate-buffered saline at three different rates to investigate rate-dependent IOP elevations. The second group (n = 16) was first infused at the fast rate and then underwent inflation tests to investigate the relationship between IOP elevations (ΔIOP) and scleral strains. The strains in the superotemporal region of the posterior sclera were measured by ultrasound speckle tracking. Linear regression was used to examine the association between ΔIOP due to micro-volumetric infusion and the scleral strains at a specific inflation pressure. Results. The average ΔIOP was 14.9 ± 4.3 mm Hg for the infusion of 15 μL in 1 second. The ΔIOP was greater for the faster infusion rates but highly correlated across different rates (P < 0.001). A significant negative association was found between the ΔIOP and the tangential strains in both the circumferential (R2 = 0.54, P = 0.003) and meridian (R2 = 0.53, P = 0.002) directions in the posterior sclera. Conclusions. This study showed a substantial increase in IOP, with a large intersubject variance during micro-volumetric change. A stiffer response of the sclera was associated with larger IOP spikes, providing experimental evidence linking corneoscleral biomechanics to IOP fluctuation. In vivo measurement of corneoscleral biomechanics may help better predict the dynamic profile of IOP. PMID:24130185

  15. Circadian intraocular pressure rhythms in athletic horses under different lighting regime.

    PubMed

    Bertolucci, Cristiano; Giudice, Elisabetta; Fazio, Francesco; Piccione, Giuseppe

    2009-02-01

    The present study was undertaken to investigate the existence of intraocular pressure (IOP) rhythms in athletic thoroughbred horses maintained under a 24 h cycle of light and darkness (LD) or under constant light (LL) or constant dark (DD) conditions. We identified an IOP circadian rhythm that is entrained to the 24 h LD cycle. IOP was low during the dark phase and high during the light phase, with a peak at the end of the light phase (ZT10). The circadian rhythm of IOP persisted in DD (with a peak at CT9.5), demonstrating an endogenous component in IOP rhythm. As previously shown in other mammalian species, horse IOP circadian rhythmicity was abolished in LL. Because tonometry is performed in horses for the diagnosis of ophthalmologic diseases, such as glaucoma or anterior uveitis, the daily variation in IOP must be taken into account in clinical practice to properly time tests and to interpret clinical findings.

  16. Management of corneal decompensation 4 decades after Sputnik intraocular lens implantation.

    PubMed

    Hirji, Nashila; Nanavaty, Mayank A

    2015-01-01

    We report an unusual case of corneal decompensation occurring four decades after complicated cataract extraction with implantation of a Sputnik intraocular lens (IOL) and highlight the clinical and practical issues faced in managing corneal decompensation with a Sputnik IOL. A 72-year-old woman presented with deterioration of the vision in her left eye, four decades after intracapsular cataract extraction with Sputnik IOL implantation. Ocular examination revealed diffuse corneal edema and thickened vitreous strands in the anterior chamber. Her best-corrected visual acuity (BCVA) worsened to 6/60 within 3 months. Anterior vitrectomy and inferior iridectomy combined with Desçemet-stripping automated endothelial keratoplasty was performed. The procedure was successful, with the patient achieving best-corrected visual acuity of 6/6 at 8 months postoperatively. Corneal decompensation after Sputnik IOL implantation can occur four decades later. When the historical preoperative visual acuity is good in such cases, careful anterior vitrectomy with Desçemet-stripping automated endothelial keratoplasty provides good visual rehabilitation.

  17. Mechanism of demyelination after HSV type I intraocular injection in rabbits.

    PubMed

    Narang, H K

    1980-02-01

    Intraocular injection of herpes simplex virus (HSV) type I into the vitreous body of 18-day-old rabbits induced, on the 7th day post-inoculation, neurological signs with marked head jerking and atazia. Examination of semi-serial 1-micrometers thick sections of the whole lengths of right and left optic nerves and chiasma of 4--64 days post-inoculated rabbits revealed a small lesion, restricted to the medial side, which had extended 2--3 mm, during the first 4 days, along the optic nerve. Ahead of the developing lesion marked chromatin changes of neuroglial cells were noticed followed by cuffing of blood vessels, infiltration by macrophages, demyelination and remyelination. The present study indicated that demyelination occurred following the infection of the myelinating cells. It appeared that virus did not become latent and many cells survived the viral attack. Repeated episodies of viral activity caused further damage while repair did not keep pace.

  18. Esterified estrogens combined with methyltestosterone raise intraocular pressure in postmenopausal women.

    PubMed

    Khurana, Rahul N; LaBree, Laurie D; Scott, Garrett; Smith, Ronald E; Yiu, Samuel C

    2006-09-01

    To investigate the effect of esterified estrogens combined with methyltestosterone (EECM) (Estratest, Solvay, Pharmaceuticals, Inc, Baudette, Minnesota, USA) on intraocular pressure (IOP) in postmenopausal women. Observational case series. The IOP of 13 consecutive postmenopausal women with dry eye syndrome were recorded before and during EECM therapy (1.25 mg of esterified estrogens and 2.5 mg of methyltestosterone for several months). The mean IOP increased from a baseline of 15.0 mm Hg before treatment to 18.2 mm Hg on EECM therapy (P < .0001) after a median duration of 11.3 months (range, 0.9 to 24 months). The increase in IOP was statistically significant at the 0.05 level of significance within three months and continued over 12 months. Two patients whose pressures increased (>4 mm Hg) returned to baseline levels after EECM was discontinued. Esterified estrogens combined with methyltestosterone produce a clinically significant increase in IOP in postmenopausal women with dry eye syndrome.

  19. Combined Cataract Extraction With Pars Plana Vitrectomy and Metallic Intraocular Foreign Body Removal Through Sclerocorneal Tunnel Using a Novel "Magnet Handshake" Technique.

    PubMed

    Dhoble, Pankaja; Khodifad, Ashish

    2018-01-01

    To study the outcomes of combined cataract extraction with pars plana vitrectomy (PPV) and metallic intraocular foreign body (IOFB) removal through a sclerocorneal tunnel using the "magnetic handshake" technique. A retrospective review. Retrospective review of case records of 14 patients from 2010 to 2016 with metallic IOFB and traumatic cataract was performed. Cataract extraction was combined with PPV. Two intraocular magnets (IOMs) introduced through 20-gauge vitrectomy port and sclerocorneal tunnel helped achieve safe delivery of IOFB outside the globe by the "magnetic handshake" technique. All patients were males with a mean age of 33.04 years. A final best corrected visual acuity (BCVA) of 20/60 or better was noted in 10 (71.42%) of 14 patients. Final reattachment with more than 1 surgery was achieved in 13 (92.85%) patients. Postoperative complications included retinal detachment (RD) and phthisis bulbi in 1 (14.28%) patient each. Combined cataract extraction with PPV and metallic IOFB removal through sclerocorneal tunnel using the "magnet handshake" technique gives good visual and surgical outcomes. Copyright 2017 Asia-Pacific Academy of Ophthalmology.

  20. A Low Concentration of Tacrolimus/Semifluorinated Alkane (SFA) Eyedrop Suppresses Intraocular Inflammation in Experimental Models of Uveitis.

    PubMed

    De Majumdar, S; Subinya, M; Korward, J; Pettigrew, A; Scherer, D; Xu, H

    2017-01-01

    Corticosteroids remain the mainstay therapy for uveitis, a major cause of blindness in the working age population. However, a substantial number of patients cannot benefit from the therapy due to steroids resistance or intolerance. Tacrolimus has been used to treat refractory uveitis through systemic administration. The aim of this study was to evaluate the therapeutic potential of 0.03% tacrolimus eyedrop in mouse models of uveitis. 0.03% tacrolimus in perfluorobutylpentane (F4H5) (0.03% Tacrolimus/SFA) was formulated using a previously published protocol. Tacrolimus suspended in PBS (0.03% Tacrolimus/PBS) was used as a control. In addition, 0.1% dexamethasone (0.1% DXM) was used as a standard therapy control. Endotoxin-induced uveitis (EIU) and experimental autoimmune uveoretinitis (EAU) were induced in adult C57BL/6 mice using protocols described previously. Mice were treated with eyedrops three times/day immediately after EIU induction for 48 h or from day 14 to day 25 post-immunization (for EAU). Clinical and histological examinations were conducted at the end of the experiment. Pharmacokinetics study was conducted in mice with and without EIU. At different times after eyedrop treatment, ocular tissues were collected for tacrolimus measurement. The 0.03% Tacrolimus/SFA eyedrop treatment reduced the clinical scores and histological scores of intraocular inflammation in both EIU and EAU to the levels similar to 0.1% DXM eyedrop treatment. The 0.03% Tacrolimus/PBS did not show any suppressive effect in EIU and EAU. Pharmacokinetic studies showed that 15 min after topical administration of 0.03% Tacrolimus/SFA, low levels of tacrolimus were detected in the retina (48 ng/g tissue) and vitreous (2.5 ng/ml) in normal mouse eyes, and the levels were significantly higher in EIU eyes (102 ng/g tissue in the retina and 24 ng/ml in the vitreous). Tacrolimus remained detectable in intraocular tissues of EIU eyes 6 h after topical administration (68 ng/g retinal tissue, 10

  1. Safety and efficacy of phacoemulsification and intraocular lens implantation through a small pupil using minimal iris manipulation.

    PubMed

    Papaconstantinou, Dimitris; Kalantzis, George; Brouzas, Dimitris; Kontaxakis, Anastasios; Koutsandrea, Chryssanthi; Diagourtas, Andreas; Georgalas, Ilias

    2016-01-01

    The aim of this study was to compare the results of phacoemulsification through a small pupil using minimal iris manipulation versus phacoemulsification through a well-dilated pupil. This prospective randomized control (comparative) study comprised 78 patients (group I) with a maximally dilated pupil size of ≤4.00 mm and 45 patients (group II) with dilated pupil size of ≥7.00 mm. In group I patients, only viscodilation and minimal push-and-pull iris stretching with two collar-button iris-retractor hooks were utilized without iris manipulation. Phacoemulsification was performed by two senior surgeons and the technique used consisted of either stop and chop or quick chop, infusion/aspiration of lens cortex, capsular bag refill with ocular viscoelastic devices, and implantation of an acrylic foldable intraocular lens. Patients were examined on the first day and 1 month postoperatively. Forty-six eyes of group I patients had pseudoexfoliation syndrome, eleven eyes had previous glaucoma surgery, 14 eyes had angle-closure or open-angle glaucoma, and seven eyes had posterior synechiae with iritis. In group I patients, the mean pupil size measured under an operating microscope was 3.2 mm preoperatively, 4.3 mm after viscoelastic and mechanical pupil dilation, and 4.1 mm at the end of a surgical procedure. Rupture of the zonular fibers occurred in six patients of group I and the intraocular lens was implanted in the sulcus. Small iris-sphincter rupture and small hemorrhages occurred in four eyes during pupillary manipulation, but they were not evident at the end of the surgery. In group II patients, no intraoperative complications occurred. Signs of significant corneal edema and iritis were observed more frequently in group I eyes (26 eyes and 20 eyes, respectively) on the first postoperative day in comparison with group II eyes (ten eyes and six eyes, respectively). Intraocular pressure was <20 mmHg in all eyes of both groups. One month postoperatively, the pupil was

  2. 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

  3. Foldable iris-fixated intraocular lens implantation in children.

    PubMed

    Ryan, Andrea; Hartnett, Claire; Lanigan, Bernadette; O'Keefe, Michael

    2012-09-01

      To describe the results of foldable iris-fixated intraocular lens (IOL) implantation in children.   Children with high bilateral or unilateral myopia who were intolerant of spectacle or contact lens correction were implanted with an iris-fixated foldable IOL and prospectively followed. We measured pre- and postoperative visual acuity, refraction, endothelial cell density (ECD) and National Eye Institute Visual Functioning Questionnaire-25.   Eleven eyes of six children were implanted. Indications were high bilateral myopia in children with comorbid neurobehavioural disorders, high anisometropia and high myopic astigmatism. Mean preoperative spherical equivalent (SE) refraction was -14.6 dioptres (D)±4.2 SD. Mean follow-up was 15 months. Postoperative SE refraction was -2.40 D±2.40 SD. Corrected distance visual acuity (CDVA) improved from mean logMAR 0.84±0.4 SD to postoperative 0.67±0.34 SD (p=0.005). CDVA was reduced because of coexistent ocular disorders and amblyopia. Vision-related quality of life (QOL) measures improved significantly. There were no intraoperative or postoperative serious complications.   Foldable iris-fixated IOL insertion can give a significant improvement in vision and in vision-related QOL in a subset of paediatric patients with special refractive needs who are intolerant to conventional treatment. Long-term follow-up is required for monitoring of ECD. © 2012 The Authors. Acta Ophthalmologica © 2012 Acta Ophthalmologica Scandinavica Foundation.

  4. Micro-Raman analysis of glisterings in intraocular lenses

    NASA Astrophysics Data System (ADS)

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

    2017-06-01

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

  5. Does postmenopausal hormone replacement therapy affect intraocular pressure?

    PubMed

    Abramov, Yoram; Borik, Sharon; Yahalom, Claudia; Fatum, Muhammad; Avgil, Gadiel; Brzezinski, Amnon; Banin, Eyal

    2005-08-01

    To assess the effects of postmenopausal hormone replacement therapy (HRT) on intraocular pressure (IOP). This was a cross-sectional controlled study, including 107 women aged 60 to 80 years receiving HRT and 107 controls who have never received HRT. All subjects underwent IOP assessment and funduscopic photography for cup-to-disc (C/D) ratios, and completed questionnaires regarding personal and family history of glaucoma, hormone replacement therapy, lifetime estrogen and progesterone exposure, and cardiovascular risk factors. Main Outcome Measures included IOP, prevalence of increased IOP, and C/D ratios. The groups did not differ in mean IOP (15.3 versus 15.3 mm Hg), mean vertical (0.18 versus 0.21) and horizontal (0.17 versus 0.14) C/D ratios, and in prevalence of increased IOP (15% versus 14%), C/D ratio (7% versus 7%), or glaucoma (9% versus 11%). A personal history of ischemic heart disease was the only risk factor associated with increased IOP (O.R. = 4.63, P = 0.003). Lifetime estrogen and progesterone exposure, including pregnancies, deliveries, menstruation years, and the use of oral contraceptives did not significantly affect the risk for increased IOP. Hormone replacement therapy and lifetime estrogen and progesterone exposure do not seem to affect IOP or the risk for increased IOP. A personal history of ischemic heart disease may be associated with a higher risk for this disorder.

  6. Molecular pathology of primary intraocular lymphoma.

    PubMed Central

    Chan, Chi-Chao

    2003-01-01

    PURPOSE: To evaluate immunoglobulin heavy chain (IgH) gene rearrangements, cytokines and chemokines, and infectious agents in primary intraocular B-cell lymphoma (PIOL) cells, in order to better diagnose and understand PIOL. METHODS: We studied ocular specimens from 57 patients with PIOL at the National Eye Institute from 1991 to 2001. Specimens were analyzed for IgH gene rearrangements using microdissection and polymerase chain reaction (PCR). We measured vitreal interleukin (IL)-10 and IL-6 levels by enzyme-linked immunosorbent assay. IL-10 mRNA was studied in PIOL cells using microdissection and reverse transcribed (RT)-PCR. Chemokine and chemokine receptor expression was examined by using immunohistochemistry. Infectious DNA of human herpetic virus-8 (HHV-8), Epstein-Bar virus (EBV), and Toxoplasma gondii was detected by using microdissection and PCR and was confirmed with Southern blot hybridization. RESULTS: IgH rearrangement(s) were demonstrated in all 50 tested cases. Cytokine levels were measured in the vitreous of 39 patients. Thirty-one had measurable cytokine levels: 24 of 31 had elevation of IL-10 relative to that of IL-6, and, in contrast, only 7 of 31 had elevation of IL-6 relative to IL-10. IL-10 mRNA was abundant in lymphoma cells of 6 examined cases. Lymphoma cells expressed chemokine receptors of CXCR4 and CXCR5 in three tested cases. HHV-8 DNA was found in 6 of 32 cases (18.8%), EBV DNA in 2 of 21 (9.5%), and T gondii DNA in 2 of 16 (12.5%). CONCLUSIONS: Molecular analyses detecting IgH rearrangements and vitreal levels of IL-10 and IL-6 are useful adjuncts for PIOL diagnosis. A role for specific infectious agents is hypothesized in the pathogenesis of some cases of PIOL. B-cell chemokine is likely involved in attracting PIOL cells into the eye. PMID:14971583

  7. Temporal evolution of intraocular pressure elevation after pupillary dilation in pigment dispersion syndrome.

    PubMed

    Jewelewicz, Daniel A; Radcliffe, Nathan M; Liebmann, Jeffrey; Ritch, Robert

    2009-03-01

    To report 4 patients with pigment dispersion syndrome (PDS) who had delayed intraocular pressure (IOP) spikes after pharmacologic pupillary dilation. Four patients with a diagnosis of PDS with documented IOP spike after pharmacologic pupillary dilation were included. Study patients were examined before and after pupillary dilation. The amount of pigment present in the anterior chamber and the IOP were measured at hourly intervals. Although maximal pigment liberation occurred immediately after maximal dilation, the IOP continued to elevate for at least 1.5 hours. The increase in IOP after pupillary dilation may not occur simultaneously with maximal pigment liberation but may follow it after the pigment has settled out of the anterior chamber. This has implications for monitoring patients with PDS after dilation to detect and treat rises in IOP.

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

    PubMed

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

    1989-09-01

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

  9. Clinical, legal and ethical implications of the intra-ocular (off-label) use of bevacizumab (avastin)--a South African perspective.

    PubMed

    Jansen, Rita-Marié; Gouws, Chris

    2009-06-01

    Choroidal neovascularisation is a potentially visually devastating element of various forms of eye pathology. Recent research has focused on neurovascular age-related macular degeneration (AMD) as a cause. AMD can be classified as being exudative (wet) or atrophic (dry). Wet AMD is characterised by a pathological process in which new blood vessels develop in the choroids, causing leakage of fluid and haemorrhage under the retina and leading to localised serous detachment and loss of central vision. Vascular endothelial growth factor (VEGF) stimulates growth of neovascular membranes. Treatments have until recently yielded disappointing results. Ophthalmologists are using intra-ocular injections of bevacizumab (Avastin), an anti-VEGF, to treat AMD. Avastin appears to be safe and effective in the short term, but its intra-ocular administration is entirely off-label. Avastin is registered for treating metastatic colorectal and breast cancer. The off-label use of medication is an important part of mainstream, legitimate medical practice worldwide. Lawyers representing plaintiffs injured by drugs increasingly encounter off-label use claims. From a legal/ethical point of view the off-label use of medication represents a delicate balance between the statutory regulation of medication and a physician's prerogative to prescribe medication that in his or her medical opinion will be beneficial to the patient. The main reason for the controversy created by the off-label use of Avastin is that there are anti-VEGF drugs on the market that have formal approval for the treatment of AMD (and other eye conditions). Lucentis, for example, is extremely expensive, with treatment cost approximately 50 times that of Avastin. Many patients suffering from AMD and macular oedema cannot afford the registered product. The off-label use of Avastin has passed the innovative or experimental stages, as ophthalmologists have used it regularly and openly for a long time, with good success. Such use

  10. Early opacification and subsequent in vivo clearing of a silicone intraocular lens.

    PubMed

    Nikrooyan, Idean; Anderson, Justin E

    2011-09-01

    To report a case of early opacification and spontaneous in vivo clearing of a silicone intraocular lens (IOL). A 79-year-old women underwent uncomplicated cataract extraction and subsequent implantation of a +21.5 D AMO Z9002 (Abbott Medical Optics, Santa Ana, CA) silicone lens. On postoperative day 1, the patient presented with a translucent, milky white appearing, diffuse IOL opacification. On postoperative day 8, the IOL periphery had cleared, but a full thickness haze persisted in the central portion of the optic. By postoperative day 14, the IOL had cleared. To date, the lens has remained clear. One possible mechanism might be exposure to industrial chemicals; however, the manufacturer reports no other similar lens opacities from this manufacturing batch of IOLs. We recommend that surgeons who implant or have implanted an AMO Z9002 silicone IOL and observe similar findings follow the patient closely for resolution of the haze.

  11. Intraocular pressure changes: the influence of psychological stress and the Valsalva maneuver.

    PubMed

    Brody, S; Erb, C; Veit, R; Rau, H

    1999-10-01

    The effects of psychological stress and the Valsalva maneuver on short-term variations of intraocular pressure (IOP) were studied in 49 healthy adults. Psychological stress consisted of mental arithmetic tasks presented in counterbalanced order by computer and by the experimenter. Additionally, a standardized Valsalva maneuver was performed (in counterbalanced order with the psychological stressors). IOP was measured with a Goldmann tonometer before and after performance of each stressor. All three stressors transiently and highly significantly increased IOP, although the Valsalva maneuver produced changes of a greater magnitude (10.2 mmHg) than the psychological stressors (1.3 mmHg). Subjective stress ratings and heart rate increased in response to all stressors. There were no effects of task sequence, eye muscle tension, sex, smoking status (some smokers misreported their smoking status), or regular marijuana use, but regular physical exercise was associated with less IOP increase during psychological stress.

  12. Optical ensemble analysis of intraocular lens performance through a simulated clinical trial with ZEMAX.

    PubMed

    Zhao, Huawei

    2009-01-01

    A ZEMAX model was constructed to simulate a clinical trial of intraocular lenses (IOLs) based on a clinically oriented Monte Carlo ensemble analysis using postoperative ocular parameters. The purpose of this model is to test the feasibility of streamlining and optimizing both the design process and the clinical testing of IOLs. This optical ensemble analysis (OEA) is also validated. Simulated pseudophakic eyes were generated by using the tolerancing and programming features of ZEMAX optical design software. OEA methodology was verified by demonstrating that the results of clinical performance simulations were consistent with previously published clinical performance data using the same types of IOLs. From these results we conclude that the OEA method can objectively simulate the potential clinical trial performance of IOLs.

  13. Hypobaric hypoxia: effects on intraocular pressure and corneal thickness.

    PubMed

    Nebbioso, Marcella; Fazio, Stefano; Di Blasio, Dario; Pescosolido, Nicola

    2014-01-01

    The purpose of this study focused on understanding the mechanisms underlying ocular hydrodynamics and the changes which occur in the eyes of subjects exposed to hypobaric hypoxia (HH) to permit the achievement of more detailed knowledge in glaucomatous disease. Twenty male subjects, aged 32±5 years, attending the Italian Air Force, were enrolled for this study. The research derived from hypobaric chamber, using helmet and mask supplied to jet pilotes connected to oxygen cylinder and equipped with a preset automatic mixer. The baseline values of intraocular pressure (IOP), recorded at T1, showed a mean of 16±2.23 mmHg, while climbing up to 18,000 feet the mean value was 13.7±4.17 mmHg, recorded at T2. The last assessment was performed returning to sea level (T4) where the mean IOP value was 12.8±2.57 mmHg, with a significant change (P<0.05) compared to T1. Pachymetry values related to corneal thickness in conditions of hypobarism revealed a statistically significant increase (P<0.05). The data collected in this research seem to confirm the increasing outflow of aqueous humor (AH) in the trabecular meshwork (TM) under conditions of HH.

  14. Hypobaric Hypoxia: Effects on Intraocular Pressure and Corneal Thickness

    PubMed Central

    Di Blasio, Dario; Pescosolido, Nicola

    2014-01-01

    Objective. The purpose of this study focused on understanding the mechanisms underlying ocular hydrodynamics and the changes which occur in the eyes of subjects exposed to hypobaric hypoxia (HH) to permit the achievement of more detailed knowledge in glaucomatous disease. Methods. Twenty male subjects, aged 32 ± 5 years, attending the Italian Air Force, were enrolled for this study. The research derived from hypobaric chamber, using helmet and mask supplied to jet pilotes connected to oxygen cylinder and equipped with a preset automatic mixer. Results. The baseline values of intraocular pressure (IOP), recorded at T1, showed a mean of 16 ± 2.23 mmHg, while climbing up to 18,000 feet the mean value was 13.7 ± 4.17 mmHg, recorded at T2. The last assessment was performed returning to sea level (T4) where the mean IOP value was 12.8 ± 2.57 mmHg, with a significant change (P < 0.05) compared to T1. Pachymetry values related to corneal thickness in conditions of hypobarism revealed a statistically significant increase (P < 0.05). Conclusions. The data collected in this research seem to confirm the increasing outflow of aqueous humor (AH) in the trabecular meshwork (TM) under conditions of HH. PMID:24550712

  15. INTRAOCULAR LENS POSITION IN COMBINED PHACOEMULSIFICATION AND VITREORETINAL SURGERY.

    PubMed

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

    2017-10-09

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

  16. 25-Gauge active aspiration silicon tip-assisted removal of glass and other intraocular foreign bodies.

    PubMed

    Singh, Ramandeep; Kumar, Abiraj; Gupta, Vishali; Dogra, Mangat R

    2016-04-01

    To describe the use of 25-gauge active aspiration silicon tip in removal of intraocular foreign bodies, including glass. Retrospective, noncomparative, interventional study. Eleven eyes of 11 patients who underwent the procedure between January 2013 and April 2015. The study included 10 males and 1 female with a mean age of 31.27 ± 9.64 years (range 12-45 years). All eyes in which 25-gauge active aspiration silicon tip-assisted removal of intraocular foreign body (IOFB) was done in a sutureless vitrectomy setup, irrespective of the nature of IOFB, were included. We excluded the participants with less than 6 months of postoperative follow-up. The primary outcome of the study was to assess the feasibility and reproducibility of 25-gauge active aspiration silicon tip-assisted removal of IOFB. The secondary outcome measures included change in best-corrected visual acuity (BCVA), and intraoperative and postoperative complications. There were iron (6), glass (2), wooden (1), pellet (1), and stone (1) IOFBs, for which 25-gauge active aspiration silicon tip-assisted removal was done successfully. The mean BCVA in Snellen's decimal equivalent improved significantly from 0.14 ± 0.16 to 0.34 ± 0.36 with a mean follow-up of 12 months (range 6-24 months). Intraoperatively, drop of IOFB because of loss of vacuum was observed in 2 eyes. Postoperatively, cystoid macular edema with epiretinal membrane was seen in 1 eye. There were no other intraoperative and postoperative complications. Use of 25-gauge active aspiration silicon tip to assist removal of magnetic and nonmagnetic IOFBs is a feasible and reproducible procedure, and required instrumentation is readily available in present-day vitrectomy era. Copyright © 2016 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  17. A longitudinal study of age-related changes in intraocular pressure: the Kangbuk Samsung Health Study.

    PubMed

    Zhao, Di; Kim, Myung Hun; Pastor-Barriuso, Roberto; Chang, Yoosoo; Ryu, Seungho; Zhang, Yiyi; Rampal, Sanjay; Shin, Hocheol; Kim, Joon Mo; Friedman, David S; Guallar, Eliseo; Cho, Juhee

    2014-09-02

    To examine the longitudinal association between age and intraocular pressure (IOP) in a large sample of Korean men and women. We conducted a prospective cohort study of 274,064 young and middle-aged Korean adults with normal fundoscopic findings, following them from January 1, 2002, to February 28, 2010. Health exams were scheduled annually or biennially. At each visit, IOP was measured in both eyes using automated noncontact tonometers. The longitudinal change in IOP with age was evaluated using three-level mixed models for longitudinal paired-eye data, accounting for correlations between paired eyes and repeated measurements over time. In fully adjusted models, the average longitudinal change in IOP per 1-year increase in age was -0.065 mm Hg (95% confidence interval [CI] -0.068 to -0.063), with marked sex differences (P < 0.001). In men, the average annual IOP change was -0.093 mm Hg (95% CI -0.096 to -0.091) throughout follow-up. In women, the average annual IOP change was -0.006 mm Hg (95% CI -0.010 to -0.003), with a relatively flat association in the age range of 30 to 59 years and more marked annual decreases at younger and older ages. Intraocular pressure was inversely associated with age in a large cohort of Korean adults attending health-screening visits. For men, this inverse association was observed throughout the entire age range, while for women it was evident only in younger (<30 years of age) and older (≥60 years of age) women, with no association in women aged 30 to 59. Further research is needed to better understand the underlying mechanisms and to reconsider cutoffs for defining high IOP by age and sex groups in Asian populations. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  18. The impact of ocular hemodynamics and intracranial pressure on intraocular pressure during acute gravitational changes.

    PubMed

    Nelson, Emily S; Mulugeta, Lealem; Feola, Andrew; Raykin, Julia; Myers, Jerry G; Samuels, Brian C; Ethier, C Ross

    2017-08-01

    Exposure to microgravity causes a bulk fluid shift toward the head, with concomitant changes in blood volume/pressure, and intraocular pressure (IOP). These and other factors, such as intracranial pressure (ICP) changes, are suspected to be involved in the degradation of visual function and ocular anatomical changes exhibited by some astronauts. This is a significant health concern. Here, we describe a lumped-parameter numerical model to simulate volume/pressure alterations in the eye during gravitational changes. The model includes the effects of blood and aqueous humor dynamics, ICP, and IOP-dependent ocular compliance. It is formulated as a series of coupled differential equations and was validated against four existing data sets on parabolic flight, body inversion, and head-down tilt (HDT). The model accurately predicted acute IOP changes in parabolic flight and HDT, and was satisfactory for the more extreme case of inversion. The short-term response to the changing gravitational field was dominated by ocular blood pressures and compliance, while longer-term responses were more dependent on aqueous humor dynamics. ICP had a negligible effect on acute IOP changes. This relatively simple numerical model shows promising predictive capability. To extend the model to more chronic conditions, additional data on longer-term autoregulation of blood and aqueous humor dynamics are needed. NEW & NOTEWORTHY A significant percentage of astronauts present anatomical changes in the posterior eye tissues after spaceflight. Hypothesized increases in ocular blood volume and intracranial pressure (ICP) in space have been considered to be likely factors. In this work, we provide a novel numerical model of the eye that incorporates ocular hemodynamics, gravitational forces, and ICP changes. We find that changes in ocular hemodynamics govern the response of intraocular pressure during acute gravitational change. Copyright © 2017 the American Physiological Society.

  19. Chitosan-adjuvanted Mycoplasma gallisepticum bacterin via intraocular administration enhances Mycoplasma gallisepticum protection in commercial layers.

    PubMed

    Limsatanun, A; Sasipreeyajan, J; Pakpinyo, S

    2018-06-01

    Mycoplasma gallisepticum (MG) causes respiratory signs and economic losses in the poultry industry. MG vaccination is one of the effective prevention and control measures that have been used around the world. Our previous study demonstrated that chitosan-adjuvanted MG bacterin could effectively reduce pathological lesions induced by MG and that chitosan could be used as an adjuvant in MG bacterin. The present study determining the efficacy of MG bacterins against the Thai MG strain was based on vaccine programs. Seven groups (25 layers/group) were received MG bacterins containing 0.5% chitosan or a commercial bacterin via intramuscular (IM) or intraocular (IO) route at 6 and 10 wk of age. Sham-negative and sham-positive controls were groups 1 and 2, respectively. Group 3: IM route of chitosan bacterin followed by IM route of chitosan bacterin; group 4: commercial bacterin via IM route followed by chitosan bacterin via IO route; group 5: commercial bacterin via IM route followed by commercial bacterin via IM route; group 6: chitosan bacterin via IM followed by chitosan bacterin via IO route; and group 7: chitosan bacterin via IO route followed by chitosan bacterin via IO route were determined. At 16 wk of age, all groups, excluding group 1, were challenged intratracheally with 0.1 mL containing Thai MG strain 107 colony-forming unit. At 17, 18, and 20 wk of age, 5 birds in each group were bled for serological testing and swabbed at the choanal cleft for the quantitative real-time PCR assay, the euthanized and necropsied. The results showed that birds vaccinated with a commercial intramuscular bacterin followed by an intraocularly chitosan adjuvant bacterin showed the best protection against the MG challenge. The study indicated that chitosan could be the effective mucosal adjuvant and increased the effectiveness of MG bacterin.

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

    PubMed

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

    2018-02-01

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

  1. A Longitudinal Study of Association between Adiposity Markers and Intraocular Pressure: The Kangbuk Samsung Health Study.

    PubMed

    Zhao, Di; Kim, Myung Hun; Pastor-Barriuso, Roberto; Chang, Yoosoo; Ryu, Seungho; Zhang, Yiyi; Rampal, Sanjay; Shin, Hocheol; Kim, Joon Mo; Friedman, David S; Guallar, Eliseo; Cho, Juhee

    2016-01-01

    Intraocular pressure (IOP) reduction or stabilization is the only proven method for glaucoma management. Identifying risk factors for IOP is crucial to understand the pathophysiology of glaucoma. To examine the associations of change in body mass index (BMI), waist circumference, and percent fat mass with change in intraocular pressure (IOP) in a large sample of Korean adults. Cohort study of 274,064 young and middle age Korean adults with normal fundoscopic findings who attended annual or biennial health exams from January 1, 2002 to Feb 28, 2010 (577,981 screening visits). BMI, waist circumference, and percent fat mass. At each visit, IOP was measured in both eyes with automated noncontact tonometers. In multivariable-adjusted models, the average increase in IOP (95% confidence intervals) over time per interquartile increase in BMI (1.26 kg/m2), waist circumference (6.20 cm), and percent fat mass (3.40%) were 0.18 mmHg (0.17 to 0.19), 0.27 mmHg (0.26 to 0.29), and 0.10 mmHg (0.09 to 0.11), respectively (all P < 0.001). The association was stronger in men compared to women (P < 0.001) and it was only slightly attenuated after including diabetes and hypertension as potential mediators in the model. Increases in adiposity were significantly associated with an increase in IOP in a large cohort of Korean adults attending health screening visits, an association that was stronger for central obesity. Further research is needed to understand better the underlying mechanisms of this association, and to establish the role of weight gain in increasing IOP and the risk of glaucoma and its complications.

  2. Effect of trabeculectomy on the accuracy of intraocular lens calculations in patients with open-angle glaucoma.

    PubMed

    Bae, Hyoung Won; Lee, Yun Ha; Kim, Do Wook; Lee, Taekjune; Hong, Samin; Seong, Gong Je; Kim, Chan Yun

    2016-08-01

    The objective of the study is to examine the effect of trabeculectomy on intraocular lens power calculations in patients with open-angle glaucoma (OAG) undergoing cataract surgery. The design is retrospective data analysis. There are a total of 55 eyes of 55 patients with OAG who had a cataract surgery alone or in combination with trabeculectomy. We classified OAG subjects into the following groups based on surgical history: only cataract surgery (OC group), cataract surgery after prior trabeculectomy (CAT group), and cataract surgery performed in combination with trabeculectomy (CCT group). Differences between actual and predicted postoperative refractive error. Mean error (ME, difference between postoperative and predicted SE) in the CCT group was significantly lower (towards myopia) than that of the OC group (P = 0.008). Additionally, mean absolute error (MAE, absolute value of ME) in the CAT group was significantly greater than in the OC group (P = 0.006). Using linear mixed models, the ME calculated with the SRK II formula was more accurate than the ME predicted by the SRK T formula in the CAT (P = 0.032) and CCT (P = 0.035) groups. The intraocular lens power prediction accuracy was lower in the CAT and CCT groups than in the OC group. The prediction error was greater in the CAT group than in the OC group, and the direction of the prediction error tended to be towards myopia in the CCT group. The SRK II formula may be more accurate in predicting residual refractive error in the CAT and CCT groups. © 2016 Royal Australian and New Zealand College of Ophthalmologists.

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

    PubMed

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

    2015-01-01

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

  4. Effect of sedation with detomidine on intraocular pressure with and without topical anesthesia in clinically normal horses.

    PubMed

    Holve, Dana L

    2012-02-01

    To determine the effect of sedation with detomidine on intraocular pressure (IOP) in standing horses and whether topical ocular application of anesthetic alters this effect. Clinical trial. 15 clinically normal horses. Horses were assigned to group 1 (n = 7) or 2 (8). Intraocular pressure measurements were obtained at baseline (before sedation) and 10 minutes after IV administration of detomidine (0.02 mg/kg [0.009 mg/lb]). Group 1 horses had an additional IOP measurement at 20 minutes after sedation. For group 2 horses, topical ocular anesthetic was administered 10 minutes prior to baseline IOP measurements. Mean ± SD baseline IOP for horses without topical anesthesia (group 1 horses; IOP, 24.30 ± 3.09 mm Hg) was significantly lower, compared with that of horses with topical anesthesia (group 2 horses; IOP, 30.40 ± 3.25 mm Hg). Compared with baseline values, IOP at 10 minutes after sedation decreased significantly in all horses (by 3.61 ± 1.48 mm Hg and 5.78 ± 4.32 mm Hg in groups 1 and 2, respectively). In group 1 horses, IOP at 10 (20.69 ± 3.45 mm Hg) and 20 (19.96 ± 2.13 mm Hg) minutes after sedation was significantly decreased, compared with baseline values; however, the difference between IOP at 10 versus 20 minutes was not significant. The difference in IOP between group 1 and 2 horses at 10 minutes after sedation was not significant. IV administration of detomidine caused a decrease in IOP in clinically normal horses and may be a safe sedative when performing ocular procedures.

  5. Investigational and experimental drugs for intraocular pressure reduction in ocular hypertension and glaucoma.

    PubMed

    Lusthaus, Jed Asher; Goldberg, Ivan

    2016-10-01

    Intraocular pressure (IOP) is the most significant modifiable risk factor to prevent onset or progression of glaucoma. Glaucoma prevalence continues to increase, emphasizing the need for improved ocular hypotensive treatment options. To try to improve on both tolerance and IOP control of currently available therapies, different receptors or mechanisms are being explored to reduce IOP more effectively and to improve tolerance. We review synthetic topical and oral drugs in early development for the management of ocular hypertension and glaucoma. New therapeutic agents for IOP control have been discovered; some appear to be reasonably tolerated. IOP reduction may be limited with some agents, but other benefits although unproven may compensate for this, such as less ocular surface disease, enhanced neuro-protection or increased ocular blood flow. Further product development promises improved treatment options for ocular hypertensives and glaucoma sufferers.

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

    PubMed Central

    Sallet, Guy

    2017-01-01

    We report the case of an emmetropic 32-year-old female with decreased uncorrected visual acuity and diplopia due to intermittent episodes of spasm of the near reflex. Neurologic, general, and ophthalmic examination could not find an organic cause. Attempts at spontaneous recovery, psychogenic therapy, and cycloplegic therapy were unsuccessful and the symptoms persisted for almost 5 years, leading to psychogenic distress. Final treatment with refractive lens exchange and implantation of a toric trifocal intraocular lens resolved the spasm of the near reflex, resulting in an uncorrected distance and near visual acuity of 20/20. PMID:29422856

  7. Forces on intraocular lens haptics induced by capsular fibrosis. An experimental study.

    PubMed

    Guthoff, R; Abramo, F; Draeger, J; Chumbley, L C; Lang, G K; Neumann, W

    1990-01-01

    Electronic dynamometry measurements, performed upon intraocular lens (IOL) haptics of prototype one-piece three-loop silicone lenses, accurately defined the relationships between elastic force and haptic displacement. Lens implantations in the capsular bag of dogs (loop span equal to capsular bag diameter, loops underformed immediately after the operation) were evaluated macrophotographically 5-8 months postoperatively. The highly constant elastic property of silicon rubber permitted quantitative correlation of subsequent in vivo haptic displacement with the resultant force vectors responsible for tissue contraction. The lens optics were well centered in 17 (85%) and slightly offcenter in 3 (15%) of 20 implanted eyes. Of the 60 supporting loops, 28 could be visualized sufficiently well to permit reliable haptic measurement. Of these 28, 20 (71%) were clearly displaced, ranging from 0.45 mm away from to 1.4 mm towards the lens' optic center. These extremes represented resultant vector forces of 0.20 and 1.23 mN respectively. Quantitative vector analysis permits better understanding of IOL-capsular interactions.

  8. Can we trust intraocular pressure measurements in eyes with intracameral air?

    PubMed

    Jóhannesson, Gauti; Lindén, Christina; Eklund, Anders; Behndig, Anders; Hallberg, Per

    2014-10-01

    To evaluate the effect of intracameral air on intraocular pressure (IOP) measurements using Goldmann applanation tonometry (GAT) and applanation resonance tonometry (ART) in an in-vitro porcine eye model. IOP was measured on thirteen freshly enucleated eyes at three reference pressures: 20, 30, and 40 mmHg. Six measurements/method were performed in a standardized order with GAT and ART respectively. Air was injected intracamerally in the same manner as during Descemet's stripping endothelial keratoplasty (DSEK) and Descemet's membrane endothelial keratoplasty (DMEK), and the measurements were repeated. Measured IOP increased significantly for both tonometry methods after air injection: 0.7 ± 2.1 mmHg for GAT and 10.6 ± 4.9 mmHg for ART. This difference was significant at each reference pressure for ART but not for GAT. Although slightly affected, this study suggests that we can trust GAT IOP-measurements in eyes with intracameral air, such as after DSEK/DMEK operations. Ultrasound-based methods such as ART should not be used.

  9. Refractive outcomes after multifocal intraocular lens exchange.

    PubMed

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

    2017-06-01

    To evaluate the refractive outcomes after multifocal intraocular lens (IOL) exchange. Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA. Retrospective case series. Patients had multifocal IOL explantation followed by IOL implantation. Outcome measures included type of IOL, surgical indication, corrected distance visual acuity (CDVA), and refractive prediction error. The study comprised 29 patients (35 eyes). The types of IOLs implanted after multifocal IOL explantation included in-the-bag IOLs (74%), iris-sutured IOLs (6%), sulcus-fixated IOLs with optic capture (9%), sulcus-fixated IOLs without optic capture (9%), and anterior chamber IOLs (3%). The surgical indication for exchange included blurred vision (60%), photic phenomena (57%), photophobia (9%), loss of contrast sensitivity (3%), and multiple complaints (29%). The CDVA was 20/40 or better in 94% of eyes before the exchange and 100% of eyes after the exchange (P = .12). The mean refractive prediction error significantly decreased from 0.22 ± 0.81 diopter (D) before the exchange to -0.09 ± 0.53 D after the exchange (P < .05). The median absolute refractive prediction error significantly decreased from 0.43 D before the exchange to 0.23 D after the exchange (P < .05). Multifocal IOL exchange can be performed safely with good visual outcomes using different types of IOLs. A lower refractive prediction error and a higher likelihood of 20/40 or better vision can be achieved with the implantation of the second IOL compared with the original multifocal IOL, regardless of the final IOL position. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  10. Change in intraocular pressure during scleral depression.

    PubMed

    Trevino, Richard; Stewart, Brandi

    2015-01-01

    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. 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). 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. 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. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  11. Long-Term Visual Outcomes of Secondary Intraocular Lens Implantation in Children with Congenital Cataracts

    PubMed Central

    Jiang, Yongxiang; Lu, Yi

    2015-01-01

    Aim The aim of this study was to evaluate the long-term visual outcomes and factors affecting visual results in children undergoing secondary intraocular lens (IOL) implantation following primary congenital cataract extraction. Methods Children with congenital cataracts who underwent secondary IOL implantation for aphakia at the Eye and ENT Hospital of Fudan University between January 1, 2001, and December 31, 2007, were retrospectively reviewed. One eye was randomly selected in children with bilateral cataracts. Laterality, type of cataract (total or partial opacity), sex, age at primary and secondary surgeries, visual axis opacity (VAO), compliance with amblyopia therapy, postoperative ocular complications, refractive error, ocular alignment, and best corrected visual acuity (BCVA) at last follow-up were recorded; potential factors that might have affected the visual results were evaluated. Results Seventy-six bilateral and 34 unilateral congenital cataract cases were analyzed; the mean ages of the children were 12.70±5.06 and 12.50±2.71 years at final follow-up, the mean follow-up periods from IOL implantation were 94.93±24.22 and 109.09±18.89 months, and the mean BCVA (Log MAR) values were 0.51±0.37 and 1.05±0.46, respectively. Final BCVA after secondary IOL implantation was significantly associated with laterality, type of cataract, age at primary cataract extraction, compliance with amblyopia therapy, and refractive correction after surgery. No significant associations were found between BCVA and sex, age at secondary IOL implantation, VAO, or other ocular complications. The most common ocular complications were VAO and elevated intraocular pressure after surgery. There were no other complications, with the exception of one eye with IOL dislocation. Conclusions The results indicate that the important determinants of long-term visual outcomes in children with congenital cataracts undergoing secondary IOL implantation are laterality, cataract type, age at

  12. Is there inter-procedural transfer of skills in intraocular surgery? A randomized controlled trial.

    PubMed

    Thomsen, Ann Sofia Skou; Kiilgaard, Jens Folke; la Cour, Morten; Brydges, Ryan; Konge, Lars

    2017-12-01

    To investigate how experience in simulated cataract surgery impacts and transfers to the learning curves for novices in vitreoretinal surgery. Twelve ophthalmology residents without previous experience in intraocular surgery were randomized to (1) intensive training in cataract surgery on a virtual-reality simulator until passing a test with predefined validity evidence (cataract trainees) or to (2) no cataract surgery training (novices). Possible skill transfer was assessed using a test consisting of all 11 vitreoretinal modules on the EyeSi virtual-reality simulator. All participants repeated the test of vitreoretinal surgical skills until their performance curve plateaued. Three experienced vitreoretinal surgeons also performed the test to establish validity evidence. Analysis with independent samples t-tests was performed. The vitreoretinal test on the EyeSi simulator demonstrated evidence of validity, given statistically significant differences in mean test scores for the first repetition; experienced surgeons scored higher than novices (p = 0.023) and cataract trainees (p = 0.003). Internal consistency for the 11 modules of the test was acceptable (Cronbach's α = 0.73). Our findings did not indicate a transfer effect with no significant differences found between cataract trainees and novices in their starting scores (mean ± SD 381 ± 129 points versus 455 ± 82 points, p = 0.262), time to reach maximum performance level (10.7 ± 3.0 hr versus 8.7 ± 2.8 hr, p = 0.265), or maximum scores (785 ± 162 points versus 805 ± 73 points, p = 0.791). Pretraining in cataract surgery did not demonstrate any measurable effect on vitreoretinal procedural performance. The results of this study indicate that we should not anticipate extensive transfer of surgical skills when planning training programmes in intraocular surgery. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  13. A compact nanopower low output impedance CMOS operational amplifier for wireless intraocular pressure recordings.

    PubMed

    Dresher, Russell P; Irazoqui, Pedro P

    2007-01-01

    Wireless sensing has shown potential benefits for the continuous-time measurement of physiological data. One such application is the recording of intraocular pressure (IOP) for patients with glaucoma. Ultra-low-power circuits facilitate the use of inductively-coupled power for implantable wireless systems. Compact circuit size is also desirable for implantable systems. As a first step towards the realization of such circuits, we have designed a compact, ultra-low-power operational amplifier which can be used to record IOP. This paper presents the measured results of a CMOS operational amplifier that can be incorporated with a wireless IOP monitoring system or other low-power application. It has a power consumption of 736 nW, chip area of 0.023 mm2, and output impedance of 69 Omega to drive low-impedance loads.

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

    NASA Astrophysics Data System (ADS)

    Siedlecki, Damian; Zając, Marek; Nowak, Jerzy

    2007-04-01

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

  15. Scanning electron microscopy analysis of a sputnik-like intraocular lens 28 years after implantation.

    PubMed

    Ferrer, Consuelo; Abu-Mustafa, Sabat K; Alió, Jorge L

    2009-09-01

    To report a pupil-supported, iris-clip intraocular lens (IOL) that was explanted more than 28 years after implantation. A pupil-supported, iris-clip, Sputnik-like IOL was implanted in the left eye of a 33-year-old man to correct aphakia after extracapsular cataract extraction due to trauma. Twenty-eight years after implantation, the patient was referred to our center with loss of vision. Clinical examination showed dislocation of the IOL, which was subsequently explanted. Scanning electron microscopic examination showed a transparent, polymethylmethacrylate (PMMA), pupil-supported, iris-clip IOL with melanosomes and cell deposits (foreign-body reaction) on its surface. This case demonstrates the inertness of PMMA material and reports that a foreign body reaction can be induced following IOL dislocation 28 years after implantation. Copyright 2009, SLACK Incorporated.

  16. Evaluation of paraxial forward scattering from intraocular lens with increased surface light scattering using goniophotometry and Hartmann-Shack wavefront aberrometry.

    PubMed

    Minami, Keiichiro; Maruyama, Yoko; Mihashi, Toshifumi; Miyata, Kazunori; Oshika, Tetsuro

    2017-03-01

    To evaluate the influence of increases in light scattering on intraocular lens (IOL) surfaces on paraxial forward scattering using goniophotometry and Hartmann-Shack wavefront aberrometry. Surface light scattering was reproduced experimentally by acceleratedly aging 4 intraocular lenses by 0, 3, 5, and 10 years each. Light scattering from both IOL surfaces was measured using Scheimpflug photography. The paraxial forward scattering from the aged IOLs was measured using a goniophotometer with a halogen light source (wavelength: 350-850 nm) and telecentric optics, and changes in the maximum intensity and full width at 10% of maximum intensity (FW10%) were evaluated. The influences on the retina image were examined using a Hartmann-Shack aberrometer (wavelength: 840 nm). The contrast and difference from the point spread function of the central centroids were evaluated. The mean surface light scattering from both IOL surfaces ranged from 30.0 to 118.3 computer compatible tape (CCT) and increased with each aging year. Evaluations using the goniophotometer and the Hartmann-Shack aberrometer showed no significant change in the paraxial forward scattering with the aging year (P > .45, Kruskal-Wallis test), and no association with the surface light scattering intensity was found (P > .75, Spearman rank correlation). This experimental study using aged IOLs demonstrated that surface light scattering does not influence paraxial forward scattering.

  17. Laser-assisted formation of micropores and nanobubbles in sclera promote stable normalization of intraocular pressure

    NASA Astrophysics Data System (ADS)

    Baum, Olga; Wachsmann-Hogiu, Sebastian; Milner, Thomas; Sobol, Emil

    2017-06-01

    Pores in sclera enhance uveoscleral water outflow and can normalize intraocular pressure in glaucomatous eyes. The aims of this study are to demonstrate laser-induced formation of pores with a dendritic structure and to answer the questions: How is a pore system stable and can laser treatment provide a long-lasting pressure stabilization effect? Effect of 1.56 µm laser radiation on porcine eye sclera was studied using atomic force microscopy and super resolution structured irradiation microscopy with fluorescent markers. Results suggest that the pores with a complex spatial configuration can arise as a result of laser irradiation and that laser-generated stable gas nanobubbles coated with calcium ions allow pore stabilization in the sclera. Our results support a laser based approach for treatment of glaucoma.

  18. Cannabinoids in glaucoma II: the effect of different cannabinoids on intraocular pressure of the rabbit.

    PubMed

    ElSohly, M A; Harland, E C; Benigni, D A; Waller, C W

    1984-06-01

    Thirty-two different cannabinoids were tested for their ability to reduce intraocular pressure (IOP) in the rabbit. These included many of delta 9- and delta 8-THC derivatives and metabolites along with other natural and synthetic cannabinoids. In addition, some non-cannabinoid constituents of Cannabis were screened using the same model. All compounds were administered intravenously, while only a few were tested topically in mineral oil. Water soluble derivatives of delta 9- and delta 8-THC were prepared and tested topically in aqueous solution. The data revealed that certain derivatives of delta 9-and delta 8-THC were more active in lowering IOP than the parent cannabinoids. In addition, compounds other than delta 9- and delta 8-THC and their derivatives were shown to have activity.

  19. 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

  20. 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

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

    PubMed Central

    Mehta, Nitish; Goldberg, Roger A; Shah, Chirag P

    2014-01-01

    Purpose Dense, vision-obscuring calcification on the posterior aspect of silicone intraocular lenses (IOLs) is often not amenable to neodymium:yttrium-aluminum-garnet capsulotomy, and, in prior reports, has required IOL exchange. We report the successful removal of dense calcium deposition on the posterior surface of a three-piece silicone lens using pars plana vitrectomy (PPV). Materials and methods A 23-gauge PPV was performed using the Stellaris® vitrectomy system. A light pipe was used to retroilluminate the IOL, and a dense fibrous tissue setting with a low cut-rate and high aspiration rate was able to clear the visual axis of the dystrophic calcification without damaging the IOL optic. Results Visual acuity improved from 20/100 to 20/25. Conclusion Small-gauge PPV may be utilized to remove dense dystrophic calcium deposits on the lens surface in lieu of IOL exchange. PMID:25045246

  2. Ultra-widefield retinal imaging through a black intraocular lens.

    PubMed

    Yusuf, Imran H; Fung, Timothy H M; Patel, Chetan K

    2015-09-01

    To evaluate the feasibility of ultra-widefield retinal imaging in patients with near infrared (IR)-transmitting black intraocular lenses (IOLs). Oxford Eye Hospital, Oxford, United Kingdom. Laboratory evaluation of a diagnostic technology with interventional case report. The field of retinal imaging through a Morcher poly(methyl methacrylate) (PMMA) black IOL was determined in a purpose-built adult schematic model eye with the HRA2 Spectralis confocal scanning laser ophthalmoscope using standard imaging, Staurenghi retina lens-assisted imaging, and ultra-widefield noncontact imaging. Retinal imaging using each modality was then performed on a patient implanted with another Morcher PMMA black IOL model. Ultra-widefield noncontact imaging and lens-assisted imaging captured up to 150 degrees of field (versus 40 degrees with a standard confocal scanning laser ophthalmoscope). Ultra-widefield retinal images were successfully acquired in a patient eye with a black IOL. This study has identified the first ultra-widefield retinal imaging modalities for patients with near IR-transmitting black IOLs. Should larger studies confirm this finding, noncontact ultra-widefield confocal scanning laser ophthalmoscopy might be considered the gold standard imaging technique for retinal surveillance in patients with near IR-transmitting black IOLs. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  3. Effect of Rebamipide Ophthalmic Suspension on Intraocular Light Scattering for Dry Eye After Corneal Refractive Surgery.

    PubMed

    Igarashi, Akihito; Kamiya, Kazutaka; Kobashi, Hidenaga; Shimizu, Kimiya

    2015-08-01

    To assess the changes in intraocular scattering before and after instillation of rebamipide ophthalmic suspension in patients with dry eye after corneal refractive surgery. This study enrolled 60 eyes of 30 dry eye patients undergoing corneal refractive surgery. Patients were randomly assigned to start topical administration of rebamipide ophthalmic suspension (rebamipide group) or artificial tears (control group) 4 times daily for 4 weeks. Tear secretion, tear break-up time (TBUT), and the fluorescein score were measured before and after treatment. Intraocular light scattering was also measured as the objective scattering index (OSI) at 0.5-second intervals over 10 seconds. In the rebamipide group, the Schirmer I test, TBUT, and fluorescein score improved significantly, from 11.4 ± 9.0 mm, 2.2 ± 0.7 seconds, and 4.3 ± 1.3 to 14.9 ± 7.4 mm, 4.5 ± 1.7 seconds, and 1.9 ± 1.0, respectively (P = 0.006, P < 0.001, P < 0.001, Wilcoxon signed rank test). We found significant improvements in OSI at 5.0 to 10.0 seconds after blinking (5-8 seconds, P = 0.01; 9 seconds, P = 0.02; 10 seconds, P < 0.001). The mean OSI, the OSI change rate, and the OSI slope of the linear regression line improved significantly, from 2.73 ± 1.52, 74.7 ± 69.5%, and 0.10 ± 0.12 to 2.19 ± 1.19, 28.6 ± 48.7%, and 0.04 ± 0.08, respectively (P = 0.02, 0.003, and 0.03). Rebamipide ophthalmic suspension was effective for improving both ocular surface parameters and optical quality in patients with dry eye undergoing corneal refractive surgery, suggesting that it may hold promise for the treatment of such patients.

  4. A Longitudinal Study of Association between Adiposity Markers and Intraocular Pressure: The Kangbuk Samsung Health Study

    PubMed Central

    Zhao, Di; Kim, Myung Hun; Pastor-Barriuso, Roberto; Chang, Yoosoo; Ryu, Seungho; Zhang, Yiyi; Rampal, Sanjay; Shin, Hocheol; Kim, Joon Mo; Friedman, David S.; Guallar, Eliseo; Cho, Juhee

    2016-01-01

    Importance Intraocular pressure (IOP) reduction or stabilization is the only proven method for glaucoma management. Identifying risk factors for IOP is crucial to understand the pathophysiology of glaucoma. Objective To examine the associations of change in body mass index (BMI), waist circumference, and percent fat mass with change in intraocular pressure (IOP) in a large sample of Korean adults. Design, setting and participants Cohort study of 274,064 young and middle age Korean adults with normal fundoscopic findings who attended annual or biennial health exams from January 1, 2002 to Feb 28, 2010 (577,981 screening visits). Exposures BMI, waist circumference, and percent fat mass. Main Outcome Measure(s) At each visit, IOP was measured in both eyes with automated noncontact tonometers. Results In multivariable-adjusted models, the average increase in IOP (95% confidence intervals) over time per interquartile increase in BMI (1.26 kg/m2), waist circumference (6.20 cm), and percent fat mass (3.40%) were 0.18 mmHg (0.17 to 0.19), 0.27 mmHg (0.26 to 0.29), and 0.10 mmHg (0.09 to 0.11), respectively (all P < 0.001). The association was stronger in men compared to women (P < 0.001) and it was only slightly attenuated after including diabetes and hypertension as potential mediators in the model. Conclusions and Relevance Increases in adiposity were significantly associated with an increase in IOP in a large cohort of Korean adults attending health screening visits, an association that was stronger for central obesity. Further research is needed to understand better the underlying mechanisms of this association, and to establish the role of weight gain in increasing IOP and the risk of glaucoma and its complications. PMID:26731527

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

    PubMed

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

    2017-08-01

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

  6. Determinants and Heritability of Intraocular Pressure and Cup-to-Disc Ratio in a Defined Older Population

    PubMed Central

    Chang, Ta C.; Congdon, Nathan G.; Wojciechowski, Robert; Muñoz, Beatriz; Gilbert, Donna; Chen, Ping; Friedman, David S.; West, Sheila K.

    2011-01-01

    Purpose To investigate the heritability of intraocular pressure (IOP) and cup-to-disc ratio (CDR) in an older well-defined population. Design Family-based cohort study. Participants Through the population-based Salisbury Eye Evaluation study, we recruited 726 siblings (mean age, 74.7 years) in 284 sibships. Methods Intraocular pressure and CDR were measured bilaterally for all participants. The presence or absence of glaucoma was determined by a glacuoma specialist for all probands on the basis of visual field, optic nerve appearance, and history. The heritability of IOP was calculated as twice the residual between-sibling correlation of IOP using linear regression and generalized estimating equations after adjusting for age, gender, mean arterial pressure, race, self-reported diabetes status, and history of systemic steroid use. The heritability of CDR was calculated using the same model and adjustments as above, while also adjusting for IOP. Main Outcome Measures Heritability and determinants of IOP and CDR, and impact of siblings’ glaucoma status on IOP and CDR. Results We estimated the heritability to be 0.29 (95% confidence interval [CI], 0.12–0.46) for IOP and 0.56 (95% CI, 0.35–0.76) for CDR in this population. Mean IOP in siblings of glaucomatous probands was statistically significantly higher than in siblings of normal probands (mean difference, 1.02 mmHg; P = 0.017). The mean CDR in siblings of glaucomatous probands was 0.07 (or 19%) larger than in siblings of glaucoma suspect referrals (P = 0.045) and siblings of normal probands (P = 0.004). Conclusions In this elderly population, we found CDR to be highly heritable and IOP to be moderately heritable. On average, siblings of glaucoma patients had higher IOPs and larger CDRs than siblings of nonglaucomatous probands. PMID:15939473

  7. Effects of morphine-alfaxalone-midazolam premedication, alfaxalone induction and sevoflurane maintenance on intraocular pressure and tear production in dogs.

    PubMed

    Mayordomo-Febrer, A; Rubio, M; Martínez-Gassent, M; López-Murcia, M M

    2017-05-13

    Intraocular pressure (IOP) and tear production are commonly affected by general anaesthesia. It is necessary to have a good control of both to guarantee successful ophthalmic surgery. The purpose of this research was to evaluate if the protocol based on the administration of morphine-alfaxalone-midazolam as premedication, alfaxalone as induction and sevoflurane as maintenance, can induce changes on IOP and Schirmer's tear test (STT-1) in healthy dogs. Twenty-two adult mixed-breed dogs scheduled for an ovariohysterectomy were enrolled for the study. IOP and STT-1 were registered at baseline (T 0 ), 5 minutes (T 1 ), 10 minutes (T 2 ) and 15 minutes (T 3 ) after premedication with a morphine-alfaxalone-midazolam combination; 5 minutes (T 4 ) after induction with alfaxalone and 15 minutes (T 5 ) and 25 minutes (T 6 ) after maintenance with sevoflurane. A one-way analysis of variance was performed to analyse the difference between IOP and STT-1 over time, respectively. The present study shows a slightly statistically significant increase in IOP (P<0.05) after premedication, induction and maintenance that can be associated with this anaesthetic protocol. STT-1 showed a statistically significant reduction during all the procedures (P<0.001). These results should be taken into consideration, especially in dogs with damaged corneas, in those predisposed to glaucoma and in those due to undergo intraocular surgery. Ocular lubrication is necessary if this protocol is used. British Veterinary Association.

  8. Adhesion of lens capsule to intraocular lenses of polymethylmethacrylate, silicone, and acrylic foldable materials: an experimental study

    PubMed Central

    Oshika, T.; Nagata, T.; Ishii, Y.

    1998-01-01

    AIMS—To investigate the adhesion characteristics of several intraocular lenses (IOLs) to the simulated and rabbit lens capsule.
METHODS—Adhesive force to bovine collagen sheets was measured in water with polymethylmethacrylate (PMMA), three piece silicone, and acrylic foldable IOLs. In rabbit eyes, phacoemulsification and IOL implantation were performed. Three weeks later, adhesion between the anterior/posterior capsules and IOL optic was tested, and the capsule was examined histologically.
RESULTS—The mean adhesive force to the collagen sheet was 1697 (SD 286) mg for acrylic foldable, 583 (49) mg for PMMA, and 0 mg for silicone IOLs (p=0.0003, Kruskal-Wallis test). Scores (0-5) of adhesion between rabbit anterior capsule and IOL optic were 4.50 (0.55) for acrylic foldable, 3.20 (0.84) for PMMA, and 0.40 (0.55) for silicone IOLs (p=0.004). Scores between rabbit posterior capsule and IOL optic displayed a similar tendency; 4.50 (0.84) for acrylic foldable, 3.00 (1.00) for PMMA, and 0.40 (0.55) for silicone IOLs (p=0.021). Histological observation indicated that the edge of IOL optic suppressed the migration of lens epithelial cells towards the centre of the posterior capsule. This inhibitory effect was most pronounced with acrylic foldable IOL and least with silicone IOL.
CONCLUSIONS—The acrylic foldable IOL adhered to the lens capsule more than the PMMA IOL, and the silicone IOL showed no adhesiveness. These differences seem to play a role in preventing lens epithelial cells from migrating and forming posterior capsule opacification.

 Keywords: intraocular lens; lens capsule; posterior capsule opacification; adhesion PMID:9713064

  9. Survey on the management of orbital and intraocular tumors among oculofacial surgeons in the Asia-Pacific region.

    PubMed

    Wang, Priscilla Xinhui; Koh, Victor Teck Chang; Lun, Katherine; Sundar, Gangadhara

    2014-06-01

    A web-based anonymous survey was performed to assess the common practices of oculofacial surgeons in the management of orbital and intraocular tumors in the Asia-Pacific region. The questionnaire comprised a series of questions covering controversial topics sent via email to 131 oculofacial surgeons across 14 countries in the Asia-Pacific region. A total response rate of 61.7 % was achieved from May to December 2012. The most common benign orbital tumor was cavernous hemangioma (39.6 %) and the most common malignant orbital tumor was lymphoma (85.7 %). 40 % of surgeons recommended orbital radiation, for which the most common indications were thyroid eye disease (70.0 %) and malignancy (30.0 %). The most common orbitotomy approach was lateral (79.2 %). Most surgeons (87.1 %) offered enucleation for retinoblastoma, but there was also a significant proportion that offered chemoreduction with transpupillary thermotherapy or cryotherapy (58.1 %). Fewer surgeons offered brachytherapy (16.1 %) and intra-arterial chemotherapy (6.5 %). When performing enucleation for retinoblastoma, 81.8 % of surgeons performed a primary orbital implant placement. The most preferred type of implant was silicone/acrylic (90.2, 90.2 and 87.8 % for elderly, adults and children, respectively). The majority of surgeons used donor sclera (57.5 %) or no wrapping material at all (32.5 %). Almost all surgeons (95.1 %) did not drill and peg the implant for motility. We report the results of the first survey of oculofacial surgeons in the Asia-Pacific region on the management of intraocular and orbital tumors. In comparison with previous surveys performed in the USA and the UK, we found the practice patterns of the Asia-Pacific surgeons to be comparable.

  10. Dynamic performance of accommodating intraocular lenses in a negative feedback control system: a simulation-based study.

    PubMed

    Schor, Clifton M; Bharadwaj, Shrikant R; Burns, Christopher D

    2007-07-01

    A dynamic model of ocular accommodation is used to simulate the stability and dynamic performance of accommodating intraocular lenses (A-IOLs) that replace the hardened natural ocular lens that is unable to change focus. Accommodation simulations of an older eye with A-IOL materials having biomechanical properties of a younger eye illustrate overshoots and oscillations resulting from decreased visco-elasticity of the A-IOL. Stable dynamics of an A-IOL are restored by adaptation of phasic and tonic neural-control properties of accommodation. Simulations indicate that neural control must be recalibrated to avoid unstable dynamic accommodation with A-IOLs. An interactive web-model of A-IOL illustrating these properties is available at http://schorlab.berkeley.edu.

  11. Further improvement of an intraocular lens holder for more physiological measurements within a mechanical eye model

    NASA Astrophysics Data System (ADS)

    Reutterer, Bernd; Traxler, Lukas; Bayer, Natascha; Drauschke, Andreas

    2017-04-01

    To evaluate the performance of intraocular lenses to treat cataract, an optomechanical eye model was developed. One of the most crucial components is the IOL holder, which should guarantee a physiological representation of the capsular bag and a stable position during measurement sequences. Individual holders are required due to the fact that every IOL has different geometric parameters. A method which allows obtaining the correct dimensions for the holder of a special IOL was developed and tested, by verifying the position of the IOL before and after a measurement sequence. Results of telecentric measurements and MTF measurements show that the IOL position does not change during the displacement sequence induced by the stepper motors of the eye model.

  12. Refractive accuracy with light-adjustable intraocular lenses.

    PubMed

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

    2014-07-01

    To evaluate efficacy, predictability, and stability of refractive treatments using light-adjustable intraocular lenses (IOLs). University Hospital Virgen de la Arrixaca, Murcia, Spain. Prospective nonrandomized clinical trial. Eyes with a light-adjustable IOL (LAL) were treated with spatial intensity profiles to correct refractive errors. The effective changes in refraction in the light-adjustable IOL after every treatment were estimated by subtracting those in the whole eye and the cornea, which were measured with a Hartmann-Shack sensor and a corneal topographer, respectively. The refractive changes in the whole eye and light-adjustable IOL, manifest refraction, and visual acuity were obtained after every light treatment and at the 3-, 6-, and 12-month follow-ups. The study enrolled 53 eyes (49 patients). Each tested light spatial pattern (5 spherical; 3 astigmatic) produced a different refractive change (P<.01). The combination of 2 light adjustments induced a maximum change in spherical power of the light-adjustable IOL of between -1.98 diopters (D) and +2.30 D and in astigmatism of up to -2.68 D with axis errors below 9 degrees. Intersubject variability (standard deviation) ranged between 0.10 D and 0.40 D. The 2 required lock-in procedures induced a small myopic shift (range +0.01 to +0.57 D) that depended on previous adjustments. Light-adjustable IOL implantation achieved accurate refractive outcomes (around emmetropia) with good uncorrected distance visual acuity, which remained stable over time. Further refinements in nomograms and in the treatment's protocol would improve the predictability of refractive and visual outcomes with these IOLs. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  13. Intraocular Pressure Changes With Positioning During Laparoscopy

    PubMed Central

    Onakpoya, Oluwatoyin H.; Adenekan, Anthony T.; Awe, Oluwaseun. O.

    2016-01-01

    Background and Objectives: Pneumoperitoneum during laparoscopy can produce changes in intraocular pressure (IOP) that may be influenced by several factors. In this study, we investigated changes in IOP during laparoscopy with different positioning. Methods: We recruited adult patients without eye disease scheduled to undergo laparoscopic operation requiring a reverse Trendelenburg tilt (rTr; group A; n = 20) or Trendelenburg tilt (Tr; Group B; n = 20). IOP was measured at 7 time points (T1–T7). All procedures were performed with standardized anaesthetic protocol. Mean arterial pressure (MAP), heart rate (HR), peak and plateau airway pressure, and end-tidal carbon dioxide (ETCO2) measurements were taken at each time point. Results: Both groups were similar in age, sex, mean body mass index (BMI), duration of surgery, and preoperative IOP. A decrease in IOP was observed in both groups after induction of anaesthesia (T2), whereas induction of pneumoperitoneum produced a mild increase in IOP (T3) in both groups. The Trendelenburg tilt produced IOP elevations in 80% of patients compared to 45% after the reverse Trendelenburg tilt (P = .012). A significant IOP increase of 5 mm Hg or more was recorded in 3 (15%) patients in the Trendelenburg tilt group and in none in the reverse Trendelenburg group. At T7, IOP had returned to preoperative levels in all but 3 (15%) in the Trendelenburg and 1 (5%) in the reverse Trendelenburg group. Reversible changes were observed in the MAP, HR, ETCO2, and airway pressures in both groups. Conclusions: IOP changes induced by laparoscopy are realigned after evacuation of pneumoperitoneum. A Trendelenburg tilt however produced significant changes that may require careful patient monitoring during laparoscopic procedures. PMID:28028381

  14. Intraocular and crystalline lens protection from ultraviolet damage.

    PubMed

    Sliney, David H

    2011-07-01

    Although the risks of excess solar ultraviolet (UV) exposure of the skin are well recognized, the need for eye protection is frequently overlooked, or when sunglasses are also recommended, specific guidance is wrong or is not explained. Guidance from the World Health Organization at its InterSun webpage advises people to wear "wrap-around" sunglasses under many conditions. The objective of this study was to examine the need for UV filtration in prescription lenses, contact lenses, and sunglasses. The geometry of UV exposure of both eyes, solar position, ground reflection, pupil size, and lid opening were studied. Because an accurate determination of cumulative ocular exposure is difficult, the cornea itself can serve as a biologic dosimeter, because photokeratitis is not experienced on a daily basis but does under certain ground-surface and sunlight conditions. From a knowledge of the UV-threshold dose required to produce photokeratitis, we have an upper level of routine ocular exposure to ambient UV. From ambient UV measurements and observed photokeratitis, the upper limits of UV exposure of the crystalline lens or an intraocular lens implant are estimated. The risk of excess UV exposure of the germinative cells of the lens is greatest from the side. Sunglasses can actually increase UV exposure of the germinative region of the crystalline lens and the corneal limbus by disabling the eyes' natural protective mechanisms of lid closure and pupil constriction! The level of UV-A risk is difficult to define. Proper UV-absorbing contact lenses offer the best mode for filtering needless exposure of UV radiation of the lens and limbus.

  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. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Superselective intra-arterial chemotherapy in the primary management of advanced intra-ocular retinoblastoma: first 4-year experience from a single institution in Turkey.

    PubMed

    Tuncer, Samuray; Sencer, Serra; Kebudi, Rejin; Tanyıldız, Burak; Cebeci, Zafer; Aydın, Kubilay

    2016-11-01

    To report our 4-year experience in Turkey, with advanced intra-ocular retinoblastoma managed primarily with intra-arterial chemotherapy (IAC). From October 2011 to September 2015, 26 group D eyes of 24 treatment-naïve retinoblastoma patients managed primarily with IAC were evaluated in this prospective study. Of 76 procedures, ophthalmic artery cannulation failed in two patients with unilateral involvement. In the remaining 22 patients (24 eyes), the mean age at diagnosis was 18 months (range, 6-55 months). Each eye received a mean of 3 IAC sessions/eye (range, 2-5 sessions). After a median follow-up of 29 months (range, 6-55 months), complete regression of the main tumour was achieved in 23 of 24 eyes. One eye with partial regression required enucleation due to ciliary body involvement by the tumour. Overall, 16 eyes (66.6%) were salvaged with primary IAC with or without additional local treatments, and eight (33.3%) required enucleation. The main IAC-related periocular complications included transient eyelid oedema (n = 13), ptosis (n = 6) and forehead hyperpigmentation (n = 3), each resolving in 2 weeks to 4 months. Intra-ocular complications included chorioretinal atrophy (n = 9), newly noted retinal detachment (n = 5) and vitreous haemorrhage (n = 1). Kaplan-Meier eye estimates of enucleation-free survival rates were 83.3% (95% CI, 68.4-98.1%), 69.1% (95% CI, 49.8-88.3%) and 62.9 (95% CI, 41.9-83.8%) at 6 months, 1 and 2 years, respectively, and stable thereafter. Our first 4-year experience in Turkey showed that enucleation or external-beam radiotherapy could be avoided in two-thirds of eyes with advanced intra-ocular retinoblastoma managed primarily with IAC. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  17. Experimental characterization of the imaging properties of multifocal intraocular lenses

    NASA Astrophysics Data System (ADS)

    Gobbi, Pier Giorgio; Fasce, Francesco; Bozza, Stefano; Brancato, Rosario

    2003-07-01

    Many different types of intraocular lenses (IOL) are currently available for implantation, both as crystalline lens replacements and as phakic refractive elements. Their optical design is increasingly sophisticated, including aspherical surface profiles and multi-zone multifocal structures, however a quantitative and comparative characterization of their imaging properties is lacking. Also a qualitative visualization of their properties would be very useful for patients in the lens choice process. To this end an experimental eye model has been developed to allow for simulated in-vivo testing of IOLs. The model cornea is made of PMMA with a dioptric power of 43 D, and it has an aspherical profile designed to minimize spherical aberration across the visible spectrum. The eye model has a variable iris and a mechanical support to accomodate IOLs, immersed in physiological solution. The eye length is variable and the retina is replaced by a glass plate. The image formed on this "retina" is optically conjugated to a CCD camera, with a suitable magnification in order to mimic the human fovea resolution, and displayed onto a monitor. With such an opto-mechanical eye model, two types of images have been used to characterize IOLs: letter charts and variable contrast gratings, in order to directly simulate human visual acuity and contrast sensitivity.

  18. A sample predictive model for intraocular pressure following laser in situ keratomileusis for myopia and an "intraocular pressure constant".

    PubMed

    Bahadir Kilavuzoglu, Ayse Ebru; Bozkurt, Tahir Kansu; Cosar, Cemile Banu; Sener, Asım Bozkurt

    2017-06-24

    To describe a sample predictive model for intraocular pressure (IOP) following laser in situ keratomileusis (LASIK) for myopia and an IOP constant. The records of patients that underwent LASIK for myopia and myopic astigmatism via WaveLight Allegretto Wave Eye-Q 400 Hz excimer laser and Hansatome XP microkeratome were retrospectively reviewed. Patients with no systemic or ocular disease other than myopia or myopic astigmatism were included in the study. Preoperative and postoperative month 1 data and intraoperative data were used to build the predictive model for IOP after LASIK. The IOP constant was calculated by subtracting the predicted IOP from preoperative IOP. The paired samples t test, Pearson's correlation analysis, curve estimation analysis, and linear regression analysis were used to evaluate the study data. The study included 425 eyes in 214 patients with a mean age of 32 ± 7.8 years. Mean spherical equivalent of the attempted correction (SE-ac) was -3.7 ± 1.7 diopters. Mean post-LASIK decrease in IOP was 4.6 ± 2.3 mmHg. The difference between preoperative and postoperative IOP was statistically significant (P < 0.001). SE-ac, preoperative IOP, and central corneal thickness had highly significant effects on postoperative IOP, based on linear regression analysis (P < 0.001 and R 2  = 0.043, P < 0.001 and R 2  = 0.370, and P < 0.001 and R 2  = 0.132, respectively). Regression model was created (F = 127.733, P < 0.001), and the adjusted R 2 value was 0.548. Evaluation of IOP after LASIK is important in myopic patients. The present study described a practical formula for predicting the true IOP with the aid of an IOP constant value in myopic eyes following LASIK.

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

    PubMed

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

    2016-03-01

    The objective of this study was to investigate capsular outcomes 12 months after pediatric cataract surgery without intraocular lens implantation via qualitative classification and quantitative measurement.This study is a cross-sectional study that was approved by the institutional review board of Zhongshan Ophthalmic Center of Sun Yat-sen University in Guangzhou, China.Digital coaxial retro-illumination photographs of 329 aphakic pediatric eyes were obtained 12 months after pediatric cataract surgery without intraocular lens implantation. Capsule digital coaxial retro-illumination photographs were divided as follows: anterior capsule opening area (ACOA), posterior capsule opening area (PCOA), and posterior capsule opening opacity (PCOO). Capsular outcomes were qualitatively classified into 3 types based on the PCOO: Type I-capsule with mild opacification but no invasion into the capsule opening; Type II-capsule with moderate opacification accompanied by contraction of the ACOA and invasion to the occluding part of the PCOA; and Type III-capsule with severe opacification accompanied by total occlusion of the PCOA. Software was developed to quantitatively measure the ACOA, PCOA, and PCOO using standardized DCRPs. The relationships between the accurate intraoperative anterior and posterior capsulorhexis sizes and the qualitative capsular types were statistically analyzed.The DCRPs of 315 aphakic eyes (95.8%) of 191 children were included. Capsular outcomes were classified into 3 types: Type I-120 eyes (38.1%); Type II-157 eyes (49.8%); Type III-38 eyes (12.1%). The scores of the capsular outcomes were negatively correlated with intraoperative anterior capsulorhexis size (R = -0.572, P < 0.001), but no significant correlation with intraoperative posterior capsulorhexis size (R = -0.16, P = 0.122) was observed. The ACOA significantly decreased from Type I to Type II to Type III, the PCOA increased in size from Type I to Type II, and the PCOO increased

  20. Tilt and decentration of intraocular lenses in vivo from Purkinje and Scheimpflug imaging. Validation study.

    PubMed

    de Castro, Alberto; Rosales, Patricia; Marcos, Susana

    2007-03-01

    To measure tilt and decentration of intraocular lenses (IOLs) with Scheimpflug and Purkinje imaging systems in physical model eyes with known amounts of tilt and decentration and patients. Instituto de Optica Daza de Valdés, Consejo Superior de Investigaciones Científicas, Madrid, Spain. Measurements of IOL tilt and decentration were obtained using a commercial Scheimpflug system (Pentacam, Oculus), custom algorithms, and a custom-built Purkinje imaging apparatus. Twenty-five Scheimpflug images of the anterior segment of the eye were obtained at different meridians. Custom algorithms were used to process the images (correction of geometrical distortion, edge detection, and curve fittings). Intraocular lens tilt and decentration were estimated by fitting sinusoidal functions to the projections of the pupillary axis and IOL axis in each image. The Purkinje imaging system captures pupil images showing reflections of light from the anterior corneal surface and anterior and posterior lens surfaces. Custom algorithms were used to detect the Purkinje image locations and estimate IOL tilt and decentration based on a linear system equation and computer eye models with individual biometry. Both methods were validated with a physical model eye in which IOL tilt and decentration can be set nominally. Twenty-one eyes of 12 patients with IOLs were measured with both systems. Measurements of the physical model eye showed an absolute discrepancy between nominal and measured values of 0.279 degree (Purkinje) and 0.243 degree (Scheimpflug) for tilt and 0.094 mm (Purkinje) and 0.228 mm (Scheimpflug) for decentration. In patients, the mean tilt was less than 2.6 degrees and the mean decentration less than 0.4 mm. Both techniques showed mirror symmetry between right eyes and left eyes for tilt around the vertical axis and for decentration in the horizontal axis. Both systems showed high reproducibility. Validation experiments on physical model eyes showed slightly higher accuracy

  1. Rotation stability of a toric intraocular lens with a second capsular tension ring.

    PubMed

    Sagiv, Oded; Sachs, Dan

    2015-05-01

    An Acrysof toric intraocular lens (IOL) and a capsular tension ring (CTR) were implanted in the highly myopic eye of a 74-year-old white man during cataract surgery. On the first postoperative day, the IOL was found 90 degrees from the required position, with a consequent high amount of astigmatism. A second procedure was performed and because it was not possible to secure the toric IOL in the correct position, an additional in-the-bag CTR was inserted, with an immediate optimal outcome. The IOL remained stable up to the final follow-up examination. Co-implantation of a toric IOL and a single CTR has been reported. In our case, 2 CTRs were required to fixate the toric IOL in the correct position. This procedure is simple and safe and should be considered in cases of postoperatively misaligned toric IOLs. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  2. [Toric add-on intraocular lenses for correction of high astigmatism after pseudophakic keratoplasty].

    PubMed

    Hassenstein, A; Niemeck, F; Giannakakis, K; Klemm, M

    2017-06-01

    Perforating keratoplasty shows good morphological results with a clear cornea; however, a limiting factor is often the resulting astigmatism, which cannot be corrected with either glasses or contact lenses (CL) in up to 20% of the patients. We retrospectively investigated 15 patients after pseudophakic perforating keratoplasty, who received implantation of toric add-on intraocular lenses (IOL) to correct astigmatism. The mean preoperative astigmatism of 6.5 diopter (dpt) could be reduced to a mean postoperative value of 1.0 dpt. The mean visual acuity could be improved from a preoperative value of sc <0.05 (cc 0.6) to a postoperative value of sc 0.4 (cc 0.63). There were no complications except for one case of a lens extension tear. Based on our good experiences we now provide toric add-on IOL to all patients with pseudophakic perforating keratoplasty when this cannot be corrected or only insufficiently corrected by conservative methods.

  3. [Miyake-Apple video analysis of movement patterns of an accommodative intraocular lens implant].

    PubMed

    Auffarth, G U; Schmidbauer, J; Becker, K A; Rabsilber, T M; Apple, D J

    2002-11-01

    The potentially accommodative intraocular lens (IOL) is a new development in IOL design We evaluated the new Humanoptics 1CU accommodative IOL in a laboratory study with human post mortem autopsy eyes. Using the Miyake-Apple posterior view video technique, the movement pattern of the IOL was tested and observed from the posterior perspective. RESULTS. A circular bend at the level of the ciliary body applied slight circular force onto the sclera allowing the relaxation of the zonules. The shift of focus was demonstrated by using a reading target. In addition, viscoelastic was injected into the vitreous resulting in the same anterior movement of the IOL optic. The 1CU Humanoptics accommodative IOL showed potential accommodative behaviour in the laboratory. The accommodative (respectively pseudoaccommodative) effect was based on the anterior shift principle with anterior movement of the IOL-optic in the state of relaxing zonules. Whether this reflects the clinical situation, especially to this extent, must be further evaluated.

  4. Intraocular Lens Opacification After Endothelial Keratoplasty as Analyzed by Environmental Scanning Electron Microscopy.

    PubMed

    Verdaguer, Paula; Gris, Oscar; Casaroli-Marano, Ricardo P; Elies, Daniel; Muñoz-Gutierrez, Gerardo; Güell, Jose L

    2015-08-01

    To describe a case of hydrophilic intraocular lens (IOL) opacification based on IOL analysis after Descemet stripping automated endothelial keratoplasty. A 60-year-old woman had uneventful phacoemulsification after the implantation of a hydrophilic IOL (Akreos-Adapt; Bausch & Lomb) into both eyes. Because of postoperative corneal decompensation in the right eye, 2 Descemet stripping automated endothelial keratoplasty operations were performed within 1 year. After the second procedure, the graft was not well attached, requiring an intracameral injection of air on day 3. After 1 year, opacification was observed on the superior 2/3 of the anterior surface of the IOL, along with a significant decrease in visual acuity. The IOL was explanted 6 months after the opacification. Environmental scanning electron microscopy followed by x-ray microanalysis revealed an organic biofilm on the surface of the IOL. To our knowledge, this is the first reported case in which the material deposited on the lens is organic rather than calcific.

  5. Evaluation of Intraocular Inflammation with Laser Flare Photometry in Behçet Uveitis.

    PubMed

    Yalcindag, Fatime Nilufer; Bingol Kiziltunc, Pinar; Savku, Esra

    2017-02-01

    To evaluate the association between intraocular inflammation and laser flare photometry measurements in Behçet disease. In total, 45 patients were included in the study. The retrospective chart reviews of patients were performed. The flare levels were compared with the grade of anterior chamber cells, the presence of vitreous cells, the complications of uveitis, and fluorescein angiography scores. The attack group had higher flare intensity; the flare levels were higher in both groups compared with the values of healthy controls. The flare levels were related to the grade of the anterior chamber cells, the presence of vitreous cells and the fluorescein angiography scores. Patients with optic atrophy and/or maculopathy also had higher values. Higher flare values were correlated with poor vision. Laser flare photometry may reduce the necessity of fluorescein angiography in monitoring subclinical inflammation and may be an indicator of posterior segment activity when fluorescein angiography is not applicable.

  6. Syrian Civil-War-Related Intraocular Foreign Body Injuries: A Four-Year Retrospective Analysis.

    PubMed

    Gurler, Bulent; Coskun, Erol; Oner, Veysi; Comez, Aysegul; Erbagci, Ibrahim

    2017-01-01

    To analyze the data of patients who underwent vitreoretinal surgery due to intraocular foreign body (IOFB) injuries that occurred in the Syrian civil war. Seventy-eight eyes of 78 patients who underwent vitreoretinal surgery due to IOFB injuries that occurred during the Syrian civil war were analyzed. Forty-four eyes (56.4%) had traumatic cataract, 44 (56.4%) had retinal tears, 42 (53.8%) had vitreous hemorrhage, 18 (23%) had retinal detachment, 12 (15.3%) had endophthalmitis, and eight eyes had hyphema (10.2%). IOFBs consisted of metal in 62 eyes (79.4%), stone in eight eyes (10.2%), organic material in four eyes (5.1%), and glass in four eyes (5.1%). Approximately 86% of the eyes had initial VAs of 4/200 or worse. However, VAs improved in 64 eyes (82%) after the surgeries. Despite delays in treatment and the severity of injuries, 82% (64/78) of the eyes had an improvement in VA after the surgeries.

  7. Intraocular involvement of a nasal natural killer T-cell lymphoma: a case report.

    PubMed

    Yoo, Jae Ho; Kim, Soo Young; Jung, Kyu Bong; Lee, Jung Joo; Lee, Sang Joon

    2012-02-01

    Herein, we report a case of nasal natural killer T-cell lymphoma (NKTL) with intraocular involvement. A 57-year-old woman was referred due to a three-day history of photophobia and diplopia in the left eye. One-month previously, she was diagnosed with nasal NKTL of the right nasal cavity. Ophthalmic examination revealed conjunctival injection and ptosis. The left pupil was fully dilated and non-reactive to light. Ocular motion was restricted on left-upper gaze. Five days later, anterior uveitis developed and persisted despite topical steroid treatment. An orbital magnetic resonance imaging was without specific findings, however, ophthalmoplegia, vitreous opacity, and an iris mass were observed. A diagnostic anterior chamber aspiration was performed. Aqueous humor aspiration revealed 35% morphologically atypical lymphocytes. After an intravitreal triamcinolone injection, radiotherapy and chemotherapy were administered; this resolved the uveitis and iris mass. When refractory uveitis or orbital pseudotumor occurs in patients with nasal NKTL, ocular and orbital involvement of the NKTL should be considered.

  8. New method for remote and repeatable monitoring of intraocular pressure variations.

    PubMed

    Margalit, Israel; Beiderman, Yevgeny; Skaat, Alon; Rosenfeld, Elkanah; Belkin, Michael; Tornow, Ralf-Peter; Mico, Vicente; Garcia, Javier; Zalevsky, Zeev

    2014-02-01

    We present initial steps toward a new measurement device enabling high-precision, noncontact remote and repeatable monitoring of intraocular pressure (IOP)-based on an innovative measurement principle. Using only a camera and a laser source, the device measures IOP by tracking the secondary speckle pattern trajectories produced by the reflection of an illuminating laser beam from the iris or the sclera. The device was tested on rabbit eyes using two different methods to modify IOP: via an infusion bag and via mechanical pressure. In both cases, the eyes were stimulated with increasing and decreasing ramps of the IOP. As IOP variations changed the speckle distributions reflected back from the eye, data were recorded under various optical configurations to define and optimize the best experimental configuration for the IOP extraction. The association between the data provided by our proposed device and that resulting from controlled modification of the IOP was assessed, revealing high correlation (R2=0.98) and sensitivity and providing a high-precision measurement (5% estimated error) for the best experimental configuration. Future steps will be directed toward applying the proposed measurement principle in clinical trials for monitoring IOP with human subjects.

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

    PubMed

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

    2017-01-01

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

  10. Tonopen XL assessment of intraocular pressure through silicone hydrogel contact lenses.

    PubMed

    Schornack, Muriel; Rice, Melissa; Hodge, David

    2012-09-01

    To assess the accuracy of Tonopen XL measurement of intraocular pressure (IOP) through low-power (-0.25 to -3.00) and high power (-3.25 to -6.00) silicone hydrogel lenses of 3 different materials (galyfilcon A, senofilcon A, and lotrafilcon B). Seventy-eight patients were recruited for participation in this study. All were habitual wearers of silicone hydrogel contact lenses, and none had been diagnosed with glaucoma, ocular hypertension, or anterior surface disease. IOP was measured with and without lenses in place in the right eye only. Patients were randomized to initial measurement either with or without the lens in place. A single examiner collected all data. No statistically significant differences were noted between IOP measured without lenses and IOP measured through low-power lotrafilcon B lenses or high-power or low-power galyfilcon A and senofilcon A lenses. However, we did find a statistically significant difference between IOP measured without lenses and IOP measured through high-power lotrafilcon B lenses. In general, Tonopen XL measurement of IOP through silicone hydrogel lenses may be sufficiently accurate for clinical purposes. However, Tonopen XL may overestimate IOP if performed through a silicone hydrogel lens of relatively high modulus.

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

    PubMed Central

    Li, Xiao; Zhao, Yang; Wang, Kaijie; Yang, Xiaohui; Zhu, Siquan

    2017-01-01

    To improve the efficacy of anti-inflammatory factors in patients who undergo cataract surgery, poly(2-hydroxyethyl methacrylate-co-methyl methacrylate) (p(HEMA-co-MMA)) hydrogels containing β-cyclodextrin (β-CD) (pHEMA/MMA/β-CD) were designed and prepared as intraocular lens (IOLs) biomaterials that could be loaded with and achieve the sustained release of dexamethasone. A series of pHEMA/MMA/β-CD copolymers containing different ratios of β-CD (range, 2.77 to 10.24 wt.%) were obtained using thermal polymerization. The polymers had high transmittance at visible wavelengths and good biocompatibility with mouse connective tissue fibroblasts. Drug loading and release studies demonstrated that introducing β-CD into hydrogels increased loading efficiency and achieved the sustained release of the drug. Administering β-CD via hydrogels increased the equilibrium swelling ratio, elastic modulus and tensile strength. In addition, β-CD increased the hydrophilicity of the hydrogels, resulting in a lower water contact angle and higher cellular adhesion to the hydrogels. In summary, pHEMA/MMA/β-CD hydrogels show great potential as IOL biomaterials that are capable of maintaining the sustained release of anti-inflammatory drugs after cataract surgery. PMID:29244868

  12. Intraocular Pressure, Tear Production, and Ocular Echobiometry in Guinea Pigs (Cavia porcellus)

    PubMed Central

    Rajaei, Seyed Mehdi; Mood, Maneli Ansari; Sadjadi, Reza; Azizi, Farzaneh

    2016-01-01

    The purpose of this study was to evaluate intraocular pressure (IOP) by means of rebound tonometry, to assess tear production by using the endodontic absorbent paper point tear test (EAPTT) and phenol red thread test (PRTT), and to determine the effects of time of day on IOP and tear production in guinea pigs. The study population comprised 24 healthy adult guinea pigs (12 male, 12 female; 48 eyes) of different breeds and ranging in age from 12 to 15 mo. IOP and tear production were measured at 3 time points (0700, 1500, and 2300) during a 24-h period. Overall values (mean ± 1 SD) were: IOP, 6.81 ± 1.41 mm Hg (range, 4.83 to 8.50); PRTT, 14.33 ± 1.35 mm (range, 12.50 to 16.83); and EAPTT, 8.54 ± 1.08 mm (range, 7.17 to 10.0 mm). In addition, ultrasound biometry was performed by using a B-mode system with linear 8-MHz transducer. This study reports reference values for IOP and tear production in guinea pigs. PMID:27423156

  13. Biocompatibility of poloxamer hydrogel as an injectable intraocular lens: a pilot study.

    PubMed

    Kwon, Ji Won; Han, Young Keun; Lee, Woo Jin; Cho, Chong Su; Paik, Seung Joon; Cho, Dong Il; Lee, Jin Hak; Wee, Won Ryang

    2005-03-01

    To induce irreversible gelation of poloxamer, a thermosensitive polymer hydrogel, by using a photoinitiator and ultraviolet (UV) irradiation and to verify the biocompatibility and use of poloxamer as an injectable intraocular lens (IOL) material. Department of Ophthalmology, Seoul National University College of Medicine, Seoul Artificial Eye Center, Clinical Research Institute, Seoul National University Hospital, Seoul, Korea. In 10 rabbits, endocapsular phacoemulsification was performed and a poloxamer-photoinitiator mixture was injected into the capsular bag through a small capsulorhexis site. In 1 eye, the capsulorhexis site was closed with a small plug and the entire eye was irradiated with UV light for 5 minutes. Postoperatively, poloxamer transparency and effect on the conjunctiva, cornea, iris, vitreous, and retina were observed. A mixture comprising 25% poloxamer and 0.01% photoinitiator produced a poloxamer that remained transparent in the lens capsule for up to 6 months. No inflammatory response or toxicity was observed in the conjunctiva, cornea, iris, vitreous, or retina. Poloxamer is a potentially suitable material for an injectable IOL. Further study is needed.

  14. Upcoming Methods and Specifications of Continuous Intraocular Pressure Monitoring Systems for Glaucoma

    PubMed Central

    Molaei, Amir; Karamzadeh, Vahid; Safi, Sare; Esfandiari, Hamed; Dargahi, Javad; Khosravi, Mohammad Azam

    2018-01-01

    Glaucoma is the leading cause of irreversible blindness and vision loss in the world. Although intraocular pressure (IOP) is no longer considered the only risk factor for glaucoma, it is still the most important one. In most cases, high IOP is secondary to trabecular meshwork dysfunction. High IOP leads to compaction of the lamina cribrosa and subsequent damage to retinal ganglion cell axons. Damage to the optic nerve head is evident on funduscopy as posterior bowing of the lamina cribrosa and increased cupping. Currently, the only documented method to slow or halt the progression of this disease is to decrease the IOP; hence, accurate IOP measurement is crucial not only for diagnosis, but also for the management. Due to the dynamic nature and fluctuation of the IOP, a single clinical measurement is not a reliable indicator of diurnal IOP; it requires 24-hour monitoring methods. Technological advances in microelectromechanical systems and microfluidics provide a promising solution for the effective measurement of IOP. This paper provides a broad overview of the upcoming technologies to be used for continuous IOP monitoring. PMID:29403593

  15. Use of a 350-mm2 Baerveldt glaucoma drainage device to maintain vision and control intraocular pressure in dogs with glaucoma: a retrospective study (2013-2016).

    PubMed

    Graham, Kathleen L; Donaldson, David; Billson, Francis A; Billson, F Mark

    2017-09-01

    To evaluate the 350-mm 2 Baerveldt glaucoma drainage device (GDD) in dogs with refractory glaucoma when modifications to address postoperative hypotony (extraluminal ligature; intraluminal stent) and the fibroproliferative response (intraoperative Mitomycin-C; postoperative oral colchicine and prednisolone) are implemented as reported in human ophthalmology. Retrospective case series. Twenty-eight client-owned dogs (32 eyes) including seven dogs (nine eyes) with primary glaucoma and 21 dogs (23 eyes) with secondary glaucoma. The medical records of all dogs undergoing placement of a 350-mm 2 Baerveldt GDD at a veterinary ophthalmology referral service between 2013 and 2016 were reviewed. Signalment, diagnosis, duration and previous treatment of glaucoma, previous intraocular surgery, IOP, visual, and surgical outcomes were recorded. IOP was maintained <20mmHg in 24 of 32 (75.0%) eyes. Fourteen eyes (43.8%) required no adjunctive treatments to maintain this IOP control. Fewer doses of glaucoma medication were required following surgery. Vision was retained in 18 of 27 (66.7%) eyes with vision at the time of surgery. No eyes that were blind at the time of surgery (n = 5) had restoration of functional vision. Complications following surgery included hypotony (26/32; 81.3%), intraocular hypertension (24/32; 75.0%), and fibrin formation within the anterior chamber (20/32; 62.5%). The average follow-up after placement of the GDD was 361.1 days (median 395.6 days). Efforts to minimize postoperative hypotony and address the fibroproliferative response following placement of a 350-mm 2 Baerveldt GDD showed an increased success rate to other reports of this device in dogs and offers an alternative surgical treatment for controlling intraocular pressure in dogs with glaucoma. © 2016 American College of Veterinary Ophthalmologists.

  16. Intraocular pressure elevation after cataract surgery and its prevention by oral acetazolamide in eyes with pseudoexfoliation syndrome.

    PubMed

    Hayashi, Ken; Yoshida, Motoaki; Sato, Tatsuhiko; Manabe, Shin-Ichi; Yoshimura, Koichi

    2018-02-01

    To examine whether intraocular pressure (IOP) increases immediately after cataract surgery in eyes with pseudoexfoliation (PXF) syndrome and to assess whether orally administered acetazolamide can prevent the IOP elevation. Hayashi Eye Hospital, Fukuoka, Japan. Prospective case series. Patients with PXF syndrome scheduled for phacoemulsification were randomly assigned to 1 of 3 groups: (1) oral acetazolamide administered 1 hour preoperatively (preoperative administration group), (2) administered 3 hours postoperatively (postoperative administration group), and (3) not administered (no administration group). The IOP was measured using a rebound tonometer 1 hour preoperatively, upon completion of surgery, and at 1, 3, 5, 7, and 24 hours postoperatively. The study comprised 96 patients (96 eyes). The mean IOP increased at 3, 5, and 7 hours postoperatively in all groups. At 1 hour and 3 hours postoperatively, the IOP was significantly lower in the preoperative administration group than in the postoperative group and no administration group (P ≤ .001). At 5, 7, and 24 hours postoperatively, the IOP was significantly lower in the preoperative group and postoperative administration group than in the no administration group (P ≤. 045). An IOP spike higher than 25 mm Hg occurred less frequently in the preoperative administration group than in the postoperative administration group and the no administration group (P = .038). Intraocular pressure increased at 3, 5, and 7 hours after cataract surgery in eyes with PXF syndrome. Oral acetazolamide administered 1 hour preoperatively reduced the IOP elevation throughout the 24-hour follow-up; acetazolamide administered 3 hours postoperatively reduced the elevation at 5 hours postoperatively and thereafter. Copyright © 2018 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  17. Intraocular lens bioactivity tested using rabbit corneal tissue cultures.

    PubMed

    Linnola, R J; Salonen, J I; Happonen, R P

    1999-11-01

    To evaluate the effects of different intraocular lens (IOL) materials on epithelial cell growth to test the sandwich theory; i.e., a bioactivity-based explanation of posterior capsule opacification (PCO) after cataract surgery. Central Hospital, Vaasa, and Institute of Dentistry and Turku Center for Biomaterials, University of Turku, Finland. Rabbit corneal tissue cultures were set up on poly(methyl methacrylate) (PMMA), heparin-surface-modified (HSM) PMMA, silicone, acrylate, and hydrogel IOLs for 1 week. The tissue consisted of intact epithelium and half the thickness of the corneal stroma, which was placed against the IOL. The growth of the epithelium was examined by light microscopy to evaluate the attachment of the corneal explant to the IOL surface. All tissue samples grew well under the culture conditions. When grown on PMMA, HSM PMMA, silicone, and hydrogel, the tissue did not attach to the IOL or the epithelium grew around the explant, suggesting that the attachment of the stroma to the IOL was poor or nonexistent. Some explants on acrylate IOLs attached directly to the IOL surface with no epithelial ingrowth between the stroma and the IOL. This tissue culture method can be used to examine the behavior of corneal tissue in contact with different IOL materials. The results suggest that the acrylate IOL may have bioactive properties. This, with the lens optic's square edge, may hinder lens epithelial cell proliferation and thus prevent PCO.

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

    PubMed

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

    2013-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2018-04-23

    To evaluate the safety and efficacy of combined 23-gauge transconjunctival pars plana vitrectomy and scleral fixation of intraocular lens (IOL) without conjunctival dissection. A retrospective study in Chang Gung Memorial Hospital, Keelung and Taoyuan, Taiwan. Patients receiving combined 23-gauge transconjunctival pars plana vitrectomy and scleral fixation of IOL without conjunctival dissection were enrolled. The ocular findings, causes of lens complication, surgical procedures, type of IOL used, and complications were documented. We included 40 eyes from 39 patients (27 male, 12 female) with a mean age of 59.5 [standard deviation (±) 14.8] years old. The mean follow-up duration was 6.8 ± 5.4 months. The cause of lens complications was ocular trauma in 24 (60%) eyes, cataract surgery complications in 11 (28%) eyes, and spontaneous subluxation of crystalline lens in 5 (13%) eyes. The overall best corrected visual acuity (BCVA) (logMAR) improved from 1.359 ± 0.735 to 0.514 ± 0.582 (p < 0.001). The BCVA also improved significantly in each group with different causes of lens complications. Preoperative BCVA was the only factor associated with the postoperative visual outcome (p = 0.008). Most surgery-related complications were self-limited, including mild vitreous hemorrhage (5%), microhyphema (5%), transient elevated intraocular pressure (3%), and transient hypotony (3%). Cystoid macular edema and IOL decentration was found in 3 (8%) eyes and 1 (3%) eye respectively. Combined 23-gauge transconjunctival vitrectomy and scleral fixation of IOL without conjunctival dissection is effective and safe in managing a wide variety of lens complications, with good postoperative comfort and visual recovery. Retrospective study, not applicable.

  1. A biological tissue adhesive and dissolvent system for intraocular tumor plaque radiotherapy: an in vivo animal model experiment.

    PubMed

    Zloto, Ofira; Alezra, Dror; Sagiv, Oded; Belkin, Michael; Dai, Vicktoria Vishnevskia; Moroz, Iris; Greenberg, Gahl; Ben-Artsi, Elad; Fabian, Ido Didi

    2015-11-01

    To examine a novel biological adhesive and dissolvent system for plaque placement and removal using fibrin glue and urokinase, respectively, in an in vivo animal model. The study was performed on 23 rabbit eyes. Of these, eight underwent a technical feasibility study and ultrasonographic plaque displacement measurements, nine were examined clinically and by magnetic resonance imaging and histopathology for tissue reaction to the biological substances used, and in six the impact of fibrin glue as an orbital space occupier on intraocular pressure was assessed. In an additional ex vivo experiment, the glue's radiation attenuating properties were tested using an oncology EDR2 film. Plaque horizontal movement throughout follow-up (7-10 days) was negligible (0.5 ± 0.2 mm), and there was no tilting whatsoever. In the tissue response experiment, no adverse effects were recorded after application of fibrin or urokinase throughout the 21-day follow-up period. Interestingly, a circumscribed local inflammatory response was noted in tissue surrounding the fibrin glue, and persisted at 21 days. In the orbital space-occupying experiment, application of 1 cc fibrin glue did not cause a significant elevation in intraocular pressure (IOP) (P = 0.06), and in the ex vivo experiment, there was no significant difference between radiation readings with and without glue separation of the radioactive sources and film (P = 0.065). The adhesive and dissolvent system was feasible and safe for plaque placement and removal. It may be superior to conventional surgical plaque placement methods in eliminating the relatively common risk of plaque tilting and complications due to scleral suturing.

  2. Bilateral reading performance of 4 multifocal intraocular lens models and a monofocal intraocular lens under bright lighting conditions.

    PubMed

    Rasp, Max; Bachernegg, Alexander; Seyeddain, Orang; Ruckhofer, Josef; Emesz, Martin; Stoiber, Josef; Grabner, Günther; Dexl, Alois K

    2012-11-01

    To compare changes in reading performance parameters after implantation of 4 multifocal intraocular lens (IOL) models and a monofocal IOL. Department of Ophthalmology, Paracelsus Medical University, Salzburg, Austria. Prospective randomized controlled clinical trial. Patients with bilateral cataract without additional ocular pathology were scheduled for bilateral implantation of Acri.Smart 48S monofocal, Acrysof Restor SN6AD3 apodized multifocal, AT LISA 366D diffractive multifocal, Tecnis ZMA00 diffractive multifocal, or Rezoom refractive multifocal IOLs. Bilateral corrected and uncorrected reading acuity, reading distance, mean and maximum reading speeds, and smallest log-scaled print size of a Radner reading chart were evaluated under bright lighting conditions (500 lux) using the Salzburg Reading Desk. Pupil size was not measured throughout the trial. The minimum follow-up was 12 months. The diffractive multifocal groups had significantly better uncorrected reading acuity and uncorrected smallest print size than the monofocal and refractive multifocal groups 1, 6, and 12 months postoperatively. The diffractive IOL groups had comparable uncorrected reading distance of approximately 32 cm, which was larger in the monofocal group (38.9 ± 8.4 cm) and refractive multifocal group (37.1 ± 7.3 cm) at the last visit. Patients with diffractive IOLs could read print sizes of approximately 0.74 to 0.87 mm, which was much better than in the monofocal and refractive multifocal groups. The diffractive AT LISA IOL provided the best reading speed values (mean and maximum, corrected and uncorrected). Multifocal IOLs with a diffractive component provided good reading performance that was significantly better than that obtained with a refractive multifocal or monofocal IOL. Drs. Grabner and Dexl were patent owners of the Salzburg Reading Desk technology (now owned by SRD-Vision, LLC). No other author has a financial or proprietary interest in any material or method mentioned

  3. Customized ultra-high-power toric intraocular lens implantation for pellucid marginal degeneration and cataract.

    PubMed

    Luck, Jonathan

    2010-07-01

    I report a case of pellucid marginal degeneration (PMD) with cataract that was successfully treated with implantation of an ultra-high-power customized bitoric AT.Comfort 646TLC intraocular lens (IOL). The preoperative uncorrected distance visual acuity (UDVA) was 6/120 and the corrected distance visual acuity (CDVA), 6/24 with 10.9 diopters (D) of keratometric astigmatism on Scheimpflug imaging. After implantation of an IOL with -0.5 +16.0 x 170, the UDVA was 6/9 with a manifest refraction of +0.25 +1.25 x 150 and the CDVA, 6/6(-1). No surgical complications or postoperative problems occurred, and the patient was very satisfied with the outcome. A longer follow-up is required to confirm this favorable clinical result. The author has no financial or proprietary interest in any material or method mentioned. Copyright 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  4. Appraisal of Bleb Using Trio of Intraocular Pressure, Morphology on Slit Lamp, and Gonioscopy.

    PubMed

    Thatte, Shreya; Rana, Rimpi; Gaur, Neeraj

    2016-01-01

    The aim of this study was to assess bleb function using Wuerzburg bleb classification score (WBCS) for bleb morphology on slit lamp, intraocular pressure (IOP), and gonioscopy. A total of randomly selected 30 eyes posttrabeculectomy were assessed for bleb function with the trio of bleb morphology, IOP, and gonioscopy. Bleb was assessed using the WBCS of 0-12 on slit lamp, IOP was assessed using applanation tonometry, and visualization of inner ostium and iridectomy were assessed using gonioscopy. Postoperative patients of less than six weeks were excluded from the study. The correlation between WBCS and the duration of trabeculectomy was found to be highly significant ( P value = 0.029). The correlation of IOP with WBCS was also found to be strongly positive ( P = 0.000). IOP was found to be highly associated with peripheral iridectomy ( P = 0.000), internal window ( P = 0.001), and bleb characteristics.

  5. The Risk of Intraocular Pressure Elevation in Pediatric Non-infectious Uveitis

    PubMed Central

    Kothari, Srishti; Foster, C. Stephen; Pistilli, Maxwell; Liesegang, Teresa L.; Daniel, Ebenezer; Sen, H. Nida; Suhler, Eric B.; Thorne, Jennifer E.; Jabs, Douglas A.; Levy-Clarke, Grace A.; Nussenblatt, Robert B.; Rosenbaum, James T.; Lawrence, Scott D.; Kempen, John H.

    2015-01-01

    Purpose To characterize the risk and risk factors for intraocular pressure (IOP) elevation in pediatric non-infectious uveitis. Design Multi-center retrospective cohort study. Participants Nine hundred sixteen children (1593 eyes) <18 years old at presentation with non-infectious uveitis followed between January 1978 through December 2007 at five academic uveitis centers in United States. Methods Medical records review by trained, certified experts. Main outcome measures Prevalence and incidence of IOP≥21 and ≥30mmHg and incidence of a rise in IOP by ≥10mmHg. To avoid under ascertainment, outcomes were counted as present when IOP-lowering therapies were in use. Results Initially 251 (15.8%) and 46 eyes (2.9%) had IOP≥21 and ≥30mmHg, respectively. Factors associated with presenting IOP elevation included age 6–12 years (versus other pediatric ages), prior cataract surgery (adjusted odds ratio≥21mmHg [aOR21]=2.42, P=0.01), pars plana vitrectomy (adjusted odds ratio≥30mmHg[aOR30]=11.1, P=0.03), duration of uveitis ≥6 months (aORs30 up to 11.8, P<0.001), contralateral IOP elevation (aOR21=16.9, aOR30=8.29; each P<0.001), visual acuity worse than 20/40 (aORs21 up to 1.73, P=0.02; aORs30 up to 2.81 P=0.03), and topical corticosteroid use (aORs up to 8.92, P<0.001 in a dose-response relationship). The median follow-up was 1.25 years (interquartile range 0.4–3.66). The estimated risk of any observed IOP elevation to ≥21 mmHg, ≥30 mmHg and of a rise in IOP by ≥10mmHg was 33.4%, 14.8% and 24.4% respectively within 2 years. Factors associated with IOP elevation included pars plana vitrectomy (adjusted hazard ratio≥21mmHg[aHR21]=3.36, P<0.001), contralateral IOP elevation (aHRs up to 9.54, P<0.001), the use of topical (aHRs up to 8.77 that followed a dose-response relationship, P<0.001), periocular (aHRs up to 7.96, P<0.001) and intraocular (aHRs up to 19.7, P<0.001) corticosteroids. Conclusions IOP elevation affects a large minority of children

  6. 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.

  7. [Fabrication and Performance Study of Polydimethylsiloxane Intraocular Lens].

    PubMed

    Du, Qiuyue; Yu, Yueqing

    2016-10-01

    To simplify the production process of intraocular lens(IOL)and to solve the problem of lacking adjustable ability,we proposed a novel soft IOL with large-scale adjustable ability and rigid haptics based on heat-assisted method,and gravity-assisted method.Polydimethylsiloxane(PDMS)and rigid material--polymethyl methacrylate(PMMA)were used as the materials for fabricating optical lens(PDMS)and haptics(PDMS and PMMA)through changing the weight ratio of the solution.A lens-smartphone microscopy system was established to replace the traditional digital microscopy to measure the tiny displacements and shape changes.The PDMS lens has excellent optical property through an experiment in which the maximum optical power was around 273.2D.Experimental results indicated that the maximum optical power of PMMA IOL was 129.3D,and that in PDMS IOL,however,was only 56.0D.Thus,the rigid PMMA-IOL has a larger adjustable range.The production process of PDMS was mold-free,rapid,real-time,and highly repeatable and there was no need for a rigorous experimental environment either.This creative processing technology reduced the manufacturing steps from which an optical lens with high transmittance and high resolution,as well as hatics with accurate dimensions,were obtained.The rigidity of haptics affected more intensely than other factors did for improving the pre-displacement and changing the appearance of PDMS lens.Even though the rigidity of PMMA haptics is large enough for accommodating,there are many drawbacks during manufacturing.It is unavailable to rapid fabricate IOL using PMMA.Thus,further work will be required to alter the weight ratio of PDMS material,increase the rigidity,and enhance the adjustable ability of PDMS IOL.

  8. Omni-focal refractive focus correction technology as a substitute for bi/multi-focal intraocular lenses, contact lenses, and spectacles

    NASA Astrophysics Data System (ADS)

    Ben Yaish, Shai; Zlotnik, Alex; Raveh, Ido; Yehezkel, Oren; Belkin, Michael; Lahav, Karen; Zalevsky, Zeev

    2009-02-01

    We present novel technology for extension in depth of focus of imaging lenses for use in ophthalmic lenses correcting myopia, hyperopia with regular/irregular astigmatism and presbyopia. This technology produces continuous focus without appreciable loss of energy. It is incorporated as a coating or engraving on the surface for spectacles, contact or intraocular lenses. It was fabricated and tested in simulations and in clinical trials. From the various testing this technology seems to provide a satisfactory single-lens solution. Obtained performance is apparently better than those of existing multi/bifocal lenses and it is modular enough to provide solution to various ophthalmic applications.

  9. Bacterial endophthalmitis in the age of outpatient intravitreal therapies and cataract surgeries: Host-microbe interactions in intraocular infection

    PubMed Central

    Sadaka, Ama; Durand, Marlene L; Gilmore, Michael S

    2012-01-01

    Bacterial endophthalmitis is a sight threatening infection of the interior structures of the eye. Incidence in the US has increased in recent years, which appears to be related to procedures being performed on an aging population. The advent of outpatient intravitreal therapy for management of age-related macular degeneration raises yet additional risks. Compounding the problem is the continuing progression of antibiotic resistance. Visual prognosis for endophthalmitis depends on the virulence of the causative organism, the severity of intraocular inflammation, and the timeliness of effective therapy. We review the current understanding of the pathogenesis of bacterial endophthalmitis, highlighting opportunities for the development of improved therapeutics and preventive strategies. PMID:22521570

  10. 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

  11. Posterior capsule opacification after implantation of a hydrogel intraocular lens

    PubMed Central

    Hayashi, K; Hayashi, H

    2004-01-01

    Aim: To compare the degree of posterior capsule opacification (PCO) in eyes with a hydrophilic hydrogel intraocular lens (IOL) with that in eyes with a hydrophobic acrylic IOL. Methods: Ninety five patients underwent a hydrogel IOL implantation in one eye and an acrylic IOL implantation in the opposite eye. The PCO value of these patients was measured using the Scheimpflug videophotography system at 1, 6, 12, 18, and 24 months postoperatively. The rate of neodymium:YAG (Nd:YAG) laser posterior capsulotomy and visual acuity were also evaluated. Results: The mean PCO value in the hydrogel group increased significantly (p<0.0001), while that in the acrylic group did not show significant change. The PCO value in the hydrogel group was significantly greater than that in the acrylic group throughout the follow up period. Kaplan-Meier survival analysis determined that the Nd:YAG capsulotomy rate in the hydrogel group was significantly higher than that in the acrylic group (p<0.0001). Mean visual acuity in the hydrogel group decreased significantly with time (p<0.0001), and became significantly worse than that in the acrylic group at 18 and 24 months postoperatively. Conclusion: Posterior capsule opacification in eyes with a hydrophilic hydrogel IOL is significantly more extensive than that in eyes with a hydrophobic acrylic IOL, and results in a significant impairment of visual acuity. PMID:14736768

  12. Baroreceptors mask sympathetic responses to high intraocular pressure in dogs.

    PubMed

    Yahagi, Toru; Koyama, Shozo; Osaka, Kazumasa; Koyama, Haruhide

    2008-05-30

    These experiments were designed to investigate whether increasing intraocular pressure (IOP) in anesthetized dogs produces differential control of sympathetic nerve activities to various organs (heart, kidney, liver, and spleen) and if these sympathetic responses are modified by baroreceptors. We performed simultaneous multi-recordings of cardiac, renal, hepatic and splenic sympathetic nerve activities (CNA, RNA, HNA and SpNA, respectively) during 2 min of increasing IOP to a mean pressure of 30 mmHg. After increasing IOP in dogs with the intact baroreceptors, all of measured nerve activities did not change significantly throughout the experiment. In dogs with denervation of baroreceptors (cervical vagotomy with denervation of the carotid sinus and aortic nerves), only RNA and CNA showed significant increases in response to the increased IOP. However, time course changes in HNA and SpNA did not show any significant differences as compared with the baseline or that of the control group. These results indicate that systemic sympathetic nerve responses to increasing IOP are masked by systemic baroreceptors. As animals were denervated of their systemic baroreceptors, the unidirectional sympathoexcitatory responses to increased IOP were observed on CNA and RNA, but not on HNA and SpNA. These sympathetic outflow, when systemic baroreceptors are impaired as observed in old age, may play an important role in management of glaucoma attack with the use of adrenolytic drugs.

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

    PubMed

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

    2017-01-01

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

  14. [The growth behavior of mouse fibroblasts on intraocular lens surface of various silicone and PMMA materials].

    PubMed

    Kammann, J; Kreiner, C F; Kaden, P

    1994-08-01

    Experience with intraocular lenses (IOL) made of PMMA dates back ca. 40 years, while silicone IOLs have been in use for only about 10 years. The biocompatibility of PMMA and silicone caoutchouc was tested in a comparative study investigating the growth of mouse fibroblasts on different IOL materials. Spectrophotometric determination of protein synthesis and liquid scintillation counting of DNA synthesis were carried out. The spreading of cells was planimetrically determined, and the DNA synthesis of individual cells in direct contact with the test sample was tested. The results showed that the biocompatibility of silicone lenses made of purified caoutchouc is comparable with that of PMMA lenses; there is no statistically significant difference. However, impurities arising during material synthesis result in a statistically significant inhibition of cell growth on the IOL surfaces.

  15. Intraocular lens scaffold technique to prevent posterior capsule rupture in cases of Morgagnian cataract.

    PubMed

    Parkash, Rohit Om; Mahajan, Shruti; Parkash, Tushya Om; Nayak, Vittal

    2017-01-01

    We describe a technique for performing safe phacoemulsification of a Morgagnian cataract using the intraocular lens (IOL) scaffold. An IOL scaffold has been used in cases in which posterior capsule rupture has occurred, leaving nonemulsified nuclear pieces. The scaffold provides a barrier that prevents the nuclear fragments from falling posteriorly into the vitreous cavity. Our technique uses the IOL as a scaffold to prevent the vulnerable posterior capsule from rupturing during nuclear emulsification in Morgagnian cataract. The technique prevents rupture of the floppy posterior capsule by providing a constant support to it. The scaffold provides stable inflation of the capsular bag and prevents inadvertent emulsification. Concurrently, it prevents dehiscence of weak zonular fibers by minimizing the stress on the zonular apparatus. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

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

    PubMed

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

    2016-02-26

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

  17. THE USE OF I$sup 125$ LABELED DIIODOFLUORESCEIN IN THE DETECTION OF HUMAN INTRAOCULAR NEOPLASMS

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Goren, S.B.; Newell, E.W.; Brizel, H.E.

    The new method which is described is believed to be superior to the usual method for detection of intraocular tumors using P/sup 32/. Because of the limited penetration of beta rays, the use of P/sup 32/ imposes relatively strict geometric restrictions and its usefulness in posterior-segment tumors is limited. The patient receives a single intravenous injection of 5.0 mu c/kg body weight of diiodofluorescein-I/sup 125/, the specific activity of which is 17 mg/mc. External counting over each closed eye is carried out with a hand scintillation counter 1, 5, 8, and 24 hr after injection. Ocular counts are performed bymore » resting the window of the counter against the closed lids; the cavernous sinus is measured by placing the counter just above the bridge of the nose. ln the 17 patients studied, eyes with neoplasms contained at least 23% more radioactivity after 8 hr than did the healthy eye. Control eyes, not containing neoplasms (idiopathic retinal detachment, retinoschisis, benign nevus, macular degeneration, phthisis bulbi, absolute glaucoma), showed less than a 13% differential. One false negative test was obtained, a patient with a metastatic bronchogenic adenocarcinoma to the choroid; no false positives were seen. Diiodofluorescein labeled with I/sup 131/ has been widely used as a diagnostic aid in suspected intracranial neoplasms. However, since the gamma rays of I/sup 131/ have a half-value layer in tissue of 6.9 cm, it has not been helpful in ocular disease; the gamma rays arising from the cavernous sinus interfere with accurate counting of intraocular radiation. I/sup 125/ decays by a complicated scheme, the most important as far as ocular studies are concerned being soft photons of 27.3 and 35.4 kev energies. It has a half-value layer in tissue of 1.9 to 2.5 cm. Therefore, it is feasible to measure radiation of the posterior globe with only minimal interference from radiation arising in the brain sinuses. Its half-life of 60 days results in a greatly

  18. Circadian rhythm of intraocular pressure in cats.

    PubMed

    Del Sole, María J; Sande, Pablo H; Bernades, José M; Aba, Marcelo A; Rosenstein, Ruth E

    2007-01-01

    To evaluate the rhythm of intraocular pressure (IOP) in healthy domestic cats with no evidence of ocular disease and to analyze the influence of photoperiod, age, gender and ocular diseases on diurnal-nocturnal variations of cat IOP. All animals were Domestic Short-haired cats; 30 were without systemic or ocular diseases, classified as follows: 12 male intact adult cats, five intact adult female, five adult spayed female, and eight male cats; the latter were less than 1 year of age. In addition, five adult cats with uveitis and three adult cats with secondary glaucoma were included. IOP was assessed with a Tono-Pen XL at 3-h intervals over a 24-h period in 12 healthy adult male cats kept under a photoperiod of 12-h light/12-h darkness for 2 weeks. Eight animals from the same group were then kept under constant darkness for 48 h, and IOP was measured at 3-h intervals for the following 24 h. In addition, IOP was assessed at 3 p.m. and 9 p.m. in five intact females, five spayed females, and in eight young cats, as well as in five adult cats with uveitis and three glaucomatous cats. Consistent, daily variations in IOP were observed in animals exposed to a light-dark cycle, with maximal values during the night. In cats exposed to constant darkness, maximal values of IOP were observed at subjective night. Differences of IOP values between 3 p.m. and 9 p.m. (diurnal-nocturnal variations) persisted in intact females, spayed females, and young animals, as well as in uveitic and glaucomatous eyes. The present results indicate a daily rhythm of cat IOP, which appears to persist in constant darkness, suggesting some level of endogenous circadian control. In addition, daily variations of cat IOP seem to be independent of gender, age, or ocular diseases (particularly uveitis and glaucoma).

  19. Assessment of intraocular pressure sensing using an implanted reflective flexible membrane

    NASA Astrophysics Data System (ADS)

    Nazarov, Andrey; Knyazer, Boris; Lifshitz, Tova; Schvartzman, Mark; Abdulhalim, Ibrahim

    2017-04-01

    Glaucoma is a neurodegenerative condition that is the leading cause of irreversible blindness worldwide. Elevated intraocular pressure (IOP) is the main cause for the development of the disease. The symptoms of this form, such as deterioration of vision and scotomas (loss of visual fields), appear in the latter stages of the disease. Therefore, an IOP monitoring device is needed for better, simpler, and faster diagnosis, and to enable a fast treatment response. We present a theoretical assessment as well as preliminary experimental results of a simple approach for easy, optical, IOP self-monitoring. It is based on a polydimethylsiloxane membrane coated with a reflective layer and a Hartmann-Shack wavefront sensor. Nearly linear correlation is found between membrane deformation and Zernike coefficients representing defocus primary spherical aberration, with high sensitivity and negligible dependence on the measurement distance. The proposed device is expected to provide an accurate IOP measurement resolution of less than ±0.2 mm Hg with a pressure dependence on working distances <0.7 mm Hg/cm for a thick membrane; the corresponding values for a thin membrane are ±0.45 mm Hg and <0.6 mm Hg/cm, respectively, at typical IOP values-up to 40 mm Hg.

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

    PubMed Central

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

    2017-01-01

    AIM To evaluate the clinical utility of automated refraction (AR) and keratometry (KR) compared with subjective or manifest refraction (MR) after cataract or refractive lens exchange surgery with implantation of Lentis Mplus X (Oculentis GmbH) refractive multifocal intraocular lens (IOL). METHODS Eighty-six eyes implanted with the Lentis Mplus X multifocal IOL were included. MR was performed in all patients followed by three consecutive AR measurements using the Topcon KR-8000 autorefractor. Assessment of repeatability of consecutive AR before and after dilation with phenylephrine 10%, and comparison of the AR and KR with MR using vector analysis were performed at 3mo follow-up. RESULTS Analysis showed excellent repeatability of the AR measurements. Linear regression of AR versus MR showed good correlation for sphere and spherical equivalent, whereas the correlation for astigmatism was low. The mean difference AR-MR was -1.28±0.29 diopters (D) for sphere. Astigmatism showed better correlation between KR and MR. CONCLUSION We suggest AR sphere plus 1.25 D and the KR cylinder as the starting point for MR in eyes with a Lentis Mplus X multifocal IOL. If AR measurements are equal to MR, decentration of the IOL should be suspected. PMID:29181318