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Sample records for multifocal intraocular lens

  1. Clinical evaluation of two multifocal intraocular lens implantation patterns

    PubMed Central

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

    2012-01-01

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

  2. Retreatments after multifocal intraocular lens implantation: an analysis

    PubMed Central

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

    2016-01-01

    Purpose To determine the incidence and etiology of required retreatment after multifocal intraocular lens (IOL) implantation and to evaluate the methods and clinical outcomes of retreatment. Patients and methods A retrospective chart review of 416 eyes of 209 patients from one site that underwent uncomplicated cataract surgery with multifocal IOL implantation. Biometry, the IOL, and refractive data were recorded after the original implantation, with the same data recorded after retreatment. Comments related to vision were obtained both before and after retreatment for retreated patients. Results The multifocal retreatment rate was 10.8% (45/416 eyes). The eyes that required retreatment had significantly higher residual refractive astigmatism compared with those who did not require retreatment (1.21±0.51 D vs 0.51±0.39 D, P<0.01). The retreatment rate for the two most commonly implanted primary IOLs, blended bifocal (10.5%, 16/152) and bilateral trifocal (6.9%, 14/202) IOLs, was not statistically significantly different (P=0.12). In those requiring retreatment, refractive-related complaints were most common. Retreatment with refractive corneal surgery, in 11% of the eyes, and piggyback IOLs, in 89% of the eyes, was similarly successful, improving patient complaints 78% of the time. Conclusion Complaints related to ametropia were the main reasons for retreatment. Residual astigmatism appears to be an important determinant of retreatment rate after multifocal IOL implantation. Retreatment can improve symptoms for a high percentage of patients; a piggyback IOL is a viable retreatment option. PMID:27041983

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

    PubMed

    Melki, Samir A; Harissi-Dagher, Mona

    2011-08-01

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

  4. 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

  5. Evaluation of Optical Quality Parameters and Ocular Aberrations in Multifocal Intraocular Lens Implanted Eyes

    PubMed Central

    Lee, Hun; Lee, Kwanghyun; Ahn, Ji Min; Kim, Eung Kweon; Sgrignoli, Bradford

    2014-01-01

    Purpose We investigated the correlations between optical quality parameters obtained from the double-pass system and ocular aberrations obtained from the ray-tracing aberrometer in multifocal intraocular lens (IOL) implanted eyes. Materials and Methods Twenty eyes from 20 patients were enrolled in this study. Modulation transfer function cutoff frequency, The Strehl ratio, objective scatter index, and objective pseudo-accommodation obtained from the double-pass system were compared with root mean square (RMS) total aberration, RMS higher-order aberration, and spherical aberration obtained from the ray-tracing aberrometer. Additionally, parameters of the double-pass system and ray-tracing aberrometer were compared with manifested refraction values and subjective visual acuity, respectively. Results There was no statistically significant correlation between optical quality parameters obtained from the double-pass system and ocular aberrations, except between the Strehl ratio and RMS total aberration (r=-0.566, p=0.018). No significant correlations were found between the parameters of both devices, and manifested refraction values or subjective visual acuity. Conclusion Optical quality parameters, especially the Strehl ratio, in multifocal IOL implanted eyes were affected by RMS total aberration. Further studies based on accurate measurements of ocular aberrations and additional optical quality parameters are needed to delineate relationships between optical quality parameters and ocular aberrations in multifocal IOL implanted eyes. PMID:25048505

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

    PubMed Central

    Schallhorn, Steven C; Venter, Jan A; Teenan, David; Schallhorn, Julie M; Hettinger, Keith A; Hannan, Stephen J; Pelouskova, Martina

    2016-01-01

    Purpose The aim of this study was to assess visual and refractive outcomes of laser vision correction (LVC) to correct residual refraction after multifocal intraocular lens (IOL) implantation. Patients and methods In this retrospective study, 782 eyes that underwent LVC to correct unintended ametropia after multifocal IOL implantation were evaluated. Of all multifocal lenses implanted during primary procedure, 98.7% were refractive and 1.3% had a diffractive design. All eyes were treated with VISX STAR S4 IR excimer laser using a convectional ablation profile. Refractive outcomes, visual acuities, patient satisfaction, and quality of life were evaluated at the last available visit. Results The mean time between enhancement and last visit was 6.3±4.4 months. Manifest spherical equivalent changed from −0.02±0.83 D (−3.38 D to +2.25 D) pre-enhancement to 0.00±0.34 D (−1.38 D to +1.25 D) post-enhancement. At the last follow-up, the percentage of eyes within 0.50 D and 1.00 D of emmetropia was 90.4% and 99.5%, respectively. Of all eyes, 74.9% achieved monocular uncorrected distance visual acuity 20/20 or better. The mean corrected distance visual acuity remained the same before (−0.04±0.06 logMAR [logarithm of the minimum angle of resolution]) and after LVC procedure (−0.04±0.07 logMAR; P=0.70). There was a slight improvement in visual phenomena (starburst, halo, glare, ghosting/double vision) following the enhancement. No sight-threatening complications related to LVC occurred in this study. Conclusion LVC in pseudophakic patients with multifocal IOL was safe, effective, and predictable in a large cohort of patients. PMID:27175059

  7. Visual Outcomes and Patient Satisfaction after Refractive Lens Exchange with a Single-Piece Diffractive Multifocal Intraocular Lens

    PubMed Central

    2014-01-01

    Purpose. To report visual outcomes and patient satisfaction after unilateral or bilateral refractive lens exchange (RLE) with a single-piece bifocal diffractive multifocal intraocular lens (MIOL). Methods. All patients underwent RLE with the ZMB00 MIOL (Abbott Medical Optics). Patient charts were reviewed to evaluate the distance, intermediate, and near visual acuity (VA), contrast sensitivity, extent of visual symptoms (0–5), satisfaction (1–5), and rate of spectacle independence between unilateral and bilateral RLE group. Results. Forty-seven eyes of 28 patients were included. No intraoperative complications developed. Mean monocular uncorrected VA at distance, intermediate (67 cm), and near (30 cm) were 0.01 ± 0.12 (standard deviation), 0.27 ± 0.18, and 0.15 ± 0.11, respectively. No eyes lost >1 line of corrected distance VA. Monocular contrast sensitivity remained at normal level. Median scores of halos, night glare, and starbursts for 27 patients were 2.0, 3.0, and 0.0, respectively. Median score of satisfaction was 4.0. There were no differences in visual symptom scores or satisfaction between unilateral and bilateral group (P > 0.05). Eighty percent of 25 patients reported total spectacle freedom, with similar rate between bilateral (82%) and unilateral group (75%) (P = 1.000). Conclusions. RLE with the bifocal diffractive MIOL was safe in presbyopic patients and resulted in a high rate of spectacle independence. PMID:25505974

  8. Visual Performance after Bilateral Implantation of a Four-Haptic Diffractive Toric Multifocal Intraocular Lens in High Myopes

    PubMed Central

    Chan, Vincent K. C.

    2016-01-01

    Background. The vision with diffractive toric multifocal intraocular lenses after cataract surgery in long eyes has not been studied previously. Objectives. To report visual performance after bilateral implantation of a diffractive toric multifocal intraocular lens in high myopes. Methods. Prospective, observational case series to include patients with axial length of ≥26 mm and corneal astigmatism of >1 dioptre who underwent bilateral AT LISA 909M implantation. Postoperative examinations included photopic and mesopic distance, intermediate, and near visual acuity; photopic contrast sensitivity; visual symptoms (0–5); satisfaction (1–5); and spectacle independence rate. Results. Twenty-eight eyes (14 patients) were included. Postoperatively, mean photopic monocular uncorrected distance, intermediate, and near visual acuities (logMAR) were 0.12 ± 0.20 (standard deviation), 0.24 ± 0.16, and 0.29 ± 0.21, respectively. Corresponding binocular values were −0.01 ± 0.14, 0.13 ± 0.12, and 0.20 ± 0.19, respectively. One eye (4%) had one-line loss in vision. Under mesopic condition, intermediate vision and near vision decreased significantly (all P ≤ 0.001). Contrast sensitivity at all spatial frequencies did not improve significantly under binocular condition (all P > 0.05). Median scores for halos, night glare, starbursts, and satisfaction were 0.50, 0.00, 0.00, and 4.25, respectively. Ten patients (71%) reported complete spectacle independence. Conclusions. Bilateral implantation of the intraocular lens in high myopes appeared to be safe and achieved good visual performance and high satisfaction. PMID:27563460

  9. Visual Performance after Bilateral Implantation of a Four-Haptic Diffractive Toric Multifocal Intraocular Lens in High Myopes.

    PubMed

    Chang, John S M; Chan, Vincent K C; Ng, Jack C M; Law, Antony K P

    2016-01-01

    Background. The vision with diffractive toric multifocal intraocular lenses after cataract surgery in long eyes has not been studied previously. Objectives. To report visual performance after bilateral implantation of a diffractive toric multifocal intraocular lens in high myopes. Methods. Prospective, observational case series to include patients with axial length of ≥26 mm and corneal astigmatism of >1 dioptre who underwent bilateral AT LISA 909M implantation. Postoperative examinations included photopic and mesopic distance, intermediate, and near visual acuity; photopic contrast sensitivity; visual symptoms (0-5); satisfaction (1-5); and spectacle independence rate. Results. Twenty-eight eyes (14 patients) were included. Postoperatively, mean photopic monocular uncorrected distance, intermediate, and near visual acuities (logMAR) were 0.12 ± 0.20 (standard deviation), 0.24 ± 0.16, and 0.29 ± 0.21, respectively. Corresponding binocular values were -0.01 ± 0.14, 0.13 ± 0.12, and 0.20 ± 0.19, respectively. One eye (4%) had one-line loss in vision. Under mesopic condition, intermediate vision and near vision decreased significantly (all P ≤ 0.001). Contrast sensitivity at all spatial frequencies did not improve significantly under binocular condition (all P > 0.05). Median scores for halos, night glare, starbursts, and satisfaction were 0.50, 0.00, 0.00, and 4.25, respectively. Ten patients (71%) reported complete spectacle independence. Conclusions. Bilateral implantation of the intraocular lens in high myopes appeared to be safe and achieved good visual performance and high satisfaction. PMID:27563460

  10. Visual outcomes and optical quality after implantation of a diffractive multifocal toric intraocular lens

    PubMed Central

    Chen, Xiangfei; Zhao, Ming; Shi, Yuhua; Yang, Liping; Lu, Yan; Huang, Zhenping

    2016-01-01

    Background: This study evaluated the visual function after implantation of a multifocal toric intraocular lenses (IOLs). Materials and Methods: This study involved 10 eyes from eight cataract patients with corneal astigmatism of 1.0 diopter (D) or higher who had received phacoemulsification with implantation of an AcrySof IQ ReSTOR Toric IOL. Six-month evaluations included visual acuity, spherical equivalent (SE), defocus curve, residual astigmatism, IOL rotation, contrast sensitivity (CS), wavefront aberrations, modulation transfer function (MTF), and patient satisfaction assessments. Results: At 6 months postoperatively, uncorrected distance visual acuity (logarithm of the minimum angle of resolution) was 0.09 ± 0.04, corrected distance visual acuity was 0.02 ± 0.11, and uncorrected near visual acuity was 0.12 ± 0.07. The mean SE was −0.095 ± 0.394 D (±0.50 D in 90%). Refractive astigmatism at the 6-month follow-up visit was significantly reduced to 0.35 ± 0.32 D from 1.50 ± 0.41 D presurgery (P < 0.05). The mean IOL axis rotation was 3.20 ± 1.55°. Postoperative CS levels were high. Postoperative total order aberrations (TOAs), lower-order aberrations (LOAs), higher-order aberrations (HOAs), and spherical aberrations were decreased compared with preoperative values (P < 0.05). At 3 months postoperatively, TOAs, LOAs, and HOAs with a 3 mm pupil diameter as well as TOAs, LOAs, and astigmatism aberrations with a 5 mm pupil diameter were statistically lower than those at 1-month post surgery, but without subsequent significant changes (P > 0.05). There was an increase in MTF results between preoperative and postoperative evaluations at all spatial frequencies. Conclusions: The diffractive multifocal toric IOL is able to provide a predictable astigmatic correction with apparently outstanding levels of optical quality after implantation. PMID:27221680

  11. The impact of multifocal intraocular lens in retinal imaging with optical coherence tomography.

    PubMed

    Dias-Santos, Arnaldo; Costa, Lívio; Lemos, Vanessa; Anjos, Rita; Vicente, André; Ferreira, Joana; Cunha, João Paulo

    2015-02-01

    Multifocal intraocular lenses (MF IOLs) have concentric optical zones with different dioptric power, enabling patients to have good visual acuity at multiple focal points. However, several optical limitations have been attributed to this particular design. The purpose of this study is to access the effect of MF IOLs design on the accuracy of retinal optical coherence tomography (OCT). Cross-sectional study conducted at the Refractive Surgery Department of Central Lisbon Hospital Center. Twenty-three eyes of 15 patients with a diffractive MF IOL and 27 eyes of 15 patients with an aspheric monofocal IOL were included in this study. All patients underwent OCT macular scans using Heidelberg Spectralis(®). Macular thickness and volume values and image quality (Q factor) were compared between the two groups. There were no statistically significant differences between both groups regarding macular thickness or volume measurements. Retinal OCT image quality was significantly lower in the MF IOL group (p < 0.01). MF IOLs are associated with a significant decrease in OCT image quality. However, this fact does not seem to compromise the accuracy of spectral domain OCT retinal measurements. PMID:25381578

  12. Multifocal intraocular lenses and glare.

    PubMed

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

    1993-06-01

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

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

    PubMed Central

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

    2015-01-01

    AIM To evaluate the prediction error in intraocular lens (IOL) power calculation for a rotationally asymmetric refractive multifocal IOL and the impact on this error of the optimization of the keratometric estimation of the corneal power and the prediction of the effective lens position (ELP). METHODS Retrospective study including a total of 25 eyes of 13 patients (age, 50 to 83y) with previous cataract surgery with implantation of the Lentis Mplus LS-312 IOL (Oculentis GmbH, Germany). In all cases, an adjusted IOL power (PIOLadj) was calculated based on Gaussian optics using a variable keratometric index value (nkadj) for the estimation of the corneal power (Pkadj) and on a new value for ELP (ELPadj) obtained by multiple regression analysis. This PIOLadj was compared with the IOL power implanted (PIOLReal) and the value proposed by three conventional formulas (Haigis, Hoffer Q and Holladay I). RESULTS PIOLReal was not significantly different than PIOLadj and Holladay IOL power (P>0.05). In the Bland and Altman analysis, PIOLadj showed lower mean difference (-0.07 D) and limits of agreement (of 1.47 and -1.61 D) when compared to PIOLReal than the IOL power value obtained with the Holladay formula. Furthermore, ELPadj was significantly lower than ELP calculated with other conventional formulas (P<0.01) and was found to be dependent on axial length, anterior chamber depth and Pkadj. CONCLUSION Refractive outcomes after cataract surgery with implantation of the multifocal IOL Lentis Mplus LS-312 can be optimized by minimizing the keratometric error and by estimating ELP using a mathematical expression dependent on anatomical factors. PMID:26085998

  14. Visual acuity and patient satisfaction at varied distances and lighting conditions after implantation of an aspheric diffractive multifocal one-piece intraocular lens

    PubMed Central

    Chang, Daniel H

    2016-01-01

    Purpose The aim of the study is to evaluate the visual acuity and patient satisfaction at varied distances under photopic and mesopic lighting conditions in patients bilaterally implanted with aspheric diffractive multifocal one-piece intraocular lenses. Methods In this retrospective–prospective study, 16 patients with a mean age of 66.2±9.2 years (range: 50–81 years) who had undergone bilateral phacoemulsification surgery with implantation of a Tecnis multifocal one-piece intraocular lens (ZMB00) were evaluated. Monocular and binocular uncorrected and distance-corrected visual acuities were measured at distance (20 ft), intermediate (70–80 cm), and near (35–40 cm) under photopic (85 cd/m2) and mesopic (3 cd/m2) lighting conditions and were compared using the paired t-test. All patients also completed a subjective questionnaire. Results At a mean follow-up of 9.5±3.9 months, distance, near, and intermediate visual acuity improved significantly from preoperative acuity. Under photopic and mesopic conditions, 93.8% and 62.5% of patients, respectively, had binocular uncorrected intermediate visual acuity of 20/40 or better, and 62.5% and 31.3% of patients had binocular uncorrected near visual acuity of 20/20 or better. All patients were satisfied with their overall vision without using glasses and/or contact lenses when compared with before surgery. A total of 87.5% of patients reported no glare and 68.8% of patients reported no halos around lights at night. Conclusion Tecnis multifocal one-piece intraocular lenses provide good distance, intermediate, and near visual acuity under photopic as well as mesopic lighting conditions. High levels of spectacle independence with low levels of photic phenomenon were achieved, resulting in excellent patient satisfaction. PMID:27536061

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

    PubMed Central

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

    2001-01-01

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

 PMID:11423455

  16. 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.

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

    PubMed Central

    Ouchi, M; Kinoshita, S

    2015-01-01

    Purpose To evaluate the postoperative outcomes of cataract eyes complicated with coexisting ocular pathologies that underwent implantation of a refractive multifocal intraocular lens (MIOL) with a surface-embedded near section. Methods LENTIS MPlus (Oculentis GmbH) refractive MIOLs were implanted in 15 eyes with ocular pathologies other than cataract (ie, six high-myopia eyes with an axial length longer than 28 mm, two fundus albipunctatus eyes, two branch retinal-vein occlusion eyes, four glaucoma eyes (one with high myopia), and two keratoconus eyes). Uncorrected or corrected distance and near visual acuity (VA) (UDVA, UNVA, CDVA, and CNVA), contrast sensitivity, and defocus curve were measured at 1 day and 6 months postoperatively, and each patient completed a 6-month postoperative questionnaire regarding vision quality and eyeglass use. Results Thirteen eyes (87%) registered 0 or better in CDVA and 12 eyes (73%) registered better than 0 in CNVA. Contrast sensitivity in the eyes of all patients was comparable to that of normal healthy subjects. No patient required eyeglasses for distance vision, but three patients (20%) required them for near vision. No patient reported poor or very poor vision quality. Conclusion With careful case selection, sectorial refractive MIOL implantation is effective for treating cataract eyes complicated with ocular pathologies. PMID:25744442

  19. Patients' satisfaction and spectacle independence after cataract surgery with multifocal intraocular lens implantation in a tertiary care hospital.

    PubMed

    Baig, Rashid; A Chaudhry, Tanveer; Kukreja, Saajan; Shakil, Sidra; Ahmad, Khabir

    2016-06-01

    This single group cohort study, undertaken at Aga Khan University Hospital, Karachi, from Jan 2012 to September 2013, assessed patients' satisfaction, spectacle independence and visual disturbance after implantation of multifocal IOLs. A total of 39 patients who underwent bilateral cataract surgery with multifocal IOL implantation were included for telephonic interviews. The mean age of participants was 55.5 ± 8.1 years. The mean follow up time was 9.60 ± 3.19 months. The overall satisfaction rate after surgery was found to be 84.6% and there was no statistically significant association of satisfaction with gender, age or education. In all 84.6%, 94.9% and 84.6% people had spectacle independence for far, intermediate and near, respectively. More than half of participants (59%) had some degree of visual disturbance. In this study, multifocal IOL implantation provided high levels of satisfaction and spectacle independence despite notable risk of halo or glare symptoms at night. Therefore, careful patient selection and preoperative counselling regarding possible risks and benefits is recommended. PMID:27339580

  20. 21 CFR 886.3600 - Intraocular lens.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Intraocular lens. 886.3600 Section 886.3600 Food... DEVICES OPHTHALMIC DEVICES Prosthetic Devices § 886.3600 Intraocular lens. (a) Identification. An intraocular lens is a device made of materials such as glass or plastic intended to be implanted to...

  1. 21 CFR 886.3600 - Intraocular lens.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Intraocular lens. 886.3600 Section 886.3600 Food... DEVICES OPHTHALMIC DEVICES Prosthetic Devices § 886.3600 Intraocular lens. (a) Identification. An intraocular lens is a device made of materials such as glass or plastic intended to be implanted to...

  2. 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...

  3. 21 CFR 886.3600 - Intraocular lens.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Intraocular lens. 886.3600 Section 886.3600 Food... DEVICES OPHTHALMIC DEVICES Prosthetic Devices § 886.3600 Intraocular lens. (a) Identification. An intraocular lens is a device made of materials such as glass or plastic intended to be implanted to...

  4. 21 CFR 886.3600 - Intraocular lens.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Intraocular lens. 886.3600 Section 886.3600 Food... DEVICES OPHTHALMIC DEVICES Prosthetic Devices § 886.3600 Intraocular lens. (a) Identification. An intraocular lens is a device made of materials such as glass or plastic intended to be implanted to...

  5. The Fyodorov Sputnik intraocular lens.

    PubMed

    Kwitko, M L

    1979-04-01

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

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

    PubMed

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

    2015-08-01

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

  7. 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

  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. Periocular migration of an intraocular lens.

    PubMed

    Jenkins, C

    1992-11-01

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

  10. Pupillary block glaucoma following intraocular lens implantation.

    PubMed

    Kielar, R A; Stambaugh, J L

    1982-08-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  13. Design and fabrication of a microstructured bifocal intraocular lens

    NASA Astrophysics Data System (ADS)

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

    1999-06-01

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

  14. Pupillary block after intraocular lens implantation.

    PubMed

    Van Buskirk, E M

    1983-01-01

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

  15. 21 CFR 886.4300 - Intraocular lens guide.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Intraocular lens guide. 886.4300 Section 886.4300...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4300 Intraocular lens guide. (a) Identification. An intraocular lens guide is a device intended to be inserted into the eye during surgery to...

  16. 21 CFR 886.4300 - Intraocular lens guide.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Intraocular lens guide. 886.4300 Section 886.4300...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4300 Intraocular lens guide. (a) Identification. An intraocular lens guide is a device intended to be inserted into the eye during surgery to...

  17. 21 CFR 886.4300 - Intraocular lens guide.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Intraocular lens guide. 886.4300 Section 886.4300...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4300 Intraocular lens guide. (a) Identification. An intraocular lens guide is a device intended to be inserted into the eye during surgery to...

  18. 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...

  19. 21 CFR 886.4300 - Intraocular lens guide.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Intraocular lens guide. 886.4300 Section 886.4300...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4300 Intraocular lens guide. (a) Identification. An intraocular lens guide is a device intended to be inserted into the eye during surgery to...

  20. 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.

  1. 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

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

    PubMed

    Bhattacharjee, Harsha; Bhattacharjee, Kasturi; Bhattacharjee, Pankaj

    2007-01-01

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

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

    PubMed Central

    Bhattacharjee, Kasturi; Bhattacharjee, Pankaj

    2007-01-01

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

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

    PubMed Central

    Espandar, Ladan; Sikder, Shameema; Moshirfar, Majid

    2011-01-01

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

  5. 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.

  6. Calcification of intraocular implant lens surfaces.

    PubMed

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

    2004-02-17

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

  7. Comparison of the efficiency, MTF and chromatic properties of four diffractive bifocal intraocular lens designs.

    PubMed

    Castignoles, Fannie; Flury, Manuel; Lepine, Thierry

    2010-03-01

    The aim of this paper is to compare the properties of four different profiles which can be used as multifocal intraocular lens. The Hankel transform based on the theory of scalar diffraction is applied to a binary profile, a parabolic one, a parabolic profile with holes, and finally a sinusoidal one. This enables to study the various distributions of the diffractive efficiencies and the axial chromatism. The image quality is evaluated by means of simulations of the MTFs with Zemax. Finally we propose a new way to graphically synthesize all the properties of these lenses, using a radar graph. PMID:20389537

  8. Update of intraocular lens implantation in children

    PubMed Central

    Al Shamrani, Mohammed; Al Turkmani, Shahira

    2012-01-01

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

  9. Bionic intraocular lens with variable focus and integrated structure

    NASA Astrophysics Data System (ADS)

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

    2015-10-01

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

  10. Varifocal optics for a novel accommodative intraocular lens

    NASA Astrophysics Data System (ADS)

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

    2006-01-01

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

  11. Visual and optical performance of diffractive multifocal intraocular lenses with different haptic designs: 6 month follow-up

    PubMed Central

    Wang, Mengmeng; Corpuz, Christine Carole C; Fujiwara, Megumi; Tomita, Minoru

    2014-01-01

    Purpose To evaluate and compare the visual acuity outcomes and optical performances of eyes implanted with two diffractive multifocal intraocular lens (IOL) models with either a plate haptic design or a modified-C design. Methods This retrospective study comprised cataract patients who were implanted with either a plate haptic multifocal IOL model (AcrivaUD Reviol BB MFM 611 [VSY Biotechnology, Amsterdam, the Netherlands], group 1) or a modified-C haptic multifocal IOL model (AcrivaUD Reviol BB MF 613 [VSY Biotechnology, Amsterdam, the Netherlands], group 2) between June 2012 and May 2013. The 6 month postoperative visual acuity, refraction, defocus curve, contrast sensitivity, and wave-front aberration were evaluated and compared between these eyes, using different IOL models. Results One hundred fifty-eight eyes of 107 patients were included in this study. Significant improvement in visual acuities and refraction was found in both groups after cataract surgery (P<0.01). The visual acuity and contrast sensitivity were statistically better in group 1 than in group 2 (P<0.01). No statistically significant difference in the corneal higher-order aberrations was found between the two groups (P>0.05). However, the ocular higher-order aberrations in group 2 were significantly greater than in group 1 (P<0.05). Conclusion At 6 months postoperatively, both AcrivaUD Reviol BB MFM 611 IOL and AcrivaUD Reviol BB MF 613 IOL achieved excellent visual and refractive outcomes. The multifocal IOL model with plate haptic design resulted in better optical performances than that with the modified-C haptic design. PMID:24868143

  12. Wavefront analysis and modulation transfer function of three multifocal intraocular lenses

    PubMed Central

    Santhiago, Marcony R; Netto, Marcelo V; Barreto, Jackson; Gomes, Beatriz AF; Schaefer, Arthur; Kara-Junior, Newton

    2010-01-01

    Purpose: To evaluate wavefront performance and modulation transfer function (MTF) in the human eye after the implantation of diffractive or refractive multifocal intraocular lenses (IOLs). Materials and Methods: This was a prospective, interventional, comparative, nonrandomized clinical study. Uncorrected distance and near visual acuity, and wavefront analysis including MTF curves (iTrace aberrometer, Tracey Technologies, Houston, TX, USA) were measured in 60 patients after bilateral IOL implantation with 6 months of follow-up. Forty eyes received the diffractive ReSTOR (Alcon), 40 eyes received the refractive ReZoom (Advanced Medical Optics) and 40 eyes, the Tecnis ZM900 (Advanced Medical Optics). The comparison of MTF and aberration between the intraocular lenses was performed using analysis of variance (ANOVA), followed by the Dunn test when necessary. Results: The mean uncorrected distance visual acuity was similar in all three groups of multifocal IOLs. The ReSTOR group provided better uncorrected near visual acuity than the ReZoom group (P < 0.001), but similar to the Tecnis group. Spherical aberration was significantly higher in the ReZoom group (P = 0.007). Similar MTF curves were found for the aspheric multifocal IOL Tecnis and the spheric multifocal IOL ReSTOR, and both performed better than the multifocal IOL ReZoom in a 5 mm pupil (P < 0.001 at all spatial frequencies). Conclusions: Diffractive IOLs studied presented similar MTF curves for a 5 mm pupil diameter. Both diffractive IOLs showed similar spherical aberration, which was significantly better with the full-diffractive IOL Tecnis than with the refractive IOL ReZoom. PMID:20195032

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

    PubMed

    Siepser, S B; Wieland, M

    1991-07-01

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

  14. 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

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

    PubMed

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

    2016-02-01

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

  16. Combined aniridic intraocular lens implantation and vitreoretinal surgery

    PubMed Central

    Mehta, Hijab; Jayadev, Chaitra; Natarajan, S

    2007-01-01

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

  17. Controversies in intraocular lens implantation in pediatric uveitis.

    PubMed

    Phatak, Sumita; Lowder, Careen; Pavesio, Carlos

    2016-12-01

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

  18. Intraocular lens exchange-removing the optic intact.

    PubMed

    Lee, Matthew Hao; Webster, Diane Lesley

    2016-01-01

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

  19. Intraocular lens exchange-removing the optic intact

    PubMed Central

    Lee, Matthew Hao; Webster, Diane Lesley

    2016-01-01

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

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

    PubMed

    Ander, B; Karlsson, A; Ohrlund, A

    2001-05-11

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

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

    PubMed

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

    2013-01-01

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

  2. Posterior Iris Fixated Intraocular Lens for Pediatric Traumatic Cataract

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

    Teng, He; Zhang, Hong

    2014-01-01

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

  4. 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

  5. In situ tumbling of the AcrySof intraocular lens.

    PubMed

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

    2000-02-01

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

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

    PubMed

    Bozorg, Sara; Pineda, Roberto

    2014-01-01

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

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

    PubMed Central

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

    2015-01-01

    Sutureless, glueless, scleral fixation of an intraocular lens is a known technique of fixing a lens in the scleral pockets. However, this technique is applied to single-piece and toric lenses instead of 3-piece lenses, allowing the advantage of the use of premium lenses in patients with poor capsular support. Favourable results without complications of pigment dispersion, iris transillumination defects, dysphotopsia, elevated intraocular pressure, intraocular hemorrhage and cystoid macular edema with a well-centered, stable intraocular lens have been observed in the 3-month postoperative period in both cases. PMID:26327909

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

    PubMed

    Lam, Hee Hong; Visvaraja, Subrayan

    2012-01-01

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

  9. Visual performance of Acrysof ReSTOR compared with a monofocal intraocular lens following implantation in cataract surgery

    PubMed Central

    JI, JING; HUANG, XIAOLIN; FAN, XIANQUN; LUO, MIN

    2013-01-01

    The aim of this study was to compare the visual performance of Acrysof ReSTOR and Acrysof Natural intraocular lenses (IOLs) following cataract surgery. A randomized prospective study was performed in which 64 eyes (51 patients) were divided randomly into two groups. Monofocal IOLs (Acrysof Natural) were implanted into 34 eyes (27 patients) and multifocal IOLs (Acrysof ReSTOR) were implanted into 30 eyes (24 patients) using phacoemulsification surgery. The corrected distance visual acuity, near visual acuity, pseudoaccommodation, contrast sensitivity (CS) and wavefront analysis were measured at 1 week, 1 month and 3 months after surgery. The distance vision of the monofocal and ReSTOR patients improved equally with glasses (P<0.05). A greater improvement in near vision without glasses was observed in the ReSTOR-implanted patients (P<0.01). The CS values of the multifocal IOL group were significantly lower than those of the monofocal IOL group for all spatial frequencies tested (P<0.05). The spherical aberration was significantly higher in the multifocal IOL group compared with the monofocal IOL group (P<0.05). We observed no differences in coma between the two groups. The difference in the amplitude of pseudoaccommodation between the two groups was statistically significant (−3.14±0.91 D in the ReSTOR group vs. −1.03±0.33 D in the Natural group, P<0.01). The improvement in near vision was significantly more evident in the ReSTOR patients. Compared with the monofocal IOL lens, the multifocal lens is able to increase the amplitude of pseudoaccommodation. However, increased spherical aberration may contribute to lower CS values in the multifocal IOL group. PMID:23251283

  10. Shape optimization of an accommodative intra-ocular lens

    NASA Astrophysics Data System (ADS)

    Jouve, François; Hanna, Khalil

    2005-03-01

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

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

    PubMed

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

    2014-06-01

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

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

    PubMed

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

    1995-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Hauer, Michelle Christine

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

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

    PubMed Central

    Gundersen, Kjell Gunnar; Potvin, Rick

    2016-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  17. Use of the Toric Intraocular Lens for Keratoconus Treatment

    PubMed Central

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

    2014-01-01

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

  18. Effect of hemodialysis on intraocular lens power calculation.

    PubMed

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

    2016-03-01

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

  19. Treatment of ophidism-induced bilateral canine cataract by extracapsular lens extraction and intraocular lens implantation.

    PubMed

    Kibar, M; Evereklioğlu, C; Doğan, Z

    2014-01-01

    The aim of this study was to report a new cause of cataract, namely snake bite induced cataract in a dog. A 3-year-old male mongrel dog was referred to our clinic for the assessment of cataract in both eyes. The dog was bitten by a snake nearly 4 months ago. A 40 dioptre acrylic lens with 13 mm haptics was implanted into the lens capsule. In the left eye, posterior synechia was detected in the temporal part of the iris, but decentration of the intraocular lens was not observed. To the best of our knowledge, this is the first report of bilateral cataract caused by ophidism and treated by surgical intervention in a dog. PMID:27175143

  20. 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.

  1. 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.

  2. 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

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

    PubMed Central

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

    2006-01-01

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

  4. Spontaneous Scleral Perforation of an Anterior Chamber Intraocular Lens

    PubMed Central

    Spierer, Oriel; O'Brien, Terrence P.

    2016-01-01

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

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

    PubMed

    Spierer, Oriel; O'Brien, Terrence P

    2016-01-01

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

  6. Extended depth of focus intra-ocular lens: a solution for presbyopia and astigmatism

    NASA Astrophysics Data System (ADS)

    Zlotnik, Alex; Raveh, Ido; Ben Yaish, Shai; Yehezkel, Oren; Belkin, Michael; Zalevsky, Zeev

    2010-02-01

    Purpose: Subjects after cataract removal and intra-ocular lens (IOL) implantation lose their accommodation capability and are left with a monofocal visual system. The IOL refraction and the precision of the surgery determine the focal distance and amount of astigmatic aberrations. We present a design, simulations and experimental bench testing of a novel, non-diffractive, non-multifocal, extended depth of focus (EDOF) technology incorporated into an IOL that allows the subject to have astigmatic and chromatic aberrations-free continuous focusing ability from 35cm to infinity as well as increased tolerance to IOL decentration. Methods: The EDOF element was engraved on a surface of a monofocal rigid IOL as a series of shallow (less than one micron deep) concentric grooves around the optical axis. These grooves create an interference pattern extending the focus from a point to a length of about one mm providing a depth of focus of 3.00D (D stands for Diopters) with negligible loss of energy at any point of the focus while significantly reducing the astigmatic aberration of the eye and that generated during the IOL implantation. The EDOF IOL was tested on an optical bench simulating the eye model. In the experimental testing we have explored the characteristics of the obtained EDOF capability, the tolerance to astigmatic aberrations and decentration. Results: The performance of the proposed IOL was tested for pupil diameters of 2 to 5mm and for various spectral illuminations. The MTF charts demonstrate uniform performance of the lens for up to 3.00D at various illumination wavelengths and pupil diameters while preserving a continuous contrast of above 25% for spatial frequencies of up to 25 cycles/mm. Capability of correcting astigmatism of up to 1.00D was measured. Conclusions: The proposed EDOF IOL technology was tested by numerical simulations as well as experimentally characterized on an optical bench. The new lens is capable of solving presbyopia and astigmatism

  7. A fibrous membrane suspends the multifocal lens in the eyes of lampreys and African lungfishes.

    PubMed

    Gustafsson, Ola S E; Ekström, Peter; Kröger, Ronald H H

    2010-08-01

    The sharpness and thus information content of the retinal image in the eye depends on the optical quality of the lens and its accurate positioning in the eye. Multifocal lenses create well-focused color images and are present in the eyes of all vertebrate groups studied to date (mammals, reptiles including birds, amphibians, and ray-finned fishes) and occur even in lampreys, i.e., the most basal vertebrates with well-developed eyes. Results from photoretinoscopy obtained in this study indicate that the Dipnoi (lungfishes), i.e., the closest piscine relatives to tetrapods, also possess multifocal lenses. Suspension of the lens is complex and sophisticated in teleosts (bony fishes) and tetrapods. We studied lens suspension using light and electron microscopy in one species of lamprey (Lampetra fluviatilis) and two species of African lungfish (Protopterus aethiopicus aethiopicus and Protopterus annectens annectens). A fibrous and highly transparent membrane suspends the lens in both of these phylogenetically widely separated vertebrate groups. The membrane attaches to the lens approximately along the lens equator, from where it extends to the ora retinalis. The material forming the membrane is similar in ultrastructure to microfibrils in the zonule fibers of tetrapods. The membrane, possibly in conjunction with the cornea, iris, and vitreous body, seems suitable for keeping the lens in the correct position for well-focused imaging. Suspension of the lens by a multitude of zonule fibers in tetrapods may have evolved from a suspensory membrane similar to that in extant African lungfishes, a structure that seems to have appeared first in the lamprey-like ancestors of allextant vertebrates. PMID:20623650

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

    PubMed Central

    Mansour, Ahmad M.; Awwad, Shady T.

    2013-01-01

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

  9. Automatic intraocular lens segmentation and detection in optical coherence tomography images.

    PubMed

    Gillner, Melanie; Eppig, Timo; Langenbucher, Achim

    2014-05-01

    We present a new algorithm for automatic segmentation and detection of an accommodative intraocular lens implanted in a biomechanical eye model. We extracted lens curvature and position. The algorithm contains denoising and fan correction by a multi-level calibration routine. The segmentation is realized by an adapted canny edge detection algorithm followed by a detection of lens surface with an automatic region of interest search to suppress non-optical surfaces like the lens haptic. The optical distortion of lens back surface is corrected by inverse raytracing. Lens geometry was extracted by a spherical fit. We implemented and demonstrated a powerful algorithm for automatic segmentation, detection and surface analysis of intraocular lenses in vitro. The achieved accuracy is within the expected range determined by previous studies. Future improvements will include the transfer to clinical anterior segment OCT devices. PMID:23928353

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

    PubMed

    Liu, Xue; Wan, Xiuhua

    2015-07-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    MedlinePlus

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

  13. 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.

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

    PubMed Central

    McCafferty, Sean J.; Schwiegerling, Jim T.

    2015-01-01

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

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

    PubMed

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

    2016-09-01

    Light rays of different wavelengths are focused at different distances when they pass through a lens (longitudinal chromatic aberration [LCA]). For animals with color vision this can pose a serious problem, because in order to perceive a sharp image the rays must be focused at the shallow plane of the photoreceptor's outer segments in the retina. A variety of fish and tetrapods have been found to possess multifocal lenses, which correct for LCA by assigning concentric zones to correctly focus specific wavelengths. Each zone receives light from a specific beam entrance position (BEP) (the lateral distance between incoming light and the center of the lens). Any occlusion of incoming light at specific BEPs changes the composition of the wavelengths that are correctly focused on the retina. Here, we calculated the effect of lens position relative to the plane of the iris and light entering the eye at oblique angles on how much of the lens was involved in focusing the image on the retina (measured as the availability of BEPs). We used rotational photography of fish eyes and mathematical modeling to quantify the degree of lens occlusion. We found that, at most lens positions and viewing angles, there was a decrease of BEP availability and in some cases complete absence of some BEPs. Given the implications of these effects on image quality, we postulate that three morphological features (aphakic spaces, curvature of the iris, and intraretinal variability in spectral sensitivity) may, in part, be adaptations to mitigate the loss of spectral image quality in the periphery of the eyes of fishes. PMID:27607515

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

    PubMed

    Jacobi, K W; Reiner, J

    1993-12-01

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

  17. Development of a universal toric intraocular lens calculator

    NASA Astrophysics Data System (ADS)

    Hjelmstad, David; Sayegh, Samir I.

    2014-02-01

    We present a method for calculating the ideal toric lens to implant in astigmatic patients following cataract surgery. We show that the online calculators provided by major toric IOL manufacturers are insufficient for both theoretical and practical reasons. We reveal important theoretical shortcomings in their approach, illustrated by a number of cases which demonstrate how the approach can lead to errors in lens selection. Our approach combines the spherical and cylindrical power calculations into one, and allows for lens data from any manufacturer to be used, eliminating the reliance on multiple programs.

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

    PubMed Central

    Anbari, Anas A.

    2015-01-01

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

  19. Visual and Optical Performances of Multifocal Intraocular Lenses with Three Different Near Additions: 6-Month Follow-Up

    PubMed Central

    Wang, Mengmeng; Corpuz, Christine Carole C; Fujiwara, Megumi; Tomita, Minoru

    2015-01-01

    Purpose : To compare the visual and optical outcomes of four multifocal intraocular lenses (IOLs) with three different near additions of +3.00 diopters (D), +3.75 D and +4.00 D. Methods : In this prospective study, 133 eyes of 88 patients were implanted with one of the following IOLs: AcrySof® ReSTOR® SN6AD1 (+3.00 D) for Group A, AcrivaUD Reviol BB MF 613 or BB MFM 611 (+3.75 D) for Group B, and AcrySof® ReSTOR® SN6AD3 (+4.00 D) for Group C. The visual acuity, refraction, intraocular pressure, tomography and corneal endothelial cell density (ECD) were compared between the three groups preoperatively and at 6 month postoperatively. Defocus curve, contrast sensitivity and higher order aberrations (HOAs) at 6 month postoperative visit were measured and compared. Results : There were no statistically significant differences in distance visual acuity, refraction, intraocular pressure or ECD among the three groups after 6 months (P > 0.05). The photopic contrast sensitivity in Group C was statistically better than in Group A (P < 0.05). The scotopic ocular aberration in Group B was statistically greater compared to that in Group A (P < 0.05). The highest near-visual peaks were -0.06 logMAR at a -2.50 D (40 cm) in Group A, -0.07 logMAR at -3.00D (33 cm) in Group B, and -0.06 logMAR at -3.50 D (29 cm) in Group C. Statistically significant differences in near and intermediate visual acuities were observed among the three groups at -2.00 D (50 cm), -2.50 D (40 cm), -3.50 D (29 cm) and -4.00 D (25 cm) (P < 0.01). Conclusion : AcrySof® ReSTOR® SN6AD1 IOLs (+3.00 D) and SN6AD3 (+4.00 D) IOLs provided the best intermediate and near vision, respectively. Both intermediate and near vision were comparatively better in the eyes with AcrivaUD Reviol BB MFM 611 IOLs or BB MF 613 IOLs (+3.75 D). PMID:25674189

  20. [Results of intraocular lens implantation in cataract complicated by medium and high myopia].

    PubMed

    Plotnikova, Iu A; Chuprov, A D; Volkov, D V

    2001-01-01

    Results of surgical treatment of cataract complicated by medium and high myopia are analyzed. The main group consisted of 90 patients (96 eyes) subjected to extracapsular cataract extraction with implantation of posterior-chamber intraocular lenses and the reference group of 128 patients in whom cataract was extracted without implantation of artificial lens. The study included creation of a mathematical model of myopic eye with estimation of pressure fluctuations in various zones of the eye, developing during transposition of the vitreous during patient's movements (head movements, jumps, falling) and the damping effect of the lens in the ocular system. It was proven by mathematical calculations that transpositions of jelly fractions of the vitreous decreased by 70% in an eye with the lens in comparison with their transposition in aphakia. Clinical studies demonstrated the efficiency of intraocular correction of aphakia in high myopia: implantation of an intraocular lens decreases the risk of detachment of the retina during the postoperative period and helps attain the desired refraction. PMID:11765458

  1. 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.

  2. Evaluation of intraocular lens implant location in the eyeball basing on the Purkinje images

    NASA Astrophysics Data System (ADS)

    Jóźwik, A.; Siedlecki, D.; Zajac, M.

    2012-01-01

    Intraocular lens (IOL) is an artificial implant substituting natural crystalline lens which is non-transparent due to cataract. Incorrect location of the IOL in the eyeball (e.g. its shift or tilt) causes significant deterioration of patient's vision. The analysis of Purkinje images (i.e. reflections from successive refracting surfaces in the eye) enables to determine the real IOL location and thus helps in evaluating the retinal image quality. The experimental setup for Purkinje images recording consists of illuminator, composed of a number of infrared LEDs, telecentric lens and detector (CCD camera). Analysis of mutual position of particular reflections enables to evaluate the lens location in respect to the corneal axis. The actual measurements are realized on artificial eye model, what allows to estimate the precision of the algorithm applied in the calculations. In the future the experimental set-up will be adapted to measure the eyes of real patients.

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

    PubMed

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

    1991-03-01

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

  4. A theoretical design of gradient index multifocal contact lens for correcting presbyopia and an attempt to elicit its performance using ray tracing

    NASA Astrophysics Data System (ADS)

    Bakaraju, Ravi C.; Ehrmann, Klaus; Papas, Eric B.; Ho, Arthur

    2009-02-01

    We propose a novel theoretical design of gradient index (GRIN) multifocal contact lens (MFCL) to compensate presbyopia and make predictions regarding its performance on a schematic model eye and to compare its performance with conventional aspheric progressive MFCL.

  5. Serial Multifocal Electroretinograms during Long-term Elevation and Reduction of Intraocular Pressure in Non-human Primates

    PubMed Central

    Nork, T. Michael; Kim, Charlene B. Y.; Heatley, Gregg A.; Kaufman, Paul L.; Lucarelli, Mark J.; Levin, Leonard A.; Ver Hoeve, James N.

    2010-01-01

    The purpose of this study was to evaluate the relationship between elevations of intraocular pressure (IOP) and the multifocal electroretinogram (mfERG) in non-human primates. Experimental glaucoma was induced in 4 rhesus and 4 cynomolgus monkeys by laser trabecular meshwork destruction (LTD) in one eye. To evaluate the contribution of ganglion cells to mfERG changes, one monkey of each species had previously underwent unilateral optic nerve transection (ONT). After ≥ 44 weeks of elevation, the IOP was reduced by trabeculectomy in 2 non-transected animals. In the intact (non-transected) animals there was an increase in the amplitude of the early mfERG waveforms (N1 and P1) of the first order kernel (K1) throughout the period of IOP elevation in all of the rhesus, but not all of the cynomolgus monkeys. A species difference was also present as a decrease of the second order kernel, first slice (K2.1) in all of the cynomolgus monkeys but only in 1 of the rhesus monkeys (the 1 with the ONT). Similar IOP effects on the mfERG were seen in the ONT animals. Surgical lowering of IOP resulted in a return of the elevated K1 amplitudes to baseline levels. However, the depressed K2.1 RMS in the cynomolgus monkeys did not recover. These results demonstrate species-specific changes in cone-driven retinal function during periods of elevated IOP. These IOP-related effects can occur in the absence of retinal ganglion cells and may be reversible. PMID:20422254

  6. 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

  7. [Aberration corrected intraocular lens for microincision cataract surgery (MICS). Intraindividual comparison with a conventional lens - 1-year follow-up].

    PubMed

    Möglich, M; Häberle, H; Pham, D T; Wirbelauer, C

    2009-10-01

    Microincision cataract surgery (MICS) is an important advancement in the field of cataract surgery. This article compares an aberration corrected hydrophilic acrylic intraocular lens (IOL) having a hydrophobic surface for MICS with a one-piece hydrophobic acrylic IOL with respect to capsule sac stability, image quality, and after-cataract formation over the course of 1 year. The operations were performed as bimanual MICS or coaxial phacoemulsification. Overall the results after implantation of the IOL by MICS can be regarded as positive in comparison to the standard operation. PMID:18836727

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

    PubMed Central

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

    2016-01-01

    Aim: To study the efficiency and safety of iris reconstruction combined with iris-claw intraocular lens (IOL) implantation in the patients with iris-lens injuries. Settings and Design: Retrospective, noncomparable consecutive case series study. Materials and Methods: Eleven patients (11 eyes) following iris-lens injuries underwent iris reconstructions combined with iris-claw IOL implantations. Clinical data, such as cause and time of injury, visual acuity (VA), iris and lens injuries, surgical intervention, follow-up period, corneal endothelial cell count, and optical coherence tomography, were collected. Results: Uncorrected VA (UCVA) in all injured eyes before combined surgery was equal to or <20/1000. Within a 1.1–4.2-year follow-up period, a significant increase, equal to or better than 20/66, in UCVA was observed in six (55%) cases, and in best-corrected VA (BCVA) was observed in nine (82%) cases. Postoperative BCVA was 20/40 or better in seven cases (64%). After combined surgery, the iris returned to its natural round shape or smaller pupil, and the iris-claw IOLs in the 11 eyes were well-positioned on the anterior surface of reconstructed iris. No complications occurred in those patients. Conclusions: Iris reconstruction combined with iris-claw IOL implantation is a safe and efficient procedure for an eye with iris-lens injury in the absence of capsular support. PMID:27146932

  9. Surface PEGylation of intraocular lens for PCO prevention: An in vivo evaluation.

    PubMed

    Xu, Xu; Tang, Jun-Mei; Han, Yue-Mei; Wang, Wei; Chen, Hao; Lin, Quan-Kui

    2016-07-01

    Posterior capsular opacification (PCO) is a common complication in cataract surgery. The development of PCO is attributed to the combination of adhesion, migration, proliferation, and transdifferentiation of the residual lens epithelial cells (LEC) onto the interface of intraocular lens (IOL) material and lens posterior, in which the initial adhesion is the beginning step and plays important roles. In the present study, hydrophilic polyethylene glycol (PEG) was immobilized onto IOL surface via plasma-aided chemical grafting procedure. The attenuated total reflection - Fourier transform infrared (ATR-FTIR) and contact angle (CA) - measurements indicate the successful surface PEGylation, as well as the excellent hydrophilicity of the surfaces. Compared with pristine IOL, the PEGylation does not influent its optical property, whereas the initial adhesion of LEC is greatly inhibited. In vivo ocular implantation results show that the PEGylated IOL presents good in vivo biocompatibility, and can effectively prevent the PCO development. PMID:26980548

  10. Endophthalmitis following intraocular lens implantation: report of 30 cases and review of the literature.

    PubMed

    Weber, D J; Hoffman, K L; Thoft, R A; Baker, A S

    1986-01-01

    Bacterial endophthalmitis is a postoperative complication of intraocular lens implantation. A review of 30 cases showed that 77% occurred within seven days of initial cataract surgery and that all cases occurred within 32 days. Common presenting symptoms and signs included pain localized to the involved eye, decreased visual acuity, conjunctival injection, anterior chamber inflammation, hypopyon, and absent or poor red reflex. Diagnosis of an infectious etiology was made by aqueous and vitreous sampling for gram stain and culture. The commonest bacterial agents were coagulase-negative staphylococci and Staphylococcus aureus, but a wide variety of gram-negative and -positive organisms were also isolated. On the basis of this series and review of the literature, optimal treatment includes prompt diagnosis by culture and gram stain of vitreous fluid, frequent application of topical antibiotics, and administration of intraocular antibiotics. Intravenous antibiotics and vitrectomy may improve the visual outcome. Removal of the intraocular lens is unnecessary for bacteriologic cure and is not associated with improved visual outcome. PMID:3513284

  11. Distribution of salicylate in lens and intraocular fluids and its effect on cataract formation.

    PubMed

    Cotlier, E; Sharma, Y R; Niven, T; Brescia, M

    1983-06-14

    Retrospective studies on cataract development in patients with rheumatoid arthritis or osteoarthritis revealed a retardant effect of aspirin on diabetic and non-diabetic cataracts. The effect of aspirin is dose-dependent. The correlation coefficient between years delay for various cataracts subcategories versus aspirin taken (in tablets per day X years of intake) was 0.69. The ocular pharmacokinetics of 14C acetylsalicylic acid or salicylate were determined after intravenous or intraperitoneal administration to rabbits. 14C acetylsalicylic acid penetrates rapidly into rabbit lens and aqueous humor after intravenous administration. After intraperitoneal administration, salicylate levels in rabbit plasma, similar to those of humans receiving four to six aspirin tablets (325 mg each), result in accumulation of salicylate by lens (mean +/- SD) of 405 +/- 72 mumoles/g and 620 +/- 30 mumoles/g at two and four hours, respectively. At those dosages, salicylate is cleared in 24 hours from rabbit plasma and intraocular fluids, but retained by lens. Penetration of salicylate into rabbit lens and rat lens is dose-dependent. The retardant aspirin effect in diabetic cataracts is linked to inhibition of tissue aldose reductase and lens protein glycosylation. Deceleration of galactose cataract formation in rats occurs after daily salicylate intraperitoneal injections of 100 mg/kg a day. PMID:6859071

  12. Effect of the color of the intraocular lens on optical and visual quality

    PubMed Central

    Díez-Ajenjo, Mª Amparo; García-Domene, Mª Carmen; Peris-Martínez, Cristina; Artigas, José Mª; Felipe, Adelina

    2014-01-01

    Purpose: To analyze the optical quality of intraocular lenses (IOL) with an orange (PC440Y) and a yellow (SN60AT) filter, and correlate these results with the visual quality of patients with these implants. Setting: Fisabio Oftalmología Médica, Valencia, Spain. Design: Randomized prospective study. Materials and Methods: The IOL optical quality was determined using the modulation transfer function (MTF) and the spectral transmission. The visual quality of 87 eyes with cataract (51 with orange filter and 36 with yellow filter) was determined by best corrected visual acuity (BCVA) and contrast sensitivity function (CSF) under photopic and mesopic conditions. To analyze the results, we use a Student's t-test. Results: Orange lens filtered more of the blue spectrum (cut-off wavelength of 370 nm) than the yellow lens (390 nm). The MTF of the yellow lens was better than the orange lens (average modulation of 0.676 for natural and 0.672 for orange). The patients’ BCVA was 0.02 + 0.10 logMAR for both lenses. The CSF obtained with the yellow lens was slightly better, although without statistically significant differences (P > 0.05). Conclusions: Both lenses are of good optical quality. The patients’ visual quality was similar with both lenses, and optical quality was also similar. The color of the lens does not affect the visual quality of the patient. PMID:25494247

  13. 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. PMID:24140374

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

    PubMed Central

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

    2014-01-01

    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. PMID:24600484

  15. Comparison of the effects of intraocular irrigating solutions on the corneal endothelium in intraocular lens implantation.

    PubMed Central

    Matsuda, M; Kinoshita, S; Ohashi, Y; Shimomura, Y; Ohguro, N; Okamoto, H; Omoto, T; Hosotani, H; Yoshida, H

    1991-01-01

    We conducted a randomised prospective controlled study to determine the effects of a glucose glutathione bicarbonate solution (BSS Plus) and a citrate acetate bicarbonate solution (S-MA2) on the corneal endothelium in patients undergoing extracapsular cataract extraction with posterior chamber lens implantation. One eye of each patient was randomly assigned to receive BSS Plus, and the other eye to receive S-MA2. BSS Plus caused significantly less corneal swelling on the first postoperative day than did S-MA2. There was no difference between the two solutions in their effect on corneal thickness one week and one month postoperatively. Computer assisted morphometric analysis of wide-field specular microscopic photographs demonstrated minimal changes in endothelial morphological characteristics in the eyes irrigated with BSS Plus. By comparison S-MA2, caused a significant loss of endothelial cells and a marked reduction in the figure coefficient. These results indicated that BSS Plus has a clinical advantage over S-MA2 with respect to the corneal endothelium. PMID:1873266

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

    PubMed Central

    Faria, Mun Yueh; Ferreira, Nuno; Neto, Eliana

    2016-01-01

    Objective To report visual outcomes, complication rate, and safety of retropupillary iris-claw intraocular lens (ICIOL) in ectopia lentis in Marfan syndrome (MFS). Design Retrospective study. Methods Six eyes of three MFS patients with ectopia lentis underwent surgery for subluxation lens and retropupillary ICIOL implantation from October 2014 to October 2015 at the Department of Ophthalmology, Santa Maria Hospital in Lisbon, Portugal. Demographics, preoperative and postoperative best-corrected visual acuity (BCVA), and intraocular pressure were evaluated. Endothelium cell count was assessed using specular microscopy; anterior chamber depth was measured using Pentacam postoperatively; and intraocular lens position was viewed by ultrasound biomicroscopy. All patients were female; mean age was 20±14.264 years (range: 7–38 years). Results The average follow-up period was 6.66 months (range: 4–16 months). Preoperative BCVA was 0.568±0.149 logMAR units, and postoperative BCVA was 0.066±0.121 logMAR units. The mean BCVA gain was −0.502±0.221 on the logMAR scale. Postoperative average astigmatism and intraocular pressure were 1.292±0.697 mmHg (range: 0.5–2.25 mmHg) and 16 mmHg (range: 12–18 mmHg), respectively. The average endothelial cell density decreased from 3,121±178 cells/mm2 before surgery to 2,835±533 cells/mm2 after surgery (measured at last follow-up visit) and in the last follow-up, representing an average endothelial cell loss of 9.16%. Mean anterior chamber depth was 4.01 mm (±0.77 mm), as measured by Pentacam. No complications were found intra- or postoperatively in any of the six studied eyes. Conclusion Retropupillary ICIOL implantation is a safe and effective procedure in the treatment of aphakia in MFS eyes, without capsular support after surgery for ectopia lens. The six eyes that underwent lensectomy and retropupillary ICIOL implantation have had excellent visual outcomes with no complications so far. PMID:27382335

  17. Decompensation of ocular torsion following malrotation of a toric intraocular lens.

    PubMed

    Ramskold, Louise; Lodhia, Vaishali; Jones, Alistair; Jain, Saurabh

    2015-12-01

    Toric intraocular lenses (IOLs) are being increasingly used to correct corneal astigmatism in cataract surgery. A quarter of patients that undergo cataract surgery may benefit from a toric rather than a spherical IOL. However, these implants must be positioned accurately, because postoperative rotation of the toric IOL can have clinically significant consequences. We present the first documented case of a 78-year-old woman who presented with diplopia as a result of exacerbation of a preexisting torsion following toric lens implantation. PMID:26691041

  18. A slide rule for calculating the power of an intraocular lens.

    PubMed

    Wang, G J; Pomerantzeff, O; Miao, T Y

    1983-01-01

    We have designed a slide rule to calculate the emmetropizing and iseikonizing power of an intraocular lens (IOL). Like the dial biometer currently used for these calculations, the slide rule is inexpensive, easy to use, simple, and a compact pocket size. It can, however, also be used to calculate postoperative refractive error, corneal power when various keratometers are used, and conversion of refractive correction at the spectacle frame to that at the cornea, or vice versa. All the calculated data are within the accuracy suitable for clinical work. PMID:6630016

  19. A capacitor-based sensor and a contact lens sensing system for intraocular pressure monitoring

    NASA Astrophysics Data System (ADS)

    Chiou, Jin-Chern; Huang, Yu-Chieh; Yeh, Guan-Ting

    2016-01-01

    This study proposes a capacitor-based sensor on a soft contact lens for the measurement of intraocular pressure (IOP). The sensor was designed and fabricated via microelectromechanical system fabrication technologies. The soft contact lens is designed to be worn on a cornea such that the curvature of the contact lens corresponds substantially to that of the cornea. In addition, the contact lens was fabricated via a cast-molding method using poly-2-hydroxyethyl methacrylate to achieve a lens with high oxygen permeability, which can be worn comfortably for a long time. An IOP sensor prototype was implemented, which exhibited 1.2239 pF mmHg-1 (13,171 ppm mmHg-1) sensitivity during measurements of an artificial anterior chamber at pressures between 18 and 30 mmHg. The results indicate that the developed capacitor-based IOP sensor exhibited high stability and reproducibility in a series of measurements performed under various pressures. The capacitance of the proposed IOP sensor can successfully be converted into a digital value via a capacitor-to-digital converter and be transmitted via a commercial wireless telemetry system in this study.

  20. Late opacification of a silicone intraocular lens caused by ophthalmic ointment.

    PubMed

    Chew, Jesse J L; Werner, Liliana; Mackman, Gary; Mamalis, Nick

    2006-02-01

    A 55-year-old man had uneventful phacoemulsification with implantation of a 3-piece silicone intraocular lens (IOL). Postoperative medications included antibiotic-steroid drops and ointments. Eight months postoperatively, the patient started having recurrent episodes of anterior chamber inflammatory reaction. Suspicion that lens instability was causing the reactions led to a lens repositioning procedure 11 months after the initial surgical implantation and again at 13 months. Eighteen months postoperatively, the IOL had a "greasy" film. Despite antiinflammatory and antibiotic treatment, the clinical outcome did not improve. Twenty-seven months after implantation, the lens was exchanged with a hydrophilic acrylic IOL. The course after the exchange was uneventful. The explanted lens was examined by gross and microscopic evaluations, scanning electron microscopy, energy-dispersive X-ray spectroscopy, and gas chromatography-mass spectrometry (GC-MS) using electronic ionization. Gross and microscopic evaluations confirmed the presence of a thin, oily film covering the IOL optic surface. Surface analyses at the level of the oily substance showed unspecific peaks of sodium, chloride, and potassium. The GC-MS analysis showed the presence of compounds characteristic of hydrocarbons, including docosane, tricosane, and tetracosane, which are commonly found in the vehicle of ophthalmic ointments. The GC-MS analysis of 1 ointment used postoperatively found matching peaks, suggesting deposition of those compounds on the IOL. PMID:16565014

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

    PubMed

    Ventura, Bruna Vieira; MacLean, Kyle Douglas; Lira, Wagner; Oliveira, Daniele Mendes de; Ventura, Camila Vieira; Werner, Liliana

    2016-01-01

    A 51-year-old patient underwent posterior vitrectomy with perfluoropropane gas injection, phacoemulsification, and implantation of an Oft Cryl® hydrophilic acrylic intraocular lens (IOL) because of traumatic retinal detachment and cataract in the right eye. On the first postoperative day, gas was filling the anterior chamber because of patient's non-compliance in terms of head positioning, and was reabsorbed within one week. Eight months later, the patient returned complaining of a significant decrease in vision. IOL opacification was noticed by slit-lamp examination. The lens was explanted to undergo gross and light microscopic analysis. The lens was also stained with the alizarin red method for calcium identification. Light microscopic analysis confirmed the presence of granular deposits, densely distributed in an overall circular pattern in the central part of the lens optic. The granules stained positive for calcium. This is the first case of the opacification of this type of hydrophilic lens. Surgeons should be aware of this potential postoperative complication, and the use of hydrophilic IOLs should be avoided in procedures involving intracameral gas because of the risk of IOL opacification. PMID:27626152

  2. Spontaneous disinsertion of a multipiece foldable acrylic intraocular lens haptic 3 and 12 months after implantation.

    PubMed

    Por, Yong Ming; Chee, Soon-Phaik

    2004-05-01

    We report 2 cases of spontaneous postoperative haptic disinsertion with the Alcon AcrySof MA60BM posterior chamber intraocular lens (PC IOL). A 14-year-old girl with a history of acute retinal necrosis and pars plana vitrectomy with lensectomy for retinal detachment repair had secondary implantation of a PC IOL in the ciliary sulcus. Three months later, the superior haptic disinserted from the optic and dislocated into the anterior chamber. In the second case, a 22-year-old man had lens aspiration and PC IOL implantation in the capsular bag. One year after surgery, the PC IOL had a similar problem, with the disinserted superior haptic remaining in the capsular bag while the optic and inferior haptic dislocated into the anterior chamber. In both patients, the PC IOLs were exchanged for rigid single-piece PC IOLs. The patients have had no further problems. PMID:15130659

  3. [Intraocular Lens as a Drug Delivery Device: State of the Art and Future Perspective].

    PubMed

    Eibl-Lindner, K H; Wertheimer, C; Kampik, A

    2016-02-01

    Development of an intraocular lens (IOL) as a drug delivery device has been pursued for many years and is a promising concept in modern cataract surgery. Common postoperative conditions such as posterior capsule opacification (PCO), intraocular inflammation or the rare but severe complications of cataract surgery like endophthalmitis are potential therapeutic targets for a drug-eluting IOL. There are three techniques of pharmacological IOL modification: Firstly, surface modification of the IOL ("coating"); secondly, IOL optic modification ("soaking") and lastly, loading the IOL haptics with a slow release system. The last option does not interfere with the IOL optics at all. Therefore, a broad spectrum of pharmacological agents needs to be assessed in preclinical and clinical studies to determine which agent/IOL combination is safe and efficient. For pharmacological PCO prophylaxis, erufosine-loaded IOLs are of great clinical interest. Heparin-coated IOLs might become clinically relevant for attenuation of intraocular inflammation after cataract surgery and cefuroxime-loaded IOLs for endophthalmitis prophylaxis. PMID:26878733

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

    PubMed Central

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

    2015-01-01

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

  5. The Balanced Two-String Technique for Sulcus Intraocular Lens Implantation in the Absence of Capsular Support

    PubMed Central

    Ibrahim, Hesham A.; Sabry, Heba Nabil

    2015-01-01

    Purpose. To describe and explore an alternative approach for sulcus intraocular lens (IOL) implantation in the absence of capsular support. Methods. The commonly available one-piece poly(methyl methacrylate) (PMMA) lens is stabilized in the sulcus by two intraocular horizontal strings of 10/0 polypropylene suture passed through the lens dialing holes in opposite directions to achieve a mechanical balance. The horizontal strings of 10/0 polypropylene work as a rail track for the IOL optics, allowing some side to side lens adjustment even following wound closure. The stability of the IOL was tested in vitro. Six aphakic patients underwent in-sulcus IOL secondary implantation using the balanced two-string technique. Patients were followed up for a minimum of six months. Best spectacle corrected vision was assessed. Lens centration and lens tilt were measured by anterior segment optical coherence tomography (AS-OCT). Results. All patients had successful lens insertion. Best spectacle corrected visual acuity (BSCVA) improved in all patients. Lens decentration ranged between 0.21 mm and 0.9 mm (average 0.53 mm). Lens tilt ranged between 1.2° and 2.8° (average 2.17°). Conclusion. The mechanically balanced two-string technique is an alternative option for sulcus IOL implantation in absence of capsular support, allowing lens centration adjustment with no additional risks. PMID:25722884

  6. Transscleral fixation of closed loop haptic acrylic posterior chamber intraocular lens in aphakic nonvitrectomized eyes

    PubMed Central

    Agrawal, Siddharth; Singh, Vinita; Gupta, Sanjiv Kumar; Misra, Nibha; Srivastava, Rajat M

    2015-01-01

    Purpose: To evaluate the outcome of transscleral fixation of closed loop haptic acrylic posterior chamber intraocular lens (PCIOL) in aphakia in nonvitrectomized eyes. Materials and Methods: Patients with postcataract surgery aphakia, trauma with posterior capsule injury, subluxated crystalline lens, and per operative complications where sulcus implantation was not possible were included over a 1-year period. Scleral fixation of acrylic hydrophilic PCIOL was performed according to the described technique, and the patients were evaluated on the day 1, 3, 14, and at 3 and 12 months postoperatively for IOL centration, pseudophakodonesis, change in best-corrected visual acuity (BCVA), and any other complications. Results: Out of twenty-nine eyes of 24 patients, who completed the study, 25 (86.2%) eyes had improved, 2 (6.9%) eyes showed no change, and 2 (6.9%) eyes had worsening of BCVA. Three (10.3%) eyes developed postoperative complications. A significant improvement in mean BCVA (P < 0.0001) was observed after the procedure. Mean duration of follow-up was 26.2 months (range 22–35 months). Conclusion: The use of closed loop haptic acrylic IOL for scleral fixation appears to be safe and effective alternative to conventional scleral fixated polymethyl methacrylate intraocular lenses. PMID:26576522

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

    PubMed Central

    Lee, Soo Jung; Kim, Wan-Soo

    2014-01-01

    AIM To evaluate factors associated with the development of strabismus after cataract extraction and primary intraocular lens implantation. METHODS The medical records of 122 patients, aged 1.5mo to 9y, who had undergone cataract extraction with primary intraocular lens implantation between January 1993 and August 2011 were reviewed. Fourteen patients (17 eyes) with strabismus before cataract surgery were excluded. Patients were divided into those with congenital bilateral cataracts (64 patients, 128 eyes) and those with unilateral cataracts (44 patients, 44 eyes). The associations between the development of strabismus and age at cataract surgery, pre- and post-cataract extraction corrected distance visual acuity (CDVA), interocular CDVA difference, nystagmus, surgical method, and secondary cataract were evaluated. RESULTS Factors significantly associated with the development of strabismus included age at cataract surgery (≤1y), preoperative mean CDVA ≤20/100, presence of nystagmus in the bilateral cataract group and postoperative interocular CDVA difference >20/70 in the unilateral group. Postoperative CDVA ≤20/100 and preservation of posterior capsule, and presence of secondary cataract were significant factors in both groups. CONCLUSION Children with congenital cataracts should be monitored carefully after cataract surgery for the development of strabismus, especially when they underwent surgery at age ≤1y, and they have nystagmus, large postoperative interocular CDVA difference, poor preoperative and postoperative CDVA, preservation of the posterior capsule, or secondary cataract. PMID:24967203

  8. Effect on contrast sensitivity after clear, yellow and orange intraocular lens implantation.

    PubMed

    Bandyopadhyay, Sabyasachi; Saha, Mita; Chakrabarti, Asim; Sinha, Abhik

    2016-06-01

    The objective of this study is to evaluate contrast sensitivity function (CSF) after clear, yellow- and orange-tinted intraocular lens (IOL) implantation. This was a prospective randomized study of 98 patients with senile cataract for a period of 6 months from day 1 of August 2014 to day 31 of January 2015. After phacoemulsification, 33 patients were implanted with clear IOLs (AcrySof UV-filtering IOL, SA60AT), 32 patients were implanted with yellow coloured IOLs (AcrySof Natural blue-light-attenuating and UV-filtering IOL, SN60AT with IMPRUV(®) filter) and 33 patients were implanted with orange-tinted blue-filtering IOLs (PC440Y Optech). After 1 month, monocular CSF was done under photopic (85 cd/m(2)) and mesopic (3 cd/m(2)) illumination condition with CSV-1000 test. The best corrected visual acuity (BCVA) after 1 month was 0.021 ± 0.058 logMAR for clear lens, 0.022 ± 0.059 logMAR for yellow lens and 0.019 ± 0.065 logMAR for orange lens (p = 0.989). Uniocular average photopic contrast sensitivity was 1.36 ± 0.19, 1.43 ± 0.18 and 1.46 ± 0.15 log units for clear lens, yellow lens and orange lens, respectively (statistically not significant; p = 0.076). Average mesopic contrast sensitivity was 1.02 ± 0.21 log units for clear lens, 1.00 ± 0.17 log units for yellow lens and 0.99 ± 0.15 log units for orange lens (statistically not significant; p = 0.771). Yellow or orange coloured blue-filtering IOLs are comparable to clear IOLs in terms of photopic and mesopic contrast sensitivity. PMID:26286756

  9. Malik`s Technique of Single Loop Fixation of Posterior Chamber Intraocular Lens in Presence of Partial Capsular Support

    PubMed Central

    Singh Malik, Krishan Pal; Goel, Ruchi; Kishore, Divya; Nagpal, Smriti

    2015-01-01

    Single loop fixation of posterior chamber intraocular lens in the presence of partial capsular support is usually performed by creation of additional scleral flap or tunnel. This extra port may expose the suture holding the intraocular lens or the tucked-in lens haptics to the outside environment thereby increasing the risk of endophthalmitis. We describe a technique of single loop fixation where the scleral tunnel is created adjacent to the site with the absent capsule, the leading haptic is placed on the capsular scaffold, the trailing haptic is tied to 9-0 polypropylene, and the suture is then secured to the inner edge of the scleral lip with enough tension to center the optics and the wound is then closed. The suture knot gets buried within the scleral tunnel with no external communication and does not require a separate port. It is an easy, safe, fast and reproducible technique with a lens tilt of less than 2°. PMID:26962380

  10. Uveitis-glaucoma-hyphema syndrome caused by posterior chamber intraocular lens--a rare complication in pediatric cataract surgery.

    PubMed

    Lin, Chun-Ju; Tan, Chau-Yi; Lin, Szu-Yuan; Jou, Jieh-Ren

    2008-01-01

    We report a case of postoperative uveitis-glaucome-hyphema (UGH) syndrome following pediatric cataract surgery due to posterior chamber intraocular lens (PC-IOL). Slit-lamp examination revealed the optic of PC-IOL migrated into anterior chamber. The PC-IOL explantation was performed and ocular inflammation subsided. PMID:19230361

  11. Prediction error and accuracy of intraocular lens power calculation in pediatric patient comparing SRK II and Pediatric IOL Calculator

    PubMed Central

    2010-01-01

    Background Despite growing number of intraocular lens power calculation formulas, there is no evidence that these formulas have good predictive accuracy in pediatric, whose eyes are still undergoing rapid growth and refractive changes. This study is intended to compare the prediction error and the accuracy of predictability of intraocular lens power calculation in pediatric patients at 3 month post cataract surgery with primary implantation of an intraocular lens using SRK II versus Pediatric IOL Calculator for pediatric intraocular lens calculation. Pediatric IOL Calculator is a modification of SRK II using Holladay algorithm. This program attempts to predict the refraction of a pseudophakic child as he grows, using a Holladay algorithm model. This model is based on refraction measurements of pediatric aphakic eyes. Pediatric IOL Calculator uses computer software for intraocular lens calculation. Methods This comparative study consists of 31 eyes (24 patients) that successfully underwent cataract surgery and intraocular lens implantations. All patients were 12 years old and below (range: 4 months to 12 years old). Patients were randomized into 2 groups; SRK II group and Pediatric IOL Calculator group using envelope technique sampling procedure. Intraocular lens power calculations were made using either SRK II or Pediatric IOL Calculator for pediatric intraocular lens calculation based on the printed technique selected for every patient. Thirteen patients were assigned for SRK II group and another 11 patients for Pediatric IOL Calculator group. For SRK II group, the predicted postoperative refraction is based on the patient's axial length and is aimed for emmetropic at the time of surgery. However for Pediatric IOL Calculator group, the predicted postoperative refraction is aimed for emmetropic spherical equivalent at age 2 years old. The postoperative refractive outcome was taken as the spherical equivalent of the refraction at 3 month postoperative follow-up. The

  12. A safe method of ciliary sulcus fixation of foldable intraocular lens using a ciliary sulcus guide.

    PubMed

    Can, Ertuğrul; Gül, Adem; Birinci, Hakkı

    2016-08-01

    To describe a novel technique for implantation of intraocular lens in the absence of capsular support using a ciliary sulcus guide. Based on the anatomic knowledge of the ciliary sulcus and the sclera, a new instrument was developed to pierce the needle safely through the ciliary sulcus and sclera. While the foldable lens is stored inside the cartridge, the leading haptic is sutured with a cow-hitch knot. The needle is then inserted into the ciliary sulcus guide. The tip of the guide is inserted from the corneal incision and proceeded under the iris to touch and fit the ciliary sulcus. The needle is pushed from back side. The needle comes out at precise point at the sclera. Implantation of the lens was performed through a 2.8 mm clear cornea incision using the injector. The trailing haptic is tied after implantation, and then the same procedure is performed at the opposite side. We performed this technique to 15 aphakic eyes without sufficient capsular support. There was no bleeding or other intraoperative complication. All the points coming out the sclera were between 2 and 2.5 mm from the limbus. The ab interno technique for scleral fixation of IOL is quicker, easier and less traumatic then ab externo techniques. A new ciliary sulcus guide which is usable with both straight and curved needles eliminates the blind maneuvers of ab interno technique and makes this technique more safe and precise. PMID:26439372

  13. Study on intra-ocular lens aberration measurement in-air

    NASA Astrophysics Data System (ADS)

    Wang, Yuanyuan; Chen, Jiaojie; Fen, Haihua; Hu, Chuan; Li, Yiyi

    2010-10-01

    In clinical ophthalmology, the wavefront aberration of human eyes is expressed by Zernike polynomial after cataract surgery and intraocular lens implantation, the human eyes aberration will change. The problem of objective evaluation of wavefront aberration introduced by the Intra-ocular (IOL) in-vivo remains unsolved. This paper introduced the measurement principal of IOL wavefront aberration with expression by Zernike polynominal in air. A Hartmann-Shack wavefront sensor system was constructed to measure the wavefront of IOL and to get the corresponding grid patterns. After a series of computer image processing steps, 7th order with 35 items Zernike coefficients was obtained. The IOL of 20.0D power was measured 5 times by this system to get the spherical aberration about 6.73+/-0.02μm, demonstrating the good repeatability of the system. Ten IOLs with the same 20.0D power but difference in surface curvature were chosen for measurement. The spherical aberration observed were in the range of 2.74μm-11.26μm. These results are valuable for the optical design of IOLs and the aberration analysis of human eyes post-operation.

  14. Hydrophilic Acrylic Intraocular Lens Opacification after Descemet Stripping Automated Endothelial Keratoplasty

    PubMed Central

    Norouzpour, Amir; Zarei-Ghanavati, Siamak

    2016-01-01

    Purpose: To report hydrophilic acylic intraocular lens (IOL) opacification after Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) in an eye with multiple prior intraocular surgeries and iatrogenic aniridia. Case Report: A 34-year-old woman with history of penetrating keratoplasty (PKP) for advanced keratoconus and subsequent Urrets-Zavalia Syndrome (UZS) underwent phacoemulsification and hydrophilic acrylic IOL implantation for her cataract. In order to control post-PKP glaucoma, multiple glaucoma surgeries including two glaucoma drainage implants were performed. As the original corneal graft failed, the patient subsequently underwent re-PKP. Four years later, she underwent DSAEK for treatment of the second graft failure. Ten months after DSAEK, a double semi-circular pattern of IOL opacification was observed on the anterior surface of the IOL. The patient did not report any complaints and we decided not to exchange the IOL. Conclusion: In an eye with UZS and iatrogenic aniridia, IOL opacification may result from direct contact between the IOL surface and exogenous air. Aniridia can be a risk factor for development of IOL opacification after DSAEK. Further studies are required to confirm this hypothesis. PMID:27413506

  15. Iris-claw intraocular lens implantation: Anterior chamber versus retropupillary implantation

    PubMed Central

    Helvacı, Sezer; Demirdüzen, Selahaddin; Öksüz, Hüseyin

    2016-01-01

    Purpose: To compare the outcomes of anterior chamber and retropupillary implantation of iris-claw Artisan intraocular lenses (IOL). Design: Prospective, randomized, single-blinded study. Patients and Methods: Forty eyes of forty aphakic patients were enrolled. Patients were randomized into two groups. Each group includes twenty patients. Group 1 received anterior chamber Artisan IOL implantation. Group 2 received retropupillary Artisan IOL implantation. Preoperative and postoperative corrected distance visual acuity (CDVA), intraocular pressure (IOP), and all complications were noted and compared at 6 months follow-up. Results: Each two groups obtained a significant improvement in CDVA (P < 0.05). Four patients in Group 1 and five patients in Group 2 had significant but nonpermanent increase at IOP values. There were one and two pupillary irregularity in Group 1 and Group 2, respectively. In one patient, a shallow and inferior located retinal detachment were encountered in anterior chamber group. Conclusions: The results were not significantly different between the two fixation techniques for iris-claw lens. The surgery procedure is dependent to surgeon experience and eye's conditions. PMID:26953023

  16. Transconjunctival sutureless intrascleral intraocular lens fixation using intrascleral tunnels guided with catheter and 30-gauge needles.

    PubMed

    Takayama, Kohei; Akimoto, Masayuki; Taguchi, Hogara; Nakagawa, Satoko; Hiroi, Kano

    2015-11-01

    We invented a new method for fixing an intraocular lens (IOL) in the scleral tunnel without using a wide conjunctival incision. Modified bent catheter needles were used to penetrate the IOL haptics through the sclerotomy sites. The IOL haptics were inserted into 30-guage (G) scleral tunnels guided by double 30-G needles piercing the sclera. All procedures were performed through the conjunctiva without wide incision. The procedure does not require special forceps, trocars or fibrin glue, only catheter and 30-G needles. The aid of an assistant was not required to support the IOL haptic. The procedures were easily learnt based on our previous method. As with other transconjunctival sutureless surgeries, patients feel less discomfort and the conjunctiva can be conserved for future glaucoma surgery. Complications included two cases of vitreous haemorrhage (16.7%), and one case each of postoperative hypotony, and iris capture (8.3%). Astigmatism induced by intraocular aberration was the same as we reported previously. Our method for fixing the IOL into the scleral tunnel is innovative, less expensive, less invasive and quick. This modified method is a good alternative for fixing IOL haptics into the sclera. PMID:25855502

  17. Late-Onset Citrobacter koseri Endophthalmitis with Suture Exposure after Secondary Intraocular Lens Implantation

    PubMed Central

    Kang, Hae Min

    2011-01-01

    A 54-year-old male patient was seen in clinic for ocular pain and decreased vision in the right eye with duration of two days. He underwent a cataract operation for his right eye 12 years ago, then a sclera-fixated secondary intraocular implantation and pars plana vitrectomy three years ago due to intraocular lens dislocation. At the initial visit, his visual acuity was restricted to the perception of hand motion. An edematous cornea, cells, flare with hypopyon, and exposed suture material at were observed at the six o'clock direction by slit lamp. Vitreous opacity was noted from B-scan ultrasonography. The patient was diagnosed with late-onset endophthalmitis and an intravitreal cocktail injection was done. On the next day, the hypopyon was aggravated, and therefore a pars plana vitrectomy was performed. A vitreous culture tested positive for Citrobacter koseri. After 12 weeks, the best corrected visual acuity of the right eye improved to 0.7 and a fundus examination revealed a relatively normal optic disc and retinal vasculature. We herein report the first case of endophthalmitis caused by Citrobacter koseri in Korea. Exposed suture material was suspected as the source of infection in this case and prompt surgical intervention resulted in a relatively good visual outcome. PMID:21860579

  18. Comparison of pseudophakic retinal straylight in spherical/aspherical and hydrophobic/hydrophilic intraocular lens

    PubMed Central

    Tang, Yong; Song, Hui; Chen, Jing; Tang, Xin

    2015-01-01

    AIM To study the potential reasons of increased straylight in pseudophakic eyes. METHODS Cross-sectional study. Seventy patients diagnosed as bilateral age-related cataract and implanted with Tecnis ZA9003, Sensar AR40e, SA60AT, XLSTABI ZO or Akeros AO intraocular lens (IOL) were enrolled in this research. Straylight was measured by a C-Quant straylight meter three to four weeks postoperatively. Five different modalities of IOL, including spherical/aspherical optics and hydrophobic/hydrophilic material were tested in this study. Normal as well as dilated pupils were used. The main outcome variable for straylight measurement was the logarithmic straylight parameter, log(s). RESULTS The straylight parameter increased significantly after pupil dilation (P<0.05). Straylight of aspherical IOL was significantly higher after pupil dilation (P<0.05) compared to spherical IOL. In normal pupil, straylight of hydrophobic IOL was significant higher when compared with hydrophilic IOL (P<0.05). CONCLUSION Straylight and visual acuity stand for the different aspects of visual function. Several factors including pupil diameter, optic material, aspherical design of IOL influence intraocular light scattering in pseudophakic eyes. Further investigation was needed to study the impact of optic material and optic surface design on pseudophakic straylight. PMID:26682163

  19. Late-onset Citrobacter koseri endophthalmitis with suture exposure after secondary intraocular lens implantation.

    PubMed

    Kang, Hae Min; Chung, Eun Jee

    2011-08-01

    A 54-year-old male patient was seen in clinic for ocular pain and decreased vision in the right eye with duration of two days. He underwent a cataract operation for his right eye 12 years ago, then a sclera-fixated secondary intraocular implantation and pars plana vitrectomy three years ago due to intraocular lens dislocation. At the initial visit, his visual acuity was restricted to the perception of hand motion. An edematous cornea, cells, flare with hypopyon, and exposed suture material at were observed at the six o'clock direction by slit lamp. Vitreous opacity was noted from B-scan ultrasonography. The patient was diagnosed with late-onset endophthalmitis and an intravitreal cocktail injection was done. On the next day, the hypopyon was aggravated, and therefore a pars plana vitrectomy was performed. A vitreous culture tested positive for Citrobacter koseri. After 12 weeks, the best corrected visual acuity of the right eye improved to 0.7 and a fundus examination revealed a relatively normal optic disc and retinal vasculature. We herein report the first case of endophthalmitis caused by Citrobacter koseri in Korea. Exposed suture material was suspected as the source of infection in this case and prompt surgical intervention resulted in a relatively good visual outcome. PMID:21860579

  20. Bilateral spontaneous anterior dislocation of intraocular lens with the capsular bag in a patient with pseudoexfoliation

    PubMed Central

    Bhattacharjee, Harsha; Saxena, Rushil Kumar; Medhi, Jnanankar

    2015-01-01

    We report a rare case of bilateral spontaneous anterior partial in-the-bag intraocular lens (IOL) dislocation in a 75-year-old man with pseudoexfoliation (PXF). He underwent uneventful phacoemulsification in both eyes with in-the-bag IOL implantation 9 years back. In the right eye, single piece poly (methyl methacrylate) (PMMA) IOL (+19 D) and in the left eye, single piece acrylic foldable IOL (+19 D) were implanted. An attempt at pharmacological IOL repositioning was unsuccessful. The dislocated IOLs were explanted and exchanged with scleral suture fixated PMMA IOLs. Vision improved to 20/30 in both eyes following surgery, without any associated ocular morbidity. We believe that zonular weakness secondary to PXF, capsular contraction, and myopia together were the predisposing factors for partial anterior dislocation of IOLs and IOL exchange with scleral suture fixation of IOL is a safe and effective treatment option. PMID:26655008

  1. 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.

  2. 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. PMID:25937341

  3. Optimization of an intraocular lens for correction of advanced corneal refractive errors.

    PubMed

    Wadbro, Eddie; Hallberg, Per; Schedin, Staffan

    2016-06-01

    Based on numerical 3D ray tracing, we propose a new procedure to optimize personalized intra-ocular lenses (IOLs). The 3D ray tracing was based on measured corneal elevation data from patients who suffered from advanced keratoconus. A mathematical shape description of the posterior IOL surface, by means of a tensor product cubic Hermite spline, was implemented. The optimized lenses provide significantly reduced aberrations. Our results include a trade-off study that suggests that it is possible to considerably reduce the aberrations with only minor perturbations of an ideal spherical lens. The proposed procedure can be applied for correction of aberrations of any optical system by modifying a single surface. PMID:27411190

  4. [The calculation of the intraocular lens power based on raytracing methods: a systematic review].

    PubMed

    Steiner, Deborah; Hoffmann, Peter; Goldblum, David

    2013-04-01

    A problem in cataract surgery consists in the preoperative identification of the appropriate intraocular lens (IOL) power. Different calculation approaches have been developed for this purpose; raytracing methods represent one of the most exact but also mathematically more challenging methods. This article gives a systematic overview of the different raytracing calculations available and described in the literature and compares their results. It has been shown that raytracing includes physical measurements and IOL manufacturing data but no approximations. The prediction error is close to zero and an essential advantage is the applicability to different conditions without the need of modifications. Compared to the classical formulae the raytracing methods are more precise overall, but due to the various data and property situations they are hardly comparable yet. The raytracing calculations represent a good alternative to the 3rd generation formulae. They minimize refractive errors, are wider applicable and provide better results overall, particularly in eyes with preconditions. PMID:23629771

  5. Combined transscleral fixation of an artificial iris prosthesis with an intraocular lens.

    PubMed

    Gunenc, Uzeyır; Ozturk, Taylan; Arikan, Gul; Kaya, Mahmut

    2016-02-01

    Post-traumatic aniridia combined with aphakia may be seen after globe injury. Aside from esthetic aspects, partial or total loss of the iris tissue may also be related to various degrees of glare and photophobia. Such patients suffer from severe visual impairment secondary to aphakia. Herein we describe a novel surgical technique for the management of an aphakic eye with traumatic aniridia for a patient who underwent transscleral fixation of a custom-tailored artificial iris prosthesis combined with a rigid intraocular lens (IOL). Tight suturing of the IOL haptic eyelets on the silicone iris prosthesis and fixation of such a complex to the scleral wall may provide excellent cosmetic and functional outcomes in aphakic eyes with aniridia. PMID:26840171

  6. Surgical technique for transscleral fixation of a foldable posterior chamber intraocular lens.

    PubMed

    Yepez, Juan B; de Yepez, Jazmin Cedeño; Valero, Alejandro; Arevalo, J Fernando

    2006-01-01

    The safety and efficacy of a modified technique for transscleral fixation of a foldable posterior chamber intraocular lens (IOL) for intracapsular aphakia (secondary IOL) or after complicated phacoemulsification was evaluated. All eyes had inadequate or no posterior capsular support. Follow-up was between 4 and 26 months (mean, 12 months). Uncorrected visual acuity improved (> 2 lines) in all patients. During follow-up, the IOL was correctly positioned in all cases. There were no major complications, such as endophthalmitis or suture erosion through the conjunctiva at the site of fixation. No patient required further surgical interventions. This modified technique of transscleral fixation of foldable posterior chamber IOL offers the advantages of a small incision and rapid visual rehabilitation, and minimizes the risk of intraoperative and postoperative complications. PMID:16749265

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

    PubMed Central

    Lok, Julie Y.C.; Young, Alvin L.

    2015-01-01

    Phacoemulsification is the main gold standard for cataract operation in the developed world together with foldable intraocular lens (IOL) implantation by injection, allowing for stable wound construction and less postoperative astigmatism. It is a safe procedure with high success rate with the advancement in machines, improvement of IOL injection systems and further maturation of surgeons' techniques. Despite the large number of operations performed every day, foldable IOL injection leading to an intra-stromal corneal track is a very rare complication. We report a case of this unusual finding in a 70-year-old gentleman who has undergone cataract operation in November 2011 in our hospital and will review on the complications related to foldable IOL injection. PMID:26086020

  8. Phacoemulsification with corneal astigmatism correction with the use of a toric intraocular lens in a case of megalocornea.

    PubMed

    Rękas, Marek; Pawlik, Rafał; Kluś, Adam; Różycki, Radosław; Szaflik, Jacek Paweł; Ołdak, Monika

    2011-08-01

    We report the case of a 49-year-old patient with megalocornea and coexisting corneal astigmatism. The corneal diameter in the right eye was 15.0 mm and in the left eye, 14.9 mm. In both eyes, a nuclear sclerotic cataract developed, with the tendency toward cortical mass swelling in the right eye. The aim of surgical treatment was to remove the cataract with simultaneous correction of corneal astigmatism by implanting an Acrysof toric intraocular lens (IOL). Intraocular lens stabilization was obtained by suturing it to an capsular tension ring (CTR) in the anterior chamber. The IOL-CTR complex was rotated into the lens capsule and aligned with the steep meridian of corneal astigmatism. The surgical technique provides a stable refractive and functional effect in patients with megalocornea and coexisting cataract and corneal astigmatism. PMID:21782100

  9. Visual and Refractive Outcomes of a Toric Presbyopia-Correcting Intraocular Lens

    PubMed Central

    Epitropoulos, Alice T.

    2016-01-01

    Purpose. To evaluate outcomes in astigmatic patients implanted with the Trulign (Bausch + Lomb) toric presbyopia-correcting intraocular lens (IOL) during cataract surgery in a clinical practice setting. Methods. Retrospective study in 40 eyes (31 patients) that underwent cataract extraction and IOL implantation in a procedure using intraoperative wavefront aberrometry guidance (ORA system). Endpoints included uncorrected visual acuity (VA), reduction in refractive cylinder, accuracy to target, axis orientation, and safety. Results. At postoperative month 1, refractive cylinder was ≤0.50 D in 97.5% of eyes (≤1.00 D in 100%), uncorrected distance VA was 20/25 or better in 95%, uncorrected intermediate VA was 20/25 or better in 95%, and uncorrected near VA was 20/40 (J3 equivalent) or better in 92.5%. Manifest refraction spherical equivalent was within 1.00 D of target in 95% of eyes and within 0.50 D in 82.5%. Lens rotation was <5° and best-corrected VA was 20/25 or better in all eyes. Conclusion. The IOL effectively reduced refractive cylinder and provided excellent uncorrected distance and intermediate vision and functional near vision. Refractive predictability and rotational stability were exceptional. Implantation of this toric presbyopia-correcting IOL using ORA intraoperative aberrometry provides excellent refractive and visual outcomes in a standard of care setting. PMID:26885382

  10. Evaluation of a class of polyurethane materials for intraocular lens manufacturing.

    PubMed

    Bozukova, Dimitriya; Bertrand, Virginie; Pagnoulle, Christophe; De Pauw-Gillet, Marie-Claire

    2015-08-01

    Ophthalmic lenses are medical devices with considerable requirements in terms of optical, biomechanical and biological performance. There is limited number of materials used for their manufacturing, comprising mainly silicones and poly(meth)acrylates. This series of publications aims at investigating the applicability of thermoplastic polyurethane elastomers (TPU) for the manufacturing of ophthalmic lenses and examining the properties of the respective devices. This study is related to the synthesis of TPUs with chemical compositions that comprise chemically grafted filters for the hazardous-light. GC-MS, attenuated total reflectance Fourier transform infrared spectroscopy, and UV-vis spectroscopies confirmed the reaction completion and the beneficial effect of the filters on the light transmittance, respectively. Relatively high refractive index of the material was measured and allows for the manufacturing of thinner lenses. The contrast sensitivity determined for a model intraocular lens (IOL) was satisfactory. Few optical defects were, however, present on the model lens prepared by thermoplastic injection molding. The elasticity of the materials was evaluated in view to their potential applicability as foldable IOLs by determining their glass transition temperature and their Young modulus and measuring their shore A. The TPU materials demonstrated more bioadhesive character compared with a benchmark hydrophilic acrylic reference material, which is already used for IOL manufacturing. PMID:25352276

  11. Visual and Refractive Outcomes of a Toric Presbyopia-Correcting Intraocular Lens.

    PubMed

    Epitropoulos, Alice T

    2016-01-01

    Purpose. To evaluate outcomes in astigmatic patients implanted with the Trulign (Bausch + Lomb) toric presbyopia-correcting intraocular lens (IOL) during cataract surgery in a clinical practice setting. Methods. Retrospective study in 40 eyes (31 patients) that underwent cataract extraction and IOL implantation in a procedure using intraoperative wavefront aberrometry guidance (ORA system). Endpoints included uncorrected visual acuity (VA), reduction in refractive cylinder, accuracy to target, axis orientation, and safety. Results. At postoperative month 1, refractive cylinder was ≤0.50 D in 97.5% of eyes (≤1.00 D in 100%), uncorrected distance VA was 20/25 or better in 95%, uncorrected intermediate VA was 20/25 or better in 95%, and uncorrected near VA was 20/40 (J3 equivalent) or better in 92.5%. Manifest refraction spherical equivalent was within 1.00 D of target in 95% of eyes and within 0.50 D in 82.5%. Lens rotation was <5° and best-corrected VA was 20/25 or better in all eyes. Conclusion. The IOL effectively reduced refractive cylinder and provided excellent uncorrected distance and intermediate vision and functional near vision. Refractive predictability and rotational stability were exceptional. Implantation of this toric presbyopia-correcting IOL using ORA intraoperative aberrometry provides excellent refractive and visual outcomes in a standard of care setting. PMID:26885382

  12. RGD Surface Functionalization of the Hydrophilic Acrylic Intraocular Lens Material to Control Posterior Capsular Opacification

    PubMed Central

    Huang, Yi-Shiang; Bertrand, Virginie; Bozukova, Dimitriya; Pagnoulle, Christophe; Labrugère, Christine; De Pauw, Edwin; De Pauw-Gillet, Marie-Claire; Durrieu, Marie-Christine

    2014-01-01

    Posterior Capsular Opacification (PCO) is the capsule fibrosis developed on implanted IntraOcular Lens (IOL) by the de-differentiation of Lens Epithelial Cells (LECs) undergoing Epithelial Mesenchymal Transition (EMT). Literature has shown that the incidence of PCO is multifactorial including the patient's age or disease, surgical technique, and IOL design and material. Reports comparing hydrophilic and hydrophobic acrylic IOLs have shown that the former has more severe PCO. On the other hand, we have previously demonstrated that the adhesion of LECs is favored on hydrophobic compared to hydrophilic materials. By combining these two facts and contemporary knowledge in PCO development via the EMT pathway, we propose a biomimetically inspired strategy to promote LEC adhesion without de-differentiation to reduce the risk of PCO development. By surface grafting of a cell adhesion molecule (RGD peptide) onto the conventional hydrophilic acrylic IOL material, the surface-functionalized IOL can be used to reconstitute a capsule-LEC-IOL sandwich structure, which has been considered to prevent PCO formation in literature. Our results show that the innovative biomaterial improves LEC adhesion, while also exhibiting similar optical (light transmittance, optical bench) and mechanical (haptic compression force, IOL injection force) properties compared to the starting material. In addition, compared to the hydrophobic IOL material, our bioactive biomaterial exhibits similar abilities in LEC adhesion, morphology maintenance, and EMT biomarker expression, which is the crucial pathway to induce PCO. The in vitro assays suggest that this biomaterial has the potential to reduce the risk factor of PCO development. PMID:25501012

  13. Intraocular lens alignment from an en face optical coherence tomography image Purkinje-like method

    NASA Astrophysics Data System (ADS)

    Sun, Mengchan; de Castro, Alberto; Ortiz, Sergio; Perez-Merino, Pablo; Birkenfeld, Judith; Marcos, Susana

    2014-06-01

    Measurement of intraocular lens (IOL) alignment implanted in patients in cataract surgery is important to understand their optical performance. We present a method to estimate tilt and decentration of IOLs based on optical coherence tomography (OCT) images. En face OCT images show Purkinje-like images that correspond to the specular reflections from the corneal and IOL surfaces. Unlike in standard Purkinje-imaging, the tomographic nature of OCT allows unequivocal association of the reflection with the corresponding surface. The locations of the Purkinje-like images are linear combinations of IOL tilt, IOL decentration, and eye rotation. The weighting coefficients depend on the individual anterior segment geometry, obtained from the same OCT datasets. The methodology was demonstrated on an artificial model eye with set amounts of lens tilt and decentration and five pseudophakic eyes. Measured tilt and decentration in the artificial eye differed by 3.7% and 0.9%, respectively, from nominal values. In patients, average IOL tilt and decentration from Purkinje were 3.30±4.68 deg and 0.16±0.16 mm, respectively, and differed on average by 0.5 deg and 0.09 mm, respectively, from direct measurements on distortion-corrected OCT images. Purkinje-based methodology from anterior segment en face OCT imaging provided, therefore, reliable measurements of IOL tilt and decentration.

  14. Current and future concepts of the design of the intraocular lens.

    PubMed

    Jaffe, N S

    1985-01-01

    Anterior chamber lenses are currently much less popular than posterior chamber lenses. They are mainly used in conjunction with intracapsular cataract extraction, as a secondary lens implant, and as a back up lens in case of intraoperative complications of extracapsular cataract extraction. A major disadvantage of anterior chamber lenses is improper sizing. Rigid lenses cause the greatest ocular tenderness and present serious problems with errors in sizing but they are the easiest to explant. Semiflexible and flexible lenses show a greater tendency to develop peripheral anterior synechiae. This makes explanation a very difficult procedure. Posterior chamber lenses are the most popular today. There is a trend toward all-PMMA lenses because of concern over the biocompatibility of polypropylene. The use of a laser ridge may inhibit posterior capsule opacification and facilitate YAG laser posterior capsulectomy. Ultraviolet blockers are being incorporated as a copolymer of a mechanical additive. There is a major trend towards capsular bag fixation of posterior chamber lenses as a result of complications associated with sulcus-fixated lenses. These include: disruption of the blood-aqueous barrier due to loop penetration of the ciliary body; chafing of the posterior surface of the iris leading to transillumination defects, microhyphaemas, and pigment dispersion glaucoma. It is predicted that the number of cataract extractions and the percentage of intraocular lens implantations will continue to increase due to demographic factors. Budgetary allocations for research and development will increase because of the involvement of some of the giants of medical industry. This will lead to new implant materials and new surgical techniques. PMID:3879394

  15. Long-term visual outcomes after Crystalens® HD intraocular lens implantation

    PubMed Central

    Karavitaki, Alexandra E; Pallikaris, Ioannis G; Panagopoulou, Sophia I; Kounis, George A; Kontadakis, George; Kymionis, George D

    2014-01-01

    Purpose Our purpose was to evaluate the long-term visual outcomes after bilateral implantation of Crystalens® HD (Bausch and Lomb, Inc.) accommodative intraocular lenses. Methods In this study, 25 patients (50 eyes) who underwent cataract surgery and bilateral Crystalens HD accommodative intraocular lens implantation were included. The Crystalens HD lens was implanted in the bag in both eyes, without any intra- or postoperative complications. The visual parameters measured before and after surgery were: uncorrected distance visual acuity, corrected distance visual acuity (CDVA) (using the Early Diabetic Retinopathy Study [EDTRS] logMAR charts), uncorrected intermediate visual acuity, and uncorrected near visual acuity using a Birkhäuser reading chart, at a distance of 66 cm and 33 cm for intermediate and near vision, respectively, directly illuminated by a lamp of 60 watts. After surgery, the patients were evaluated at 1, 3, 6, 12, 24, and 36 months. Results The mean age was 68.70±7.1 (range: 54 to 83) years. The mean follow-up was 42.72±0.49 (range: 42.33 to 43.27) months. The uncorrected distance visual acuity improved from 0.56±0.41 (range: 0 to 2) preoperatively to 0.19±0.13 (range: 0 to 0.38) (logMAR scale) at the last follow-up visit, and the CDVA improved from 0.17±0.18 (range: 0 to 0.7) preoperatively to 0.05±0.05 (range: −0.02 to 0.22) at the last follow-up visit. No eyes lost lines of CDVA during the follow-up period, while 54% of patients gained one or more lines of CDVA. The uncorrected intermediate and near visual acuity was J2 or better in 71% and 69% of our patients, respectively. Conclusion Crystalens HD implantation seems to provide an improvement in visual acuity for far, intermediate, and near distances. PMID:24899793

  16. Stability of Cachet Phakic Intraocular Lens Position During 6-Months Follow-Up

    PubMed Central

    Lomoriello, D Schiano; Lombardo, M; Gualdi, L; Iacobelli, L; Tranchina, L; Ducoli, P; Serrao, S

    2013-01-01

    Purpose: To evaluate the position stability of a phakic intraocular lens (Cachet pIOL; Alcon, Laboratories, Inc., Fort Worth, TX) in the anterior chamber (AC) during a 6-months follow-up. Methods: Thirty eyes of 16 subjects underwent a Cachet pIOL implantation for the correction of high myopia from -6.50 to -16.00 D with plano targeted refraction. The position stability of the Cachet pIOL was evaluated using an Anterior Segment-OCT (AS-OCT, Carl Zeiss AG, Oberkochen, Germany) at 1- and 6-months postoperatively. Three measurements have been taken into account: 1) the minimum distance between the anterior surface of the Cachet pIOL optic disk and the central corneal endothelium; 2) the minimum distance between the optic disk’s edges of the pIOL and the endothelium; 3) the minimum distance between the posterior surface of the pIOL optic disk and the anterior surface of the crystalline lens. The endothelial cell density (ECD) was also recorded. Results: No statistically significant changes of the Cachet pIOL position in the AC were found during follow-up. The average changes were ≤0.1 mm between 1- and 6-months postoperatively (P>0.05). At the end of follow-up, The mean ECD loss was 0.7 % (from 2794 ± 337 cell/mm2 to 2776 ± 388 cell/mm2; P>0.05). Conclusion: A high position stability of the Cachet pIOL in the anterior chamber was shown during a 6-months follow-up. PMID:23898355

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

    PubMed Central

    Mendoza-Mendieta, María Elena; Lorenzo-Mejía, Ana Aurora

    2016-01-01

    Background With aging, the crystalline lens turns yellowish, which increases the absorption of wavelengths in the blue electromagnetic spectrum, reducing their photoreception in the retina. Since these wavelengths are the main stimulus in the regulation of the circadian rhythm, progressive reduction in their transmission is associated with chronic sleep disturbances and depression in elderly patients. Cataract extraction improves circadian photoreception at any age. However, lenses that block blue waves have 27% to 38% less melatonin suppression than lenses that block only ultraviolet (UV) rays. Purpose To assess the depression symptoms in subjects who have had bilateral phacoemul-sification and intraocular lens (IOL) implants, one group with yellow chromophore IOLs and the other group with transparent IOLs were compared. Setting Association to Prevent Blindness in Mexico (APEC), Hospital “Dr Luis Sánchez Bulnes”. Design This was an observational, cross-sectional, and single-center study. Materials and methods Twenty-six subjects between 60 and 80 years of age, with a history of bilateral phacoemulsification and placement of the same type of IOL in both eyes from 4 to 12 months prior to the study, who attended the follow-up visits and agreed to participate in this study, and provided signed informed consent were included in the study. They were asked to answer the short version of the 15-item Geriatric Depression Scale. Results The average age of the study participants was 72.5±5.94 years. The group without chromophore included 46.1% (n=12) of the patients and the group with chromophore included 53.9% (n=14) of the patients (P=0.088). Conclusion In the group of patients with IOLs that block the passage of blue light, the depression rate was 21.4%, a rate similar to that observed in the elderly population, whereas no patients in the group with transparent IOLs had depression. PMID:27099465

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

    PubMed Central

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

    2015-01-01

    Purpose: To evaluate the predictability of the refractive correction achieved with a positional accommodating intraocular lenses (IOL) and to develop a potential optimization of it by minimizing the error associated with the keratometric estimation of the corneal power and by developing a predictive formula for the effective lens position (ELP). Materials and Methods: Clinical data from 25 eyes of 14 patients (age range, 52–77 years) and undergoing cataract surgery with implantation of the accommodating IOL Crystalens HD (Bausch and Lomb) were retrospectively reviewed. In all cases, the calculation of an adjusted IOL power (PIOLadj) based on Gaussian optics considering the residual refractive error was done using a variable keratometric index value (nkadj) for corneal power estimation with and without using an estimation algorithm for ELP obtained by multiple regression analysis (ELPadj). PIOLadj was compared to the real IOL power implanted (PIOLReal, calculated with the SRK-T formula) and also to the values estimated by the Haigis, HofferQ, and Holladay I formulas. Results: No statistically significant differences were found between PIOLReal and PIOLadj when ELPadj was used (P = 0.10), with a range of agreement between calculations of 1.23 D. In contrast, PIOLReal was significantly higher when compared to PIOLadj without using ELPadj and also compared to the values estimated by the other formulas. Conclusions: Predictable refractive outcomes can be obtained with the accommodating IOL Crystalens HD using a variable keratometric index for corneal power estimation and by estimating ELP with an algorithm dependent on anatomical factors and age. PMID:26139807

  19. Modulation of the pupil function of microscope objective lens for multifocal multi-photon microscopy using a spatial light modulator

    NASA Astrophysics Data System (ADS)

    Matsumoto, Naoya; Okazaki, Shigetoshi; Takamoto, Hisayoshi; Inoue, Takashi; Terakawa, Susumu

    2014-02-01

    We propose a method for high precision modulation of the pupil function of a microscope objective lens to improve the performance of multifocal multi-photon microscopy (MMM). To modulate the pupil function, we adopt a spatial light modulator (SLM) and place it at the conjugate position of the objective lens. The SLM can generate an arbitrary number of spots to excite the multiple fluorescence spots (MFS) at the desired positions and intensities by applying an appropriate computer-generated hologram (CGH). This flexibility allows us to control the MFS according to the photobleaching level of a fluorescent protein and phototoxicity of a specimen. However, when a large number of excitation spots are generated, the intensity distribution of the MFS is significantly different from the one originally designed due to misalignment of the optical setup and characteristics of the SLM. As a result, the image of a specimen obtained using laser scanning for the MFS has block noise segments because the SLM could not generate a uniform MFS. To improve the intensity distribution of the MFS, we adaptively redesigned the CGH based on the observed MFS. We experimentally demonstrate an improvement in the uniformity of a 10 × 10 MFS grid using a dye solution. The simplicity of the proposed method will allow it to be applied for calibration of MMM before observing living tissue. After the MMM calibration, we performed laser scanning with two-photon excitation to observe a real specimen without detecting block noise segments.

  20. Clinical Outcomes after Binocular Implantation of a New Trifocal Diffractive Intraocular Lens

    PubMed Central

    Kretz, Florian T. A.; Breyer, Detlev; Diakonis, Vasilios F.; Klabe, Karsten; Henke, Franziska; Auffarth, Gerd U.; Kaymak, Hakan

    2015-01-01

    Purpose. To evaluate visual, refractive, and contrast sensitivity outcomes, as well as the incidence of pseudophakic photic phenomena and patient satisfaction after bilateral diffractive trifocal intraocular lens (IOL) implantation. Methods. This prospective nonrandomized study included consecutive patients undergoing cataract surgery with bilateral implantation of a diffractive trifocal IOL (AT LISA tri 839MP, Carl Zeiss Meditec). Distance, intermediate, and near visual outcomes were evaluated as well as the defocus curve and the refractive outcomes 3 months after surgery. Photopic and mesopic contrast sensitivity, patient satisfaction, and halo perception were also evaluated. Results. Seventy-six eyes of 38 patients were included; 90% of eyes showed a spherical equivalent within ±0.50 diopters 3 months after surgery. All patients had a binocular uncorrected distance visual acuity of 0.00 LogMAR or better and a binocular uncorrected intermediate visual acuity of 0.10 LogMAR or better, 3 months after surgery. Furthermore, 85% of patients achieved a binocular uncorrected near visual acuity of 0.10 LogMAR or better. Conclusions. Trifocal diffractive IOL implantation seems to provide an effective restoration of visual function for far, intermediate, and near distances, providing high levels of visual quality and patient satisfaction. PMID:26301104

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

    PubMed

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

    2016-01-01

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

  2. Sutureless intrascleral intraocular lens fixation with lamellar dissection of scleral tunnel

    PubMed Central

    Kawaji, Takahiro; Sato, Tomoki; Tanihara, Hidenobu

    2016-01-01

    Purpose To report the results of sutureless scleral fixation of a posterior chamber intraocular lens (IOL) by using our developed simple technique. Methods We retrospectively reviewed the medical records of 48 eyes of 47 patients who underwent sutureless intrascleral IOL fixation by using our modified technique. A 25-gauge microvitreoretinal knife was used to perform sclerotomies and create limbus-parallel scleral tunnels with lamellar dissection in which the haptics were fixed. Results The IOLs were fixed and centered well. The mean follow-up period was 26.7 months. Postoperative complications included smooth vitreous hemorrhage in four eyes (8.3%), cystoid macular edema in two eyes (4.2%), and iris capture of the IOL in two eyes (4.2%). No other complications, such as breakage of the IOL, spontaneous IOL dislocation, or retinal detachment, were detected during the follow-up period. Conclusion The lamellar dissection of the limbus-parallel scleral tunnel can simplify the forceps-assisted introduction of the haptics into the scleral tunnel, and this technique seemed to be safe. PMID:26869757

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

    PubMed Central

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

    2016-01-01

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

  4. Tram-Track Suture Technique for Pupillary Capture of a Scleral Fixated Intraocular Lens

    PubMed Central

    Kim, Sung In; Kim, Kiseok

    2016-01-01

    Purpose To report a new technique using tram-track suture for pupillary capture of a scleral fixated posterior chamber intraocular lens (PC-IOL) to reposition the tilted IOL. Methods In this prospective interventional case series, we describe a tram-track suture for pupillary capture of a scleral fixated PC-IOL. A long straight needle with double-armed 10-0 polypropylene is passed behind the iris and just above the optic portion (tilted forward) of the IOL. The other straight needle with double-armed 10-0 polypropylene is passed just below the optic portion (tilted backward) of the IOL. After the IOL is repositioned properly, the polypropylene sutures are gently pulled and tied. Results Four eyes of 4 patients underwent tram-track suture for pupillary capture of a scleral fixated PC-IOL. No intra- or postoperative complications were noted, and no pupillary captures were detected during the follow-up period. Conclusions The tram-track suture technique provides good centration and stability of a PC-IOL. This technique is an easy and effective way to reposition pupillary capture of an IOL. Further, it is also minimally invasive as it maintains a closed system. PMID:27462257

  5. The Application of a Contact Lens Sensor in Detecting 24-Hour Intraocular Pressure-Related Patterns

    PubMed Central

    2016-01-01

    Glaucoma is one of the leading causes of blindness worldwide. Recent studies suggest that intraocular pressure (IOP) fluctuations, peaks, and rhythm are important factors in disease advancement. Yet, current glaucoma management remains hinged on single IOP measurements during clinic hours. To overcome this limitation, 24-hour IOP monitoring devices have been employed and include self-tonometry, permanent IOP, and temporary IOP monitoring. This review discusses each IOP measuring strategy and focuses on the recently FDA-approved contact lens sensor (CLS). The CLS records IOP-related ocular patterns for 24 hours continuously. Using the CLS, IOP-related parameters have been found to be associated with the rate of visual field progression in primary open-angle glaucoma, disease progression in primary angle-closure glaucoma, and various clinical variables in ocular hypertension. The CLS has been used to quantify blink rate and limbal strain and measure the circadian rhythm in a variety of disease states including normal-tension glaucoma and thyroid eye disease. The effects of various IOP-lowering interventions were also characterized using the CLS. CLS provides a unique, safe, and well-tolerated way to study IOP-related patterns in a wide range of disease states. IOP-related patterns may help identify patients most at risk for disease progression and assist with the development of tailored treatments. PMID:27525110

  6. Biological performance of functionalized biomedical polymers for potential applications as intraocular lens.

    PubMed

    Zheng, Zhiwen; Wang, Yingjun; Jiao, Yan; Zhai, Zhichen

    2016-08-01

    To study the biological performance of surface-modified biomedical polymer materials, a model of the functional mechanism of nonspecific adsorption resistance was constructed. Cell behavior on the surface and in vivo transplantation features of intraocular lens (IOL) materials, such as hydrophobic acrylic ester and polymethyl methacrylate (PMMA), were investigated. The results of cell adhesion and proliferation studies showed that the addition of hirudin can significantly resist epithelial cell adhesion, better than the pure amination process, and thereby inhibit excessive proliferation on the surface. Experiments on the eyes of rabbits indicated that the IOL surfaces with hirudin modification reduced the incidence of cell aggregation and inflammation. Combined with a study of protein-resistant layer construction with recombinant hirudin on the material surface, the mechanism of surface functionalization was determined. The biological performance indicated that nonspecific adsorption is greatly decreased due to the existence of amphiphilic ions or hydration layers, which lead to stability and long-term resistance to nonspecific adsorption. These results offer a theoretical basis for the use of traditional biomedical polymer materials in long-term clinical applications. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 1961-1967, 2016. PMID:27027387

  7. The Application of a Contact Lens Sensor in Detecting 24-Hour Intraocular Pressure-Related Patterns.

    PubMed

    Xu, Sarah C; Gauthier, Angela C; Liu, Ji

    2016-01-01

    Glaucoma is one of the leading causes of blindness worldwide. Recent studies suggest that intraocular pressure (IOP) fluctuations, peaks, and rhythm are important factors in disease advancement. Yet, current glaucoma management remains hinged on single IOP measurements during clinic hours. To overcome this limitation, 24-hour IOP monitoring devices have been employed and include self-tonometry, permanent IOP, and temporary IOP monitoring. This review discusses each IOP measuring strategy and focuses on the recently FDA-approved contact lens sensor (CLS). The CLS records IOP-related ocular patterns for 24 hours continuously. Using the CLS, IOP-related parameters have been found to be associated with the rate of visual field progression in primary open-angle glaucoma, disease progression in primary angle-closure glaucoma, and various clinical variables in ocular hypertension. The CLS has been used to quantify blink rate and limbal strain and measure the circadian rhythm in a variety of disease states including normal-tension glaucoma and thyroid eye disease. The effects of various IOP-lowering interventions were also characterized using the CLS. CLS provides a unique, safe, and well-tolerated way to study IOP-related patterns in a wide range of disease states. IOP-related patterns may help identify patients most at risk for disease progression and assist with the development of tailored treatments. PMID:27525110

  8. Accuracy of Intraocular Lens Power Formulas Involving 148 Eyes with Long Axial Lengths: A Retrospective Chart-Review Study.

    PubMed

    Chen, Chong; Xu, Xian; Miao, Yuyu; Zheng, Gaoxin; Sun, Yong; Xu, Xun

    2015-01-01

    Purpose. This study aims to compare the accuracy of intraocular lens power calculation formulas in eyes with long axial lengths from Chinese patients subjected to cataract surgery. Methods. A total of 148 eyes with an axial length of >26 mm from 148 patients who underwent phacoemulsification with intraocular lens implantation were included. The Haigis, Hoffer Q, Holladay 1, and SRK/T formulas were used to calculate the refractive power of the intraocular lenses and the postoperative estimated power. Results. Overall, the Haigis formula achieved the lowest level of median absolute error 1.025 D (P < 0.01 for Haigis versus each of the other formulas), followed by SRK/T formula (1.040 D). All formulas were least accurate when eyes were with axial length of >33 mm, and median absolute errors were significantly higher for those eyes than eyes with axial length = 26.01-30.00 mm. Absolute error was correlated with axial length for the SRK/T (r = 0.212, P = 0.010) and Hoffer Q (r = 0.223, P = 0.007) formulas. For axial lengths > 33 mm, eyes exhibited a postoperative hyperopic refractive error. Conclusions. The Haigis and SRK/T formulas may be more suitable for calculating intraocular lens power for eyes with axial lengths ranging from 26 to 33 mm. And for axial length over 33 mm, the Haigis formula could be more accurate. PMID:26793392

  9. 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

  10. Postsurgical Cystoid Macular Edema following Posterior Chamber Toric Phakic Intraocular Lens Implantation Surgery: A Case Report

    PubMed Central

    Canan, Julide; Akkan, Umurhan; Tuncer, Kemal; Elbay, Ahmet

    2015-01-01

    Purpose To describe a case of cystoid macular edema (CME) developing after posterior chamber toric phakic intraocular lens (PIOL) implantation. Methods Case report. Results A 33-year-old male underwent implantation of toric implantable collamer lenses (ICL), a new generation of PIOLs, for both eyes. Preoperative best spectacle-corrected distance visual acuity (BCVA) was 20/25 in the right eye and 20/32 in the left eye, with a manifest refraction of −9.25 −4.0 × 4° and −9.75 −4.25 × 171°, respectively. On day 1 postoperatively, the left eye had an uncorrected distance visual acuity (UDVA) of 20/60 with a refraction of +2.0 −3.5 × 11°. Despite the rotation of the PIOL, the cylindrical refractive component persisted in the left eye with a refraction of +2.0 −3.5 × 11°. Two weeks after the initial surgery, he presented with a decrease in his visual acuity in the left eye. The UDVA and BCVA were both 20/100 in the left eye with a refraction of +2.0 −4.25 × 3°. Dilated fundus examination and macular optical coherence tomography revealed a CME in the left eye. Following topical nepafenac therapy and explantation of the ICL, we observed a complete resolution of the CME at 3 months with an improvement in BCVA to 20/32 in the left eye. Conclusions To our knowledge, this is the first reported case of postsurgical CME following toric ICL implantation. In cases of phakic eyes with an intact posterior capsule, postsurgical CME can develop, thus highlighting the purpose of this report. PMID:26265909

  11. Predictability of Intraocular Lens Power Calculation After Simultaneous Pterygium Excision and Cataract Surgery.

    PubMed

    Kamiya, Kazutaka; Shimizu, Kimiya; Iijima, Kei; Shoji, Nobuyuki; Kobashi, Hidenaga

    2015-12-01

    This study was aimed to assess the predictability of intraocular lens (IOL) power calculation after simultaneous pterygium excision and phacoemulsification with IOL implantation. We retrospectively reviewed the clinical charts of 60 eyes of 60 consecutive patients (mean age ± standard deviation, 73.5 ± 7.0 years) who developed pterygium and cataract. We determined visual acuity (logMAR), manifest spherical equivalent, manifest astigmatism, corneal astigmatism, and mean keratometry, preoperatively and 3 months postoperatively. Corrected visual acuity was significantly improved from 0.19 ± 0.20 preoperatively to -0.06 ± 0.07 postoperatively (P < 0.001, Wilcoxon signed-rank test). Uncorrected visual acuity was also significantly improved from 0.62 ± 0.33 preoperatively to 0.31 ± 0.32 postoperatively (P < 0.001). At 3 months, 48% and 82% of the eyes were within ± 0.5 and ± 1.0 D, respectively, of the targeted correction. We found significant correlations of the prediction errors with the changes in the mean keratometry (Spearman signed-rank test, r = -0.535, P < 0.001) and with the pterygium size (r = -0.378, P = 0.033). Simultaneous pterygium and cataract surgery was safe and effective, and the accuracy was moderately predictable. However, it should be noted that a significant myopic shift occurred postoperatively, possibly resulting from the steepening of the cornea after pterygium removal, especially when the size of pterygium was large. PMID:26717362

  12. Accelerated 20-year sunlight exposure simulation of a photochromic foldable intraocular lens in a rabbit model

    PubMed Central

    Werner, Liliana; Abdel-Aziz, Salwa; Peck, Carolee Cutler; Monson, Bryan; Espandar, Ladan; Zaugg, Brian; Stringham, Jack; Wilcox, Chris; Mamalis, Nick

    2011-01-01

    PURPOSE To assess the long-term biocompatibility and photochromic stability of a new photochromic hydrophobic acrylic intraocular lens (IOL) under extended ultraviolet (UV) light exposure. SETTING John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. DESIGN Experimental study. METHODS A Matrix Aurium photochromic IOL was implanted in right eyes and a Matrix Acrylic IOL without photochromic properties (n = 6) or a single-piece AcrySof Natural SN60AT (N = 5) IOL in left eyes of 11 New Zealand rabbits. The rabbits were exposed to a UV light source of 5 mW/cm2 for 3 hours during every 8-hour period, equivalent to 9 hours a day, and followed for up to 12 months. The photochromic changes were evaluated during slitlamp examination by shining a penlight UV source in the right eye. After the rabbits were humanely killed and the eyes enucleated, study and control IOLs were explanted and evaluated in vitro on UV exposure and studied histopathologically. RESULTS The photochromic IOL was as biocompatible as the control IOLs after 12 months under conditions simulating at least 20 years of UV exposure. In vitro evaluation confirmed the retained optical properties, with photochromic changes observed within 7 seconds of UV exposure. The rabbit eyes had clinical and histopathological changes expected in this model with a 12-month follow-up. CONCLUSIONS The new photochromic IOL turned yellow only on exposure to UV light. The photochromic changes were reversible, reproducible, and stable over time. The IOL was biocompatible with up to 12 months of accelerated UV exposure simulation. PMID:21241924

  13. Clinical performance of a new aspheric dual-optic accommodating intraocular lens

    PubMed Central

    Marques, Eduardo F; Castanheira-Dinis, António

    2014-01-01

    Purpose To describe the clinical performance of a new dual-optic intraocular lens (IOL) with an enhanced optic profile designed to mimic natural accommodation. Patients and methods Prospective multicenter clinical study with the new dual-optic aspheric accommodating IOL (Synchrony Vu) in 74 patients (148 eyes) undergoing cataract surgery. Refractive target was emmetropia. Examinations at 1 month and 6 months included subjective refractions; visual acuities at near, intermediate, and far; mesopic contrast sensitivity with and without glare; safety data; and subjective survey on dysphotopsia (halos and glare). Results Clinical data at 6 months showed 89% of the eyes within ±1.0 D spherical equivalent refraction. Mean binocular uncorrected and distance-corrected visual acuity was 20/20 at far (0.00±0.11 logMAR and −0.06±0.08 logMAR, respectively), 20/20 at intermediate (0.01±0.13 logMAR and −0.01±0.10 logMAR, respectively), and 20/25 at near (0.10±0.14 logMAR and 0.14±0.15 logMAR, respectively). Mesopic contrast sensitivity was within normal limits. Seventy-eight percent of the patients had no spectacles and 70% had no dysphotopsia. One eye had IOL repositioning within 1 month of surgery. Conclusion The new aspheric Synchrony Vu accommodating IOL provided good visual performance at a range of distances without affecting quality of vision and with minimal safety considerations. PMID:25429198

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

    PubMed Central

    Mazzini, Cinzia

    2013-01-01

    Purpose The aim of this study was to evaluate and report the visual, refractive and aberrometric outcomes of cataract surgery with implantation of the new aspheric Tecnis ZCT toric intraocular lens (IOL) in eyes with low to moderate corneal astigmatism. Methods We conducted a prospective study of 19 consecutive eyes of 17 patients (mean age: 78 years) with a visually significant cataract and moderate corneal astigmatism [higher than 1 diopter (D)] undergoing cataract surgery with implantation of the aspheric Tecnis ZCT toric IOL (Abbott Medical Optics). Visual, refractive and aberrometric changes were evaluated during a 6-month follow-up. Ocular aberrations as well as IOL rotation were evaluated by means of the OPD-Station II (Nidek). Results The six-month postoperative spherical equivalent and power vector components of the refractive cylinder were within ±0.50 D in all eyes (100%). Postoperative logMAR uncorrected and corrected distance visual acuities (UDVA/CDVA) were 0.1 (about 20/25) or better in almost all eyes (94.74%). The mean logMAR CDVA improved significantly from 0.41 ± 0.23 to 0.02 ± 0.05 (p < 0.01). No significant changes were found in corneal astigmatism (p = 0.73). The mean IOL rotation was 3.33 ± 1.94°. This parameter did not correlate with higher-order aberrations (r = −0.09, p = 0.73). A significant improvement in the Strehl ratio was also observed (p < 0.01), which was consistent with the significant reduction in higher-order aberrations (p = 0.02). Conclusion Cataract surgery with implantation of the aspheric Tecnis ZCT IOL is a predictable and effective procedure for visual rehabilitation in eyes with cataract and low to moderate corneal astigmatism, providing an excellent postoperative ocular optical quality. PMID:23898293

  15. Visual and optical performance of eyes with different corneal spherical aberration implanted with aspheric intraocular lens

    PubMed Central

    Gong, Xian-Hui; Zheng, Qin-Xiang; Wang, Na; Chen, Ding; Zhao, Juan; Li, Jin; Zhao, Yun-E

    2012-01-01

    AIM To compare the visual and optical performance of eyes with different corneal spherical aberration (SA) implanted with spherical aberration-free intraocular lens (IOLs). METHODS Thirty-six patients with different corneal SA had phacoemulsification with implantation of spherical aberration-free IOLs. Patients were divided into 3 groups according to the value of preoperative corneal SA. Eyes with corneal SA <0.10µm were assigned to group A, those with 0.10 ≤corneal SA <0.20µm to Group B, and those with 0.20≤ corneal SA <0.35µm to Group C. Best-corrected visual acuity (BCVA), contrast sensitivity, corneal SA, total ocular aberrations, and depth of focus were recorded 3 months postoperatively. Distance-corrected near and intermediate visual acuity was studied to measure depth of focus. RESULTS BCVA and contrast sensitivity were similar between groups. There were no significant differences in distance-corrected near or intermediate visual acuity. Corneal SA was similar before and 3 months after surgery in the 3 groups. With a 5.0mm pupil diameter, root mean square values for total ocular higher-order aberrations (HOAs) were lower in groups A and B than in group C. Total ocular SA was lower in group A than in groups B and C. SA was also lower in group B than in group C. Coma and trefoil were similar between the groups. CONCLUSION Implantation of spherical aberration-free IOLs in eyes with different corneal SA results in similar visual performance at BCVA, contrast sensitivity and depth of focus. PMID:22773981

  16. Accuracy of Corneal Power Measurements for Intraocular Lens Power Calculation after Myopic Laser In situ Keratomileusis

    PubMed Central

    Helaly, Hany A.; El-Hifnawy, Mohammad A. M.; Shaheen, Mohamed Shafik; Abou El-Kheir, Amr F.

    2016-01-01

    Purpose: To evaluate the accuracy of corneal power measurements for intraocular lens (IOL) power calculation after myopic laser in situ keratomileusis (LASIK). Methods: The study evaluated 45 eyes with a history of myopic LASIK. Corneal power was measured using manual keratometry, automated keratometry, optical biometry, and Scheimflug tomography. Different hypothetical IOL power calculation formulas were performed for each case. Results: The steepest mean K value was measured with manual keratometry (37.48 ± 2.86 D) followed by automated keratometry (37.31 ± 2.83 D) then optical biometry (37.06 ± 2.98 D) followed by Scheimflug tomography (36.55 ± 3.08). None of the K values generated by Scheimflug tomography were steeper than the measurements from the other 3 instruments. Using equivalent K reading (EKR) 4 mm with the Double-K SRK/T formula, the refractive outcome generated 97.8% of cases within ± 2 D, 80.0% of cases within ± 1 D, and 42.2% of cases within ± 0.5 D. The best combination of formulas was “Shammas-PL + Double-K SRK/T formula using EKR 4 mm.” Conclusion: Scheimflug tomography imaging using the Holladay EKR 4 mm improved the accuracy of IOL power calculation in post-LASIK eyes. The best option is a combination of formulas. We recommended the use the combined “Shammas-PL ± Double-K SRK/T formula using EKR 4 mm”h for optical outcomes. PMID:26957851

  17. Pupil Dilation with Intracameral Epinephrine Hydrochloride during Phacoemulsification and Intraocular Lens Implantation

    PubMed Central

    Yu, A-Yong; Guo, Hua; Wang, Qin-Mei; Bao, Fang-Jun; Huang, Jing-Hai

    2016-01-01

    Objective. To investigate mydriatic effect of intracamerally injected epinephrine hydrochloride during phacoemulsification and intraocular lens (IOL) implantation. Methods. Eighteen cataract patients for bilateral phacoemulsification were enrolled. To dilate pupil, one eye was randomly selected to receive intracamerally 1 mL epinephrine hydrochloride 0.001% for 1 minute after corneal incision (intracameral group), and the contralateral eye received 3 drops of compound tropicamide 0.5% and phenylephrine 0.5% at 5-minute intervals 30 minutes before surgery (topical group). Pupil diameters were measured before corneal incision, before ophthalmic viscoelastic device (OVD) injection, after OVD injection, before IOL implantation, and at the end of surgery. Results. At each time point, the mean pupil diameter in the intracameral group was 2.20 ± 0.08, 5.09 ± 0.20, 6.76 ± 0.19, 6.48 ± 0.18, and 5.97 ± 0.24 mm, respectively, and in the topical group it was 7.98 ± 0.15, 7.98 ± 0.15, 8.53 ± 0.14, 8.27 ± 0.16, and 7.93 ± 0.20 mm, respectively. The topical group consistently had larger mydriatic effects than the intracameral group (P < 0.05). The onset of mydriatic effect was rapid in the intracameral group. There was no difference in surgical performance or other parameters between groups. Conclusions. Intracameral epinephrine hydrochloride appears to be an alternative to the mydriatic modalities for phacoemulsification and IOL implantation. In comparison with topical mydriatics, intracameral epinephrine hydrochloride offers easier preoperative preparation, more rapid pupil dilation, and comparable surgical performance. PMID:26904274

  18. Pupil Dilation with Intracameral Epinephrine Hydrochloride during Phacoemulsification and Intraocular Lens Implantation.

    PubMed

    Yu, A-Yong; Guo, Hua; Wang, Qin-Mei; Bao, Fang-Jun; Huang, Jing-Hai

    2016-01-01

    Objective. To investigate mydriatic effect of intracamerally injected epinephrine hydrochloride during phacoemulsification and intraocular lens (IOL) implantation. Methods. Eighteen cataract patients for bilateral phacoemulsification were enrolled. To dilate pupil, one eye was randomly selected to receive intracamerally 1 mL epinephrine hydrochloride 0.001% for 1 minute after corneal incision (intracameral group), and the contralateral eye received 3 drops of compound tropicamide 0.5% and phenylephrine 0.5% at 5-minute intervals 30 minutes before surgery (topical group). Pupil diameters were measured before corneal incision, before ophthalmic viscoelastic device (OVD) injection, after OVD injection, before IOL implantation, and at the end of surgery. Results. At each time point, the mean pupil diameter in the intracameral group was 2.20 ± 0.08, 5.09 ± 0.20, 6.76 ± 0.19, 6.48 ± 0.18, and 5.97 ± 0.24 mm, respectively, and in the topical group it was 7.98 ± 0.15, 7.98 ± 0.15, 8.53 ± 0.14, 8.27 ± 0.16, and 7.93 ± 0.20 mm, respectively. The topical group consistently had larger mydriatic effects than the intracameral group (P < 0.05). The onset of mydriatic effect was rapid in the intracameral group. There was no difference in surgical performance or other parameters between groups. Conclusions. Intracameral epinephrine hydrochloride appears to be an alternative to the mydriatic modalities for phacoemulsification and IOL implantation. In comparison with topical mydriatics, intracameral epinephrine hydrochloride offers easier preoperative preparation, more rapid pupil dilation, and comparable surgical performance. PMID:26904274

  19. In vitro optical performance of a new aberration-free intraocular lens

    PubMed Central

    Madrid-Costa, D; Ruiz-Alcocer, J; Ferrer-Blasco, T; García-Lázaro, S; Montés-Micó, R

    2014-01-01

    Purpose To assess the optical performance of the new EnVista intraocular lens (IOL). Materials and methods Four aspheric IOLs were evaluated; the new EnVista is one amoung them. This IOL, similarly to the Z-Flex HB and the Bi-Flex 1.8 667AB ones, has a neutral aspheric design, whereas the fourth IOL under test (AcrySof IQ IOL SN60WF) presents a negative spherical aberration (SA). The IOL's aberration patterns were measured in vitro, by setting them up on an optical bench. From these aberration-pattern data, the modulation transfer function (MTF), the average modulation values, and the points spread function (PSF) were calculated. Furthermore, in order to assess the potential optical quality that these IOLs would yield once they are implanted, an average corneal-aberration pattern was juxtaposed to the in-vitro profiles and the same parameters were calculated again. Results For the IOL-only scenario (ie, without including the corneal factor), it was the EnVista IOL, which is aberration-free that showed the higher MTF, PSF values. This was followed by the other two aberration-free IOL models. However, when the effect of an average corneal pattern was also taken into consideration, the AcrySof IQ IOL SN60WF always outperformed the other neutral-asphericity IOLs. Conclusions The in-vitro optical performance of the EnVista IOL was good, but it decreases substantially in a whole-eye scenario, when the wavefront profile of an average cornea is added. Other designs with different degrees of SA should be considered for this IOL in order to surpass these results. PMID:24556881

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

    PubMed Central

    Lubiński, Wojciech; Kaźmierczak, Beata; Gronkowska-Serafin, Jolanta; Podborączyńska-Jodko, Karolina

    2016-01-01

    Purpose. To evaluate the clinical outcomes after uncomplicated cataract surgery with implantation of an aspheric toric intraocular lens (IOL) during a 6-month follow-up. Methods. Prospective study including 27 consecutive eyes of 18 patients (mean age: 66.1 ± 11.4 years) with a visually significant cataract and corneal astigmatism ≥ 0.75 D and undergoing uncomplicated cataract surgery with implantation of the Tecnis ZCT toric IOL (Abbott Medical Optics). Visual, refractive, and keratometric outcomes as well as IOL rotation were evaluated during a 6-month follow-up. At the end of the follow-up, patient satisfaction and perception of optical/visual disturbances were also evaluated using a subjective questionnaire. Results. At 6 months after surgery, mean LogMAR uncorrected (UDVA) and corrected distance visual acuity (CDVA) were 0.19 ± 0.12 and 0.14 ± 0.10, respectively. Postoperative UDVA of 20/40 or better was achieved in 92.6% of eyes. Mean refractive cylinder decreased significantly from −3.73 ± 1.96 to −1.42 ± 0.88 D (p < 0.001), while keratometric cylinder did not change significantly (p = 0.44). Mean absolute IOL rotation was 1.1 ± 2.4°, with values of more than 5° in only 2 eyes (6.9%). Mean patient satisfaction score was 9.70 ± 0.46, using a scale from 0 (not at all satisfied) to 10 (very satisfied). No postoperative optical/visual disturbances were reported. Conclusion. Cataract surgery with implantation of the Tecnis toric IOL is an effective method of refractive correction in eyes with corneal astigmatism due to the good IOL positional stability, providing high levels of patient's satisfaction. PMID:27022478

  1. Simultaneous corneal crosslinking and surface ablation combined with phakic intraocular lens implantation for managing keratoconus.

    PubMed

    Assaf, Ahmed; Kotb, Ahmed

    2015-06-01

    To assess the efficacy and stability of simultaneous topography-guided photorefractive keratectomy (PRK) and crosslinking (Athens protocol) followed by phakic intraocular lens (IOL) implantation for managing keratoconus. Ain-Shams University, Cairo, Egypt. Prospective non-randomized study. All patients underwent topography-guided PRK followed immediately by collagen crosslinking (Athens protocol), 2-4 months later, eyes were implanted with either an iris claw or an angle-supported phakic IOL. Statistical analysis was performed with SigmaPlot software version 11.0 (Systat Software, Inc.). This study evaluated 22 eyes of 14 patients. Follow-up interval was at least 6 months. A Veriflex phakic IOL was implanted in 14 eyes (63.6 %), and a Cachet phakic IOL was implanted in 8 eyes (36.4 %). The mean preoperative keratometric reading (45.57 ± 1.51 D) was significantly reduced at 3 months and at 6 months after treatment (43.82 ± 1.98 D, P < 0.001). The mean spherical equivalent was significantly reduced from -9.08 ± 2.5 to -0.69 ± 0.67 D, P = <0.001. The mean UCVA improved from 1.24 ± 0.49 to 0.37 ± 0.08 logMAR. The mean corrected distance visual acuity (CDVA; logMAR) improved from 0.69 ± 0.3 preoperatively to 0.35 ± 0.01 postoperatively (P = <0.001). At last follow-up, all eyes could achieve CDVA of 0.3 or better. The difference between pre- and postoperative endothelial cell counts was not statistically significant. Combining phakic IOLs and the Athens protocol improved and stabilized visual performance in patients with keratoconus. These results justify a future, large-scale study with a longer follow-up. PMID:24980419

  2. [Special intra-ocular lenses].

    PubMed

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

    1990-01-01

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

  3. Refractive cylinder outcomes after calculating toric intraocular lens cylinder power using total corneal refractive power

    PubMed Central

    Davison, James A; Potvin, Richard

    2015-01-01

    Purpose To determine whether the total corneal refractive power (TCRP) value, which is based on measurement of both anterior and posterior corneal astigmatism, is effective for toric intraocular lens (IOL) calculation with AcrySof® Toric IOLs. Patients and methods A consecutive series of cataract surgery cases with AcrySof toric IOL implantation was studied retrospectively. The IOLMaster® was used for calculation of IOL sphere, the Pentacam® TCRP 3.0 mm apex/ring value was used as the keratometry input to the AcrySof Toric IOL Calculator and the VERION™ Digital Marker for surgical orientation. The keratometry readings from the VERION reference unit were recorded but not used in the actual calculation. Vector differences between expected and actual residual refractive cylinder were calculated and compared to simulated vector errors using the collected VERION keratometry data. Results In total, 83 eyes of 56 patients were analyzed. Residual refractive cylinder was 0.25 D or lower in 58% of eyes and 0.5 D or lower in 80% of eyes. The TCRP-based calculation resulted in a statistically significantly lower vector error (P<0.01) and significantly more eyes with a vector error ≤0.5 D relative to the VERION-based calculation (P=0.02). The TCRP and VERION keratometry readings suggested a different IOL toric power in 53/83 eyes. In these 53 eyes the TCRP vector error was lower in 28 cases, the VERION error was lower in five cases, and the error was equal in 20 cases. When the anterior cornea had with-the-rule astigmatism, the VERION was more likely to suggest a higher toric power and when the anterior cornea had against-the-rule astigmatism, the VERION was less likely to suggest a higher toric power. Conclusion Using the TCRP keratometry measurement in the AcrySof toric calculator may improve overall postoperative refractive results. Consideration of measured posterior corneal astigmatism, rather than a population-averaged value, appears advantageous. PMID:26316693

  4. Visual Outcomes, Patient Satisfaction and Spectacle Independence with a Trifocal Diffractive Intraocular Lens

    PubMed Central

    Kretz, Florian Tobias Alwin; Choi, Chul Young; Müller, Matthias; Gerl, Matthias; Gerl, Ralf Helmar

    2016-01-01

    Purpose To evaluate visual outcomes following implantation of a trifocal diffractive intraocular lens (IOL) and to analyze their correlation with patient satisfaction and ease of performing daily tasks. Methods This was a prospective study enrolling 100 eyes of 50 patients undergoing cataract surgery with implantation of trifocal IOL AT LISA tri 839MP. Visual and refractive outcomes were evaluated during a 3-month follow-up. Postoperatively, a questionnaire was used to evaluate patient satisfaction with regard to surgical outcome, spectacle independence, perception of photic phenomena, and ease of performing some vision-related activities. Results A total of 91%, 87%, and 79% of eyes achieved a monocular uncorrected distance, near, and intermediate visual acuity of 0.1 logarithm of the minimum angle of resolution or better, respectively. After the surgery, 96% of the patients could perform their daily activities without problems. The mean spectacle independence scores for reading, doing computer work, and for distance were 10.33 ± 12.47, 5.71 ± 11.90, and 3.92 ± 9.77, respectively (scale: 0 = no spectacles needed; 40 = spectacles always needed). No correlation was found between spectacle independence and visual outcome (-0.101 ≤ r ≤ 0.244, p ≥ 0.087). Mean scores (0 = no symptoms; 40 = strong symptoms) for glare at night, ghost images, and halos were 15.15 ± 12.02, 4.49 ± 7.92, and 13.34 ± 10.82, respectively. No correlation was found between photic phenomena and visual outcome (-0.199 ≤ r ≤ 0.209, p ≥ 0.150). A total of 80% of patients reported satisfaction with the surgery outcome, and 86% would recommend the surgery to friends and family. Conclusions Implantation of the AT LISA tri 839MP IOL after cataract surgery provides effective visual restoration associated with a minimal level of photic phenomena, a positive impact on the performance of vision-related daily activities, and a high level of postoperative patient satisfaction. PMID:27247517

  5. Astigmatism management in cataract surgery with Precizon® toric intraocular lens: a prospective study

    PubMed Central

    Vale, Carolina; Menezes, Carlos; Firmino-Machado, J; Rodrigues, Pedro; Lume, Miguel; Tenedório, Paula; Menéres, Pedro; Brochado, Maria do Céu

    2016-01-01

    Purpose The purpose of this study was to evaluate the visual and refractive outcomes and rotational stability of the new aspheric Precizon® toric intraocular lens (IOL) for the correction of corneal astigmatism in cataract surgery. Setting Department of Ophthalmology, Hospital Geral de Santo António – Centro Hospitalar do Porto, EPE and Hospital de Pedro Hispano, Matosinhos, Portugal. Design This was a prospective clinical study. Patients and methods A total of 40 eyes of 27 patients with corneal astigmatism greater than 1.0 diopter (D) underwent cataract surgery with implantation of Precizon® toric IOL. IOL power calculation was performed using optical coherence biometry (IOLMaster®). Outcomes of uncorrected (UDVA) and best-spectacle corrected distance visual acuities (BCDVA), refraction, and IOL rotation were analyzed at the 1st week, 1st, 3rd, and 6th month’s evaluations. Results The median postoperative UDVA was better than preoperative best-spectacle corrected distance visual acuity (0.02 [0.06] logMAR vs 0.19 [0.20] logMAR, P<0.001). At 6 months, postoperative UDVA was 0.1 logMAR or better in 95% of the eyes. At last follow-up, the mean spherical equivalent was reduced from −3.35±3.10 D to −0.02±0.30 D (P<0.001) with 97.5% of the eyes within ±0.50 D of emmetropia. The mean preoperative keratometric cylinder was 2.34±0.95 D and the mean postoperative refractive cylinder was 0.24±0.27 D (P<0.001). The mean IOL rotation was 2.43°±1.55°. None of the IOLs required realignment. Conclusion Precizon® toric IOL revealed very good rotational stability and performance regarding predictability, efficacy, and safety in the correction of preexisting regular corneal astigmatism associated with cataract surgery. PMID:26855559

  6. Visual Outcomes and Complications of Piggyback Intraocular Lens Implantation Compared to Aphakia for Infantile Cataract

    PubMed Central

    Joshaghani, Mahmood; Soleimani, Mohammad; Foroutan, Alireza; Yaseri, Mehdi

    2015-01-01

    Purpose: To evaluate the long-term visual outcomes and complications of the piggyback intraocular lens (IOL) implantation compared to aphakia for infantile cataract. Patients and Methods: In a comparative study from 1998 to 2007, piggyback IOL implantation (piggyback IOL group) was performed for 14 infants (23 eyes) with infantile cataract and 20 infants (32 eyes) who were aphakic (aphakia group) after infantile cataract surgery. Data were collected on logMAR visual acuity, and postoperative complications over a mean follow-up time of 6.2 ± 1.7 years and 5.8 ± 1.7 years. Results: The mean age at surgery was 7.5 ± 0.6 months and 6.0 ± 3.3 months for the piggyback and the aphakic group respectively (P > 0.05). At the last follow-up visit, visual acuity was 0.85 ± 0.73 (median = 0.70, interquartile range = 0.3–1.32) in the piggyback IOL group and 0.89 ± 0.56 (median = 0.86, interquartile range = 0.50–1.24) in the aphakic group (P > 0.05). There was a positive relationship between age and visual outcomes in the aphakic group (r = 0.4, P = 0.04) but not in the piggyback IOL group (P = 0.48). There was no significant difference between the mean myopic shift in the piggyback IOL group (∑5.28 ± 1.06 D) and the aphakic group (∑5.10 ± 1.02 D) (P > 0.05). The incidence of reoperation due to complications in piggyback IOL group was higher than aphakic group (%48 vs. %16, respectively, P ≤ 0.01). However, in patients older than 6 months, this risk was not significantly different compared to the aphakic group. Conclusions: Although piggyback IOL implantation for infantile cataract is optically acceptable as a treatment option, there is no significant difference in visual outcomes compared to aphakia. The incidence in reoperation due to complications in patients aged 6 months or younger is higher than those treated with aphakia. PMID:26692724

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

    PubMed Central

    Hassan, Alahmady Hamad Alsmman; Sayed, Khulood M.; ElAgooz, Mohammed; Elhawary, Ashraf Mostafa

    2016-01-01

    In this study we evaluate the visual outcomes, safety, efficacy, and stability of implanting of second sulcus intraocular lens (IOL) to correct unsatisfied ametropic patients after phacoemulsification. Methods. Retrospective study of 15 eyes (15 patients) underwent secondary intraocular lens implanted into the ciliary sulcus. The IOL used was a Sensar IOL three-piece foldable hydrophobic acrylic IOL. The first IOL in all patients was acrylic intrabagal IOL implanted in uncomplicated phacoemulsification surgery. Results. Fifteen eyes (15 patients) were involved in this study. Preoperatively, mean log⁡MAR UDVA and CDVA were 0.88 ± 0.22 and 0.19 ± 0.13, respectively, with a mean follow-up of 28 months (range: 24 to 36 months). At the end of the follow-up, all eyes achieved log⁡MAR UDVA of 0.20 ± 0.12 with postoperative refraction ranging from 0.00 to −0.50 D of attempted emmetropia. Conclusions. Implantation of the second sulcus SensarAR40 IOL was found to be safe, easy, and simple technique for management of ametropia following uncomplicated phacoemulsification. PMID:27313869

  8. Visual outcome of pars plana vitrectomy with intraocular foreign body removal through sclerocorneal tunnel and sulcus-fixated intraocular lens implantation as a single procedure, in cases of metallic intraocular foreign body with traumatic cataract

    PubMed Central

    Mahapatra, Santosh K; Rao, Nageswar G

    2010-01-01

    Aim: To evaluate visual outcome following pars plana vitrectomy (PPV) and intraocular foreign body (IOFB) removal through the sclerocorneal tunnel combined with simultaneous cataract extraction and sulcus-fixated intraocular lens (IOL) implantation as a single procedure in penetrating ocular trauma with IOFB and traumatic cataract. Materials and Methods: Eighteen cases of penetrating ocular trauma with retained IOFB and traumatic cataract who underwent PPV, IOFB body removal and cataract extraction with posterior chamber IOL (PCIOL) implantation in the same sitting, between June '04 and December '05 were retrospectively analyzed. All the foreign bodies were removed through the sclerocorneal tunnel. Result: All the 18 patients were young males, with an average follow-up period of 12 months. In 12 cases the foreign body was intravitreal and in six cases it was intraretinal but extramacular. Thirteen cases had a best corrected visual acuity ranging from 20/20 to 20/60 at their last follow-up. Five cases developed retinal detachment due to proliferative vitreoretinopathy (PVR) changes postoperatively and were subsequently managed by surgery. Conclusion: Primary IOL implantation with combined cataract and vitreo-retinal surgery is a safe option reducing the need for two separate surgeries in selected patients with retained IOFB and traumatic cataract. This combined procedure provides good visual outcome with early rehabilitation in young working patients. PMID:20195033

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

    PubMed Central

    Gundersen, Kjell Gunnar; Potvin, Rick

    2016-01-01

    Purpose To compare the visual acuity (VA) and quality of vision between bilateral implantation of a trifocal intraocular lens (IOL) and blended bifocal IOLs with an intermediate add in the dominant eye and a near add in the nondominant eye. Patients and methods Patients with either trifocal or blended bifocal IOLs implanted were recruited after surgery. Subjects returned for a single diagnostic visit between 3 and 24 months after surgery. VA was tested at various distances, including low-contrast acuity and acuity at their preferred reading distance. A binocular defocus curve was obtained, and subjective visual function and quality of vision were evaluated. Results Twenty-five trifocal subjects and 30 blended bifocal subjects were enrolled. There were no significant differences in low-contrast acuity, preferred reading distance, or acuity at that reading distance. Binocular vision at 4 m, 60 cm, and 40 cm was not statistically significantly different. The trifocal provided statistically significantly better visual acuity (P<0.05) at vergences from −0.5 to −1.5 D (from 2 m to 67 cm viewing distance, P<0.05). There was no statistically significant difference in the near vision subscale scores of the 39-question National Eye Institute Visual Function Questionnaire or the overall scores of the Quality of Vision questionnaire, though significantly more trifocal subjects reported that the observed visual disturbances were “bothersome” (P<0.05). Conclusion Both lens modalities provided subjects with excellent binocular near and distance vision, with similar low rates of visual disturbances and good reported functional vision. The trifocal IOL provided significantly better intermediate VA in the viewing distance range of 2 m to 67 cm, corresponding to viewing things such as a car dashboard or grocery shelf. VA was similar between groups at viewing distances from 60 to 40 cm, corresponding to computer or reading distance. PMID:27274184

  10. Lens Position Parameters as Predictors of Intraocular Pressure Reduction After Cataract Surgery in Nonglaucomatous Patients With Open Angles

    PubMed Central

    Hsu, Chi-Hsin; Kakigi, Caitlin L.; Lin, Shuai-Chun; Wang, Yuan-Hung; Porco, Travis; Lin, Shan C.

    2015-01-01

    Purpose To evaluate the relationship between lens position parameters and intraocular pressure (IOP) reduction after cataract surgery in nonglaucomatous eyes with open angles. Methods The main outcome of the prospective study was percentage of IOP change, which was calculated using the preoperative IOP and the IOP 4 months after cataract surgery in nonglaucomatous eyes with open angles. Lens position (LP), defined as anterior chamber depth (ACD) + 1/2 lens thickness (LT), was assessed preoperatively using parameters from optical biometry. Preoperative IOP, central corneal thickness, ACD, LT, axial length (AXL), and the ratio of preoperative IOP to ACD (PD ratio) were also evaluated as potential predictors of percentage of IOP change. The predictive values of the parameters we found to be associated with the primary outcome were compared. Results Four months after cataract surgery, the average IOP reduction was 2.03 ± 2.42 mm Hg, a 12.74% reduction from the preoperative mean of 14.5 ± 3.05 mm Hg. Lens position was correlated with IOP reduction percentage after adjusting for confounders (P = 0.002). Higher preoperative IOP, shallower ACD, shorter AXL, and thicker LT were significantly associated with percentage of IOP decrease. Although not statistically significant, LP was a better predictor of percentage of IOP change compared to PD ratio, preoperative IOP, and ACD. Conclusions The percentage of IOP reduction after cataract surgery in nonglaucomatous eyes with open angles is greater in more anteriorly positioned lenses. Lens position, which is convenient to compute by basic ocular biometric data, is an accessible predictor with considerable predictive value for postoperative IOP change. PMID:26650901

  11. OPTICAL PRINCIPLES, BIOMECHANICS, AND INITIAL CLINICAL PERFORMANCE OF A DUAL-OPTIC ACCOMMODATING INTRAOCULAR LENS (AN AMERICAN OPHTHALMOLOGICAL SOCIETY THESIS)

    PubMed Central

    McLeod, Stephen D.

    2006-01-01

    Purpose To design and develop an accommodating intraocular lens (IOL) for endocapsular fixation with extended accommodative range that can be adapted to current standard extracapsular phacoemulsification technique. Methods Ray tracing analysis and lens design; finite element modeling of biomechanical properties; cadaver eye implantation; initial clinical evaluation. Results Ray tracing analysis indicated that a dual-optic design with a high plus-power front optic coupled to an optically compensatory minus posterior optic produced greater change in conjugation power of the eye compared to that produced by axial movement of a single-optic IOL, and that magnification effects were unlikely to account for improved near vision. Finite element modeling indicated that the two optics can be linked by spring-loaded haptics that allow anterior and posterior axial displacement of the front optic in response to changes in ciliary body tone and capsular tension. A dual-optic single-piece foldable silicone lens was constructed based on these principles. Subsequent initial clinical evaluation in 24 human eyes after phacoemulsification for cataract indicated mean 3.22 diopters of accommodation (range, 1 to 5 D) based on defocus curve measurement. Accommodative amplitude evaluation at 1- and 6-month follow-up in all eyes indicated that the accommodative range was maintained and that the lens was well tolerated. Conclusions A dual-optic design increases the accommodative effect of axial optic displacement, with minimal magnification effect. Initial clinical trials suggest that IOLs designed on this principle might provide true pseudophakic accommodation following cataract extraction and lens implantation. PMID:17471355

  12. Safety and efficacy of phacoemulsification and intraocular lens implantation through a small pupil using minimal iris manipulation

    PubMed Central

    Papaconstantinou, Dimitris; Kalantzis, George; Brouzas, Dimitris; Kontaxakis, Anastasios; Koutsandrea, Chryssanthi; Diagourtas, Andreas; Georgalas, Ilias

    2016-01-01

    Purpose 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. Methods 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. Results 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

  13. Comparison between Limbal and Pars Plana Approaches Using Microincision Vitrectomy for Removal of Congenital Cataracts with Primary Intraocular Lens Implantation

    PubMed Central

    Liu, Xin; Zheng, Tianyu; Zhou, Xingtao; Lu, Yi; Zhou, Peng; Fan, Fan; Luo, Yi

    2016-01-01

    Purpose. To compare the surgical outcomes of limbal versus pars plana vitrectomy using the 23-gauge microincision system for removal of congenital cataracts with primary intraocular lens implantation. Methods. We retrospectively reviewed all eyes that underwent cataract removal through limbal or pars plana incision. Main outcome measures included visual outcomes and complications. Results. We included 40 eyes (26 patients) in the limbal group and 41 eyes (30 patients) in the pars plana group. The mean age was 46 months. There was no significant difference in best-corrected visual acuity between the two groups (P = 0.64). Significantly, more eyes had at least one intraoperative complication in the limbal group than in the pars plana group (P = 0.03) that were mainly distributed at 1.5–3 years of age (P = 0.01). The most common intraoperative complications were iris aspiration, iris prolapse, and iris injury. More eyes in the limbal group had postoperative complications and required additional intraocular surgery, but the difference was not significant (P = 0.19). Conclusions. The visual results were encouraging in both approaches. We recommend the pars plana approach for lower incidence of complications. The limbal approach should be reserved for children older than 3 years of age and caution should be exercised to minimize iris disturbance. PMID:27313872

  14. Comparison between Limbal and Pars Plana Approaches Using Microincision Vitrectomy for Removal of Congenital Cataracts with Primary Intraocular Lens Implantation.

    PubMed

    Liu, Xin; Zheng, Tianyu; Zhou, Xingtao; Lu, Yi; Zhou, Peng; Fan, Fan; Luo, Yi

    2016-01-01

    Purpose. To compare the surgical outcomes of limbal versus pars plana vitrectomy using the 23-gauge microincision system for removal of congenital cataracts with primary intraocular lens implantation. Methods. We retrospectively reviewed all eyes that underwent cataract removal through limbal or pars plana incision. Main outcome measures included visual outcomes and complications. Results. We included 40 eyes (26 patients) in the limbal group and 41 eyes (30 patients) in the pars plana group. The mean age was 46 months. There was no significant difference in best-corrected visual acuity between the two groups (P = 0.64). Significantly, more eyes had at least one intraoperative complication in the limbal group than in the pars plana group (P = 0.03) that were mainly distributed at 1.5-3 years of age (P = 0.01). The most common intraoperative complications were iris aspiration, iris prolapse, and iris injury. More eyes in the limbal group had postoperative complications and required additional intraocular surgery, but the difference was not significant (P = 0.19). Conclusions. The visual results were encouraging in both approaches. We recommend the pars plana approach for lower incidence of complications. The limbal approach should be reserved for children older than 3 years of age and caution should be exercised to minimize iris disturbance. PMID:27313872

  15. Capsule Contraction Syndrome with a Microincision Foldable Hydrophilic Acrylic Intraocular Lens: Two Case Reports and Review of the Literature

    PubMed Central

    Balestrazzi, Angelo; Malandrini, Alex; Martone, Gianluca; Marigliani, Davide; Caporossi, Tomaso; Tosi, Gian Marco

    2014-01-01

    Here we present 2 cases of capsule contraction syndrome (CCS). In both cases, a hydrophilic acrylic Akreos MI60 (Bausch and Lomb) intraocular lens (IOL) was implanted in the capsular bag through microincision cataract surgery, and the literature on the subject is reviewed. Since CCS has been described after the implantation of every IOL type, it is unlikely that the Akreos MI60 chemical and physical properties may cause CCS. When CCS occurs with IOLs composed of increasingly flexible materials that are inserted through incisions of decreasing size, a severe dislocation and deformation of IOL optics and haptics may develop. In both cases illustrated here, Nd:YAG laser anterior capsulotomy was highly effective. Hence, also based on the literature, which reports severe complications as a result of surgical intervention, it is suggested that Nd:YAG laser anterior capsulotomy be the first line of CCS treatment when the luxation of an IOL capsular bag is absent. PMID:25473400

  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

    2016-01-01

    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. PMID:26921366

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

    PubMed Central

    Can, Ertuğrul; Koçak, Nurullah; Yücel, Özlem Eşki; Gül, Adem; Öztürk, Hilal Eser; Sayın, Osman

    2016-01-01

    Aim of Study: To describe a simplified ab-interno cow-hitch suture fixation technique for repositioning decentered posterior chamber intraocular lens (PC IOL). Materials and Methods: Two cases are presented with the surgical correction of decentered and subluxated IOL. Ab-interno scleral suture fixation technique with hitch-cow knot in the eye was performed with a ciliary sulcus guide instrument and 1 year follow-up was completed. Results: Both of the patients had well centered lenses postoperatively. Corrected distant and near visual acuities of the patients were improved. There was no significant postoperative complication. In the follow-up period of 1 year, no evidence of suture erosion was found. Conclusions: Ab-interno scleral suture loop fixation with hitch-cow knot in the eye was effective in repositioning decentered or subluxated PC IOLs with excellent postoperative centered lenses and visual outcomes. PMID:27050346

  18. 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

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

    PubMed Central

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

    2016-01-01

    Purpose The aim of this study was to evaluate the operational impact of using preloaded intraocular lens (IOL) delivery systems compared with manually loaded IOL delivery processes during routine cataract surgeries. Methods Time and motion data, staff and surgery schedules, and cost accounting reports were collected across three sites located in the US, France, and Canada. Time and motion data were collected for manually loaded IOL processes and preloaded IOL delivery systems over four surgery days. Staff and surgery schedules and cost accounting reports were collected during the 2 months prior and after introduction of the preloaded IOL delivery system. Results The study included a total of 154 routine cataract surgeries across all three sites. Of these, 77 surgeries were performed using a preloaded IOL delivery system, and the remaining 77 surgeries were performed using a manual IOL delivery process. Across all three sites, use of the preloaded IOL delivery system significantly decreased mean total case time by 6.2%–12.0% (P<0.001 for data from Canada and the US and P<0.05 for data from France). Use of the preloaded delivery system also decreased surgeon lens time, surgeon delays, and eliminated lens touches during IOL preparation. Conclusion Compared to a manual IOL delivery process, use of a preloaded IOL delivery system for cataract surgery reduced total case time, total surgeon lens time, surgeon delays, and eliminated IOL touches. The time savings provided by the preloaded IOL delivery system provide an opportunity for sites to improve routine cataract surgery throughput without impacting surgeon or staff capacity. PMID:27382245

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

    PubMed Central

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

    2009-01-01

    Purpose: To evaluate the outcome of intraocular lens (IOL) implantation using capsular tension ring (CTR) in subluxated crystalline or cataractous lenses in children. Setting: Tertiary care setting Materials and Methods: We prospectively studied 18 eyes of 15 children with subluxation of crystalline or cataractous lenses between 90° up to 210° after phacoemulsification, CTR and IOL implantation. Each child was examined for IOL centration, zonular dehiscence and posterior capsular opacification (PCO). Results: Age of the patient ranged between five to 15 years. Out of 18 eyes, seven had traumatic and 11 had spontaneous subluxation of crystalline or cataractous lens. Phacoemulsification was successfully performed with CTR implantation in the capsular bag. Intraoperative zonular dialysis occurred in two eyes. Anterior vitrectomy was performed in six eyes to manage vitreous prolapse. IOL implanted was polymethyl methacrylate (PMMA) in eight eyes, hydrophobic acrylic in seven and hydrophilic acrylic in three. Follow-up ranged from 24 months to 72 months. Sixteen eyes had a best corrected visual acuity of 20/40 or better. Nine eyes developed significant PCO and were managed with Neodymium Yttrium Aluminum Garnet (Nd:YAG) laser posterior capsulotomy. One eye with acrylic IOL in the capsular bag had IOL dislocation after two years which was managed with vitrectomy and secondary trans-scleral fixation of IOL. Conclusions: Phacoaspiration with CTR implantation makes capsular bag IOL fixation possible in most of the eyes with subluxated crystalline or cataractous lenses. PCO still remains a challenge in children with successful phacoaspiration with CTR implantation PMID:19861744

  1. 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). PMID:25316617

  2. Long term results of primary posterior chamber intraocular lens implantation for congenital cataract in the first year of life

    PubMed Central

    Gouws, P; Hussin, H M; Markham, R H C

    2006-01-01

    Aim To document the long term outcome of congenital cataract surgery with primary posterior chamber (PC) lens implantation in the first year of life. Method A retrospective review of congenital cataract surgery in the first year of life with PC lens implantation in 18 infants, eight with unilateral and 10 with bilateral cataract. The average age at surgery was 15 weeks (range 3–44 weeks). The mean follow up was 95 months (range 60–139 months). Results The best outcomes were in the bilateral group where 50% of eyes achieved 6/18 or better, with a best acuity of 6/9. Acuities were poor in the unilateral group where only 38% achieved 6/60 or better, with a best acuity of 6/24. There was a mean refractive shift between first refraction after surgery and refraction at 36 months after surgery of −3.44 dioptres with a very wide range (+2.00 to −15.50). There was a significantly greater myopic shift in the unilateral cases. Many eyes in both groups continued to show an increasing myopic shift between 36 months after surgery and their final recorded refraction. The main complications were amblyopia, especially in unilateral cataracts, and posterior capsular opacification. Amblyopia was most probably related to a combination of early onset of dense cataract in this young age group, late presentation for initial surgery, delay in capsulotomies, and imperfect compliance with a rigorous occlusion regime. Conclusion Intraocular lens implantation in infants less than 1 year of age is generally a safe procedure. The spread of final refractive error was very wide. Final refraction in the unilateral group was significantly more myopic than the bilateral group. Final acuities were often disappointing especially in the unilateral group. PMID:16597661

  3. Foreign body giant cells selectively covering haptics of intraocular lens implants: indicators of poor toleration?

    PubMed

    Wolter, J R

    1983-10-01

    A Sputnik lens implant removed after five years because of bullous keratopathy exhibits a dense covering of its Supramid anterior staves with large foreign body giant cells, while its Prolene loops and Polymethylmethacrylate optics have attracted only few of these cell units. The glass-membrane-like component of the reactive membrane also shows significant differences on the different parts of this implant. The use of observation of the components of reactive membranes on lens implants as indicators of toleration in the eye is suggested. PMID:6364004

  4. Additive manufacturing of a trifocal diffractive-refractive lens

    NASA Astrophysics Data System (ADS)

    Hinze, Ulf; El-Tamer, Ayman; Doskolovich, Leonid L.; Bezus, Evgeni A.; Reiß, Stefan; Stolz, Heinrich; Guthoff, Rudolf F.; Stachs, Oliver; Chichkov, Boris

    2016-08-01

    The application of two-photon polymerization and molding for the fabrication of a multifocal diffractive-refractive lens operating in water is studied. The fabricated lens is of aspheric shape and combines diffractive and refractive parts in a single element to generate three foci. The lens performance is characterized by visualization of the beam propagation in a transparent basin filled with water containing fluorescein. The experimental measurements are in good agreement with the theoretical description. The obtained results are promising for the realization of trifocal intraocular lenses with predetermined light intensity distribution between the foci.

  5. Quality of vision in patients implanted with aspherical and spherical intraocular lens: Intraindividual comparison

    PubMed Central

    Semeraro, Francesco; Romano, Mario R; Duse, Sarah; Costagliola, Ciro

    2014-01-01

    Aims: To compare the quality of vision in pseudophakic patients implanted with aspherical and spherical intraocular lenses (IOLs). Materials and Methods: Randomized prospective longitudinal intrapatient comparison between aspherical and spherical IOLs performed on 22 patients who underwent bilateral cataract surgery. Best corrected visual acuity, subjective contrast sensitivity, Strehl ratio and spherical aberrations (SA), and higher order wavefront aberrations for a 3.5 mm and a 6.0 mm pupil were measured after 3 months of cataract surgery. Results: SA (Z4,0) decreased significantly in eyes with aspherical IOL implant (P =0.004). Modulation transfer function (MTF) and point spread function (PSF) resulted no significant difference between the two groups (P =0.87; P = 0.32). Conclusion: Although the SA is significantly lower in eyes implanted with aspherical IOL, the quality of vision determined with MTF and PSF does not significantly differ for subjective and objective parameters that were analyzed. PMID:24008781

  6. A Circadian and Cardiac Intraocular Pressure Sensor for Smart Implantable Lens.

    PubMed

    Donida, Achille; Di Dato, Giuseppe; Cunzolo, Paolo; Sala, Marco; Piffaretti, Filippo; Orsatti, Paolo; Barrettino, Diego

    2015-12-01

    This paper presents a new system to measure the Intraocular Pressure (IOP) with very high accuracy (0.036 mbar) used for monitoring glaucoma. The system not only monitors the daily variation of the IOP (circadian IOP), but also allows to perform an spectral analysis of the pressure signal generated by the heartbeat (cardiac IOP). The system comprises a piezoresistive pressure sensor, an application-specific integrated circuit (ASIC) to read out the sensor data and an external reader installed on customized glasses. The ASIC readout electronics combines chopping modulation with correlated double sampling (CDS) in order to eliminate both the amplifier offset and the chopper ripple at the sampling frequency. In addition, programmable current sources are used to compensate for the atmospheric pressure ( 800-1200 mbar ) and the circadian component (± 7 mbar) thus allowing to read out the very weak cardiac signals (± 1.6 mbar) with a maximum accuracy of 0.036 mbar. PMID:26800549

  7. Audit of exracapsular cataract extraction with posterior chamber intraocular lens implantation in a tertiary eye care center in Ethiopia.

    PubMed

    Tilahun, Yonas; Sisay, Alemayehu

    2006-01-01

    A retrospective audit of records of 370 eyes of 315 patients for whom extracapsular cataract extraction with posterior chamber intraocular lens implantation (ECCE-PC IOL) was performed between 1998 and 1999 was made to determine postoperative visual outcome and complications. One hundred and ninety three patients were males and one hundred and seventy seven were females making a male to female ratio of 1:0.9. At two months postoperatively 82 (30.4%) of eyes had uncorrected visual acuity of 6/18 or better; while 176 (53.7%) of eyes attained an uncorrected visual acuity between 6/18 and 6/60, and 31 (11.5%) had visual acuity between 3/60 and 6/60. 340 of 358 (94.9%) had a preoperative visual acuity of < 3/60. As a result of the surgery, the percentage of blind eyes dropped from 94.9% to 4.4%. The commonest intra operative and early postoperative complications encountered were posterior capsular tear with vitreous loss (5.7%) and striate keratopathy (11.1%) respectively. Posterior capsular opacity was documented in 17 (4.6%) eyes as a late postoperative complication. Routine biometry, to calculate Intra ocular Lens (IOL) power was not done and this was the major limitation of the study. In conclusion, the study increases awareness of cataract surgery outcomes and provides a feedback to achieve better results both in terms of quality and quantity in cataract surgery. Further study with biometric measurement is recommended. PMID:17447364

  8. Long-Term Efficacy and Rotational Stability of AcrySof Toric Intraocular Lens Implantation in Cataract Surgery

    PubMed Central

    Kim, Myung Hun; Chung, Tae-Young

    2010-01-01

    Purpose To evaluate the long-term efficacy and rotational stability of the AcrySof toric intraocular lens (IOL) in correcting preoperative astigmatism in cataract patients. Methods This prospective observational study included 30 eyes from 24 consecutive patients who underwent implantation of an AcrySof toric IOL with micro-coaxial cataract surgery between May 2008 and September 2008. Outcomes of visual acuity, refractive and keratometric astigmatism, and IOL rotation after 1 day, 1 month, 3 months, and long-term (mean, 13.3±5.0 months) follow-up were evaluated. Results At final follow-up, 73.3% of eyes showed an uncorrected visual acuity of 20/25 or better. The postoperative keratometric value was not different from the preoperative value; mean refractive astigmatism was reduced to -0.28±0.38 diopter (D) from -1.28±0.48 D. The mean rotation of the toric IOL was 3.45±3.39 degrees at final follow-up. One eye (3.3%) exhibited IOL rotation of 10.3 degrees, the remaining eyes (96.7%) had IOL rotation of less than 10 degrees. Conclusions Early postoperative and long-term follow-up showed that implantation of the AcrySof toric IOL is an effective, safe, and predictable method for managing corneal astigmatism in cataract patients. PMID:20714383

  9. Effect of Myopic Defocus on Visual Acuity after Phakic Intraocular Lens Implantation and Wavefront-guided Laser in Situ Keratomileusis.

    PubMed

    Kamiya, Kazutaka; Shimizu, Kimiya; Igarashi, Akihito; Kawamorita, Takushi

    2015-01-01

    This study aimed to investigate the effect of myopic defocus on visual acuity after phakic intraocular lens (IOL) implantation and wavefront-guided laser in situ keratomileusis (wfg-LASIK). Our prospective study comprised thirty eyes undergoing posterior chamber phakic IOL implantation and 30 eyes undergoing wfg-LASIK. We randomly measured visual acuity under myopic defocus after cycloplegic and non-cycloplegic correction. We also calculated the modulation transfer function by optical simulation and estimated visual acuity from Campbell &Green's retinal threshold curve. Visual acuity in the phakic IOL group was significantly better than that in the wfg-LASIK group at myopic defocus levels of 0, -1, and -2 D (p < 0.001, p < 0.001, and p = 0.02, Mann-Whitney U-test), but not at a defocus of -3 D (p = 0.30). Similar results were also obtained in a cycloplegic condition. Decimal visual acuity values at a myopic defocus of 0, -1, -2, and -3 D by optical simulation were estimated to be 1.95, 1.21, 0.97, and 0.75 in the phakic IOL group, and 1.39, 1.11, 0.94, and 0.71 in the wfg-LASIK group, respectively. From clinical and optical viewpoints, phakic IOL implantation was superior to wfg-LASIK in terms of the postoperative visual performance, even in the presence of low to moderate myopic regression. PMID:25994984

  10. Intraocular Lens Opacification following Intracameral Injection of Recombinant Tissue Plasminogen Activator to Treat Inflammatory Membranes after Cataract Surgery

    PubMed Central

    Fung, Simon S. M.; Islam, Niaz M.; Zambarakji, Hadi J.; Khoramnia, Ramin; Auffarth, Gerd U.; Parmar, Dipak N.

    2015-01-01

    Purpose. To report 7 cases of intraocular lens (IOL) opacification following treatment of postoperative anterior chamber fibrin with recombinant tissue plasminogen activator (rtPA) after cataract surgery. Methods. Retrospective case series of 7 eyes in 7 patients who developed IOL opacification after receiving rtPA for anterior chamber inflammatory membrane formation resulting from phacoemulsification cataract surgery. Three explanted IOLs were investigated with light microscopy, histochemical analysis, scanning electron microscopy, and X-ray spectrometry. Results. All patients underwent uncomplicated cataract surgery and posterior chamber hydrophilic IOL implantation. Anterior chamber inflammatory membranes developed between 1 and 4 weeks of surgery and were treated with intracameral rtPA. IOL opacification was noted between 4 weeks and 6 years after rtPA treatment with reduced visual acuity, and IOL exchange was carried out in 3 patients. Light microscopy evaluation revealed diffuse fine granular deposits on the anterior surface/subsurface of IOL optic that stained positive for calcium salts. Scanning electron microscopy (SEM) and energy-dispersive X-ray spectrometry (EDS) confirmed the presence of calcium and phosphate on the IOL. Conclusions. Intracameral rtPA, though rapidly effective in the treatment of anterior chamber inflammatory membranes following cataract surgery, may be associated with IOL opacification. PMID:25861464

  11. High order aberration and straylight evaluation after cataract surgery with implantation of an aspheric, aberration correcting monofocal intraocular lens

    PubMed Central

    Kretz, Florian T A; Tandogan, Tamer; Khoramnia, Ramin; Auffarth, Gerd U

    2015-01-01

    AIM To evaluate the quality of vision in respect to high order aberrations and straylight perception after implantation of an aspheric, aberration correcting, monofocal intraocular lens (IOL). METHODS Twenty-one patients (34 eyes) aged 50 to 83y underwent cataract surgery with implantation of an aspheric, aberration correcting IOL (Tecnis ZCB00, Abbott Medical Optics). Three months after surgery they were examined for uncorrected (UDVA) and corrected distance visual acuity (CDVA), contrast sensitivity (CS) under photopic and mesopic conditions with and without glare source, ocular high order aberrations (HOA, Zywave II) and retinal straylight (C-Quant). RESULTS Postoperatively, patients achieved a postoperative CDVA of 0.0 logMAR or better in 97.1% of eyes. Mean values of high order abberations were +0.02±0.27 (primary coma components) and -0.04±0.16 (spherical aberration term). Straylight values of the C-Quant were 1.35±0.44 log which is within normal range of age matched phakic patients. The CS measurements under mesopic and photopic conditions in combination with and without glare did not show any statistical significance in the patient group observed (P≥0.28). CONCLUSION The implantation of an aspherical aberration correcting monofocal IOL after cataract surgery resulted in very low residual higher order aberration (HOA) and normal straylight. PMID:26309872

  12. Comparison of two different methods of preoperative marking for toric intraocular lens implantation: bubble marker versus pendulum marker

    PubMed Central

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

    2016-01-01

    AIM To compare the accuracy of two different methods of preoperative marking for toric intraocular lens (IOL) implantation, bubble marker versus pendulum marker, as a means of establishing the reference point for the final alignment of the toric IOL to achieve an outcome as close as possible to emmetropia. METHODS Toric IOLs were implanted in 180 eyes of 110 patients. One group (55 patients) had preoperative marking of both eyes done with bubble marker (ASICO AE-2791TBL) and the other group (55 patients) with pendulum marker (Rumex®3-193). Reference marks were placed at 3-, 6-, and 9-o'clock positions on the limbus. Slit-lamp photographs were analyzed using Adobe Photoshop (version 7.0). Amount of alignment error (in degrees) induced in each group was measured. RESULTS Mean absolute rotation error in the preoperative marking in the horizontal axis was 2.42±1.71 in the bubble marker group and 2.83±2.31in the pendulum marker group (P=0.501). Sixty percent of the pendulum group and 70% of the bubble group had rotation error ≤3 (P=0.589), and 90% eyes of the pendulum group and 96.7% of the bubble group had rotation error ≤5 (P=0.612). CONCLUSION Both preoperative marking techniques result in approximately 3 of alignment error. Both marking techniques are simple, predictable, reproducible and easy to perform. PMID:27275425

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

    PubMed

    Fizia-Orlicz, Anna; Misiuk-Hojło, Marta

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

    Purpose To evaluate the repeatability of power profiles measured on NIMO TR1504 (Lambda-X, Belgium) and investigate the effects of lens decentration on the power profiles for single vision (SV), bifocal (BF) and multifocal (MF) contact lenses. Methods Accuracy of the sphere power was evaluated using single vision BK-7 calibration glass lenses of six minus and six plus powers. Three SV and four BF/MF contact lenses – three lenses each, were measured five times to calculate the coefficients of repeatability (COR) of the instrument. The COR was computed for each chord position, lens design, prescription power and operator. One lens from each type was measured with a deliberate decentration up to ±0.5 mm in 0.1 mm steps. Results For all lenses, the COR varied across different regions of the half-chord position. In general, SV lenses showed lower COR compared to the BF/MF group lenses. There were no noticeable trends of COR between prescription powers for SV and BF/MF lenses. The shape of the power profiles was not affected when lenses were deliberately decentered for all SV and PureVision MF lenses. However, for Acuvue BF lenses, the peak to trough amplitude of the power profiles flattened up to 1.00 D. Conclusion The COR across the half-chord of the optic zone diameter was mostly within clinical relevance except for the central 0.5 mm half-chord position. COR were dependent on the lens type, whereby BF/MF group produced higher COR than SV lenses. The effects of deliberate decentration on the shape of power profiles were pronounced for lenses where the profiles had sharp transitions of power. PMID:26590009

  15. Ultrasound Biomicroscopy Comparison of Ab Interno and Ab Externo Intraocular Lens Scleral Fixation.

    PubMed

    Horiguchi, Lie; Garcia, Patricia Novita; Malavazzi, Gustavo Ricci; Allemann, Norma; Gomes, Rachel L R

    2016-01-01

    Purpose. To compare ab interno and ab externo scleral fixation of posterior chamber intraocular lenses (PCIOL) using ultrasound biomicroscopy (UBM). Methods. Randomized patients underwent ab externo or ab interno scleral fixation of a PCIOL. Ultrasound biomicroscopy was performed 3 to 6 months postoperatively, to determine PCIOL centration, IOL distance to the iris at 12, 3, 6, and 9 hours, and haptics placement in relation to the ciliary sulcus. Results. Fifteen patients were enrolled in the study. The ab externo technique was used in 7 eyes (46.6%) and the ab interno in 8 eyes (53.3%). In the ab externo technique, 14 haptics were located: 4 (28.57%) in the ciliary sulcus; 2 (14.28%) anterior to the sulcus; and 8 (57.14%) posterior to the sulcus, 6 in the ciliary body and 2 posterior to the ciliary body. In the ab interno group, 4 haptics (25.0%) were in the ciliary sulcus, 2 (12.50%) anterior to the sulcus, and 10 (75.0%) posterior to the sulcus, 4 in the ciliary body and 6 posterior to the ciliary body. Conclusions. Ab externo and ab interno scleral fixation techniques presented similar results in haptic placement. Ab externo technique presented higher vertical tilt when compared to the ab interno. PMID:27293878

  16. Ultrasound Biomicroscopy Comparison of Ab Interno and Ab Externo Intraocular Lens Scleral Fixation

    PubMed Central

    Horiguchi, Lie; Garcia, Patricia Novita; Malavazzi, Gustavo Ricci; Allemann, Norma

    2016-01-01

    Purpose. To compare ab interno and ab externo scleral fixation of posterior chamber intraocular lenses (PCIOL) using ultrasound biomicroscopy (UBM). Methods. Randomized patients underwent ab externo or ab interno scleral fixation of a PCIOL. Ultrasound biomicroscopy was performed 3 to 6 months postoperatively, to determine PCIOL centration, IOL distance to the iris at 12, 3, 6, and 9 hours, and haptics placement in relation to the ciliary sulcus. Results. Fifteen patients were enrolled in the study. The ab externo technique was used in 7 eyes (46.6%) and the ab interno in 8 eyes (53.3%). In the ab externo technique, 14 haptics were located: 4 (28.57%) in the ciliary sulcus; 2 (14.28%) anterior to the sulcus; and 8 (57.14%) posterior to the sulcus, 6 in the ciliary body and 2 posterior to the ciliary body. In the ab interno group, 4 haptics (25.0%) were in the ciliary sulcus, 2 (12.50%) anterior to the sulcus, and 10 (75.0%) posterior to the sulcus, 4 in the ciliary body and 6 posterior to the ciliary body. Conclusions. Ab externo and ab interno scleral fixation techniques presented similar results in haptic placement. Ab externo technique presented higher vertical tilt when compared to the ab interno. PMID:27293878

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

    SciTech Connect

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

    1985-03-01

    A prospective double-masked study of 301 patients was undertaken to compare the effect of ultraviolet (UV) filtering in implant intraocular lenses (IOL) on the angiographic incidence of cystoid macular edema (CME) in patients undergoing extracapsular cataract extraction. Patients were randomized to receive either a posterior chamber IOL that contained UV-absorbing chromophore or an identical IOL which did not contain such a chromophore. All patients were scheduled for fluorescein angiography between three and six months after surgery; 228 angiograms were obtained that were readable for the presence or absence of angiographic CME. The mean interval following surgery was 4.3 months. The incidence of CME was 18.8% (21 of 112) in patients who received lenses without UV-filtering chromophore and 9.5% (11 of 116) in patients who received IOLs that contained UV-filtering chromophore. These findings show that UV-filtering-IOLs resulted in a statistically significant decrease in the incidence of CME. The presence or absence of the UV-filtering chromophore did not, however, significantly affect visual acuity in the early postoperative period.

  18. 1004 cases of traumatic cataract surgery with implantation of an intraocular lens.

    PubMed

    Fyodorov, S N; Egorova, E V; Zubareva, L N

    1981-04-01

    Traumatic cataracts occurring after ocular trauma were removed by phacoemulsification, cryoextraction or extracapsular cataract extraction, depending on the degree of lens absorption. All eyes received sputnik-style iridocapsular lenses. Most cases were complicated by the presence of synechiae and/or the need for iridoplasty. The surgical technique varied with the specific nature of the ocular pathology. Eyes with penetrating injuries has a higher complication rate. Anterior chamber shallowing or collapse was the most frequent intraoperative complication, and was directly related to the incidence of postoperative complications. Most postoperative complications were typical of those associated with cataract surgery in complicated situations. PMID:7263486

  19. Role of intraocular lens parameters in visual rehabilitation of patients after extracapsular cataract extraction

    NASA Astrophysics Data System (ADS)

    Bakutkin, Valery V.; Galanzha, Vladimir A.

    2001-01-01

    The main method of cataract treatment is micro surgical removing of the opaque lens from the eye with implantation of an intra ocular lens. We performed the comparative study of using various IOL models differing in its materials, index of refraction, spectral properties, configuration, shape, size and other features. Before and after the IOL implantation we performed the following test: visual acuity measuring, refractometry, keratometry, laser interferometric retinometry, color perception assessment, digital photo- and videorecording of the eye with image processing and some others. We found a number of correlations between the IOL properties and some characteristics of the patient's vision. The decentration of the IOL optical part more than 1,5 mm conduced to the non-corneal astigmatism and the prismatic effect. A small diameter of the IOL optical part and high index of refraction promotes to the appearance of the optical aberrations. Leucosapphire IOLs revealed the high degree of light reflection and the minimal adhesive ability of the IOL surface. Leucosapphire IOL revealed the high degree of light reflection and the minimal adhesive ability of the IOL surface. PMMA IOL revealed the low reflective power and the high adhesive ability. The best color vision was revealed in patients with PMMA IOL with an additional compound absorbing not only UV light but also short-wave blue light.

  20. Imaging of aphakic intraocular lens with a slit-scanning tomography system

    NASA Astrophysics Data System (ADS)

    Oliveira, Cristina M.; Almeida, J. B.; Franco, S.

    2011-05-01

    Nowadays, cataract extraction with IOL implantation aims not only to restore the crystalline lens' transparency, but also to improve patients' retinal image quality. The refractive outcome and visual quality in pseudophakic eyes is mainly determined by the combination of corneal and internal optics resulting from the implanted IOLs. The optical function of the IOLs depends on its position in the eye. The IOL distance to the corneal apex determines the optical power needed for optical correction. In this paper it is described the usage of a slit-scanning imaging system to determine IOL positioning. Through the projection of the light from a slit onto the eye, this tomography system allows to acquire multiple sections of the anterior eye segment, at different meridians. The developed system's software corrects geometric and optical distortion of the images and provides 3-dimentional models of the eye's structures from the 2-dimensional sections. With this noninvasive technique, cross-sectional images of an eye with an aphakic IOL were obtained in order to reconstruct its 3- dimensional model of the lens and assess its position in the anterior segment camera.

  1. Hydrophilic Acrylic versus PMMA Intraocular Lens Implantation in Pediatric Cataract Surgery

    PubMed Central

    Panahi-Bazaz, Mahmoud-Reza; Zamani, Mitra; Abazar, Bijan

    2009-01-01

    Purpose To compare primary implantation of foldable hydrophilic acrylic with polymethylmethacrylate (PMMA) intraocular lenses (IOLs) in pediatric cataract surgery in terms of short-term complications and visual outcomes. Methods This randomized clinical trial included 40 eyes of 31 consecutive pediatric patients aged 1 to 6 years with unilateral or bilateral congenital cataracts undergoing cataract surgery with primary IOL implantation. Two types of IOLs including foldable hydrophilic acrylic and rigid PMMA were randomly implanted in the capsular bag during surgery. Primary posterior capsulotomy and anterior vitrectomy were performed in all eyes. Patients were followed for at least 1 year. Intra- and postoperative complications, visual outcomes and refractive errors were compared between the study groups. Results Mean age was 3.2±1.8 years in the hydrophilic acrylic group and 3.7±1.3 years in the PMMA group. Mean follow-up period was 19.6±5 (12–29) months. No intraoperative complication occurred in any group. Postoperative uveitis was seen in 2 (10%) eyes in the acrylic group versus 5 (25%) eyes in the PMMA group (P=0.40). Other postoperative complications including pigment deposition (30%), iridocorneal adhesions (10%) and posterior synechiae formation (10%), were seen only in the PMMA group. The visual axis remained completely clear and visual outcomes were generally favorable and comparable in the study groups. Conclusion In pediatric eyes undergoing lensectomy with primary posterior capsulotomy and anterior vitrectomy, hydrophilic acrylic IOLs are comparable to PMMA IOLs in terms of biocompatibility and visual axis clarity, and seem to entail less frequent postoperative complications. PMID:23198075

  2. The Individual Virtual Eye: a Computer Model for Advanced Intraocular Lens Calculation

    PubMed Central

    Einighammer, Jens; Oltrup, Theo; Bende, Thomas; Jean, Benedikt

    2010-01-01

    Purpose To describe the individual virtual eye, a computer model of a human eye with respect to its optical properties. It is based on measurements of an individual person and one of its major application is calculating intraocular lenses (IOLs) for cataract surgery. Methods The model is constructed from an eye's geometry, including axial length and topographic measurements of the anterior corneal surface. All optical components of a pseudophakic eye are modeled with computer scientific methods. A spline-based interpolation method efficiently includes data from corneal topographic measurements. The geometrical optical properties, such as the wavefront aberration, are simulated with real ray-tracing using Snell's law. Optical components can be calculated using computer scientific optimization procedures. The geometry of customized aspheric IOLs was calculated for 32 eyes and the resulting wavefront aberration was investigated. Results The more complex the calculated IOL is, the lower the residual wavefront error is. Spherical IOLs are only able to correct for the defocus, while toric IOLs also eliminate astigmatism. Spherical aberration is additionally reduced by aspheric and toric aspheric IOLs. The efficient implementation of time-critical numerical ray-tracing and optimization procedures allows for short calculation times, which may lead to a practicable method integrated in some device. Conclusions The individual virtual eye allows for simulations and calculations regarding geometrical optics for individual persons. This leads to clinical applications like IOL calculation, with the potential to overcome the limitations of those current calculation methods that are based on paraxial optics, exemplary shown by calculating customized aspheric IOLs.

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

    PubMed Central

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

    2014-01-01

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

  4. Meta-analysis and review: effectiveness, safety, and central port design of the intraocular collamer lens

    PubMed Central

    Packer, Mark

    2016-01-01

    The purpose of this review is to summarize relevant data from publications appearing in the peer-reviewed scientific literature over the past decade since US Food and Drug Administration approval of the implantable collamer lens (ICL), and, in particular, to review studies relating to sizing methodology, safety, and effectiveness, as well as more recent studies reporting clinical outcomes of the V4c Visian ICL with KS Aquaport, VICMO. A literature search was conducted using two databases, PubMed.gov and Science.gov, to identify all articles published after 2005 related to the Visian ICL (STAAR Surgical, Inc.). Articles were examined for their relevance to sizing methodology, clinical safety, and effectiveness, and the references cited in each article were also searched for additional relevant publications. The literature review revealed that all currently reported methods of determining the best-fit size of the ICL achieve similarly satisfactory results in terms of vault, the safe distance between the crystalline lens and the ICL. Specifically, meta-analysis demonstrated that sulcus-to-sulcus and white-to-white measurement-based sizing methods do not result in clinically meaningful nor statistically significant differences in vault (two-sample two-sided t-test using pooled mean and standard deviations; t (2,594)=1.33; P=0.18). The reported rates of complications related to vault are very low, except in two case series where additional risk factors such as higher levels of myopia and older age impacted the incidence of cataract. On the basis of preclinical studies and initial clinical reports, with up to 5 years of follow-up, the new VICMO central port design holds promise for further reduction of complications. Given its safety record and the significant improvement in vision and quality of life that the ICL makes possible, the benefits of ICL implantation outweigh the risks. PMID:27354760

  5. Meta-analysis and review: effectiveness, safety, and central port design of the intraocular collamer lens.

    PubMed

    Packer, Mark

    2016-01-01

    The purpose of this review is to summarize relevant data from publications appearing in the peer-reviewed scientific literature over the past decade since US Food and Drug Administration approval of the implantable collamer lens (ICL), and, in particular, to review studies relating to sizing methodology, safety, and effectiveness, as well as more recent studies reporting clinical outcomes of the V4c Visian ICL with KS Aquaport, VICMO. A literature search was conducted using two databases, PubMed.gov and Science.gov, to identify all articles published after 2005 related to the Visian ICL (STAAR Surgical, Inc.). Articles were examined for their relevance to sizing methodology, clinical safety, and effectiveness, and the references cited in each article were also searched for additional relevant publications. The literature review revealed that all currently reported methods of determining the best-fit size of the ICL achieve similarly satisfactory results in terms of vault, the safe distance between the crystalline lens and the ICL. Specifically, meta-analysis demonstrated that sulcus-to-sulcus and white-to-white measurement-based sizing methods do not result in clinically meaningful nor statistically significant differences in vault (two-sample two-sided t-test using pooled mean and standard deviations; t (2,594)=1.33; P=0.18). The reported rates of complications related to vault are very low, except in two case series where additional risk factors such as higher levels of myopia and older age impacted the incidence of cataract. On the basis of preclinical studies and initial clinical reports, with up to 5 years of follow-up, the new VICMO central port design holds promise for further reduction of complications. Given its safety record and the significant improvement in vision and quality of life that the ICL makes possible, the benefits of ICL implantation outweigh the risks. PMID:27354760

  6. Modified Small Incision Cataract Surgery and Intraocular Lens Implantation in HIV Patients

    PubMed Central

    Giles, Kagmeni; Domngang, Christelle; Nguefack-Tsague, Georges; Come, Ebana Mvogo; Wiedemann, Peter

    2015-01-01

    AIM To describe a surgical technique suitable for cataract surgery in regions with a high prevalence of HIV infection. METHODS We reviewed the medical records of 20 consecutive AIDS patients with cataract who underwent modified small-incision cataract surgery (mSICS) with posterior chamber lens implantation. Classic extracapsular cataract extraction (ECCE) was compared to mSICS. The number of potentially risky steps for contamination during surgery and duration of surgery were analyzed. A risky step was defined as any time when the surgeon had to use a sharp instrument. Student’s paired t-test was carried out to compare continuous variables, and P-values <0.05 were considered statistically significant. RESULTS Twenty patients were included in the study, 13 males (65%) and seven females (35%). The mean age was 46.3 ± 13.6 years (range 22–70 years). The number of potentially risky steps for contamination was significantly higher in the classical ECCE than in mSICS (P < 0.001). The mean duration of cataract surgery with mSICS was significantly shorter as well (P < 0.001). CONCLUSION Conversion to mSICS is essential in order to reduce accidental injuries during cataract surgery in sub-Saharan countries. Sharp instruments should be passed through a neutral zone to ensure that the surgeon and nurse do not touch the same instrument at the same time. PMID:26604848

  7. Use of a Toric Intraocular Lens and a Limbal-Relaxing Incision for the Management of Astigmatism in Combined Glaucoma and Cataract Surgery

    PubMed Central

    Gibbons, Allister

    2016-01-01

    Purpose We report the surgical management of a patient with glaucoma undergoing cataract surgery with high preexisting astigmatism. A combination of techniques was employed for her astigmatism management. Methods A 76-year-old female with 5.5 dpt of corneal astigmatism underwent surgery in her left eye consisting of one-site trabeculectomy, phacoemulsification, toric intraocular lens implantation and a single inferior limbal-relaxing incision. Results Intraocular pressure control was achieved with no medication at 11 mm Hg; before the filtering procedure, the pressure was 16 mm Hg on two topical drugs. Astigmatism was reduced to 0.75 dpt, and both corrected and uncorrected visual acuity improved. Conclusions Astigmatism management can have a good outcome in combined procedures. We encourage surgeons to address astigmatism in the preoperative planning of patients undergoing glaucoma surgery associated with phacoemulsification. PMID:27293408

  8. Changes in corneal endothelium cell characteristics after cataract surgery with and without use of viscoelastic substances during intraocular lens implantation

    PubMed Central

    Schulze, Stephan D; Bertelmann, Thomas; Manojlovic, Irena; Bodanowitz, Stefan; Irle, Sebastian; Sekundo, Walter

    2015-01-01

    Purpose To evaluate whether the use of balanced salt solution (BSS) or an ophthalmic viscoelastic device (OVD) during hydrophilic acrylic intraocular lens (IOL) implantation variously impacts corneal endothelial cell characteristics in eyes undergoing uneventful phacoemulsifications. Methods Prospective nonrandomized observational clinical trial. Patients were assigned either to the BSS plus® or to the OVD Z-Celcoat™ group depending on the substance used during IOL implantation. Corneal endothelium cell characteristics were obtained before, 1 week, and 6 weeks after surgery. Intraoperative parameters (eg, surgery time, phacoemulsification energy) were recorded. Results Ninety-seven eyes were assigned to the BSS plus and 86 eyes to the Z-Celcoat group. Preoperative corneal endothelium cell density (ECD) and endothelium cell size were 2,506±310 cells/mm2/2,433±261 cells/mm2 and 406±47 µm2/416±50 µm2 (P=0.107/P=0.09). After 1 and 6 weeks, ECD decreased and endothelium cell size increased significantly in both groups (each P<0.001) without significant differences between both groups (each P>0.05). Irrigation–aspiration suction time (30.3±16.6 versus 36.3±14.5 seconds) and overall surgical time (7.2±1.2 versus 8.0±1.4 minutes) were significantly longer in the OVD Z-Celcoat group (each P<0.001). No complications or serious side effects occurred. Conclusion Implantation of a hydrophilic acrylic IOL under BSS infusion seems to be a useful and faster alternative in experienced hands without generating higher ECD loss rates. PMID:26609218

  9. Effect of Myopic Defocus on Visual Acuity after Phakic Intraocular Lens Implantation and Wavefront-guided Laser in Situ Keratomileusis

    PubMed Central

    Kamiya, Kazutaka; Shimizu, Kimiya; Igarashi, Akihito; Kawamorita, Takushi

    2015-01-01

    This study aimed to investigate the effect of myopic defocus on visual acuity after phakic intraocular lens (IOL) implantation and wavefront-guided laser in situ keratomileusis (wfg-LASIK). Our prospective study comprised thirty eyes undergoing posterior chamber phakic IOL implantation and 30 eyes undergoing wfg-LASIK. We randomly measured visual acuity under myopic defocus after cycloplegic and non-cycloplegic correction. We also calculated the modulation transfer function by optical simulation and estimated visual acuity from Campbell & Green’s retinal threshold curve. Visual acuity in the phakic IOL group was significantly better than that in the wfg-LASIK group at myopic defocus levels of 0, –1, and –2 D (p < 0.001, p < 0.001, and p = 0.02, Mann-Whitney U-test), but not at a defocus of –3 D (p = 0.30). Similar results were also obtained in a cycloplegic condition. Decimal visual acuity values at a myopic defocus of 0, −1, −2, and -3 D by optical simulation were estimated to be 1.95, 1.21, 0.97, and 0.75 in the phakic IOL group, and 1.39, 1.11, 0.94, and 0.71 in the wfg-LASIK group, respectively. From clinical and optical viewpoints, phakic IOL implantation was superior to wfg-LASIK in terms of the postoperative visual performance, even in the presence of low to moderate myopic regression. PMID:25994984

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

    PubMed Central

    Khambhiphant, Bharkbhum; Sasiwilasagorn, Suganlaya; Chatbunchachai, Nattida; Pongpirul, Krit

    2016-01-01

    Purpose The purpose of this study was to evaluate the effect of pupillary dilation on the Haigis formula-calculated intraocular lens (IOL) power and ocular biometry measurements by using IOLMaster®. Methods A prospective study was performed for biometry measurements of 373 eyes of 192 healthy subjects using the IOLMaster at the outpatient department of King Chulalongkorn Memorial Hospital from February 2013 to July 2013. The axial length (AL), anterior chamber depth (ACD), keratometry (K), and IOL power were measured before and after 1% tropicamide eye drop instillation. The Haigis formula was used in the IOL power calculation with the predicted target to emmetropia. Each parameter was compared by a paired t-test prior to and after pupillary dilation. Bland–Altman plots were also used to determine the agreement between each parameter. Results The mean age of the subjects was 53.74±14.41 years (range 18–93 years). No differences in AL (P=0.03), steepest K (P=0.42), and flattest K (P=0.41) were obtained from the IOLMaster after pupillary dilation. However, ACD and IOL power were significantly different postdilation (P<0.01 and P<0.01, respectively). In ACD and IOL power measurements, the concordance rates were 93.03% and 97.05% within 95% limits of agreement (−0.48 to 0.26 mm and −1.09 to 0.88 D, respectively) in the Bland–Altman plots. Conclusion Biometry measurements in the cycloplegic stage should be considered in the IOL formulas that use parameters other than AL and K. PMID:27555746

  11. Distribution of pseudoexfoliation material on anterior segment structures in human autopsy eyes after cataract surgery with intraocular lens implantation.

    PubMed

    Schmack, Ingo; Auffarth, Gerd Uwe

    2016-06-01

    The purpose of the study was to evaluate the distribution and amount of pseudoexfoliation material (PXM) on anterior segment structures in pseudophakic human autopsy eyes with pseudoexfoliation (PEX) syndrome and to study its impact on fixation and decentration of posterior chamber intraocular lenses (IOLs). Sixteen human autopsy eyes (donor age [mean ± SD] 77.5 ± 8.6 years; range, 70-90 years) with history of cataract surgery and PEX syndrome were analyzed for distribution and accumulation of PXM on structures of the anterior segment by light microscopy. Quantitative IOL decentration measurements were performed using the Miyake-Apple posterior view technique. All 16 eyes displayed IOLs which were either fixed symmetrically in the capsular bag (n = 8) or asymmetrically with one haptic in the sulcus and one in the bag (n = 7) or at the pars plicata of the ciliary body (n = 1). In the majority, PXM was found around the pars plicata (average grade: 1.6 ± 0.53 µm) and the lens capsule (average grade: 1.05 ± 0.46 µm). Minor amounts were detected at the pars plana and the trabecular meshwork. IOL decentration measurements ranged from 0.51 ± 0.35 (symmetrical-fixation) to 0.61 ± 0.43 mm (asymmetrical-fixation). There was only a weak statistically not significant correlation in regard to the amount of PXM and IOL decentration and between PXM distribution and the IOL fixation site. PXM contributes to weakening of the suspensory apparatus of the crystalline lens. Although PXM induced tissue alterations predispose for a broad spectrum of intra- and postoperative complications, the amount and distribution of PXM on different anterior segment structures showed only a weak correlation to IOL decentration or fixation location. PMID:26307751

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

    PubMed Central

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

    2014-01-01

    Presbyopia occurs in the aging eye due to changes in the ciliary muscle, zonular fibers, crystalline lens, and an increased lens sclerosis. As a consequence, the capacity of accommodation decreases, which hampers to focus near objects. With the aim of restoring near vision, different devices that produce multiple focuses have been developed and introduced. However, these devices are still unable to restore accommodation. In order to achieve that goal, dual-optic accommodating Intraocular Lenses have been designed, whose anterior optic displaces axially to increase ocular power, and focus near objects. Although dual-optic accommodating IOLs are relatively new, their outcomes are promising, as they provide large amplitudes of accommodation and a greater IOL displacement than single-optic accommodating IOLs. The outcomes show comfortable near vision, higher patients’ satisfaction rates, and minimal postoperative complications like Posterior Capsular Opacification and Anterior Capsular Opacification, due to their design and material. PMID:25248803

  13. In-the-Bag Intraocular Lens Placement via Secondary Capsulorhexis with Radiofrequency Diathermy in Pediatric Aphakic Eyes

    PubMed Central

    Wang, Chunxiao; Zhang, Xinyu; Tang, Xiangchen; Liu, Jianping; Congdon, Nathan; Chen, Jingjing; Lin, Zhuoling; Liu, Yizhi

    2013-01-01

    Pediatric ophthalmologists increasingly recognize that the ideal site for intraocular lens (IOL) implantation is in the bag for aphakic eyes, but it is always very difficult via conventional technique. We conducted a prospective case series study to investigate the success rate and clinical outcomes of capsular bag reestablishment and in-the-bag IOL implantation via secondary capsulorhexis with radiofrequency diathermy (RFD) in pediatric aphakic eyes, in which twenty-two consecutive aphakic pediatric patients (43 aphakic eyes) enrolled in the Childhood Cataract Program of the Chinese Ministry of Health were included. The included children underwent either our novel technique for secondary IOL implantation (with RFD) or the conventional technique (with a bent needle or forceps), depending on the type of preoperative proliferative capsular bag present. In total, secondary capsulorhexis with RFD was successfully applied in 32 eyes (32/43, 74.4%, age 5.6±2.3 years), of which capsular bag reestablishment and in-the-bag IOL implantation were both achieved in 30 eyes (30/43, 70.0%), but in the remaining 2 eyes (2/32, 6.2%) the IOLs were implanted in the sulcus with a capsular bag that was too small. Secondary capsulorhexis with conventional technique was applied in the other 11 eyes (11/43, 25.6%, age 6.9±2.3 years), of which capsular bag reestablishment and in-the-bag IOL implantation were both achieved only in 3 eyes(3/43, 7.0%), and the IOLs were implanted in the sulcus in the remaining 8 eyes. A doughnut-like proliferative capsular bag with an extensive Soemmering ring (32/43, 74.4%) was the main success factor for secondary capsulorhexis with RFD, and a sufficient capsular bag size (33/43, 76.7%) was an additional factor in successful in-the-bag IOL implantation. In conclusion, RFD secondary capsulorhexis technique has 70% success rate in the capsular bag reestablishment and in-the-bag IOL implantation in pediatric aphakic eyes, particularly effective in cases with

  14. Intraocular Lens-Shell Technique: Adjustment of the Surgical Procedure Leads to Greater Safety When Treating Dense Nuclear Cataracts

    PubMed Central

    Chen, Weirong; Qu, Bo; Zhang, Xinyu; Lin, Zhuoling; Chen, Jingjing; Liu, Yizhi

    2014-01-01

    Objective To compare the efficacy and safety of the intraocular lens (IOL)-shell procedure versus conventional phacoemulsification for the surgical treatment of dense cataracts. Methods Eighty eyes with dense nuclear cataracts were enrolled in a prospective, randomized controlled study. Patients were assigned to two groups. In Group I, the IOL was traditionally implanted after all nuclear fragments were completely removed, and in Group II, the IOL was innovatively implanted in the bag before the last residual nuclear fragment was removed. This novel adjusted surgical procedure, named the “IOL-shell technique”, features use of the IOL as a protective barrier rather than simply as a refractive alternative, and it is conceptually different from the traditional step-by-step procedure. Clinical examinations, including uncorrected visual acuity, central corneal thickness (CCT), temporal clear corneal incision thickness and corneal endothelial cell density, were carried out. Results The inter-group difference in temporal corneal thickness was found to be of no statistical significance at any of the visits. Compared to eyes in Group I, those in Group II were shown to have significantly less corneal endothelial cell loss on both the 7th and 30th day following surgery. At 7 days after surgery, the mean corneal endothelial cell loss in Group II was 10.29%, compared to 14.37% in Group I (P<0.05). The mean endothelial cell loss measured on postoperative day 30 was 16.88% in Group II compared to 23.32% in Group I (P<0.05). On the 1st day after surgery, the mean CCT of eyes in Group II was significantly smaller compared to Group I (Group I vs. Group II: 19.42% vs. 13.50%, P<0.05). Conclusions Compared to conventional phacoemulsification, the IOL-shell technique was shown to be a relatively safer procedure without compromised efficiency for dense cataracts, and it caused less corneal endothelial cell loss and milder postoperative corneal edema (Clinical Trials Identifier: NCT

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

    PubMed Central

    Lindstrom, Richard L; Loden, James C; Walters, Thomas R; Dunn, Steven H; Whitaker, J Steven; Kim, Terry; Demopulos, Gregory A; Tjia, Khiun

    2014-01-01

    Background The purpose of this study was to evaluate the effect of OMS302 on intraoperative pupil diameter and early postoperative ocular pain when administered during intraocular lens replacement surgery. Methods Four hundred and six patients (406 study eyes; 202 in the OMS302 group and 204 in the placebo group) were entered into this randomized, double-masked, placebo-controlled, multicenter Phase III study, which was conducted at 15 centers in the USA and the Netherlands. The patients received OMS302 (60.75 mM phenylephrine HCl and 11.25 mM ketorolac tromethamine) or placebo in irrigation solution during intraocular lens replacement. No other changes in procedure were required. Coprimary endpoints were change in pupil diameter over time from surgical baseline to end of procedure and patient-reported ocular pain during the first 12 hours postoperatively. Secondary endpoints included additional measures of pupil diameter and postoperative pain. Results OMS302 was superior to placebo in maintaining intraoperative mydriasis, preventing miosis, and reducing postoperative pain. The weighted mean (standard error) difference (OMS302 – placebo) in change in the area under the curve from baseline for pupil diameter was 0.590 ([0.049]; 95% confidence interval 0.494 to 0.686; P<0.0001). For ocular pain scores, the weighted mean (standard error) difference was −4.580 ([1.192]; 95% confidence interval −6.917 to 2.244; P=0.0002). All secondary efficacy results favored OMS302. Specifically, analyses supporting prevention of miosis (patients with ≥6 mm pupil diameter at completion of cortical clean-up and those with <6 mm diameter at any time during surgery) were significant for OMS302 (95.9% versus 77.0% and 9.2% versus 38.0%, respectively; P<0.0001 for each endpoint). OMS302 was well tolerated and not associated with any unexpected adverse events. Conclusion OMS302 maintained mydriasis, prevented miosis, and reduced early postoperative pain when administered in

  16. Optical performance test & analysis of intraocular lenses

    NASA Astrophysics Data System (ADS)

    Choi, Junoh

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

  17. In-the-bag decentration of an intraocular lens in a patient with a tendency to hypertrophic scarring.

    PubMed

    Joshi, Rajesh Subhash

    2016-01-01

    We report a case of rapid anterior lens capsular contraction leading to decentration of a hydrophilic acrylic lens with stiff haptics (Rayner design). To our knowledge, this is the first report to investigate early capsular contraction with folding of the haptic over the optic in a patient with a tendency toward hypertrophic scar formation. PMID:27330480

  18. In-the-bag decentration of an intraocular lens in a patient with a tendency to hypertrophic scarring

    PubMed Central

    Joshi, Rajesh Subhash

    2016-01-01

    Summary We report a case of rapid anterior lens capsular contraction leading to decentration of a hydrophilic acrylic lens with stiff haptics (Rayner design). To our knowledge, this is the first report to investigate early capsular contraction with folding of the haptic over the optic in a patient with a tendency toward hypertrophic scar formation. PMID:27330480

  19. Posterior chamber collagen copolymer phakic intraocular lens with a central hole for moderate-to-high myopia: First experience in China.

    PubMed

    Cao, Xinfang; Wu, Weiliang; Wang, Yang; Xie, Chen; Tong, Jianping; Shen, Ye

    2016-09-01

    The purpose of this article is to evaluate the clinical outcomes of a posterior chamber phakic intraocular lens (pIOL) (Visian Implantable Collamer Lens V4c) for the correction of moderate to high myopia in Chinese eyes.The article is designed as a retrospective case series.This study included the first consecutive eyes that had implantation of a new pIOL design with a central hole, at our department by the same surgeon. The safety, efficacy, predictability, stability, and adverse events of the surgery were evaluated over 6 months.The study enrolled 63 eyes (32 patients). The mean spherical equivalent decreased from -12.81 ± 3.11 diopters (D) preoperatively to -0.05 ± 0.27 D 6 months postoperatively; 96.8% of eyes were within ±0.50 D of the target and 100% of eyes were within ±1.00 D. All eyes had a decimal uncorrected distance visual acuity of 0.5 (20/40) or better at every follow-up visit. The safety and efficacy indices were 1.42 ± 0.34 and 1.11 ± 0.19, respectively. Postoperatively, the intraocular pressure (IOP) remained stable over time. No significant rises in IOP (including pupillary block) and no secondary cataract were found. After 6 months, the mean vault was 505.2 ± 258.9 μm (range 120-990 μm), and the mean endothelial cell loss was 2.0%.Implantation of the pIOL was safe, effective, predictable, and stable in the correction of moderate-to-high myopia in Han Chinese patients, even without peripheral iridectomy. PMID:27603356

  20. The Predictability of Preoperative Pilocarpine-Induced Lens Shift on the Outcomes of Accommodating Intraocular Lenses Implanted in Senile Cataract Patients

    PubMed Central

    Li, Jin; Chen, Qi; Lin, Zhibo; Leng, Lin; Huang, Fang

    2016-01-01

    Purpose. To evaluate the predictability of lens shift induced by pilocarpine (LSPilo) on the outcomes of accommodating intraocular lens (Acc-IOL) implantation. Methods. Twenty-four eyes of 24 senile cataract patients who underwent phacoemulsification and Acc-IOL implantation were enrolled. LSPilo was evaluated with anterior segment optical coherence tomography (AS-OCT). At 3 months postoperatively, the best corrected distance visual acuities (BCDVA), distance-corrected near visual acuities (DCNVA), and subjective and objective accommodations were measured. IOL shifts under accommodation stimulus (IOLSAcc) were evaluated with AS-OCT. Results. The mean LSPilo was 112.29 ± 30.72 µm. LSPilo was not associated with any preoperative parameters. The mean IOLSAcc was 130.46 ± 42.71 µm. The mean subjective and objective accommodation were 1.54 ± 0.39 D and 1.27 ± 0.41 D, respectively. The mean postoperative BCDVA and DCNVA (log MAR value) were 0.22 ± 0.11 and 0.24 ± 0.12, respectively. LSPilo positively correlated with IOLSAcc (r = 0.541; P = 0.006), subjective accommodation (r = 0.412; P = 0.022), and objective accommodation (r = 0.466; P = 0.045), respectively. Conclusion. LSPilo is an independent preoperative parameter associated with the postoperative Acc-IOL mobility and pseudophakic accommodation. It may offer valuable information for ophthalmologists in determining the suitable candidates for Acc-IOL implantation. PMID:27516899

  1. Refractive and Visual Outcomes of Different Intraocular Lenses with Femtosecond Laser Cataract Surgery: The Expectation of Independence from Spectacles

    PubMed Central

    Crispim, Joao; Nose, Ricardo; Yogi, Milton; Nose, Walton

    2015-01-01

    Purpose: To evaluate the visual performance of different types of intraocular lens (IOL) in eyes submitted to femtosecond laser (FSL) cataract surgery and to analyze whether this technology could result in spectacles independence. Design: Retrospective comparative case series. Methods: Consecutive eyes that were scheduled for FSL cataract surgery were included in this study. After one month postoperative, patients were divided into two groups: cases that required prescription for eyeglasses and cases that did not require prescription. In addition, the patients were analyzed according to the type of IOL that was implanted (monofocal, monofocal toric, multifocal and multifocal toric). Results: Thirty-five cataract surgeries were analyzed. Twenty-three eyes had a monofocal IOL implanted, and 12 had a multifocal IOL implanted. After 1 month, 12 cases required prescription (Group 1), and 23 did not require prescription (Group 2). The proportion of eyes that did not require corrective lenses was significantly greater (P = 0.02) in eyes that received multifocal IOL (91.67%) compared with those that received monofocal IOL (47.83%). Additionally, 100% of eyes that received multifocal toric IOL did not require eyeglasses at one month postoperatively. Conclusion: The FSL surgical precision associated with modern IOL technology may be an important factor related to vision satisfaction after cataract surgery. PMID:26535071

  2. Multifocal Motor Neuropathy

    MedlinePlus

    ... Diversity Find People About NINDS NINDS Multifocal Motor Neuropathy Information Page Table of Contents (click to jump ... done? Clinical Trials Organizations What is Multifocal Motor Neuropathy? Multifocal motor neuropathy is a progressive muscle disorder ...

  3. Phakic anterior chamber intraocular lens (Verisyse™) implantation in children for treatment of severe ansiometropia myopia and amblyopia: Six-month pilot clincial trial and review of literature

    PubMed Central

    Pirouzian, Amir; Ip, Kenneth C; O’Halloran, Henry S

    2009-01-01

    Purpose: The current study aims to evaluate both safety and efficacy of Verisyse™ (AMO, Irvine, CA) phakic anterior chamber intraocular lens (IOL) in the reduction of clinically significant (>−8 D) myopic anisometropia in children who are noncompliant to traditional medical treatment including spectacle correction or contact lenses. Design: Retrospective interventional case series. Methods: Six anisometropic myopic pediatric patients in one practice were identified through chart-review. None of the patients were compliant with specatacle correction or contact lens wear and as a result had dense amblyopia of less than 20/400 by Snellen or Allen visual acuity (mean <20/400). All patients underwent Verisyse™ phakic IOL implantation in the more myopic eye by one surgeon (AP). Pre- and post-operative visual acuity, anterior/posterior segment examination, stereoacuity, axial biometry measurements, cycloplegic refraction, and endothelial cell counts were performed in all patients whenever feasible. Results: The age of patients ranged from 5–11 years. The mean post-operative follow-up time was six months from the time of IOL insertion. Improvement in visual acuity >6 lines was achieved in four patients (mean visual acuity of 20/70 at six months). Improvement in stereoacuity was noted in all six patients (from total mean zero seconds-arc to six-months post-operative mean of 500 seconds-arc by randot stereoacuity testing). Improvement of >2 lines of visual acuity lines was achieved in the other two patients. No patient lost any lines of visual acuity. Enhanced physical activity, coordination, and improved social interaction were noted in patients and were reported by the parents. No intra/post-operative complications were noted. Discussion: Irreversible or intractable amblyopia secondary to severe anisometropic myopia is a serious medical concern in the pediatric population. Failure of compliance with contact lens therapy consistently leads to visual loss. Anterior

  4. Sustained-Release Celecoxib from Incubated Acrylic Intraocular Lenses Suppresses Lens Epithelial Cell Growth in an Ex Vivo Model of Posterior Capsule Opacity

    PubMed Central

    Davis, Jennifer L.; Yi, Na Young; Salmon, Jacklyn H.; Charlton, Anna N.; Colitz, Carmen M.H.

    2012-01-01

    Abstract Purpose To determine whether celecoxib (CXB) can be released from incubated intraocular lenses (IOLs) sufficiently to inhibit lens epithelial cell (LEC) growth in an ex vivo model of posterior capsule opacification (PCO). Materials LEC growth was evaluated for 14 days in canine lens capsules (LCs) that had been exposed to media containing 20 μM CXB for 1–5 days. After the incubation of hydrophilic and hydrophobic IOLs in CXB solution, the determination of the in vitro release of CXB from the IOLs was performed for up to 28 days. The incubated and nonincubated IOLs were evaluated in the ex vivo model of PCO, and the rate of LEC growth was evaluated over 28 days. Results The treatment of LCs with 20 μM CXB for 4 and 5 days completely inhibited LEC growth. LEC repopulation did not occur after the removal of CXB. IOLs incubated in CXB for 24 h resulted in a sustained release of CXB in vitro at levels theoretically sufficient to inhibit PCO. LCs in the ex vivo model of PCO treated with acrylic IOLs incubated in CXB had significantly suppressed LEC ingrowth compared with untreated and IOL-only LCs. Conclusions A 4-day treatment of LCs with a concentration of 20 μM CXB may effectively prevent PCO. IOLs incubated in CXB for 24 h resulted in a sustained release of CXB in vitro at levels sufficient to inhibit LEC growth in the ex vivo model of PCO. Further studies are needed to determine whether CXB-incubated IOLs can effectively prevent the development of PCO in vivo. PMID:22372691

  5. A Comparison of Clinical Outcomes of Dislocated Intraocular Lens Fixation between In Situ Refixation and Conventional Exchange Technique Combined with Vitrectomy

    PubMed Central

    Eum, Sun Jung; Kim, Myung Jun; Kim, Hong Kyun

    2016-01-01

    Purpose. To evaluate surgical efficacy of in situ refixation technique for dislocated posterior chamber intraocular lens (PCIOL). Methods. This was a single-center retrospective case series. 34 patients (34 eyes) who underwent sclera fixation for dislocated IOLs combined with vitrectomy were studied. Of 34 eyes, 17 eyes underwent IOL exchange and the other 17 eyes underwent in situ refixation. Results. Mean follow-up period was 6 months. Mean logMAR best corrected visual acuity (BCVA) was not significantly different between the groups 6 months after surgery (0.10 ± 0.03 in the IOL exchange group and 0.10 ± 0.05 in the refixation group; p = 0.065). Surgically induced astigmatism (SIA) was significantly lower in the refixation group (0.79 ± 0.41) than in the IOL exchange group (1.29 ± 0.46) (p = 0.004) at 3 months, which persisted to 6 months (1.13 ± 0.18 in the IOL exchange group and 0.74 ± 0.11 in the refixation group; p = 0.006). Postoperative complications occurred in 3 eyes in the IOL exchange group (17.6%) and 2 eyes in the refixation group (11.8%). However, all of the patients were well managed without additional surgery. Conclusion. The in situ refixation technique should be preferentially considered if surgery is indicated since it seemed to produce a sustained less SIA compared to IOL exchange. PMID:27119019

  6. The Repeatability Assessment of Three-Dimensional Capsule-Intraocular Lens Complex Measurements by Means of High-Speed Swept-Source Optical Coherence Tomography

    PubMed Central

    Chang, Pingjun; Li, Jin; Savini, Giacomo; Huang, Jinhai; Huang, Shenghai; Zhao, Yinying; Liao, Na; Lin, Lei; Yu, Xiaoyu; Zhao, Yun-e

    2015-01-01

    Purpose To rebuild the three-dimensional (3-D) model of the anterior segment by high-speed swept-source optical coherence tomography (SSOCT) and evaluate the repeatability of measurement for the parameters of capsule-intraocular lens (C-IOL) complex. Methods Twenty-two pseudophakic eyes from 22 patients were enrolled. Three continuous SSOCT measurements were performed in all eyes and the tomograms obtained were used for 3-D reconstruction. The output data were used to evaluate the measurement repeatability. The parameters included postoperative aqueous depth (PAD), the area and diameter of the anterior capsule opening (Area and D), IOL tilt (IOL-T), horizontal, vertical, and space decentration of the IOL, anterior capsule opening, and IOL-anterior capsule opening. Results PAD, IOL-T, Area, D, and all decentration measurements showed high repeatability. Repeated measure analysis showed there was no statistically significant difference among the three continuous measurements (all P > .05). Pearson correlation analysis showed high correlation between each pair of them (all r >0.90, P<0.001). ICCs were all more than 0.9 for all parameters. The 95% LoAs of all parameters were narrow for comparison of three measurements, which showed high repeatability for three measurements. Conclusion SSOCT is available to be a new method for the 3-D measurement of C-IOL complex after cataract surgery. This method presented high repeatability in measuring the parameters of the C-IOL complex. PMID:26600254

  7. A Comparison of Clinical Outcomes of Dislocated Intraocular Lens Fixation between In Situ Refixation and Conventional Exchange Technique Combined with Vitrectomy.

    PubMed

    Eum, Sun Jung; Kim, Myung Jun; Kim, Hong Kyun

    2016-01-01

    Purpose. To evaluate surgical efficacy of in situ refixation technique for dislocated posterior chamber intraocular lens (PCIOL). Methods. This was a single-center retrospective case series. 34 patients (34 eyes) who underwent sclera fixation for dislocated IOLs combined with vitrectomy were studied. Of 34 eyes, 17 eyes underwent IOL exchange and the other 17 eyes underwent in situ refixation. Results. Mean follow-up period was 6 months. Mean logMAR best corrected visual acuity (BCVA) was not significantly different between the groups 6 months after surgery (0.10 ± 0.03 in the IOL exchange group and 0.10 ± 0.05 in the refixation group; p = 0.065). Surgically induced astigmatism (SIA) was significantly lower in the refixation group (0.79 ± 0.41) than in the IOL exchange group (1.29 ± 0.46) (p = 0.004) at 3 months, which persisted to 6 months (1.13 ± 0.18 in the IOL exchange group and 0.74 ± 0.11 in the refixation group; p = 0.006). Postoperative complications occurred in 3 eyes in the IOL exchange group (17.6%) and 2 eyes in the refixation group (11.8%). However, all of the patients were well managed without additional surgery. Conclusion. The in situ refixation technique should be preferentially considered if surgery is indicated since it seemed to produce a sustained less SIA compared to IOL exchange. PMID:27119019

  8. Effect of Co-Implantation of a Capsular Tension Ring on Clinical Outcomes after Cataract Surgery with Monofocal Intraocular Lens Implantation

    PubMed Central

    Park, Hyun Ju; Lee, Hun; Kim, Do Wook; Kim, Eung Kweon; Seo, Kyoung Yul

    2016-01-01

    Purpose The objective was to evaluate the effect of co-implantation of a preloaded capsular tension ring (CTR) and aberration-free monofocal intraocular lens (IOL) on clinical outcomes and visual quality after cataract surgery. Materials and Methods Patients who underwent cataract surgery were randomized into two groups that were implanted with a CTR and IOL (group 1, 26 eyes) or an IOL only (group 2, 26 eyes). At 1 and 3 months after surgery, visual acuity, refractive errors, refractive prediction errors, ocular aberrations, and modulation transfer function (MTF) were analyzed. At 3 months postoperatively, anterior chamber depth (ACD) and contrast sensitivity were evaluated. Results Group 1 showed greater hyperopic shift, which caused the refractive prediction error at 3 months after surgery to be significantly different between the two groups (p=0.049). Differences in ACD between the preoperative and postoperative periods tended to be greater in group 1 than in group 2. At 3 months postoperatively, internal MTF values at 20, 25, and 30 cycles per degree were significantly better in group 1 than in group 2 (p=0.034, 0.017, and 0.017, respectively). Contrast sensitivity showed comparable results at almost all spatial frequencies between the groups. Conclusion Regarding visual acuity and quality, both groups showed comparable results. Co-implantation of a CTR and aberration-free monofocal IOL was associated with hyperopic refractive outcomes. Surgeons should consider the position of the IOL when planning co-implantation of a CTR and IOL. PMID:27401657

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

    PubMed Central

    Huang, Jane; Uchio, Eiichi; Goto, Satoru

    2015-01-01

    Purpose To determine the biomechanical response of an impacting airbag on eyes with different axial lengths with transsclerally fixated posterior chamber intraocular lens (PC IOL). Materials and methods Simulations in a model human eye were performed with a computer using a finite element analysis program created by Nihon, ESI Group. The airbag was set to be deployed at five different velocities and to impact on eyes with three different axial lengths. These eyes were set to have transsclerally fixated PC IOL by a 10-0 polypropylene possessing a tensile force limit of 0.16 N according to the United States Pharmacopeia XXII. Results The corneoscleral opening was observed at a speed of 40 m/second or more in all model eyes. Eyes with the longest axial length of 25.85 mm had the greatest extent of deformity at any given impact velocity. The impact force exceeded the tensile force of 10-0 polypropylene at an impact velocity of 60 m/second in all eyes, causing breakage of the suture. Conclusion Eyes with transsclerally fixated PC IOL could rupture from airbag impact at high velocities. Eyes with long axial lengths experienced a greater deformity upon airbag impact due to a thinner eye wall. Further basic research on the biomechanical response for assessing eye injuries could help in developing a better airbag and in the further understanding of ocular traumas. PMID:25709387

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

    PubMed Central

    Beiko, George HH

    2015-01-01

    Purpose To determine if intraocular lens (IOL) choice at the time of cataract surgery affects driving habits. Materials and methods Pseudophakes who were 28–35 months postbilateral cataract surgery with one of two contemporary one-piece hydrophobic acrylic IOLs (SN60WF or ZCB00) were asked to complete the Driving Habits Questionnaire, a validated instrument for determining self-reported driving status, frequency, and difficulty. To determine if there were any differences in driving habits between the two groups, t-tests and χ2 tests were used. Results Of 90 respondents, 72 (40 SN60WF and 32 ZCB00) were still active drivers. The SN60WF-implanted subjects were less likely to drive at the same speed or faster than the general flow of traffic, less likely to rate their quality of driving as average/above average, less likely to have traveled beyond their immediate neighborhood, less likely to drive at night, more likely to have moderate-to-severe difficulty driving at night, and more likely to have self-reported road traffic accidents. The differences did not reach statistical significance. Conclusion Changes in patients’ driving habits 2–3 years after cataract surgery may be associated with the type of IOL implanted. A larger study, powered to demonstrate statistical significance, is needed to verify the trends identified in this pilot study and discover possible contributing factors. PMID:26357458