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Sample records for multifocal intraocular lens

  1. Refractive outcomes after multifocal intraocular lens exchange.

    PubMed

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

    2017-06-01

    To evaluate the refractive outcomes after multifocal intraocular lens (IOL) exchange. Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA. Retrospective case series. Patients had multifocal IOL explantation followed by IOL implantation. Outcome measures included type of IOL, surgical indication, corrected distance visual acuity (CDVA), and refractive prediction error. The study comprised 29 patients (35 eyes). The types of IOLs implanted after multifocal IOL explantation included in-the-bag IOLs (74%), iris-sutured IOLs (6%), sulcus-fixated IOLs with optic capture (9%), sulcus-fixated IOLs without optic capture (9%), and anterior chamber IOLs (3%). The surgical indication for exchange included blurred vision (60%), photic phenomena (57%), photophobia (9%), loss of contrast sensitivity (3%), and multiple complaints (29%). The CDVA was 20/40 or better in 94% of eyes before the exchange and 100% of eyes after the exchange (P = .12). The mean refractive prediction error significantly decreased from 0.22 ± 0.81 diopter (D) before the exchange to -0.09 ± 0.53 D after the exchange (P < .05). The median absolute refractive prediction error significantly decreased from 0.43 D before the exchange to 0.23 D after the exchange (P < .05). Multifocal IOL exchange can be performed safely with good visual outcomes using different types of IOLs. A lower refractive prediction error and a higher likelihood of 20/40 or better vision can be achieved with the implantation of the second IOL compared with the original multifocal IOL, regardless of the final IOL position. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  2. Additional multifocal sulcus-based intraocular lens: alternative to multifocal intraocular lens in the capsular bag.

    PubMed

    Schrecker, Jens; Kroeber, Sandra; Eppig, Timo; Langenbucher, Achim

    2013-04-01

    To compare the visual outcomes of additional multifocal intraocular lenses (IOLs) for sulcus fixation with those of standard multifocal IOLs in the capsular bag. Department of Ophthalmology, Rudolf-Virchow-Klinikum Glauchau, Glauchau, Germany. Prospective controlled clinical trial. Eyes had phacoemulsification and implantation of a monofocal IOL in the capsular bag and an additional aberration-free diffractive IOL in the ciliary sulcus (multifocal add-on IOL group). Measurements of uncorrected and distance-corrected distance, intermediate, and near visual acuities; contrast sensitivity; and defocus curve were performed 3 months postoperatively. Results were compared with those in eyes with an aberration-correcting diffractive posterior chamber IOL (multifocal PC IOL group). The multifocal add-on IOL group comprised 34 eyes of 20 patients and the multifocal PC IOL group, 31 eyes of 17 patients. Cataract surgery, IOL implantation, and the postoperative course were uneventful in all cases. There were no statistically significant differences in uncorrected and distance-corrected distance, intermediate, or near visual acuities between the 2 groups. The median uncorrected distance visual acuity was 0.00 logMAR in both groups, and the median uncorrected near visual acuity was 0.10 logMAR in both groups. Contrast sensitivity testing yielded significantly better results in the multifocal add-on IOL group, especially at spatial frequencies over 1.5 cycles per degree. Defocus curves were similar in the 2 groups. Visual performance with a multifocal diffractive add-on IOL was equivalent to that achieved with a commonly used multifocal diffractive PC IOL. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

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

    PubMed

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

    2014-04-01

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

  4. Mini-monovision versus multifocal intraocular lens implantation.

    PubMed

    Labiris, Georgios; Giarmoukakis, Athanassios; Patsiamanidi, Maria; Papadopoulos, Zois; Kozobolis, Vassilios P

    2015-01-01

    To compare the effect of monovision correction and multifocal intraocular lens (IOL) implantation on patient satisfaction, spectacle dependence, visual acuity, and dysphotopsia in cataract patients. University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece. Prospective randomized trial. Patients with a diagnosis of senile cataract with stage 2 nuclear opalescence were randomly assigned to 2 groups: monovision and multifocal IOL implantation. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity, Visual Function Index-14 (VF-14) scores, and spectacle dependence were assessed prior to surgery and 6 months postoperatively. The monovision group comprised 38 patients and the multifocal IOL implantation group, 37 patients. Both techniques provided excellent refractive outcomes in UDVA and VF-14 scores (all P < .01). No significant intergroup differences were detected in VF-14 scores at the final postoperative examination. The monovision group patients presented significantly more spectacle dependence for near vision but less glare. Monovision and multifocal IOL implantation provided excellent refractive outcomes for distance vision. Multifocal IOL insertion was associated with less dependence on glasses overall but significantly more dysphotopsia. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  5. Multifocal intraocular lens to correct presbyopia

    NASA Astrophysics Data System (ADS)

    Jiang, Lai; Liu, Yongji; Wang, Xiaolin; Wang, Zhaoqi

    2016-10-01

    Due to the loss of the flexibility of the crystalline lens, presbyopia is the most common vision dysfunction for adults after 40. To correct presbyopia, this paper presents a design of a MIOL, which can give extended clear vision range both in photopic vision(3mm pupil diameter) and in the mesopic vision(4.5mm pupil diameter). With a pseudophakic eye model, a multi-configuration with object distance covering a full range of normal visual from 8m to 0.4m was applied. The surfaces of MIOL were aspherical diffractive surface. MIOL was divided into two regions: the inner zone was optimized when the pupil diameter was 3mm and the outer zone was optimized when the pupil diameter was 4.5mm. Finally, we got a 22 diopters (D) MIOL with a central thickness of 0.652mm and an optical diameter of 4.5mm. By evaluating the modulation transfer function, we got optical performance of the pseudophakic eye with this MIOL. When the pupil diameter of pseudophakic eye was 3mm, MTF at 50c/mm and 100c/mm was respectively above 0.4 and 0.15 for the object distance from 8m to 0.4m. When the pupil diameter of pseudophakic eye was 4.5mm, MTF at 50c/mm and 100c/mm was respectively above 0.25 and 0.09 for the object distance from 8m to 0.4m.The visual acuity was above 0.9 for the whole visual range at both of two pupil diameters. Therefore it is safe to say that the new MIOL design provides good optical performance for whole visual range under both of the photopic vision and the mesopic vision.

  6. Multifocal Toric Intraocular Lens for Traumatic Cataract in a Child

    PubMed Central

    Zeng, Yanfeng; Fan, Licheng; Lu, Peirong

    2016-01-01

    A child suffering from traumatic cataract and corneal astigmatism of 2.14 D had a phacoemulsification operation and implantation of a ReSTOR Toric intraocular lens (IOL) to correct the astigmatism. The primary outcome measurements were the uncorrected distance visual acuity (UDVA), uncorrected near vision at 40 cm, intraocular pressure, spherical equivalent refraction, residual astigmatism, corneal astigmatism, presence of unusual optical phenomena, and use of spectacles. At 7 months postoperatively, UDVA was maintained between 16/20 and 24/20, near vision was between J1 and J3, residual spherical refraction was 0–0.37 D, and residual refractive cylinder was between 0 and 0.67 D. A multifocal toric IOL can provide the possibility of satisfactory vision for both distant and near conditions without the use of spectacles to meet children's needs when studying and doing sports. Additionally, binocular vision can be reconstructed. This intervention, therefore, seems to be a satisfactory alternative. PMID:28101039

  7. 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

  8. Presbyopia correction with an anterior chamber phakic multifocal intraocular lens.

    PubMed

    Alió, Jorge L; Mulet, M Emilia

    2005-08-01

    To investigate in a pilot study the potential of an anterior chamber phakic refractive multifocal intraocular lens (IOL) prototype for the correction of near and far vision in those with myopic and hyperopic presbyopia. A multicenter, open-label, prospective, noncomparative pilot evaluation. There were 17 patients (34 eyes), 16 women and 1 man, with a mean age of 52+/-3.94 years (range, 46-62 years). Six eyes were myopic (mean spherical equivalent [SE], -9.3+/-3.83 diopters (D)) and 28 were hyperopic (mean SE, +2.3+/-0.77 D), with astigmatism less than 1.5 D. The prototype multifocal phakic IOL was implanted through a 6.5-mm temporal incision. The dominant eye was targeted for emmetropia and the nondominant eye for -1.0 D. The efficacy of the implant was assessed after surgery by measuring monocular and binocular uncorrected and distance-corrected visual acuity (VA) at distance, intermediate, and near, and distance-corrected near VA with near add. Distance-corrected distance and near VA also were determined in low contrast (25%). The safety index and efficacy index were calculated, and patient satisfaction questionnaires also were administered. Follow-up was at 1-3 days, 5-9 days, 21 days, 3 months, 6 months, and 1 year after surgery. Spherical equivalent refraction ranged from -11.75 to +4.25 D before surgery, and from -2.0 to +1.85 D 1 year after surgery. The binocular efficacy index was 0.68 (near) and 1.0 (distance), and the binocular safety index was 1.0 for both near and distance. Mean binocular uncorrected distance VA improved from 20/59 (+/-4 lines) before surgery to 20/18 (+/-1 line) 1 year after surgery. Mean binocular uncorrected intermediate VA improved from 20/125 (+/-10 lines) to 20/21 (+/-1 line), and mean binocular uncorrected near VA improved from 20/78 (+/-5 lines) to 20/32 (+/-1 line). Binocular uncorrected visual acuity was at least 20/40 (distance and intermediate) and Jaeger 3 in 88.2% of patients, and it was at least 20/40 and Jaeger 5 in 100

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

    PubMed

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

    2016-01-01

    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. 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. 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. 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.

  10. 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

  11. Refractive lens exchange with the diffractive multifocal Tecnis ZM900 intraocular lens.

    PubMed

    Goes, Frank Joseph

    2008-03-01

    To assess visual outcomes and patient satisfaction after refractive lens exchange followed by bilateral implantation of the multifocal Tecnis intraocular lens (IOL). This prospective case series involved 59 eyes of 30 patients aged 56 +/- 8 years. Fifty-seven eyes were hyperopic (+3.52 +/- 1.80 diopters [D]) and 2 eyes were myopic (-1.12 +/- 0.53 D). Near, intermediate, and distance visual acuities were assessed at 1 and 6 months postoperatively. At last follow-up, patients were asked about their overall satisfaction, the occurrence of photic phenomena, difficulties driving at night, and spectacle independence. Six months after surgery and laser retreatment in 15 eyes, 90% of eyes achieved monocular uncorrected distance visual acuity of 20/30 or better (0.087 +/- 0.085 logMAR) and 100% of eyes could read J2 or better without correction, including 90% of eyes achieving J1 or better (0.133 +/- 0.095 logMAR). Evaluation of visual performance at 1 month versus 6 months (n = 44 eyes, no retreatment) revealed a considerable improvement of the uncorrected (0.175 +/- 0.122 vs 0.127 +/- 0.094 logMAR; P = .005) and distance-corrected (0.099 +/- 0.057 vs 0.068 +/- 0.031 logMAR; P = .001) near visual acuity whereas mean refractive errors and distance visual acuity remained unchanged. Overall, 96.4% of patients were very satisfied with the procedure and would choose the same lens again. The majority of patients (92.8%) were totally free from spectacles with only 7.2% occasionally wearing glasses for intermediate tasks. The multifocal Tecnis ZM900 IOL provides good distance and near vision after refractive lens exchange and a period of neuroadaptation. However, laser vision correction might be required to achieve emmetropia as well as spectacles to achieve good intermediate vision.

  12. Multifocal toric intraocular lens implantation for forme fruste and stable keratoconus.

    PubMed

    Montano, Margarita; López-Dorantes, Karla P; Ramirez-Miranda, Arturo; Graue-Hernández, Enrique O; Navas, Alejandro

    2014-04-01

    To describe the results of multifocal toric intraocular lens implantation in two patients (one with forme fruste keratoconus and the other with frank but stable keratoconus). A 50-year-old woman with forme fruste keratoconus and positive family history of keratoconus and a 42-year-old man with frank keratoconus underwent corneal collagen cross-linking. Uncorrected distance visual acuity was 20/800 in the right eye and 20/400 in the left eye and 20/400 in the right eye and 20/100 in the left eye, respectively. Refractive lens exchange was performed using multifocal toric intraocular lenses in both cases. After phacoemulsification, uncorrected distance visual acuity, corrected distance visual acuity, binocular uncorrected distance visual acuity was 20/25 and 20/30 in cases 1 and 2, respectively, and residual refraction was within 0.5 diopters of emmetropia in both cases. Patients were subjectively satisfied. Presbyopic treatment options are scarce for patients with keratoconus and multifocal toric intraocular lenses may be useful in selected cases. Copyright 2014, SLACK Incorporated.

  13. Imaging quality of bifocal piggyback intraocular lens versus ReSTOR and TECNIS multifocal lenses.

    PubMed

    Artigas, José M; Felipe, Adelina; Diaz-Llopis, Manuel; Garcia-Delpech, Salvador; Navea, Amparo

    2010-01-01

    The imaging quality provided by a piggyback integrated by a monofocal intraocular lens (IOL) + a bifocal IOL of zero power and +3.75 diopters of addition is compared with the optics quality of a simple multifocal IOL of the same power and addition. The imaging quality was evaluated by determining the modulation transfer function (MTF), using an artificial eye simulating in vivo conditions of the anterior chamber, including an artificial cornea and a wet cell containing physiologic solution where the IOL was positioned. The MTFs of the bifocal piggyback for near and distance vision were measured, with pupil diameters of 3 and 5 mm, and compared with the MTFs of an equivalent power of ReSTOR and TECNIS multifocal IOLs measured under the same conditions. The MTFs for distance and near focus of the bifocal piggyback are similar to the MTFs of the ReSTOR and TECNIS multifocal IOLs with the two diameters of pupil. A more accurate comparison, values of average modulation, and Strehl ratio show a greater similitude with ReSTOR than with TECNIS. The bifocal piggyback system provides a similar imaging quality to that obtained with a ReSTOR multifocal IOL and, like the ReSTOR, provides better performance in distance vision than in near vision, whereas the TECNIS multifocal IOL provides the best performance.

  14. Visual and optical performance with the ReZoom multifocal intraocular lens.

    PubMed

    Muñoz, Gonzalo; Albarrán-Diego, César; Cerviño, Alejandro; Ferrer-Blasco, Teresa; García-Lázaro, Santiago

    2012-01-01

    This study evaluated visual acuity, contrast sensitivity, and wavefront aberrations after refractive multifocal intraocular lens (IOL) implantation. A prospective study comprising 174 eyes of 87 patients who had bilateral implantation of a multifocal IOL was carried out. A control group of 100 eyes of 50 age-matched patients with a monofocal IOL was used for comparison. Uncorrected and corrected distance and near visual acuity, contrast sensitivity (CS), and wavefront analysis (Hartmann-Shack) was performed 6 months after surgery. Contrast sensitivity was tested for distance and near under mesopic (2 cd/m2) and photopic conditions (90 cd/m2). Distance photopic CS was not significantly different from the monofocal group, while distant mesopic CS and near photopic and mesopic CS were significantly lower. Mean aberration root mean square (RMS) values for the multifocal IOL group were 0.229 ± 0.103 µm for coma, 0.137 ± 0.067 µm for spherical aberration (SA), and 0.301 ± 0.133 µm for higher order aberrations (HOAs). Strehl ratio averaged 0.096 ± 0.045. Distant visual performance with the multifocal IOL was excellent under photopic conditions, but was reduced under mesopic levels. Near vision showed suboptimal results in both photopic and mesopic conditions. Coma, SA, and HOAs with the multifocal IOL were higher than those reported previously, with a lower Strehl ratio.

  15. Combination of Toric and multifocal intraocular lens implantation in bilateral cataract patients with unilateral astigmatism

    PubMed Central

    Liang, Jing-Li; Tian, Fang; Zhang, Hong; Teng, He

    2016-01-01

    AIM To assess the binocular visual function in bilateral cataract patients with unilateral astigmatism after combined implantations of Toric with multifocal intraocular lens (IOL), and to compare with that of Toric and monofocal IOL implantation. METHODS All the 30 patients with unilateral astigmatism suffered bilateral cataract were randomly divided into two groups: Toric plus multifocal IOL group and Toric plus monofocal IOL group. Uncorrected and corrected visual acuity at distance (5.0 m), intermediate distance (0.6 m), and near (0.33 m), contrast sensitivity, and stereopsis were assessed 6mo after surgery. Patients were also surveyed for visual disturbances and spectacle dependence. RESULTS Binocular uncorrected visual acuity (LogMAR) of Toric/multifocal IOL eyes at distance, intermediate, near were 0.05±0.05, 0.24±0.10, and 0.14±0.06 respectively. The values of Toric plus monofocal IOL eyes were 0.06±0.07, 0.26±0.08, and 0.37±0.10 respectively. These values did not indicate significant differences between two groups with exception of near visual acuity. In the photopic condition (with or without glare), the contrast sensitivity of multifocal IOL eyes was significant lower than the monofocal IOL eyes in 18 cpd. In the mesopic condition, the contrast sensitivity of multifocal group was significant lower than monofocal group in 12 cpd, and in mesopic glare condition, this significant difference was found both in 6 cpd and 12 cpd. The stereopsis of Toric/multifocal IOL eyes decreased slightly (100±80 seconds of arc, t=2.222, P=0.136). Mean near vision for patient satisfaction was statistically significantly higher in Toric/multifocal IOL group patients versus than that in Toric/monofocal IOL group (80% vs 25.5%, P=0.000). Visual disturbance was not noticed in either group. CONCLUSION Although the combination of Toric and multifocal IOL implantation results in compromising stereoacuity, it can still provide patients with high levels of spectacle freedom and

  16. 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

  17. Visual function after bilateral implantation of a new zonal refractive aspheric multifocal intraocular lens.

    PubMed

    Muñoz, Gonzalo; Albarrán-Diego, César; Ferrer-Blasco, Teresa; Sakla, Hani F; García-Lázaro, Santiago

    2011-11-01

    To evaluate visual function after bilateral implantation of a zonal refractive aspheric multifocal intraocular lens (IOL). Private practice surgery center, Valencia, Spain. Cohort study. Consecutive eyes with cataract had bilateral implantation of Lentis Mplus LS-312 multifocal IOLs. Distance, intermediate, and near visual acuities; contrast sensitivity; defocus curves; and a quality-of-vision questionnaire, including presence of halos or dysphotopsia, were evaluated 6 months postoperatively. A control group of age-matched monofocal pseudophakic patients was included to compare contrast sensitivity function. In the multifocal group, the mean binocular corrected distance visual acuity (logMAR) was -0.04 ± 0.07 at 6 m, 0.11 ± 0.10 at 1 m, and 0.06 ± 0.07 at 40 cm. The defocus curve showed little intermediate vision drop off. Photopic contrast sensitivity for distance was similar to the monofocal IOL contrast sensitivity function, while photopic contrast sensitivity for near and mesopic contrast sensitivity for distance with or without glare was reduced at high frequencies. The mean patient satisfaction was 8.09 ± 1.30 (scale 0 to 10); 84.4% of patients were completely independent of spectacles. Moderate halos, glare, and night-vision problems were reported by 6.2%, 12.5%, and 15.6% of patients, respectively. The new-generation multifocal IOL provided adequate distance, intermediate, and, to a lesser extent, near vision with high rates of spectacle freedom. Halos occurred, and other photic phenomena should be expected in a small percentage of patients. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  18. Primary piggyback implantation using the Tecnis ZM900 multifocal intraocular lens: case series.

    PubMed

    Akaishi, Leonardo; Tzelikis, Patrick F; Gondim, Joyce; Vaz, Rodrigo

    2007-12-01

    To assess the postoperative outcomes of primary piggyback implantation using the Tecnis ZM900 multifocal intraocular lens (IOL) (Advanced Medical Optics). Hospital Oftalmológico de Brasília, Brasília, Brazil. Patients who had phacoemulsification with primary piggyback IOL implantation were analyzed prospectively. In all cases, a Tecnis ZM900 multifocal IOL was implanted in the capsular bag and a second silicone IOL was implanted in the ciliary sulcus. Information collected included near and distance uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and the spherical equivalent (SE) before and after the surgery. Twenty eyes of 12 patients were included in the study. They were followed for 6 months. The mean preoperative distance UCVA was 20/400. At the last follow-up (6 months), the mean distance UCVA was 20/29, significantly better than before referral (P<.001). The mean preoperative SE was +6.35 diopters (D) +/- 2.25 (SD). Six months after surgery, the mean SE was -0.25 +/- 0.40 D (range -1.00 to +0.50 D), significantly better than before referral (P<.001). No patient lost lines of BCVA after surgery. At the last follow-up, 90% of the eyes achieved a near UCVA of J1 and 83.3% of patients were spectacle independent for near and distance vision. A second refractive procedure was performed in 2 eyes. Primary piggyback implantation using the Tecnis ZM900 multifocal IOL was a simple, safe, and accurate option for patients with high hyperopia who wanted to reduce their dependency on spectacles.

  19. Intermediate optimization of vision with bilateral nonaspheric multifocal intraocular lens implantation.

    PubMed

    Blaylock, John F; Si, Zhaomin; Prescott, Cheryl; Aitchison, Sandi

    2009-02-01

    To evaluate binocular visual function, refraction, and subjective outcomes of intermediate optimization of vision after simultaneous bilateral implantation of the nonaspheric AcrySof SA60D3 ReSTOR multifocal intraocular lens (IOL). Private clinic, Abbotsford, British Columbia, Canada. Intermediate optimization was performed by overcorrection of 1.00 diopter (D) to induce mild myopia in the nondominant eye in patients having bilateral implantation of the multifocal IOL. Distance manifest refraction and visual acuity at several distances were determined; contrast sensitivity function (CSF), near-point stereo acuity, and subjective outcomes were assessed postoperatively at 2 weeks and 1, 3, 6, and 12 months. Thirty-two patients with intended intermediate optimization and 5 patients with unintended intermediate optimization were prospectively evaluated. The mean manifest refraction spherical equivalent was stable from 2 weeks (-0.94 D+/-0.22 [SD]) to 12 months (-0.93+/-0.23 D) in the intermediate optimization eyes. Overall, postoperative mean binocular uncorrected near, intermediate, and distance visual acuities were 20/23, 20/23, and 20/22, respectively. No significant differences were found between best distance-corrected and uncorrected stereo acuity or between best distance-corrected and uncorrected binocular CSF under most conditions (P> .05). On questioning, 97% of patients had little or no difficulty seeing and were bothered occasionally or never by the visual fluctuation between the near range and intermediate range. Intermediate optimization with slight myopia in 1 eye after bilateral implantation of the multifocal IOL offered consistent good vision at all ranges, indicating it a safe option for patients who require good vision at intermediate ranges.

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

    PubMed

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

    2014-12-01

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

  1. 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

  2. Toric multifocal intraocular lens implantation in a case of bilateral anterior and posterior lenticonus in Alport syndrome

    PubMed Central

    Ladi, Jeevan S; Shah, Nitant A

    2016-01-01

    We report the first case of toric multifocal intraocular lens (IOL) implantation in both the eyes of a young patient of Alport syndrome with anterior and posterior lenticonus with a successful outcome. An 18-year-old female patient presented with progressively blurred vision in both eyes since 4–5 years not improving with glasses. Refraction showed high myopia with astigmatism; however, the vision did not improve beyond 6/60 with glasses correction. Clinical examination on slit lamp showed anterior and posterior lenticonus bilaterally with a classical oil droplet appearance. We performed clear lens extraction by phacoemulsification with toric multifocal IOL implantation in both eyes. Postoperatively, the patient achieved an excellent refractive outcome with the unaided vision of 6/9, N6 in both eyes. PMID:27958211

  3. Clinical outcomes after cataract surgery with implantation of the Tecnis ZMB00 multifocal intraocular lens

    PubMed Central

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

    2014-01-01

    Background The aim of this study was to evaluate visual performance, contrast sensitivity, and patient satisfaction in patients undergoing cataract surgery with bilateral implantation of the Tecnis ZMB00 diffractive multifocal IOL (intraocular lens). Material/Methods This was a prospective study of 40 eyes of 20 patients with an age range from 48 to 67 years and undergoing cataract surgery with implantation of the diffractive 1-piece IOL Tecnis ZMB00 (Abbott Medical Optics) in 1 eye and 3 weeks later in the other eye. The following parameters were evaluated at 3 and 6 months after the operation: binocular uncorrected distance, intermediate and near visual acuity (UDVA, UIVA, UNVA), uncorrected binocular photopic and mesopic distance and photopic near contrast sensitivity (CSV-1000), subjective symptoms, and patient satisfaction (VF-14). Results No significant change was observed in logMAR UDVA between 3 and 6 months postoperatively (−0.11±0.14 vs. −0.10±0.13, p>0.05). In contrast, UNVA (0.06±0.12 vs. −0.02±0.12, p=0.004) and UIVA (0.12±0.15 vs. 0.07±0.11, p=0.005) in this period improved significantly. At 3 and 6 months after surgery, 85% of patients no longer needed to wear corrective lenses. Contrast sensitivity under different conditions was within normal age-matched limits, with significant improvements for some spatial frequencies at 3 and 6 months after surgery (p<0.04). Mean overall patient satisfaction was 9.39±1.06 and 9.19±1.20 (scale from 1 to 10, with 10 being the best score) at 3 and 6 months, respectively. Low level of halo perception was reported in 75% of patients. Conclusions The Tecnis ZMB00 IOL provides an effective restoration of the distance, intermediate, and near visual function, allowing patients to be totally free of need to wear corrective lenses and providing high levels of patient satisfaction. PMID:25022700

  4. Quality of life evaluation after implantation of 2 multifocal intraocular lens models and a monofocal model.

    PubMed

    Alió, Jorge L; Plaza-Puche, Ana B; Piñero, David P; Amparo, Francisco; Rodríguez-Prats, Jose L; Ayala, María José

    2011-04-01

    To compare vision-related quality of life using the National Eye Institute Visual Function Questionnaire (NEI VFQ-25) in patients with 1 of 3 types of intraocular lenses (IOLs) and to correlate it with postoperative visual outcomes. Vissum Corporation-Instituto Oftalmológico de Alicante, Alicante, Spain. Comparative case series. This study comprised eyes having cataract surgery with bilateral implantation of a monofocal IOL (Group A), apodized multifocal IOL (Group B), or full diffractive multifocal IOL (Group C). Distance and near visual acuities, contrast sensitivity, and quality of life were evaluated preoperatively and postoperatively. The study enrolled 106 eyes (53 patients; age range 49 to 80 years). All groups had significant improvement in uncorrected and corrected distance visual acuities postoperatively (P ≤.05). Near vision outcomes were significantly better in Groups B and C (P ≤.01). Groups B and C had significantly less difficulty in some near tasks, such as reading the newspaper (A-B, P=.02; A-C, P=.02) or reading bills (A-B, P=.04; A-C, P=.004). Group C also had significantly less difficulty driving at night than Group B (P<.01). Near visual acuity and contrast sensitivity were significantly correlated with difficulty in near visual tasks in Groups B and C. Night-driving difficulty correlated significantly with contrast sensitivity in Group B. Patients with multifocal IOLs could perform several daily tasks at near and intermediate distances, with less night-driving limitation with the full diffractive IOL than with apodized multifocal and monofocal IOLs. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  5. 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

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

    PubMed

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

    2009-12-01

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

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

    PubMed

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

    2016-02-01

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

  8. 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

  9. Visual and optical performance with two different diffractive multifocal intraocular lenses compared to a monofocal lens.

    PubMed

    Alió, Jorge L; Piñero, David P; Plaza-Puche, Ana B; Amparo, Francisco; Jiménez, Ramón; Rodríguez-Prats, Jose L; Javaloy, Jaime

    2011-08-01

    To compare the visual acuity outcomes as well as the ocular optical performance of eyes implanted with either a monofocal or one of two diffractive multifocal intraocular lenses (IOLs). One hundred two consecutive eyes of 51 bilateral cataract patients (age 49 to 80 years) were divided into three groups: 22 eyes were implanted with a monofocal IOL (monofocal group), 40 eyes with the Acrysof ReSTOR SN6AD3 IOL (ReSTOR group), and 40 eyes with the Acri.Lisa 366D IOL (Acri.Lisa group). Visual acuity and contrast sensitivity were evaluated pre- and postoperatively. Additionally, ocular optical quality and intraocular aberrations were evaluated postoperatively. Significant improvement after surgery in uncorrected and corrected distance and near visual acuity was observed in all three groups (P≤.05). Uncorrected near visual acuity was significantly better in eyes from the ReSTOR and Acri.Lisa groups compared to the monofocal group (P≤.01). Photopic contrast sensitivity was significantly better for the spatial frequency of 3 cycles/degree in the monofocal group (P<.01). Significantly higher values of the ocular Strehl ratio and cutoff modulation transfer function spatial frequency were also found in the Acri.Lisa group (P=.01). An acceptable range of vision between near and distance peaks was observed in the defocus curves of the ReSTOR and Acri.Lisa groups. The AcrySof ReSTOR and Acri.Lisa 366D IOLs are able to successfully restore near and intermediate visual function after cataract surgery; however, the Acri.Lisa design seems to provide better optical performance. These results need to be confirmed in a randomized, prospective trial. Copyright 2011, SLACK Incorporated.

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

    PubMed Central

    Tchah, Hungwon; Nam, Kiyeun; Yoo, Aeri

    2017-01-01

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

  11. Optical analysis, reading performance, and quality-of-life evaluation after implantation of a diffractive multifocal intraocular lens.

    PubMed

    Alió, Jorge L; Plaza-Puche, Ana B; Piñero, David P; Amparo, Francisco; Jiménez, Ramón; Rodríguez-Prats, Jose L; Javaloy, Jaime; Pongo, Vanessa

    2011-01-01

    To evaluate the reading performance, changes in quality of life, and optical performance after cataract surgery with multifocal diffractive intraocular lens (IOL) implantation. Vissum Corporation, Alicante, Spain. Prospective case series. Patients with bilateral cataract had implantation of Acri.LISA 366D multifocal IOLs. Visual acuity and contrast sensitivity outcomes were evaluated during a 6-month follow-up. Other parameters evaluated included reading performance (Salzburg Reading Desk), a 25-item quality-of-life questionnaire (National Eye Institute Visual Functioning Questionnaire-25 [NEI VFQ-25] and appendix NEI VFQ-39), and ocular optical performance (ocular aberrometry and modulation transfer function). The study included 48 eyes (24 patients) ranging in age from 47 to 77 years. The mean uncorrected distance visual acuity (logMAR) improved significantly 1 month postoperatively (P<.01), with no significant changes afterward (6 months, P≥.06). The mean reading acuity without correction improved significantly from 0.68 logRAD ± 0.20 (SD) to 0.16 ± 0.08 logRAD 1 month after surgery (P < .01). However, it was worse by the end of the follow-up (6 months, P = .04). During the follow-up, no significant changes were found in the mean reading speed without near correction (6 months, P = .50). Contrast sensitivity improved significantly at all spatial frequencies under photopic and scotopic conditions after surgery (6 months, P≤.02). The quality-of-life index related to reading ability also improved significantly (3 months, P = .03). Implantation of the multifocal diffractive IOL significantly improved reading performance, which had a positive effect on the patient's quality of life postoperatively. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  12. Clinical Evaluation of Reading Performance Using the Salzburg Reading Desk With a Refractive Rotational Asymmetric Multifocal Intraocular Lens.

    PubMed

    Linz, Katharina; Attia, Mary S A; Khoramnia, Ramin; Tandogan, Tamer; Kretz, Florian T; Auffarth, Gerd Uwe

    2016-08-01

    To evaluate functional results and reading performance using the Salzburg Reading Desk after implantation of a sector-shaped near-embedded, rotational asymmetrical multifocal intraocular lens (IOL) and a multifocal toric IOL with a +3.00 diopter (D) near addition. In a prospective study, the LentisMplus and Mplus toric IOLs (Oculentis GmbH, Berlin, Germany) were implanted in 34 eyes of 18 patients at the University Eye Hospital of Heidelberg. Uncorrected and corrected distance visual acuity (UDVA, CDVA) and uncorrected and corrected near visual acuity (UNVA, CNVA) were evaluated using standardized visual acuity charts (ETDRS). The Salzburg Reading Desk was used to analyze unilateral and bilateral uncorrected and corrected reading acuity, reading distance, reading speed, and the smallest log-scaled print size that could be read effectively at a set (40 cm/80 cm) and subjective chosen near and intermediate distance. Postoperatively, the median UDVA was 0.08 logMAR (20/25 Snellen) and the median CDVA was 0.01 logMAR (20/20 Snellen). The median UNVA was 0.12 logMAR (20/25 Snellen) and the median CNVA was 0.03 logMAR (20/20 Snellen). The median uncorrected reading acuity measured with the Salzburg Reading Desk for near distance at 40 cm was 0.18 logMAR (20/32 Snellen). The subjectively preferred near distance was 39 cm and revealed similar visual acuity results. The best reading acuity for intermediate distance with a median of 0.22 logMAR (20/32 Snellen) was achieved at a median distance of 62 cm. Reading performance of the multifocal IOL corresponded for near standardized and individual distance, whereas reading function was better at the patient's preferred intermediate distance. [J Refract Surg. 2016;32(8):526-532.]. Copyright 2016, SLACK Incorporated.

  13. Validity of autorefraction after cataract surgery with multifocal ReZoom intraocular lens implantation.

    PubMed

    Muñoz, Gonzalo; Albarrán-Diego, César; Sakla, Hani F

    2007-09-01

    To evaluate the clinical utility of spherocylindrical automated refraction (AR) compared with subjective manifest refraction (MR) after cataract surgery with implantation of ReZoom refractive multifocal intraocular lenses (IOLs) (Advanced Medical Optics, Inc.). Private Practice. This prospective nonrandomized interventional study consisted of 72 patients with bilateral cataract and a potential visual acuity of at least 20/40. Patients had bilateral nonsimultaneous cataract surgery and implantation of a ReZoom IOL. Manifest refraction was performed in all patients followed by 3 consecutive measurements using the Topcon KR-8000 autorefractor with nondilated and dilated pupils. Assessment of repeatability of multiple consecutive ARs and comparison of the AR and MR using power vector analysis were performed at the 6-month follow-up. The main outcome measures were the correlation between AR and MR with sphere, spherical equivalent, and astigmatism as well as the repeatability of AR before and after dilation with phenylephrine 10%. Repeatability analysis showed that the initial nondilated AR was not significantly different from the mean of the 3 refractions for nondilated and dilated measurements. The mean difference between the initial AR and the MR was -0.84 +/- 0.62 diopters (D) for sphere (SD), -1.00 +/- 0.61 D for spherical equivalent, and -0.06 +/- 0.19 D and -0.01 +/- 0.17 D, respectively, for J(0) and J(45), the 2 components of astigmatism. Linear regression of AR versus MR data showed poor correlation for sphere (R(2) = 0.4852) and spherical equivalent (R(2) = 0.5529), whereas the correlation for the 2 astigmatic components of vector analysis was excellent (J(0), R(2) = 0.8881; J(45), R(2) = 0.8640). Correlation was better when the MR residual refractive defect was higher. Although autorefraction showed excellent agreement with subjective refractive astigmatism, correlation with spherical values was poor, with a trend toward more negative values. Autorefraction

  14. Successful Restoration of Visual Acuity with an Extended Range of Vision Intraocular Lens after Multifocal Laser Ablation.

    PubMed

    Black, Sondra

    2016-01-01

    As our baby boomer population is aging and developing cataracts, so are our post-LASIK patients. These patients underwent LASIK surgery as they wished to be spectacle-free and are hoping to remain so after intraocular lens (IOL) surgery. Unfortunately, very little information is available regarding the suitability of presbyopia correcting IOLs for post-LASIK patients. This case represents successful implantation of an extended range of vision IOL in a 59-year-old patient who underwent multifocal ablation excimer laser surgery 12 years before. Emmetropia was targeted for the dominant eye and -0.5 D for the fellow eye. The 13 month follow-up after bilateral implantation of the TECNIS Symfony IOL revealed an uncorrected visual acuity of 20/25 for distance, 20/20 for intermediate and 20/16 for near. The patient is very happy and did not report any visual symptoms when asked. This successful case should encourage surgeons to consider implanting an extended range of vision IOLs in post-LASIK patients.

  15. Successful Restoration of Visual Acuity with an Extended Range of Vision Intraocular Lens after Multifocal Laser Ablation

    PubMed Central

    Black, Sondra

    2016-01-01

    As our baby boomer population is aging and developing cataracts, so are our post-LASIK patients. These patients underwent LASIK surgery as they wished to be spectacle-free and are hoping to remain so after intraocular lens (IOL) surgery. Unfortunately, very little information is available regarding the suitability of presbyopia correcting IOLs for post-LASIK patients. This case represents successful implantation of an extended range of vision IOL in a 59-year-old patient who underwent multifocal ablation excimer laser surgery 12 years before. Emmetropia was targeted for the dominant eye and −0.5 D for the fellow eye. The 13 month follow-up after bilateral implantation of the TECNIS Symfony IOL revealed an uncorrected visual acuity of 20/25 for distance, 20/20 for intermediate and 20/16 for near. The patient is very happy and did not report any visual symptoms when asked. This successful case should encourage surgeons to consider implanting an extended range of vision IOLs in post-LASIK patients. PMID:28101037

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

    PubMed Central

    Khoramnia, Rahmin; Attia, Mary Safwat; Koss, Michael Janusz; Linz, Katharina; Auffarth, Gerd Uwe

    2016-01-01

    Purpose To evaluate postoperative outcomes and visual performance in intermediate distance after implantation of a +1.5 diopters (D) addition, aspheric, rotational asymmetric multifocal intraocular lens (MIOL). Methods Patients underwent bilateral cataract surgery with implantation of an aspheric, asymmetric MIOL with +1.5 D near addition. A complete ophthalmological examination was performed preoperatively and 3 months postoperatively. The main outcome measures were monocular and binocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), distance corrected intermediate visual acuity (DCIVA), uncorrected near visual acuity (UNVA) and distance corrected keratometry, and manifest refraction. The Salzburg Reading Desk was used to analyze unilateral and bilateral functional vision with uncorrected and corrected reading acuity, reading distance, reading speed, and the smallest log-scaled print size that could be read effectively at near and intermediate distances. Results The study comprised 60 eyes of 30 patients (mean age, 68.30 ± 9.26 years; range, 34 to 80 years). There was significant improvement in UDVA and CDVA. Mean UIVA was 0.01 ± 0.09 logarithm of the minimum angle of resolution (logMAR) and mean DCIVA was -0.02 ± 0.11 logMAR. In Salzburg Reading Desk analysis for UIVA, the mean subjective intermediate distance was 67.58 ± 8.59 cm with mean UIVA of -0.02 ± 0.09 logMAR and mean word count of 96.38 ± 28.32 words/min. Conclusions The new aspheric, asymmetric, +1.5 D near addition MIOL offers good results for distance visual function in combination with good performance for intermediate distances and functional results for near distance. PMID:27729759

  17. 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

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

    PubMed

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

    2015-01-01

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

  19. A United States cost-benefit comparison of an apodized, diffractive, presbyopia-correcting, multifocal intraocular lens and a conventional monofocal lens.

    PubMed

    Maxwell, William A; Waycaster, Curtis R; D'Souza, Anna O; Meissner, Brian L; Hileman, Kendra

    2008-11-01

    To demonstrate the value, from the patient's perspective, of an apodized, diffractive, presbyopia-correcting multifocal intraocular lens (MF-IOL) compared to a conventional monofocal intraocular lens (CM-IOL). Open-label, multi-site U.S. clinical trial. A cost-benefit analysis was conducted using cataract patients' willingness-to-pay (WTP) for spectacle independence as the measure of economic benefit. WTP was elicited from participants in a clinical trial comparing a MF-IOL and a CM-IOL. Costs borne by patients were obtained from standard reference sources. A 14-year analytical timeframe was used, and a 3% annual discount rate was applied to both costs and benefits. The outcome of interest was net benefit (difference between benefits and costs). A probabilistic sensitivity analysis was used to confirm the robustness of the economic results. Four hundred ninety-five patients provided WTP estimates for spectacle independence (MF-IOL, n = 339; CM-IOL, n = 156). Eighty percent of all patients were willing to pay at least $5 per day to be spectacle independent. The incremental acquisition cost associated with bilateral implantation of 2 MF-IOLs was estimated at $4,000. Eighty percent in the MF-IOL group and 8% in the CM-IOL group reported post-operative spectacle independence. The net benefit was $11,670 in the MF-IOL group and $155 in the CM-IOL group. The probabilistic sensitivity analysis confirmed the robustness of the economic outcomes. The net benefit of the MF-IOL exceeded its acquisition cost and the net benefit of the CM-IOL, demonstrating its value to select cataract patients willing to pay a premium for spectacle independence.

  20. [Vision with bifocal and multifocal intraocular lenses].

    PubMed

    Kirschfeld, K; Land, M F

    2011-12-01

    Bifocal or multifocal intraocular lenses (IOLs) can be used to replace natural lenses during cataract surgery. These lenses are recommended by cataract surgeons as the replacement lenses of choice when patients wish to avoid wearing spectacles. There are, however, drawbacks to these lenses: one drawback is that the contrast in the images of bifocal and multifocal lenses is reduced as documented in the ophthalmology literature. It is claimed that acuity is similar in multifocal compared to monofocal lenses, however, we show that any loss in contrast inevitably reduces visual acuity. The other drawback is that the sharp in-focus image is always seen superimposed on one or more blurred out of focus images of the same object. In the ophthalmology literature it is assumed that the brain can suppress the undesired blurred image and only perceive the sharp image. We argue that there are no known mechanisms that would make this possible. This means that vision with bifocal or multifocal implanted lenses cannot be as good as vision with monofocal implants supplemented by spectacles, and this should be explained to patients before undergoing surgery for lens replacement. The results also hold for bifocal and multifocal contact lenses.

  1. 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

  2. Multifocal contact lens myopia control.

    PubMed

    Walline, Jeffrey J; Greiner, Katie L; McVey, M Elizabeth; Jones-Jordan, Lisa A

    2013-11-01

    Previous studies on soft multifocal contact lens myopia control published in the peer-reviewed literature reported findings of noncommercial contact lenses worn for 1 year or less. This study sought to determine the progression of myopia and axial elongation of children fitted with commercially available distance center soft multifocal contact lenses for 2 years. Eight- to eleven-year-old children with -1.00 D to -6.00 D spherical component and less than 1.00 D astigmatism were fitted with soft multifocal contact lenses with a +2.00 D add (Proclear Multifocal "D"; CooperVision, Fairport, NY). They were age- and gender-matched to participants from a previous study who were fitted with single-vision contact lenses (1 Day Acuvue; Vistakon, Jacksonville, FL). A-scan ultrasound and cycloplegic autorefraction were performed at baseline, after 1 year, and after 2 years. Multilevel modeling was used to compare the rate of change of myopia and axial length between single-vision and soft multifocal contact lens wearers. Forty participants were fitted with soft multifocal contact lenses, and 13 did not contribute complete data (5 contributed 1 year of data). The adjusted mean ± standard error spherical equivalent progression of myopia at 2 years was -1.03 ± 0.06 D for the single-vision contact lens wearers and -0.51 ± 0.06 for the soft multifocal contact lens wearers (p < 0.0001). The adjusted mean axial elongation was 0.41 ± 0.03 and 0.29 ± 0.03 for the single-vision and soft multifocal contact lens wearers, respectively (p < 0.0016). Soft multifocal contact lens wear resulted in a 50% reduction in the progression of myopia and a 29% reduction in axial elongation during the 2-year treatment period compared to a historical control group. Results from this and other investigations indicate a need for a long-term randomized clinical trial to investigate the potential for soft multifocal contact lens myopia control.

  3. 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.

  4. Intraocular lens fabrication

    DOEpatents

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

    1997-07-08

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

  5. 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

  6. Visual Outcomes, Quality of Vision, and Quality of Life of Diffractive Multifocal Intraocular Lens Implantation after Myopic Laser In Situ Keratomileusis: A Prospective, Observational Case Series

    PubMed Central

    2017-01-01

    Purpose. To report visual performance and quality of life after implantation of a bifocal diffractive multifocal intraocular lens (MIOL) in postmyopic laser in situ keratomileusis (LASIK) patients. Methods. Prospective, observational case series. Patients with prior myopic LASIK who had implantation of Tecnis ZMA00/ZMB00 MIOL (Abbott Medical Optics) at Hong Kong Sanatorium and Hospital were included. Postoperative examinations included monocular and binocular distance, intermediate and near visual acuity (VA), and contrast sensitivity; visual symptoms (0–5); satisfaction (1–5); spectacle independence rate; and quality of life. Results. Twenty-three patients (27 eyes) were included. No intraoperative complications developed. Mean monocular uncorrected VA at distance, intermediate, and near were 0.13 ± 0.15 (standard deviation), 0.22 ± 0.15, and 0.16 ± 0.15, respectively. Corresponding mean values for binocular uncorrected VA were 0.00 ± 0.10, 0.08 ± 0.13, and 0.13 ± 0.10, respectively. No eyes lost >1 line of corrected distance VA. Contrast sensitivity at different spatial frequencies between operated and unoperated eyes did not differ significantly (all P > 0.05). Mean score for halos, night glare, starbursts, and satisfaction were 1.46 ± 1.62, 1.85 ± 1.69, 0.78 ± 1.31, and 3.50 ± 1.02, respectively. Eighteen patients (78%) reported complete spectacle independence. Mean composite score of the quality-of-life questionnaire was 90.31 ± 8.50 out of 100. Conclusions. Implantation of the MIOL after myopic LASIK was safe and achieved good visual performance. PMID:28133543

  7. Optical performance of multifocal intraocular lenses.

    PubMed

    Holladay, J T; Van Dijk, H; Lang, A; Portney, V; Willis, T R; Sun, R; Oksman, H C

    1990-07-01

    The optical performance of one monofocal and five multifocal lenses was evaluated in the laboratory and photographically. The laboratory testing included determination of the modulation transfer function (MTF), through focus response (TFR), resolution efficiency, and Strehl ratio of each lens. The photographic testing included photographs of the Regan high contrast acuity chart at ten feet with clearest focus and 18 additional photographs in which the image was defocused using minus trial lenses in 0.25 diopter increments. A color photograph of the Kodak color chart was also taken using each lens. All testing was conducted using a 3 mm artificial pupil under ideal implant conditions with no decentration or tilt. The laboratory and photographic results demonstrate that all the multifocal lenses had a two- to three-fold increase in the depth of field with at least a 50% lower contrast in the retinal image. The photographic testing revealed a one to two line better resolution limit with the monofocal lens, which corresponded to the 12% to 41% better MTF cut-off value with the monofocal lens by laboratory testing. The measured resolution efficiencies of all six lenses were comparable. The color photographs revealed color mixing of adjacent colors with the multifocal lenses, whereas the colors appeared unchanged from the original with the monofocal lens.

  8. Temporal multiplexing to simulate multifocal intraocular lenses: theoretical considerations

    PubMed Central

    Akondi, Vyas; Dorronsoro, Carlos; Gambra, Enrique; Marcos, Susana

    2017-01-01

    Fast tunable lenses allow an effective design of a portable simultaneous vision simulator (SimVis) of multifocal corrections. A novel method of evaluating the temporal profile of a tunable lens in simulating different multifocal intraocular lenses (M-IOLs) is presented. The proposed method involves the characteristic fitting of the through-focus (TF) optical quality of the multifocal component of a given M-IOL to a linear combination of TF optical quality of monofocal lenses viable with a tunable lens. Three different types of M-IOL designs are tested, namely: segmented refractive, diffractive and refractive extended depth of focus. The metric used for the optical evaluation of the temporal profile is the visual Strehl (VS) ratio. It is shown that the time profiles generated with the VS ratio as a metric in SimVis resulted in TF VS ratio and TF simulated images that closely matched the TF VS ratio and TF simulated images predicted with the M-IOL. The effects of temporal sampling, varying pupil size, monochromatic aberrations, longitudinal chromatic aberrations and temporal dynamics on SimVis are discussed. PMID:28717577

  9. Performance of the Sulcoflex piggyback intraocular lens in pseudophakic patients.

    PubMed

    Khan, Mohammad I; Muhtaseb, Mohammed

    2011-09-01

    To present our experience with a pseudophakic piggyback intraocular lens (IOL) (Sulcoflex; Rayner Intraocular Lenses Ltd) in five eyes of four patients. One patient desired increased spectacle independence after bilateral LASIK and refractive lens exchange with an accommodating IOL. The remaining three patients with residual refractive error desired increased spectacle independence following cataract surgery with a monofocal IOL. Four eyes received a multifocal Sulcoflex IOL and one eye received a toric Sulcoflex IOL. All patients achieved uncorrected distance visual acuity (UDVA) of 0.1 logMAR (Snellen 20/25) or better and those who received the multifocal Sulcoflex achieved uncorrected near visual acuity (UNVA) of N6 (Jaeger 4) or better. The Sulcoflex IOL may be a safe and effective method for enhancing the refractive outcome in pseudophakic eyes, providing good UDVA and UNVA when using the multifocal platform. Copyright 2011, SLACK Incorporated.

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. Understanding the accommodating intraocular lens.

    PubMed

    Rana, Azhar; Miller, David; Magnante, Peter

    2003-12-01

    To review current accommodating intraocular lens (IOL) designs and introduce a new design consisting of a plus lens and a minus lens. Cornea Consultants of Boston, Boston, Massachusetts, USA. Computer simulation studies of a model eye calculated the pseudoaccommodation range with different powers of 1 IOL or of 2 IOLs acting as a doublet. The doublet consisting of a convex (plus) lens and a concave (minus) lens gave a greater range of power change than a single convex lens or a doublet consisting of 2 convex lenses. The greater range of power results from the plus lens moving forward. The results show that an IOL design consisting of positive and negative lenses that move closer or farther from each other offers a greater range of pseudoaccommodation than other designs.

  16. 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.

  17. [Clinical results of tinted aspheric multifocal toric intraocular lens (SND1T3, SND1T4, SND1T5, SND1T6) for eyes following cataract extraction].

    PubMed

    Nakamura, Kunihiko; Bissen-Miyajima, Hiroko; Hayashi, Ken; Yoshino, Mami; Hirasawa, Manabu; Masumoto, Miki; Takimoto, Minehiro; Horikawa, Kumi; Maeda, Naoyuki

    2015-01-01

    The efficacy and safety of tinted aspheric multifocal toric intraocular lens (IOL) (SND1T3, SND1T4, SND1T5, SND1T6 : Alcon) were evaluated in 130 eyes of 65 patients following cataract removal. Visual acuities (VAs) at distance, near (40 cm) and intermediate (50 cm, 1 m), IOL rotation, contrast sensitivity, spectacle usage and glare/halo were examined up to 1 year postoperatively. The mean bilateral uncorrected distance VA was -0.04 ± 0.10 logMAR, near VA was 0.00 ± 0.11 logMAR, intermediate VA at 50 cm was -0.00 ± 0.11 logMAR, intermediate VA at 1 m was 0.11 ± 0.15 logMAR. IOL rotation was 5.73 ± 4.36 degrees, photopic contrast sensitivities were within normal range, and 76.9% of the patients did not require any spectacles. None of the patients complained of either serious glare or halo. The multifocal toric IOL provides better VA from distance to near at 40 cm.

  18. Experimental characterization of the imaging properties of multifocal intraocular lenses

    NASA Astrophysics Data System (ADS)

    Gobbi, Pier Giorgio; Fasce, Francesco; Bozza, Stefano; Brancato, Rosario

    2003-07-01

    Many different types of intraocular lenses (IOL) are currently available for implantation, both as crystalline lens replacements and as phakic refractive elements. Their optical design is increasingly sophisticated, including aspherical surface profiles and multi-zone multifocal structures, however a quantitative and comparative characterization of their imaging properties is lacking. Also a qualitative visualization of their properties would be very useful for patients in the lens choice process. To this end an experimental eye model has been developed to allow for simulated in-vivo testing of IOLs. The model cornea is made of PMMA with a dioptric power of 43 D, and it has an aspherical profile designed to minimize spherical aberration across the visible spectrum. The eye model has a variable iris and a mechanical support to accomodate IOLs, immersed in physiological solution. The eye length is variable and the retina is replaced by a glass plate. The image formed on this "retina" is optically conjugated to a CCD camera, with a suitable magnification in order to mimic the human fovea resolution, and displayed onto a monitor. With such an opto-mechanical eye model, two types of images have been used to characterize IOLs: letter charts and variable contrast gratings, in order to directly simulate human visual acuity and contrast sensitivity.

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

    PubMed

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

    2012-03-01

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

  20. Minus Piggyback Lens Overlaying ReSTOR(®) Multifocal Lens in High Myopia.

    PubMed

    Gupta, Isha; Oakey, Zack; Stagg, Brian C; Ambati, Balamurali K

    2013-05-01

    We report the case of a 40-year-old female patient treated with implantation of the Acrysof® IQ ReSTOR® lens (Alcon, Fort Worth, Tex., USA) with overlaying Acrysof EXpand® minus piggyback lens (Alcon). The patient had high myopia and was diagnosed with presbyopia and bilateral posterior subcapsular cataract. She desired to be spectacle-free and opted to undergo bilateral placement of the ReSTOR multifocal lens. The necessary intraocular lens (IOL) power was +3.5 in the right eye and +4.0 in the left eye, though the range of commercially available ReSTOR lenses is +6.0 to +34.0 D. In order to achieve emmetropia in this case of high myopia, it was determined that an EXpand minus piggyback lens would be necessary. Implantation of the ReSTOR lens with overlaying EXpand minus piggyback lens was performed successfully and without complication. At 5 months postoperatively, the patient had 20/20 uncorrected visual acuity in both eyes. She reported a high level of satisfaction and was able to return to her daily activities including reading and driving without spectacles. We report successful primary implantation of AcrySof EXpand minus piggyback lenses overlying the AcrySof IQ ReSTOR lens in a patient with high myopia. Long-term follow-up and further evaluation is necessary to establish piggyback IOL implantation with multifocal IOL as an accepted treatment for high myopia with presbyopia.

  1. Intraocular lens optics and aberrations.

    PubMed

    Chang, Daniel H; Rocha, Karolinne M

    2016-07-01

    This review outlines concepts in intraocular lens (IOL) optics and aberrations important both for current IOLs and for new IOLs in development. Optical aberrations make a significant impact on the laboratory and clinical performance of IOLs, especially under mesopic and low-contrast conditions. Minimizing or correcting these aberrations can potentially improve visual function. Strategic management of aberrations can have clinical utility for extended depth of focus and presbyopia correction. All IOLs affect ocular aberrations in some manner. It is important for clinicians and researchers to understand the implications how any residual aberrations could affect visual quality, visual side-effects, and depth of focus.

  2. 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

  3. 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

  4. Colour vision through intraocular lens.

    PubMed

    Mäntyjärvi, M; Syrjäkoski, J; Tuppurainen, K; Honkonen, V

    1997-04-01

    Fifty patients aged from 30 to 69 years (mean 54.7 +/- 11.3 years, SD) with a UV-protected monofocal polymethylmethacrylate intraocular lens (IOL) were examined with the Farnsworth-Munsell 100 hue (FM 100) test and the Color Vision Meter 712 anomaloscope. The spectral transmission of the same kind of IOLs as was used surgically was measured with Lambda 2 UV/VIS Spectrometer. In the FM 100 test, there was no significant difference between the results of the IOL eyes and normal eyes. However, the IOL eyes showed better error scores than the normal eyes in the blue-purple box IV in the FM 100 test. In the anomaloscope testing, the Rayleigh (red-green) equation showed no differences between the IOL patients and controls. In the Moreland (blue) equation, however, the mid matching point was significantly shifted towards more green (meaning better blue colour sensitivity) in the IOL eyes than in the control eyes. This is due to the spectral transmission of the IOLs which showed 80-90% transmission already starting at the wavelength of about 420 nm. In comparison, the transmission of the normal human lens reaches those percentages near 500 nm or even further at advanced age.

  5. [Intraocular lens implantation in developmental lens disorders in children].

    PubMed

    Kanigowska, Krystyna; Grałek, Mirosława; Kepa, Beata; Chipczyńska, Barbara

    2009-01-01

    The pediatric cataract surgery in eyes with developmental disorders, stay with still considerable challenge. At children, the lasting vision development extorts necessity quick settlement of refraction defect formed after operation. The intraocular lens old boy with cataract in microspherophakia and 12 years old boy with cataract in lens with coloboma. One-piece flexible and rigid PMMA intraocular lens was placed with success at posterior chamber without scleral fixations and without using capsular tension ring in this cases. After 3 years of observation there were no decentration or dislocation of intraocular lens in both children. Authors concluded that in some cases posterior chamber intraocular lens implantation despite defective zonular or capsular support, can make up the effective method of surgical treatment without risk of early dislocation.

  6. Visual performance with accommodating and multifocal intraocular lenses

    PubMed Central

    Lan, Jie; Huang, Yu-Sen; Dai, Yun-Hai; Wu, Xiao-Ming; Sun, Jia-Jun; Xie, Li-Xin

    2017-01-01

    AIM To compare the visual functional outcomes with accommodating and multifocal intraocular lenses (IOLs). METHODS Our retrospective comparative study included 51 patients (60 eyes) received implantation of an accommodating IOL (Tetraflex; 16 patients, 20 eyes), a refractive multifocal IOL (ReZoom; 18 patients, 20 eyes), or a diffractive multifocal IOL (ZMA00; 17 patients, 20 eyes). Subjective refraction, visual acuity, contrast sensitivity (CS), intraocular aberration, and subjective photic phenomena were detected at 3mo after surgery. RESULTS The spherical equivalent in the three groups was -0.38±0.54 D, 0.14±0.56 D, and 0.35±0.41 D, respectively. No statistically significant differences were found in uncorrected and corrected distance visual acuity and uncorrected intermediate visual acuity among the groups (P=0.39). The ReZoom group had significantly better distance-corrected intermediate visual acuity than the ZMA00 group (P=0.003). The ZMA00 group had significantly better near visual acuity than the other groups (P<0.05). Better contrast sensitivity values were observed in the Tetraflex group under most of the spatial frequencies conditions (P=0.025). The total aberration was lowest in the ZMA00 group (P=0.000), and the spherical aberration was highest in the Tetraflex group (P=0.000). The three groups had similar frequency of ghosting and glare, and the Tetraflex group had a low rate of halos (P=0.01). CONCLUSION Both accommodating and multifocal IOLs can successfully restore distance and uncorrected intermediate visual acuities. Tetraflex accommodating IOLs perform better in CS and with less halos of photic phenomena. ReZoom refractive multifocal IOLs have better performance in distance-corrected intermediate visual acuity than ZMA00 diffractive multifocal IOLs, and the latter achieved better near visual acuity and efficiently decreased the optical aberration. PMID:28251082

  7. 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.

  8. Disk halo size measured in individuals with monofocal versus diffractive multifocal intraocular lenses.

    PubMed

    Puell, M C; Pérez-Carrasco, M J; Hurtado-Ceña, F J; Álvarez-Rementería, L

    2015-11-01

    To compare disk halo size in response to a glare source in eyes with an aspheric apodized diffractive multifocal intraocular lens (IOL) or aspheric monofocal IOL. Rementeria Ophthalmological Clinic, Madrid, Spain. Prospective randomized masked study. Halo radius was measured using a vision monitor (MonCv3) with low-luminance optotypes in eyes that had cataract surgery and bilateral implantion of an Acrysof Restor SN6AD1 multifocal IOL or Acrysof IQ monofocal IOL 6 to 9 months previously. The visual angle subtended by the disk halo radius was calculated in minutes of arc (arcmin). Patient complaints of halo disturbances were recorded. Monocular uncorrected distance visual acutity (UDVA) and corrected distance visual acuity (CDVA) were measured using high-contrast (96%) and low-contrast (10%) logMAR letter charts. The study comprised 39 eyes of 39 subjects (aged 70 to 80 years); 21 eyes had a multifocal IOL and 18 eyes a monofocal IOL. The mean halo radius was 35 arcmin larger in the multifocal IOL group than the monofocal group (P < .05). Greater halo effects were reported in the multifocal IOL group (P < .05). The mean monocular high-contrast UDVA and low-contrast UDVA did not vary significantly between groups, whereas the mean monocular high-contrast CDVA and low-contrast CDVA were significantly worse at 0.12 logMAR and 0.13 logMAR in the multifocal than in the monofocal IOL group, respectively (P < .01). A significant positive correlation was detected by multiple linear regression between the halo radius and low-contrast UDVA in the multifocal IOL group (r = 0.72, P < .001). The diffractive multifocal IOL gave rise to a larger disk halo size, which was correlated with a worse low-contrast UDVA. None of the authors has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  9. Minus Piggyback Lens Overlaying ReSTOR® Multifocal Lens in High Myopia

    PubMed Central

    Gupta, Isha; Oakey, Zack; Stagg, Brian C.; Ambati, Balamurali K.

    2013-01-01

    Background We report the case of a 40-year-old female patient treated with implantation of the Acrysof® IQ ReSTOR® lens (Alcon, Fort Worth, Tex., USA) with overlaying Acrysof EXpand® minus piggyback lens (Alcon). Methods The patient had high myopia and was diagnosed with presbyopia and bilateral posterior subcapsular cataract. She desired to be spectacle-free and opted to undergo bilateral placement of the ReSTOR multifocal lens. The necessary intraocular lens (IOL) power was +3.5 in the right eye and +4.0 in the left eye, though the range of commercially available ReSTOR lenses is +6.0 to +34.0 D. In order to achieve emmetropia in this case of high myopia, it was determined that an EXpand minus piggyback lens would be necessary. Results Implantation of the ReSTOR lens with overlaying EXpand minus piggyback lens was performed successfully and without complication. At 5 months postoperatively, the patient had 20/20 uncorrected visual acuity in both eyes. She reported a high level of satisfaction and was able to return to her daily activities including reading and driving without spectacles. Conclusion We report successful primary implantation of AcrySof EXpand minus piggyback lenses overlying the AcrySof IQ ReSTOR lens in a patient with high myopia. Long-term follow-up and further evaluation is necessary to establish piggyback IOL implantation with multifocal IOL as an accepted treatment for high myopia with presbyopia. PMID:23898294

  10. 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

  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

    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.

  12. Optimization of aspheric multifocal contact lens by spline curve

    NASA Astrophysics Data System (ADS)

    Lien, Vu. T.; Chen, Chao-Chang A.; Qiu, Yu-Ting

    2016-10-01

    This paper presents a solution for design aspheric multifocal contact lens with various add powers. The multi-aspheric curve on the optical surface profile is replaced by a single freeform spline curve. A cubic spline curve is optimized to remove all unsmooth transitions between different vision correction zones and still satisfy the power distribution of the aspheric multifocal contact lens. The result shows that the contact lens using a cubic spline curve could provide not only a smooth lens surface profile but also a smooth power distribution that is difficultly obtained by an aspheric multifocal contact lens. The proposed contact lens is easily transferred to CAD format for further analysis or manufacture. Results of this study can be further applied for progressive contact lens design.

  13. [Halos and multifocal intraocular lenses: origin and interpretation].

    PubMed

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

    2014-10-01

    To present the theoretical and experimental characterization of the halo in multifocal intraocular lenses (MIOL). The origin of the halo in a MIOL is the overlaying of 2 or more images. Using geometrical optics, it can be demonstrated that the diameter of each halo depends on the addition of the lens (ΔP), the base power (P(d)), and the diameter of the IOL that contributes to the «non-focused» focus. In the image plane that corresponds to the distance focus, the halo diameter (δH(d)) is given by: δH(d)=d(pn) ΔP/P(d), where d(pn) is the diameter of the IOL that contributes to the near focus. Analogously, in the near image plane the halo diameter (δH(n)) is: δH(n)=d(pd) ΔP/P(d), where d(pd) is the diameter of the IOL that contributes to the distance focus. Patients perceive halos when they see bright objects over a relatively dark background. In vitro, the halo can be characterized by analyzing the intensity profile of the image of a pinhole that is focused by each of the foci of a MIOL. A comparison has been made between the halos induced by different MIOL of the same base power (20D) in an optical bench. As predicted by theory, the larger the addition of the MIOL, the larger the halo diameter. For large pupils and with MIOL with similar aspheric designs and addition (SN6AD3 vs ZMA00), the apodized MIOL has a smaller halo diameter than a non-apodized one in distance vision, while in near vision the size is very similar, but the relative intensity is higher in the apodized MIOL. When comparing lenses with the same diffractive design, but with different spherical-aspheric base design (SN60D3 vs SN6AD3), the halo in distance vision of the spherical MIOL is larger, while in near vision the spherical IOL induces a smaller halo, but with higher intensity due to the spherical aberration of the distance focus in the near image. In the case of a trifocal-diffractive IOL (AT LISA 839MP) the most noticeable characteristic is the double-halo formation due to the 2 non

  14. Prevention of hyperopic surprise after LASIK in patients with refractive multifocal intraocular lenses.

    PubMed

    Albarrán-Diego, César; Muñoz, Gonzalo; Ferrer-Blasco, Teresa; García-Lázaro, Santiago

    2011-01-01

    Three cases of patients who developed a similar hyperopic defect in refraction following laser in situ keratomileusis (LASIK) after multifocal intraocular lens (IOL) implantation are described. Ophthalmologic evaluation including refractive status, corrected and uncorrected visual acuity (both at far and near), and corneal topography in patients presenting similar hyperopic refractive surprise in one eye as a result of LASIK refinement of residual ametropia after refractive multifocal IOL implantation. Laser in situ keratomileusis enhancement for residual ametropia of -1.00 to -1.50 D in patients with a prior implantation of refractive multifocal IOL resulted in a refractive surprise of +2.25 to +2.50 D. After excluding other possible sources of error, an explanation for such a refractive surprise is suggested, and a simple method for avoiding this error is presented. Proper knowledge of the defocus curve and the use of a systematic method for determining subjective refraction in patients implanted with refractive multifocal IOLs will reduce the possibility of refractive surprise after LASIK enhancement in a bioptics procedure.

  15. Comparison of ocular straylight after implantation of multifocal intraocular lenses.

    PubMed

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

    2016-04-01

    A comprehensive review of the effect of multifocal intraocular lens (IOL) designs on postoperative ocular straylight was performed. Studies reporting straylight values obtained with the natural pupil using the C-Quant device after uneventful multifocal IOL implantation were included. The IOLs were categorized based on their material characteristics; that is, hydrophobicity and presence of colored chromophores. Age adjustment was achieved using the straylight age-dependency norm for pseudophakic eyes. This norm also served as a reference for comparing mean straylight levels of the various IOLs. The literature review identified 10 studies reporting 9 multifocal IOL designs. The hydrophilic IOLs showed less straylight than the hydrophobic IOLs by 0.08 log(s) (P = .001). Blue violet light-filtering IOLs showed less straylight than standard IOLs by 0.04 log(s), which was not statistically significant (P = .32). Hydrophobicity was a factor that significantly affected straylight in multifocal IOLs. The Netherlands Academy of Arts and Sciences owns a patent on straylight measurement, with Dr. van den Berg as the inventor, and licenses it to Oculus Optikgeräte GmbH for the C-Quant instrument. No other author has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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.

  2. Intraocular lens in a fighter aircraft pilot.

    PubMed Central

    Loewenstein, A; Geyer, O; Biger, Y; Bracha, R; Shochat, I; Lazar, M

    1991-01-01

    A pseudophakic pilot of the Israeli air force flying an F-15 (Eagle) aircraft was followed up for three years. He experienced about 100 flying hours, 5% of the time under high g stress. The intraocular lens did not dislocate and no complications were observed. It seems that flying high performance fighter aircraft is not contraindicated in pseudophakic pilots. PMID:1768669

  3. Bio-inspired accommodating fluidic intraocular lens.

    PubMed

    Qiao, Wen; Johnson, Daniel; Tsai, Frank S; Cho, Sung Hwan; Lo, Yu-Hwa

    2009-10-15

    The invention of intraocular lens (IOL), a substitute for crystalline lens, represents a major advancement in cataract surgery. After about sixty years of IOL development, one key remaining problem is its limited accommodation range compared with natural eyes. To overcome this performance limit, we explore bio-inspired fluidic IOL. By mimicking the working principle of natural eyes, a fluidic intraocular lens can achieve an exceedingly large accommodation range. An experiment on fluidic IOL demonstrated a very high tuning range of 12 D. This accommodation range was achieved with a modest amount of force (0.06 N) and equatorial radius change (0.286 mm), in conditions matching well with the characteristics of aged eyes.

  4. 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

  5. Multifocal liquid-crystal-lens properties with an additional ring-electrodes

    NASA Astrophysics Data System (ADS)

    Kawamura, Marenori; Tamura, Kensuke; Chida, Makoto; Itoda, Hiroki; Sato, Susumu

    2015-09-01

    We propose a low-driving-voltage multifocal liquid crystal (LC) lens such as a concave lens inside a convex lens. The multifocal LC lens is prepared using a glass substrate with a transparent circularly hole-patterned electrode, an additional ring electrode inside, and a center electrode. The multifocal lens properties are attained, and the focal length of the concave lens and/or convex lens can be changed by applying low voltages to the electrodes.

  6. Bilateral Pseudoexfoliation Deposits on Intraocular Lens Implants

    PubMed Central

    Bonafonte Marquez, Elena; Bonafonte Royo, Sergio

    2015-01-01

    We present a rare case of bilateral pseudoexfoliative deposits on both intraocular lens (IOL) implants in an 83-year-old woman with no other associated pathology, 5 years after cataract surgery. Pseudoexfoliation syndrome is the most common cause of secondary open-angle glaucoma worldwide and these deposits are usually found on the natural lens. The fact that pseudoexfoliative deposits have been found on IOL implants implies the need for a thorough examination in pseudophakic patients, for it could be the only sign of secondary glaucoma. PMID:25713742

  7. Energy distribution between distance and near images in apodized diffractive multifocal intraocular lenses.

    PubMed

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

    2011-07-29

    To determine the energy distribution between the distance and near images formed in a model eye by spherical and aspheric apodized diffractive multifocal intraocular lenses (IOLs). The IOL was inserted in a model eye with an artificial cornea with positive spherical aberration (SA) similar to that of the human cornea. The energy of the distance and near images, as a function of the pupil size, was experimentally obtained by image analysis. The level of SA on the IOL, which is pupil-size-dependent, was determined from simulations. The influence of the SA was deduced from results obtained in monofocal IOLs and by comparison of the experimentally obtained energy efficiency to theoretical results based solely on the diffractive profile of the IOL. In contrast with theoretical predictions, the energy efficiency of the distance image strongly decreased for large pupils, because of the high level of SA in the IOL. The decrease was smaller in the apodized diffractive multifocal lens with aspheric design. As for the near image, since the diffractive zone responsible for the formation of this image was the same in the spherical and aspheric lenses and the apertures involved were small (and so the level of SA), the results turned out to be similar for both designs. For large pupils, the energy efficiency of the distance image is strongly affected by the level of SA, although aspheric IOLs perform slightly better than their counterparts with a spherical design. For small pupils, there are no differences between the spherical and aspheric IOLs.

  8. Elevated intraocular pressure in secondary piggyback intraocular lens implantation.

    PubMed

    Iwase, Takeshi; Tanaka, Nobushige

    2005-09-01

    We report 2 cases of postoperative intraocular pressure (IOP) elevation in secondary piggyback intraocular lens (IOL) implantation without history of glaucoma or ocular hypertension. A 74-year-old woman with myopic pseudophakia and a 68-year-old man with hyperopic pseudophakia received secondary piggyback AcrySof IOL implantation in their left eyes. In both patients, the left IOP gradually increased and sustained around 30 mm Hg for about 1 year. In the first, IOP continued elevating despite topical and systemic medications. There was an episode of pupillary block in the second. Gonioscopically, heavier trabecular meshwork pigmentation in their left eyes was observed. Because of this, the 2 IOLs implanted were removed and replaced by an adequate IOL and trabeculotomy was performed in the former. The AcrySof IOL has a truncated optic edge, which increases the risk for chafing the iris, resulting in pigment dispersion syndrome; thus, it would be a poor choice for a sulcus-placed piggyback implantation.

  9. Predictability and Vector Analysis of Laser In Situ Keratomileusis for Residual Errors in Eyes Implanted With Different Multifocal Intraocular Lenses.

    PubMed

    Santhiago, Marcony R; Ventura, Bruna V; Ghanem, Ramon C; Kara-Junior, Newton; Moraes, Haroldo V; Ghanem, Emir

    2016-11-01

    To investigate potential differences in predictability, efficacy, and safety of corneal excimer laser to correct residual myopia, hyperopia, and astigmatism in eyes previously implanted with multifocal intraocular lenses using distinct optical surfaces and platforms for multifocality. This prospective comparative study included 37 eyes submitted to laser in situ keratomileusis correction for residual errors after implantation of either an apodized diffractive-refractive (Restor) or a full-diffractive (Tecnis) multifocal intraocular lens. Data analysis included investigation of predictability, efficacy, and safety of excimer laser surgery to correct residual errors. A double-angle plot, using vector analysis, was also created to evaluate predictability of astigmatism correction. At 6-month follow-up, statistical analyses revealed a significant improvement when comparing preoperative (0.51 ± 0.25 and 0.44 ± 0.18) and postoperative values (0.17 ± 0.10 and 0.09 ± 0.07) of uncorrected distance visual acuity (P < 0.0001 and <0.0001), preoperative (0.92 ± 0.61 and 1.02 ± 0.45) and postoperative values (0.33 ± 0.23 and 0.19 ± 0.17) of manifest refractive spherical equivalent (P = 0.0006 and <0.0001), and preoperative (-1.08 ± 0.70 and -0.65 ± 0.42) and postoperative values (-0.25 ± 0.28 and -0.14 ± 0.21) of astigmatism (P < 0.0001 and <0.0001) in eyes implanted with Restor and Tecnis, respectively. Vector analysis revealed a predictable correction of astigmatism in all groups. Ninety-two percent of total eyes achieved a manifest refractive spherical equivalent within ±0.5 of emmetropia. Corneal excimer laser refractive surgery seems to be equally effective to correct different residual errors, including astigmatism, in eyes implanted with intraocular lenses with various platforms for multifocality.

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

    PubMed

    Espandar, Ladan; Sikder, Shameema; Moshirfar, Majid

    2011-01-10

    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.

  11. 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

  12. Achromatic doublet intraocular lens for full aberration correction

    PubMed Central

    Fernandez, Enrique J.; Artal, Pablo

    2017-01-01

    A doublet intraocular lens optimized for both chromatic and monochromatic aberration correction in pseudophakic eyes is presented. Ray-tracing techniques were applied to design the lens in white light within a chromatic eye model. Combinations of two materials, already commonly used in intraocular lenses, as acrylic and silicone, were used. Iterative optimization algorithms were employed to correct for longitudinal chromatic aberration, spherical aberration and off-axis aberrations within 10 degrees of visual field. The performance of this lens was compared with a standard single-material aspheric intraocular lens. Near full aberration correction was achieved with the doublet intraocular lens. The modulation transfer function and Strehl ratio were superior for the doublet lens. Through-focus calculations were also conducted showing better optical quality for the doublet. Real higher-order aberrations from normal eyes were incorporated in the model to evaluate the effect on the doublet intraocular lens performance. Results showed that the doublet lens preserved its benefits under realistic conditions. This doublet intraocular lens should provide patients with a better quality of vision after it is further developed in terms of manufacturing and surgical limitations. PMID:28663881

  13. Implantation of multifocal intraocular lenses using a magnification strategy in cataractous eyes with age-related macular degeneration.

    PubMed

    Gayton, Johnny L; Mackool, Richard J; Ernest, Paul H; Seabolt, ReBecca A; Dumont, Susan

    2012-03-01

    To examine visual function after targeting -2.0 diopter (D) spherical equivalent (SE) when implanting a multifocal intraocular lens (IOL) in eyes with cataract and age-related macular degeneration (AMD). Three private practices. Case series. Lenses of cataractous eyes with AMD were replaced with the Acrysof Restor SN60D3 multifocal IOL, targeting an SE of -2.0 D, which yielded +5.2 D near addition. Near and distance visual acuities were examined. Patients completed a visual function questionnaire preoperatively and 6 months postoperatively. At 6 months, 13 patients with 20 eligible eyes were examined. The uncorrected near visual acuity improved in 18 eyes (90%) and was unchanged in 2 eyes. The corrected distance visual acuity improved in 14 eyes (70%), was unchanged in 4 eyes (20%), and decreased (≤ 3 lines) in 2 eyes (10%). All vision-related questionnaire items improved. For cataractous eyes with AMD, replacing the crystalline lens with this myopia-targeted multifocal IOL improved or maintained near vision without severely compromising distance vision. Drs. Mackool and Ernest are consultants to Alcon. Dr. Mackool is an inventor in the patent of the IOLs related to this strategy. No other author has a financial or proprietary interest in any material or method mentioned. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  14. 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.

  15. Impact of low mesopic contrast sensitivity outcomes in different types of modern multifocal intraocular lenses.

    PubMed

    Plaza-Puche, Ana B; Alio, Jorge L; Sala, Esperanza; Mojzis, Peter

    2016-11-04

    To investigate the low mesopic contrast sensitivity function (LMCSF) of patients implanted with different modern optical bifocal and trifocal designs of multifocal intraocular lenses (mfIOLs). This prospective, comparative, nonrandomized consecutive case series included 180 eyes that underwent cataract surgery. Six groups of eyes were differentiated: group A, eyes with the diffractive AT LISA tri 839MP; group B, eyes with diffractive FineVision; group C, eyes with the bifocal Lentis Mplus-LS313; group D, eyes with the diffractive bifocal Acri.Lisa 366D; group E, eyes with the diffractive apodized Acrysof ReSTOR SN6AD1; group F, as the control group, implanted with a monofocal spherical intraocular lens. The LMCSF was evaluated with the OPTEC® 6500 device at 3 months postoperatively using a luminance of 3 cd/m2. No significant differences among groups were detected in LMCSF for the spatial frequencies of 1.5, 3.0, 6.0, and 12.0 cpd (1.5 cpd: F = 1.81, p = 0.13; 3.0 cpd: F = 1.14, p = 0.14; 6.0 cpd: F = 1.87, p = 0.11; 12.0 cpd: F = 1.26, p = 0.29), but significant differences were found among groups for the spatial frequency of 18 cpd (F = 2.62, p = 0.03). When comparing the groups in pairs, only statistically significant differences were observed between groups E and F for the spatial frequency of 18.0 cpd (t = 3.27, p = 0.03) with better values for group F. No significant differences were observed in LMCSF among the different mfIOLs studied. The third focus of trifocal IOL models did not adversely affect the LMCSF. The ReSTOR SN6AD1 showed the poorest LMCSF for the highest spatial frequency analyzed when compared with the control group.

  16. Longitudinal study of intraocular lens exchange.

    PubMed

    Marques, Frederico F; Marques, Daniela M V; Osher, Robert H; Freitas, Lincoln L

    2007-02-01

    To analyze the indications for intraocular lens (IOL) exchange, interval between the first IOL implantation and the exchange, type and mix of IOLs used, effect on vision, and frequency of complications. Cincinnati Eye Institute-Cincinnati-Ohio-USA. This retrospective study comprised 49 eyes of 49 adult patients who had IOL exchange between 1986 and 2002 performed by the same surgeon. The mean age was 70 years old, and 55% were women. The mean interval between surgeries was 53.8 months and the mean follow-up, 35.6 months. The patients were divided into 2 groups according to the type of IOL originally implanted: anterior chamber (AC) or posterior chamber (PC). There were 15 eyes with an AC IOL and 34 eyes with a PC IOL. The difference in mean age and follow-up were not statistically significant between groups. The mean interval between the primary surgery and IOL explantation was 82.3 months in the AC IOL group and 37.9 months in the PC IOL group. The main reason for IOL exchange was inflammation (53.34%) and dislocation/decentration (85.30%), respectively. The preoperative best corrected visual acuity was similar in both groups, and visual acuity was maintained or improved in 80%. Vitreous prolapse was the main intraoperative complication. The primary indication for IOL exchange was intraocular inflammation in patients with an AC IOL and IOL malposition in patients with a PC IOL. The results confirm the safety and positive visual outcome in this complex group of patients.

  17. Coculture with intraocular lens material-activated macrophages induces an inflammatory phenotype in lens epithelial cells.

    PubMed

    Pintwala, Robert; Postnikoff, Cameron; Molladavoodi, Sara; Gorbet, Maud

    2015-03-01

    Cataracts are the leading cause of blindness worldwide, requiring surgical implantation of an intraocular lens. Despite evidence of leukocyte ingress into the postoperative lens, few studies have investigated the leukocyte response to intraocular lens materials. A novel coculture model was developed to examine macrophage activation by hydrophilic acrylic (poly(2-hydroxyethyl methacrylate)) and hydrophobic acrylic (polymethylmethacrylate) commercial intraocular lens. The human monocytic cell line THP-1 was differentiated into macrophages and cocultured with human lens epithelial cell line (HLE-B3) with or without an intraocular lens for one, two, four, or six days. Using flow cytometry and confocal microscopy, expression of the macrophage activation marker CD54 (intercellular adhesion molecule-1) and production of reactive oxygen species via the fluorogenic probe 2',7'-dichlorodihydrofluorescein diacetate were examined in macrophages. α-Smooth muscle actin, a transdifferentiation marker, was characterized in lens epithelial cells. The poly(2-hydroxyethyl methacrylate) intraocular lens prevented adhesion but induced significant macrophage activation (p < 0.03) versus control (no intraocular lens), while the polymethylmethacrylate intraocular lens enabled adhesion and multinucleated fusion, but induced no significant activation. Coculture with either intraocular lens increased reactive oxygen species production in macrophages after one day (p < 0.03) and increased expression of α-smooth muscle actin in HLE B-3 after six days, although only poly(2-hydroxyethyl methacrylate) induced a significant difference versus control (p < 0.01). Our results imply that-contrary to prior uveal biocompatibility understanding-macrophage adherence is not necessary for a strong inflammatory response to an intraocular lens, with hydrophilic surfaces inducing higher activation than hydrophobic surfaces. These findings provide a new method of inquiry into uveal

  18. Binocularity enhances visual acuity of eyes implanted with multifocal intraocular lenses.

    PubMed

    Tsaousis, Konstantinos T; Plainis, Sotiris; Dimitrakos, Stavros A; Tsinopoulos, Ioannis T

    2013-04-01

    To investigate the effect of binocularity on long-term visual acuity in patients who have undergone bilateral implantation of a presbyopia-correcting diffractive multifocal intraocular lens (IOL). Twenty patients (9 men and 11 women) with an average age of 70 ± 7 years (range: 56 to 78 years) underwent bilateral implantation of a diffractive multifocal IOL (AcrySof IQ ReSTOR IOL, SN60D3; Alcon Laboratories, Inc., Fort Worth, TX). Uncorrected visual acuity was measured monocularly and binocularly on average 26 ± 6 months following implantation in the second eye (range: 17 to 40 months) using the University of Crete European-wide modified Early Treatment Diabetic Retinopathy Study charts at the following distances: (1) 4 m, uncorrected distance visual acuity (UDVA), (2) 66 cm, uncorrected intermediate visual acuity (UIVA), and (3) 33 cm, uncorrected near visual (UNVA). Mean ± standard deviation UDVA was 0.07 ± 0.10 and 0.21 ± 0.12 logMAR (20/23 and 20/32 Snellen) in the better and worse eye, respectively, improving to 0.00 ± 0.09 logMAR (20/20 Snellen) binocularly. Mean ± standard deviation UIVA was 0.18 ± 0.14 and 0.32 ± 0.15 logMAR (20/30 and 20/42 Snellen) in the better and worse eye, respectively, improving to 0.08 ± 0.15 logMAR (20/24 Snellen) binocularly. Mean ± standard deviation UNVA was 0.20 ± 0.09 and 0.32 ± 0.12 logMAR (20/32 and 20/42 Snellen) in the better and worse eye, respectively, improving to 0.11 ± 0.10 logMAR (20/26 Snellen) binocularly. Binocular summation, defined as the difference between the binocular and better eye visual acuity, was found to be statistically significant at all distances: 0.07 ± 0.05 logMAR at 4 m, 0.10 ± 0.11 logMAR at 66 cm, and 0.09 ± 0.08 logMAR at 33 cm. The results confirm that there is substantial benefit of binocular vision in individuals with bilateral multifocal IOL implantation in terms of increased visual acuity. This effect is evident at all distances. Copyright 2013, SLACK Incorporated.

  19. Compared optical performances of multifocal and monofocal intraocular lenses (contrast sensitivity and dynamic visual acuity)

    PubMed Central

    Williamson, W; Poirier, L; Coulon, P; Verin, P

    1994-01-01

    The functional results (contrast sensitivity and dynamic visual acuity) of 19 multifocal (3M design) and 14 all polymethylmethacrylate biconvex monofocal intraocular lenses (IOLs), 6 mm in optical diameter were compared. Best corrected visual acuity was > or = 8/10 (Monoyer chart) Parinaud 2 in all cases. Major differences of functional performance in favour of monofocal IOLs were found outside standard conditions of vision (low contrast and illumination levels). A significant difference in contrast sensitivity was found for each spatial frequency in favour of multifocal IOLs (0.0016 < p < 0.05). Mesopic vision was statistically higher in the monofocal IOL group (p = 0.0015). Moreover, dynamic visual acuity allowed accurate evaluation of the difference in performance between these two models of implant. In view of these results multifocal IOLs should be reserved for patients with normal psychosensitive adaptation; an ocular pathology that could alter contrast sensitivity or mesopic vision is a contraindication for multifocal IOLs. PMID:8199107

  20. Stereo-acuity in patients implanted with multifocal intraocular lenses: is the choice of stereotest relevant?

    PubMed

    Varón, Consuelo; Gil, Miguel A; Alba-Bueno, Francisco; Cardona, Genís; Vega, Fidel; Millán, María S; Buil, José A

    2014-07-01

    A randomized and double-blinded study design was implemented to assess the stereo-acuity in patients symmetrically implanted with four types of multifocal intraocular lenses (MIOLs), compared to a monofocal lens (control group). In addition, the influence of the type of test employed for the evaluation of stereo-acuity was explored. Six months after cataract intervention, stereo-acuity was measured with the Titmus and TNO stereotests in 143 patients implanted with one of the following MIOL lens types: hybrid spherical SN60D3, hybrid aspheric SN6AD1, diffractive aspheric ZMA00 and refractive spherical NXG1. A control group implanted with the monofocal aspheric ZA9003 (in which stereo-acuity was measured with a near addition) was also included in the study. Statistically significant better stereo-acuity was found in the monofocal group with both stereotests (except for the SN60D3 group with the Titmus test) (all p < 0.001). No significant differences in stereo-acuity between MIOLs were found using the Titmus test. However, with the TNO, patients implanted with hybrid diffractive MIOLs exhibited statistically significant worse stereo-acuity than those with the refractive design (SN60D3, p < 0.001; SN6AD1, p = 0.006). Patients implanted with MIOLs have worse stereo-acuity than those implanted with monofocal IOLs due to the decrease in retinal image contrast originating in the simultaneous presence of two images. A wavelength-based stereotest such as the TNO induces large differences in image contrast between fellow eyes implanted with diffractive-based MIOLs, which may result in an underestimation of the real stereo-acuity of the patient.

  1. 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.

  2. Intraocular lens short wavelength light filtering.

    PubMed

    Edwards, Keith H; Gibson, G Anthony

    2010-11-01

    There is increasing interest in the effects of reactive oxygen species ('free radicals') in ageing, both in the body overall and specifically in the eye. Cataract and age-related macular degeneration (AMD) are two major causes of blindness, with cataract accounting for 48 per cent of world blindness and AMD accounting for 8.7 per cent. Both cataract and AMD affect an older population (over 50 years of age) and while cataract is largely treatable provided resources are available, AMD is a common cause of untreatable, progressive visual loss. There is evidence that AMD is linked to exposure to short wavelength electromagnetic radiation, which includes ultraviolet, blue and violet wavelengths. The ageing crystalline lens provides some protection to the posterior pole because, as it yellows with age, its spectral absorption increasingly blocks the shorter wavelengths of light. Ultraviolet blocking intraocular lenses (IOLs) have been the standard of care for many years but a more recent trend is to include blue-blocking filters based on theoretical benefits. As these filters absorb part of the visible spectrum, they may affect visual function. This review looks at the risks and the benefits of filtering out short wavelength light in pseudophakic patients.

  3. Secondary implantation of a double intraocular lens after penetrating keratoplasty.

    PubMed

    Gayton, J L

    1998-02-01

    Penetrating keratoplasty (PKP) patients often have severe, visually disabling refractive errors. Astigmatism can be addressed by refractive surgery; however, correcting hyperopia is more problematic. Although pseudophakic PKP patients can have a lens exchange, it can be traumatic in this population. In this pseudophakic PKP patient, I added a second posterior chamber intraocular lens, correcting the hyperopia and resolving visual complaints.

  4. Unilateral phacoemulsification and intraocular lens implantation in a dachshund

    PubMed Central

    Kopala, Robyn L.

    2008-01-01

    A 1.5-year-old, spayed, female dachshund was presented with a cataract and lens-induced uveitis in the left eye. The cataract progressed from immature to hypermature in 4 months. Phacoemulsification and intraocular lens implantation was performed and the dog remains visual in the left eye 1 year post-surgery. PMID:19119375

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

    PubMed

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

    2014-05-01

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

  6. Intraocular lens providing good vision 23 years after placement.

    PubMed Central

    Gillan, J. G.

    1977-01-01

    A Ridley Perspex lens was placed in the posterior chamber of a man's eye 23 years ago; 20/25 vision has been maintained since. This technique, first carried out in 1949, has been abandoned because of the high incidence of lens dislocation and glaucoma, but many modified versions of the lens have been produced. Implantation of intraocular lenses is still considered experimental, though careful selection of cases and meticulous surgical procedure can yield good results. PMID:608150

  7. Refractive lens exchange with foldable toric intraocular lens.

    PubMed

    Ruíz-Mesa, Ramón; Carrasco-Sánchez, Daniel; Díaz-Alvarez, Sara B; Ruíz-Mateos, M Angeles; Ferrer-Blasco, Teresa; Montés-Micó, Robert

    2009-06-01

    To assess visual and refractive outcomes, and rotational stability after refractive lens exchange (RLE) with toric intraocular lens (IOL) implantation to correct ametropia and preexisting astigmatism. Prospective, nonrandomized, observational case series (self-controlled). This prospective, nonrandomized, and self-controlled study included 32 eyes of 19 consecutive patients with more than 1.00 diopter (D) of preexisting corneal astigmatism having RLE with AcrySof Toric IOL implantation (Alcon Laboratories Inc, Fort Worth, Texas, USA). Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), refractive sphere, and keratometric and refractive cylinder were recorded preoperatively and 6 months after surgery. Toric IOL axis shift was also measured. A patient satisfaction, visual phenomena, and spectacle dependency questionnaire was also carried out. At 6 months postoperatively, UCVA was 20/32 or better in 100% of the eyes, with 84.3% achieving 20/25 or better. One hundred percent of eyes achieved 20/25 or better BCVA. No eye lost >or=2 lines, 1 eye lost 1 line, 16 eyes did not change, 4 eyes gained 1 line, and 11 eyes gained >or=2 lines of BCVA after the surgery. Mean refractive cylinder was reduced significantly after surgery from -2.46 +/- 0.99 D to -0.53 +/- 0.30 D (P < .001). Vector analysis to compare attempted vs achieved correction showed that 100% of eyes were within +/- 1.00 D for the spherical equivalent, and 100% of eyes were within +/-0.50 D for the astigmatic components (J(0) and J(45)). Mean toric IOL axis rotation was 0.90 +/- 1.76 degrees, being

  8. Secondary diffractive bifocal piggyback intraocular lens implantation.

    PubMed

    Alfonso, José F; Fernández-Vega, Luis; Baamonde, M Begoña

    2006-11-01

    To assess the efficacy and safety of implanting a bifocal diffractive intraocular lens (IOL) using the piggyback technique to provide pseudoaccommodation. Instituto Oftalmológico Fernández-Vega, Oviedo, Spain. This prospective noncomparative case series included 6 pseudophakic emmetropic patients who had a monofocal IOL implanted in the capsular bag. All eyes had secondary piggyback Acri. Twin bifocal diffractive IOL (Acri.Tec) implantation in the ciliary sulcus to provide pseudoaccommodation. Contralateral implantation of 1 Acri. Twin near-weighted 733D IOL in the nondominant eye and 1 Acri. Twin distance-weighted 737D IOL in the dominant eye was performed. Monocular and binocular best distance-corrected visual acuity and distance-corrected near visual acuity were evaluated 6 months after surgery. The mean binocular best distance-corrected visual acuity and distance-corrected near visual acuity were -0.080 +/- 0.056 logMAR and -0.016 +/- 0.037 logMAR, respectively. There were no statistically significant differences in binocular best distance-corrected acuity after the piggyback IOL implantation (P>.01). The differences between monocular and binocular visual acuity were the result of the distance- and near-weighted light distribution of the Acri. Twin IOLs. All IOLs were well centered with no tilt. Two eyes had pupillary capture of the optic. The Acri. Twin bifocal diffractive IOL implanted in the ciliary sulcus using the piggyback technique provided pseudoaccommodation in emmetropic pseudophakic eyes. Binocular implantation of these IOLs should be performed considering the differences in light distribution of the distance-weighted IOL and the near-weighted IOL models.

  9. 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

  10. Influence of multifocal intraocular lenses on standard automated perimetry test results.

    PubMed

    Aychoua, Nancy; Junoy Montolio, Francisco G; Jansonius, Nomdo M

    2013-04-01

    A multifocal intraocular lens (MFIOL) allows for spectacle independence after cataract surgery and is thus a seemingly attractive option. However, several optical limitations have been reported or can be hypothesized. To evaluate the influence of an MFIOL on standard automated perimetry (SAP) size III and size V test results. Cross-sectional case-control. The University Medical Center Groningen and the Nij Smellinghe Hospital Drachten, the Netherlands. Sixteen eyes of 16 patients with a diffractive MFIOL (median age, 64 years), 18 phakic eyes of 18 healthy individuals serving as controls (median age, 62 years), and 12 eyes of 12 patients with a monofocal IOL (median age, 64 years) were included. All participants underwent (1) SAP using a 30-2 grid and the Swedish Interactive Threshold Algorithm standard strategy with stimulus size III and (2) a full threshold test with stimulus size V. Primary outcome measures were the mean deviation (MD) for size III and the mean sensitivity (MS) for size V. Comparisons between groups were adjusted for age and pupil size. RESULTS For SAP size III, the average difference in MD between patients in the MFIOL group and phakic controls was -2.40 dB (P < .001) and between patients in the monofocal IOL group and phakic controls was -0.32 dB (P = .52). For SAP size V, the corresponding differences in MS were -1.61 dB (P = .002) and -0.80 dB (P = .09), respectively. The differences were essentially independent of eccentricity for both SAP size III and SAP size V. Patients with a diffractive MFIOL have a clinically relevant reduction of the visual sensitivity as assessed with SAP size III and size V. The reduction seems to be related to the multifocal design of the IOL rather than to pseudophakia. The reduction interferes with the assessment of common eye diseases such as glaucoma and comes on top of the decline of visual sensitivity due to normal aging or age-related eye diseases, thus potentially accelerating visual impairment.

  11. Functional Magnetic Resonance Imaging to Assess the Neurobehavioral Impact of Dysphotopsia with Multifocal Intraocular Lenses.

    PubMed

    Rosa, Andreia M; Miranda, Ângela C; Patrício, Miguel; McAlinden, Colm; Silva, Fátima L; Murta, Joaquim N; Castelo-Branco, Miguel

    2017-09-01

    To investigate the association between dysphotopsia and neural responses in visual and higher-level cortical regions in patients who recently received multifocal intraocular lens (IOL) implants. Cross-sectional study. Thirty patients 3 to 4 weeks after bilateral cataract surgery with diffractive IOL implantation and 15 age- and gender-matched control subjects. Functional magnetic resonance imaging (fMRI) was performed when participants viewed low-contrast grating stimuli. A light source surrounded the stimuli in half of the runs to induce disability glare. Visual acuity, wavefront analysis, Quality of Vision (QoV) questionnaire, and psychophysical assessment were performed. Cortical activity (blood oxygen level dependent [BOLD] signal) in the primary visual cortex and in higher-level brain areas, including the attention network. When viewing low-contrast stimuli under glare, patients showed significant activation of the effort-related attention network in the early postoperative period, involving the frontal, middle frontal, parietal frontal, and postcentral gyrus (multisubject random-effects general linear model (GLM), P < 0.03). In contrast, controls showed only relative deactivation (due to lower visibility) of visual areas (occipital lobe and middle occipital gyrus, P < 0.03). Patients also had relatively stronger recruitment of cortical areas involved in learning (anterior cingulate gyrus), task planning, and solving (caudate body). Patients reporting greater symptoms induced by dysphotic symptoms showed significantly increased activity in several regions in frontoparietal circuits, as well as cingulate gyrus and caudate nucleus (q < 0.05). We found no correlation between QoV questionnaire scores and optical properties (total and higher order aberration, modulation transfer function, and Strehl ratio). This study shows the association between patient-reported subjective difficulties and fMRI outcomes, independent of optical parameters and psychophysical

  12. Halo and Through-Focus Performance of Four Diffractive Multifocal Intraocular Lenses.

    PubMed

    Vega, Fidel; Alba-Bueno, Francisco; Millán, María S; Varón, Consuelo; Gil, Miguel A; Buil, Jose A

    2015-06-01

    To compare, as a function of pupil size, the through-focus performance and halo features of four diffractive intraocular lenses (IOLs). Three diffractive bifocal IOLs (ReSTOR +2.5 D SV25T0, Tecnis +2.75 D ZKB00, and AT LISA +3.75 D 809M) and a diffractive trifocal IOL (AT LISA tri +3.33 D, +1.66 D 839MP) were tested in vitro in a modified International Organization for Standardization eye model. The modulation transfer function (MTF) at the IOLs' foci was obtained with pupils ranging from 2.0 to 5.0 mm. Through-focus MTF curves (at 50 cycles/mm) were compared among all the IOLs. The halo formation and characteristics were obtained from image analysis. The multifocal IOLs studied in this work showed, at their foci, secondary out-of-focus images, which originate halos and whose characteristics depend on the lens design and pupil size. The smallest halo occurred for the distance focus of the SV25T0. The distance and near foci of the SV25T0 yielded, respectively, the best and lowest optical quality among the studied IOLs. The distance focus of the ZKB00, AT LISA, and AT LISA tri were of similar quality, but the near focus of the ZKB00 outperformed the near foci of the rest of the IOLs. The IOLs' optical performance gradually deteriorates as pupil increases. Differences in the design of the diffractive IOLs translate into differences in optical quality at their foci, through-focus performance, and halo features, which can offer further information to surgeons when selecting which IOL to implant.

  13. The control of aniseikonia after intraocular lens implantation.

    PubMed

    Hillman, J S; Hawkswell, A

    1985-01-01

    This paper reports a study of postoperative refraction and eikonometry of 50 patients who had unilateral cataract extraction with implantation of a pupil-supported intraocular lens. The mean postoperative aniseikonia (+/- SD) was 1.97 (+/- 1.82). A statistically significant relationship was shown between anisometropia and aniseikonia. Despite aniseikonia of up to 7.8 per cent there were no diplopia problems as the visual system exhibits a high degree of tolerance. It is concluded that aniseikonia can be controlled to within clinically acceptable limits by the simple calculation of intraocular lens power for isometropia.

  14. Predicting postoperative intraocular lens position and refraction.

    PubMed

    Preussner, Paul-Rolf; Wahl, Jochen; Weitzel, Daniela; Berthold, Silke; Kriechbaum, Katharina; Findl, Oliver

    2004-10-01

    To predict the postoperative IOL position and refraction as accurately as possible independent of individualization of the parameters. Universitats-Augenklinik, Mainz, Germany, and Vienna, Austria. One patient cohort (189 eyes, Vienna) was used to calibrate the prediction method, which was then applied to a second cohort (65 eyes, Mainz). All calculations were based on consistent numerical ray tracing of the pseudophakic eye using the original manufacturer's intraocular lens (IOL) data (radii, thickness, refractive index). A new algorithm to predict IOL position was developed. Ultrasound (US) axial lengths were calibrated relative to partial coherence interferometry (PCI). Corneal radii extracted from topography were checked against radii measured with the IOLMaster (Zeiss) and by Littmann keratometry. Zero mean prediction errors for IOL position and refraction were obtained without adjusting the parameters and with PCI lengths or US lengths calibrated relative to the PCI values. There was no significant loss of accuracy of US data compared to PCI data. Corneal radii extracted from topography were slightly but statistically significantly different from the Littmann values, and they were more accurate than the latter with respect to prediction error. The measured mean central IOL position (distance from posterior corneal surface) for all IOL types was 4.580 mm, a value very close to the mean recalculated from A-constants (4.587 mm). The difference in the individual central IOL position relative to the mean value depended only linearly (ie, no higher orders such as square or cubic are needed) on axial length, with the mean central IOL position as a free parameter. This parameter should be 4.6 +/- 0.2 mm (the same value as independently measured or recalculated) to obtain zero steepness of the prediction error as a function of axial length, producing zero bias for long and short eyes. Calculation errors from formulas and confusing adjusting parameters can be avoided

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

    PubMed

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

    2017-01-01

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

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

    PubMed

    Holladay, J T; Maverick, K J

    1998-09-01

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

  17. Eye lens crystallins: a component of intraocular pseudoexfoliative material.

    PubMed

    Veromann, Siiri; Sünter, Alar; Juronen, Erkki; Tasa, Gunnar; Panov, Aleksei

    2004-01-01

    Feeding experimental animals (19 pigs) with surplus sucrose and salt (NaCl) caused cataractous changes in lens tissue and triggered the formation of pseudoexfoliative material on the lens capsule. In the control animals (15 pigs) pseudoexfoliative material was absent. The avidin-biotin complex immunohistochemical method was applied to the pseudoexfoliative material obtained from 15 porcine experimental precataractous lenses and 1 spontaneously cataractous eye and revealed crystallins as a component of the intraocular pseudoexfoliative material. To prevent the development of both intraocular pseudoexfoliative material and crystallin-dependent glaucomatous changes in the trabecular meshwork of the eye, it is important to avoid any cataractogenic insult, including surplus sucrose and salt consumption, causing crystallin leakage from the lens. Copyright 2004 S. Karger AG, Basel

  18. [Iritis with destabilization of the intraocular pressure due to dislocation of a posterior chamber intraocular lens].

    PubMed

    Handzel, D M

    2012-04-01

    This report concerns the case of a 67-year-old male patient who underwent uncomplicated phacoemulsification with implantation of a posterior chamber intraocular lens (IOL). After an interval of 2 months the patient developed iritis together with an uncontrollable increase in intraocular pressure. After a detailed examination a dislocated haptic of the IOL was identified as the cause of the symptoms. The dislocation had led to uveitis-glaucoma-hyphema syndrome although no hemorrhage was observed. In addition to this complication the haptic had arroded the zonular complex which made implantation of an anterior chamber lens necessary. Although improvements in operating techniques, lens materials and designs have been made uveitis-glaucoma-hyphema syndrome has to be kept in mind. Surgical intervention is the only therapeutic option.

  19. Calcification of intraocular hydrogel lens: evidence of dystrophic calcification.

    PubMed

    Yong, Jim L C; Lertsumitkul, Somsak; Killingsworth, Murray C; Filipic, Marijan

    2004-10-01

    To report and describe the surface calcification of three cases of implanted intraocular hydrogel lens. Three surgically extracted hydrogel intraocular lenses were studied by light and transmission electron microscopy as well as by energy dispersion X-ray microanalysis. The lens surfaces were covered by granular deposits of calcium phosphate, clearly delineated by von Kossa and alizarin stains for calcium. Transmission electron microscopy showed the deposits to be located within the superficial lens material to a depth of 7 microm and to be associated with what appear to be traces of cellular material including basement membrane and plasmalemma. To the authors' knowledge there has been only one other transmission electron microscopic study. Energy dispersion X-ray microanalysis showed the deposits to contain calcium and phosphorous in all cases. This study confirms and extends the previous reports of five cases of calcification of hydrogel intraocular lenses. The exact mechanism of calcification remains obscure but evidence suggesting cell-mediated dystrophic calcification of the lens surface is presented. Further study is required to monitor the incidence and development of this phenomenon.

  20. Intraocular lens implants and risk of endophthalmitis

    PubMed Central

    Bainbridge, J; Teimory, M; Tabandeh, H; Kirwan, J; Dalton, R; Reid, F; Rostron, C

    1998-01-01

    AIM—To investigate the possible association between the use of three piece foldable silicone polypropylene (SPP) intraocular lenses (IOLs) and an increased risk of postoperative endophthalmitis.
METHODS—A retrospective analysis was conducted of all cases of postoperative endophthalmitis following phacoemulsification surgery in a single unit over a 3 year period. The incidence of postoperative endophthalmitis in eyes with SPP IOLs was compared with the incidence in eyes with single piece polymethylmethacrylate (PMMA) IOLs.
RESULTS—772 cataract extractions by phacoemulsification were performed. One (0.16%) of the 622 patients with PMMA IOLs developed endophthalmitis. Excluding one patient who had aplastic anaemia, five (3.33%) of 150 patients with SPP IOLs developed endophthalmitis. The relative risk for postoperative endophthalmitis associated with the use of the SPP IOL compared with the PMMA IOL was 20.1 (p=0.015).
CONCLUSION—This study adds further evidence to the concept that SPP IOLs can be a significant risk factor in the development of postoperative endophthamitis.

 Keywords: cataract surgery; phacoemulsification; intraocular lenses; endophthalmitis PMID:9924340

  1. 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

  2. Recurrent enterococcal endophthalmitis seeded by an intraocular lens biofilm

    PubMed Central

    Miller, Kimberly V.; Eisley, Kari M.; Shanks, Robert M.Q.; Lahr, Roni M.; Lathrop, Kira L.; Kowalski, Regis P.; Noecker, Robert J.

    2012-01-01

    A case of endophthalmitis following uneventful phacoemulsification and posterior chamber intraocular lens (IOL) implantation in a 77-year-old diabetic man was culture-positive for Enterococcus faecalis. After successful treatment with intravitreal, topical, and systemic antibiotic agents, the infection seemed to clear and the patient achieved a corrected visual acuity of 20/25. Four months after the initial presentation, the patient again developed signs and symptoms of endophthalmitis, with regrowth of E faecalis. The antibiotic therapy was repeated. One month later, the IOL was removed surgically and found to harbor a biofilm of the strain demonstrated by DNA analysis. The microbiologic and DNA analyses support that a biofilm on an IOL could be a vector for a cause of recurrent endophthalmitis. Intraocular lens exchange in cases of postoperative endophthalmitis caused by E faecalis may be considered to decrease the risk for recurrent infection. PMID:21700113

  3. Management of the posterior capsule during pediatric intraocular lens implantation.

    PubMed

    Buckley, E G; Klombers, L A; Seaber, J H; Scalise-Gordy, A; Minzter, R

    1993-06-15

    One of the major obstacles in pediatric intraocular lens implantation has been the subsequent dense opacification of the posterior capsule. We used a modification of the standard pediatric cataract surgical procedure, which involved endocapsular cataract extraction, posterior chamber intraocular lens implantation, pars plana posterior capsulotomy, and pars plana anterior vitrectomy in 20 consecutive patients with unilateral traumatic, radiation-induced, and developmental cataracts. Visual axes were rapidly restored in all patients without further intervention for posterior capsule opacification. Visual acuity returned to 20/40 or better in all patients and 75% of all patients (15 patients) reached maximum improvement by five weeks. No complications attributed to intraoperative removal of the posterior capsule occurred.

  4. Pupillary block glaucoma associated with a secondary piggyback intraocular lens.

    PubMed

    Kim, Shane K; Lanciano, Ralph C; Sulewski, Michael E

    2007-10-01

    A 53-year-old woman developed pupillary block glaucoma associated with iris capture of a piggyback intraocular lens (IOL) that was treated with laser peripheral iridotomy. The piggyback IOL was repositioned by dilating the iris pharmacologically and reclining the patient. The IOL maintained its proper position behind the iris with the use of low-concentration pilocarpine eyedrops. Pupillary block glaucoma can occur as a complication of secondary piggyback IOL implantation.

  5. Placement of a crystalline lens and intraocular lens: Retinal image quality.

    PubMed

    Siedlecki, Damian; Nowak, Jerzy; Zajac, Marek

    2006-01-01

    The influence of changes of both crystalline lens and intraocular lens (IOL) misalignment on the retinal image quality was investigated. The optical model of the eye used in investigations was the Liou-Brennan model, which is commonly considered as one of the most anatomically accurate. The original crystalline lens from this model was replaced with an IOL, made of rigid polymethylmethacrylate, in a way that recommend obligatory procedures. The modifications that were made both for crystalline lens and IOL were the longitudinal, the transversal, and the angular displacement.

  6. Intraocular lens subluxation in marfan syndrome.

    PubMed

    Rodrigo, Bolaños-Jiménez; Paulina, López-Lizárraga E; Francesc, March de R; Eduardo, Telich-Tarriba J; Alejandro, Navas

    2014-01-01

    Ectopia lentis (EL) is a major criteria for the diagnosis of Marfan syndrome, it may vary from an asymptomatic mild displacement to a significant subluxation that places the equator of the lens in the pupillary axis. The purpose of this work is to present the case of a patient with Marfan syndrome who received treatment for subluxation at our institution. A 51-year-old female diagnosed with Marfan syndrome presented to the emergency department with bilateral eye redness, foreign body sensation and crusting around the eyes on awakening. She had the following history of cardiac and ophthalmologic complications, including: 1. Lens subluxation 2. High myopia 3. Aortic root dilation, 4. Mitral valve prolapse and 5. Tricuspid insufficiency. The ophthalmological management of Marfan patients is challenging and periodical follow-up is needed. Surgical versus conservative management is controversial, each case needs to be evaluated individually to analyze the risks and benefits of the procedures.

  7. Intraocular Lens Subluxation in Marfan Syndrome

    PubMed Central

    Rodrigo, Bolaños-Jiménez; Paulina, López-Lizárraga E; Francesc, March de R; Eduardo, Telich-Tarriba J; Alejandro, Navas

    2014-01-01

    Purpose : Ectopia lentis (EL) is a major criteria for the diagnosis of Marfan syndrome, it may vary from an asymptomatic mild displacement to a significant subluxation that places the equator of the lens in the pupillary axis. The purpose of this work is to present the case of a patient with Marfan syndrome who received treatment for subluxation at our institution. Case Report : A 51-year-old female diagnosed with Marfan syndrome presented to the emergency department with bilateral eye redness, foreign body sensation and crusting around the eyes on awakening. She had the following history of cardiac and ophthalmologic complications, including: 1. Lens subluxation 2. High myopia 3. Aortic root dilation, 4. Mitral valve prolapse and 5. Tricuspid insufficiency. Conclusion : The ophthalmological management of Marfan patients is challenging and periodical follow-up is needed. Surgical versus conservative management is controversial, each case needs to be evaluated individually to analyze the risks and benefits of the procedures. PMID:25279020

  8. Current concepts in intraocular lens implantation.

    PubMed

    Bernitsky, D A; Stark, W J; McCartney, D L; Wong, S K; Maumenee, A E

    1987-01-01

    PC IOLs appear to be safe and effective and there are few contraindications. Based on the available data we feel confident about implanting PC IOLs in healthy eyes of patients aged 40 or older. For younger patients, we do not recommended an IOL unless glasses or contact lens use is not feasible. Caution is urged however in the use of semiflexible, closed-loop AC IOLs as well as 'soft' PC IOLs. Other questions regarding material of choice, bag versus sulcus fixation, and UV absorbers remain controversial.

  9. Scanning electron microscopic study of an anterior chamber intraocular lens: latent endophthalmitis.

    PubMed

    Schémann, J F

    1987-01-01

    Two years after intracapsular cataract extraction and intraocular lens implantation, an anterior chamber lens was removed. The lens was studied by scanning electron microscope which demonstrated the presence of colonies of cocci, a thin acellular membrane covering part of the lens and some modifications of the lens surface.

  10. 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

  11. Intraocular lens implantation for patients with coloboma of the iris

    PubMed Central

    LI, JUANJUAN; LI, YAN; HU, ZHULIN; KONG, LEI

    2014-01-01

    The aim of this study was to analyze the techniques for intraocular lens (IOL) implantation in patients with coloboma of the iris. A retrospective cohort study was used to analyze the degree of iris coloboma and the characteristics of the crystalline lens in 56 patients with iris coloboma. The patients with a lesser degree of coloboma of the iris and an intact lens capsule were treated by iris suture and IOL implantation into the posterior chamber. Patients with an iris coloboma confined to one quadrant, severe iris atrophy and significant lens capsule coloboma were treated with an annular suture at the edge of the pupil and IOL implantation into the anterior chamber. Patients with a greater degree of iris coloboma and an intact lens capsule were treated with an artificial iris and IOL implantation. The patients were followed up for between five months and five years after surgery. Data relating to vision, photophobia, IOL location, postoperative complications and treatment were also obtained at follow-up. The vision of the patients was improved to varying degrees following the surgery, with the exception of those with amblyopia or serious corneal scars. The photophobia of the patients had also improved. The patients’ levels of satisfaction and comfort were deemed to be satisfactory. Early postoperative complications included hyphema, increased intraocular pressure and uveitis. However, serious complications such as corneal decompensation and IOL dislocation were not observed. Various techniques for IOL implantation were selected based on the degree of iris and lens capsule coloboma; these techniques were capable of improving the vision and photophobia of the patients. PMID:24926350

  12. Angle-closure glaucoma after piggyback intraocular lens implantation.

    PubMed

    García-Feijo, J; Saenz-Frances, F; Martinez-De-La-Casa, J M; Mendez-Hernandez, C; Fernandez-Vidal, A; Elias-de-Tejada, M; Reche-Frutos, J; Garcia-Sanchez, J

    2008-01-01

    To report a case of angle closure glaucoma after piggyback intraocular lens implantation and its treatment. The authors present the case of a 75-year-old woman who was seen in the emergency department with angle closure glaucoma. Two years before she had undergone piggyback intraocular lens (IOL) implantation in order to correct a refractive error after cataract surgery. Ultrasound biomicroscopy revealed a closed angle with synechiae in 360 degrees as well as the presence of two IOLs: one in the capsular bag and the other in the ciliary sulcus. Extraction of the anterior IOL was precluded due to the poor endothelial count. Peripheral iridotomy and trabeculectomy were ineffective to lower the intraocular pressure (IOP); the authors decided to implant with an Ahmed valve and to place the valve's tube between the two IOLs to protect the endothelium. After Ahmed valve implantation, IOP maintains stable around 10-12 mmHg without medical treatment. Ahmed valve implantation is a good option in angle closure glaucoma due to piggyback. The placement of the valve's tube between the two IOLs is a good option to protect corneal endothelium.

  13. 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

  14. Foldable acrylic intraocular lens with distended haptics for transscleral fixation.

    PubMed

    Yaguchi, Saori; Yaguchi, Shigeo; Noda, Yoshiko; Taguchi, Yoko; Negishi, Kazuno; Tsubota, Kazuo

    2009-12-01

    We describe a foldable acrylic intraocular lens (IOL) with distended haptics suitable for transscleral fixation and the insertion procedure. The IOL has an acrylic optic and poly(methyl methacrylate) haptics with a microscopic indentation 1.3 mm from the tip. Transscleral fixation of the IOL was performed through corneal incisions in 22 eyes, and surgical results were retrospectively assessed. The IOL was sutured firmly in position using the cow-hitch procedure, and there was no suture loosening to the distended haptic. The IOL design provided suitable fixation and may be indicated for bag fixation as well as transscleral fixation.

  15. Repositioning a decentered intraocular lens with 4 haptics.

    PubMed

    Liu, Jiewei; Liu, Wenjie; Jia, Yading; Al-Mohtaseb, Zaina N; Wang, Li

    2016-03-01

    We describe a technique to reposition a decentered 4-haptic intraocular lens (IOL). Using an ophthalmic viscosurgical device, the haptic with the worst distortion is dissected from the capsular bag and pulled outside the bag. The opposite haptic (180 degrees away) is also dissected and placed in front of the anterior capsule. The remaining 2 haptics are left in the capsular bag. With this repositioning, the 2 haptics in the bag limit the IOL movement, the 2 haptics outside the bag are no longer distorted, and the IOL is centered. We present 2 cases in which this technique was used to reposition decentered 4-haptic IOLs.

  16. 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.

  17. Retro iris suture fixation of a rigid intraocular lens.

    PubMed

    Haripriya, Aravind; Sharma, Sankalp S

    2016-11-01

    We present an iris suture fixation technique for a rigid poly(methyl methacrylate) (PMMA) intraocular lens (IOL). A 10-0 polypropylene suture on a long curved needle is used to preplace 2 iris suture bites 180 degrees apart. The suture loops below the iris are retracted through the main scleral tunnel using a Kuglen hook and a McPherson forceps. The 2 suture loops are twirled twice around the corresponding haptics of a standard 3-piece PMMA IOL, and the IOL is placed in the sulcus. After it is confirmed that the loop surrounds the haptic, the suture knot is tied to secure the IOL to the iris.

  18. Spontaneous Late Intraocular Lens and Capsule Tension Ring Dislocation

    PubMed Central

    Koçak Altıntaş, Ayşe Gül; Omay, Aslıhan Esra; Çelik, Selda

    2017-01-01

    In this report, three cases with pseudoexfoliation (PEX) and advanced age with spontaneous intraocular lens (IOL) and capsule tension ring (CTR) dislocation were presented. All of our cases experienced progressive vision loss without an episode of strenuous physical activity, trauma, or any other ocular disease. Spontaneous dislocation was observed 2.5 to 8 years after uneventful phacosurgery. Each patient underwent complete IOL and CTR removal combined with anterior chamber IOL implantation. No complications were noticed during follow-up. As a result, capsule tension ring does not prevent late IOL dislocation after uncomplicated phacosurgery in the presence of PEX. Therefore, close follow-up is essential for patients with PEX. PMID:28405485

  19. 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

  20. 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).

  1. Factors affecting near vision after monofocal intraocular lens implantation.

    PubMed

    Lim, Dong Hui; Han, Jong Chul; Kim, Myung Hun; Chung, Eui-Sang; Chung, Tae-Young

    2013-03-01

    To identify factors that influence near vision after monofocal intraocular lens (IOL) implantation for distance vision. A retrospective review was conducted of patients who underwent cataract surgery with monofocal IOL implantation from October 2009 to April 2010 at Samsung Medical Center. Eyes were classified as having good (⩾ J4) or poor (< J4) near vision. Factors analyzed included age, sex, intraocular lens (IOL) movement, axial length, pupil size, degree and type of astigmatism, IOL type, total aberration, and higher-order aberrations. Binary logistic regression and odds ratios with 95% confidence intervals were determined. This retrospective study involved 84 eyes of 84 patients. Thirty-four eyes were classified as having good near vision and 50 eyes as having poor near vision. All groups had a postoperative uncorrected visual acuity greater than 0.2 logMAR (Snellen 20/32) and a refractive error within ± 0.5 diopter of spherical equivalent. Pupil size and axial length were inversely associated with good near vision (P = .034 and .039, respectively). A pupil size smaller than 2.6 mm and an axial length less than 23.0 mm resulted in better near vision than larger measurements after monofocal IOL implantation for distant target. Among the factors analyzed, small pupil size and short axial length predicted good near vision after phacoemulsification and monofocal IOL implantation. Copyright 2013, SLACK Incorporated.

  2. Retinal images in the human eye with implanted intraocular lens

    NASA Astrophysics Data System (ADS)

    Zając, Marek; Siedlecki, Damian; Nowak, Jerzy

    2007-04-01

    A typical proceeding in cataract is based on the removal of opaque crystalline lens and inserting in its place the artificial intraocular lens (IOL). The quality of retinal image after such procedure depends, among others, on the parameters of the IOL, so the design of the implanted lens is of great importance. An appropriate choice of the IOL material, especially in relation to its biocompatibility, is often considered. However the parameter, which is often omitted during the IOL design is its chromatic aberration. In particular lack of its adequacy to the chromatic aberration of a crystalline lens may cause problems. In order to fit better chromatic aberration of the eye with implanted IOL to that of the healthy eye we propose a hybrid - refractive-diffractive IOL. It can be designed in such way that the total longitudinal chromatic aberration of an eye with implanted IOL equals the total longitudinal chromatic aberration of a healthy eye. In this study we compare the retinal image quality calculated numerically on the basis of the well known Liou-Brennan eye model with typical IOL implanted with that obtained if the IOL is done as hybrid (refractive-diffractive) design.

  3. Soft wearable contact lens sensor for continuous intraocular pressure monitoring.

    PubMed

    Chen, Guo-Zhen; Chan, Ion-Seng; Leung, Leo K K; Lam, David C C

    2014-09-01

    Intraocular pressure (IOP) is a primary indicator of glaucoma, but measurements from a single visit to the clinic miss the peak IOP that may occur at night during sleep. A soft chipless contact lens sensor that allows the IOP to be monitored throughout the day and at night is developed in this study. A resonance circuit composed of a thin film capacitor coupled with a sensing coil that can sense corneal curvature deformation is designed, fabricated and embedded into a soft contact lens. The resonance frequency of the sensor is designed to vary with the lens curvature as it changes with the IOP. The frequency responses and the ability of the sensor to track IOP cycles were tested using a silicone rubber model eye. The results showed that the sensor has excellent linearity with a frequency response of ∼8 kHz/mmHg, and the sensor can accurately track fluctuating IOP. These results showed that the chipless contact lens sensor can potentially be used to monitor IOP to improve diagnosis accuracy and treatment of glaucoma.

  4. 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.

  5. Sturgeons, sharks, and rays have multifocal crystalline lenses and similar lens suspension apparatuses.

    PubMed

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

    2012-07-01

    Crystalline lenses with multiple focal lengths in monochromatic light (multifocal lenses) are present in many vertebrate groups. These lenses compensate for chromatic aberration and create well-focused color images. Stabilization of the lens within the eye and the ability to adjust focus are further requirements for vision in high detail. We investigated the occurrence of multifocal lenses by photorefractometry and lens suspension structures by light and electron microscopy in sturgeons (Acipenseriformes, Chondrostei) as well as sharks and rays (Elasmobranchii, Chondrichthyes). Multifocal lenses were found in two more major vertebrate groups, the Chondrostei represented by Acipenseriformes and Chondrichthyes represented by Elasmobranchii. The lens suspension structures of sturgeons, sharks, and rays are more complex than described previously. The lens is suspended by many delicate suspensory fibers in association with a ventral papilla in all groups studied. The arrangements of the suspensory fibers are most similar between sturgeons and sharks. In rays, the lens is suspended by a smaller ventral papilla and the suspensory fibers are arranged more concentrically to the lens.

  6. 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

  7. Evaluation of an unused 1952 Ridley intraocular lens.

    PubMed

    Patel, A S; Carson, D R; Patel, P H

    1999-11-01

    To evaluate an unused 1952 historic Ridley intraocular lens (IOL) brought to Bombay, India, in 1952 from an Oxford Ophthalmologic Conference in England and given to 1 of the authors during his residency. Alcon Laboratories, Fort Worth, Texas, USA. The Ridley IOL was evaluated at Alcon Laboratories, Inc., using the established procedures of its Intraocular R&D Laboratories. Various optical and physical aspects of the Ridley lens were evaluated including (1) dimensions, (2) weight, (3) power, (4) resolution efficiency and modulation transfer function (MTF), (5) surface sphericity by interferometry, (6) ultraviolet (UV)-visible transmission characteristic, (7) attenuated total reflectance (ATR)-Fourier transform infrared reflectance spectrum, and (8) cosmetics by visual inspection using light microscopy. This 8.5 mm diameter, 2.4 mm thick, 23 diopter biconvex IOL weighed 108 mg. The ATR spectrum, UV-visible transmission, and refractive index confirmed its poly-(methyl methacrylate) material. The 0.56 MTF value at 100 line pairs/mm, per the International Standards Organization--IOL Optics Standard, and 93% resolution efficiency in water, per the American National Standard Institute IOL Optics Standard, revealed the IOL's excellent optics. This was confirmed by 0.278 wave root mean square surface figure as measured by Zygo interferometer using a 633 nm wavelength. Visual inspection revealed rough edges with sharp corners and some surface scratches. Early clinical experience with Ridley IOLs in Bombay, India, is briefly given. The Ridley IOL had excellent optical quality, meeting the requirements of current IOL optics standards. The selection of its dimensions was guided by the human crystalline lens, and the Ridley IOL was half as bulky. Although its clinical results were mixed, successful cases inspired subsequent improvements, leading to modern, highly satisfactory IOLs. This IOL represented a revolutionary innovation in ophthalmology.

  8. Intraocular and crystalline lens protection from ultraviolet damage.

    PubMed

    Sliney, David H

    2011-07-01

    Although the risks of excess solar ultraviolet (UV) exposure of the skin are well recognized, the need for eye protection is frequently overlooked, or when sunglasses are also recommended, specific guidance is wrong or is not explained. Guidance from the World Health Organization at its InterSun webpage advises people to wear "wrap-around" sunglasses under many conditions. The objective of this study was to examine the need for UV filtration in prescription lenses, contact lenses, and sunglasses. The geometry of UV exposure of both eyes, solar position, ground reflection, pupil size, and lid opening were studied. Because an accurate determination of cumulative ocular exposure is difficult, the cornea itself can serve as a biologic dosimeter, because photokeratitis is not experienced on a daily basis but does under certain ground-surface and sunlight conditions. From a knowledge of the UV-threshold dose required to produce photokeratitis, we have an upper level of routine ocular exposure to ambient UV. From ambient UV measurements and observed photokeratitis, the upper limits of UV exposure of the crystalline lens or an intraocular lens implant are estimated. The risk of excess UV exposure of the germinative cells of the lens is greatest from the side. Sunglasses can actually increase UV exposure of the germinative region of the crystalline lens and the corneal limbus by disabling the eyes' natural protective mechanisms of lid closure and pupil constriction! The level of UV-A risk is difficult to define. Proper UV-absorbing contact lenses offer the best mode for filtering needless exposure of UV radiation of the lens and limbus.

  9. [Refractive long-term results after piggyback intraocular lens implantation].

    PubMed

    Moustafa, B; Häberle, H; Wirbelauer, C; Pham, D T

    2007-09-01

    Piggyback lens implantation is an alternative to exchange of the original intraocular lens (IOL) to treat high anisometropia in pseudophakic eyes. We present our results. A second IOL (piggyback) was implanted in 27 patients from 2000 to 2006. Nineteen patients were clinically investigated late postoperatively, and data for the other eight patients were evaluated from the patients' files. The patients were 65+/-9 years old. Follow-up time was 38+/-25 months. The mean preoperative spherical equivalent (SE) in the myopic eyes was -7.86+/-3.82 D and in the hyperopic eyes was 1.64+/-0.74 D. After surgery, the mean SE in the myopic eyes was -1.77+/-1.82 D and in the hyperopic eyes was -0.09+/-0.51 D. Postoperative anisometropia was reduced from 4.64+/-3.3 D. to 0.9+/-0.82 D. Piggyback lens implantation is a safe and effective surgical procedure and is less traumatic than exchange of the original IOL.

  10. 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

  11. 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

  12. Precrystalline posterior chamber intraocular lens for surgical correction of severe myopia.

    PubMed

    Barraquer, J

    1999-08-01

    To report early experience with a posterior chamber precrystalline intraocular lens designed for correction of severe myopia from -10 to -30 diopters. This intraocular lens respects the transparent crystalline lens and does not interfere with accommodation. The concave-convex methylmethacrylate lens, with flexible haptics that are supported in the sulcus, is placed behind the iris, in front of the lens, and centered with the pupil. From July 1995 to November 1998, 149 precrystalline lenses have been inserted with few, generally reversible complications, which are now largely prevented by adequate modification of the intraocular lens. Correction has been satisfactory and stable. Although follow-up is relatively short, precrystalline lens placement may be considered an important contribution to the surgical management of severe myopia to improve the patient's vision and, consequently, quality of life.

  13. Toric intraocular lens orientation and residual refractive astigmatism: an analysis

    PubMed Central

    Potvin, Rick; Kramer, Brent A; Hardten, David R; Berdahl, John P

    2016-01-01

    Purpose To analyze intraocular lens (IOL) orientation data from an online toric back-calculator (astigmatismfix.com) for determining if differences were apparent by lens type. Methods A retrospective review of astigmatismfix.com toric back-calculations that included IOL identification and intended orientation axis. Results Of 12,812 total validated calculation records, 8,229 included intended orientation and lens identification data. Of the latter, 5,674 calculations (69%) involved lenses oriented 5° or more from their intended position. Using estimated toric lens usage data, the percentage of lenses with orientation ≥5° from intended was 0.89% overall, but the percentage varied significantly between specific toric lens brands (P<0.05). The percentage of back-calculations related to lenses that were not oriented as intended was also statistically significantly different by lens brand (P<0.05). When IOLs were misoriented, they were significantly more likely to be misoriented in a counterclockwise direction (P<0.05). This was found to be due to a bias toward counterclockwise orientation observed with one specific brand, a bias that was not observed with the other three brands analyzed here. Conclusion The percentage of eyes with lens orientation ≥5° from intended in the Toric Results Analyzer data set was <1% of toric IOLs in general, with the relative percentage of Tecnis® Toric IOLs significantly higher than AcrySof® Toric IOLs. Both of these had higher rates than the Staar® Toric and Trulign® Toric lenses, with the availability of higher Tecnis and AcrySof cylinder powers a likely contributing factor. The AcrySof Toric IOL appears to be less likely than the Tecnis Toric IOL to cause residual astigmatism as a result of misorientation. The Tecnis Toric IOL appears more likely to be misoriented in a counterclockwise direction; no such bias was observed with the AcrySof Toric, the Trulign® Toric, or the Staar Toric IOLs. PMID:27703323

  14. Sources of error in intraocular lens power calculation.

    PubMed

    Olsen, T

    1992-03-01

    The hypothesis that the minimum error in predicted refraction after implantation of an intraocular lens (IOL) of calculated power is the sum of the random error in (1) the measurement of the axial length, (2) the measurement of the corneal power, and (3) the estimation of the pseudophakic anterior chamber depth (ACD) is proposed. Based on preoperative and postoperative biometry of 584 IOL implantations, 54% of the error was attributed to axial length errors, 8% to corneal power errors, and 38% to errors in the estimation of the postoperative ACD, when a fixed ACD was used in the IOL calculations. However, if the ACD was predicted according to a previously described regression method, the contribution of error from the ACD source was reduced to 22%, thereby reducing the total refractive prediction error from +/- 1.03 diopters (D) (+/- SD) to +/- 0.92 D (+/- SD). These predictions accord with clinical results.

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

    PubMed

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

    2008-01-01

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

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

    PubMed

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

    2002-01-01

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

  17. Reversible opacification of a hydrophilic acrylic intraocular lens.

    PubMed

    Park, Choul Yong; Chuck, Roy S

    2012-01-01

    A 56-year-old woman with diabetic retinopathy and chronic myelogenous leukemia had phacoemulsification cataract removal and hydrophilic acrylic intraocular lens (IOL) (Akreos MI-60) implantation in both eyes. One month after surgery, significant IOL opacity and severe cystoid macular edema were observed in both eyes. After bilateral intravitreal injection of bevacizumab (Avastin) to control macular edema, central clearing of the IOL opacity was observed in both eyes. Two months after the injection, the IOL opacity had almost disappeared from both eyes. To our knowledge, this is the first case of early postoperative bilateral IOL opacity in a hydrophilic acrylic IOL cleared after anti-vascular endothelial growth factor (VEGF) intravitreal injection. The role of anti-VEGF therapy in clearing IOL opacification requires further investigation.

  18. Artiflex Toric Phakic Intraocular Lens Implantation in Congenital Nystagmus

    PubMed Central

    Muñoz, Gonzalo; Belda, Lurdes; Albarrán-Diego, César; Ferrer-Blasco, Teresa; García-Lázaro, Santiago

    2011-01-01

    Case A 44-year-old woman with congenital nystagmus and myopic astigmatism in both eyes who was submitted to phakic intraocular lens (pIOL) implantation. Methods Full ophthalmologic examination including refractive status, corrected (CDVA) and uncorrected (UCVA) monocular and binocular visual acuities, ocular motility, slit-lamp evaluation, tonometry and fundoscopy before and after implantation of toric pIOLs (Artiflex; Ophtec BV, The Netherlands) in both eyes. Results Preoperative logMAR CDVA were 0.699 and 0.420 in the right and left eye, respectively. Three months after surgery, logMAR UCVA were 0.398 and 0.182, reaching binocular logMAR UCVA of 0.132. There were no changes in nystagmus characteristics after surgery. Conclusions pIOL implantation may be a safe and suitable treatment to correct high refractive errors in patients with congenital nystagmus. Significant improvement in CDVA and UCVA can be achieved. PMID:21941505

  19. Artiflex toric phakic intraocular lens implantation in congenital nystagmus.

    PubMed

    Muñoz, Gonzalo; Belda, Lurdes; Albarrán-Diego, César; Ferrer-Blasco, Teresa; García-Lázaro, Santiago

    2011-05-01

    A 44-year-old woman with congenital nystagmus and myopic astigmatism in both eyes who was submitted to phakic intraocular lens (pIOL) implantation. Full ophthalmologic examination including refractive status, corrected (CDVA) and uncorrected (UCVA) monocular and binocular visual acuities, ocular motility, slit-lamp evaluation, tonometry and fundoscopy before and after implantation of toric pIOLs (Artiflex; Ophtec BV, The Netherlands) in both eyes. Preoperative logMAR CDVA were 0.699 and 0.420 in the right and left eye, respectively. Three months after surgery, logMAR UCVA were 0.398 and 0.182, reaching binocular logMAR UCVA of 0.132. There were no changes in nystagmus characteristics after surgery. pIOL implantation may be a safe and suitable treatment to correct high refractive errors in patients with congenital nystagmus. Significant improvement in CDVA and UCVA can be achieved.

  20. Extended depth of focus intraocular lens: Chromatic performance

    PubMed Central

    Millán, Maria S.; Vega, Fidel

    2017-01-01

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

  1. Intraocular lens exchange surgery at a tertiary referral center: Indications, complications, and visual outcomes.

    PubMed

    Davies, Emma C; Pineda, Roberto

    2016-09-01

    To identify indications for and visual outcomes of intraocular lens (IOL) exchange to understand recent changes in this surgery. Academic tertiary referral center. Retrospective case series. Cases were identified by searching the institution's electronic medical records from January 2010 to September 2015 for patients treated by 1 staff physician with the American Medical Association's Current Procedural Terminology code for IOL exchange. These cases were reviewed to determine the surgical indication, type of IOL removed, type of IOL implanted, time between surgeries, surgical complications, and visual outcomes. The study comprised medical records of 109 eyes. The mean time between the primary cataract surgery and IOL exchange was 1657 days. Dislocation of an in-the-bag posterior chamber IOL (27.5%), intolerance of a multifocal IOL (18.3%), and uveitis-glaucoma-hyphema syndrome (11.9%) were the most frequent indications for IOL exchange. The final IOL position after exchange was most frequently in the capsular bag (43.1%), anterior chamber (25.7%), or sulcus (22%). The final visual acuity at 1 month was 20/40 or better in 78.9% of cases. Of those not achieving this level of acuity, pathology not related to exchange surgery was identified in 48% of cases. The most frequent complications after IOL exchange surgery were posterior capsule opacification (13.8%), cystoid macular edema (10.1%), and high astigmatism (>1.5 diopters) (8.3%). The most frequent indication for IOL exchange surgery was dislocated IOLs; the second most frequent indication was patient dissatisfaction after multifocal IOL implantation. The increased ability to place an intracapsular IOL with few intraoperative complications and largely treatable postoperative complications enhances the effectiveness of IOL exchange surgery and patient satisfaction. Neither author has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier

  2. Ultra-widefield retinal imaging through a black intraocular lens.

    PubMed

    Yusuf, Imran H; Fung, Timothy H M; Patel, Chetan K

    2015-09-01

    To evaluate the feasibility of ultra-widefield retinal imaging in patients with near infrared (IR)-transmitting black intraocular lenses (IOLs). Oxford Eye Hospital, Oxford, United Kingdom. Laboratory evaluation of a diagnostic technology with interventional case report. The field of retinal imaging through a Morcher poly(methyl methacrylate) (PMMA) black IOL was determined in a purpose-built adult schematic model eye with the HRA2 Spectralis confocal scanning laser ophthalmoscope using standard imaging, Staurenghi retina lens-assisted imaging, and ultra-widefield noncontact imaging. Retinal imaging using each modality was then performed on a patient implanted with another Morcher PMMA black IOL model. Ultra-widefield noncontact imaging and lens-assisted imaging captured up to 150 degrees of field (versus 40 degrees with a standard confocal scanning laser ophthalmoscope). Ultra-widefield retinal images were successfully acquired in a patient eye with a black IOL. This study has identified the first ultra-widefield retinal imaging modalities for patients with near IR-transmitting black IOLs. Should larger studies confirm this finding, noncontact ultra-widefield confocal scanning laser ophthalmoscopy might be considered the gold standard imaging technique for retinal surveillance in patients with near IR-transmitting black IOLs. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

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

    PubMed Central

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

    2010-01-01

    Aims We report the case of a myopic patient who, after intraocular lens transplant in the posterior chamber, suffered elevated intraocular pressure due to pigment dispersion, with recurrent episodes of blurred vision. The patient was treated with a new surgical technique that can avoid potential iridolenticular contact. Methods Complete ophthalmologic examination and optical coherence tomography (OCT) of the anterior segment were performed. Results Contact between the pigmentary epithelium and the iris with an intraocular lens was revealed by utrasound biomicroscopy and OCT. In this case, Nd:YAG laser iridotomy and laser iridoplasty were not effective for iridolenticular separation and control of the pigment dispersion. We propose a new technique: stitches on the surface of the iris to obtain good iridolenticular separation and good intraocular pressure control. Conclusion Stitches on the iris surface should be considered as optional therapy in pigmentary glaucoma secondary to intraocular lens implantation. This surgical technique can avoid potential iridolenticular contacts more definitively. PMID:21151331

  4. Intraocular pressure elevation during early postoperative period after secondary intraocular lens implantation in children and adolescents.

    PubMed

    Trivedi, Rupal H; Boden, John H; Mickler, Casey; Wilson, M Edward

    2012-09-01

    To look at the intraocular pressure (IOP) spike in the early postoperative period after secondary intraocular lens (IOL) implantation in children. Miles Center for Pediatric Ophthalmology, Medical University of South Carolina, South Carolina, USA. Retrospective chart review. The postoperative day-1 examination of patients having secondary IOL implantation by the same surgeon was reviewed for an IOP greater than 26 mm Hg. In patients with an IOP spike, the medical history and examination findings that might be associated with the rise were evaluated. Review of 85 patient charts (133 eyes) identified 9 eyes that developed an IOP spike during the early postoperative period. Six eyes were symptomatic, with symptoms including pain, ocular discomfort, nausea, and emesis, and 6 eyes had preoperative aphakic glaucoma, which was controlled with medication. Six of 22 eyes (27%) with preoperative aphakic glaucoma and 3 of 111 eyes (3%) without glaucoma (P<.001) developed an acute IOP rise (relative risk, 10.1). The high incidence of a symptomatic early IOP spike in patients with aphakic glaucoma warrants meticulous ophthalmic viscosurgical device removal at the end of surgery, consideration of the routine use of prophylactic topical and/or systemic glaucoma medication, and monitoring during the early postoperative period. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  5. 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.

  6. Intraocular stability of an angle-supported phakic intraocular lens with changes in pupil diameter.

    PubMed

    Alió, Jorge L; Piñero, David P; Sala, Esperanza; Amparo, Francisco

    2010-09-01

    To use anterior segment optical coherence tomography (AS-OCT) to evaluate the stability of a recently released angle-supported phakic intraocular lens (pIOL) in the anterior segment with changes in pupil diameter. Keratoconus Unit, Vissum Corporation, Alicante, Spain. In this observational cross-sectional study of consecutive eyes with moderate to high myopia, an AcrySof Cachet pIOL was implanted with the aim of minimizing the refractive error. An analysis of the position and stability of the pIOL before and after pharmacologic pupil dilation was performed 3 months postoperatively using the Visante AS-OCT system. A measurement protocol that included several anatomic parameters was developed and applied; the parameter values before and after dilation were compared. Twenty eyes of 20 patients ranging in age from 24 to 48 years old were evaluated. The anterior chamber depth increased significantly with pupil dilation (mean change 0.06 mm +/- 0.08 [SD]) (P<.01). A significant change was also observed in the distance between the center of the cornea at the endothelial plane and the anterior surface of the pIOL (mean change 0.03 +/- 0.05 mm) (P = .01). The distances between the peripheral edges of the pIOL and the corneal endothelium and the distance between the crystalline lens and the pIOL did not change significantly (P>or=.14). The angle-supported pIOL showed excellent intraocular behavior after pupil dilation, with no shortening of the distance between the pIOL and corneal endothelium at the center or peripheral edges of the pIOL. Copyright (c) 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  7. Intracapsular lensectomy and sulcus intraocular lens fixation in dogs with primary lens luxation or subluxation.

    PubMed

    Stuhr, Charles M; Schilke, Hillary K; Forte, Christina

    2009-01-01

    To evaluate the postoperative results of lensectomy and sulcus intraocular lens fixation (SIOLF) via an ab interno approach in dogs with progressive lens subluxation or early luxation. Retrospective study. Twenty eyes from 19 dogs presented to the Animal Eye Clinic for lens luxation or subluxation between 1999 and 2006. Medical records were reviewed to evaluate preoperative lens position, vision status, intraocular pressure (IOP), and whether surgery was performed on an emergent or elective nature. Lensectomy and SIOLF were performed and postoperative status including vision, glaucoma, and retinal detachment was assessed. Average age was 8.6 years (range 4-14 years) and 55% (11/20) were terriers. Patients were followed a mean of 29.2 months (range 1-92 months) after surgery. Retinal detachment or secondary glaucoma was observed in 1 of 20 (5%) and 5 of 20 (20%) eyes, respectively, with 1 of 20 (5%) exhibiting both. Mean preoperative IOP was 16 mmHg and preoperative lens position was equally divided between luxated and subluxated lenses. Surgery was performed more frequently as an elective procedure (18/20; 90%) due to normalized IOP vs. an emergency procedure (2/20; 10%). Vision was retained in 70% (14/20) of eyes with a mean time to vision loss of 41 months in the remaining eyes due to glaucoma, retinal detachment, or retinal degeneration. Complications of glaucoma and retinal detachment after SIOLF in this study were less when compared with previously reported incidence rates in the literature for lensectomy alone which may reflect improved patient selection.

  8. 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.

  9. Opaque intraocular lens for intractable diplopia-UK survey.

    PubMed

    Kwok, Thomas; Watts, Patrick

    2009-01-01

    To assess the practice of the use of an opaque intraocular lens (IOL) for intractable diplopia in the UK. A questionnaire was sent to 892 consultant ophthalmologists in practice requesting information on the treatment of intractable diplopia with an opaque IOL. Respondents were asked whether they would consider using an opaque IOL for intractable diplopia. Information was gathered on the numbers of lenses implanted, the type of lens used, and whether the lens was implanted inside or outside the capsular bag. In addition, we asked for the causes of intractable diplopia, the success in eliminating diplopia, the use of postoperative pilocarpine, and whether postoperative surveillance was part of the follow-up protocol. Of the 481 completed questionnaires received, 72% would consider implanting an opaque IOL. A total of 48 surgeons had implanted 1 or more lenses. There were 97 patients who were implanted with an opaque IOL over the past 15 years. Strabismus, nerve palsies, and previous retinal detachment surgery with diplopia were the main indications. Pseudophakic lenses were used by 38 surgeons in the capsular bag, 6 used iris-supported phakic lenses, and 2 used phakic lenses in the anterior chamber angle. The use of postoperative pilocarpine was reported by 9 surgeons, and 6 surgeons used regular ultrasound fundal surveillance. Patients were reported to be completely asymptomatic at discharge by 31 surgeons, with 15 surgeons reporting patients who were still symptomatic postoperatively. Only 1 intraoperative complication was reported. An opaque IOL is a safe method for treating intractable diplopia. This survey confirms that its practice is widely accepted in the UK.

  10. [Wave front aberrations -- practical conclusions in eye with Restor 3+ difractive multifocal lens].

    PubMed

    Staicu, Corina; Moraru, Ozana; Moraru, Cristian

    2014-01-01

    Implantation of multifocal intraocular lenses has become a rutine nowadays, but achieving good visual results requires a perfect intraoperative technique and also an adequate preoperative selection of the patients. We analysed the wave front aberrations (spherical aberations, coma and astigmatism) in the eyes implanted with ReStor + 3 IOL, and we realized some clinical correlations of these aberations with the pupil diameter in scotopic and fotopic conditions, kappa angle, IOL centration, residual refraction errors postoperatively. Taking into account the causes of postoperative high order aberration will allow the surgeon to make a good selection of the patiens and to a higher degree of satisfaction of both sides.

  11. 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

  12. Free volume study on calcification process in an intraocular lens after cataract surgery.

    PubMed

    Ramani, R; Parihar, J K S; Ranganathaiah, C; Awasthi, P; Alam, S; Mathur, G N

    2005-10-01

    An opacified intraocular lens explanted from a patient in the postoperative period after phacoemulsification was investigated to find the cause of opacification. From the UV-visible and energy dispersive X-ray spectroscopy (EDS) measurements, the opacification in the present case seems to be due to calcification of the intraocular lens and not due to modification in the UV absorber material of the lens. The average free volume size of the intraocular lens both in unimplanted and explanted state were obtained from positron lifetime spectroscopy (PLS). Further, the combined FTIR and PLS results indicate that calcium gets into the free volume cavities of the intraocular lens matrix as a cationic moiety, may be in the form of Ca(++). The small decrease in glass transition temperature of the calcified lens seems to indicate the plasticizing action of calcium ions. The present results could be of some use in the design of the intraocular lens material in which calcification would be minimum. (c) 2005 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2005.

  13. Ghost cell glaucoma following sutureless scleral-fixated posterior chamber intraocular lens placement.

    PubMed

    Thompson, Jordan M; Chang, Jonathan S; Bermudez-Magner, J Antonio; Dubovy, Sander R

    2015-01-01

    Secondary intraocular lens (IOL) placement in the absence of a capsular bag may result in several complications. The authors report the clinicopathologic features of a case of ghost cell glaucoma after the placement of a sutureless posterior chamber IOL. A 47-year-old male presented with a dislocated IOL and underwent lens exchange using a sutureless scleral-fixation technique. Over the following year, the patient developed recurrent vitreous hemorrhages and elevated intraocular pressure despite medical therapy, and an aqueous specimen disclosed ghost cells. Although uncommon, mechanical contact between the iris and a secondary IOL may produce persistent vitreous hemorrhage and elevated intraocular pressures with the formation of ghost cells.

  14. Effect of intraocular lens design on migration of lens epithelial cells onto the posterior capsule.

    PubMed

    Nagamoto, T; Eguchi, G

    1997-01-01

    To find the conditions that prevent posterior capsule opacification through in vitro analysis of the relationship between intraocular lens (IOL) optic configuration and lens epithelial cell (LEC) migration. Division of Morphogenesis, Department of Developmental Biology, National Institute for Basic Biology, Okazaki, Japan. In a preliminary experiment, we measured the size of the capsular bag of rabbits at 8, 16, 20, and 26 weeks of age. The size of a 20-week-old capsular bag was the same size as the capsular bag in senescent Japanese eyes. We isolated the capsular bags in 20- and 8-week-old rabbits. The bags along with a biconvex (BC), convex-plano (CP), or no IOL (C) were cultured, and the eyes were divided into one of six groups (8W-C, 8W-BC, 8W-CP, 20W-C, 20W-BC and 20W-CP), each including six specimens. Two specimens in the 8W-CP group completely blocked LEC migration at the optic edge. All specimens in the 20W-CP group and one in the 20W-BC group showed cell aggregation along the optic edge. None of the other specimens in the BC and C groups blocked migration or showed cell aggregation. In the rabbit-model study, the convex-plano lens was superior to the biconvex lens in inhibiting migration of LECs. A firm contact between the IOL and the posterior capsule blocked the migration.

  15. [First results with a new aberration correcting bifocal intraocular lens].

    PubMed

    Kaymak, H; Mester, U

    2007-12-01

    To investigate the functional results with a new bifocal intraocular lens. The *Acri.LISA (*Acri.Tec) was implanted bilaterally in 20 patients after uneventful cataract surgery. The new bifocal IOL has a light distribution of 65% for distance and 35% for the near range. The diffractive optics of the lens are designed to be independent of pupil size. Smooth steps in diffractive structure should reduce glare. An aspheric design of the posterior optic surface is engineered to counteract the asphericity of the cornea (-0.26). Postoperative evaluation included 6 weeks after surgery: uncorrected (UCVA) and best corrected (BCVA) visual acuity for distance (ETDRS charts) and near (C.A.T. charts, Birkhäuser charts) monocular and binocular, defocus curve, contrast sensitivity under photopic and mesopic lighting conditions (F.A.C.T.), and subjective assessment of halos At the 6-week follow-up mean binocular UCVA and BCVA (LogMAR) were -0.02+/-0.10 and -0.07+/-0.09, respectively, for distance. Near UCVA (LogMAR) was 0.09+/-0.16; distance corrected near VA was 0.04+/-0.13. Visual acuity was significantly superior when tested binocularly compared to monocular testing (p<0.01). The depth of field showed an intermediate decimal VA of 0.6+/-0.21 at 70 cm and a pseudoaccommodation range of 5.5 D. Of 20 patients, 16 reported slight halos, but no patient was seriously impaired. The *Acri.LISA showed very good visual performance 6 weeks after bilateral surgery.

  16. Intraocular Pressure After 2 Hours of Small-Diameter Scleral Lens Wear.

    PubMed

    Nau, Cherie B; Schornack, Muriel M; McLaren, Jay W; Sit, Arthur J

    2016-11-01

    Compression of episcleral veins or deformation of tissue in the Schlemm's canal beneath the landing zone of scleral lenses could elevate intraocular pressure (IOP). We examined the effect of 2 hr of small-diameter scleral lens wear on IOP. Twenty-nine participants, 29 ± 6 years old (mean ± SD) who experienced no history of eye disease or scleral lens wear, were included in the study. Each participant was fitted with a 15-mm Jupiter scleral lens on one eye (study eye). Intraocular pressure was measured in both eyes by pneumatonometry centrally on the cornea and peripherally on the sclera. The lens was then placed on one eye and was worn for 2 hr. Intraocular pressure was remeasured immediately after lens placement, at 1 and 2 hr of lens wear, and immediately after lens removal. Intraocular pressure after removal of the scleral lens was compared with IOP before placing the lens and to IOP in the control eye using paired t tests. Immediately after removing the scleral lens, mean central IOP in the study eye (13.9 ± 3.1 mm Hg) was not different from mean central IOP in the control eye (13.5 ± 2.2 mm Hg, P = 0.4) or in the same eye before lens wear (13.6 ± 1.9 mm Hg, P = 0.6). There were also no differences in IOP measured peripherally at 2 hr of lens wear (P = 0.8). Neophyte scleral lens wear of a 15-mm scleral lens for 2 hr does not increase IOP in healthy eyes.

  17. INTRAOCULAR LENS POSITION IN COMBINED PHACOEMULSIFICATION AND VITREORETINAL SURGERY.

    PubMed

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

    2017-10-09

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

  18. Sleeveless-extrusion cannula for levitation of dislocated intraocular lens.

    PubMed

    Agarwal, Ashvin; Narang, Priya; Agarwal, Amar; Kumar, Dhivya A

    2014-07-01

    To characterise a sleeveless-extrusion cannula-based suction technique to levitate dislocated intraocular lens (IOLs) and review the surgical outcome. This retrospective, non-comparative, single surgeon, interventional, consecutive case series examined 10 patients (10 eyes) who underwent the surgical procedure from October 2011 to December 2012. Reliability, reproducibility, and intraoperative and postoperative complications of the technique were analysed. The technique involved suction levitation of a 3-piece acrylic foldable IOL in six cases, 1-piece acrylic foldable IOL in three cases and a plate haptic IOL in one case. The IOL was exchanged in four eyes whereas the same IOL was repositioned in six eyes with sulcus repositioning in two eyes and glued intrascleral fixation in four eyes. Intraoperative suction loss and a subsequent IOL dislocation were reported in 1 (10%) eye. Early preoperative complications included pigment dispersion in 1 (10%) eye, grade 2 anterior chamber cellular reaction in 2 (20%) eyes and intraoperative corneal oedema in 1 (10%) eye which resolved with medical line of management. Intermediate and late complications included macular oedema in one patient (10%) which resolved considerably with medical line of management. No incidence of postoperative vitreous or retinal haemorrhage, retinal break or retinal detachment was reported. The early results demonstrate this surgical intervention as a reliable, reproducible and an effective alternative treatment option for levitation of dislocated IOLs with a low complication rate.

  19. 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

  20. Wrong intraocular lens implant; learning from reported patient safety incidents.

    PubMed

    Kelly, S P; Jalil, A

    2011-06-01

    To consider wrong intraocular lens (IOL) implant events in cataract surgical care reported through a national incident reporting database. To propose potential solutions for such events where possible. Thematic retrospective review of wrong IOL implantation incidents, as reported through clinical incident reporting methods in NHS care in England and Wales from 2003 to 2010, ascertained from database mining at the National Patient Safety Agency. In total, 164 patient safety incident (PSI) reports of wrong IOL implantation were located from the study period and considered. There were 47 reports where further surgical intervention was required. All, but one of these required IOL exchange surgery. A total of 62 reports did not provide any causal reason for the wrong IOL implantation and thus provide little if any potential learning. Inaccurate biometry (n=29), wrong IOL selection (n=21), transcription errors (n=10) and handwriting misinterpretations (n=7) were causal reasons reported and are thus potential areas for ophthalmic teams to review and improve practice. Although infrequent, biometry/IOL implant errors or wrong implants do occasionally occur during cataract care and are thus a threat to quality. There is room for improvement in incident reporting in NHS cataract care as root causation of error was usually lacking in the PSI reports. Nevertheless, lessons for improvement of care from a national incident reporting database for a frequently undertaken surgical procedure were found. Suggestions are proposed for improving quality by reducing wrong IOL problems in cataract care based on analysis of such reports.

  1. Wrong intraocular lens implant; learning from reported patient safety incidents

    PubMed Central

    Kelly, S P; Jalil, A

    2011-01-01

    Purpose To consider wrong intraocular lens (IOL) implant events in cataract surgical care reported through a national incident reporting database. To propose potential solutions for such events where possible. Methods Thematic retrospective review of wrong IOL implantation incidents, as reported through clinical incident reporting methods in NHS care in England and Wales from 2003 to 2010, ascertained from database mining at the National Patient Safety Agency. Results In total, 164 patient safety incident (PSI) reports of wrong IOL implantation were located from the study period and considered. There were 47 reports where further surgical intervention was required. All, but one of these required IOL exchange surgery. A total of 62 reports did not provide any causal reason for the wrong IOL implantation and thus provide little if any potential learning. Inaccurate biometry (n=29), wrong IOL selection (n=21), transcription errors (n=10) and handwriting misinterpretations (n=7) were causal reasons reported and are thus potential areas for ophthalmic teams to review and improve practice. Conclusion Although infrequent, biometry/IOL implant errors or wrong implants do occasionally occur during cataract care and are thus a threat to quality. There is room for improvement in incident reporting in NHS cataract care as root causation of error was usually lacking in the PSI reports. Nevertheless, lessons for improvement of care from a national incident reporting database for a frequently undertaken surgical procedure were found. Suggestions are proposed for improving quality by reducing wrong IOL problems in cataract care based on analysis of such reports. PMID:21350567

  2. Transscleral fixation of a foldable posterior chamber intraocular lens.

    PubMed

    Wallmann, Andrew C; Monson, Bryan K; Adelberg, Daniel A

    2015-09-01

    We describe an approach to transscleral fixation of a foldable posterior chamber intraocular lens (PC IOL) using a 25-gauge pars plana vitrectomy. The technique was used in 80 consecutive eyes, and the results were analyzed for corrected distance visual acuity and safety indicators. Postoperative complications included retinal detachment in 2 eyes (2.5%), Irvine-Gass cystoid macular edema in 3 eyes (3.75%), persistent postoperative corneal edema in 1 eye (1.25%), hyphema in 2 eyes (2.5%), and postoperative vitreous hemorrhage with spontaneous clearing in 1 eye (1.25%). The modified external approach with a 25-gauge pars plana vitrectomy had relatively few complications, improved visual acuity in patients requiring a transsclerally sutured PC IOL, and offered several advantages over traditional anterior chamber and conventional techniques of scleral suturing. Dr. Adelberg is a consultant to Bausch & Lomb. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  3. Motorized injector-assisted intrascleral intraocular lens fixation.

    PubMed

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

    2017-03-01

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

  4. Influence of intraocular lens subsurface nanoglistenings on functional visual acuity

    PubMed Central

    Miyata, Kazunori; Hayashidera, Takeshi; Iida, Masaharu; Takada, Keita; Minami, Keiichiro; Oshika, Tetsuro

    2017-01-01

    To investigate the influence of intraocular lens subsurface nanoglistenings (SSNGs) on functional visual acuity (FVA), thirty-nine eyes of 29 patients were examined in this study. The SSNG group comprised 19 eyes of 14 patients (75.7± 5.4 years, mean ± standard deviation), and the control group comprised 20 eyes of 15 patients (73.6 ± 6.5 years). The SSNGs were diagnosed on the basis of the typical whitish IOL appearance upon slit-lamp examination and results of densitometry regarding surface light scattering using Scheimpflug images. The FVA measurement system (AS-28; Kowa, Aichi, Japan) was used to examine changes in continuous visual acuity (VA) over time, and visual function parameters such as FVA, visual maintenance ratio (VMR), maximum VA, minimum VA, standard deviation of VA, and number of blinks were assessed. The results were compared between the SSNG and control groups, and correlations of FVA parameters with the intensity of surface light scattering, time after surgery, and age were also evaluated. There were significant differences in VMR (P = 0.035) and standard deviation of VAs (P = 0.031) between the two groups, although no significant differences were found in baseline VA, FVA, maximum VA, minimum VA, and number of blinks. None of the FVA parameters showed any significant correlations with the intensity of surface light scattering, time after surgery, or age. There is a possibility that VA is unstable during a continuous gazing task in patients with SSNGs. PMID:28328997

  5. Experimental investigation on mechanism of hydrophilic acrylic intraocular lens calcification.

    PubMed

    Drimtzias, Evangelos G; Rokidi, Stamatina G; Gartaganis, Sotirios P; Koutsoukos, Petros G

    2011-11-01

    To construct a model simulating intraocular lens (IOL) opacification attributable to the formation of calcium phosphate deposits and to investigate the kinetics of deposit formation. Prospective laboratory investigation. Department of Ophthalmology, Medical School and Department of Chemical Engineering, Laboratory of Inorganic and Analytical Chemistry, University of Patras, Greece. Three hydrophilic acrylic IOLs (26% water content) were placed inside a 10-mL double-walled thermostated reactor simulating the anterior chamber. Simulated aqueous humor was injected continuously into the reactor using a pump with variable speed. The observation of IOLs was carried out in situ daily by optical microscopy. Scanning electron microscopy and energy-dispersive radiographic spectroscopy were used for the identification of the morphologic features and the composition of the deposits. The lenses were removed and inspected 5, 9, and 12 months after the initiation of the experiment. Investigation showed deposits of calcium phosphate crystallites in the interior of opacified IOLs. However, these deposits were not observed on the surface of the IOLs. In agreement with earlier reports by our group and in the literature, IOL opacification is the result of calcification. It is suggested that the surface hydroxyl groups of the polyacrylic polymeric components of the IOLs are capable of inducing surface nucleation and crystal growth of calcium phosphates. However, most important is the finding that the calcification of IOLs is initiated from their interior through the development of sufficiently high local supersaturation, realized through the diffusion of calcium and phosphate ions. Copyright © 2011 Elsevier Inc. All rights reserved.

  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 rapid method for measuring intraocular lens power in vitro with a focimeter.

    PubMed

    García-Domene, Mari Carmen; Díez-Ajenjo, María Amparo; Peris-Martínez, Cristina; Navea, Amparo; Artigas, José María

    2015-11-01

    In this paper we describe a new method for measuring the intraocular lens (IOL) power using a focimeter, a negative ophthalmic lens and a saline solution (0.9% NaCl). To test this we measured the power of 58 different IOLs and we compared them with the power stated by the manufacturer. Despite the limitations, the results show a good correlation.

  8. Visual outcomes after bilateral trifocal diffractive intraocular lens implantation.

    PubMed

    Carballo-Alvarez, Jesús; Vazquez-Molini, Jose M; Sanz-Fernandez, Juan C; Garcia-Bella, Javier; Polo, Vicente; García-Feijoo, Julián; Martinez-de-la-Casa, Jose M

    2015-03-14

    In recent years new models of intraocular lenses are appearing on the market to reduce requirements for additional optical correction. The purpose of this study is to assess visual outcomes following bilateral cataract surgery and the implant of a FineVision® trifocal intraocular lens (IOL). Prospective, nonrandomized, observational study. Vision was assessed in 44 eyes of 22 patients (mean age 68.4 ± 5.5 years) before and 3 months after surgery. Aberrations were determined using the Topcon KR-1 W wave-front analyzer. LogMAR visual acuity was measured at distance (corrected distance visual acuity, CDVA 4 m), intermediate (distance corrected intermediate visual acuity, DCIVA 60 cm) and near (distance corrected near visual acuity, DCNVA 40 cm). The Pelli-Robson letter chart and the CSV-1000 test were used to estimate contrast sensitivity (CS). Defocus curve testing was performed in photopic and mesopic conditions. Adverse photic phenomena were assessed using the Halo v1.0 program. Mean aberration values for a mesopic pupil diameter were: total HOA RMS: 0.41 ± 0.30 μm, coma: 0.32 ± 0.22 μm and spherical aberration: 0.21 ± 0.20 μm. Binocular logMAR measurements were: CDVA -0.05 ± 0.05, DCIVA 0.15 ± 0.10, and DCNVA 0.06 ± 0.10. Mean Pelli-Robson CS was 1.40 ± 0.14 log units. Mean CSV100 CS for the 4 frequencies examined (A: 3 cycles/degree (cpd), B: 6 cpd, C: 12 cpd, D: 18 cpd) were 1.64 ± 0.14, 1.77 ± 0.18, 1.44 ± 0.24 and 0.98 ± 0.24 log units, respectively. Significant differences were observed in defocus curves for photopic and mesopic conditions (p < 0.0001). A mean disturbance index of 0.28 ± 0.22 was obtained. Bilateral FineVision IOL implant achieved a full range of adequate vision, satisfactory contrast sensitivity, and a lack of significant adverse photic phenomena. Eudract Clinical Trials Registry Number: 2014-003266-2.

  9. Lack of effect of intraocular lens asphericity on visual performance with acrylic intraocular lenses.

    PubMed

    Muñoz, Gonzalo; Albarrán-Diego, César; Galotto, M Ángeles; Pascual, Javier; Ferrer-Blasco, Teresa

    2011-01-01

    To determine whether implantation of acrylic intraocular lens (IOL) with aspheric design (Tecnis Z9003, AMO) results in improved visual acuity or contrast sensitivity compared with conventional spherical acrylic IOL (AR40e, AMO). In an intraindividual randomized prospective study of 60 patients with bilateral cataract, the Tecnis Z9003 IOL was compared with the AR40e IOL. Ocular aberrations for a 4.0-mm pupil and 6.0-mm pupil were measured with a Hartmann-Shack aberrometer. Quality of vision was measured using visual acuity and contrast sensitivity under mesopic and photopic conditions. Eyes with the Tecnis Z9003 IOL had significantly less spherical aberration and greater Strehl ratio after surgery, showing a better optical quality in comparison with the standard spherical IOL. However, visual acuity and both mesopic and photopic contrast sensitivity were not significantly different between the groups. The significantly better optical quality achieved with the aspheric acrylic IOL design did not result in improved visual acuity or contrast sensitivity in comparison with a conventional spherical acrylic IOL.

  10. New concentrator multifocal Fresnel lens for improved uniformity: design and characterization

    NASA Astrophysics Data System (ADS)

    Vázquez-Moliní, Daniel; Fernández-Balbuena, Antonio Álvarez; Bernabeu, Eusebio; Muñoz de Luna Clemente, Javier; Domingo-Marique, Alfonso; García-Botella, Ángel

    2009-08-01

    The emergence of high efficiency photovoltaic cells is leading the industry into using solar concentrators in order to reduce costs by decreasing the number of cells used. In this paper Optics department of Universidad Complutense de Madrid has designed a multifocal Fresnel lens of PMMA and has studied the main parameters that have influence on its final function. This has been done by taking into account its manufacturing tolerances. The lens is square shaped with sides measuring 270 mm and it is composed of three different zones based on three different criteria: The central zone has been designed by using paraxial formulation, the intermediate one has been designed based on Fresnel classical formula while the marginal zone's purpose is to deflect the light by total internal reflection on prism faces. All three zones have different focal areas and different optical axis so the energy distribution will be more uniform whilst avoiding cell damage caused by hot spots. The design stage is feedback through simulations using a ray tracer software. In order to characterize the lens operation a measure of optical concentration was first taken on different lens areas using an integrating sphere. Finally, the lens performance in terms of concentration and in terms of uniformity at the focal spot was studied by processing the images taken with a CCD camera on a screen placed at the focal plane of the lens.

  11. [The effect of crystalline lens extraction on intraocular pressure in patients with primary open-angle glaucoma].

    PubMed

    Macarie, S; Macarie, Daniela

    2013-01-01

    This issue presents the results of a study on patients with cataract and primary open angle glaucoma who suffered lens extraction for cataract. We analise the effects of the lens extraction on the level of intraocular pressure at this patients.

  12. Intraocular Lens Power Calculation after Corneal Refractive Surgery

    PubMed Central

    Javadi, Mohammad-Ali; Feizi, Sepehr; Malekifar, Parviz

    2012-01-01

    Purpose: To report refractive outcomes following phacoemulsification (PE) and posterior chamber intraocular lens (PCIOL) implantation in eyes with previous corneal refractive surgery. Methods: In this retrospective comparative study, 18 consecutive eyes of 14 patients with previous keratorefractive surgery for myopia including photorefractive keratectomy (PRK, 6 eyes; 33.3%) and laser in situ keratomileusis (LASIK, 12 eyes; 66.7%) underwent PE+PCIOL. Computerized corneal topography was employed to determine the flattest keratometric reading within the 3-mm central zone. This value was inserted into the Sanders-Retzlaff-Kraff/T (SRK/T) formula to calculate IOL power. IOL power selected for implantation was 1 D greater than the calculated value described above. Results: Mean age and follow-up period were 54.1±11.5 years and 29.9±26.3 months, respectively. Mean implanted lens power was 18.56±3.86 D which was not significantly different from mean back-calculated IOL power for target refraction (19.04±4.16 D) (P=0.28). There was no significant difference between mean target refraction (−0.94±0.52 D) and achieved postoperative spherical equivalent refractive error (−0.62±1.06) at final follow-up (P=0.28). The achieved spherical equivalent refractive error was within ±0.50 D of intended refraction in 8 (44.4%) eyes, within ±1.0 D in 11 (61.1%) eyes, and within ±2.0 D in 16 (88.9%) eyes. In a subgroup of patients (5 eyes) with complete pre-refractive surgery data, the difference between post-refractive surgery keratometry method and all other methods (P=0.02) and between the current method and the Feiz-Mannis method (P=0.01) was statistically significant. Conclusion: The method suggested herein is simple and independent of pre-refractive surgery data with results comparable to other commonly used methods. PMID:22737381

  13. Intraocular lens exchange for high myopia in pseudophakic children.

    PubMed

    Kraus, C L; Trivedi, R H; Wilson, M E

    2016-09-01

    PurposeThe purpose of this study was to examine the preoperative factors and postoperative outcomes following intraocular lens (IOL) exchange for high myopia in pseudophakic children.MethodsThe medical records of all patients undergoing IOL exchange for high myopia were retrospectively reviewed.ResultsA total of 15 eyes were identified that had undergone an IOL exchange for myopic shift. Average age of cataract extraction (CE) was 5.4 months. In all, 10/15 had a unilateral cataract. IOL exchange usually occurred at an average of 6 years following cataract surgery. The average spherical equivalent (SE) of the refractive error at that time was -9.6 D. Following IOL exchange, SE was -1.3 D. A two-line reduction in best-corrected visual acuity was observed in 1/13 of our patients for whom pre- and post-exchange data were available. The average axial length (AL) of the eye undergoing the IOL exchange was 24.0 mm, average AL in the non-operative eye was 22.1 mm. On average, the operative eyes grew 4.4 mm and the non-operative eyes 3.02 mm. No adverse events were seen in the operative eyes.ConclusionYounger age at the time of CE creates a greater likelihood of AL elongation and predisposes a child to myopic shift. IOL exchange should be considered an option to reduce anisometropia and associated aniseikonia to improve visual outcomes. Successful visual rehabilitation and predictable post-exchange refractions were seen with our patients.

  14. Analysis of intraocular lens surface adhesiveness by atomic force microscopy.

    PubMed

    Lombardo, Marco; Carbone, Giovanni; Lombardo, Giuseppe; De Santo, Maria P; Barberi, Riccardo

    2009-07-01

    To analyze intraocular lens (IOL) optic surface adhesiveness using atomic force microscopy (AFM). LiCryL Laboratory, University of Calabria, Rende, Italy. The surface adhesive properties of poly(methyl methacrylate) (PMMA), silicone, hydrophilic acrylic, and hydrophobic acrylic IOLs were evaluated by AFM. Analysis was performed at room temperature (21 degrees C) in a liquid environment using the force-versus-distance mode of a commercial instrument (NanoScope III). Measurements were acquired with rectangular silicon cantilevers of a nominal elastic constant of 10 Newton/m. The nominal value of the tip's radius of curvature was 1 mum, and the scanning speed during the acquisitions ranged from 10 to 400 nm/s. The adhesion force measurements showed different characteristics for the various types of IOLs (P<.001, analysis of variance). The hydrophobic acrylic IOL had the largest mean adhesive force (283.75 nanoNewton [nN] +/- 0.14 [SD]) followed by the hydrophilic acrylic (84.76 +/- 0.94 nN), PMMA (45.77 +/- 0.47 nN), and silicone (2.10 +/- 0.01 nN) IOLs. The surface properties of the biomaterials used to manufacture IOLs are important because they can influence the incidence and severity of posterior capsule opacification (PCO). Although further studies are necessary to elucidate the mechanism of PCO development and the interface interactions between the IOL and capsule, the results in this study may bolster the theory of manufacturing more-adhesive materials to prevent PCO.

  15. [Phacoemulsification and acrylic intraocular lens in uveitis: a comparative study].

    PubMed

    González-Guijarro, J Jacobo; Tamés Haye, I; Valdivia Pérez, A

    2012-01-01

    To describe the outcomes of phacoemulsification with the implant of an acrylic intraocular lens (IOL) in cataracts of adult patients with and without uveitis Descriptive retrospective comparative study of 35 patients (45 eyes) with uveitis (group 1) and 38 (44 eyes) control patients (group 2), who were operated on by the same surgeon, and were homogeneous as regards sex, surgical technique, IOL (hydrophobic or hydrophilic) and follow-up. The pre-surgical characteristics of risk, the difficulties and intra-surgical and postsurgical complications, the date of posterior capsulotomy (PC) and the pre- and post-surgical visual acuity (VA), were analysed. In both groups the coaxial phacoemulsification was used in 75% of the eyes, bimanual microincision cataract surgery (MICS) in 20% and micro-coaxial in the rest. The pre-surgical risk factors (P = .002, OR 6.83), the surgical difficulties and complications (P = .001, OR 7.54) and postsurgical complications (P = .069, OR 3.42) were more frequent in the uveitis group. In both 93% and 91% respectively of eyes improved 2 or more lines of VA. After an average follow-up of 4.9 years in both groups, 22.7% and 32% eyes (log-rank P = .357) needed PC. The hydrophilic IOLs needed PC earlier than the hydrophobic ones (log rank P = .001), neither the location nor the uveitis course influenced the PC rate. The consequences because of previous ocular inflammation make cataract surgery in uveitis more difficult, but with postsurgical complications, visual results and need of PC similar to our patients without inflammation. Copyright © 2010 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  16. Capsular bag opacification with a new accommodating intraocular lens.

    PubMed

    Floyd, Anne M; Werner, Liliana; Liu, Erica; Stallings, Shannon; Ollerton, Andrew; Leishman, Lisa; Bodnar, Zachary; Morris, Caleb; Mamalis, Nick

    2013-09-01

    To evaluate the biocompatibility and capsular bag opacification of an accommodating intraocular lens (IOL) containing large haptic elements that separate the anterior and posterior capsules. John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. Experimental study. Bilateral phacoemulsification with IOL implantation was performed in 6 New Zealand rabbits. Each animal received a study (accommodating) IOL and a control (1-piece hydrophobic acrylic) IOL. Eyes were examined at the slitlamp from 1 day through 6 weeks postoperatively. The globes were then enucleated and evaluated grossly. Capsular bag opacification was scored from the posterior aspect (Miyake-Apple view). The eyes were then processed for complete histopathologic evaluation. At 6 weeks, the mean posterior capsule opacification (PCO) clinical score was 0.5 ± 0.3 (SD) in the study group and 3.0 ± 0.9 in the control group (P=.001, 2-tail paired t test). Anterior capsule opacification was practically absent in the study group and mild in the control group. Miyake-Apple posterior view showed a mean central PCO score of 0 ± 0 in the study group and 3.0 ± 1.1 in the control group (P=.001), peripheral PCO score of 0.7 ± 0.4 and 3.5 ± 0.8 (P=.0006), respectively, and Soemmerring ring score of 2.3 ± 0.8 and 7.0 ± 2.8 (P=.01), respectively. Histopathology showed no signs of toxicity in any eye. The study IOL maintained an expanded capsular bag secondary to the large size of the haptic elements, which appears to prevent capsular bag opacification. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  17. Influence of intraocular lens haptic design on refractive error.

    PubMed

    Savini, Giacomo; Barboni, Piero; Ducoli, Pietro; Borrelli, Enrico; Hoffer, Kenneth J

    2014-09-01

    To assess the influence of intraocular (IOL) haptic design on the refraction prediction error in patients having cataract surgery. Private practice. Comparative case series. Corneal power and axial length were measured with the same devices in eyes with a 3-piece Acrysof IOL and eyes with a 1-piece Acrysof IOL and were entered into the Haigis, Hoffer Q, Holladay 1, and SRK/T formulas. The median absolute error and mean absolute error in refraction prediction (ie, difference between expected refraction and actual refraction) were assessed 1 month postoperatively. The study evaluated 110 eyes with the 3-piece IOL and 84 eyes with the 1-piece IOL. With all formulas, the median absolute error was lower with the 3-piece IOL. It ranged between 0.15 diopter (D) (Haigis and Holladay 1) and 0.19 D (SRK/T) with the 3-piece IOL and between 0.23 D (Haigis) and 0.30 D (SRK/T) with the 1-piece IOL. With all formulas, a higher percentage of eyes with the 3-piece IOL were within ±0.25 D and ±0.50 D of the target refraction. Three-piece IOLs may yield better refractive outcomes than 1-piece IOLs. A possible reason is that once the early forward IOL shift previously observed with the 3-piece design occurs because of the haptic-compression force decay typical of these IOLs, the rigid haptics of 3-piece IOLs still exert more pressure against the capsular bag than the haptics of 1-piece IOLs. Therefore, 3-piece IOLs may better resist subsequent capsule contraction and provide a more predictable effective lens position. Dr. Hoffer receives royalties for his book IOL Power, Slack, Inc., and formula royalties from all manufacturers using the Hoffer Q formula. No other author has a financial or proprietary interest in any material or method mentioned. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  18. [Evaluation of colour vision according to type of implanted artificial foldable intraocular lens].

    PubMed

    Stopyra, Wiktor

    2012-01-01

    The aim of research was comparing the colour vision of patients with blue light filtering artificial lens to the patients with implant without blue light filter. 99 patients (120 eyes) divided on three groups were examined. 40 patients (40 eyes) after cataract surgery with implantation of blue light filtering lens were the first group. 39 patients (40 eyes) who had implanted lens without filter were the second group. 20 patients (40 eyes) with own transparent lens were the third group. Farnsworth-Munsell 100 Hue test was used in research. Each patient made test on thirtieth day after cataract surgery. Following average total error score (TES) values in groups were observed: the first group--60.66, the second group--83.71, the third group--61.55. Average axis of disorder in blue-yellow range was following: patients after cataract surgery with implantation of blue light filtering lens--5.48, patients with implant without blue light filter--7.28, control group--5.74. 1. Kind of artificial intraocular lens has meaning in colour vision at pseudophakic patients. 2. Blue light filter of artificial intraocular foldable lens advantageously effects perception of colours. 3. Lack of blue light filter in artificial intraocular lens gets worse colour vision especially in blue-yellow range.

  19. Phakic posterior chamber intraocular lens for the correction of anisometropia and treatment of amblyopia.

    PubMed

    BenEzra, D; Cohen, E; Karshai, I

    2000-09-01

    To assess the potential visual benefits of posterior chamber phakic intraocular lens implants in eyes of children with anisometropic amblyopia. In a prospective study, three girls 9, 14, and 18 years old with high anisometropia and deep amblyopia were included in this study. The phakic posterior chamber intraocular lens (ICL; STAAR Surgical AG, Nidau, Switzerland) was used to correct the anisometropia. This intraocular lens was inserted in the anterior chamber through a 3.0-mm temporal clear cornea incision and manipulated into the posterior chamber using an iris manipulator. A peripheral iridectomy was performed using the Ocutome Probe (Storz; Premiere, St. Louis, Missouri). Local therapy with corticosteroids and antibiotics were prescribed for 2 weeks, and patients were followed regularly for a period of 6 to 9 months. In the three amblyopic eyes of the three patients, the preoperative best-corrected visual acuity of 6/30, 6/60, and 6/30 improved, to 6/7.5 (20/25), 6/30 (20/100), and 6/15 (20/50), respectively, 6 months after the surgery. Binocular functions with development of fusional abilities and stereopsis were observed in two of these patients after the intraocular lens implantation. In the third patient, the fusional abilities developed only after surgical correction of the exotropia. The intraocular pressure remained within normal limits, and there was no significant change in the corneal endothelial cell count during the period of follow-up. No major intraoperative or postoperative complications were observed, except for a temporary pigment dispersion. Implantation of phakic posterior chamber intraocular lenses may be beneficial for the treatment of amblyopia in children with anisometropia. Although additional cases and long-term follow-up observations are necessary, it appears that amblyopia may be overcome by the use of posterior chamber phakic intraocular lens implants, even in eyes of children beyond the age generally considered to be responsive to

  20. Long-term change in intraocular pressure after extracapsular cataract extraction with posterior chamber intraocular lens implantation versus phacoemulsification with posterior chamber intraocular lens implantation in Indians.

    PubMed

    Pal, Virendra K; Agrawal, Ajai; Suman, Suwarna; Pratap, V B

    2013-01-01

    The purpose of the study is to evaluate the long-term changes in intraocular pressure (IOP) after extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (PCIOL) implantation versus phacoemulsification with PCIOL implantation in otherwise normal cataract patients in India. The study was conducted in the Department of Ophthalmology, King George's Medical College, Lucknow between August 2000 and August 2001. One hundred and seventeen eyes of 115 patients were included in the study. 84 patients were randomly selected for ECCE with PCIOL implantation (ECCE group) and 31 patients were selected for phacoemulsification with PCIOL implantation (Phaco group). IOP was measured pre-operatively and post-operatively, from the 1(st) month to the 12(th) month. Statistical significance was indicated by P > 0.05. There was a mean fall in IOP of 2.70 mm Hg (19.74%) in the ECCE group and 2.74 mm Hg (20.57%) in the phaco group. The decrease in the mean post-operative IOP from baseline was statistically significant (P > 0.01) at the end of 2 months in both groups. There was no statistically significant difference in post-operative IOP at any visit between groups (P < 0.05, all post-operative visits). After 4(th) monthpost-operatively, the IOP was mostly stable, but it was significantly lower than the pre-operative IOP. Significant IOP reduction may be expected after cataract surgery with either ECCE or phacoemulsification with IOL implantation. The lowering of IOP became statistically significant at about 2 months post-operatively, but became almost stable after the 4(th) month.

  1. Long-Term Change in Intraocular Pressure after Extracapsular Cataract Extraction with Posterior Chamber Intraocular Lens Implantation Versus Phacoemulsification with Posterior Chamber Intraocular Lens Implantation in Indians

    PubMed Central

    Pal, Virendra K; Agrawal, Ajai; Suman, Suwarna; Pratap, V B

    2013-01-01

    Purpose: The purpose of the study is to evaluate the long-term changes in intraocular pressure (IOP) after extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (PCIOL) implantation versus phacoemulsification with PCIOL implantation in otherwise normal cataract patients in India. Materials and Methods: The study was conducted in the Department of Ophthalmology, King George's Medical College, Lucknow between August 2000 and August 2001. One hundred and seventeen eyes of 115 patients were included in the study. 84 patients were randomly selected for ECCE with PCIOL implantation (ECCE group) and 31 patients were selected for phacoemulsification with PCIOL implantation (Phaco group). IOP was measured pre-operatively and post-operatively, from the 1st month to the 12th month. Statistical significance was indicated by P > 0.05. Results: There was a mean fall in IOP of 2.70 mm Hg (19.74%) in the ECCE group and 2.74 mm Hg (20.57%) in the phaco group. The decrease in the mean post-operative IOP from baseline was statistically significant (P > 0.01) at the end of 2 months in both groups. There was no statistically significant difference in post-operative IOP at any visit between groups (P < 0.05, all post-operative visits). After 4th monthpost-operatively, the IOP was mostly stable, but it was significantly lower than the pre-operative IOP. Conclusion: Significant IOP reduction may be expected after cataract surgery with either ECCE or phacoemulsification with IOL implantation. The lowering of IOP became statistically significant at about 2 months post-operatively, but became almost stable after the 4th month. PMID:24339684

  2. LIGHT-ADJUSTABLE LENS: CUSTOMIZING CORRECTION FOR MULTIFOCALITY AND HIGHER-ORDER ABERRATIONS

    PubMed Central

    Sandstedt, Christian A.; Chang, Shiao H.; Grubbs, Robert H.; Schwartz, Daniel M.

    2006-01-01

    Purpose To determine the feasibility of creating customized multifocal and aspheric patterns onto a light-adjustable lens (LAL) using a digital light delivery (DLD) system. Methods Silicone LALs were placed in a wet cell and irradiated in vitro using the DLD. Spatial intensity patterns were designed and generated to (1) create a multifocal optic with customized power and diameter and (2) simultaneously correct defocus and spherical aberration. In addition, the LALs were adjusted in vivo for defocus and spherical aberration using a rabbit model. Optical properties of the adjusted LALs were determined using a phase-shifting Fizeau Interferometer and a Shack-Hartmann wavefront sensor. Results In vitro creation of multifocal patterns demonstrated ability to reproducibly customize zone diameter and power. Both bull’s-eye bifocal and annular patterns were successfully created on LAL. Central adds ranging from +2.0 to +3.5 D with zone diameters ranging from 1.5 to 2.5 mm were demonstrated with the bull’s-eye pattern. Application of the annular pattern showed that an annular zone ranging from +2.25 to +2.8 D was written around either an unchanged or −2.5 D corrected LAL central 2-mm region. Spherical aberration was reduced simultaneously with correction of hyperopia and myopia, both in vitro and in vivo. Additionally, these customized spatial intensity profiles can be written onto an LAL that is first adjusted to emmotropia. The ability to readjust the LAL is demonstrated. Conclusions Customized multifocal optics were created in vitro on the LAL. Spherical aberration was reduced simultaneously with correction of defocus both in vitro and in vivo. Potential correction for higher-order aberrations was also demonstrated. PMID:17471323

  3. 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.

  4. Effects of Contact Lens Wear on Biometry Measurements for Intraocular Lens Calculations.

    PubMed

    Meyer, Jay J; Kim, Michelle J; Kim, Terry

    2017-09-21

    To determine the effects of contact lens (CL) wear on biometry measurements for cataract surgery and whether a CL hiatus can reduce the prediction error of intraocular lens (IOL) calculations. Retrospective, interventional case series of eyes that received repeat biometry measurements for IOL calculations after discontinuing hard or soft CLs for at least 14 days. intersession change in axial length, average keratometry, astigmatism, and axis. change in recommended IOL power and toricity, postoperative refraction prediction error. Thirty-two eyes of 16 patients had a mean duration of CL wear (12 hard and 20 soft) of 39.5 years (range, 29-55 years) and mean CL hiatus duration of 25 days (range, 14-56 days). Mean absolute intersession change in axial length was 0.016 mm (range, 0-0.05 mm), average keratometry 0.31 D (range, 0.02-1.01 D), astigmatism 0.41 D (range, 0.01-1.10 D), and axis 6.3° (range, 0-28°). The IOL power predicting the lowest postoperative spherical equivalent changed for 17 of 32 eyes (by 0.5 D for 12 eyes and 1.0 D for five eyes). Recommended IOL toricity changed for nine of 14 eyes (by 0.75 D for six eyes and 1.50 D for three eyes). The median absolute prediction error of IOL calculations was 0.69 D (range, 0.19-2.93 D) before and 0.57 D (range, 0.01-2.82 D) after the CL hiatus (P=0.16). Contact lens wear may affect biometry measurements and subsequent IOL power and toricity selection. For some eyes, repeating biometry measurements after a CL hiatus may improve the accuracy of IOL calculations.

  5. [Optimisation of the visualisation technique for optical paths through intraocular lenses for characterisation of multifocal imaging properties of Fresnel-zone plates].

    PubMed

    Reiß, S; Forbrig, J; Guthoff, R F; Terwee, T; Stolz, H; Siewert, S; El-Tamer, A; Hinze, U; Chichkov, B N; Stachs, O

    2014-12-01

    The utilisation of the diffractive properties of Fresnel zone plates offers the possibility of intraocular lens designs with multiple foci. Such intraocular lenses can be manufactured by two-photon polymerisation (2PP). This paper explains the underlying concept and shows the principles for visualisation of the focus properties of such implants.

  6. Iris-fixated toric phakic intraocular lens for myopic astigmatism.

    PubMed

    Muñoz, Gonzalo; Cardoner, Antoni; Albarrán-Diego, César; Ferrer-Blasco, Teresa; Belda-Salmerón, Lurdes

    2012-07-01

    To evaluate the efficacy, predictability, safety, stability, and complications of the Artiflex toric iris-fixated phakic intraocular lens (pIOL) for myopic astigmatism. Private practice surgery centers, Valencia and Terrassa, Spain. Cohort study. At 12 months, refraction, uncorrected (UDVA) and corrected (CDVA) distance visual acuities, complications, pIOL misalignment, and endothelial cell count (ECC) were evaluated. Indices of success and misalignment were calculated using vector analysis. The study enrolled 42 eyes in 25 patients aged 21 to 39 years. The mean spherical equivalent decreased from -8.85 diopters (D) ± 2.71 (SD) to -0.37 ± 0.46 D, with 66.7% of the eyes within ± 0.50 D. The mean cylinder power decreased from -2.90 D (range -1.50 to -5.00 D) to -0.39 D (range 0.00 to -1.50 D); refraction was highly stable. All eyes achieved a decimal UDVA of 0.5 or better and a CDVA of 0.8 or better. A gain of 1 line or more of CDVA was found in 69.1% of eyes. The mean clinical pIOL misalignment was 2.6 ± 1.8 degrees; 1 eye (2.4%) required surgical repositioning of the pIOL. The mean ECC decrease was 9.3% ± 1.8%; iris pigment precipitates were observed in 16.7% of eyes. Vector analysis showed excellent mean indices of success for overall (0.94 ± 0.04), spherical (0.96 ± 0.05), and astigmatic (0.95 ± 0.16) corrections; the mean angle of error was 1.8 ± 2.7 degrees. Implantation of the toric pIOL was effective, predictable, safe, and stable for the correction of myopic astigmatism. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  7. Opaque intraocular lens implantation: a case series and lessons learnt.

    PubMed

    Lee, Richard Mh; Dubois, Vincent Djp; Mavrikakis, Ioannis; Okera, Salim; Ainsworth, Gerard; Vickers, Sarah; Liu, Christopher Sc

    2012-01-01

    To report the use of opaque intraocular devices in three patients with complex neuro-ophthalmic symptoms. A case series of three patients with neuro-ophthalmic symptoms requiring occlusion of one eye when alternative methods had failed to control symptoms. Morcher (Stuttgart, Germany) opaque intraocular implants were used in all patients. All three patients observed an improvement in symptoms following opaque intraocular device implantation. One patient (Case 2) required multiple devices for symptom relief. Opaque intraocular occlusive devices are an increasingly popular choice for clinicians in patients with intractable diplopia but we highlight their use in patients with other complex neuro-ophthalmic symptoms. We learned a number of useful lessons in these patients as summarized in this case series.

  8. Long-term results of clear lens extraction combined with piggyback intraocular lens implantation to correct high hyperopia

    PubMed Central

    Hua, Xia; Yuan, Xiao-Yong; Song, Hui; Tang, Xin

    2013-01-01

    AIM To assess the refractive outcome of clear lensectomy combined with piggyback intraocular lens implantation in highly hyperopic patients. METHODS This case review included 19 eyes of 10 patients with high hyperopia and axial length less than 21mm. Intraocular lens power was calculated for emmetropia using the Holladay II formula in 17 eyes, and SRK/T formula in 2 eyes following clear lens extraction and piggyback intraocular lens implantation. Patients were examined periodically over 24 months for visual acuity and spherical equivalent (SE). RESULTS The mean postoperative SE at 24 months was 0.20±1.39D (range, -3.00 to 2.50D), better than preoperative 9.81±2.62D (range, +6.00 to +14.50D) (P<0.001). Five eyes had SE within ±0.5D of emmetropia and 11 eyes within ±1.00D at postoperative 24 months. The mean postoperative uncorrected visual acuity (UCVA) at 24 months was 0.60±0.36, significantly improved compared to preoperative 1.39±0.33 (P<0.001). The mean best-corrected visual acuity (BCVA) at 24 months was 0.49±0.35, not statistically different compared to preoperative 0.38±0.30 (P=0.34). Twelve eyes maintained and 1 gained 1 or more Snellen line of BCVA, 4 eyes lost 1 line, and 2 eyes lost 2 lines at 24 postoperative months. Twelve eyes best-corrected near visual acuity (BCNVA) achieved J1 at postoperative 24 months compared to preoperative 7 eyes and the other 7 eyes better than J3. CONCLUSION Clear lens extraction combined piggyback intraocular lens implantation appears to be an effective procedure to correct high hyperopia but mild overcorrection and intralenticular opacification may require secondary procedure. PMID:24195042

  9. Long-term results of clear lens extraction combined with piggyback intraocular lens implantation to correct high hyperopia.

    PubMed

    Hua, Xia; Yuan, Xiao-Yong; Song, Hui; Tang, Xin

    2013-01-01

    To assess the refractive outcome of clear lensectomy combined with piggyback intraocular lens implantation in highly hyperopic patients. This case review included 19 eyes of 10 patients with high hyperopia and axial length less than 21mm. Intraocular lens power was calculated for emmetropia using the Holladay II formula in 17 eyes, and SRK/T formula in 2 eyes following clear lens extraction and piggyback intraocular lens implantation. Patients were examined periodically over 24 months for visual acuity and spherical equivalent (SE). The mean postoperative SE at 24 months was 0.20±1.39D (range, -3.00 to 2.50D), better than preoperative 9.81±2.62D (range, +6.00 to +14.50D) (P<0.001). Five eyes had SE within ±0.5D of emmetropia and 11 eyes within ±1.00D at postoperative 24 months. The mean postoperative uncorrected visual acuity (UCVA) at 24 months was 0.60±0.36, significantly improved compared to preoperative 1.39±0.33 (P<0.001). The mean best-corrected visual acuity (BCVA) at 24 months was 0.49±0.35, not statistically different compared to preoperative 0.38±0.30 (P=0.34). Twelve eyes maintained and 1 gained 1 or more Snellen line of BCVA, 4 eyes lost 1 line, and 2 eyes lost 2 lines at 24 postoperative months. Twelve eyes best-corrected near visual acuity (BCNVA) achieved J1 at postoperative 24 months compared to preoperative 7 eyes and the other 7 eyes better than J3. Clear lens extraction combined piggyback intraocular lens implantation appears to be an effective procedure to correct high hyperopia but mild overcorrection and intralenticular opacification may require secondary procedure.

  10. 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.

  11. Delayed pupillary capture and noninvasive repositioning of a posterior chamber intraocular lens after pupil dilation.

    PubMed

    Galvis, Virgilio; Tello, Alejandro; Montezuma, Sandra

    2002-10-01

    We present a case of pupillary capture of a posterior chamber intraocular lens after routine pupil dilation during a follow-up visit 6 years postoperatively. A noninvasive approach was used to resolve the capture. The possible causes and measures to avoid this complication are discussed.

  12. Spontaneous intraocular lens extrusion in a patient with scleromalacia secondary to herpes zoster ophthalmicus.

    PubMed

    Ahmed, Taha Y; Carrim, Zia I; Diaper, Charles J M; Wykes, William N

    2007-05-01

    We report a case of spontaneous intraocular lens (IOL) extrusion in association with scleromalacia 10 years after uneventful endocapsular surgery. The patient had a history of iridocyclitis secondary to herpes zoster ophthalmicus in the affected eye. A minimally invasive approach involving repositioning the IOL and closure with a conjunctival flap resulted in restoration of visual acuity.

  13. Implantation of Artisan toric phakic intraocular lens following Intacs in a patient with keratoconus.

    PubMed

    Kamburoğlu, Günhal; Ertan, Aylin; Bahadir, Mehmet

    2007-03-01

    We report a 24-year-old man with bilateral keratoconus in whom Intacs (Addition Technology, Inc.) were implanted in both eyes. The procedure was followed by Artisan toric phakic intraocular lens (Ophtec) implantation to correct the residual myopic and astigmatic refractive error.

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

    PubMed

    Schmidinger, G; Pemp, B; Werner, L

    2013-11-01

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

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

    PubMed Central

    Han, Yuemei; Xu, Xu; Tang, Junmei; Shen, Chenghui; Lin, Quankui; Chen, Hao

    2017-01-01

    Intraocular lens (IOL) is an efficient implantable device commonly used for treating cataracts. However, bioadhesion of bacteria or residual lens epithelial cells on the IOL surface after surgery causes postoperative complications, such as endophthalmitis or posterior capsular opacification, and leads to loss of sight again. In the present study, zwitterionic polymer brushes were fabricated on the IOL surface via bottom-up grafting procedure. The attenuated total reflection-Fourier transform infrared and contact angle measurements indicated successful surface modification, as well as excellent hydrophilicity. The coating of hydrophilic zwitterionic polymer effectively decreased the bioadhesion of lens epithelial cells or bacteria. In vivo intraocular implantation results showed good in vivo biocompatibility of zwitterionic IOL and its effectiveness against postoperative complications. PMID:28053528

  16. 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.

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

    MedlinePlus

    ... Stories Español Eye Health / Eye Health A-Z Cataracts Sections What Are Cataracts? Cataract Symptoms Who Is ... Cataracts Look Like? IOL Implants: Lens Replacement and Cataract Surgery Written by: Kierstan Boyd Reviewed by: Elizabeth ...

  18. Effect on falls of providing single lens distance vision glasses to multifocal glasses wearers: VISIBLE randomised controlled trial.

    PubMed

    Haran, Mark J; Cameron, Ian D; Ivers, Rebecca Q; Simpson, Judy M; Lee, Bonsan B; Tanzer, Michael; Porwal, Mamta; Kwan, Marcella M S; Severino, Connie; Lord, Stephen R

    2010-05-25

    To determine whether the provision of single lens distance glasses to older wearers of multifocal glasses reduces falls. Parallel randomised controlled trial stratified by recruitment site and source of referral, with 13 months' follow-up and outcome assessors blinded to group allocation. Community recruitment and treatment room assessments in Sydney and Illawarra regions of NSW, Australia. 606 regular wearers of multifocal glasses (mean age 80 (SD 7) years). Inclusion criteria included increased risk of falls (fall in previous year or timed up and go test >15 seconds) and outdoor use of multifocal glasses at least three times a week. Provision of single lens distance glasses with recommendations for wearing them for walking and outdoor activities compared with usual care. Number of falls and injuries resulting from falls during follow-up. Single lens glasses were provided to 275 (90%) of the 305 intervention group participants within two months; 162 (54%) of the intervention group reported satisfactory use of distance glasses for walking and outdoor activities for at least 7/12 months after dispensing. In the 299 intervention and 298 control participants available to follow-up, the intervention resulted in an 8% reduction in falls (incidence rate ratio 0.92, 95% confidence interval 0.73 to 1.16). Pre-planned sub-group analyses showed that the intervention was effective in significantly reducing all falls (incidence rate ratio 0.60, 0.42 to 0.87), outside falls, and injurious falls in people who regularly took part in outside activities. A significant increase in outside falls occurred in people in the intervention group who took part in little outside activity. With appropriate counselling, provision of single lens glasses for older wearers of multifocal glasses who take part in regular outdoor activities is an effective falls prevention strategy. The intervention may be harmful, however, in multifocal glasses wearers with low levels of outdoor activity. Clinical

  19. In-the-bag nasal intraocular lens optic truncation for treatment of negative dysphotopsia.

    PubMed

    Alapati, Neeti Meghnad; Harocopos, George J; Sheybani, Arsham

    2016-12-01

    We describe in-the-bag nasal intraocular lens (IOL) optic truncation, a new technique for the treatment of negative dysphotopsia. After a plane is created between the nasal capsular bag and the IOL, micrograspers and intraocular scissors are used to amputate the nasal optic edge. The amputation is to reduce the optical impact of the IOL edge and nasal anterior capsule on the occurrence of negative dysphotopsia. The technique addresses many of the proposed mechanisms contributing to the development of negative dysphotopsia and can theoretically be used in all patients with chronic symptomatology. In the case we describe, the dysphotopsia resolved immediately after in-the-bag nasal IOL optic truncation.

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

    NASA Astrophysics Data System (ADS)

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

    2015-08-01

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

  1. Synchrony dual-optic accommodating intraocular lens. Part 1: optical and biomechanical principles and design considerations.

    PubMed

    McLeod, Stephen D; Vargas, Luis G; Portney, Val; Ting, Albert

    2007-01-01

    To describe a dual-optic accommodating intraocular lens (IOL) based on theoretical considerations. University and independent research group. Ray-tracing analysis using optical modeling software (ZEMAXTM, Focus Software Inc., Tucson, Ariz) in a theoretical model eye was used to analyze lens configurations to optimize the accommodative and magnification effects of axial lens displacement. Finite-element modelling using a commercially available PC-based software package (COSMOS DesignSTAR) was applied to design the biomechanical parameters of the inter-optic articulations and optics. Ray-tracing analysis indicated that a dual-optic design with a high plus-powered front optic coupled to a minus posterior optic produced greater change in conjugation power of the eye compared to a single-optic intraocular lens and that magnification effects were unlikely to account for improved near vision. Finite-element modelling indicated that the 2 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 design linked by spring haptics increases the accommodative effect of axial optic displacement with minimal magnification effect and has promise for improving the performance of accommodative intraocular lenses.

  2. [A study on cytokine levels and nitric oxide content in rabbit aqueous humor after lens extraction and intraocular lens implantation].

    PubMed

    Qi, Ming-xin; Huang, Xiu-rong; Shen, Shi-ren; Zheng, Liang-pu; Lin, Jiu-mao; Wei, Lin

    2003-01-01

    To investigate the relationship among inflammatory reaction and cytokine levels, nitric oxide (NO) content in aqueous humor after intraocular lens implantation. Eighteen New Zealand rabbits were divided randomly into 3 groups (each 6 rabbits): (1) control group, (2) extracapsular cataract extraction group (ECCE) and (3) ECCE and posterior chamber intraocular lens implantation group (ECCE + IOL). The inflammation of all experimental rabbit eyes were observed by a zoom-photo slit-lamp microscope 0, 1, 3, 7, 14, 30 days postoperatively, including corneal edema and anterior chamber exudation. Meanwhile, aqueous humor was drawn for white blood cell (WBC) count and classification, as well as for NO(2)(-)/NO(3)(-) and cytokine assays, including interleukin-2 (IL-2), tumor necrosis factor-alpha (TNF-alpha). Statistics were taken by SPSS software. (1) The anterior chamber exudation was the most serious and monocyte/macrophage in aqueous humor were the highest in ECCE + IOL group in postoperative 7 - 14 days. (2) The levels of IL-2, TNF-alpha and the content of NO(2)(-)/NO(3)(-) in aqueous humor of ECCE + IOL group were higher than that in ECCE group and control group in the postoperative 1 - 14 days respectively, and they increased to their peak values at the postoperative 3 - 7 days and decreased gradually after postoperative two weeks. (3) The change regularity of IL-2, TNF-alpha, NO(2)(-)/NO(3)(-) and inflammatory reaction in each group were basically similar, i.e. the more serious the reaction, the higher the levels of the contents. The intraocular inflammation after intraocular lens implantation is closely related to the changes of cytokine levels and NO content in aqueous humor.

  3. 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.

  4. Use of Verisyse iris-supported phakic intraocular lens for myopia in keratoconic patients.

    PubMed

    Moshirfar, Majid; Grégoire, François J; Mirzaian, Garen; Whitehead, George F; Kang, Paul C

    2006-07-01

    We report 2 patients with stable keratoconus and high myopia who benefited from implantation of an iris-supported phakic intraocular lens (Verisyse, AMO) for correction of their refractive error. Both patients had a postoperative uncorrected visual acuity of 20/40. Endothelial cell density showed at most a 4% decrease, and no evidence of keratoconus progression was witnessed. The use of the Verisyse lens may be beneficial for certain keratoconic patients as an alternative step between rigid gas-permeable lenses and penetrating keratoplasty.

  5. The triple procedure: in the bag placement versus ciliary sulcus placement of the intraocular lens

    PubMed Central

    Borderie, V.; Touzeau, O.; Bourcier, T.; Carvajal-Gonzalez, S.; Laroche, L.

    1999-01-01

    AIMS—To evaluate the influence of intraocular lens (IOL) placement on triple procedure clinical results and to investigate whether it is appropriate to use phacoemulsification in patients with large lens nucleus.
METHODS—40 consecutive penetrating keratoplasties combined with cataract extraction performed in a single institution were studied. Whenever possible a capsulorhexis was performed and the IOL was placed into the capsular bag. Phacoemulsification was used when the nucleus was too large to pass through the capsulorhexis.
RESULTS—Out of 25 patients with an intact capsulorhexis phacoemulsification was used in 13 (52.0%) whereas the entire nucleus passed through the capsulorhexis in the remaining 12 patients (48%). The average 12 month visual acuity was 0.46 (SD 0.21) in patients with in the bag IOL (n = 23) and 0.29 (0.08) in patients with ciliary sulcus IOL (n = 13) (p = 0.04). Elevated intraocular pressure occurred in 26.1% (6/23) of patients with in the bag IOL and 61.5% (8/13) of patients with ciliary sulcus IOL (p = 0.08). The average postoperative graft thickness at 18 months was 552 (27) µm in the former group and 650 (29) µm in the latter group (p = 0.04). No significant difference in graft survival, postoperative endothelial cell density, astigmatism, and videokeratoscopic measurements was found between both groups.
CONCLUSION—In the bag placement of the intraocular lens during the triple procedure results in better outcome of transplantation than ciliary sulcus placement of the IOL. Phacoemulsification allows removal of large nuclei through a 5 mm capsulorhexis without performing relaxing incisions out towards the periphery of the capsule.

 Keywords: corneal transplantation; graft survival; intraocular lens; triple procedure; visual acuity PMID:10434870

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

    PubMed

    Anita, K B; Fernandez, V; Rao, R

    2010-01-01

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

  7. 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

  8. [Comparing patients' quality of life after phacoemulsification with intraocular lens implantation with that after extracapsular cataract extraction with intraocular lens implantation].

    PubMed

    Liu, Jie-wei; Xu, Jing-jing; He, Ming-guang

    2003-02-01

    To Compare the effects of phacoemulsification with intraocular lens implantation (PHACO + IOL) to extracapsular cataract extraction with intraocular lens implantation (ECCE + IOL) on quality of life. The study population consisted of 116 patients receiving PHACO + IOL and 93 patients receiving ECCE + IOL. They were interviewed using the quality of life questionnaire, and the clinical outcomes were obtained before surgery and in 1 week, 1 month, 3 months after surgery respectively. Patients receiving PHACO + IOL reported larger benefit in quality of life and all sub-scales than did those receiving ECCE + IOL in 1 week after surgery. Subjects underwent PHACO + IOL showed better improvement in quality of life and two sub-scales (social and mental) than did those underwent ECCE + IOL in 1 month and 3 months after surgery. However, the improvement in other two sub-scales (self-care and mobility) was similar between two surgical groups in 1 month and 3 months after surgery. The patients receiving PHACO + IOL reported better and more rapid improvement in quality of life within 3 months after surgery. PHACO + IOL and ECCE + IOL have the same effects on improvement in self-care and mobility. So quality of life in patients receiving PHACO + IOL are better than those of ECCE + IOL.

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

    PubMed

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

    2007-02-15

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

  10. [Flexibility of intraocular lens haptics of various geometry and materials].

    PubMed

    Guthoff, R; Abramo, F; Draeger, J

    1990-07-01

    The relations between the deformation and resulting resilience of lens haptics with various geometries and made of different materials were studied. While there are no fundamental differences between PMMA and PP haptics with identical geometries, the resilience of soft lenses made of poly-HEMA and silicone rubber subjected to the same deformation is significantly higher. On the basis of such measurements it is possible to estimate stress on the capsular bag during and after implantation. In light of recent publications concerning the prevention of secondary cataract, permanent circular tensioning of the lens capsule appears a desirable goal. This requirement is best satisfied with a material with permanently high elasticity, which tensions the equator of the capsular bag over 360 degrees.

  11. Effect of multifocal lens glasses on the stepping patterns of novice wearers.

    PubMed

    Beschorner, Kurt E; Milanowski, Autumn; Tomashek, Dennis; Smith, Roger O

    2013-09-01

    Multifocal lens glasses (MfLs) negatively affect vision, increase falling risk and contribute to gait changes during stepping. Previous studies on the effects of MfLs on gait have focused on experienced wearers. Thus, the initial response of first-time wearers, who may face significant challenges in adapting to these glasses, is not well understood. This study aimed to quantify the effects of MfLs on novice wearers during stepping up and down. Additionally, young adults were compared against a middle-aged adults to determine the validity of convenience sampling in testing novice response to MfLs. Fifteen young adults (18-34 y.o.) and seven middle-aged adults (46-56 y.o.) were recruited to perform stepping trials while wearing progressive MfLs and blank single lens glasses. Participants stepped up and down from a 75 mm and 150 mm step in randomized order. Step placement, minimum toe clearance, lower body kinematics and stepping time were measured during step up. Step placement, minimum heel clearance, vertical forces and stepping time were measured during step down. MfLs significantly increased toe clearance in the lead and trailing legs, hip flexion, knee flexion and stepping time during step up and increased vertical forces and stepping time during step down. Step placement and hip angle explained 17% of the toe clearance variability. Changes during step up suggest a more conservative adaptation while increased forces during step down suggest a reduced level of control. No age group effects were observed, which supports the use of convenience sampling for evaluating the novice response to MfLs. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. 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

  13. 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

  14. Intraocular Lens Calcifications After (Triple-) Descemet Membrane Endothelial Keratoplasty.

    PubMed

    Schrittenlocher, Silvia; Penier, Marius; Schaub, Friederike; Bock, Felix; Cursiefen, Claus; Bachmann, Björn

    2017-07-01

    To identify incidence of and risk factors for calcifications of intraocular lenses (IOLs) after Descemet membrane endothelial keratoplasty (DMEK). Retrospective cohort study. Retrospective review of charts and slit-lamp images of 564 consecutive patients from the prospective Cologne DMEK database who underwent DMEK in pseudophakic eyes or DMEK in combination with cataract surgery (triple-DMEK) between September 3, 2013 and October 30, 2015 at the Department of Ophthalmology, University of Cologne. IOL calcifications after (triple-)DMEK occurred in 14 patients (2.5%). Visual acuities in affected and unaffected eyes were 0.33 ± 0.24 logMAR and 0.16 ± 0.01 logMAR after 3 months (P < .001) as well as 0.28 ± 0.16 logMAR and 0.13 ± 0.08 logMAR (P < .001) after 6 months, respectively. The proportions of triple-DMEK vs DMEK, the use of SF6 gas vs room air for anterior chamber tamponade, and the presence of hydrophilic vs hydrophobic acrylic IOLs were comparable in affected and unaffected eyes. Patients with IOL calcifications had higher rebubbling rates than patients without. Larger pupil diameters at the time of surgery showed a tendency to slightly larger areas of IOL calcifications. IOL calcifications after anterior chamber gas tamponade in DMEK lead to visual impairment and are associated with the number of rebubblings after DMEK. IOL calcifications also occur in hydrophobic acrylic IOLs. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    NASA Astrophysics Data System (ADS)

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

    2004-07-01

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

  16. Trabecular meshwork and lens partitioning of corticosteroids: implications for elevated intraocular pressure and cataracts.

    PubMed

    Thakur, Ashish; Kadam, Rajendra; Kompella, Uday B

    2011-07-01

    To determine whether adverse effects such as elevated intraocular pressure and cataracts, which are lower with dexamethasone when compared with fluocinolone acetonide or triamcinolone acetonide, may be explained in part by the differences in drug lipophilicity and partitioning of these drugs into the trabecular meshwork and lens. The n-octanol/phosphate-buffered saline (pH 7.4) partition coefficient (log distribution coefficient [D]) and bovine/human ocular tissue partition coefficients were determined for triamcinolone, prednisolone, dexamethasone, fluocinolone acetonide, triamcinolone acetonide, and budesonide at 37°C. The log D of the corticosteroids ranged from 0.712 to 2.970. The ranges of tissue:PBS partition coefficients following drug incubation at 0.4, 2.0, and 10.0 μg/mL were 0.35 to 1.56, 0.30 to 2.12, and 0.30 to 1.95, respectively, for the bovine lens, 0.87 to 4.18, 0.71 to 4.40, and 0.69 to 5.86, respectively, for the human lens, and 2.98 to 9.48, 2.41 to 9.16, and 1.71 to 9.96, respectively, for the bovine trabecular meshwork. In general, tissue partitioning showed a positive correlation with log D. Dexamethasone, with lipophilicity less than triamcinolone acetonide and fluocinolone acetonide, exhibited the least amount of partitioning in the trabecular meshwork and lens among these 3 corticosteroids commonly used for treating diseases at the back of the eye. Binding of corticosteroids to the trabecular meshwork and lens increases as drug lipophilicity increases. Less lipophilic corticosteroids with limited partitioning to the trabecular meshwork and lens may result in reduced incidence of elevated intraocular pressure and cataracts.

  17. Biomechanical properties of crystalline lens as a function of intraocular pressure assessed noninvasively by optical coherence elastography

    NASA Astrophysics Data System (ADS)

    Wu, Chen; Aglyamov, Salavat R.; Liu, Chih-Hao; Han, Zhaolong; Singh, Manmohan; Larin, Kirill V.

    2017-02-01

    Many ocular diseases such as glaucoma and uveitis can lead to the elevation of intraocular pressure (IOP). Previous research implies a link between elevated IOP and lens disease. However, the relationship between IOP elevation and biomechanical properties of the crystalline lens has not been directly studied yet. In this work, we investigated the biomechanical properties of porcine lens as a function of IOP by acoustic radiation force optical coherence elastography.

  18. Effect on falls of providing single lens distance vision glasses to multifocal glasses wearers: VISIBLE randomised controlled trial

    PubMed Central

    Haran, Mark J; Cameron, Ian D; Ivers, Rebecca Q; Simpson, Judy M; Lee, Bonsan B; Tanzer, Michael; Porwal, Mamta; Kwan, Marcella M S; Severino, Connie

    2010-01-01

    Objective To determine whether the provision of single lens distance glasses to older wearers of multifocal glasses reduces falls. Design Parallel randomised controlled trial stratified by recruitment site and source of referral, with 13 months’ follow-up and outcome assessors blinded to group allocation. Setting Community recruitment and treatment room assessments in Sydney and Illawarra regions of NSW, Australia. Participants 606 regular wearers of multifocal glasses (mean age 80 (SD 7) years). Inclusion criteria included increased risk of falls (fall in previous year or timed up and go test >15 seconds) and outdoor use of multifocal glasses at least three times a week. Interventions Provision of single lens distance glasses with recommendations for wearing them for walking and outdoor activities compared with usual care. Main outcome measures Number of falls and injuries resulting from falls during follow-up. Results Single lens glasses were provided to 275 (90%) of the 305 intervention group participants within two months; 162 (54%) of the intervention group reported satisfactory use of distance glasses for walking and outdoor activities for at least 7/12 months after dispensing. In the 299 intervention and 298 control participants available to follow-up, the intervention resulted in an 8% reduction in falls (incidence rate ratio 0.92, 95% confidence interval 0.73 to 1.16). Pre-planned sub-group analyses showed that the intervention was effective in significantly reducing all falls (incidence rate ratio 0.60, 0.42 to 0.87), outside falls, and injurious falls in people who regularly took part in outside activities. A significant increase in outside falls occurred in people in the intervention group who took part in little outside activity. Conclusions With appropriate counselling, provision of single lens glasses for older wearers of multifocal glasses who take part in regular outdoor activities is an effective falls prevention strategy. The intervention may

  19. 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

  20. Luxated intraocular lens fixation using anterior chamber slipknot of the haptic to the sclera: a simple procedure to fixate intraocular lens to the sclera.

    PubMed

    Micelli Ferrari, T; Cardascia, N; Furino, C; Recchimurzo, N; Boscia, F; Sborgia, L

    2003-07-01

    To describe a technique for suturing a luxated intraocular lens (IOL) in the vitreous cavity directly to the ciliary sulcus using intraocular slipknot without IOL extraction. Noncomparative interventional case series. A three-port vitrectomy was performed in all cases. According to the Lewis procedure, two scleral flaps and relative sclerectomies were performed at 3 and 9 o'clock position. IOL was rescued from vitreous cavity by means of perfluorocarbon and stabilized in anterior chamber by intravitreal forceps. Corneal endothelium was preserved by a dispersive ophthalmic viscosurgical device coating. Double armed 10-0 polypropylene was introduced into the vitreous cavity through the 9 o'clock sclerotomy incision and both the needles were passed out of the eye by the 3-o'clock position sclerotomy, guided by a bent 27-gauge needle 1.5 mm from the limbus. Hooking the slipknot around the haptics of the IOL in the anterior chamber by means of vitreous forceps, the 10-0 polypropylene was pulled so that the IOL haptic was fixated onto the sulcus. The same procedure was used to fixate the opposite haptic to the ciliary sulcus at the opposite position. In all four cases, the IOL fixated stably and remained well positioned. No significant intraoperative or postoperative complications occurred. This technique enables secure fixation of the luxated IOL in the vitreous without extracting it.

  1. Cost of intraocular lens versus contact lens treatment after unilateral congenital cataract surgery: retrospective analysis at age 1 year.

    PubMed

    Carrigan, Anna K; DuBois, Lindreth G; Becker, Edmund R; Lambert, Scott R

    2013-01-01

    To describe the differences in treatment costs for infants randomized to contact lens correction versus primary intraocular lens (IOL) implantation after unilateral cataract surgery in the Infant Aphakia Treatment Study (IATS). Retrospective cost analysis of a prospective, randomized clinical trial based on Georgia Medicaid data and the actual costs of supplies used. The IATS is a randomized, multicenter (n=12) clinical trial comparing treatment of aphakia with a primary IOL or contact lens in 114 infants with unilateral congenital cataract. Infants underwent cataract surgery with or without placement of an IOL. The mean cost of cataract surgery and all additional surgeries, examinations, and supplies used up to 12 months of age. The mean cost of treatment for a unilateral congenital cataract with primary IOL implantation was $14 752 versus $10 726 with contact lens correction. The initial cataract surgery accounted for approximately 50% of the treatment costs for both groups. Contact lens costs accounted for 15% ($1600/patient) in the aphakic group, whereas glasses costs represented only 4% ($535/patient) in the IOL group. The increased costs in the IOL group were primarily due to the higher cost of cataract surgery in this group ($7302 vs. $5357) and the cost of additional operations. For IATS patients up to 12 months of age, cataract surgery coupled with IOL implantation and spectacle correction was 37.5% (∼$4000) more expensive than cataract surgery coupled with contact lens correction. The author(s) have no proprietary or commercial interest in any materials discussed in this article. Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  2. Comparision of surgical outcomes of intraocular lens refixation and intraocular lens exchange with perfluorocarbon liquid and fibrin glue-assisted sutureless scleral fixation.

    PubMed

    Oh, S Y; Lee, S J; Park, J M

    2015-06-01

    The purpose of this study was to compare the surgical outcomes of intraocular lens (IOL) refixation with intraocular lens exchange using perfluorocarbon liquid (PFCL) and fibrin glue-assisted sutureless scleral fixation surgery in patients with dislocation of the IOL. Twenty-five eyes of 25 patients who underwent surgery for dislocated IOLs with PFCL and fibrin glue-assisted scleral fixation were studied; 13 eyes experienced IOL refixation (in-the-bag and out-of-the-bag), and 12 eyes experienced IOL exchange. Preoperative and postoperative clinical features from patient charts and 25 eyes with >6 months' follow-up information were reviewed and analyzed. At postoperative 6 months, best-corrected visual acuity (BCVA) and spherical equivalent of IOL refixation and exchange were significantly improved (P=0.042, P=0.001), and endothelial cell density was significantly decreased in the two groups with no significant difference between them. Surgically induced astigmatism of IOL refixation improved from 0.90±0.47 to 0.61±0.37 (P=0.012), and IOL exchange improved from 1.17±0.64 to 0.73±0.37 (P=0.037) at postoperative 6 months, with no significant difference between the two groups. Complications occurred in four eyes in the IOL refixation group and in three eyes in the IOL exchange group. PFCL and fibrin glue-assisted IOL sutureless scleral refixation or exchanged fixation was an effective surgical treatment for IOL dislocation. Also, because postoperative BCVA, surgical outcomes, and complications did not differ significantly between IOL refixation and exchange surgery, if IOL exchange surgery is not indicated, IOL refixation surgical techniques should be considered.

  3. Closure of a persistent cyclodialysis cleft using the haptics of a normal-sized intraocular lens.

    PubMed

    Shentu, Xingchao; Zhu, Yanan; Tang, Yelei

    2011-11-01

    A 50-year-old man suffering from hypotony in the right eye caused by a traumatic cyclodialysis and complicated by a choroidal detachment and cataract was treated in our clinic. After an unsuccessful direct cyclopexy, phacoemulsification was performed and a normal-sized single-piece polymethyl methacrylate posterior chamber intraocular lens (PMMA PCIOL) was inserted into the ciliary sulcus, with the haptic rotated toward the cyclodialysis cleft. Postoperatively, the corrected visual acuity improved to 20/20, and the intraocular pressure returned to normal. Ultrasound biomicroscopy showed the closure of the cleft. Phacoemulsification with a normal-sized PMMA PCIOL inserted into the ciliary sulcus is a safe, effective and technically simple surgical treatment for small cyclodialysis induced hypotony complicated by cataract. Internal compression of the cleft by the haptic of a normal sized IOL along with postoperative inflammation led to scarring and closure of the cleft.

  4. Implantation of iris-claw Artisan intraocular lens for aphakia in Fuchs’ heterochromic iridocyclitis

    PubMed Central

    Kheirkhah, Ahmad; Nikdel, Mojgan; Ghadimi, Hadi

    2014-01-01

    Implantation of iris-claw Artisan intraocular lens (IOL) is a surgical option for correction of aphakia; however, these IOLs have not been used in eyes with uveitis including Fuchs’ heterochromic iridocyclitis (FHI) due to possible risk of severe postoperative intraocular inflammation. In the case reported here, we secondarily implanted an Artisan IOL in a 28-year-old man with FHI who had aphakia with no capsular support due to a previous complicated cataract surgery. Enclavation was easily performed and no intraoperative complication was noted. Postoperative course was uneventful with no significant anterior chamber inflammation during 12 months of follow-up. Although there were few deposits on the IOL surface, the patient achieved a best-corrected visual acuity of 20/20 without developing glaucoma or other complications. Therefore, Artisan IOL may be considered for correction of aphakia in patients with FHI. However, studies on large number of patients are required to evaluate safety of the procedure. PMID:23571252

  5. [Intraocular lenses for the correction of refraction errors. Part II. Phakic posterior chamber lenses and refractive lens exchange with posterior chamber lens implantation].

    PubMed

    Kohnen, T; Kasper, T; Terzi, E

    2005-11-01

    In this overview, the current status of intraocular lens surgery to correct refractive error is reviewed. The interventions are divided into additive surgery with intraocular lens implantation without extraction of the crystalline lens (phakic intraocular lens, PIOL) or removal of the crystalline lens with implantation of an IOL (refractive lens exchange, RLE). Phakic IOLs are constructed as angle-supported or iris-fixated anterior chamber lenses and posterior chamber lenses which are fixated in the ciliary sulcus. The implantation of phakic IOLs has been demonstrated to be an effective, safe, predictable and stable procedure to correct higher refractive errors. Complications are rare and differ for the three types of PIOL; for posterior chamber lenses these are mainly cataract formation and pigment dispersion. RLE is preferable in cases of high ametropia in which the natural lens has lost its accommodative effect. The main complications for myopic RLA include retinal detachment, while hyperopic refractive lens exchange may be associated with surgical problems in the narrower anterior eye segment.

  6. Better Visual Outcome by Intraocular Lens Ejection in Geriatric Patients with Ruptured Ocular Injuries

    PubMed Central

    Sugita, Tadasu; Tsunekawa, Taichi; Matsuura, Toshiyuki; Takayama, Kei; Yamamoto, Kentaro; Kachi, Shu; Ito, Yasuki; Ueno, Shinji; Nonobe, Norie; Kataoka, Keiko; Suzumura, Ayana; Iwase, Takeshi; Terasaki, Hiroko

    2017-01-01

    Ocular trauma is one of the leading causes of visual impairment worldwide. Because of the popularity of cataract surgeries, aged individuals with ocular trauma commonly have a surgical wound in their eyes. The purpose of this study was to evaluate the visual outcome of cases that were coincident with intraocular lens (IOL) ejection in the eyes with ruptured open-globe ocular injuries. Consecutive patients with open-globe ocular injuries were first reviewed. Patients’ characteristics, corrected distance visual acuities (CDVAs) over 3 years after the trauma, causes of injuries, traumatic wound patterns, and coexistence of retinal detachment were examined. The relationships between poor CDVA and the other factors, including the complications of crystalline lens and IOL ejection, were examined. A total of 105 eyes/patients [43 eyes with rupture, 33 with penetrating, 28 with intraocular foreign body (IOFB), and 1 with perforating injuries] were included. Rupture injuries were common in aged patients and were mostly caused by falls, whereas penetrating and IOFB injuries were common in young male patients. CDVAs of the eyes with rupture injuries were significantly worse than those of the eyes with penetrating or IOFB injuries. CDVA from more than 50% of the ruptured eyes resulted in no light perception or light perception to 20/500. CDVA of the ruptured eyes complicated by crystalline lens ejection was significantly worse than that of those complicated by IOL ejection. The wounds of the ruptured eyes complicated by IOL ejection were mainly located at the superior corneoscleral limbus, whereas those of the eyes complicated by crystalline lens ejection were located at the posterior sclera. There were significant correlations between poor CDVA and retinal detachment and crystalline lens ejection. These results proposed a new trend in the ocular injuries that commonly occur in aged patients; history of cataract surgery might affect the final visual outcome after open

  7. [Evaluation of the safety and visual quality after implantation of the domestic made aspheric intraocular lens].

    PubMed

    Song, X D; Hao, Y S; Li, X R; Zhang, H; Ye, J; Wang, N L

    2016-02-01

    To evaluate the safety and efficacy of the domestic foldable one-piece aspheric intraocular lens (IOL, Model: A1-UV) for the treatment of cataract. A prospective randomized controlled clinical research were conducted. One hundred and nineteen cases (119 eyes) of cataract patients were randomly assigned to the study group (58 cases) and the control group (61 cases). The study group were implanted with the domestic made aspheric intraocular lens (Model: A1-UV) and the control group were implanted with imported aspheric intraocular lens (Model: SN60WF, Alcon Laboratories, Inc.). The visual acuity and the slit lamp examination were evaluated 1-2 day, 1 week, 1 month, 3 months, 6 months and 1 year postoperatively. In addition, the contrast sensitivity tests were carried out 3 months, 6 months and 1 year postoperatively. Data were analyzed by chi-square test and independent t-test. 100 patients had completed 1 year of follow-up, among which 49 cases were from the study group and 51 cases were from the control group. No severe inflammation or complications associated with intraocular lens were noted in either group within 1 year follow-up. The mean BCDVA, BCNVA, UCDVA, UCNVA(Log MAR) of the study group and the control group were 0.04±0.11, 0.11±0.17, 0.13±0.20, 0.35± 0.19 and 0.07±0.15, 0.15±0.20, 0.18±0.23, 0.41±0.21 at 1 year postoperatively. No statistically significant differences were noted between groups in mean BCDVA, BCNVA, UCDVA, UCNVA (t=-1.39, P=0.166; t=- 1.25, P=0.216; t=-1.06, P=0.292; t=-1.59, P=0.116) at 1 year postoperatively. And there was no significant difference in visual acuity between the two groups (P>0.05) 1-2 day, 1 week, 1 month, 3 months and 6 months postoperatively. The difference of the contrast sensitivity between the two groups was not statistically significant (P>0.05), besides the contrast sensitivity of the study group was significantly better than the control group at 12c/d, 18 c/d under bright light(t=2.18, P=0.031; t=2.67, P=0

  8. Patient-reported benefit of ReSTOR® multi-focal intraocular lenses after cataract surgery: Results of Principal Component Analysis on clinical trial data

    PubMed Central

    Berdeaux, Gilles; Viala, Muriel; Roborel de Climens, Aude; Arnould, Benoit

    2008-01-01

    Background Restoration of functional distance and near vision independently of additional correction remains a goal for cataract surgery. ReSTOR®, a new multi-focal intraocular lens (IOL) addresses this issue with an improvement in both distance and near vision, often without need for glasses. This analysis attempted to discuss the patient-reported benefit of ReSTOR® using a full but organised representation of data. Methods Two non-randomised, open-label clinical trials conducted in Europe and the United-States were conducted to compare the efficacy of ReSTOR® to AcrySof® mono-focal IOLs. A total of 710 patients in need of bilateral cataract extraction were included in the pooled study. The TyPE, a patient questionnaire, was fully completed by 672 of them before and after each eye surgery. The TyPE, composed of 67 items measuring overall visual functioning in both conditions (with and without wearing glasses), evaluates limitations, troubles and satisfaction in distance and near vision. A principal component analysis (PCA) of the TyPE questionnaire was performed on pooled data from baseline and post-surgery observations in order to fully represent the change in the TyPE data over time. ReSTOR® and mono-focal groups were used as illustrative variables. The coordinates of the first 2 factors were compared between visits and between IOLs (ReSTOR® vs. mono-focal), using paired t-tests and t-tests, respectively. Results The first factor of the PCA explained 55% of the variance and represented 'visual functioning and patient satisfaction'. The second factor explained 6% of the variance and was interpreted as 'independence from glasses'. An overall difference in factorial coordinates in both factors was seen between baseline and the first eye surgery, and between the first and the second eye surgery. No difference between ReSTOR® and mono-focal IOL groups was observed at baseline. After surgery, ReSTOR® treated-patients had higher coordinates on both "visual

  9. Toric markers-assisted implantation of the scleral-fixated intraocular lens

    PubMed Central

    Song, Hu-Ping; Tian, Bing-Yu; Peng, Jing

    2016-01-01

    AIM To evaluate the efficacy of toric intraocular lens markers-assisted implantation of the scleral-fixated intraocular lens (SFIOL). METHODS From October 2010 to December 2013, all patients who had undergone secondary SFIOL implantation were assigned to group 1 and 2, in group 1 SFIOL was performed with the assist of radial keratotomy (RK)-marker, and in group 2 SFIOL was performed with the assisted of toric intraocular lens markers (T-and axis markers). Patients' demographic data and information on baseline preoperative visual acuity, indication for surgery and latest postoperative visual acuity were collected and analyzed. The haptic and optic positions were determined by ultrasound biomicroscopy. The optic tilt angle and decentration distance were measured. RESULTS The study evaluated 43 eyes of 43 patients ranging in age from 3 to 66y. Group 1 comprised 24 eyes (24 patients) and group 2, 19 eyes (19 patients). Uncorrected reoperative acuity was improved on all the eyes postoperatively. The improved postoperative acuity was significantly more in group 2 than that in group 1 (1.11±0.38 vs 0.82±0.45 logMAR; F=4.85, P=0.03). Ultrasonic biomicrograph examination showed that the rate of haptic asymmetry was significantly higher in group 1 (42%, 10/24) than that in group 2 (11%; 2/19) (Chi square=3.68, P=0.04). The mean tilted degree in group 1 was significantly higher than that in group 2 (P=0.04). Mean decentration distance in group 1 was greater than that in group 2 (P=0.03). CONCLUSION During SFIOL the toric markers help the surgeon identify the placement of fixation more precisely than that with the use of RK marker. PMID:27672593

  10. Sutureless 25-Gauge Pars Plana Vitrectomy Combined with Retropupillary Fixation of an Iris-Claw Intraocular Lens

    PubMed Central

    Chalkiadakis, Spyridon E.; Parikakis, Efstratios A.; Taylor, Simon R.J.

    2016-01-01

    Background The surgical case of a dropped intraocular lens inside the vitreous cavity constitutes a real challenge for the operating surgeon. Herein, we describe a case series where an alternative optical rehabilitation technique for late intraocular lens-bag complex dislocation has been used. Methods A modern vitrectomy device was used to remove the capsule with the dropped intraocular lens using sutureless 25-gauge pars plana vitrectomy. To ensure a better aesthetic result, with faster patient recovery and a reduced number of operations, the whole procedure was performed during the same operating session; an iris-claw intraocular lens for aphakia was selected for implantation. The implant was passed behind the constricted iris with the concave surface facing it. The lens was grasped with the manufacturer's holding forceps and fixed onto the posterior surface of the iris using the special enclavation needles. Results We have operated 12 eyes in two different clinical centres successfully, with minimal intra- and/or postoperative complications. Conclusion We believe that this is a viable solution for the visual rehabilitation of patients, who would otherwise need more than one operation for a lens exchange. PMID:27790132

  11. Fragmatome lifting: surgical option for intraocular lens and foreign body removal.

    PubMed

    Jorge, Rodrigo; Siqueira, Rubens C; Cardillo, José A; Costa, Rogério A

    2005-01-01

    A new technique for intraocular lens (IOL) and foreign body removal using the fragmatome is described. Removal of the formed vitreous, including cortical vitreous, was performed using a conventional vitrectomy probe. The fragmatome tip was placed on the center of the anterior surface of both the IOL optics and the foreign bodies, and active 250 mm Hg vacuum suction was applied. IOLs and foreign bodies were easily held and manipulated after being aspirated into the fragmatome tip, avoiding the use of a forceps or other grasping instrument that may damage the retina. Fragmatome lifting is a reasonable treatment option for IOL and nonmagnetic foreign body removal.

  12. The “correct shake” for “handshake” in glued intrascleral fixation of intraocular lens

    PubMed Central

    Narang, Priya; Agarwal, Amar

    2016-01-01

    We hereby describe the correct method to perform a “handshake technique” and easy transfer of haptics from one hand to another for glued intrascleral fixation of an intraocular lens (glued IOL). The procedure was implemented in 57 cases that necessitated the application of performing a glued IOL procedure and it resulted in an appropriate and easy externalization of haptic in all the cases. The surgeons’ positioning with reference to the scleral flap is an essential component and the surgeon should always be positioned perpendicular to the plane of scleral flaps and the plane of haptic maneuver. The surgeons who intend to perform glued IOL should adopt this technical point. PMID:27958214

  13. Toxic anterior segment syndrome after foldable artiflex iris-fixated phakic intraocular lens implantation.

    PubMed

    van Philips, Lucien A M

    2011-01-01

    Toxic anterior segment syndrome (TASS) developed in four cases after uneventful implantation of a foldable iris-fixated phakic intraocular lens (pIOL). Two cases occurred sequentially in one patient. The TASS subsided without complications in all cases after intensive topical steroid treatment. A multitude of possible causes is considered for the occurrence of these TASS cases. From the sterilization and cleaning of surgical instruments to the possibility of endotoxines in ophthalmic viscosurgical devices (OVD). These rare cases should alert the surgeon to the possibility of TASS after pIOL implantation.

  14. 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

  15. Intraocular lens confusions: a preventable "never event" - The Royal Victorian Eye and Ear Hospital protocol.

    PubMed

    Zamir, Ehud; Beresova-Creese, Katarina; Miln, Linda

    2012-09-01

    Intraocular lens (IOL) confusions and errors are among the most common postoperative adverse events. Errors may occur at any stage from the decision to operate to the insertion of the IOL. The most common errors occur during IOL selection pre-operative preparation (anaesthesia given before recognition that the intended IOL is not available), or intraoperatively (wrong IOL implanted because of confusion in the operating room). We review the mechanisms of errors reported in the literature and describe the experience at The Royal Victorian Eye and Ear Hospital. We also describe the implementation of an error-detection protocol and provide qualitative data on its performance.

  16. Toxic Anterior Segment Syndrome after Foldable Artiflex Iris-Fixated Phakic Intraocular Lens Implantation

    PubMed Central

    van Philips, Lucien A. M.

    2011-01-01

    Toxic anterior segment syndrome (TASS) developed in four cases after uneventful implantation of a foldable iris-fixated phakic intraocular lens (pIOL). Two cases occurred sequentially in one patient. The TASS subsided without complications in all cases after intensive topical steroid treatment. A multitude of possible causes is considered for the occurrence of these TASS cases. From the sterilization and cleaning of surgical instruments to the possibility of endotoxines in ophthalmic viscosurgical devices (OVD). These rare cases should alert the surgeon to the possibility of TASS after pIOL implantation. PMID:21772989

  17. A randomized clinical trial comparing contact lens with intraocular lens correction of monocular aphakia during infancy: grating acuity and adverse events at age 1 year.

    PubMed

    Lambert, Scott R; Buckley, Edward G; Drews-Botsch, Carolyn; DuBois, Lindreth; Hartmann, E Eugenie; Lynn, Michael J; Plager, David A; Wilson, M Edward

    2010-07-01

    To compare the visual outcomes and adverse events of contact lens with primary intraocular lens (IOL) correction of monocular aphakia during infancy. In a randomized, multicenter (12 sites) clinical trial, 114 infants with a unilateral congenital cataract were assigned to undergo cataract surgery between 1 to 6 months of age either with or without primary IOL implantation. Contact lenses were used to correct aphakia in patients who did not receive IOLs. Grating visual acuity was tested at 1 year of age by a masked traveling examiner. Grating visual acuity at 1 year of age. The median logMAR visual acuity was not significantly different between the treated eyes in the 2 groups (contact lens group, 0.80; IOL group, 0.97; P = .19). More patients in the IOL group underwent 1 or more additional intraocular operations than patients in the contact lens group (63% vs 12%; P < .001). Most of these additional operations were performed to clear lens reproliferation and pupillary membranes from the visual axis. There was no statistically significant difference in grating visual acuity at age 1 year between the IOL and contact lens groups; however, additional intraocular operations were performed more frequently in the IOL group. Until longer-term follow-up data are available, caution should be exercised when performing IOL implantation in children aged 6 months or younger given the higher incidence of adverse events and the absence of an improved short-term visual outcome compared with contact lens use.

  18. Sulcus fixated injectable toric intraocular lens to correct astigmatism following penetrating keratoplasty in a pseudophakic eye

    PubMed Central

    Srinivasan, Sathish; Lyall, Douglas; Watt, John

    2010-01-01

    A 56-year-old Caucasian male was referred to the corneal service for the management of post penetrating keratoplasty (PK) astigmatism in his right eye. He had also previously undergone trabeculectomy and cataract surgery in the same eye. Corneal topography showed high postoperative astigmatism of 8.74 dioptres. He was intolerant to contact lens wear and could not tolerate spectacle correction due to high anisometropia. He proceeded to undergo a secondary ‘piggyback’ toric intraocular lens (IOL) insertion procedure with an improvement in his best corrected visual acuity to 6/9. With the decrease in anisometropia he was able to tolerate a full spectacle correction. We report the use of a new injectable sulcus fixated toric piggyback IOL for the correction of post PK astigmatism in a pseudophakic eye. To the best of our knowledge this is the first report on the use of this new ‘add on’ IOL for this clinical condition.

  19. Iris-fixated phakic intraocular lens implantation for correction of high myopia in microspherophakia.

    PubMed

    Moshirfar, Majid; Meyer, Jay J; Schliesser, Joshua A; Espandar, Ladan; Chang, Joann C

    2010-04-01

    We report the refractive correction of high myopia in a 23-year-old patient with idiopathic microspherophakia using iris-fixated phakic intraocular lenses (pIOLs) (Verisyse/Artisan). Four years after bilateral implantation, the uncorrected distance visual acuity was 20/25 with a correction of 20/20(-1) in both eyes. No intraoperative or postoperative complications occurred. Iris-fixated pIOLs are not recommended for every patient with microspherophakia. However, this procedure may be an option in microspherophakic patients with appropriate anterior chamber depth and no history of lens dislocation who are likely to comply with annual eye examinations. Follow-up should include monitoring the endothelial cell count and biomicroscopy for adequate space between the pIOL, the natural crystalline lens, and the corneal endothelium. Scheimpflug photography can be a valuable tool in such cases.

  20. Calcification of a hydrophilic acrylic intraocular lens: case report with laboratory analysis.

    PubMed

    Bodnar, Z M; Rozot, P; Leishman, L; Ollerton, A; Michelson, J; Plasse-Fauque, S; Werner, L

    2013-09-01

    We analyzed a single-piece plate-type hydrophilic acrylic posterior chamber intraocular lens (IOL) that was explanted due to a progressive loss of vision, which occurred 6 years after uncomplicated phacoemulsification. Gross and light microscopy, as well as anterior segment optical coherence tomography (OCT) revealed granular deposits below the IOL surface. Light scattering, as measured with Scheimpflug photography and densitometry analyses was found to be increased; spectrophotometry demonstrated a decrease in the light transmittance of the explanted lens. The granular deposits within the IOL material were found to be composed of calcium by histochemical methods (alizarin red and Von Kossa stains). To our knowledge this is the only report of calcification of this IOL design. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  1. Keratometry, biometry and prediction of intraocular lens power in the equine eye.

    PubMed

    McMullen, Richard J; Gilger, Brian C

    2006-01-01

    To determine ocular dimensions (A- and B-scan ultrasound) and corneal curvature (radius of corneal diameter determined in B-scan ultrasound) in the equine eye and to calculate the appropriate dioptric power for a posterior chamber intraocular lens (IOL) necessary to achieve emmetropia in the eyes of horses undergoing lens extraction. Fourteen clinically normal adult horses of various breeds. Additionally, for comparison, one American Miniature colt foal, and one 2.5-year-old Shire gelding were examined. B-scan ultrasound was performed on one eye from each horse. One eye from both the Shire and the American Miniature were examined for comparison. Data from ultrasound (globe measurements and corneal curvature), and the estimated postoperative IOL positions were entered into theoretical IOL formulas (Binkhorst and Retzlaff theoretical formulas) in order to calculate the predicted IOL strength required to achieve emmetropia after lens extraction in horses. Mean axial length of globes was 39.23 mm +/- 1.26 mm, mean preoperative anterior chamber depth (ACD) was 5.63 +/- 0.86 mm, and mean lens thickness was 11.75 +/- 0.80 mm. Predicted postoperative ACD (PACD) was calculated as the ACD plus 50% of the lens thickness. Additionally, PACD 2 mm anterior and 2 mm posterior to the center of the lens were calculated in order to evaluate the effect of IOL position on its required refractive power. Required IOL strength calculated, using the three values for the predicted postoperative ACD, was 29.91 D +/- 2.50, 29 D +/- 2.52 (center of lens); 27.13 D +/- 2.27, 26.33 D +/- 2.20 (2 mm anterior to center of lens); and 33.18 D +/- 2.78, 32.24 D +/- 2.68 (2 mm posterior to center of lens) with the Binkhorst and Retzlaff theoretical formulas, respectively. An IOL of substantially lower diopter strength than that needed in either dogs or cats is required to achieve emmetropia after lens extraction in adult horses. IOL strength of approximately 30 D, depending on where the IOL ultimately

  2. 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.

  3. [The study of cyclosporin A modified intraocular lens preventing posterior capsular opacification in rabbit eyes].

    PubMed

    Teng, H; Zhang, H; Tian, F; Gu, H Q; Liu, X; Sun, J

    2016-02-01

    To investigate the safety and efficacy of cyclosporine A sustained release from modified intraocular lens for preventing posterior capsular opacification (PCO) in rabbit eyes. Forty-five New Zealand albino rabbits undergoing phacoemulsification in their right eyes were randomly and equally divided into three groups. Group A had implanted original IOL, group B had implanted PLGA-IOL(IOL coated with polylactide-glycoli acid), and group C had implanted CsA-PLGA-IOL (CsA loaded PLGA-IOL). All the 45 eyes were examined by a slit-lamp microscope. The intraocular pressures were recorded. Anterior chamber flare and aqueous humor cells were graded at different time point after surgery. The concentrations of CsA in the aqueous humor and blood were determined by high performance liquid chromatography. Anterior segment tissue was histologically examined. Wet posterior capsules were weighed. PCO was graded 6 months later. The mean concentrations of CsA in group C at 2 h,1 d,3 d,7 d,14 d,30 d,60 d after operation were (11.47±2.42) mg/L, (10.30±2.15) mg/L, (6.71±1.45) mg/L, (4.81±1.16) mg/L, (6.11±0.84) mg/L, (2.53±0.77) mg/L, (0.86±0.28) mg/L. The concentrations of CsA in blood were undetectable. During the early days after operation, the reactions of the anterior chamber in group A and B were more severe than group C. The initial appearance of PCO in group C was much later than in the other two groups, and the grade of PCO in group C was much lower than the other two groups. The mean weights of wet posterior capsules in group A(312.86±52.91) mg and B(310.64±62.42) mg were much heavier than that of group C(56.93 ± 24.24) mg. Histological observation showed that there was remarkably less accumulation of lens materials on the posterior capsules in group C than in the other two groups. No toxic actions were found in intraocular tissues in group C. Our study suggested that Cyclosporin A modified intraocular lens could effectively and safely prevent the formation and

  4. Comparison of Visian toric collamer lens and toric acrylic intraocular lens implantation for the treatment of myopia with astigmatism

    PubMed Central

    Ammar, Hatem; Anbar, Mohamed; Abdellah, Marwa M

    2017-01-01

    Purpose To compare the efficacy and outcome of phakic toric implantable collamer lens (TICL) and refractive clear lens extraction with AcrySof Toric intraocular lens (TIOL) implantation for the treatment of myopic astigmatism. Patients and methods This study assessed eyes with myopic astigmatism >−1 D and ≤−4 D with a spherical equivalent >10 D or <10 D if the patients were unsuitable for corneal refractive surgery. These eyes were divided into group A, in which Visian Toric ICL™ Phakic TICL was implanted, and group B, which involved clear lens extraction with implantation of an AcrySof IQ toric SN60T3-9™ IOL. The outcome and complications were evaluated. Results This study enrolled 63 eyes of 38 patients with a follow-up period of at least 6 months. The mean postoperative spherical equivalent was −0.19±0.31 D in group A and −0.21±0.28 D in group B (P=0.69). The mean postoperative cylinder value was −0.46±0.53 D in group A and −0.32±0.41 D in group B (P=0.35). Postoperative cylinder was <1 D in 76.47% and 79.31% of eyes in groups A and B, respectively. The mean endothelial cell count was reduced by 4.32% in group A and by 5.32% in group B (P=0.003). The mean postoperative intraocular pressure increased insignificantly in group A (P=0.22) and reduced significantly in group B (P=0.004). The complication rate was 11.76% in group A and 6.90% in group B. Conclusion Both procedures showed predictable results and good visual results. However, the loss of accommodation and risk of retinal complications in the TIOL group suggest that the use of TICL for myopic astigmatism is a better choice in younger patients. PMID:28096654

  5. Reproducibility of intraocular lens decentration and tilt measurement using a clinical Purkinje meter.

    PubMed

    Nishi, Yutaro; Hirnschall, Nino; Crnej, Alja; Gangwani, Vinod; Tabernero, Juan; Artal, Pablo; Findl, Oliver

    2010-09-01

    To determine the reproducibility of intraocular lens (IOL) decentration and tilt measurements with a new Purkinje meter instrument. Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom. After pupil dilation, images of pseudophakic eyes with a plate-style IOL (Akreos Adapt) were obtained using a recently developed Purkinje meter. Intraocular lens decentration and tilt were evaluated by analyzing the captured images using a semiobjective method by marking the reflexes in the images and automatic calculation using a dedicated software program. In study 1, examiner 1 examined the eyes first followed by examiner 2. Ten minutes later, examiner 1 performed a second measurement, after which the intraexaminer and interexaminer reproducibility were determined. In study 2, a Purkinje meter was used to measure pseudophakic eyes with slitlamp finding of clinical IOL decentration, IOL tilt, or both. The results were compared with retroillumination photographs and slitlamp findings. In study 1, there was high intraexaminer reproducibility for decentration (r = 0.95) and tilt (r = 0.85) and high interexaminer reproducibility for decentration (r = 0.84) and tilt (r = 0.75). In study 2, even in extreme cases of decentration and/or tilt, the Purkinje meter measurements were possible and appeared to correlate well with slitlamp findings. Acquisition of images in pseudophakic eyes with the Purkinje meter was simple and rapid. The method was highly reliable for 1 examiner and between 2 examiners. Copyright (c) 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  6. Forces on intraocular lens haptics induced by capsular fibrosis. An experimental study.

    PubMed

    Guthoff, R; Abramo, F; Draeger, J; Chumbley, L C; Lang, G K; Neumann, W

    1990-01-01

    Electronic dynamometry measurements, performed upon intraocular lens (IOL) haptics of prototype one-piece three-loop silicone lenses, accurately defined the relationships between elastic force and haptic displacement. Lens implantations in the capsular bag of dogs (loop span equal to capsular bag diameter, loops underformed immediately after the operation) were evaluated macrophotographically 5-8 months postoperatively. The highly constant elastic property of silicon rubber permitted quantitative correlation of subsequent in vivo haptic displacement with the resultant force vectors responsible for tissue contraction. The lens optics were well centered in 17 (85%) and slightly offcenter in 3 (15%) of 20 implanted eyes. Of the 60 supporting loops, 28 could be visualized sufficiently well to permit reliable haptic measurement. Of these 28, 20 (71%) were clearly displaced, ranging from 0.45 mm away from to 1.4 mm towards the lens' optic center. These extremes represented resultant vector forces of 0.20 and 1.23 mN respectively. Quantitative vector analysis permits better understanding of IOL-capsular interactions.

  7. [Study of risk factors of laser irradiation-induced intraocular lens damage].

    PubMed

    Gamidov, A A; Sosnovskiĭ, V V; Boev, V I; Buzykanova, M A

    2006-01-01

    The rate of distant damages to intraocular lens (IOL) was studied in relation to its material and manufacture procedure (punching or turning), and its posterior lens capsular position in 120 patients (125 eyes) who had undergone laser secondary cataract discussion. The resistance of lenses made from silicone, polymethylmethacrylate (PMMA), and acryl to YAG laser irradiation (1.076 microm) was studied in an experiment. The findings suggest that the risk for distant IOL damaged in YAG-capsulotomy is higher in PMMA lenses made by punching and silicone IOL. Artificial acryl lenses show a high resistance to YAG laser irradiation. The nature and depth of IOL damages are not entirely determined by the physical properties of a lens material and they are also associated with the distance of a lens and an irradiated structure. If there are specific posterior capsular changes as jelly-like thickening and if convex-designed lenses are implanted, then there is no safe distance between the capsule and IOL, which permanently leads to its damage by YAG-laser irradiation.

  8. Accuracy of intraocular lens power calculations using the Zeiss IOL master. A prospective study.

    PubMed

    Verhulst, E; Vrijghem, J C

    2001-01-01

    Partial Coherence Interferometry (PCI) is a fast, noncontact method to calculate lens implant power for cataract surgery. It has been reported as a potentially more accurate method than ultrasound biometry. Prospective study of the refractive outcomes of a consecutive series of patients undergoing phacoemulsification surgery with preoperative biometry by both ultrasound A-scan and PCI. A series of 50 eyes of 35 patients underwent small-incision phacoemulsification cataract surgery and lens implantation by one single surgeon. All patients had preoperative biometry performed by both ultrasound using the Sonomed and IOL Master optical biometry. The IOL Master results were included in the SRK II formula to calculate the lens implant power. Postoperative refractive assessment was performed 4 weeks after surgery. The mean difference in axial length between ultrasound and optical biometry was 0.2 mm. The IOL Master measures a longer axial length. The mean keratometric power using the Javal instrument was 43.4 D and for the Zeiss IOL Master it was 42.9 D. At the week 4 postsurgery assessment, the overall refractive outcome was in the range of +/- 1D. Five patients were unable to undergo PCI biometry due to the density of cataract. Intraocular lens power calculations using the Zeiss IOL Master are easy to perform and result in excellent refractive outcomes. A-scan biometry is still needed in case of mature cataract.

  9. Primary Phacoemulsification and Intraocular Lens Implantation for Acute Primary Angle-Closure

    PubMed Central

    Su, Wei-Wen; Chen, Phil Yeong-Fung; Hsiao, Ching-Hsi; Chen, Henry Shen-Lih

    2011-01-01

    Background To investigate the effect of primary phacoemulsification on intraocular pressure (IOP) in patients with acute primary angle-closure (PAC) and coexisting cataract. Methodology Sixteen eyes of 14 patients with acute PAC received phacoemulsification and intraocular lens implantation as initial management for medically uncontrolled IOP in a retrospective chart review. The effects on IOP, vision, anterior chamber depth (ACD), and number of antiglaucoma medications were evaluated. Principal Findings The postoperative IOP was reduced in 16 eyes (100%). The mean ± standard deviation preoperative IOP was 48.81±16.83 mm Hg, which decreased postoperatively to 16.46±10.67 mm Hg at 1 day, 9.43±3.03 mm Hg at 1 week, 9.49±2.14 mm Hg at 2 weeks, 10.78±3.56 mm Hg at 1 month, and 10.70±2.80 mm Hg at 3 months (p<0.001). The mean number of antiglaucoma medications decreased from 3.56±1.14 to 0.13±0.34 (p<0.001). The average preoperative ACD was 2.08±0.35 mm, which increased to 3.59±0.33 mm after surgery (p<0.001). Visual acuity (converted into logarithm of the minimum angle of resolution [logMAR]) improved from 1.14±0.71 to 0.73±0.53 (p = 0.001). Conclusions Primary phacoemulsification plus intraocular lens implantation lowered IOP, reduced the use of antiglaucoma medications, and improved vision in patients with acute PAC. This is a safe and effective method of IOP control and can be considered a first treatment option in managing patients with acute PAC and coexisting cataract. PMID:21629644

  10. The efficacy and complications of black diaphragm intra-ocular lens implantation in patients with congenital aniridia.

    PubMed

    Qiu, Xiaodi; Ji, Yinghong; Zheng, Tianyu; Lu, Yi

    2016-08-01

    To evaluate the efficacy and complications of black diaphragm intra-ocular (BDI) lens implantation in patients with congenital aniridia. Twenty patients underwent BDI lens implantation for the treatment of congenital aniridia from January 1999 to December 2012. Fifteen patients (23 eyes) were enrolled in our study, and the mean follow-up period was 26 months. Patient demographics, clinical evaluations [visual acuity (VA), best-corrected visual acuity (BCVA), intra-ocular pressure measurement (IOP), corneal endothelial cell density (ECD) and ultrasound biomicroscopy (UBM)], complications and treatments were analysed for each patient. Sixteen eyes (70.1%) had a BCVA better than 20/200 after BDI lens implantation, and photophobia obviously decreased in all patients. Six eyes (26.09%) developed secondary glaucoma after BDI lens implantation, and one eye underwent glaucoma surgery. Corneal decompensation occurred in two eyes (8.70%), one of which was complicated by glaucoma. Two eyes (8.70%) developed visual axis opacity (VAO) after surgery. One patient (4.35%) had limbal stem cell failure, and another patient (4.35%) had an eccentric BDI lens. Intra-ocular pressure measurement elevation and ECD reduction were found after BDI lens implantation. Black diaphragm intra-ocular lens implantation can effectively improve VA, decrease photophobia and resolve cosmetic issues in most congenital aniridia eyes. Glaucoma, corneal decompensation and VAO were the major long-term complications of BDI lens implantation in patients with congenital aniridia. All patients should be managed attentively because of high risk of complications and followed long term to achieve favourable outcomes. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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

    PubMed

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

    2013-08-01

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

  12. Intraocular lens power calculation after intrastromal femtosecond laser treatment for presbyopia: Theoretic approach.

    PubMed

    Rabsilber, Tanja M; Haigis, Wolfgang; Auffarth, Gerd U; Mannsfeld, Annett; Ehmer, Angela; Holzer, Mike P

    2011-03-01

    To evaluate the accuracy of intraocular lens (IOL) power calculation after an intrastromal femtosecond laser procedure to treat presbyopia using a theoretic approach. International Vision Correction Research Centre, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany. Nonrandomized clinical trial. Preoperatively and 12 months after intrastromal femtosecond laser treatment (IntraCor) of presbyopia, biometry was performed by partial coherence interferometry (PCI) (IOLMaster). The postoperative keratometry (K) values and IOL power calculation formulas (Holladay I, Haigis, SRK/T, Hoffer Q) were compared with results derived from the clinical history method, taking the manifest refraction change into account. The study enrolled 25 patients (median age 54 years). Three eyes were excluded for age-related lens changes. The median spherical equivalent change in the other 22 eyes was -0.38 diopter (D). The median difference in K values between the clinical history method and PCI was -0.21 D, resulting in a median IOL power difference between -0.23 D (SRK/T) and -0.29 D (Haigis) (range -1.58 to +1.00 D). The IOL power was underestimated in 59.1% of cases with the Hoffer Q and 63.6% of cases with the Holladay I, Haigis, and SRK/T. There was a difference of ±0.75 D in 72.7% of eyes using the Holladay I, Haigis, and Hoffer Q and in 86.4% of eyes using the SRK/T. Neither K values nor IOL power differences were statistically significant (P > .17). Intraocular lens power calculation using modern standard formulas incorporated in a PCI biometry device after intrastromal femtosecond presbyopia treatment was reliable, with minimum underestimation on average. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  13. C constant: new concept for ray tracing-assisted intraocular lens power calculation.

    PubMed

    Olsen, Thomas; Hoffmann, Peter

    2014-05-01

    To evaluate the accuracy of the C constant for ray tracing-assisted intraocular lens (IOL) power calculation. Case series. Public university hospital and private clinic. Preoperatively, all intraocular distances were measured using laser biometry. Various IOL designs were studied; powers ranged from -5.0 diopters (D) to +38.0 D. The IOL power calculation was performed with the Olsen formula using the C constant and compared with the Haigis, Hoffer Q, Holladay 1, and the SRK/T formulas on optimized datasets. Outcome measures were the error of the prediction, expressed as the arithmetic error, and the absolute error between the observed refraction and the predicted refraction. Two thousand forty-three cases from the 2 centers were studied. No significant differences were found between the Haigis, Hoffer Q, Holladay 1, and SRK/T formulas with the exception of the SRK/T formula, which performed better than the other thin-lens formulas in eyes with an axial length (AL) greater than 27.0 mm (P<.01). Compared with the SRK/T formula, the Olsen formula showed an improvement of 15% and 14% in the mean absolute error and a 39% and 85% reduction in the number of large errors (>1.0 D) for the 2 series, respectively (P<.0001). Contrary to the Olsen formula, all thin-lens formulas showed a significant bias in terms of the AL, keratometry reading, and anterior segment length (P<.0001). The C constant is a promising concept for ray tracing-assisted IOL power calculation. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  14. Correction of extreme hyperopia: artisan iris-fixated intraocular lens implantation for pseudophakia after clear lens extraction.

    PubMed

    Xu, Wen; Ye, Pan-Pan; Yao, Ke; Li, Zhao-Chun; He, Feng-Ying; Shi, Jun-Ting; Liu, Jun

    2011-01-01

    A 22-year-old patient suffering from both-side extreme hyperopia with amblyopia was corrected with an Artisan iris-fixated intraocular lens (IOL) implantation followed to clear lens extraction (CLE) with posterior chamber (PC)-IOL implantation. The preoperative refraction values were +17.75DS -1.50DC × 168° for the right eye and +17.25DS -0.75DC × 8° for the left eye. The uncorrected visual acuity (UCVA) was 20/200 bilaterally and the spectacle-corrected visual acuity (BSCVA) was 20/50 bilaterally. One year after Artisan iris-fixated IOL implantation, bilateral BSCVA was 20/50 with a refraction of +1.25DS -0.75DC × 13° for the right eye and +1.50DS -1.00DC × 55° for the left eye. The outcomes of an Artisan iris-fixated IOL implantation followed to CLE with PC-IOL implantation were encouraging for the correction of extreme hyperopia. Long term follow-up examinations were necessary for further determination of the efficacy and safety of this combinational procedure.

  15. Inhibition of lens epithelial cell migration at the intraocular lens optic edge: role of capsule bending and contact pressure.

    PubMed

    Nagamoto, Toshiyuki; Fujiwara, Takaaki

    2003-08-01

    To evaluate the inhibitory effect of a sharp intraocular lens (IOL) optic edge, a sharp capsule bend, and contact pressure between the optic edge and posterior capsule on lens epithelial cell (LEC) migration. Department of Ophthalmology, Kyorin University, Tokyo, Japan. This in vitro laboratory study evaluated a tumble-polished convex-plano IOL (CP group), an AcrySof IOL (Alcon) with a sharp edge (AS group), a new IOL with a round ridge (RR group), and a new IOL with a sharp ridge (SR group). The 2 new IOLs have high ridges and high angled loops that create firm contact between the ridge and posterior capsule. After sham cataract surgery, an IOL and a capsular tension ring (CTR) were implanted in the capsular bag of rabbit eyes. The extracted capsular bags containing the CTR and IOL were cultured. The inhibitory effect of each IOL on cell migration was analyzed. Furthermore, LEC migration on the posterior capsule was compared in culture between capsules having a sharp right angle and those with gradually curving bends. The inhibitory effect on cell migration was statistically greatest in the SR group followed by the RR, AS, and CP groups. A sharp capsule bend did not inhibit cell migration. The results suggest that inhibition of cell migration at the optic edge is regulated by the degree of contact pressure between the optic edge and posterior capsule. A sharp capsule bend might indicate strong contact but does not in itself inhibit cell migration.

  16. Cost of Intraocular Lens vs. Contact Lens Treatment after Unilateral Congenital Cataract Surgery in the IATS at Age 5 Years

    PubMed Central

    Kruger, Stacey J.; DuBois, Lindreth; Becker, Edmund R.; Morrison, David; Wilson, Lorri; Wilson, M. Edward; Lambert, Scott R.

    2014-01-01

    Purpose To analyze differences in the cost of treatment for infants randomized to primary intraocular lens (IOL) implantation versus optical correction with a contact lens (CL) after unilateral cataract surgery in the Infant Aphakia Treatment Study (IATS). Design Retrospective cost analysis of a prospective, randomized clinical trial based on Georgia Medicaid reimbursement data as well as actual costs of supplies used during the study, adjusted for inflation. Participants The IATS is a multicenter (n=12) randomized, clinical trial comparing the optical treatment of aphakia with either primary IOL implantation (n=57) or CL correction (n=57) in 114 infants with unilateral congenital cataract. Intervention One hundred fourteen infants underwent unilateral cataract surgery and were either optically corrected by primary IOL implantation at the time of surgery or were corrected with a CL after surgery. Main Outcome Measures The mean cost of cataract surgery and all additional surgeries, examinations and supplies used up to 5 years of age. Results The 5-year treatment cost of an infant with a unilateral congenital cataract optically corrected with an IOL was $35,293 versus $33,452 for a patient treated with a CL after initial cataract surgery. The total cost of supplies was $2669 in the IOL group vs $6128 in the CL group. Conclusions Unilateral cataract surgery in infancy coupled with primary IOL implantation is about 5% more expensive than aphakia and CL correction. Patient costs are more than double with CL versus IOL. PMID:25439604

  17. [Optical performance of multifocal intraocular lenses. Investigation of the Array SA40N vs. Acri. Twin at the "physical eye" according to Reiner and Jacobi].

    PubMed

    Jacobi, F K; Kessler, W; Held, S

    2007-03-01

    Reduced contrast sensitivity, glare disability and insufficient bifocality are the main drawbacks of multifocal intraocular lenses (IOL). The bilateral implantation of diffractive IOL with an asymmetrical light distribution for distance and near focus is an alternative concept that aims to improve the contrast sensitivity and bifocality of conventional multifocal IOL. The optical performance of monofocal (PhacoFlexII SI40) and multifocal IOL (Array SA40N; Acri. Twin 737D/733D) was quantitatively assessed in 18 healthy probands and qualitatively determined by digital photographic recording using an optical apparatus, the "physical eye", according to Reiner and Jacobi. Vision examination included standard tests of distance and near visual acuity, contrast sensitivity and low contrast visual acuity testing under varying pupil size using a video acuity tester. Distance visual acuity was significantly superior with the SI40 and distant-dominant 737D compared to the SA40N and near-dominant 733D. At near, the 733D had the best performance. Contrast sensitivity was better with the 737D than the SA40N when both were compared with the SI40. No normal contrast sensitivity could be determined with the 733D because of the optical phenomenon of 'spurious resolution'. Variation in pupil size had less impact on contrast acuity with the Acri. Twin IOL compared to the SI40 and SA40N. Photographic testing revealed better edge contrast with the Acri. Twin than the SA40N. The optical performance of multifocal IOL correlates with the properties of physical light distribution. Differences in edge contrast may be discerned using photographic recording.

  18. The impact of intraocular pressure on elastic wave velocity estimates in the crystalline lens

    NASA Astrophysics Data System (ADS)

    Park, Suhyun; Yoon, Heechul; Larin, Kirill V.; Emelianov, Stanislav Y.; Aglyamov, Salavat R.

    2017-02-01

    Intraocular pressure (IOP) is believed to influence the mechanical properties of ocular tissues including cornea and sclera. The elastic properties of the crystalline lens have been mainly investigated with regard to presbyopia, the age-related loss of accommodation power of the eye. However, the relationship between the elastic properties of the lens and IOP remains to be established. The objective of this study is to measure the elastic wave velocity, which represents the mechanical properties of tissue, in the crystalline lens ex vivo in response to changes in IOP. The elastic wave velocities in the cornea and lens from seven enucleated bovine globe samples were estimated using ultrasound shear wave elasticity imaging. To generate and then image the elastic wave propagation, an ultrasound imaging system was used to transmit a 600 µs pushing pulse at 4.5 MHz center frequency and to acquire ultrasound tracking frames at 6 kHz frame rate. The pushing beams were separately applied to the cornea and lens. IOP in the eyeballs was varied from 5 to 50 mmHg. The results indicate that while the elastic wave velocity in the cornea increased from 0.96  ±  0.30 m s-1 to 6.27  ±  0.75 m s-1 as IOP was elevated from 5 to 50 mmHg, there were insignificant changes in the elastic wave velocity in the crystalline lens with the minimum and the maximum speeds of 1.44  ±  0.27 m s-1 and 2.03  ±  0.46 m s-1, respectively. This study shows that ultrasound shear wave elasticity imaging can be used to assess the biomechanical properties of the crystalline lens noninvasively. Also, it was observed that the dependency of the crystalline lens stiffness on the IOP was significantly lower in comparison with that of cornea.

  19. Opacification of hydrophilic MemoryLens U940A intraocular lenses: analysis of 2 explanted lenses.

    PubMed

    Mattová, Jana; Bohácová, Eulália; Murgasová, Zuzana; Kadlec, Róbert; Forgác, Frantisek; Klobusická, Erika; Durcanský, Dusan

    2004-09-01

    To determine the rate of opacification of hydrophilic MemoryLens U940A intraocular lenses (IOLs) (Mentor Ophthalmics, Inc.) in the given cohort and perform a histopathological and spectrophotometer analysis of 2 explanted opacified IOLs. Ophthalmology Department, Faculty Hospital, Nitra, Slovakia. This retrospective study comprised 182 patients (205 eyes) who had implantation of a MemoryLens U940A IOL from June 1997 to June 2000. The patients were examined using a slitlamp to detect the presence of IOL opacification. In 4 cases, the lenses were explanted because of significant opacification and patient-reported problems; 2 lenses were provided for further analysis. One unused reference MemoryLens U940A IOL was also evaluated. All IOL were stained with von Kossa to determine the presence of calcium in the opacification. To confirm the components presence of an ultraviolet (UV) absorber, the IOLs were examined with an Avatar 330 Fourier transfer infrared (IR) spectroscope and a UV visible spectrophotometer (Philips). The IR spectrums for the IOL were identified using an IR spectrum atlas. The opacified IOLs, reference IOL, and the IOL packaging were further examined to determine the presence of silicone. Various amounts of opacification were found on the MemoryLens U940A IOL in 30 eyes (30 patients) (14.63%). Two explanted IOLs were positive for von Kossa staining, proving the presence of calcium deposits; the reference lens staining was negative. Spectrophotometry showed that the reference IOL and opacified IOLs were of the same polymer. The presence of the UV absorber on the benzophenone base was seen in the reference lens but not the opacified IOLs. In contrast, an increased concentration of low-molecular-weight components generated during the degradation of the polymer was present in the opacified lenses. The white cover pf the IOL is of polydimethyl siloxane, a silicone rubber. However, no silicone rubber was present in any examined lens, perhaps because the

  20. The impact of intraocular pressure on elastic wave velocity estimates in the crystalline lens.

    PubMed

    Park, Suhyun; Yoon, Heechul; Larin, Kirill V; Emelianov, Stanislav Y; Aglyamov, Salavat R

    2016-12-20

    Intraocular pressure (IOP) is believed to influence the mechanical properties of ocular tissues including cornea and sclera. The elastic properties of the crystalline lens have been mainly investigated with regard to presbyopia, the age-related loss of accommodation power of the eye. However, the relationship between the elastic properties of the lens and IOP remains to be established. The objective of this study is to measure the elastic wave velocity, which represents the mechanical properties of tissue, in the crystalline lens ex vivo in response to changes in IOP. The elastic wave velocities in the cornea and lens from seven enucleated bovine globe samples were estimated using ultrasound shear wave elasticity imaging. To generate and then image the elastic wave propagation, an ultrasound imaging system was used to transmit a 600 µs pushing pulse at 4.5 MHz center frequency and to acquire ultrasound tracking frames at 6 kHz frame rate. The pushing beams were separately applied to the cornea and lens. IOP in the eyeballs was varied from 5 to 50 mmHg. The results indicate that while the elastic wave velocity in the cornea increased from 0.96  ±  0.30 m s(-1) to 6.27  ±  0.75 m s(-1) as IOP was elevated from 5 to 50 mmHg, there were insignificant changes in the elastic wave velocity in the crystalline lens with the minimum and the maximum speeds of 1.44  ±  0.27 m s(-1) and 2.03  ±  0.46 m s(-1), respectively. This study shows that ultrasound shear wave elasticity imaging can be used to assess the biomechanical properties of the crystalline lens noninvasively. Also, it was observed that the dependency of the crystalline lens stiffness on the IOP was significantly lower in comparison with that of cornea.

  1. Biometry, keratometry, and calculation of intraocular lens power for the bald eagle (Haliaeetus leucocephalus).

    PubMed

    Kuhn, Sonia E; Hendrix, Diane V H; Jones, Michael P; Ward, Daniel A; Baine, Katherine H; Franklin, Stephen R

    2015-01-01

    To document intraocular measurements and predict intraocular lens (IOL) power specific to the bald eagle. Eleven adult, captive bald eagles. Axial globe length (AGL), anterior chamber depth (ACD), crystalline lens thickness (CLT), and the distance from the cornea to the posterior lens capsule (CPLC) were measured in eight adult bald eagles using B-mode with vector A-mode ultrasound. Keratometry was done on four eagles. Two estimates for postoperative anterior chamber depth (PACD) were obtained from four aphakic eyes from three eagles by measuring from the apex of the anterior cornea to the center of an imaginary line that would connect the remaining edges of the anterior lens capsule across the capsulorhexis (PACD1) and from the apex of the anterior cornea to halfway between the anterior and posterior lens capsule (PACD2). IOL strength was predicted using the Colenbrander, Binkhorst, and Fyodorov theoretical formulas. Mean ± SD biometry for phakic eyes was AGL = 26.57 ± 0.45 mm, ACD = 4.45 ± 0.18 mm, CLT = 5.49 ± 0.14 mm, and CPLC = 10.00 ± 0.33 mm. Mean predicted PACD1 was 6.1 ± 0.66 mm, and PACD2 was 6.4 ± 0.70 mm. Mean horizontal and vertical corneal refractive power was 39.91 ± 0.43 diopters (D) and 40.02 ± 0.08 D, respectively. Calculated IOL power ranged from +16.4 to 17.4 D. Calculations using ultrasonographic biometry, keratometry, and theoretical IOL formulas suggest that the strength of an IOL necessary to return an aphakic bald eagle to emmetropia is between +16.4 and +17.4 D. © 2013 American College of Veterinary Ophthalmologists.

  2. Manual small incision cataract surgery (MSICS) with posterior chamber intraocular lens versus extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens for age-related cataract.

    PubMed

    Ang, Marcus; Evans, Jennifer R; Mehta, Jod S

    2014-11-18

    Age-related cataract is the opacification of the lens, which occurs as a result of denaturation of lens proteins. Age-related cataract remains the leading cause of blindness globally, except in the most developed countries. A key question is what is the best way of removing the lens, especially in lower income settings. To compare two different techniques of lens removal in cataract surgery: manual small incision surgery (MSICS) and extracapsular cataract extraction (ECCE). We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 8), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to September 2014), EMBASE (January 1980 to September 2014), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to September 2014), Web of Science Conference Proceedings Citation Index- Science (CPCI-S), (January 1990 to September 2014), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 23 September 2014. We included randomised controlled trials (RCTs) only. Participants in the trials were people with age-related cataract. We included trials where MSICS with a posterior chamber intraocular lens (IOL) implant was compared to ECCE with a posterior chamber IOL implant. Data were collected independently by two authors. We aimed to collect data on presenting visual acuity 6/12 or better and best-corrected visual acuity of less than 6/60 at three months and one year after surgery. Other outcomes included intraoperative complications, long-term complications (one year or more after surgery), quality of life, and cost

  3. Manual small incision cataract surgery (MSICS) with posterior chamber intraocular lens versus extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens for age-related cataract.

    PubMed

    Ang, Marcus; Evans, Jennifer R; Mehta, Jod S

    2012-04-18

    Age-related cataract is the opacification of the lens, which occurs as a result of denaturation of lens proteins. Age-related cataract remains the leading cause of blindness globally, except in the most developed countries. A key question is what is the best way of removing the lens, especially in lower income settings. To compare two different techniques of lens removal in cataract surgery: manual small incision surgery (MSICS) and extracapsular cataract extraction (ECCE). We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 1), MEDLINE (January 1950 to February 2012), EMBASE (January 1980 to February 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to February 2012), Web of Science Conference Proceedings Citation Index- Science (CPCI-S), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). There were no date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 14 February 2012. We included randomised controlled trials (RCTs) only. Participants in the trials were people with age-related cataract. We included trials where MSICS with a posterior chamber intraocular lens (IOL) implant was compared to ECCE with a posterior chamber IOL implant. Data were collected independently by two authors. We aimed to collect data on presenting visual acuity 6/12 or better and best-corrected visual acuity of less than 6/60 at three months and one year after surgery. Other outcomes included intraoperative complications, long-term complications (one year or more after surgery), quality of life, and cost-effectiveness. There were not enough data available from the included trials to perform a meta-analysis. Three trials randomly allocating people with age

  4. Morphological Findings of Intraocular Lens with Haptics Detached from Optics Following Cataract Surgery.

    PubMed

    Suzuki, Yukihiko; Suzuki, Kaori; Metok, Tomomi; Nakazawai, Mitsuru

    2010-03-09

    A 55-year-old woman was treated using phacoemulsification, aspiration, and intraocular lens (IOL) implantation. Three months after surgery, the optical zone of the anterior capsule was completely closed due to strong capsular contractions. As the two haptics were found to be completely detached from the optics, the IOL was subsequently extracted and morphologically examined. Although the optics and haptics of the IOL when viewed with a stereomicroscope appeared to have no marked damage on their surfaces, an ultra-structural examination showed that a portion of the acrylic optics on the detached surface was defective. We considered that the IOL haptics might have become detached from the optics due to continuous force from postoperative capsular contractions.

  5. One-year follow-up of toric intraocular lens implantation in forme fruste keratoconus.

    PubMed

    Navas, Alejandro; Suárez, Raúl

    2009-11-01

    We present 2 cases of toric intraocular lens implantation for keratoconus: A 55-year-old man with forme fruste keratoconus with a preoperative uncorrected distance visual acuity (UDVA) of 20/800 and a refraction of -6.50-3.00x135 and a 46-year-old man with a claw-shaped topographic pattern, a family history of keratoconus, and a UDVA of 20/800 with a refraction of -5.00-3.00x85. The refraction had been stable for at least 5 years in both patients. Phacoemulsification and implantation of an acrylic toric IOL were uneventful. One year postoperatively, the UDVA was 20/25 in both cases, with a refraction of -0.25-0.50x140 and 0.25-0.50x60, respectively. No progression and no IOL rotation were observed. Toric IOLs may provide excellent outcomes in patients with stable and nonprogressive corneal ectasia.

  6. Spontaneous fracture of an implanted posterior chamber polyimide intraocular lens haptic: a case report.

    PubMed

    Kang, Haemin; Han, Kyung Eun; Kim, Tae-im; Kim, Eung Kweon

    2014-03-01

    A 57-year-old male patient visited our clinic for decreased visual acuity in the right eye for 10 days. He denied any trauma history, but recalled that the symptom developed after straining. He had undergone uncomplicated phacoemulsification and posterior chamber intraocular lens (IOL) implantation in the bag of the right eye 11 years ago. The IOL was a three-piece silicone polyimide-haptics design. On slit-lamp examination, the IOL optic and proximal part of nasal fractured haptic were found in the anterior chamber. The distal part of fractured haptic was observed in the capsular bag. He underwent IOL exchange. The fracture site of the haptic was near the optic-haptic junction. This is the unique case report of a spontaneous fracture of an implanted posterior chamber polyimide IOL haptic, which implies the possibility of IOL haptic fracture in various haptic materials.

  7. Novel corneal piggyback technique for consecutive intraocular lens implantation and penetrating keratoplasty surgery.

    PubMed

    Matsumoto, Yukihiro; Dogru, Murat; Shimazaki, Jun; Tsubota, Kazuo

    2015-06-01

    To report a novel "piggyback" penetrating keratoplasty technique performed in a patient with severe keratoconus. A 43-year-old man underwent cataract surgery and a new "piggyback" penetrating keratoplasty (PKP) technique in his right eye, as he suffered from severe keratoconus and mature cataract due to severe atopic dermatitis. Under general anesthesia, phacoemulsification and aspiration (PEA), intraocular lens (IOL) implantation, and "piggyback" PKP while avoiding open-sky surgery was performed to prevent serious complications including IOL and vitreous prolapse. This PKP technique had been completed as a totally closed surgery. One year after "piggyback" PKP and cataract surgery, the grafted cornea remained clear and IOL was also well positioned. Best-corrected visual acuity improved from hand motions to 30/100. A novel "piggyback" PKP technique was successfully performed in a patient with severe keratoconus. The new "piggyback" corneal transplantation technique may become an indispensable tool for transplant surgeons who want to improve surgical safety and predictability.

  8. Scanning electron microscopy analysis of a sputnik-like intraocular lens 28 years after implantation.

    PubMed

    Ferrer, Consuelo; Abu-Mustafa, Sabat K; Alió, Jorge L

    2009-09-01

    To report a pupil-supported, iris-clip intraocular lens (IOL) that was explanted more than 28 years after implantation. A pupil-supported, iris-clip, Sputnik-like IOL was implanted in the left eye of a 33-year-old man to correct aphakia after extracapsular cataract extraction due to trauma. Twenty-eight years after implantation, the patient was referred to our center with loss of vision. Clinical examination showed dislocation of the IOL, which was subsequently explanted. Scanning electron microscopic examination showed a transparent, polymethylmethacrylate (PMMA), pupil-supported, iris-clip IOL with melanosomes and cell deposits (foreign-body reaction) on its surface. This case demonstrates the inertness of PMMA material and reports that a foreign body reaction can be induced following IOL dislocation 28 years after implantation. Copyright 2009, SLACK Incorporated.

  9. No-stitch, small incision cataract surgery with flexible intraocular lens implantation.

    PubMed

    Menapace, R; Radax, U; Amon, M; Papapanos, P

    1994-09-01

    Small incision cataract surgery has several advantages over conventional surgery, including faster postoperative visual rehabilitation. We evaluated 100 consecutive cases of no-stitch, small incision surgery with a square sclerocorneal tunnel and a flexible intraocular lens. Permanent self-sealing of the wound seemed to increase intraoperative safety considerably. With the specific incision used, corneal trauma and irrigation fluid outflow were minimal. Refraction and K-readings stabilized within the first postoperative week, which is when most eyes attained best final visual acuity. No early peak or protracted drift of astigmatism occurred. Minimally leaking wounds in three eyes were left unsutured; a transient filtering bleb was observed in two of these eyes after resorption of an intracameral air bubble. Our results support the theoretical concept and justify the use of no-stitch, small incision surgery.

  10. 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

  11. 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.

  12. Simultaneous bilensectomy and endothelial keratoplasty for angle-supported phakic intraocular lens-induced corneal decompensation

    PubMed Central

    Mittal, Vikas; Mittal, Ruchi; Singh, Daljit

    2011-01-01

    A 40-year-old lady presented with severe endothelial cell loss in both eyes 14 years after angle-supported phakic intraocular lens (AS PIOL) implantation. The left eye had severe corneal edema with bullous keratopathy. The right eye had markedly reduced endothelial cell count (655 cells/mm2) although the cornea was clear. She underwent simultaneous bilensectomy (AS PIOL explantation and phacoemulsification) and Descemet's stripping and endothelial keratoplasty (DSEK) in the left eye. Explanted AS PIOL was identified as ZSAL-4 (Morcher, Stuttgart, Germany) model. Corneal edema cleared completely in 2 months with a best corrected visual acuity (-2.25 D sph) of 20/60. No intervention was done in the right eye. The present case illustrates that AS PIOL-induced endothelial decompensation can be effectively managed by simultaneous bilensectomy and endothelial keratoplasty. PMID:21666321

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

    PubMed

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

    2013-01-01

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

  14. Preoperative evaluation and workup of the cataract and intraocular lens implant patient.

    PubMed

    Hagan, J C; Wyatt, B

    1993-01-01

    1. Cataract and intraocular lens (IOL) implant surgery is the most common operation in ophthalmology. Much of the success of cataract and implant surgery depends on thorough and accurate preoperative patient counseling, testing, and biometric measurements. 2. The preoperative workup of cataract and implant surgery should include a complete ocular history and physical examination, patient education, preoperative testing, and informed consent. 3. Essential preoperative testing includes keratometric readings, ultrasound axial length of the eye (A-scan), and a calculation of implant power requirements using a modern implant formula. 4. In some circumstances, corneal endothelial cell counts, corneal pachymetry, and B-scan ultrasonographic scanning of the posterior segment will be needed. Optional testing also might include potential visual acuity (PVA) testing, ophthalmic photography, and corneal topographic scanning.

  15. Piggy back intraocular lens for the correction of buckling surgery-induced refractive error in pseudophakia.

    PubMed

    Sinha, Rajesh; Singh, Reena; Sharma, Vijay K; Titiyal, Jeewan S

    2016-12-30

    A 29-year-old man presented to us with bilateral pseudophakia with suboptimal vision in right eye. His uncorrected distance visual acuity (UDVA) on Snellen's chart was 6/36 and 6/9 in right eye (OD) and left eye (OS), respectively. It improved to 6/9 OD with -5.00DS/-0.50DC at 90° and 6/6 OS with -0.5DC at 100°. He had undergone buckling surgery 1 year back for rhegmatogenous retinal detachment in right eye and subsequently developed a myopic refractive error. A spherical piggyback intraocular lens (IOL; Rayner Sulcoflex, East Sussex) was implanted in the sulcus for refractive correction. The postoperative UDVA at 4 weeks was 6/6p. The intraocular pressure was normal and there was no significant endothelial cell loss. Piggyback IOLs can be an effective tool to correct the induced refractive error due to an increase in axial length following buckling surgery.

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

    PubMed Central

    Fouda, Sameh Mosaad; Al Aswad, Mahmoud A; Ibrahim, Basem M; Bori, Ashraf; Mattout, Hala K

    2016-01-01

    Purpose: This study aimed to evaluate the safety and efficacy of retropupillary fixation of an iris-claw intraocular lens (IOL; Verisyse polymethyl methacrylate IOL, Abbott Medical Optics [AMO], Netherlands) for the surgical correction of aphakia in microspherophakic eyes without sufficient capsular support. Design: This was a prospective, interventional, noncomparative case series. Methods: This interventional case series comprised 17 eyes of 9 microspherophakic patients. Retropupillary fixation of the Verisyse iris-claw IOL (AMO) was performed in all cases. The surgical time was measured. Corrected distance visual acuity, astigmatism, intraocular pressure (IOP), tissue reaction, pigment dispersion, and stability of the IOL were studied 1 day, 3 days, 1 week, 2 weeks, 1 month, and 6 months postoperatively. Results: Eight patients had familial microspherophakia and one patient had Marfan's syndrome. Eighty-two percent of the cases achieved a visual acuity of 0.3 or better. There was no significant postoperative inflammatory reaction. Transient elevation of IOP was recorded in two cases in the 1st week only. One IOL developed disengagement of one of the haptics from the iris and was successfully re-engaged. All the other IOLs were well centered and stable. The mean surgical time was 18.0 ± 4.5 min. Conclusions: Retropupillary fixation of an iris-claw IOL is a safe and effective procedure that provides early visual recovery. It is also a time-saving method for correcting aphakia in microspherophakic eyes without sufficient capsular support. PMID:28112127

  17. High speed small gauge anterior vitrectomy cutter for scleral fixated intraocular lens implantation

    PubMed Central

    Liang, Yuan Bo; Fong, Yoly Y.Y.; Cheng, Lulu L.; Young, Alvin L.

    2017-01-01

    AIM To report the outcomes of anterior vitrectomy using high speed cutter for scleral fixated intraocular lens (SFIOL) implantation in patients with posterior capsular rupture. METHODS Medical records of 51 patients with posterior capsular rupture who received high speed cutter anterior vitrectomy via limbal incision with SFIOL implantation from June 2011 to December 2013 were reviewed retrospectively for visual outcomes and complications. RESULTS Totally 51 eyes of 51 patients were identified (23 males and 28 females). Mean age at surgery was 67.2±15y (range 27-91y), with mean follow-up of 23±8.2mo (range 12-40mo). The 49 (96.1%) eyes had improvement or unchanged of final postoperative visual acuity. The most common complication was vitreous haemorrhage (5.9%) and transient rise in intraocular pressure (5.9%) which all spontaneously resolved CONCLUSION High speed cutter anterior vitrectomy via limbal incision is a safe and effective method for those with posterior capsular rupture for SFIOL implantation. PMID:28149781

  18. 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.

  19. 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

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

    PubMed

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

    2013-03-01

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

  1. 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.

  2. 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

  3. Hydrophobic versus double-square-edged hydrophilic foldable acrylic intraocular lens: effect on posterior capsule opacification.

    PubMed

    Iwase, Takeshi; Nishi, Yutarou; Oveson, Brian C; Jo, Young-Joon

    2011-06-01

    To evaluate posterior capsule opacification (PCO) 2 years after cataract surgery with implantation of a hydrophobic acrylic or single-piece sharp-edged hydrophilic acrylic intraocular lens (IOL). Toyama Prefectural Central Hospital, Toyama, Japan. Case-control study. Patients with bilateral senile cataract were prospectively randomized to receive a hydrophobic IOL (Acrysof SA60AT) in 1 eye and a hydrophilic IOL (Meridian HP60M) in the other eye. The PCO density value, degree of IOL decentration and tilt, and anterior chamber depth (ACD) were measured using Scheimpflug videophotography 1, 6, 12, 18, and 24 months after surgery. Visual acuity and the number of eyes requiring neodymium:YAG laser capsulotomy were also assessed. The study evaluated 16 eyes (63 patients). The PCO value in the hydrophilic group increased significantly with time and was statistically significantly greater than in the hydrophobic group 18 and 24 months postoperatively (both P < .001). The capsulotomy rate was statistically significantly higher in the hydrophilic group than in the hydrophobic group (P < .01). Visual acuity in the hydrophilic group worsened significantly with time and was statistically significantly worse than in the hydrophobic group at 18 and 24 months (both P < .001). Intraocular lens decentration, IOL tilt, and the ACD did not change significantly during the follow-up in either group (P > .05), and there were no statistically significant postoperative differences in these parameters between the 2 IOL groups (P > .05). Two years after surgery, the hydrophobic IOL group had less PCO, a lower capsulotomy rate, and better visual acuity than the hydrophilic IOL group. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  4. Capsular bag opacification after experimental implantation of a new accommodating intraocular lens in rabbit eyes.

    PubMed

    Werner, Liliana; Pandey, Suresh K; Izak, Andrea M; Vargas, Luis G; Trivedi, Rupal H; Apple, David J; Mamalis, Nick

    2004-05-01

    To evaluate the development of capsular bag opacification in rabbit eyes after implantation of an intraocular lens (IOL) designed to minimize contact between the anterior capsule and the IOL and ensure expansion of the capsular bag. David J. Apple, MD Laboratories for Ophthalmic Devices Research, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. Ten New Zealand white rabbits had a study IOL (new accommodating silicone IOL [Synchrony, Visiogen, Inc.]) implanted in 1 eye and a control IOL (1-piece plate silicone IOL with large fixation holes) implanted in the other eye. Intraocular lens position, anterior capsule opacification (ACO), and posterior capsule opacification (PCO) were qualitatively assessed using slitlamp retroillumination photographs of the dilated eyes. Anterior capsule opacification and PCO were graded on a 0 to 4 scale after the eyes were enucleated (Miyake-Apple posterior and anterior views after excision of the cornea and iris). The eyes were also evaluated histopathologically. The rate of ACO and PCO was significantly higher in the control group. Fibrosis and ACO were almost absent in the study group; the control group exhibited extensive capsulorhexis contraction, including capsulorhexis occlusion. Postoperative IOL dislocation into the anterior chamber and pupillary block syndrome were observed in some eyes in the study group. The special design features associated with the study IOL appeared to help prevent PCO. Complications in the study group were probably caused by the increased posterior vitreous pressure in rabbit eyes compared to human eyes and the relatively large size of the study IOL relative to the anterior segment of rabbit eyes.

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

    PubMed

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

    2015-04-01

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

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

    PubMed

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

    2015-01-01

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

  7. Three-year follow-up of the Artisan phakic intraocular lens for hypermetropia.

    PubMed

    Saxena, Ruchi; Landesz, Monika; Noordzij, Bastiaantje; Luyten, Gregorius P M

    2003-07-01

    We report the postoperative results of the Artisan Hyperopia phakic intraocular lens (IOL; model 203W; Ophtec, Groningen, The Netherlands). Prospective, nonrandomized trial. Twenty-six eyes of 13 self-selected patients with refractive error ranging from +3.00 to +11.00 diopters (D). Patients with hypermetropia were implanted with the Artisan Hyperopia phakic IOL. Mean follow-up was 22.4 months (range, 3-36 months). Predictability, stability, efficacy, loss of best spectacle-corrected visual acuity, and complications. At six months, 90.9% (20 of 22 eyes) were +/-1.00 D of intended correction and 81.8% (18 eyes) were +/-1.00 D of emmetropia. The mean spherical equivalent was stable within 0.25 D during the entire 3-year follow-up period. Twenty-four eyes (92.3%) had a postoperative best spectacle-corrected visual acuity of 0.50 or better at all of their individual follow-up examinations. No patient lost 2 or more lines after the procedure. There was a significant negative correlation between anterior chamber depth and endothelial cell loss. Two patients experienced posterior synechiae with pigment deposits in both eyes. One of these patients had convex irides and underwent implant removal within 2 years with a consequent clear lens extraction and posterior chamber lens implantation. Implantation of the Artisan Hyperopic lens leads to accurate and stable refractive results with no significant loss of vision. More attention should be paid to convex irides and shallow anterior chambers during the preoperative screening to avoid unnecessary complications.

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

    PubMed

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

    2006-11-01

    Cataract surgery is routinely performed to replace the clouded lens by a rigid polymeric intra-ocular lens unable to accommodate. By implanting a silicone gel into an intact capsular bag the accommodating properties of the natural lens can be maintained or enhanced. The implantation success of accommodating lenses is hampered by the occurrence of capsular opacification (PCO) due to lens epithelial cell (LEC) growth. In order to prevent LEC proliferation, a treatment regime using actinomycin D, cycloheximide and water was developed. The effectiveness of treatment was analyzed using an in vitro, MTT-based cell culture system and an ex vivo pig eye model in which the implanted lens-in-the-bag is cultured as a whole. LEC were exposed to treatment solutions for 5 min, then the cells were allowed to recover and to re-colonize the substratum. MTT conversion by cells was transiently inhibited by cycloheximide dissolved in water and by water alone. Exposure to actinomycin D resulted in a lasting inhibition of MTT conversion and consequently cell proliferation. These in vitro data could not be fully reproduced in the ex vivo pig eye model due to essential differences between both models. Treatment with actinomycin D containing solutions, however, resulted in a nearly complete absence of cells on the capsular wall. The pig eye model is a promising approach to further evaluate the effects of peri-surgical treatment during the accommodating intra-ocular lens implantation.

  9. Evaluation of intraocular lens power prediction methods using the American Society of Cataract and Refractive Surgeons Post-Keratorefractive Intraocular Lens Power Calculator.

    PubMed

    Wang, Li; Hill, Warren E; Koch, Douglas D

    2010-09-01

    To evaluate the accuracy of methods of intraocular lens (IOL) power prediction after previous laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) using the American Society of Cataract and Refractive Surgery IOL power calculator. Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, and private practice, Mesa, Arizona, USA. The following methods were evaluated: methods using pre-LASIK/PRK keratometry (K) and surgically induced change in refraction, methods using surgically induced change in refraction, and methods using no previous data. The predicted IOL power was calculated with each method using the actual refraction after cataract surgery as the target. The IOL prediction error was calculated as the implanted IOL power minus the predicted IOL power. Arithmetic and absolute IOL prediction errors, variances in mean arithmetic IOL prediction error, and percentage of eyes within +/-0.50 diopter (D) and +/-1.00 D of refractive prediction errors were calculated. Methods using surgically induced change in refraction or no previous data had significantly smaller mean absolute IOL prediction errors, smaller variances, and a greater percentage of eyes within +/-0.50 D and +/-1.00 D of refractive prediction errors than methods using pre-LASIK/PRK keratometry (K) values and surgically induced change in refraction (all P<.05 with Bonferroni correction). There were no statistically significant differences between methods using surgically induced change in refraction and methods using no previous data. Methods using surgically induced change in refraction and methods using no previous data gave better results than methods using pre-LASIK/PRK K values and surgically induced change in refraction. Copyright (c) 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  10. Etiology and Management of Raised Intraocular Pressure following Posterior Chamber Phakic Intraocular Lens Implantation in Myopic Eyes

    PubMed Central

    Senthil, Sirisha; Choudhari, Nikhil S.; Vaddavalli, Pravin K.; Murthy, Somasheila; Reddy, Jagadesh; Garudadri, Chandra S.

    2016-01-01

    Aim To evaluate the etiology and management of elevated intraocular pressure (IOP) following posterior chamber phakic implantable collamer lens (ICL) surgery. Methods Between 2009 and 2015, 638 eyes of 359 subjects with refractive myopia, underwent V4b and V4c (CentraFLOW) model ICL implantation. Ocular hypertension (OHT) was defined as IOP of ≥ 22 mm Hg on two separate occasions and elevated IOP with corresponding optic disc or visual field damage was defined as glaucoma. Results Elevated IOP ≥ 22 mm Hg was noted in 33 eyes of 30 subjects (33/638; 5.17%). Median age of subjects with raised IOP was 26 years (Inter quartile range (IQR):22, 29) and median refarctive error was -16 diopters (-19.5, -13). The median follow up was 7.8 months (IQR:0.3, 17.6) and median time for postoperative IOP rise was 12 days, (IQR:2, 24). The various etiologies for elevated IOP were steroid response in 21 eyes (64%; 10 eyes with V4b, 11 eyes with V4c), retained viscoelastic in 5 eyes (15%) (3 with V4b, 2 with V4c), pupillary block in four eyes (12%; 3 with V4b, 1 with V4c), malignant glaucoma in one eye (3%, V4b), and missed pre-existing Juvenile open angle glaucoma (JOAG) in two eyes (6% with V4b). Elevated IOP in 31 eyes resolved with conservative management. One eye (centraFLOW design) with central aquaport block by viscoelastic, needed AC wash and one eye with malignant glaucoma needed parsplana vitrectomy and hyaloidotomy. Ten eyes required longterm (>2 months) antiglaucoma medications (AGM) for IOP control. Except the two eyes with JOAG, none had disc and field damage. Conclusion In our series, OHT was seen in 4.85% and glaucoma in 0.3% eyes that underwent V4b and V4c model ICL implantation. Multiple etiologies were noted and steroid induced ocular hypertension was the most common cause of elevated IOP followed by retained viscoelastic and pupillary block. One third of these eyes required longterm AGM for IOP control. PMID:27855172

  11. 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.

  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. Visual acuity tolerance to residual refractive errors in patients with an apodized diffractive intraocular lens.

    PubMed

    Fernández-Vega, Luis; Alfonso, José F; Montés-Micó, Robert; Amhaz, Hussein

    2008-02-01

    To assess visual acuity tolerance to defocus caused by residual refractive errors after clear lens extraction (CLE) with apodized diffractive intraocular lens (IOL) implantation. Fernández-Vega Ophthalmological Institute, Oviedo, Spain. In this prospective study, 150 eyes of 75 consecutive patients who had bilateral CLE with implantation of an AcrySof ReSTOR Natural IOL (Alcon) were evaluated. The eyes were divided into 2 groups: myopia and hyperopia. Residual refractive errors were analyzed using vector analysis. Monocular and binocular uncorrected distance visual acuity, best corrected distance visual acuity, uncorrected distance near visual acuity, and best distance-corrected near visual acuity 6 months after surgery were recorded. When the distance residual refractive error was corrected, there was a statistically significant improvement in uncorrected distance acuity in the myopia group and hyperopia group (P<.001). No differences were found between uncorrected-distance near acuity and best distance-corrected near acuity (P>.2). A significant trend toward worse visual acuity as a function of spherical equivalent (SE) value was significant only for uncorrected distance acuity (P<.001). No significant correlations were found for best corrected distance acuity, uncorrected-distance near acuity, and best distance-corrected near acuity as a function of SE (P>.2). Correction of distance residual refractive error improved distance visual acuity in patients with apodized diffractive IOLs. However, near visual acuity was maintained whether the residual refractive error was corrected or not.

  14. Accuracy of optical biometry combined with Placido disc corneal topography for intraocular lens power calculation

    PubMed Central

    Savini, Giacomo; Hoffer, Kenneth J.; Barboni, Piero; Balducci, Nicole; Schiano-Lomoriello, Domenico; Ducoli, Pietro

    2017-01-01

    Purpose To investigate the accuracy of a new optical biometer for intraocular lens (IOL) power calculation in eyes undergoing cataract surgery. Methods Consecutive eyes of patients undergoing cataract surgery with the same IOL model were enrolled in a prospective cohort study. Axial length (AL) and corneal power were measured with an optical biometer based on optical low-coherence interferometry and Placido-disc corneal topography. IOL power was calculated with the Hoffer Q, Holladay 1 and SRK/T formulas. For each formula the lens constant was optimized in retrospect in order to achieve a mean prediction error (PE) of zero (difference between the predicted and the postoperative refraction). Median absolute error (MedAE) and percentage of eyes with PE ±0.50 D were calculated. Results Seventy-four eyes of 74 cataract patients were enrolled. The MedAE was 0.25 D with all formulas. A PE within ±0.50 D was obtained in 89.04% of cases with the Hoffer Q and SRK/T formulas, and in 87.67% of cases with the Holladay 1 formula. Conclusions The optical biometer investigated in the present study provides accurate measurements for IOL power calculation. PMID:28231267

  15. Postoperative deposition of calcium on the surfaces of a hydrogel intraocular lens.

    PubMed

    Werner, L; Apple, D J; Escobar-Gomez, M; Ohrström, A; Crayford, B B; Bianchi, R; Pandey, S K

    2000-12-01

    To report clinical, pathological and histochemical features of 5 Hydroview intraocular lenses (IOLs) explanted from five patients who had visual disturbances caused by postoperative deposits on the lens surfaces. Noncomparative small case series with clinicopathologic and histochemical correlations. Five hydrophilic IOLs explanted from five different patients. All patients presented with decreased visual acuity and glare circa 12 months after uneventful phacoemulsification and IOL implantation, associated with a red-brown granularity on the optical surfaces of the IOLs. The lenses were explanted, fixed in buffered formaldehyde and examined by gross and light microscopy. Staining of the IOLs with 1% alizarin red and with the von Kossa method (both stains for calcium). Two additional IOLs were also stained and included as controls. The optical surfaces of all five IOLs were covered by a layer of irregular granular deposits, composed of multiple fine, translucent spherical-ovoid granules. The deposits stained positive for calcium in all cases. No deposit or positive staining was observed on the IOLs haptics. Staining of the control IOLs was also negative. This is the first histopathological report of calcified deposits on the surfaces of this hydrogel IOL model. Further studies on other similar cases with this lens should be done to determine the incidence and possible mechanisms of this phenomenon.

  16. Stability of the acrysof toric intraocular lens in combined cataract surgery and transconjunctival sutureless vitrectomy.

    PubMed

    Toussaint, Brian W; Appenzeller, Matthew F; Miller, Daniel M; Petersen, Michael R; Foster, Robert E; Osher, Robert H; Snyder, Michael E; Hunt, Christine K; Sisk, Robert A; Riemann, Christopher D

    2015-06-01

    To report the outcomes of combined cataract surgery with toric intraocular lens (IOL) implantation when performed in conjunction with transconjunctival sutureless pars plana vitrectomy. Retrospective interventional case series. Consecutive series of 55 eyes of 51 patients from April 2007 to December of 2010. All eyes underwent combined simultaneous small incision cataract surgery, toric IOL implantation, and transconjunctival sutureless vitrectomy surgery. Postoperative visual acuity, postoperative astigmatism, and rotational stability of the IOL. Preoperative best-corrected visual acuity was 0.32 ± 0.15 logMar (Snellen 20/43) and improved to 0.16 ± 0.10 (Snellen 20/29) postoperatively uncorrected (P < 0.01) and to 0.08 ± 0.11 best-corrected (Snellen 20/24) (P < 0.01). Preoperative astigmatism was 1.75 ± 1.0 diopters (D) (range, 0-4.75 D) and improved to 0.5 ± 0.50 D (range, 0-2.5 D) postoperatively (P < 0.01). Final measured postoperative IOL axis deviation from target axis was 4 ± 6° (range, 0-32). Final IOL axis was within 5° of target in 47 (85%) eyes, within 10 degrees of target in 51 (93%) eyes, and was within 15° of target in 52 (95%) eyes. Toric lens position and axis remained stable after implantation during combined cataract surgery and transconjunctival sutureless vitrectomy.

  17. Early clinical experience with a new preloaded one-piece intraocular lens in paediatric cataract surgery.

    PubMed

    Gosling, D B; Chan, T K J

    2016-09-01

    PurposeTo report the clinical experience of using the Tecnis PCB00 (Abbott Medical Optics, Santa Ana, CA, USA) preloaded one-piece intraocular lens (IOL) in the setting of a tertiary referral centre for paediatric cataract.MethodsA retrospective case note review of all paediatric cataract surgeries using the Tecnis PCB00 IOL, at a single UK paediatric ophthalmology department.ResultsNine eyes in seven patients received the IOL between December 2014 and January 2016. All patients underwent lens aspiration and insertion of the IOL 'in the bag.' The indications for surgery included developmental cataract (8/9) and traumatic cataract (1/9). Mean age at the time of surgery was 7 years (range 2-14). The median improvement in logMAR best-corrected visual acuity was 0.475 (range 0.250-1.500). The mean follow-up duration was 5 months (range 1-13). No operative or post-operative complications occurred as a result of using the device.ConclusionThe Tecnis PCB00 preloaded IOL appears to be a safe and effective device in treating paediatric cataract.

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

    PubMed

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

    2012-09-01

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

  19. Intraocular Lens Calculation for Cataract Treated with Photorefractive Keratectomy Using Ray Tracing Method.

    PubMed

    Ishikawa; Hirano; Murai; Kumagai; Nakayasu; Kanai

    2000-09-01

    Purpose: Conventional methods (such as the SRK-II formula) do not accurately calculate the power of the intraocular lens (IOL) after refractive surgery. Therefore, we compared a new formula including a ray tracing method to the conventional method for foldable IOL lens implantation.Method: Foldable IOLs (MA 60 BM) were implanted in 26 patients (32 eyes) using the phakoemulsification technique. The power of the IOL was measured preoperatively using the SRK-II formula in all cases. From the results of postoperative refractive errors of these cases, the power of IOL calculated by the ray tracing method was compared to the SRK-II formula. Cataract patients first treated with photorefractive keratectomy (PRK) received IOL implants using our ray tracing method and their postoperative refraction was measured.Results: The average postoperative refractive error was 1.32 D in SRK-II formula, 0.95 D in the ray tracing method with Ray 1 used and 0.89 D with Ray 2 used. Postoperative refraction of both eyes first treated with PRK was -1.00 D.Conclusion: The average postoperative refractive error was reduced in the ray tracing method using Olsen's predicted ACD (Ray 2) compared to SRK-II formula. This new tracing method appears to be useful for determination of IOL power and it may be applied for IOL calculation for cataract surgery after refractive surgery.

  20. 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. © 2014 Wiley Periodicals, Inc.

  1. Matrix-optical representation of currently used intraocular lens power formulas.

    PubMed

    Haigis, Wolfgang

    2009-02-01

    The formulas presently used to calculate the power of intraocular lenses (IOLs) are the SRK II, SRK/T, Holladay I, Hoffer Q, and Haigis. Apart from the empirical SRK II, these formulas are based on paraxial optics. With different notations and different algebraic forms, a comparison between formulas is difficult. Matrix techniques, on the other hand, have been successfully used in paraxial optics for many years, offering an elegant, simple, and straightforward way to characterize complex optical systems. The aim of this study, therefore, was to represent the current theoretical IOL formulas in matrix notation. The SRK/T, Holladay I, Hoffer Q, and Haigis formulas were analyzed, algebraically transformed, and expressed in matrix-optical notation in the form of translation and refraction matrices and the system matrix. An example calculation was carried out and compared to results from two commercial biometry instruments (Zeiss IOLMaster and Tomey AL-2000). Although all formulas examined are based on thin lens optics in paraxial approximation, considerable differences exist in the interpretation and calculation of corneal power, axial length, and effective lens position as well as the manner in which individual IOLs are represented ("IOL constants"). All relations necessary for matrix-optical representation are given. The matrix-optical representation of the currently used IOL power formulas offers new insights into the calculation of IOLs and allows a deeper understanding of the advantages and drawbacks of each formula.

  2. Preventing falls in older multifocal glasses wearers by providing single-lens distance glasses: the protocol for the VISIBLE randomised controlled trial

    PubMed Central

    Haran, Mark J; Lord, Stephen R; Cameron, Ian D; Ivers, Rebecca Q; Simpson, Judy M; Lee, Bonsan B; Porwal, Mamta; Kwan, Marcella MS; Severino, Connie

    2009-01-01

    Background Recent research has shown that wearing multifocal glasses increases the risk of trips and falls in older people. The aim of this study is to determine whether the provision of single-lens distance glasses to older multifocal glasses wearers, with recommendations for wearing them for walking and outdoor activities, can prevent falls. We will also measure the effect of the intervention on health status, lifestyle activities and fear of falling, as well as the extent of adherence to the program. Methods/Design Approximately 580 older people who are regular wearers of multifocal glasses people will be recruited. Participants will be randomly allocated to either an intervention group (provision of single lens glasses, with counselling and advice about appropriate use) or a control group (usual care). The primary outcome measure will be falls (measured with 13 monthly calendars). Secondary measures will be quality of life, falls efficacy, physical activity levels and adverse events. Discussions The study will determine the impact of providing single-lens glasses, with advice about appropriate use, on preventing falls in older regular wearers of multifocal glasses. This pragmatic intervention, if found to be effective, will guide practitioners with regard to recommending appropriate glasses for minimising the risk of falls in older people. Trial Registration The protocol for this study was registered with the Clinical Trials.gov Protocol Registration System on June 7th 2006 (#350855). PMID:19321012

  3. Preventing falls in older multifocal glasses wearers by providing single-lens distance glasses: the protocol for the VISIBLE randomised controlled trial.

    PubMed

    Haran, Mark J; Lord, Stephen R; Cameron, Ian D; Ivers, Rebecca Q; Simpson, Judy M; Lee, Bonsan B; Porwal, Mamta; Kwan, Marcella M S; Severino, Connie

    2009-03-26

    Recent research has shown that wearing multifocal glasses increases the risk of trips and falls in older people. The aim of this study is to determine whether the provision of single-lens distance glasses to older multifocal glasses wearers, with recommendations for wearing them for walking and outdoor activities, can prevent falls. We will also measure the effect of the intervention on health status, lifestyle activities and fear of falling, as well as the extent of adherence to the program. Approximately 580 older people who are regular wearers of multifocal glasses people will be recruited. Participants will be randomly allocated to either an intervention group (provision of single lens glasses, with counselling and advice about appropriate use) or a control group (usual care). The primary outcome measure will be falls (measured with 13 monthly calendars). Secondary measures will be quality of life, falls efficacy, physical activity levels and adverse events. The study will determine the impact of providing single-lens glasses, with advice about appropriate use, on preventing falls in older regular wearers of multifocal glasses. This pragmatic intervention, if found to be effective, will guide practitioners with regard to recommending appropriate glasses for minimising the risk of falls in older people. The protocol for this study was registered with the Clinical Trials.gov Protocol Registration System on June 7th 2006 (#350855).

  4. Clinical results with the light adjustable intraocular lens after cataract surgery.

    PubMed

    von Mohrenfels, Christoph Winkler; Salgado, Josefina; Khoramnia, Ramin; Maier, Mathias; Lohmann, Chris P

    2010-05-01

    The accuracy of intraocular lens (IOL) calculation is limited by the variation of the measurement of corneal power, axial length, anterior chamber depth, and effective postoperative lens position. Therefore, IOL predictability is limited. The aim of this study was to evaluate the performance of the novel light adjustable lens (LAL, Calhoun Vision). Ten eyes with cataracts (seven patients) were included. After standard phacoemulsification, the LAL was implanted. Two to 3 weeks after surgery, all IOL adjustments had been completed. Preoperatively, pre-adjustment, pre-lock-in, and 1 month post-lock-in, a full ophthalmic examination including objective (autorefraction) and subjective refraction (ie, manifest uncorrected visual acuity [UCVA] and manifest best spectacle-corrected visual acuity [BSCVA]) and topography were performed. All cataract surgeries were performed with no complications. Two weeks after surgery, the mean refraction was +0.78+/-0.79 diopters (D). After adjustment and lock-in, the refraction was -0.07+/-0.21 D. In 4 of 10 eyes, second adjustments were necessary. One month after surgery, all patients were within +/-0.50 D of the intended refraction. Preoperatively, the cylinder was 0.88+/-0.77 D, but was reduced after adjustments to 0.15+/-0.20 D. Mean UCVA was 1.02, and all eyes gained at least two lines on the Snellen visual acuity test (ie, BSCVA) after surgery. The LAL is a new IOL with the ability to correct up to 2.00 D of sphere and cylinder after implantation. Our first clinical results are promising and indicate effective safety and stability. Copyright 2010, SLACK Incorporated.

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

    PubMed

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

    2011-02-01

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

  6. Clinical outcomes of glued transscleral fixated intraocular lens in functionally one-eyed patients.

    PubMed

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

    2014-07-01

    To analyze the indications, visual outcome, mental status, and quality of life after glued transscleral fixated intraocular lens (IOL) in functionally one-eyed individuals. Dr Agarwal's Eye Hospital and Eye Research Centre, Chennai, India. Prospective observational comparative case series. Patients with one functioning eye with surgical indications (aphakia, luxated IOL, or dislocated lens) and the fellow eye with no perception of light were included. Indications, uncorrected distant visual acuity (UDVA), corrected distant visual acuity (CDVA), mental status (Amsterdam Preoperative Anxiety and Information Scale) and quality of life (visual function scoring VF-14) were assessed. Outcomes of nonsurgical and surgical management were evaluated and compared. Of 22 patients, 10 (45.4%) patients underwent glued IOL (group A) and 12 (54.5%) wore spectacles (group B). There was a strong association between the initial clinical presentation and management (χ, P=0.000). Subluxated cataract and dislocated lens (or IOL) required surgical treatment. Postoperative aphakia with adequate spectacle correction were conservatively treated. There was change (P=0.005) in UDVA and CDVA after glued IOL surgery. There was no loss of CDVA. There was difference between the 2 groups in reading small prints (P=0.021), sporting activities (P=0.000), and night driving (P=0.000). Surgical anxiety was higher in group B (P=0.014). Females were more anxious than the males (P=0.014). There was an association of increasing age and the decision for nonsurgical management (χ, P=0.005). Glued transscleral fixated IOL can be safely performed in one-eyed patients for specific indications to provide good functional results.

  7. Crystalens HD intraocular lens analysis using an adaptive optics visual simulator.

    PubMed

    Pérez-Vives, Cari; Montés-Micó, Robert; López-Gil, Norberto; Ferrer-Blasco, Teresa; García-Lázaro, Santiago

    2013-12-01

    To compare visual and optical quality of the Crystalens HD intraocular lens (IOL) with that of a monofocal IOL. The wavefront aberration patterns of the monocular Akreos Adapt AO IOL and the single-optic accommodating Crystalens HD IOL were measured in a model eye. The Crystalens IOL was measured in its nonaccommodative state and then, after flexing the haptic to produce 1.4 mm of movement, in its accommodative state. Using an adaptive optics system, subjects' aberrations were removed and replaced with those of pseudophakes viewing with either lens. Monocular distance visual acuity (DVA) at high (100%), medium (50%), and low (10%) contrast and contrast sensitivity (CS) were measured for both IOL optics. Near VA (NVA) and CS were measured for the Crystalens HD IOL in its accommodative state. Depth of focus around the distance and near focus was also evaluated for the Crystalens HD IOL. Modulation transfer function (MTF), point spread function (PSF), and Strehl ratio were also calculated. All measures were taken for 3- and 5-mm pupils. The MTF, PSF, and Strehl ratio showed comparable values between IOLs (p > 0.05). There were no significant differences in DVA and CS between IOLs for all contrasts and pupils (p > 0.05). When spherically focused, mean DVA and NVA with the Crystalens HD IOL were ≥20/20 at 100 and 50% contrasts for both pupils. Monocular DVA, NVA, and CS were slightly better with 3- than 5-mm pupils, but without statistically significant differences. The Crystalens HD IOL showed about 0.75 and 0.50 D of depth of focus in its accommodative state and nonaccommodative state, respectively. The optical and visual quality with the nonaccommodatied Crystalens HD IOL was comparable to that of a monofocal IOL. If this lens can move 1.4 mm in the eye, it will provide high-quality optics for near vision as well.

  8. 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.

  9. Empty-bag technique for acrylic intraocular lens implantation using Healon5.

    PubMed

    Cionni, Robert J; Temel, Mustafa; Marques, Daniela M V; Marques, Frederico F

    2004-02-01

    To determine how often the empty-bag technique (EBT) for injecting an acrylic foldable intraocular lens (IOL) into the capsular bag using Healon5 (sodium hyaluronate 2.3%) will require a 2-compartment technique to remove the ophthalmic viscosurgical device (OVD) and compare this with that of a standard injection method using Healon5. Cincinnati Eye Institute and Ambulatory Surgical Center, Cincinnati, Ohio, USA. Forty-one eyes of 40 patients were randomly assigned to 1 of 2 groups. In Group A, standard capsular bag expansion was performed with Healon5 before implantation of an acrylic posterior chamber (PC) IOL. In Group B, Healon5 was placed in the anterior chamber followed by balanced salt solution expansion of the capsular bag before acrylic PC IOL implantation. In all patients, complete OVD removal was attempted with the automated aspiration tip anterior to the optic (rock 'n roll technique). The number of patients in each group who required placement of the aspiration tip posterior to the optic for complete removal was compared. Early postoperative intraocular pressure (IOP) was also compared. In Group A, 15 (75%) of 20 eyes required placement of the aspiration tip posterior to the optic for complete OVD removal and in Group B, 1 (0.05%) of 20 eyes. The postoperative IOP was similar in both groups. The EBT decreased the likelihood that a 2-compartment OVD removal method would be necessary when using Healon5 for acrylic PC IOL implantation. The limitations of this new technique must be fully understood before it is used.

  10. Anterior segment optical coherence tomography in the assessment of postoperative intraocular lens optic changes.

    PubMed

    Werner, Liliana; Michelson, Jennifer; Ollerton, Andrew; Leishman, Lisa; Bodnar, Zachary

    2012-06-01

    To evaluate the use of anterior segment optical coherence tomography (AS-OCT) to assess postoperative intraocular lens (IOL) optic changes. John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. Experimental study. Intraocular lenses explanted because of various complications were used, including poly(methyl methacrylate) (PMMA) IOLs with snowflake degeneration, hydrophilic acrylic IOLs with calcification, a silicone IOL with calcification from an eye with asteroid hyalosis, and hydrophobic acrylic IOLs explanted because of decentration, subluxation, or uveitis-glaucoma-hyphema syndrome. After gross and light microscopy, the IOLs were examined in the dry and hydrated states using AS-OCT. Selected hydrophilic acrylic IOLs were stained for calcium. In-the-bag IOLs in pseudophakic cadaver eyes were also evaluated by AS-OCT before and after explantation to confirm correspondence with the clinical situation. Intraoptic changes, such as snowflake lesions in PMMA IOLs, calcification in hydrophilic acrylic IOLs, and glistenings in hydrophobic acrylic IOLs, could be imaged by AS-OCT. The method was also helpful in analyzing the location and density. However, in cases of more superficial changes, unless the lesions/deposits were present on the optic surface with an extension to the optic substance of at least 0.1 mm, they could not be clearly differentiated from the overall outline of the IOL surface. Anterior segment OCT may be helpful in assessing the presence, location, and density of intraoptic changes, avoiding a misdiagnosis of IOL opacification and the performance of unnecessary procedures, such as posterior capsulotomy or vitrectomy. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  11. Intermittent pupillary capture of intraocular lens after transscleral fixation in congenital ectopia lentis patient triggered by dark environment

    PubMed Central

    Wang, Zhirong; Cao, Qianzhong; Jin, Guangming; Young, Charlotte Aimee; Wang, Yiyao; Zheng, Danying

    2017-01-01

    Abstract Rationale: Although transscleral-fixated intraocular lens (IOL) implantation has been the most frequently chosen treatment for patients with inadequate capsule support, the ghost pupillary capture phenomenon did not cause enough attention. Patient Concerns: We present an unusual case withintermittent pupillary capture of intraocular lens. Diagnosis: After 5 minutes staying in the dark environment, the pentacam examination revealed a mild nasal pupillary capture of the IOL. Interventions: A clear observation using the slit-lamp was attempted, and the light shining on the pupil sped up the sliding of the captured IOL. Outcomes: The captured portion of the IOL recovered rapidly accompanied with pupil retraction when the patient was exposed in the light. Conclusions: Pupillary capture of an IOL is an uncommon but potentially serious postoperative complication of transscleral fixation. Many pupillary capture cases may have been overlooked in the past. Physicians should be aware of its potential side effect, recognize its clinical manifestation, and knowledgeable of effective management. PMID:28296765

  12. Biocompatibility of Intraocular Lenses.

    PubMed

    Özyol, Pelin; Özyol, Erhan; Karel, Fatih

    2017-08-01

    The performance of an intraocular lens is determined by several factors such as the surgical technique, surgical complications, intraocular lens biomaterial and design, and host reaction to the lens. The factor indicating the biocompatibility of an intraocular lens is the behavior of inflammatory and lens epithelial cells. Hence, the biocompatibility of intraocular lens materials is assessed in terms of uveal biocompatibility, based on the inflammatory foreign-body reaction of the eye against the implant, and in terms of capsular biocompatibility, determined by the relationship of the intraocular lens with residual lens epithelial cells within the capsular bag. Insufficient biocompatibility of intraocular lens materials may result in different clinical entities such as anterior capsule opacification, posterior capsule opacification, and lens epithelial cell ongrowth. Intraocular lenses are increasingly implanted much earlier in life in cases such as refractive lens exchange or pediatric intraocular lens implantation after congenital cataract surgery, and these lenses are expected to exhibit maximum performance for many decades. The materials used in intraocular lens manufacture should, therefore, ensure long-term uveal and capsular biocompatibility. In this article, we review the currently available materials used in the manufacture of intraocular lenses, especially with regard to their uveal and capsular biocompatibility, and discuss efforts to improve the biocompatibility of intraocular lenses.

  13. Retropupilar positioning of foldable iris-claw intraocular lens for correction of aphakia with no capsular support

    PubMed Central

    Faria, Mun Yueh; Pinto Ferreira, Nuno; Gama, Ivo; Pinto, Joana Medeiros; Canastro, Mario; Monteiro Grillo, Manuel

    2016-01-01

    Summary Iris-claw intraocular lens (ICIOL) for aphakia needs a large 5.4 mm corneal incision for its implantation. The technique needs corneal suture, associated with some postoperative astigmatism. Foldable ICIOL is used in phakic patients undergoing refractive surgery and has the advantage of a sutureless small corneal incision. We report a case of a high myopic patient with dislocated intraocular lens (IOL) and no capsular support. Dislocated IOL with its capsular bag was released with three-port, 23-gauge vitrectomy; placed in the anterior chamber; sliced; and extruded through a 3.2-mm corneal incision, where a foldable ICIOL was introduced and placed retropupillary. This technique achieved a stable fixation of the IOL. Retropupillary implantation of a foldable ICIOL on aphakic patients has advantages over that of a polymethylmethacrylate (PMMA) ICIOL due to smaller corneal incision. The technique may be safe and easy to perform. Purpose The purpose of this report was to describe the technique of retropupillary implantation of a foldable iris-claw intraocular lens (ICIOL) in a patient with dislocated intraocular lens (IOL) in mid vitreous cavity. Methods Foldable ICIOL (Artiflex® Myopia Model 401) is used in phakic patients undergoing refractive surgery and has the advantage of a sutureless small corneal incision. We report a case of a high myopic patient with dislocated IOL and no capsular support. The calculation was a −5.0 D IOL for retropupilar position, and a foldable ICIOL was introduced through a 3.2-mm corneal incision and placed retropupillary. Results The technique was easy to achieve. IOL was properly positioned retropupillary and maintained stable. There was no ocular hypertension and no anterior chamber flare or iris atrophy. Conclusion Retropupillary implantation of a foldable ICIOL on aphakic patients has advantages over that of a PMMA ICIOL due to smaller corneal incision. The technique may be safe and easy to perform. PMID:27843355

  14. Echobiometric evaluation of the axial length of the eye and intraocular lens calculation in pseudophakic eyes: our experience.

    PubMed

    Polizzi, A; Schenone, M; Ciurlo, C; Bertagno, R; Molfino, F; Camoriano, G P; Saccà, S C

    1998-01-01

    Intraocular lens (IOL) power calculation in 46 pseudophakic eyes (extracapsular cataract extraction with IOL in posterior chamber), utilizing a Javal keratometer, a Sonomed A 2000 echobiometer (probe 10 MHz, velocity=1,548 m/s) and the SRK2 formula, although there was a statistically significant reduction of the axial length, both in normal and hyperopic eyes, demonstrated no statistically significant differences of IOL power, when compared to the power previously calculated in the phakic eye.

  15. Implantable Collamer Lens Versus Iris-Fixed Phakic Intraocular Lens Implantation to Correct Myopia: A Meta-Analysis

    PubMed Central

    Liang, Guan-Lu; Wu, Jing; Shi, Jun-Ting; Liu, Jian; He, Feng-Ying; Xu, Wen

    2014-01-01

    This study is a meta-analysis comparing the efficacy, predictability, and safety of correcting myopia via implantation of two types of phakic intraocular lens (PIOLs): the implantable collamer lens (ICL) and iris-fixed PIOL. The Cochrane library, Pubmed, and EMBASE were searched. Study selection, data exclusion, and quality assessment were performed by two independent observers. The pooled relative risk (RR), pooled standardized mean difference (SMD), and their 95% confidence intervals (CIs) were used to compare lenses. Seven studies, involving 511 eyes, were included. The pooled SMD in postoperative uncorrected distance visual acuity (UDVA) comparing ICLs to iris-fixed PIOLs was −0.22 (95% CI, −0.58 to 0.13; P = .22). The pooled RR values of UDVA of 20/20 or better and of 20/40 or better comparing ICLs to iris-fixed PIOLs were 1.15 (95% CI, 0.89 to 1.47; P = .29) and 1.01 (95% CI, 0.95 to 1.08; P = .75), respectively. The pooled RR of loss of best spectacle-corrected visual acuity (BSCVA) and gain in BSCVA comparing ICLs to iris-fixed PIOLs were 1.20 (95% CI, 0.24 to 6.00; P = .82) and 1.14 (95% CI, 0.89 to 1.48; P = .31), respectively. The pooled RR comparing ICLs to iris-fixed PIOLs was 0.78 (95% CI, 0.29 to 2.12; P = .63) for all reported complications and 2.80 (95% CI, 1.04 to 7.52; P = .04) for severe complications. The pooled RR of achieving a result within ±0.5 D (diopter) of the intended target comparing ICLs to iris-fixed PIOLs was 1.35 (95% CI, 1.04 to 1.77; P = .03). Overall, there is no significant difference in efficacy between the two types of PIOLs or in safety, except that the ICL is associated with a greater incidence of severe complications, especially anterior subcapsular cataract, primarily in the Version 2 and Version 3 groups. However, ICL has better predictability. PMID:25115906

  16. COMBINED PARS PLANA VITRECTOMY AND SCLERAL FIXATION OF AN INTRAOCULAR LENS USING GORE-TEX SUTURE: One-Year Outcomes.

    PubMed

    Khan, M Ali; Samara, Wasim A; Gerstenblith, Adam T; Chiang, Allen; Mehta, Sonia; Garg, Sunir J; Hsu, Jason; Gupta, Omesh P

    2017-05-10

    To report the 1-year clinical outcomes of combined pars plana vitrectomy and ab externo scleral fixation of an intraocular lens using Gore-Tex suture. Retrospective, interventional case series. Outcome measures were change in visual acuity and occurrence of intraoperative and postoperative complications with minimum follow-up of 1 year. Eighty-four eyes of 83 patients were identified. The mean best available visual acuity improved from 20/782 preoperatively to 20/65 postoperatively (P < 0.001). The mean follow-up was 598 ± 183 days (median 533 days, range 365-1,323 days). There were no intraoperative complications noted. A Bausch & Lomb Akreos AO60 intraocular lens was implanted in 77 eyes and an Alcon CZ70BD in 7 eyes. Postoperative complications included transient vitreous hemorrhage in six eyes (7.1%), cystoid macular edema in four eyes (4.8%), ocular hypertension in three eyes (3.6%), hyphema in two eyes (2.4%), and transient corneal edema in two eyes (2.4%). There were no cases of postoperative endophthalmitis, suture erosion/breakage, hypotony, retinal detachment, suprachoroidal hemorrhage, choroidal detachment, uveitis-glaucoma-hyphema syndrome, or persistent postoperative inflammation during the follow-up period. Combined pars plana vitrectomy and ab externo scleral fixation of an intraocular lens with Gore-Tex suture was well tolerated at a minimum of 1-year follow-up. No suture-related complications were encountered.

  17. 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

  18. Stability and safety of MA50 intraocular lens placed in the sulcus

    PubMed Central

    Kemp, P S; Oetting, T A

    2015-01-01

    Purpose To describe the safety and stability of sulcus placement of the MA50 intraocular lens (IOL). Patients and methods Consecutive patients with MA50 IOLs placed in the sulcus at the University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA, from 1997 to 2012 were identified. Inclusion criteria included patients with over 4 weeks of follow-up data. AEL was compared with incidence of IOL decentration using at two-tailed Student's t-test. Results Fifty eyes of 49 patients meeting the inclusion criteria were identified. Four weeks post-operatively, the average best-corrected visual acuity was 20/30. IOL decentration occurred in 14% of patients; patients with decentered IOLs had a significantly longer average AEL (25.37 mm) than patients whose IOL remained centered (23.94 mm, P=0.017). Other complications included uveitis-glaucoma-hyphema syndrome (12%), iritis (8%), and glaucoma (6%). There were no cases of pigment dispersion syndrome or need for lens exchange. Twelve eyes (24%) had intra-operative optic capture by the anterior capsule, none of which had post-operative decentration. Conclusion The MA50 IOL is a reasonable, stable option for placement in the sulcus, with a low-risk profile; however, in eyes with longer AEL and presumably larger anterior segment, surgeons should consider placing an IOL with longer haptic distance than the MA50 to maintain centration. Optic capture of the MA50 IOL by the anterior capsule should be considered for longer eyes, as it is protective against decentration. PMID:26139047

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

    PubMed

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

    2016-01-01

    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. 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. Association to Prevent Blindness in Mexico (APEC), Hospital "Dr Luis Sánchez Bulnes". This was an observational, cross-sectional, and single-center study. 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. 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). 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.

  20. 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

  1. Fixation elements on plate intraocular lens: large positioning holes to improve security of capsular fixation.

    PubMed

    Whiteside, S B; Apple, D J; Peng, Q; Isaacs, R T; Guindi, A; Draughn, R A

    1998-05-01

    This study aimed to evaluate in rabbit eyes the effects of large positioning holes in one-piece silicone plate-haptic intraocular lenses (IOLs) with respect to security of capsular bag fixation. Mechanical strength of capsular fixation is correlated with the histologic findings of regenerating lens material and fibrous tissue ingrowth through the positioning holes on silicone plate IOLs, comparing capsules implanted with large-hole style plate IOLs to fellow capsules implanted with small-hole style plate IOLs. The study design was a prospective, randomized, experimental study. A total of 40 fellow capsular bags from 20 New Zealand white rabbits were examined. Capsules implanted with conventional small-hole silicone plate IOLs were used as the control in all pairs of fellow capsules. Phacoemulsification and implantation of a silicone plate IOL with small positioning holes in one eye and implantation of a silicone plate IOL with large positioning holes in the fellow eye were measured. All rabbits were killed at 2 months. The force required to extract the IOLs from the capsular bag was measured. All capsular bags underwent histopathologic analysis. Extraction force measurements and histopathologic examination, comparing capsules implanted with small-hole plate IOLs with fellow capsules implanted with large-hole plate IOLs, were measured. The large-hole style IOL required significantly more force to extract from the capsular bag compared to the conventional small-hole style (P = 0.003). Histologically, proliferating lens epithelial material and fibrous tissue were observed growing through all of the large positioning holes (synechia formation) but not through any of the small positioning holes. Silicone plate IOLs with large positioning holes become affixed more firmly within the capsular bag compared to conventional small-hole plate IOLs. These findings suggest that large holes in silicone plate IOLs allow for superior capsular bag fixation. This should reduce the

  2. Risk factor evaluation for cataract development in patients with low vaulting after phakic intraocular lens implantation.

    PubMed

    Maeng, Hyo-Sung; Chung, Tae-Young; Lee, Doon-Hoon; Chung, Eui-Sang

    2011-05-01

    To evaluate the occurrence of cataract in eyes with low vaulting after phakic intraocular lens (pIOL) implantation for myopia and suggest guidelines for such cases. Samsung Medical Center, Seoul, Korea. Cross-sectional study. Eyes with low Implantable Collamer Lens pIOL vaulting (<250 μm) were followed 1, 3, and 6 months as well as 1, 2, 3, and 4 years postoperatively. Frequency and time to cataract development were evaluated. Risk factors for cataract development were assessed using logistic regression analysis. Cutoff values for differentiating eyes at higher risk for cataract development were evaluated using Fisher exact and chi-square tests. Cataract developed in 8 (30.8%) of 26 eyes (6 of 20 patients) a mean of 18.7 months ± 10.1 (SD) postoperatively. Risk factors that were significant for cataract formation included lower vaulting (mean 42.4 ± 34.0 μm versus 141.4 ± 82.2 μm; odds ratio [OR], 1.05), older age (mean 42.6 ± 7.3 versus 34.9 ± 6.9 years; OR, 1.22), and higher preoperative spherical equivalent (SE) (mean -17.1 ± 4.4 diopters [D] versus -10.7 ± 2.7 D; OR, 1.64). The optimum cutoff values were 51.7 μm, 45 years, and -14.00 D (P=.0095, P=.0367, and P=.0342 respectively). In cases of low pIOL vaulting, close follow-up should be considered when central vaulting is less than 52 μm, patient age is more than 45 years, or the preoperative SE is greater than -14.00 D because these factors increase the risk for cataract. Copyright © 2011. Published by Elsevier Inc.

  3. Simulated prototype of posterior chamber phakic intraocular lens for presbyopia correction.

    PubMed

    Pérez-Vives, Cari; Ferrer-Blasco, Teresa; Cerviño-Expósito, Alejandro; Madrid-Costa, David; Montés-Micó, Robert

    2015-10-01

    To evaluate the visual impact of adding different spherical aberration values to an Implantable Collamer Lens phakic intraocular lens (pIOL) to increase the depth of focus using an adaptive optics visual simulator. University of Valencia, Valencia, Spain. Experimental study. Wavefront aberrations in -3.00 D and -6.00 diopter (D) pIOLs were measured in vitro. Afterward, different simulated pIOL experimental prototypes were created along with variances in the spherical aberration. An adaptive optics visual simulator was used to simulate vision after the implantation of the different pIOL prototypes from their wavefront aberrations. The corrected distance visual acuity (CDVA) and depth of focus were measured in 3.0 and 4.5 mm pupils. In a 3.0 mm pupil, the CDVA achieved with -3.00 and -6.00 D pIOLs and all pIOL prototypes evaluated was above 20/20 except for a -6.00 D pIOL + spherical aberration 4 at 50% CDVA contrast, which decreased to 20/25. However, in a 4.5 mm pupil, the CDVA obtained with the pIOL prototypes decreased significantly and was more pronounced when the spherical aberration induced was negative. The depth of focus increment was larger with the highest spherical aberration added and with a small pupil. Nevertheless, it was independent of the sign of the added spherical aberration. The outcomes show that residual negative spherical aberration after pIOL implantation will disrupt the CDVA. However, some residual positive spherical aberration after pIOL implantation increased the depth of focus with excellent CDVA, providing a possible pIOL design for young presbyopic patients. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  4. Corneal astigmatism analysis for toric intraocular lens implantation: precise measurements for perfect correction.

    PubMed

    Lee, Hun; Kim, Tae-Im; Kim, Eung Kweon

    2015-01-01

    Corneal astigmatism is a common refractive error observed in a significant percentage of cataract patients. Accurate measurements of the preexisting corneal astigmatism are essential in order to achieve the desired refractive outcome after toric intraocular lens (IOL) implantation. This article presents a comprehensive review of recent published literatures on methods for measuring preoperative corneal astigmatism for toric IOL implantation. A variety of instruments has been introduced and used to measure the magnitude and meridian of corneal astigmatism during preoperative assessments of cataract patients. Instruments that consider both the anterior and posterior corneal surfaces as critical factors for measuring total corneal astigmatism are expected to provide better accuracy. Although these instruments facilitate improved evaluations of corneal astigmatism and have helped minimize postoperative residual astigmatism, a perfect method to analyze preoperative corneal astigmatism has not yet been established. Perfect correction of astigmatism after toric IOL implantation by using accurate corneal astigmatism values is the goal of this surgical procedure. To achieve this, correct and precise measurements of corneal astigmatism to determine the magnitude and meridian should be obtained.

  5. Primary piggyback implantation using the ReSTOR intraocular lens: case series.

    PubMed

    Akaishi, Leonardo; Tzelikis, Patrick F

    2007-05-01

    To assess the postoperative outcomes of piggyback implantation using the AcrySof ReSTOR intraocular lens (IOL) (model SA60D3, Alcon Surgical Laboratories). Hospital Oftalmológico de Brasília, Brasília, Brazil. Thirteen eyes of 7 patients who had phacoemulsification with piggyback IOL implantation were analyzed prospectively. In all cases, a ReSTOR IOL was implanted in the capsular bag and a second silicone IOL was implanted in the ciliary sulcus. Information collected included uncorrected visual acuity (UCVA) at near and distance, best corrected visual acuity (BCVA), and spherical equivalent (SE) before and after surgery. The patients were followed for 12 months. The mean distance UCVA was 0.25 (20/80) preoperatively and 0.88 (20/23) at the last follow-up (1 year), which was significantly better than before surgery (P<.05). The mean SE was +4.25 diopters (D) +/- 1.5 (SD) preoperatively and +0.15 +/- 0.44 D (range -0.50 to +0.75 D) at 1 year, which was significantly better than preoperatively (P<.05). No patient lost lines of BCVA after surgery. At the last follow-up, all eyes had a near UCVA of J1 and none required spectacles for near or distance vision. Piggyback implantation using the ReSTOR IOL appeared to be a safe and efficient procedure providing high-quality visual acuity for near and distance vision in selected patients.

  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. © 2016 Wiley Periodicals, Inc.

  7. Management of corneal decompensation 4 decades after Sputnik intraocular lens implantation.

    PubMed

    Hirji, Nashila; Nanavaty, Mayank A

    2015-01-01

    We report an unusual case of corneal decompensation occurring four decades after complicated cataract extraction with implantation of a Sputnik intraocular lens (IOL) and highlight the clinical and practical issues faced in managing corneal decompensation with a Sputnik IOL. A 72-year-old woman presented with deterioration of the vision in her left eye, four decades after intracapsular cataract extraction with Sputnik IOL implantation. Ocular examination revealed diffuse corneal edema and thickened vitreous strands in the anterior chamber. Her best-corrected visual acuity (BCVA) worsened to 6/60 within 3 months. Anterior vitrectomy and inferior iridectomy combined with Desçemet-stripping automated endothelial keratoplasty was performed. The procedure was successful, with the patient achieving best-corrected visual acuity of 6/6 at 8 months postoperatively. Corneal decompensation after Sputnik IOL implantation can occur four decades later. When the historical preoperative visual acuity is good in such cases, careful anterior vitrectomy with Desçemet-stripping automated endothelial keratoplasty provides good visual rehabilitation.

  8. Ultrasound biomicroscopic analysis of iris-fixed acrylic intraocular lens in the absence of capsule support.

    PubMed

    Avitabile, Teresio; Bonfiglio, Vincenza; Castiglione, Francesco; Gagliano, Caterina; Reibaldi, Michele; Pulvirenti, Manuela; Reibaldi, Alfredo

    2012-12-01

    The aim of the study was to investigate postoperative complications and to determine with ultrasound biomicroscopy (UBM) the position of a foldable acrylic intraocular lens (IOL) implanted with a surgical technique of iris suturing in eyes without capsule support. Six eyes with iris-sutured IOLs were examined postoperatively with UBM. The examination included the position of haptics and their relationship to the surrounding structures. Other parameters studied were central anterior chamber depth, IOL iris contact and pigment dispersion. The position of all 12 haptics was determined. All haptics were in touch with the iris. Pigment dispersion was seen in two cases. The anterior chamber depth of the sutured eyes was normal. There was neither cystoid macular edema nor chronic uveitis postoperatively. In conclusion, in most cases surgical placement of iris-fixed lenses is a blind procedure and UBM could be an appropriate method to determine the position of IOL haptics postoperatively and to demonstrate that this surgical technique is reproducible, safe, and effective with the limitation of the difficulty of iris suturing IOL.

  9. Posterior capsule opacification 9 years after phacoemulsification with a hydrophobic and a hydrophilic intraocular lens.

    PubMed

    Chang, Anthony; Kugelberg, Maria

    2017-03-10

    To compare the development of posterior capsule opacification (PCO) and survival rate without capsulotomy after implantation of a hydrophobic or hydrophilic acrylic intraocular lens (IOL) at the 9-year postoperative follow-up. One of 3 experienced cataract surgeons performed standard phacoemulsification in one eye of 120 patients with cataract. The patients were randomized to implantation of either a hydrophobic acrylic IOL or a hydrophilic acrylic IOL. Both IOLs had sharp posterior edges. Retroillumination images of PCO were obtained with a fundus camera 9 years postoperatively and analyzed semiobjectively using POCOman computer software. Seventy-eight of the 120 patients completed the 9-year follow-up examination. Patients implanted with the hydrophilic IOL had significantly (p<0.001) more and denser PCO. The survival rate without Nd:YAG capsulotomy was significantly higher (p<0.001) in eyes with the hydrophobic IOL. After 9 years, more and denser PCO developed in eyes with the hydrophilic IOL than the hydrophobic IOL. The survival rate without the need for capsulotomy was higher in eyes with the hydrophobic IOL.

  10. Long-term corneal endothelial cell changes in pediatric intraocular lens reposition and exchange cases.

    PubMed

    Wang, Yan; Wu, Mingxing; Zhu, Liyuan; Liu, Yizhi

    2012-04-01

    To evaluate long-term corneal endothelial cell changes of intraocular lens (IOL) reposition and exchange in children. State key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China In this retrospective study, all IOL reposition and exchange procedures performed in patients under 14 years old between January 1999 and April 2009 were included. Follow-up outcomes included corneal endothelial cell density, hexagonality, coefficient of variance, average cell size. IOL reposition procedures in 12 eyes (12 cases) (reposition group, RPG), and IOL exchanges in eight eyes (eight cases) (exchange group, EXG) were performed because of IOL pupillary capture or IOL dislocation. Median of follow-up was 44.5 months in RPG and 66.2 months in EXG. The density of corneal endothelial cells in RPG (2,053 ± 493/mm(2)) and EXG (2,100 ± 758/mm(2)) was significantly decreased in comparison to the control eyes (3,116 ± 335/mm(2)). Hexagonality of corneal endothelial cells and coefficient of variance showed no difference among the control group, RPG and EXG (P > 0.05). The density of corneal endothelial cells was conspicuously decreased after IOL reposition or exchange procedures in childhood cases. Longer follow-up must be conducted in these cases.

  11. Opacification of hydrophilic acrylic intraocular lens attributable to calcification: investigation on mechanism.

    PubMed

    Gartaganis, Sotirios P; Kanellopoulou, Dimitra G; Mela, Ephigenia K; Panteli, Vassiliki S; Koutsoukos, Petros G

    2008-09-01

    To identify the nature and to investigate the biochemical mechanisms leading to late opacification of implanted hydrophilic acrylic intraocular lenses (IOLs). Retrospective laboratory investigation. setting: Department of Ophthalmology, Medical School, Department of Chemical Engineering, Laboratory of Inorganic and Analytical Chemistry, University of Patras and FORTH-ICEHT, Greece. study population: Thirty IOLs were explanted one to 12 years postimplantation attributable to gradual opacification of the lens material. observation procedures: Materials analysis was done using scanning electron microscopy (SEM) equipped with a microanalysis probe (EDS), confocal microscopy, x-ray diffraction (XRD), and Fourier transform infrared (FTIR) for the identification of the substances involved in the opacified lenses. SEM investigation showed plate-like as well as prismatic nanoparticle deposits of calcium phosphate crystallites on the surface and in the interior of opacified IOLs. The plate-like deposits exhibited morphology and particle size typical for octacalcium phosphate (OCP), while the respective characteristics of the prismatic nanocrystals were typical of hydroxyapatite (HAP). EDS analysis confirmed the chemical composition of the deposits. Aqueous humor analysis showed that the humor is supersaturated with respect to both OCP and HAP, favoring the formation of the thermodynamically more stable HAP, while the formation and kinetic stabilization of other transient phases is also very likely. In vitro experiments using polyacrylic materials confirmed the clinical findings. Hydrophilic acrylic IOLs' opacification may be attributed to the deposition of calcium phosphate crystallites. HAP is the predominant crystalline phase of these crystallites. Surface hydroxyl groups of the polyacrylic materials facilitate surface nucleation and growth.

  12. Photoreversibility and Biocompatibility of Polydimethylsiloxane-Coumarin as Adjustable Intraocular Lens Material.

    PubMed

    Jellali, Rachid; Bertrand, Virginie; Alexandre, Michaël; Rosière, Nancy; Grauwels, Magda; De Pauw-Gillet, Marie-Claire; Jérôme, Christine

    2017-07-01

    Polydimethylsiloxane (PDMS) constitutes an interesting material for a variety of biomedical applications, especially as intraocular lenses (IOLs), for its excellent transparency. In this work, a photoreversible PDMS-coumarin network, whose shape and properties can be adjusted postoperatively in a noninvasive manner, is developed. The synthesis of PDMS-coumarin is achieved by amidation of a coumarin acid chloride derivative with amine-functionalized PDMSs. Under exposure of λ > 300 nm, these polymers can be cured by dimerization of coumarin. The cured polymers can be uncrosslinked via photocleavage of cyclobutane dimers upon illumination at λ < 290 nm. The diffusion of linear PDMSs in a crosslinked network and the controlled shape modification are studied, which demonstrate that these polymers are good candidates for adjustable IOL application. IOL disks prepared from these materials show high hydrophobicity and good transparency. In vitro cytotoxicity, lens epithelial cell adhesion assays, and rabbit host reaction against implanted disks demonstrate the biocompatibility of the polymer. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  13. 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

  14. Structured extracapsular cataract extraction-intraocular lens microsurgical training: report of a trainee's experience.

    PubMed

    Aghaji, A E; Natchiar, G

    2011-01-01

    The aim was to report the experience an ophthalmologist gained in a structured intraocular lens (IOL) microsurgery training program for the information and benefit of colleagues in ophthalmology training institutions. An ophthalmologist was trained in extracapsular cataract extraction (ECCE)-IOL implant in Aravind Eye Hospital (AEH), Madurai, for a period of 8 weeks. Details of patients operated on, procedures observed, and conferences attended were prospectively recorded in a log book. Training was available in conventional ECCE with posterior chamber IOL (ECCE-PCIOL), small incision sutureless cataract surgery, and phacoemulsification. During the period, this trainee observed a total of 1527 cataract extractions, administered 528 retrobulbar and 1047 facial blocks, and also operated on 75 patients. The trainee gained experience and confidence to perform high-quality, low-cost cataract surgery. Hands-on experience and competence in quality ECCE-IOL implant microsurgery can be acquired in a short period of time in a high-volume cataract center. Trainees can also be exposed to other techniques of cataract surgery. Ophthalmology training centers with diminishing surgical training opportunities can also benefit from this structured training in a high-volume cataract center like Aravind Eye Hospital.

  15. Voltage-controlled IPMC actuators for accommodating intra-ocular lens systems

    NASA Astrophysics Data System (ADS)

    Horiuchi, Tetsuya; Mihashi, Toshifumi; Fujikado, Takashi; Oshika, Tetsuro; Asaka, Kinji

    2017-04-01

    An ion polymer–metal composite (IPMC) actuator has unique performance characteristics that were applied in this study for use within the eye. Cataracts are a common eye disease causing clouding of the lens. To treat cataracts, surgeons replace clouded lenses with intraocular lenses (IOLs). However, patients who receive this treatment must still wear reading glasses for tasks requiring close-up vision. We suggest a new voltage-controlled accommodating IOL consisting of an IPMC actuator to change the lens’ focus. We examined the relationship between the displacement performance of an IPMC actuator and the accommodating range of the IOL using in vitro experiments. We show that this system has an accommodating range of approximately 1.15 D under an applied voltage of ±1.2 V. By Lagrange interpolation, we estimate that with an IPMC actuator displacement of 0.14 mm, we can achieve a refractive power of 4 D, which is equivalent to the accommodating range of a 40 year old person.

  16. 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

  17. Triple procedure; analysis of outcome, refraction, and intraocular lens power calculation

    PubMed Central

    Geerards, A.; Hassmann, E.; Beekhuis, W; Remeyer, L; van Rij, G.; Rijneveld, W.

    1997-01-01

    AIMS—A total of 97 triple procedures performed over a 6 year period were studied retrospectively to determine the best approach to calculate intraocular lens power.
METHODS—The cases were divided into two diagnostic categories.
RESULTS—After 1 year best corrected visual acuity was 20/40 or better in 37.5% of the cases of the `modified group'. This group consists of patients with the diagnosis Fuchs' dystrophy, non-guttate endothelial dystrophy, and Reis-Buckler dystrophy. Analysis of visual acuity was made using logMAR. A final postoperative refraction within 2 dioptres of predicted refraction was achieved in 76.5% of patients in the modified group.
CONCLUSION—In future, in the absence of a keratometry, a keratometry value of 7.49 mm will be used for calculation of the power of the implant as analysed in this study.

 PMID:9422932

  18. Effect of incision types for Artisan phakic intraocular lens implantation on ocular higher order aberrations

    PubMed Central

    Park, Young Min; Choi, Bong Joon; Lee, Jong Soo

    2016-01-01

    AIM To evaluate the effect of incision types for Artisan phakic intraocular lens (PIOL) implantation on ocular higher-order aberrations (HOAs). METHODS A retrospective review was conducted of the patients who had undergone Artisan PIOL implantation for the correction of myopia and followed up for at least 6mo. Patients are classified into 2 groups considering the incision type: cornea group with patients undergone clear corneal incision; sclera group with patients undergone sclera tunnel incision. All patients with postoperative astigmatism of under 1 diopter (D) were included to minimize the effect of residual astigmatism on postoperative HOAs. Visual acuity, special equivalents, astigmatism, predictability (±1 D from target refraction), HOAs (coma, trefoil, spherical aberration), and corneal endothelial counts were analyzed preoperatively and 6mo postoperatively. RESULTS At the postoperative 6mo, all patients of both groups achieved uncorrected visual acuity of 16/20 or better, and significantly decreased the spherical equivalents compared with preoperative values. The predictability of refractive correction was 96% in the former, and 94% in the latter. Unlike the sclera group, preoperative astigmatism decreased significantly in cornea group at postoperative 6mo. The HOAs increased significantly at postoperative 6mo compared to the preoperative values in both groups, and the root mean square (RMS) total and trefoil wavefront aberration of cornea group were significantly higher than those of sclera group. CONCLUSION Although corneal incision significantly reduces preexisting astigmatism, the postoperative 6mo of total RMS and trefoil aberration change may deteriorate the visual quality after Artisan PIOL implantation. PMID:28003980

  19. Accuracy of the newer generation intraocular lens power calculation formulas in long and short eyes.

    PubMed

    Olsen, T; Thim, K; Corydon, L

    1991-03-01

    The accuracy of two newer generation theoretical intraocular lens (IOL) power calculation formulas and of the empirical SRK I and II formulas was evaluated in a series of 500 IOL implantations including a series of unusually long and short eyes. The prediction error of the theoretical formulas was found to be largely unaffected by the variation in axial length and corneal power, while the prediction of the SRK I formula was less accurate in the short and long eyes. The prediction of the SRK II formula was more accurate than the SRK I in that no systematic offset error with axial length could be demonstrated. However, because of a relatively larger scatter in the long eyes and a significant bias with the corneal power, the absolute error of the SRK II formula was higher than that of the theoretical formulas in the long eyes. The higher accuracy of the newer generation theoretical formulas was attributed to their improved prediction of the pseudophakic anterior chamber depth.

  20. Capsular bag stabilization during lens extraction and intraocular lens implantation in cases of Marfan syndrome with ectopia lentis using ultra-high-viscosity ophthalmic viscosurgical devices.

    PubMed

    Rosenthal, Kenneth J; Venkateswaran, Nandini

    2016-10-01

    Capsule-sparing lens surgery in the setting of compromised zonular support presents several surgical challenges. One challenge has been achieving early stabilization of the capsular bag prior to cataract removal. We developed a technique that uses a high-molecular-weight viscoadaptive substance to distend and stabilize the capsular bag from within, with or without early insertion of a capsular tension ring, during lens extraction and intraocular lens (IOL) implantation in cases of zonular insufficiency. The technique obviates the use of capsule hooks or similar devices that have been used traditionally for early stabilization of the capsular bag. It has also resulted in immediate and long-term stability of the IOL-zonule-capsular bag complex, with excellent visual outcomes in both pediatric and adult patients.

  1. A Randomized Clinical Trial Comparing Contact Lens to Intraocular Lens Correction of Monocular Aphakia During Infancy: Grating Acuity and Adverse Events at Age 1 Year

    PubMed Central

    2011-01-01

    Objective To compare the visual outcomes and adverse events of contact lens to primary intraocular lens (IOL) correction of monocular aphakia during infancy. Methods In a randomized, multicenter (12 sites) clinical trial, 114 infants with a unilateral congenital cataract were assigned to undergo cataract surgery between 1 to 6 months of age either with or without primary IOL implantation. Contact lenses were used to correct aphakia in patients who did not receive IOLs. Grating visual acuity was tested at 1 year of age by a masked traveling examiner Main Outcome Measures Grating visual acuity at 1 year of age. Results The median logMAR visual acuity was not significantly different between the treated eyes in the two groups (CL = 0.80, IOL = 0.97, p =.20). More patients in the IOL group underwent one or more additional intraocular surgeries than patients in the CL group (63% vs 12%; p <.0001). Most of these additional surgeries were performed to clear lens reproliferation and pupillary membranes from the visual axis. Conclusions There was no statistically significant difference in grating visual acuity at age 1 year between the IOL and CL groups; however, additional intraocular surgeries were performed more frequently in the IOL group. Application to Clinical Practice Until longer term follow-up data are available, caution should be exercised when performing IOL implantation in children 6 months of age or younger given the higher incidence of adverse events and the absence of an improved short-term visual outcome compared to contact lens use. PMID:20457949

  2. [Results of intraocular lens implantation on top of the anterior capsule in cases of phaco complications].

    PubMed

    Sheludchenko, V M; Sheludchenko, N V; Éksarenko, O V; Poleva, R P

    2014-01-01

    Posterior capsule rupture during cataract extraction requires that the intraocular lens (IOL) implanted on top of the capsular bag was stable and well-centered. The objective of this study was to evaluate the results of Rayner C-flex aspheric and M-flex aspheric (United Kingdom) IOLs implantation on top of the capsular bag and their stability in patients with phaco complications. A total of 2556 phacoemulsification cases were analyzed. Posterior capsule rupture as a complication occurred in 7 cases, that is 0.27%. In all patients Rayner C-flex (5) and M-flex (6) IOLs were implanted on top of the capsular bag according to the initial calculations and with no modifications in the procedure. The 2nd-year follow-up included measurement of the corneal compensated intraocular pressure (IOP) and B-mode and 3D grey-scale ultrasound in order to assess the structures of the anterior segment and to check the position of the IOL. All surgeries yielded positive clinical results. In 2 years after the intervention uncorrected visual acuity averaged 0.7-0.13, corrected-- 0.91+0.07; clinical refraction: sphera-- +0.46 +/- 0.26 diopters, cylinder-- 0.71 +/- 0.29 diopters. The shape and other parameters of Rayner IOLs contribute to their long-term stability. Postoperative lOP in the treated eye was higher than in the fellow nonoperated eye (13.9 +/- 0.76 and 11.8 +/- 0.59 mmHg correspondingly) but the difference lied within the range of normal asymmetry. The 3D ultrasound technology is an informative mean of monitoring the position of the IOL in case of its extracapsular implantation; a comparatively higher IOP in the operated eye does not exceed the range of normal asymmetry between the two eyes; Rayner C-flex and M-flex IOLs remain stable and well-centered after being implanted on top of the capsular bag.

  3. 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

  4. Adhesion of lens capsule to intraocular lenses of polymethylmethacrylate, silicone, and acrylic foldable materials: an experimental study

    PubMed Central

    Oshika, T.; Nagata, T.; Ishii, Y.

    1998-01-01

    AIMS—To investigate the adhesion characteristics of several intraocular lenses (IOLs) to the simulated and rabbit lens capsule.
METHODS—Adhesive force to bovine collagen sheets was measured in water with polymethylmethacrylate (PMMA), three piece silicone, and acrylic foldable IOLs. In rabbit eyes, phacoemulsification and IOL implantation were performed. Three weeks later, adhesion between the anterior/posterior capsules and IOL optic was tested, and the capsule was examined histologically.
RESULTS—The mean adhesive force to the collagen sheet was 1697 (SD 286) mg for acrylic foldable, 583 (49) mg for PMMA, and 0 mg for silicone IOLs (p=0.0003, Kruskal-Wallis test). Scores (0-5) of adhesion between rabbit anterior capsule and IOL optic were 4.50 (0.55) for acrylic foldable, 3.20 (0.84) for PMMA, and 0.40 (0.55) for silicone IOLs (p=0.004). Scores between rabbit posterior capsule and IOL optic displayed a similar tendency; 4.50 (0.84) for acrylic foldable, 3.00 (1.00) for PMMA, and 0.40 (0.55) for silicone IOLs (p=0.021). Histological observation indicated that the edge of IOL optic suppressed the migration of lens epithelial cells towards the centre of the posterior capsule. This inhibitory effect was most pronounced with acrylic foldable IOL and least with silicone IOL.
CONCLUSIONS—The acrylic foldable IOL adhered to the lens capsule more than the PMMA IOL, and the silicone IOL showed no adhesiveness. These differences seem to play a role in preventing lens epithelial cells from migrating and forming posterior capsule opacification.

 Keywords: intraocular lens; lens capsule; posterior capsule opacification; adhesion PMID:9713064

  5. Effects of phacoemulsification and intraocular lens implantation combined with ciliarotomy in the treatment of angle-closure glaucoma with cataract

    PubMed Central

    Li, Bo; Wang, Feng-Yun; Lv, Tai-Liang; Zhu, Yu

    2016-01-01

    The aim of the present study was to examine the effects of phacoemulsification and intraocular lens implantation combined with ciliarotomy in the treatment of angle-closure glaucoma with cataract in the elderly. A total of 68 patients were consecutively selected and divided into the control group with 33 cases (48 eyes) and the observation group with 35 cases (53 eyes). Cataract surgery combined with trabeculectomy was performed on the patients in the control group and phacoemulsification cataract extraction combined with ciliarotomy was performed on the subjects in the observation group, to compare postoperative effects and complications. Following surgery, the visual acuity of patients in the two groups significantly improved, intraocular pressure decreased, and improvement of the observation group was more evident (P<0.05). Following surgery, the depth of central anterior chamber and width of chamber angle of patients in two groups was increased, and improvement of the observation group was significantly more evident (P<0.05). Additionally, the incidence of complications, including corneal swelling, shallow of anterior chamber, fibrinous exudate in iris, and filtering bleb leaking and following cataract removal, of patients in the observation group was significantly reduced compared to the control group (P<0.05). In summary, the results of the present study show that, phacoemulsification and intraocular lens implantation combined with ciliarotomy in the treatment of angle-closure glaucoma with cataract in the elderly is a safe and effective method and should be applied in the clinic. PMID:27698750

  6. Transscleral intraocular lens fixation with preservation of the anterior vitreous face in patients with marfan syndrome and ectopia lentis.

    PubMed

    Kim, Wan-Soo

    2010-11-01

    To evaluate the safety and efficacy of transscleral intraocular lens fixation with preservation of the anterior vitreous in the treatment of ectopia lentis in patients with Marfan syndrome. Patients who had undergone surgical intervention for ectopia lentis with or without lenticular opacity were included. Best-corrected visual acuity before and after surgery was compared. Perioperative complications were evaluated. A total of 23 patients (45 eyes) whose mean age at surgery was 16.9 ± 8.9 years were recruited. The mean follow-up period was 10.1 ± 5.8 months. Mean best-corrected visual acuity change (with respect to preoperative logarithm of the minimum angle of resolution value) was 1.03 ± 0.39. All patients showed >2 lines of improvement in visual acuity. Pupillary capture was found in 6 eyes. Medically controllable intraocular pressure elevation was noted in 12 eyes. Transscleral intraocular lens fixation with preservation of the anterior vitreous face is a safe and effective technique for treatment of ectopia lentis in patients with Marfan syndrome.

  7. Clinical outcomes of new toric trifocal diffractive intraocular lens in patients with cataract and stable keratoconus

    PubMed Central

    Farideh, Doroodgar; Azad, Sanginabadi; Feizollah, Niazi; Sana, Niazi; Cyrus, Alinia; Mohammad, Ghoreishi; Alireza, Baradaran-rafii

    2017-01-01

    Abstract Purpose: To evaluate the clinical results of toric trifocal diffractive intraocular lens in eyes with cataract and mild keratoconus. Methods: Five keratoconus patients (10 eyes) that had bilateral AT LISA 939 implantation were selected and had followed in 3-time horizons of 1, 3, and 6 months. Patients were 46 to 65 years old age, corneal astigmatism of (2.00 D at 6.75 D) and cataract that all of them needed cataract surgery. The distance, intermediate and near visual acuities, defocus curve, ocular aberrations, contrast sensitivity, were measured as effectiveness criteria. Results: Average of binocular uncorrected distance visual acuity (UDVA) improved from 0.72 log MAR ± 0.11 (SD) to 0.04 ± 0.04 (P < 0.05) log MAR, average of uncorrected binocular intermediate visual acuity (UIVA) (80 cm) improved from 0.52 ± 0.07 log MAR to 0.14 ± 0.04 (P < 0.05) log MAR, and average of binocular uncorrected near visual acuity (UNVA) improved from 0.48 ± 0.09 log MAR to 0.02 ± 0.07 (P < 0.05) log MAR at 6 months, respectively. Contrast sensitivity testing showed acceptable results, the binocular defocus curve corroborate were in appropriate good visual acuity even at the intermediate distances, by a gentle slope less than log MAR 0.2 at −1.5 D, with regard to the best distance visual acuity at the 0 D defocus. Conclusions: Trifocal AT LISA 939MP IOLs provided appropriate distances, near and intermediate of the visual results. Prediction of the refractive results and optical performances were good. PMID:28328814

  8. Intraocular lens power calculation for humanitarian missions based on partial biometry.

    PubMed

    Schmitz, Joseph W; Davis, Kimberly D; McClatchey, Scott K

    2012-07-01

    To determine whether the correlation between corneal power (K) and axial length (AL) can be used for intraocular lens (IOL) power calculation when biometric data are incomplete. Developing regions served by United States Navy humanitarian assistance missions. Case series. Measurements of K and AL were collected from all adult cataract surgery charts and used to calculate emmetropic IOL powers. A formula for estimating K or AL was derived by Deming regression analysis. The emmetropic IOL powers were calculated by hypothetical scenarios as follows: (1) K estimated from the formula and measured AL, (2) mean population K and measured AL, (3) measured K and estimated AL, and (4) measured K and mean population AL. The mean absolute refractive error (MAE) was calculated for each hypothetical scenario and an additional scenario (scenario 5) using single IOL power for all eyes. The MAEs were compared with a paired t test. The formula derived from Deming regression analysis was K = 74.56 - 1.317 × AL. The MAE for the scenarios were (1) 0.90 diopters (D), (2) 1.11 D, (3) 1.91 D, (4) 1.55 D, and (5) 1.22 D. The MAE for scenario 1 was significantly less (P<.01) than that for scenarios 2 and 5. The MAE for scenario 5 was significantly less than that for scenarios 3 and 4. The correlation between K and AL can be used to improve accuracy of IOL calculation when K is unavailable. When the AL is unavailable, the mean population IOL power is most accurate. No author has a financial or proprietary interest in any material or method mentioned. Published by Elsevier Inc.

  9. Phakic posterior chamber intraocular lens for unilateral high myopic amblyopia in Chinese pediatric patients

    PubMed Central

    Zhang, Jing; Li, Jin-Rong; Chen, Zi-Dong; Yu, Min-Bin; Yu, Ke-Ming

    2016-01-01

    AIM To assess the outcomes of posterior chamber implantable collamer lens (ICL) implantation in Chinese pediatric patients with unilateral high myopic amblyopia. METHODS Eleven eyes of 11 amblyopic patients aged 11.02±3.34y underwent ICL (model V4, Staar Surgical Inc.) implantation to treat unilateral anisometropia were studied. Visual acuity, cycloplegic refraction, contrast sensitivity, stereopsis, intraocular pressure (IOP), vaulting, corneal endothelial cell count and complications were evaluated. Patients completed follow-up at 3d, 1, 3mo and the last follow-up time (mean 8.18±2.82mo) after surgery. RESULTS The mean myopic anisometropia was -13.70±3.25 D preoperatively and +0.69±2.63 D at 8mo postoperatively. The logMAR corrected distance visual acuity (CDVA) of the amblyopic eye was 1.51±0.72 preoperatively and 0.75±0.40 at 8mo postoperatively. The logMAR CDVA at 3d, 1, 3 and 8mo postoperatively improved by a mean of 0.64, 1.55, 1.82 and 2.64 lines and gained more than 2 lines accounted for 18%, 45%, 45%, 64%, respectively. The contrast sensitivity of 0.5, 1 and 2 cpd in amblyopic eyes was significantly increased after surgery. No patient had near stereopsis recovery. The vaulting at 3 and 8mo was significantly lower than that at 1mo postoperatively. No other intraoperative or postoperative complications were observed, except an acute pupillary block glaucoma happened in a patient at two weeks postoperatively. CONCLUSION This short-term results indicate that ICL implantation can be a promising alternative therapy for high myopic anisometropic amblyopia in pediatric patients who have failed with conventional treatments and not suitable to corneal refraction surgery. PMID:28003981

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

    PubMed

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

    2014-05-01

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

  11. Changes in higher order aberrations and contrast sensitivity after implantation of a phakic artisan intraocular lens.

    PubMed

    Chung, So-Hyang; Lee, Seung Jae; Lee, Hyung Keun; Seo, Kyoung Yul; Kim, Eung Kweon

    2007-01-01

    To evaluate higher-order aberrations (HOAs) and contrast sensitivity (CS), and investigate their relationship, after implantation of a phakic Artisan intraocular lens (IOL) for high myopia. A prospective study including 25 eyes of 15 patients with high myopia (greater than -8.00 D) who underwent phakic Artisan IOL implantation was carried out. Uncorrected visual acuity (UCVA), best corrected visual acuity, manifest refraction, and pupil diameter were measured at baseline and at 1 and 3 months postoperatively. HOAs were measured by Wavescan(R) (VISX Inc., Santa Clara, Calif., USA) from the 3.0 mm pupil entrance, and CS was measured using the VCTS(R) 6500 (Vistech consultants, Inc., Dayton, Ohio, USA) under photopic conditions. The area under the log contrast sensitivity function (AULCSF), defined as the integration of the fitted third order polynomial of the log CS units between the fixed limits of 0.18 (1.5 CPD) and 1.25 (18 CPD) on the log spatial frequency scale, was calculated. UCVA LogMAR improved from 1.58 at baseline to 0.22 at 3 months, and spherical equivalent refraction was -0.77 +/- 0.34 D at 3 months. The total HOAs had increased slightly at 1 month. CS had decreased significantly at all cycles per degree (p < 0.05) at 1 month, but returned to baseline values at 3 months. Postoperative AULCSF did not correlate with total HOAs under photopic conditions, but correlated with UCVA LogMAR at 1 month (p = 0.037). Phakic Artisan IOL implantation for the correction of high myopia resulted in a small increase of HOAs under photopic conditions. At 1 month, CS was decreased, but returned to baseline at 3 months under photopic conditions. Postoperative AULCSF did not correlate with total HOAs at 1 month. Copyright (c) 2007 S. Karger AG, Basel.

  12. Comparison of outcomes of primary and secondary implantation of scleral fixated posterior chamber intraocular lens

    PubMed Central

    Lee, V Y W; Yuen, H K L; Kwok, A K H

    2003-01-01

    Aim: To assess and compare the results of primary and secondary implantation of scleral fixated posterior chamber intraocular lens (SFIOL). Methods: The medical records of a consecutive series of 55 eyes of 55 patients with SFIOLs implanted during (group 1) or after (group 2) complicated senile cataract surgery were retrospectively reviewed and analysed. Results: There were 30 and 25 eyes in group 1 and 2, respectively. Follow up was from 6 to 36 months. Mean logMAR postoperative best corrected visual acuity in group 1 was not significantly different (0.50 (SD 0.36)) from that of group 2 (0.36 (0.21)) (p = 0.109). Postoperative best corrected visual acuity of 6/12 or better was achieved in 58.6% and 76.0% in group 1 and 2, respectively. The difference was not statistically significant (p = 0.177). In group 1, 25 (83.3%) eyes had a total of 55 early complications, while in group 2, 16 (64%) eyes had 26 early complications (p = 0.028). The difference in early complication was statistically significant. For late complication after 1 month, 21 (70.0%) eyes had a total of 37 complications in group 1, while 13 eyes (52.0%) had 19 complications in group 2 (p = 0.077). The difference in late complication was not statistically significant. Conclusion: Secondary implantation of SFIOL after cataract extraction seems to have a lower early complication rate than primary implantation in complicated cataract extraction although the final visual acuity and late complication rate are not significantly different. PMID:14660452

  13. Secondary intraocular lens implantation following infantile cataract surgery: intraoperative indications, postoperative outcomes.

    PubMed

    Wood, K S; Tadros, D; Trivedi, R H; Wilson, M E

    2016-09-01

    PurposeThe purpose of this study was to determine the long-term complications and outcomes of secondary intraocular lens (IOL) implantation in patients with congenital cataracts.Patients and MethodsThe medical records of children operated for secondary IOL implantation surgery between 2000 and 2014 were retrospectively reviewed. Those who had undergone their initial congenital cataract surgery before 7 months of age were included and were analyzed for intra- and postoperative factors and postoperative refractive outcomes. We focused on three complications: visual axis opacification (VAO), glaucoma, and IOL exchange after at least 1 year of follow-up.ResultsA total of 49 eyes of 49 patients were analyzed for intraoperative indications. Of those, 37 eyes of 37 patients had at least 1 year of follow-up and were analyzed for postoperative outcomes. The mean age at secondary implantation was 55.2±21.6 months. At secondary implantation, 69.4% of eyes were implanted in the capsular bag, 28.6% in the sulcus, and 2.0% that were angle-supported. There was no significant correlation between the site of secondary IOL implantation and age at implantation (P=0.216). The mean follow-up after implantation was 57.6±33.6 months. The rate of VAO was 5.4%, the rate of glaucoma occurring after secondary implantation was 16.2%, and the rate of IOL exchange was 2.7%. The median visual acuity at final follow-up was 20/40. For patients with unilateral cataracts it was 20/60 and for bilateral patients it was 20/30.ConclusionsThe secondary IOL implantation in children is a relatively safe procedure associated with low rates of postoperative complications. Visual outcomes are acceptable and are better for bilateral patients than for unilateral patients.

  14. 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

  15. Impact of Posterior Corneal Surface on Toric Intraocular Lens (IOL) Calculation.

    PubMed

    Preussner, Paul-Rolf; Hoffmann, Peter; Wahl, Jochen

    2015-01-01

    To quantify the impact of posterior cornea on toric IOL calculation accuracy using Placido-topography of anterior corneal surface and Scheimpflug measurements of corneal thickness. Three-hundred seventy-nine non-selected eyes undergoing cataract surgery with non-toric intraocular lens (IOL) implantation were measured with TMS-5 (Tomey, Japan), IOLMaster (Zeiss, Germany) and Lenstar (Haag-Streit, Switzerland). Anterior, posterior and total measured corneal astigmatisms were compared with astigmatisms from postoperative refraction by calculating vector differences. The average absolute vector difference between anterior astigmatism and total astigmatism combining the measurements of anterior and posterior cornea was only 0.3 ± 0.2 D, with a median of only 0.27 D, but a maximum of 1.5 D. Measurements of anterior cornea alone show a systematic difference from refractive cylinder of 0.3-6 D at 90, 0.38 D at 89° and 0.28 D at 91° (IOLMaster, Lenstar and anterior TMS5), whereas the total TMS5 cylinder differs on average by only 0.14D at 81° from the refractive cylinder. With-the-rule (WTR) corneal astigmatism is slightly reduced and against-the-rule (ATR) astigmatism slightly increased on average when posterior corneal surface is taken into account additionally. This could also be confirmed by the calculation of an average pachymetry of all eyes in which the thinnest central part shows an ellipsoidal shape with horizontally long axis. Measurements of posterior cornea have on average only a small but significant impact on the outcome of toric IOL calculation, however, they are nevertheless recommended to detect outliers in which corneal irregularities (e.g. beginning keratokonus) may be overlooked.

  16. Results of congenital cataract surgery with and without intraocular lens implantation in infants and children.

    PubMed

    Borisovsky, Gilad; Silberberg, Gilad; Wygnanski-Jaffe, Tamara; Spierer, Abraham

    2013-09-01

    Operations for congenital cataract in children in the past had resulted in aphakia. Improvement in surgical tools and techniques as well as in intraocular lens (IOL) implantation has led to correction of the aphakia by IOL implantation. We report the outcome of cataract surgery with and without IOL on these children in our institution between 1991-2008. In this retrospective cohort study, the medical records of all children who underwent surgery for congenital cataract were reviewed. The final study group included 144 children (218 eyes). Postoperative visual acuity (VA) was tested either by Teller Acuity Cards (in preverbal children) or by the Snellen chart. Data on VA status and postoperative complications were retrieved. Patients with bilateral cataract had better postoperative VA than patients with unilateral cataract (logMAR 0.559 ± 0.455 vs. 0.919 ± 0.685, respectively, P < 0.001). Children who underwent IOL implantation had better postoperative VA than those who did not, but the type of surgery had no significant effect after correction for the child's age at surgery (P = 0.346). Secondary cataract occurred more frequently in the extra-capsular cataract extraction (ECCE) + IOL implantation group than in the ECCE only group (20.6 % vs. 8.3 %, respectively, P = 0.018). Patients with bilateral cataract had better postoperative VA compared with those with unilateral cataract. The type of surgery had no effect on final VA, but there was a higher rate of secondary cataract in the ECCE + IOL patients compared to the ECCE only patients.

  17. 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

  18. 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

  19. Introduction of a Toric Intraocular Lens to a Non-Refractive Cataract Practice: Challenges and Outcomes

    PubMed Central

    Kirwan, Clare; Nolan, John M; Stack, Jim; Dooley, Ian; Moore, Johnny; Moore, Tara CB; Beatty, Stephen

    2016-01-01

    Aim To identify challenges inherent in introducing a toric intraocular lens (IOL) to a non-refractive cataract practice, and evaluate residual astigmatism achieved and its impact on patient satisfaction. Methods Following introduction of a toric IOL to a cataract practice with all procedures undertaken by a single, non-refractive, surgeon (SB), pre-operative, intra-operative and post-operative data was analysed. Attenuation of anticipated post-operative astigmatism was examined, and subjectively perceived visual functioning was assessed using validated questionnaires. Results Median difference vector (DV, the induced astigmatic change [by magnitude and axis] that would enable the initial surgery to achieve intended target) was 0.93D; median anticipated DV with a non-toric IOL was 2.38D. One eye exhibited 0.75D residual astigmatism, compared to 3.8D anticipated residual astigmatism with a non-toric IOL. 100% of respondents reported satisfaction of ≥ 6/10, with 37.84% of respondents entirely satisfied (10/10). 17 patients (38.63%) reported no symptoms of dysphotopsia (dysphoptosia score 0/10), only 3 respondents (6.8%) reported a clinically meaningful level of dysphotopsia (≥ 4/10). Mean post-operative NEI VF-11 score was 0.54 (+/-0.83; scale 0 – 4). Conclusion Use of a toric IOL to manage astigmatism during cataract surgery results in less post-operative astigmatism than a non-toric IOL, resulting in avoidance of unacceptable post-operative astigmatism. PMID:27830188

  20. Late in-the-bag intraocular lens dislocation requiring explantation: risk factors and outcomes

    PubMed Central

    Fernández-Buenaga, R; Alio, J L; Pérez-Ardoy, A L; Larrosa-Quesada, A; Pinilla-Cortés, L; Barraquer, R; Alio, J L; Muñoz-Negrete, F J

    2013-01-01

    Purpose To study the predisposing factors for late in-the-bag intraocular lens (IOL) dislocation and to analyze the outcomes after explantation surgery. Methods In this retrospective multicentre study, 61 eyes were enrolled. The main inclusion criterion was in-the-bag spontaneous IOL dislocation after uneventful phacoemulsification cataract extraction. Only eyes with serious dislocation that required IOL explantation were eligible. Follow-up after explantation surgery of at least 3 months was required. Exclusion criteria were complicated cataract surgery, out-of-the-bag IOL dislocation, and dislocations that occurred in the first year after the cataract surgery. The main outcome measures were predisposing factors for dislocation, interval between cataract surgery and dislocation, surgical treatment at the time of explantation, preoperative and postoperative corrected distance visual acuity (CDVA), and postoperative complications. Results High myopia was detected in 12 cases (19.7%) and it was the main predisposing factor. Mean time interval from cataract surgery to dislocation was 7.5 (SD 5.2) years. The dislocated in-the-bag IOL was replaced with a scleral fixated IOL (36.1%), angle-supported anterior chamber IOL (31.1%), sulcus repositioning (18%), or posterior chamber iris sutured IOL (4.9%). Finally, 9.8% of the patients were left aphakic. Mean CDVA improved significantly after surgery (P=0.005). Final CDVA of 20/40 or better was achieved in 29 cases (47.5%). Conclusions High myopia was the main risk factor for late in-the-bag IOL dislocation. Surgical treatment significantly improved the CDVA in our sample and was associated with a low complication rate. PMID:23764989

  1. Optimizing intraocular lens power calculations in eyes with axial lengths above 25.0 mm.

    PubMed

    Wang, Li; Shirayama, Mariko; Ma, Xingxuan Jack; Kohnen, Thomas; Koch, Douglas D

    2011-11-01

    To evaluate the accuracy of refractive prediction of 4 intraocular lens (IOL) power calculation formulas in eyes with axial length (AL) greater than 25.0 mm and to propose a method of optimizing AL to improve the accuracy. Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA, and Department of Ophthalmology, Goethe University, Frankfurt am Main, Germany. Case series. Refractive prediction errors with the Holladay 1, Haigis, SRK/T, and Hoffer Q formulas were evaluated in consecutive cases. Eyes were randomized to a group used to develop the method of optimizing AL by back-calculation or a group used for validation. Further validation was performed in 2 additional data sets. The optimized AL values were highly correlated with the IOLMaster AL (R(2) from 0.960 to 0.976). In the validating group, the method of optimizing AL significantly reduced the mean numerical errors for IOLs greater than 5.00 diopters (D) from +0.27 to +0.68 D to -0.10 to -0.02 D and for IOLs of 5.00 D or less from +1.13 to +1.87 D to -0.21 to +0.01 D, respectively (all P<.05). In 2 additional validation data sets, this method significantly reduced the percentage of eyes that would be left hyperopic. The proposed method of optimizing AL significantly reduced the percentage of long eyes with a hyperopic outcome. Updated optimizing AL formulas by combining all eyes from the 2 study centers are proposed. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  2. In-the-bag scleral suturing of intraocular lens in eyes with severe zonular dehiscence

    PubMed Central

    Hayashi, K; Hirata, A; Hayashi, H

    2012-01-01

    Purpose To compare the degree of tilt and decentration of an intraocular lens (IOL), refractive status, and prediction error between eyes that underwent trans-scleral suturing of the IOL within the capsular bag (in-the-bag scleral suturing) and eyes that underwent scleral suturing outside of the bag (out-of-the-bag scleral suturing) because of severe zonular dehiscence. Patients and methods Thirty eyes that underwent in-the-bag scleral suturing of an IOL and 38 eyes that underwent out-of-the-bag scleral suturing were recruited sequentially. The tilt and decentration of the IOL, anterior chamber depth, manifest refractive spherical equivalent (MRSE), prediction error, and incidence of complications were examined. Results The mean tilt angle and the decentration length of the IOL of the in-the-bag suturing group were significantly less than those of the out-of-the-bag suturing group (P=0.0003 in tilt and P=0.0391 in decentration), although the anterior chamber depth was similar. The mean MRSE and prediction error of the in-the-bag suturing group were less than those of the out-of-the-bag suturing group (P=0.0006 in MRSE and P=0.0034 in error). The incidence of vitreous loss was less in the in-the-bag suturing group than in the out-of-the-bag suturing group (20% vs63.2%, P=0.0009). Conclusions The tilt and decentration of the IOL after in-the-bag scleral suturing are significantly less than those after out-of-the-bag scleral suturing, which may lead to less MRSE and less prediction error. As the incidence of vitreous loss is less after in-the-bag scleral suturing, in-the-bag suturing is advantageous for eyes of younger patients and of less complicated cases. PMID:21941359

  3. Predictability of intraocular lens calculation and early refractive status: the Infant Aphakia Treatment Study.

    PubMed

    VanderVeen, Deborah K; Nizam, Azhar; Lynn, Michael J; Bothun, Erick D; McClatchey, Scott K; Weakley, David R; DuBois, Lindreth G; Lambert, Scott R

    2012-03-01

    To report the accuracy of intraocular lens (IOL) power calculations and the early refractive status in pseudophakic eyes of infants in the Infant Aphakia Treatment Study. Eyes randomized to receive primary IOL implantation were targeted for a postoperative refraction of +8.0 diopters (D) for infants 28 to 48 days old at surgery and +6.0 D for those 49 days or older to younger than 7 months at surgery using the Holladay 1 formula. Refraction 1 month after surgery was converted to spherical equivalent, and prediction error (PE; defined as the calculated refraction minus the actual refraction) and absolute PE were calculated. Baseline eye and surgery characteristics and A-scan quality were analyzed to compare their effect on PE. Prediction error. Fifty-six eyes underwent primary IOL implantation; 7 were excluded for lack of postoperative refraction (n = 5) or incorrect technique in refraction (n = 1) or biometry (n = 1). Overall mean (SD) absolute PE was 1.8 (1.3) D and mean (SD) PE was +1.0 (2.0) D. Absolute PE was less than 1 D in 41% of eyes but greater than 2 D in 41% of eyes. Mean IOL power implanted was 29.9 D (range, 11.5-40.0 D); most eyes (88%) implanted with an IOL of 30.0 D or greater had less postoperative hyperopia than planned. Multivariate analysis revealed that only short axial length (<18 mm) was significant for higher PE. Short axial length correlates with higher PE after IOL placement in infants. Less hyperopia than anticipated occurs with axial lengths of less than 18 mm or high-power IOLs. Application to Clinical Practice Quality A-scans are essential and higher PE is common, with a tendency for less hyperopia than expected. clinicaltrials.gov Identifier: NCT00212134.

  4. 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

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

    PubMed

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

    2011-02-01

    To assess the long-term biocompatibility and photochromic stability of a new photochromic hydrophobic acrylic intraocular lens (IOL) under extended ultraviolet (UV) light exposure. John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. Experimental study. 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 IOL (n = 5) in left eyes of 11 New Zealand rabbits. The rabbits were exposed to a UV light source of 5 mW/cm(2) 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. 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. 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. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  6. [Enhanced near stereopsis after phacoemulsification and implantation of posterior chamber intraocular lens by prescribing addition properly].

    PubMed

    Yu, A-yong; Wang, Qin-mei; Zhuge, Jing; Jin, Wan-qing; Jiang, Jun; Zhao, Yun-e

    2008-08-01

    To improve near stereopsis in pseudophakic eyes after phacoemulsification and implantation of posterior chamber intraocular lens (IOL). This prospective case-series study comprised 92 eyes of 46 patients aged 50 to 70 years [mean age (61.33 +/- 5.54) years] who had phacoemulsification and implantation of posterior chamber IOL, including 24 unilateral pseudophakia (Group A) and 22 bilateral pseudophakia (Group B). The accommodative amplitude, relative accommodation, reading addition, near stereoacuity, etc. were measured. All data were analyzed with the SPSS11.0 for Windows. (1) The mean value of monocular accommodative amplitude in the group A and group B was (2.05 +/- 1.12) and (2.35 +/- 1.30) D, respectively. (2) In the group A and group B, the binocular add was (2.08 +/- 0.37) and (2.13 +/- 0.46) D, respectively, and the monocular add was (2.20 +/- 0.42) and (2.01 +/- 0.39) D, respectively. There was a significant difference between the binocular add and the monocular add (t = 2.33, 2.20, P<0.05) , and between left monocular add and right one (t =3.70, 5.02, P<0.01) in each group. (3) The near stereopsis with monocular add was better than that with binocular add in each group, the difference was significant (X2 = 6.46, 7.02, P = 0.04, 0.03). Monocular add is beneficial to a pseudophakia with posterior chamber IOL implantation to improve near stereopsis.

  7. 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

  8. Optical coherence tomography evaluation of posterior capsule opacification related to intraocular lens design.

    PubMed

    Moreno-Montañés, Javier; Alvarez, Aurora; Bes-Rastrollo, Maira; García-Layana, Alfredo

    2008-04-01

    To evaluate posterior capsule opacification (PCO) and the impact of different intraocular lens (IOL) models on PCO characteristics using optical coherence tomography (OCT). Eighty-three eyes with PCO (fibrosis or pearl type) and 32 pseudophakic eyes without PCO were included. Horizontal 3.0 mm long OCT scans of the posterior capsule were obtained. Measurements and means of the peak posterior capsule intensity (PCI) and posterior capsule thickness (PCT) (distance between 2 spikes at posterior capsule) at 3 scan points were recorded. The PCI and PCT were compared with best corrected visual acuity (BCVA) and IOL data. The PCT was high for IOLs with a rounded edge (P = .001) and with poly(methyl methacrylate) (PMMA) IOLs (P<.001). If the IOL optic was concave-convex, the PCT was higher than if the optic was biconvex (P = .001). The PCT of hydrophilic acrylic IOLs was higher than of hydrophobic acrylic IOLs (P = .04). Multivariate analysis of PCT showed that PMMA was the only factor statistically associated with PCT (P = .02). The worse logMAR BCVA correlated significantly with a higher PCT value (P<.001) but not with PCI (P = .42). An IOL size of 12.5 mm was related to fibrosis-type PCO (odds ratio, 3.14; P = .04). The PCT was most affected by IOL characteristics. Poly(methyl methacrylate) IOLs and IOLs with rounded edges were associated with higher PCT. Hydrophilic acrylic IOLs were associated with greater PCT than hydrophobic IOLs. Posterior capsule thickness was a factor in decreased BCVA.

  9. Meta-analysis of accuracy of intraocular lens power calculation formulas in short eyes.

    PubMed

    Wang, Qiwei; Jiang, Wu; Lin, Tiao; Wu, Xiaohang; Lin, Haotian; Chen, Weirong

    2017-09-09

    Intraocular lens (IOL) power selection is a critical factor affecting visual outcome after IOL implantation in short eyes. Many formulas have been developed to achieve a precise prediction of the IOL power. However, controversy regarding the accuracy remains. To investigate the accuracy of different IOL power calculation formulas in short eyes. Meta-analysis PARTICIPANTS: Patients with the axial length of eyes less than 22mm from previously reported studies. A comprehensive search in Pubmed, EMBASE, Cochrane Data Base of Systematic Reviews and the Cochrane Central Register of Controlled Trials was conducted by October 2016. We assessed the methodological quality using a modified QUADAS-2 tool and performed analysis on weighted mean differences of mean absolute errors (MAE) among different formulas. the between-group difference of MAE was evaluated with weighted mean difference and 95% confidence intervals. Ten observational studies, involving 1161 eyes, were enrolled to compare six formulas: Haigis, Holladay 2, Hoffer Q, Holladay 1, SRK/T and SRK II. Among them, the Holladay 2 introduced the smallest overall MAE (0.496D) without statistical significance. The difference of MAE is statistically significant between Haigis and Hoffer Q (mean difference=-0.07D, p=0.003), Haigis and SRK/T (mean difference=-0.07D, p=0.009), Haigis and SRK II (mean difference=-0.41D, p=0.01). For publication bias and small-study effect, neither funnel plot nor egger's test detected statistical finding. The overall evidence from the studies confirmed the superiority of Haigis over Hoffer Q, SRK/T and SRK II in prediction IOL power in short eyes. This article is protected by copyright. All rights reserved.

  10. Comparison of Preoperative and Postoperative Ocular Biometry in Eyes with Phakic Intraocular Lens Implantations

    PubMed Central

    Shin, Joo Youn; Lee, Jae Bum; Seo, Kyoung Yul; Kim, Eung Kweon

    2013-01-01

    Purpose To compare preoperative and postoperative ocular biometry in patients with iris-fixated phakic intraocular lens (pIOLs): Artisan and Artiflex. Materials and Methods This study included 40 eyes with Artisan and 36 eyes with Artiflex pIOL implants. Anterior chamber depth (ACD) and axial length (AL) were measured by applanation ultrasonography (A-scan) and partial coherence interferometry (IOLMaster) preoperatively and 3 months after pIOL implantation. Results ACD measurements after Artisan or Artiflex pIOL implantation were smaller than preoperative measurements. Specifically, the difference after Artisan pIOL implantation was -1.07±0.17 mm by A-scan and -0.08±0.08 mm by IOLMaster. The difference after Artiflex pIOL implantation was -1.31±0.15 mm by A-scan and -0.05±0.07 mm by IOLMaster. After Artisan pIOL implantation, differences in AL measurements by A-scan were insignificant (difference: -0.03±0.15 mm), whereas postoperative AL measurements by IOLMaster were significantly longer than preoperative measurements (difference: 0.12±0.07 mm). After Artiflex pIOL implantation, AL measurements by both A-scan and IOLMaster were significantly longer than preoperative measurements (difference: 0.09±0.16 mm by A-scan and 0.07±0.10 mm by IOLMaster). In the Artiflex group, differences in AL measurements by A-scan correlated with the central thickness of the Artiflex pIOL. Conclusion ACD and AL measurements were influenced by iris-fixated phakic IOL implantation. PMID:23918579

  11. Scheimpflug corneal power measurements for intraocular lens power calculation in cataract surgery.

    PubMed

    Saad, Elie; Shammas, Maya C; Shammas, H John

    2013-09-01

    To compare the keratometric (K) readings from the Pentacam-HR (High Resolution) unit with the automated K values from the IOLMaster keratometer (KIOLM), and to evaluate them in the commonly used intraocular lens (IOL) power calculation formulas for routine cataract surgery. Prospective, comparative observational study. setting: Private practice, Lynwood, California. study population: Fifty cataractous eyes scheduled for surgery between July and August 2012. observation procedure: The K readings from the Pentacam-HR unit taken at the 2-, 3-, 4-, and 5-mm zones and the 2-, 3-, 4-, and 5-mm rings, respectively, from 3 different maps: sagittal corneal front (KF), true net power (KTNP), and total refractive power (KRP) are compared with KIOLM. IOL power calculations were performed with each of the 25 sets of K readings. main outcome measures: The IOL prediction median absolute error (MedAE) obtained with each measurement. KF averaged 0.03-0.13 diopter (D) higher than KIOLM (P > .05), KTNP averaged 1.16-1.21 D lower than KIOLM (P > .001), and KRP averaged 0.23-0.72 D lower than KIOLM (P > .001), with large variations in the measurements. The MedAE obtained with the different Pentacam K readings ranged from 0.44-0.64 D vs 0.52 D obtained with KIOLM (P > .05). MedAE was lower in all categories when the pupil was 3 mm or smaller. The Pentacam KF values were the closest to KIOLM and the KF readings from the 2-mm ring yielded the best results for IOL power calculation. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Prevention of capsular bag opacification with a modified hydrophilic acrylic disk-shaped intraocular lens.

    PubMed

    Leishman, Lisa; Werner, Liliana; Bodnar, Zachary; Ollerton, Andrew; Michelson, Jennifer; Schmutz, Mason; Mamalis, Nick

    2012-09-01

    To evaluate the stability and capsular bag opacification with a modified disk-shaped 1-piece hydrophilic acrylic intraocular lens (IOL) suspended between 2 complete haptic rings connected by a pillar of the haptic material and with a commercially available 1-piece hydrophilic acrylic IOL. John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. Experimental study. Study and control IOLs were implanted into the left eyes and right eyes of 5 New Zealand rabbits. Eyes were examined at the slitlamp from 1 through 4 weeks. At 4 weeks, the globes were enucleated and evaluated under a very-high-frequency ultrasound. Photographs were taken and capsular bag opacification scored from the posterior aspect (Miyake-Apple view), and the eyes were processed for complete histopathology. At 4 weeks, the posterior capsule opacification score was 0.0 in the study group and 1.75 ± 0.5 (SD) in the control group (P=.005, paired t test). Ultrasound examination showed that 2 of the study IOLs had no contact between the posterior optic surface and the posterior capsule. Minimal proliferative cortical material was confined to the peripheral space between anterior and posterior rings of the study IOL haptics in localized areas at the equatorial region of the capsular bag. Anterior capsule opacification was absent in all eyes. The study IOL is a modification of a previous design, incorporating haptic perforations between the peripheral rings. By maintaining an open capsular bag and enhancing endocapsular inflow of aqueous, this modified design appears to prevent capsular bag opacification. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  13. Visual function after implantation of a diffractive aspheric trifocal intraocular lens.

    PubMed

    Alfonso, José F; Fernández-Vega Cueto, Luis; Belda-Salmerón, Lurdes; Montés-Micó, Robert; Fernández-Vega, Luis

    2016-08-04

    To evaluate distance, intermediate, and near vision after bilateral implantation of a diffractive aspheric trifocal intraocular lens (IOL). This study enrolled 204 eyes of 102 patients who had bilateral implantation of the AT LISA tri 839MP IOL. Monocular and binocular uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) (4 meters), monocular and binocular uncorrected near visual acuity (UNVA) and distance-corrected near visual acuity (DCNVA) (30, 40 centimeters), binocular uncorrected intermediate visual acuity (UIVA) and distance-corrected intermediate visual acuity (DCIVA) (50, 60, 70 centimeters), the defocus curve, and binocular photopic and mesopic contrast sensitivity with and without glare were evaluated over 6 months. No statistically significant differences in visual acuity outcomes between follow-up visits were found at any distance evaluated (p>0.05). Six months postoperatively, the mean monocular UDVA and UNVA were comparable to preoperative CDVA and DCNVA, respectively. All patients achieved a binocular CDVA of 20/25 or better. The mean binocular DCIVA ranged from 0.11 ± 0.11 (70 cm) to 0.07 ± 0.11 logMAR (50 cm). The mean binocular DCNVA was 20/25 or better in nearly 87% of patients. The defocus curve showed a wide range of useful vision, with no statistically significant differences in visual acuity at intermediate distances (p = 0.151). Mesopic contrast sensitivity was lower than under photopic conditions, particularly at medium and high spatial frequencies (p<0.001). Bilateral implantation of this trifocal IOL provides good visual outcomes at far, intermediate, and near distances, being an effective solution to reduce spectacle dependence after lensectomy.

  14. Lens Position Parameters as Predictors of Intraocular Pressure Reduction After Cataract Surgery in Glaucomatous Versus Nonglaucomatous Eyes

    PubMed Central

    Coh, Paul; Moghimi, Sasan; Chen, Rebecca I.; Hsu, Chi-Hsin; Masís Solano, Marissé; Porco, Travis; Lin, Shan C.

    2016-01-01

    Purpose To evaluate the relationship between lens position parameters and intraocular pressure (IOP) reduction after cataract surgery in patients with primary open-angle glaucoma (POAG) and in nonglaucomatous patients. Methods The main outcomes of this prospective study were percent and absolute IOP change, which were calculated using the preoperative IOP and the IOP 4 months after cataract surgery in POAG and nonglaucomatous eyes. Lens position (LP), defined as anterior chamber depth (ACD) + one-half lens thickness (LT), was assessed preoperatively using parameters from optical biometry. Preoperative IOP, axial length (AL), ACD, LT, relative lens position (RLP), and the ratio of preoperative IOP to ACD (PD ratio) were also evaluated as potential predictors of IOP change. Results Four months postoperatively, the average IOP reduction was 2.80 ± 3.83 mm Hg (15.79%) from the preoperative mean of 14.73 ± 2.89 mm Hg for nonglaucomatous eyes. The average IOP reduction was 2.66 ± 2.07 mm Hg (16.98%) from the preoperative mean of 14.86 ± 2.97 mm Hg for POAG eyes. Preoperative IOP, sex, AL, ACD, PD ratio, and LP predicted IOP change in nonglaucomatous eyes. Preoperative IOP and PD ratio predicted IOP change in POAG eyes. Conclusions Intraocular pressure reduction after phacoemulsification cataract surgery in nonglaucomatous eyes is significantly greater in more anteriorly positioned lenses. Though it did not reach statistical significance in patients with glaucoma, the association of LP with IOP reduction is in the same direction as in nonglaucomatous patients where smaller LP appears to predict greater IOP reduction. Lens position is a simple, easily calculable, accurate, and widely available parameter, which clinicians can potentially utilize in managing glaucoma. PMID:27163773

  15. Refractive results with the use of AT.Lisa intraocular lens (2008-2015).

    PubMed

    Filip, Mircea; Nicolae, Miruna; Filip, Andrei; Antonescu, Cristina; Dragne, Carmen; Triantafyllidis, Grigorios; Moisescu, Raluca; Lutic, Irina; Ungureanu, Ileana; Teodorov, Anamaria

    2016-01-01

    The purpose of the study was to evaluate the refractive results on a large cohort of patients who were implanted spherical or toric multifocal IOL's for cataract surgery or for refractive purpose. Preoperative refractive investigations included auto refractometer topography, pentacam, contact and noncontact biometry and many non-refractive investigations. The target in multifocal IOL usage was emmetropia and it was achieved in most cases. Ametropia occurrence involved correction in different ways.

  16. Optical principles, biomechanics, and initial clinical performance of a dual-optic accommodating intraocular lens (an American Ophthalmological Society thesis).

    PubMed

    McLeod, Stephen D

    2006-01-01

    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. Ray tracing analysis and lens design; finite element modeling of biomechanical properties; cadaver eye implantation; initial clinical evaluation. 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. 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.

  17. A Surprising Cause for Corneal Edema after Cataract Surgery: A Missed Posterior Chamber Intraocular Lens Haptic Remnant.

    PubMed

    Elyashiv, Sivan; Barequet, Irina

    2015-01-01

    We present a case of retained intraocular lens (IOL) haptic segment in the anterior chamber, diagnosed seven months following a reportedly uneventful cataract surgery due to manifestation of inferior corneal edema. Specular microscopy revealed low endothelial counts of 513/mm(2). Upon diagnosis, prompt surgical removal of the IOL haptic segment resulted in rapid resolution of the corneal edema within a week. Despite the clearing of the cornea, no improvement in the visual acuity occurred and cystoid macular edema was diagnosed and treated with topical anti-inflammatory agents and two intra-vitreal anti-VEGF injections, followed by complete resolution of ocular findings and improvement of the visual acuity.

  18. Vitrectomy and translocation of the anterior chamber intraocular lens to the sulcus: a closed microsurgical technique for the UGH syndrome.

    PubMed

    Gualtieri, William; Rossini, Paolo; Forlini, Cesare

    2008-01-01

    This interventional case report presents an anterior chamber intraocular lens (AC-IOL) translocation technique to manage a case of uveitis-glaucoma-hyphema (UGH) syndrome associated with posterior dislocation of nuclear fragments and vitreitis as a consequence of capsule rupture during cataract surgery. Pars plana vitrectomy followed by an AC-IOL translocation from the anterior chamber to the sulcus without additional surgical corneal incision was performed. At 12 months' follow-up, the original AC-IOL was in stable position in the posterior chamber, with binocular refractive balance and no further astigmatism and resolution of the UGH syndrome.

  19. Use of true net power in intraocular lens power calculations in eyes with prior myopic laser refractive surgery.

    PubMed

    Frings, Andreas; Hold, Veronika; Steinwender, Gernot; El-Shabrawi, Yosuf; Ardjomand, Navid

    2014-10-01

    Intraocular lens (IOL) power calculation following laser refractive surgery is still one of the most challenging aspects in cataract surgery. This study was initiated to investigate the application of true net power (TNP; Pentacam, software version 6.02r10, Oculus, Germany) in IOL power calculations in eyes with prior laser refractive surgery. Our data contribute to the notion that the TNP of the Pentacam is a reliable alternative to determine the IOL power in cases where the historical data are missing. Based on our data, we recommend implementing the TNP to obtain the true corneal power and thus, reliable IOL power calculations.

  20. Visual loss due to progressive multifocal leukoencephalopathy in a heart transplant patient.

    PubMed

    Lewis, A R; Kline, L B; Pinkard, N B

    1993-12-01

    A 59-year-old male heart transplant recipient experienced progressive visual loss following routine cataract surgery with intraocular lens implantation. Cranial magnetic resonance (MR) imaging suggested and brain biopsy confirmed the cause to be progressive multifocal leukoencephalopathy (PML). The patient died 2 months following cataract surgery. This case illustrates that visual failure may be the initial manifestation of PML, and the ophthalmologist should be aware of this central demyelinating disorder when dealing with immunocompromised patients.

  1. Assessment of multifocal contact lens over-refraction using an infrared, open-field autorefractor: A preliminary study.

    PubMed

    Giner, Anna; Aldaba, Mikel; Arjona, Montserrat; Vilaseca, Meritxell; Pujol, Jaume

    2015-10-01

    To evaluate the usefulness of an infrared open-field autorefractor as a predictor of the refractive error when fitting multifocal contact lenses (MCL). Objective and subjective measurements of the non-cycloplegic distance refractive error were compared in patients wearing MCL. We used the Grand Seiko WAM-5500 autorefractor for the objective measurements. Three commercially available MCL were tested. Twenty-one eyes of sixteen healthy adults were included in the study. Over-refraction was evaluated in terms of spherical equivalent (SE) and astigmatic vectors (J0 and J45). The mean difference±SD of each parameter was calculated. The Kolmogorov-Smirnov test was used to verify the normal distribution. Pearson's correlation, Bland and Altman plot and paired sample t test were used to compare the results obtained with both methods. The mean difference between objective and subjective results of the SE over-refraction was 0.13±0.42D; for astigmatic vectors J0 and J45 were 0.03±0.32D and -0.00±0.17D, respectively. The Kolmogorov-Smirnov test showed a normal distribution for all parameters. The highest Pearson's correlation coefficients were obtained for the SE with values of 0.98 without MCL and 0.97 with MCL. The lowest were obtained for J45 with values of 0.65 without MCL and 0.75 with MCL. Significant correlations were obtained for each parameter. The paired sample t test failed to show significant differences in analyzed parameters except for J0 without MCL. The Grand Seiko WAM-5500 can be used as a screening method of over-refraction in the clinical fitting of MCL. Copyright © 2015 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  2. 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

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

    PubMed

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

    2015-01-01

    To evaluate the long-term visual outcomes and complications of the piggyback intraocular lens (IOL) implantation compared to aphakia for infantile cataract. 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. 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. 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.

  4. 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

  5. Endothelial distance after phakic iris-fixated intraocular lens implantation: a new safety reference

    PubMed Central

    Ferreira, Tiago Bravo; Portelinha, Joana

    2014-01-01

    Purpose To evaluate the distance between the endothelial surface of the cornea to the anterior edge of an Artiflex® phakic intraocular lens (IOL) implant to improve the safety profile of this implant. Methods This is a retrospective clinical case series of 45 patients who had Artiflex phakic IOL implantation (Artiflex p-IOL) with a follow-up period of 3 years. A Pentacam HR imaging system was used to measure the distance from various points of the anterior edge of the Artiflex IOL to the endothelial surface of the cornea, which we called endothelial–IOL (E–IOL) distance, in 45 eyes. The E–IOL distances were assessed at 1, 3, 6, 12, 24, and 36 months. Corresponding correlations of central endothelial distance to temporal and nasal edges and center of the IOL anterior surface were tabulated. Results Mean follow-up was 21.39±11.28 months. A statistically significant reduction of the E–IOL distance was observed over the follow-up period (P<0.05), with the mean annual reduction being 24.70 μm. A strong positive correlation between the E–IOL distance of the edges of the IOL and the central distance was observed (correlation coefficients nasal/central: month 1, 0.905; month 36, 0.806; temporal/central: month 1, 0.906; month 36, 0.806; P<0.001). Moderate negative correlations were found between the spherical equivalent power of the implanted IOL and the E–IOL distance (correlation coefficients −0.271 to −0.412, P>0.05). For an E–IOL distance of the IOL edge >1500 μm, the distance from the endothelium to the central point of the p-IOL optic should be a minimum of 1,700 μm to improve the safety profile for Artiflex p-IOL implantation and reduce the potential complication of accelerated endothelial cell loss. Conclusion After Artiflex IOL implantation, the mean annual reduction of the E–IOL distance was 25 μm. A negative correlation existed between the spherical equivalent power of the implanted IOL and the postoperative E–IOL distance. The minimum

  6. Microincision Hydrophobic Acrylic Aspheric Toric Intraocular Lens for Astigmatism and Cataract Correction.

    PubMed

    Bissen-Miyajima, Hiroko; Negishi, Kazuno; Hieda, Osamu; Kinoshita, Shigeru

    2015-06-01

    To evaluate the efficacy and safety of a new acrylic one-piece toric intraocular lens (IOL). This prospective multicenter clinical trial included 93 eyes of 61 patients that were implanted with a hydrophobic acrylic toric IOL from 2010 to 2012 and followed for 1 year. This IOL uses the platform of a microincision one-piece aspheric IOL, the NY-60 IOL (HOYA, Tokyo, Japan), with three increments in cylindrical power (NHT15, 1.5 diopters [D]; NHT23, 2.25 D; and NHT30, 3.0 D). The inclusion criterion was preoperative corneal astigmatism from 0.75 to 3.00 D. The primary endpoint was uncorrected distance visual acuity (UDVA) of 0.0 logMAR (20/20 Snellen) or better 6 months postoperatively. In addition to UDVA, corrected distance visual acuity (CDVA), residual astigmatism, stability of the IOL alignment, need of realignment, and the rate of Nd:YAG laser capsulotomy were evaluated up to 1 year postoperatively. Errors in astigmatic correction were assessed using Alpin's vector analysis. The primary endpoint was achieved in 54.8% of eyes. One year postoperatively, the logMAR UDVAs were 0.02 ± 0.13, 0.05 ± 0.17, and 0.09 ± 0.14 with models NHT15, NHT23, and NHT30, which corresponds to 0.96 (19/20 Snellen), 0.89 (18/20 Snellen), and 0.82 (16/20 Snellen), respectively. One year postoperatively, the residual astigmatism was 0.66 ± 0.58 D. In each evaluation, the mean absolute change in the position of the axis mark was between 1.93° and 2.32°. Three eyes required repositioning of the IOL axis and 2 eyes received Nd:YAG laser capsulotomy. The correction error showed an undercorrection with against-the-rule astigmatism and overcorrection with with-the-rule astigmatism. The new one-piece toric IOL provided desirable clinical outcomes and stability in eyes with corneal astigmatism. Copyright 2015, SLACK Incorporated.

  7. Use of fellow eye data in the calculation of intraocular lens power for the second eye.

    PubMed

    Olsen, Thomas

    2011-09-01

    To test the hypothesis that the refractive outcome of the first eye can be used to improve the intraocular lens (IOL) power calculation for the second eye. Retrospective, consecutive case series in a university clinic setting. One thousand two hundred thirty-five patients who underwent sequential bilateral IOL implantation using the same type of IOL for both eyes. The refractive outcome was analyzed in retrospect and the IOL power calculation was reviewed using 3 different methods: (1) the old Sanders-Retzlaff-Kraff (SRK) II formula, (2) the newer SRK/T formula, and (3) the more recent Olsen formula. In a subgroup of 232 eyes, the actual postoperative anterior chamber depth (ACD) was measured using the Lenstar LS900 laser biometer (Haag-Streit AG, Koeniz, Switzerland). The error in diopters (D) of the predicted refraction in the spectacle plane. The correlation coefficients between the prediction errors for the right and left eyes were 0.56, 0.38, and 0.27 for the SRK II, SRK/T, and Olsen formula, respectively (P<0.001). Based on the observed correlation, the prediction of the second eye could be corrected according to the regression formula: Rx(cor) = Rx(exp)+β×Px(err), where Rx(cor) and Rx(exp) are the corrected and the uncorrected refractive prediction, respectively, Px(err) is the observed error of the first eye, and β is a formula-specific regression coefficient. Using this formula, the mean absolute error (MAE) was found to decrease from 0.56 D to 0.46 D, from 0.47 D to 0.41 D, and from 0.42 D to 0.40 D with the SRK II (P<0.001), the SRK/T (P<0.001), and the Olsen formula (P<0.05), respectively. Substituting the measured postoperative ACD of the first eye for the estimated ACD for the second eye in the Olsen formula was found to have a similar accuracy as the empirical regression formula. Depending on the IOL power calculation formula, the prediction error of the first eye may be used to improve the prediction for the second eye. The reason for this effect

  8. Near and intermediate reading performance of a diffractive trifocal intraocular lens using a reading desk.

    PubMed

    Attia, Mary S A; Auffarth, Gerd U; Khoramnia, Ramin; Linz, Katharina; Kretz, Florian T A

    2015-12-01

    To evaluate reading performance of a trifocal intra-ocular lens (IOL) at near and intermediate distances using the Salzburg Reading Desk. International Vision Correction Research Centre and David J. Apple Laboratory, University Eye Clinic, Heidelberg, Germany. Prospective, nonrandomized clinical study. Follow-up examinations at a minimum of 3 months postoperatively included uncorrected (UDVA) and corrected (CDVA) distance visual acuity, uncorrected (UIVA) and distance-corrected (DCIVA)) intermediate as well as uncorrected (UNVA) and distance-corrected (DCNVA) near visual acuity. Uncorrected and distance-corrected reading acuity at 40 cm for near, 80 cm for intermediate distance, and at the patient's preferred near and intermediate distances were evaluated with the reading desk. In this study, 22 eyes of 11 patients having cataract surgery with implantation of the trifocal Finevision IOL were evaluated. Postoperative monocular Snellen median values were 20/21.44 (range 20/52.61 to 20/14.49) for UDVA, 20/20.47 (range 20/38.11 to 20/16.64) for UIVA, and 20/26.39 (range 20/43.76 to 20/18.24) for UNVA. Subjective intermediate distance at the binocular uncorrected examination on the reading desk was 64.2 cm (range 51.9 to 80.0) with a reading acuity of 0.10 logMAR (range 0.32 to 0.00). Subjective near distance at the uncorrected binocular reading desk examination was 36.5 cm (30.8 to 41.2) with a near reading acuity of 0.06 logMAR (range 0.23 to -0.01). The preferred distances differed significantly from the fixed ones of 40 and 80 cm. The preferred intermediate distance was almost consistent, with the intermediate addition of 1.75 D corresponding to 57.1 cm. The visual and reading function of the trifocal IOL was better at the patient's preferred near and intermediate distances. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

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

    PubMed Central

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

    2017-01-01

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

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

    PubMed Central

    Ye, Pan-Pan; Li, Xia; Yao, Ke

    2013-01-01

    AIM To evaluate the visual function after bilateral implantation of aspheric diffractive multifocal Tecnis ZMA00, aspheric monofocal ZA9003 versus spherical monofocal Akreos Adapt intraocular lenses (IOLs). METHODS Tecnis ZMA00, Tecnis ZA9003 or Akreos Adapt IOLs were bilaterally implanted in 180 eyes from 90 patients. The following parameters were assessed 3 months postoperatively: monocular and binocular uncorrected visual acuity (UCVA) and distance-corrected visual acuity (DCVA) for distance, intermediate and near, spherical aberration (SA), contrast and glare sensitivity, near point refractive power, uncorrected and best-corrected near stereoscopic acuity (NSA). Patient satisfaction was assessed by a questionnaire. RESULTS Three months postoperatively, the monocular and binocular UCVA and DCVA at near of Tecnis ZMA00 were significantly better than other two groups. The mean SA for 5.0mm optical zone in Tecnis ZMA00 and Tecnis ZA9003 was significantly lower than that in Akreos Adapt. Mean contrast sensitivity and glare sensitivity were better for Tecnis ZA9003 group than for other two groups. Patients with Tecnis ZMA00 had higher monocular and binocular near point refractive power and uncorrected NSA than monofocal groups. The patients in Tecnis ZMA00 had higher mean values for halo compared with other two groups. CONCLUSION Tecnis ZMA00 provided better near VA and uncorrected NSA and higher near point refractive power than monofocal IOLs and patients were spectacle independent. The IOLs with Tecnis aspheric design improved contrast and glare sensitivity. Patients with Tecnis ZMA00 reported more disturbances on visual phenomena of halo. PMID:23826522

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

    PubMed

    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.

  12. 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

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

    PubMed

    Gundersen, Kjell G; Potvin, Rick

    2017-01-01

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

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

    PubMed Central

    Gundersen, Kjell G; Potvin, Rick

    2017-01-01

    Purpose To compare two different diffractive trifocal intraocular lens (IOL) designs, evaluating longer-term refractive outcomes, visual acuity (VA) at various distances, low contrast VA and quality of vision. Patients and methods Patients with binocularly implanted trifocal IOLs of two different designs (FineVision [FV] and Panoptix [PX]) were evaluated 6 months to 2 years after surgery. Best distance-corrected and uncorrected VA were tested at distance (4 m), intermediate (80 and 60 cm) and near (40 cm). A binocular defocus curve was collected with the subject’s best distance correction in place. The preferred reading distance was determined along with the VA at that distance. Low contrast VA at distance was also measured. Quality of vision was measured with the National Eye Institute Visual Function Questionnaire near subset and the Quality of Vision questionnaire. Results Thirty subjects in each group were successfully recruited. The binocular defocus curves differed only at vergences of −1.0 D (FV better, P=0.02), −1.5 and −2.00 D (PX better, P<0.01 for both). Best distance-corrected and uncorrected binocular vision were significantly better for the PX lens at 60 cm (P<0.01) with no significant differences at other distances. The preferred reading distance was between 42 and 43 cm for both lenses, with the VA at the preferred reading distance slightly better with the PX lens (P=0.04). There were no statistically significant differences by lens for low contrast VA (P=0.1) or for quality of vision measures (P>0.3). Conclusion Both trifocal lenses provided excellent distance, intermediate and near vision, but several measures indicated that the PX lens provided better intermediate vision at 60 cm. This may be important to users of tablets and other handheld devices. Quality of vision appeared similar between the two lens designs. PMID:28652693

  15. Toward New Engagement Paradigms For Intraocular Lenses: Light-Initiated Bonding of Capsular Bag to Lens Materials.

    PubMed

    Marcos, Susana; Alejandre, Nicolás; Lamela, Jorge; Dorronsoro, Carlos; Kochevar, Irene E

    2015-07-01

    Successful intraocular lens procedures, that is, implantation of accommodating intraocular lenses (A-IOL), require firm engagement of the IOL haptics to the capsular bag. We evaluated the use of photochemical bonding to engage IOL materials to the capsular bag. Freshly enucleated eyes of New Zealand rabbits were used in two types of photobonding experiments using Rose Bengal (RB) photoinitiation and green light (532-nm) irradiation. First, RB-stained capsular bag strips were photobonded ex vivo to IOL polymer [poly(2-hydroxyethyl methacrylate) pHEMA] strips in an atmosphere of air and of nitrogen. Second, IOLs were implanted intracapsularly and photobonded intraocularly. Irradiation times were between 30 and 180 seconds, and laser irradiance was between 0.25 and 0.65 W/cm(2). The strength of the bonding was tested using a custom-developed uniaxial extensiometry system and the breakage load (the load that caused breakage per bonded area) was calculated. The breakage load of ex vivo capsule-pHEMA bonds increased exponentially with irradiation time, using 0.45 W/cm(2). In air, the average breakage load across all conditions was 1 g/mm(2) and 1.6 times lower than that in a nitrogen atmosphere. Intraocularly, RB-stained IOLs were strongly photobonded to the capsule bag with breakage loads > 0.8 g/mm(2). Breakage of the photobonded linkage between IOL material and capsular bag required loads substantially greater than the maximum force of ciliary muscle, suggesting that this technology may introduce a new paradigm for engagement of A-IOLs. The bonding produced in air was stronger than that in nitrogen atmosphere, suggesting that oxygen is involved in the chemical mechanism for photobonding.

  16. Hydrophilic acrylic intraocular lens optic and haptics opacification in a diabetic patient: bilateral case report and clinicopathologic correlation.

    PubMed

    Pandey, Suresh K; Werner, Liliana; Apple, David J; Kaskaloglu, Mahmut

    2002-11-01

    To report clinicopathologic and ultrastructural features of two opacified single-piece hydrophilic acrylic intraocular lenses (IOLs) explanted from a diabetic patient. Interventional case report with clinicopathologic correlation. A 64-year-old white female underwent phacoemulsification and implantation of a single-piece hydrophilic acrylic lens (SC60B-OUV; Medical Developmental Research, Inc., Clear Water, FL) in October 1998 in the left eye and in July 1999 in the right eye. The best-corrected visual acuity after surgery was 20/60 in the left eye and 20/50 in the right eye. The patient had a marked decrease in visual acuity in June 2000 as a result of a milky, white opalescence of both lenses. Intraocular lens explantation and exchange was performed in both eyes and the explanted IOLs were submitted to our center for detailed pathologic, histochemical, and ultrastructural evaluation. They were stained with alizarin red and the von Kossa method for calcium, and also underwent scanning electron microscopy and energy dispersive radiograph spectroscopy to ascertain the nature of the deposits leading to opacification. Documentation of calcium deposits confirmed by histochemical stains and surface analyses. Opacification of the IOL was found to be the cause of decreased visual acuity. The opacification involved both the IOL optic and the haptics in the left eye and was confined to the IOL optic in the right eye. Histochemical and ultrastructural analyses revealed that the opacity was caused by deposition of calcium and phosphate within the lens optic and haptics. There are two features that distinguish this case from those reported earlier. This is the first clinicopathologic report of lens opacification that has involved completely the lens optic and the haptics. Second, these two explanted IOLs document the first bilateral case. This process of intraoptic and haptic opacification represents dystrophic calcification of unknown cause. Diabetic patients appear to be

  17. Posterior capsular opacification and intraocular lens decentration. Part I: Comparison of various posterior chamber lens designs implanted in the rabbit model.

    PubMed

    Hansen, S O; Solomon, K D; McKnight, G T; Wilbrandt, T H; Gwin, T D; O'Morchoe, D J; Tetz, M R; Apple, D J

    1988-11-01

    Experimental phacoemulsification procedures were performed in 54 Rex rabbits. In 96 eyes, posterior chamber intraocular lenses (IOLs) were implanted in the capsular sac, and 12 eyes served as controls with no lens implantation. The IOLs were divided into eight groups consisting of both one-piece and three-piece styles with various optic designs. Each lens was evaluated for the relative effect on posterior capsular opacification (PCO) and optic decentration, two of the most common complications of modern cataract surgery and IOL implantation. Optics with a convex-anterior, plano-posterior design (the type of IOL optic most frequently implanted today) had the highest incidence of PCO. With capsular fixated IOLs, the features that have a statistically significant impact on reducing PCO include (1) one-piece, all-polymethylmethacrylate (PMMA) IOL styles, (2) a biconvex or posterior convex optic design, and (3) angulated loops. Lens decentration was not affected by the optic design, but statistical analysis showed that one-piece, all-PMMA IOL construction provided the most consistent centration.

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

    PubMed Central

    Grob, Seanna R; Gonzalez-Gonzalez, Luis A; Daly, Mary K

    2014-01-01

    The maintenance of mydriasis and the control of postoperative pain and inflammation are critical to the safety and success of cataract and intraocular lens replacement surgery. Appropriate mydriasis is usually achieved by topical and/or intracameral administration of anticholinergic agents, sympathomimetic agents, or both, with the most commonly used being cyclopentolate, tropicamide, and phenylephrine. Ocular inflammation is common after cataract surgery. Topical steroids and nonsteroidal anti-inflammatory drugs are widely used because they have been proved effective to control postsurgical inflammation and decrease pain. Topical nonsteroidal anti-inflammatory drugs have also been shown to help maintain dilation. However, use of multiple preoperative drops for pupil dilation, inflammation, and pain control have been shown to be time consuming, resulting in delays to the operating room, and they cause dissatisfaction among perioperative personnel; their use can also be associated with systemic side effects. Therefore, ophthalmologists have been in search of new options to streamline this process. This article will review the current medications commonly used for intraoperative mydriasis, as well as pain and inflammation control. In addition, a new combination of ketorolac, an anti-inflammatory agent, and phenylephrine, a mydriatic agent has recently been designed to maintain intraoperative mydriasis and to reduce postoperative pain and irritation from intraocular lens replacement surgery. Two Phase III clinical trials evaluating this combination have demonstrated statistically significant differences when compared to placebo in maintaining intraoperative mydriasis (P<0.00001) and in reducing pain in the early postoperative period (P=0.0002). This medication may be of benefit for use in cataract and lens replacement surgery in the near future. PMID:25061276

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

    PubMed Central

    2011-01-01

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

  20. 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

  1. A technique of experimental and numerical analysis of influence of defects in the intraocular lens on the retinal image quality

    NASA Astrophysics Data System (ADS)

    Geniusz, Malwina; ZajÄ c, Marek

    2016-09-01

    Intraocular lens (IOL) is an artificial lens implanted into the eye in order to restore correct vision after the removal of natural lens cloudy due to cataract. The IOL prolonged stay in the eyeball causes the creation of different changes on the surface and inside the implant mainly in form of small-size local defects such as vacuoles and calcium deposites. Their presence worsens the imaging properties of the eye mainly due to occurence of scattered light thus deteriorating the vision quality of patients after cataract surgery. It is very difficult to study influence the effects of these changes on image quality in real patients. To avoid these difficulties two other possibilities were chosen: the analysis of the image obtained in an optomechanical eye model with artificially aged IOL as well as numerical calculation of the image characteristics while the eye lens is burdened with adequately modeled defects. In experiments the optomechanical model of an eye consisting of a glass "cornea", chamber filled with liquid where the IOL under investigation was inserted and a high resulution CCC detector serving as a "retina" was used. The Modulation Transfer Function (MTF) of such "eye" was evaluated on the basis of image of an edge. Experiments show that there is significant connection between ageing defects and decrease in MTF parameters. Numerical part was performed with a computer programme for optical imaging analysis (OpticStudio Professional, Zemax Professional from Radiant Zemax, LLC). On the basis of Atchison eye model with lens burdened with defects Modulation Transfer Functio was calculated. Particular parameters of defects used in a numerical model were based on own measurements. Numerical simulation also show significant connection between ageing defects and decrease of MTF parameters. With this technique the influence of types, density and distribution of local defect in the IOL on the retinal image quality can be evaluated quickly without the need of

  2. Long-term complications of iris-claw phakic intraocular lens implantation in Weill-Marchesani syndrome.

    PubMed

    Burakgazi, Ahmet Z; Ozbek, Zeynep; Rapuano, Christopher J; Rhee, Douglas J

    2006-04-01

    This study was designed to report the long-term complications of iris-claw phakic intraocular lens implantation in a patient with Weill-Marchesani syndrome. Case report and literature review. A 26-year-old man with a history of glaucoma had bilateral phakic lens implantation for high myopia 10 years previously. Two years later, the left implant dislocated and was repositioned. Slit-lamp examination of both eyes revealed phakic implants of the iris-claw variety. There were moderate iridocorneal adhesions in the areas in which the lens haptics pinched the iris in both eyes and moderate epithelial and stromal edema over the temporal one-third of the left cornea. The crystalline lenses were clear with 3+phacodonesis OU. Dilated fundus examinations revealed bilateral severe optic nerve cupping. Crystalline lens diameters were measured at 7.5mm in the right eye and 8 mm in the left. Anterior chamber depths were 2.63 mm OD and 2.40 mm OS. Specular microscopy revealed central endothelial cell counts of 1133 and 587 cells/mm OD and OS, respectively. Axial lengths were 23.3 mm OD and 25 mm OS. Gonioscopic examination revealed bilateral angle closure with marked peripheral anterior synechiae. Based on our findings of short stature, shortened and thickened fingers, relatively normal axial length, microspherophakia, high myopia, and glaucoma, we diagnosed the patient with Weill-Marchesani syndrome. Iris claw-lens phakic lenses may be an effective surgical alternative to correct high myopia in select patients; however, it may produce long-term complications in eyes with specific features.

  3. 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

  4. 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

  5. Hydrophilic acrylic intraocular lens as a drug delivery system: influence of the presoaking time and comparison to intracameral injection.

    PubMed

    Lipnitzki, Inna; Bronshtein, Relli; Ben Eliahu, Shmuel; Marcovich, Arie L; Kleinmann, Guy

    2013-05-01

    To evaluate the influence of different intraocular lens (IOL) presoaking times in an antibiotic solution and to compare the results with intracameral antibiotic injection alone. Part A: 45 IOLs were soaked in gatifloxacin, moxifloxacin, or prednisolone acetate for 10 min, 24 h, and 1 week and then placed in a vial with a balanced salt solution. The solutions were sampled 12 and 24 h later. Part B: 90 eyes of 45 rabbits were divided into three groups. Group A received intracameral injection of moxifloxacin after lens removal and nonpresoaked IOL implantation. Groups B and C were implanted with IOLs that were presoaked for 15 min in moxifloxacin (group B) or gatifloxacin (group C), after lens removal with no intracameral antibiotic injections. Aqueous humor samples were taken 2, 4, 6, 8, and 10 h after surgery for high-performance liquid chromatography. Part A: In comparison with the 24-h group, the 10-min group showed release of about 30% of the antibiotics amount; the 1-week group showed a longer release time of the antibiotics and an increase of 27% for gatifloxacin and 43% for moxifloxacin. No prednisolone acetate was found. Part B: The moxifloxacin concentrations in the intracameral injection group were higher after surgery, but with faster antibiotic decrease in comparison with both presoaked IOL groups. Intracameral antibiotic injection showed a high antibiotic concentration for a short time. Presoaked IOLs showed slower decrease rates of the antibiotic level.

  6. 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

  7. A Case of Delayed-Onset Propionibacterium acnes Endophthalmitis after Cataract Surgery with Implantation of a Preloaded Intraocular Lens

    PubMed Central

    Hayashi, Yuki; Eguchi, Hiroshi; Miyamoto, Tatsuro; Inoue, Masayuki; Mitamura, Yoshinori

    2012-01-01

    Purpose To report a case of delayed-onset endophthalmitis after implantation of a preloaded intraocular lens (IOL) and examine the surgically removed IOL by scanning electron microscopy (SEM). Case A 77-year-old female underwent uneventful phacoemulsification and aspiration with preloaded silicone IOL implantation. Since intraocular inflammation unexpectedly worsened 1 month after the surgery, she was referred to our hospital. Her visual acuity was hand motion in the left eye. Hypopyon and fibrin formation were observed in the anterior chamber. A diagnosis of postoperative delayed-onset endophthalmitis was made, and vitrectomy with anterior chamber wash-out was performed. As intraocular inflammation remained unchanged postoperatively, an additional surgery with IOL removal was performed. We cultivated the surgically removed samples of aqueous humor and vitreous fluid under both aerobic and anaerobic conditions, performed 16S rDNA clone library analysis of these clinical samples, and examined the removed IOL by SEM. Result Inflammation subsided after the re-operation. Although cultures of aqueous and vitreous samples were negative, DNA of Propionibacterium acnes was detected in the aqueous humor. The SEM images showed that the rod bacteria and biofilm-like material formed on the tip of the IOL haptic. Conclusion Delayed-onset endophthalmitis may occur after uneventful implantation of a preloaded IOL. The SEM findings suggested that the tip of the preloaded IOL haptic might scratch bacteria which adhered to the tip of the injector nozzle when the IOL was inserted into the anterior chamber. In some cases with delayed-onset endophthalmitis, IOL removal is needed to eliminate the bacteria which adhere to the tip of the IOL haptic. PMID:23275791

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

    PubMed

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

    2011-04-01

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

  9. 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

  10. Capsule contraction syndrome with a microincision foldable hydrophilic acrylic intraocular lens: two case reports and review of the literature.

    PubMed

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

    2014-09-01

    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.

  11. 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

  12. Calcification of a hydrophilic acrylic intraocular lens after Descemet-stripping endothelial keratoplasty: case report and laboratory analyses.

    PubMed

    Fellman, Melissa A; Werner, Liliana; Liu, Erica T; Stallings, Shannon; Floyd, Anne M; van der Meulen, Ivanka J E; Lapid-Gortzak, Ruth; Nieuwendaal, Carla P

    2013-05-01

    We describe the case of an 83-year-old woman who had uneventful phacoemulsification with implantation of a tripod hydrophilic acrylic intraocular lens (IOL). Because of postoperative corneal decompensation, 2 Descemet-stripping endothelial keratoplasty (DSEK) procedures were performed within 2 years. After the second procedure, the graft was not well attached, requiring an intracameral injection of air on day 3. Approximately 9 months later, opacification was observed on the anterior surface of the IOL, with a significant decrease in visual acuity. The IOL was explanted within the capsular bag. Laboratory analyses revealed granular deposits densely distributed in a round pattern within the margins of the capsulorhexis. Granules were located at the anterior surface/subsurface of the IOL and stained positive for calcium (alizarin red and von Kossa method). Scheimpflug photography revealed high levels of light scattering from the opacified area. Surgeons should be aware of possible localized calcification following DSEK procedures in pseudophakic patients with hydrophilic acrylic IOLs.

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

    PubMed

    Kang, Kyung Tae; Kim, Yu Cheol

    2013-11-01

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

  14. Evidence of octacalcium phosphate and Type-B carbonated apatites deposited on the surface of explanted acrylic hydrogel intraocular lens.

    PubMed

    Lin, Shan-Yang; Chen, Ko-Hua; Li, May-Jane; Cheng, Wen-Ting; Wang, Shun-Li

    2004-08-15

    Fourier-transform infrared (FTIR) microspectroscopy combining with attenuated total reflection (ATR) microsampling technique and micro-Raman spectrophotometer were used to detect the deposited materials on the surface of acrylic hydrogel intraocular lens (IOL) with or without ocular implantation. Surface morphology and the interface of this IOL were further examined by a confocal laser scanning microscope. The brand-new IOL exhibited a very smooth, transparent and featureless surface, but the explanted IOL had an irregular cerebriform-like opaque appearance. Both FTIR/ATR and Raman microspectroscopic analyses showed the deposits on the surface of acrylic hydrogel IOL after ocular implantation to consist of octacalcium phosphate (OCP) and Type B carbonated apatites, leading to the opalescence of acrylic hydrogel IOL. Both vibrational microspectroscopic examinations also confirmed the mineralization still in progress on the surface of acrylic hydrogel IOL after ocular implantation for 2 years.

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

    PubMed

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

    2017-03-29

    To report the clinical features of patients with reverse pupillary block (RPB) after scleral-sutured posterior chamber intraocular lens (PC IOL) implantation and biometric changes after laser peripheral iridotomy (LPI). Eight patients attending our hospital's ophthalmology outpatient clinic, who developed RPB after implantation of a scleral-sutured PC IOL due to subluxation of the crystalline lens or IOL, were investigated in this retrospective, observational study. Preoperative evaluations showed angle pigmentation in all cases and iridodonesis in 2 cases. Two subjects had used an α1A-adrenoceptor antagonist for benign prostatic hyperplasia. Pars plana or anterior partial vitrectomy was performed in all cases. All eyes showed an extremely deep anterior chamber, a concave iris configuration, and contact between the IOL optic and the iris at the pupillary margin. Pupil capture was detected in 2 cases. The mean (± SD) anterior chamber angle (ACA) was 89.91 ± 10.06°, and the anterior chamber depth (ACD) was 4.42 ± 0.16 mm before LPI. After LPI, the iris immediately became flat with a decreased ACA (51.70 ± 2.59°; P = 0.018) and ACD (4.14 ± 0.15 mm; P = 0.012). After LPI, the intraocular pressure decreased from 19.75 ± 3.77 mmHg to 15.63 ± 4.30 mmHg (P = 0.011), and the spherical equivalent decreased from -0.643 ± 0.385 D to - 0.875 ± 0.505 D (P = 0.016). Concomitant vitrectomy, angle pigmentation, and iridodonesis may be risk factors for RPB after scleral-sutured PC IOL implantation. LPI is effective for relieving the RPB.

  16. Cataract surgery with intraocular lens implantation in children aged 5-15 in local anaesthesia: visual outcomes and complications.

    PubMed

    Giles, Kagmeni; Christelle, Domngang; Yannick, Bilong; Fricke, Otto Herrmann; Wiedemann, Peter

    2016-01-01

    The aim of this study was to report feasibility, the visual outcomes and complications of pediatric cataract surgery with primary intraocular lens implantation in children aged 5 to15 years in local anesthesia. This retrospective interventional case series included 62 eyes from 50 children who underwent pediatrc cataract surgery with primary intraocular lens implantation at the Mana eye Clinic Nkongsamba between 2006 and 2015 Main outcome measures were: best-corrected post operative visual acuity, and intraoperative and postoperative complications. Mean age at surgery was 10.18 ± 3.21 years. Mean follow up length was 15.75 ± 3.36 weeks. Etiology included: 10 congenital cataracs (16.12%). 35 developmental cataracts (56.45%) and 17 traumatic cataracts (27.41%). The mean preoperative BCVA was logMAR 1.19 ± 0.33. (range 0.6-2.3). After cycloplegia refraction 2 weeks after surgery, the mean postoperative BCVA was log MAR 0.58 ± 0.88 ( range 0.5-1.8). The mean implanted IOL power was 22.01 ±3.16 D. IOL was succefuly implanted in 54 eyes (87.07%). Eight eyes (9.67%) were left aphakic. Increase in BCVA of 4 logMAR lines and above was recorded in 27 patients (43.55%). Intraoperative complications included: 4 posterior capsule holes with vitrous lost, 3 lenses subluxation and 1 case of iris dialyse. Late postoperative complications included: posterior capsular opacity which occurred in 16 patients, 3 posterior synechia, 2 retinal detachment. Peribulbar anaesthesia can be considered as a viable option in selected patients presenting developmental cataract undergoing cataract surgery in developing countries. Effort should be made to improve the early identification of congenital cataract and its early surgical intervention and prompt optical rehabilitation to prevent amblyopia.

  17. 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

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

    PubMed

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

    2015-01-01

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

  19. Cataract surgery with intraocular lens implantation in children aged 5-15 in local anaesthesia: visual outcomes and complications

    PubMed Central

    Giles, Kagmeni; Christelle, Domngang; Yannick, Bilong; Fricke, Otto Herrmann; Wiedemann, Peter

    2016-01-01

    The aim of this study was to report feasibility, the visual outcomes and complications of pediatric cataract surgery with primary intraocular lens implantation in children aged 5 to15 years in local anesthesia. This retrospective interventional case series included 62 eyes from 50 children who underwent pediatrc cataract surgery with primary intraocular lens implantation at the Mana eye Clinic Nkongsamba between 2006 and 2015 Main outcome measures were: best-corrected post operative visual acuity, and intraoperative and postoperative complications. Mean age at surgery was 10.18 ± 3.21 years. Mean follow up length was 15.75 ± 3.36 weeks. Etiology included: 10 congenital cataracs (16.12%). 35 developmental cataracts (56.45%) and 17 traumatic cataracts (27.41%). The mean preoperative BCVA was logMAR 1.19 ± 0.33. (range 0.6-2.3). After cycloplegia refraction 2 weeks after surgery, the mean postoperative BCVA was log MAR 0.58 ± 0.88 ( range 0.5-1.8). The mean implanted IOL power was 22.01 ±3.16 D. IOL was succefuly implanted in 54 eyes (87.07%). Eight eyes (9.67%) were left aphakic. Increase in BCVA of 4 logMAR lines and above was recorded in 27 patients (43.55%). Intraoperative complications included: 4 posterior capsule holes with vitrous lost, 3 lenses subluxation and 1 case of iris dialyse. Late postoperative complications included: posterior capsular opacity which occurred in 16 patients, 3 posterior synechia, 2 retinal detachment. Peribulbar anaesthesia can be considered as a viable option in selected patients presenting developmental cataract undergoing cataract surgery in developing countries. Effort should be made to improve the early identification of congenital cataract and its early surgical intervention and prompt optical rehabilitation to prevent amblyopia. PMID:27795795

  20. Impact of blue-light filtering intraocular lens implantation on the quality of sleep in patients after cataract surgery

    PubMed Central

    Feng, Xue; Xu, Ke; Hao, Yansheng; Qi, Hong

    2016-01-01

    Abstract Background: There are 2 main types of intraocular lens (IOL) currently implanted in patients after cataract surgery. Till now, we do not know exactly what the effect of intraocular lens implantation will be on the quality of sleep after cataract surgery. Methods: The binocular BF-IOL (BF-IOL Groups) and UVB-IOL (UVB-IOL Groups) implantations were performed in 60 and 59 cataract patients, respectively. Pittsburgh Sleep Quality Index (PSQI) questionnaires were administered to evaluate the quality of sleep in patients preoperatively, 1 month (1 m) and 12 months (12 m) postoperatively. Independent sample test and χ2 test were used to evaluate the difference between the 2 groups; one-way ANOVA was used to evaluate the difference preoperatively and postoperatively in each group. The rank sum test was used for statistical analysis of 7 independent sleep components in PSQI. Results: As compared to preoperatively, the PSQI overall scores in both groups improved significantly postoperatively (P = 0.00 at 1 m and 12 m). Among the 7 components of PSQI, 2 of them (sleep latency and daytime dysfunction) improved greatly postoperatively in both groups (P< 0.05). Although the improvement of PSQI overall score in the UVB-IOL group was greater than that in the BF-IOL Group only at early time (1 m) postoperatively (P = 0.00), but not late time (12 m, P > 0.05) after the cataract surgery. Conclusion: The sleep quality of cataract patients improved after IOL implantation, regardless of the type of IOL, suggesting that BF-IOL might serve as an alternative to conventional UVB-IOL without a detrimental effect on quality of sleep after cataract surgery. PMID:28002333

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

    PubMed

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

    2016-01-01

    The aim of this study was to evaluate the operational impact of using preloaded intraocular lens (IOL) delivery systems compared with manually loaded IOL delivery processes during routine cataract surgeries. Time and motion data, staff and surgery schedules, and cost accounting reports were collected across three sites located in the US, France, and Canada. Time and motion data were collected for manually loaded IOL processes and preloaded IOL delivery systems over four surgery days. Staff and surgery schedules and cost accounting reports were collected during the 2 months prior and after introduction of the preloaded IOL delivery system. The study included a total of 154 routine cataract surgeries across all three sites. Of these, 77 surgeries were performed using a preloaded IOL delivery system, and the remaining 77 surgeries were performed using a manual IOL delivery process. Across all three sites, use of the preloaded IOL delivery system significantly decreased mean total case time by 6.2%-12.0% (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. 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.

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

    PubMed

    Siegel, Michael J; Condon, Garry P

    2015-11-01

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

  3. The effect of elevated intraocular oxygen on organelle degradation in the embryonic chicken lens.

    PubMed

    Bassnett, Steven; McNulty, Richard

    2003-12-01

    In the vertebrate lens, nuclei and other cytoplasmic organelles are degraded in fiber cells situated in the center of the tissue. This is believed to ensure the transparency of the tissue. The mechanism that triggers this process is unknown. We hypothesized that standing gradients of oxygen generated within the tissue may serve as a spatial cue for organelle degradation. To examine this possibility, we incubated fertilized chicken eggs under hyperoxic (50% O(2)) or normoxic (21% O(2)) conditions. Hyperoxic treatment was initiated on the seventh day of embryonic development (E7), five days before organelle degradation normally commences in the lens core. Hyperoxia was maintained until E17. Under normoxic conditions, the partial pressure of oxygen (P(O)) within the vitreous compartment was low. Direct measurement of P(O) using an optode oxygen sensor indicated values of 1.3 kPa and 0.4 kPa for the mid- and anterior vitreous, respectively. Similarly, treatment with pimonidazole, a bio-reductive hypoxia marker, led to the formation of immuno-positive protein adducts within the lens, suggesting that the embryonic lens is chronically hypoxic in situ. Following hyperoxic treatment, vitreous P(O) significantly increased, although pimonidazole staining in the lens was not markedly affected. Confocal microscopy of slices prepared from hyperoxic lenses revealed a significant increase in the size of the lens relative to age-matched normoxic controls. By E13, an organelle-free zone (OFZ) was present in the center of normoxic and hyperoxic lenses. However, in hyperoxic lenses, the OFZ was consistently smaller, and the distance from the lens surface to the border of the OFZ significantly larger, than in normoxic controls. These observations suggest that hyperoxia delays organelle breakdown and are consistent with a model in which hypoxia in the deep cortical layers of the normal lens serves as a trigger for the organelle loss process.

  4. Ultrasound biomicroscopy in pupillary block glaucoma secondary to ophthalmic viscosurgical device remnants in the posterior chamber after anterior chamber phakic intraocular lens implantation.

    PubMed

    Sun, Chuan-Bin; Liu, Zhe; Yao, Ke

    2010-12-01

    A 25-year-old woman developed pupillary block glaucoma in the right eye after implantation of an angle-supported phakic intraocular lens despite a preexisting moderate-sized iridectomy. Ultrasound biomicroscopy (UBM) showed ophthalmic viscosurgical device retention in the posterior chamber and a full-thickness, patent-appearing iridectomy at 12 o'clock. The intraocular pressure gradually decreased to normal after a neodymium:YAG laser iridotomy was performed midperipherally at 9 o'clock. To our knowledge, this is the first report of UBM findings of this complication.

  5. Visual Function after Primary Posterior Chamber Intraocular Lens Implantation in Pediatric Unilateral Cataract: Stereopsis and Visual Acuity

    PubMed Central

    Park, Jung Hyun; Kim, Jeong Hun; Kim, Seong Joon; Choung, Ho Kyung

    2007-01-01

    Purpose To investigate the association between binocular function and vision after cataract removal and primary posterior chamber intraocular lens (PC-IOL) implantation in children with unilateral cataract and to identify visual function differences according cataract type. Methods Clinical records of 2- to 6-year-old patients with unilateral cataract removal and primary PC-IOL implantation were reviewed retrospectively. Visual acuity and ocular alignment were measured. Sensory fusion was assessed with the Worth 4-dot test, and stereoacuity with the Titmus stereo test. Cataracts were classified according to cause, lens opacity location, age at onset, and presence of strabismus. Clinical characteristics of patients who obtained good visual function were identified. Results Forty-seven patients were included. Among 22 (46.8%) with good vision (20/40 or better), only 6 (27.3%) achieved good binocular function (the presence of fusion and 100 seconds of arc or better of stereoacuity). Visual acuity was better in eyes with good binocular function (p=0.002). No other variables were significant for achieving good binocular function. Conclusions The removal of unilateral cataract in a visually immature child can result in a combination of good visual acuity and binocular function. Good binocular function is closely related to good visual acuity. PMID:18063882

  6. Interaction of intraocular lenses with fibronectin and human lens epithelial cells: Effect of chemical composition and aging.

    PubMed

    Tortolano, Lionel; Serrano, Carole; Jubeli, Emile; Saunier, Johanna; Yagoubi, Najet

    2015-12-01

    The aim of this study is to investigate in vitro interactions between hydrophobic acrylate intraocular lenses (IOLs) and their biological environment. The influence of lens chemical composition and aging on fibronectin (FN) adsorption and on IOLs cytotoxicity on human lens epithelial cells was examined. Cytotoxicity of acrylate monomers used in IOLs manufacture was also investigated. Four different IOLs were included in the study: Acrysof(®), Tecnis(®), EnVista(®), and iSert(®). Implants were artificially aged in a xenon arc chamber to simulate 2 years of light exposure. Fibronectin adsorption on IOL surface was quantified using ELISA and correlated to surface roughness determined with AFM. Direct contact cytotoxicity was determined with the MTT assay and cell morphology was observed with light microscopy. Results showed that fibronectin adsorption did not differ significantly among IOLs, whatever their chemical composition. Moreover, aging conditions did not impact fibronectin adsorption. All IOLs were biocompatible even after applying 2-year aging conditions, with cell viability higher than 70%. Five acrylate monomers appeared to be toxic in the range of concentrations tested, but no monomer release from the IOLs could be detected during accelerated 2-year incubation with saline solution. This study did not reveal an influence of chemical composition and aging on protein adsorption and on biocompatibility.

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

    NASA Astrophysics Data System (ADS)

    Lin, Lin; Wang, Yao; Huang, Xiao-Dan; Xu, Zhi-Kang; Yao, Ke

    2010-10-01

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

  8. Fast in situ enzymatic gelation of PPO-PEO block copolymer for injectable intraocular lens in vivo.

    PubMed

    Lee, Hanna; Oh, Han Jin; Yoon, Kyung Chul; Tae, Giyoong; Kim, Young Ha

    2014-04-01

    Foldable intraocular lenses (IOLs) have been utilized to substitute natural lens of cataract patients. In this study, we developed a fast, in situ gelable hydrogel requiring no toxic agent as an injectable IOL material. A 4-armed PPO/PEO-phenol conjugate by a non-degradable linker was synthesized to form a hydrogel in situ by horseradish peroxidase. The gelation time and modulus could be controlled, ranging from 20 s to 2 min and from 1 to 43 kPa. The adhesion of human lens epithelial cells on the hydrogel was significantly reduced compared to that on commercial IOLs. The hydrogels were injected into the rabbit eyes to evaluate the in vivo biocompatibility for 8 weeks. Corneal endothelial cell loss and central corneal thickness were comparable with the common IOL implantation procedure. Histologically, the cornea and retina showed the intact structure. The change of refraction after application of pilocarpine was +0.42 D preoperatively and +0.83 D postoperatively, which may indicate the maintenance of accommodation amplitude.

  9. Comparison of results obtained with keratophakia, hypermetropic keratomileusis, intraocular lens implantation, and extended-wear contact lenses.

    PubMed

    Swinger, C A

    1983-01-01

    The limited experience with LRK precludes a valid comparison with IOLs and extended-wear contact lenses. Only observations, unsupported by valid statistical analysis, are possible. Some of these observations follow. Technically, LRK is very difficult. In their present form, the classic Barraquer procedures could never be used widely. However, if lenticle banks were to supply preground lenticles, the level of difficulty of LRK procedures would be comparable to IOL implantation. The magnitude of refractive correction possible with LRK compares favorably with that of contact lenses and IOLs. However, the accuracy of achieving a given correction is lower with LRK. Unlike contact lenses or IOLs, LRK induces both regular and irregular astigmatism. The latter accounts, in part, for the delayed visual result with LRK. The percentage of patients with 20/40 or better vision following LRK compares favorably with the percentages for contact lenses or IOLs, whereas the percentage of patients with 20/25 or better vision does not. This is true for at least 1 year following surgery. Compared to extended-wear contact lenses, IOLs and LRK typically require less commitment, fewer postoperative visits, and less expenditure by the patient, in terms of time and money, to achieve full-time correction. Although LRK is associated with a number of postoperative complications, none are known to be intraocular, and there have been no known reports of permanent severe visual loss. In contrast, the patient with an extended-wear contact lens or IOL is permanently at risk to develop sight-threatening complications. This is not the case with LRK, which has no known complications after the early postoperative period. Application of the IOL or extended-wear contact lens to the neonate or pediatric patient is associated with increased risk and difficulty. This may not be true with LRK, especially epikeratophakia. The major advantages of LRK appear to be permanent optical correction without the threat

  10. A 3-D "Super Surface" Combining Modern Intraocular Lens Formulas to Generate a "Super Formula" and Maximize Accuracy.

    PubMed

    Ladas, John G; Siddiqui, Aazim A; Devgan, Uday; Jun, Albert S

    2015-12-01

    Cataract surgery is the most common eye surgery. Calculating the most accurate power of the intraocular lens (IOL) is a critical factor in optimizing patient outcomes. To develop a graphical method for displaying IOL calculation formulas in 3 dimensions, and to describe a method that uses the most accurate and current information on IOL formulas, adjustments, and lens design to create one "super surface" and develop an IOL "super formula." A numerical computing environment was used to create 3-D surfaces of IOL formulas: Hoffer Q, Holladay I, Holladay I with Koch adjustment, Haigis, and SRK/T. The surfaces were then analyzed to determine where the IOL powers calculated by each formula differed by more than 0.5, 1.0, and 1.5 diopters (D) from each of the other formulas. Next, based on the current literature and empirical knowledge, a super surface was rendered that incorporated the ideal portions from 4 of the 5 formulas to generate a super formula. Last, IOL power values of a set of 100 eyes from consecutive patients at an eye institute were calculated using the 5 formulas and super formula. The study was performed from December 11, 2014, to April 20, 2015. Analysis was conducted from February 18 to May 6, 2015. Intraocular lens power value in diopters and the magnitude of disparity between an existing individual IOL formula and our super formula. In the 100 eyes tested, the super formula localized to the correct portion of the super surface 100% of the time and thus chose the most appropriate IOL power value. The individual formulas deviated from the optimal super formula IOL power values by more than 0.5 D 30% of the time in Hoffer Q, 16% in Holladay I, 22% in Holladay I with Koch adjustment, 48% in Haigis, and 24% in SRK/T. A novel method was developed to represent IOL formulas in 3 dimensions. An IOL super formula was formulated that incorporates the ideal segments from each of the existing formulas and uses the ideal IOL formula for an individual eye. The

  11. 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.

  12. Ultrasound biomicroscopy of anterior segment accommodative changes with posterior chamber phakic intraocular lens in high myopia.

    PubMed

    Du, Chixin; Wang, Jianhua; Wang, Xiaoyu; Dong, Ying; Gu, Yangshun; Shen, Ye

    2012-01-01

    To investigate changes in anterior chamber depth (ACD) and the distance between the Visian implantable Collamer lens (ICL) and the crystalline lens during pharmacologic accommodation in high myopia. Prospective, comparative case series. Thirty-three phakic eyes of 18 high myopic patients (range, -8.63 to -23.86 diopters) with a mean age of 29 years (range, 20-44 years) were examined at least 1 year after ICL implantation. Ultrasound biomicroscopy was used to measure distance changes between the corneal endothelium, the ICL, and the crystalline lens after inducing pharmacologic accommodation with topical pilocarpine in 1 eye. The contralateral eye served as the control. Mean changes of ACD measured from the posterior corneal surface to the crystalline lens (ACD-L), from the posterior corneal surface to the anterior surface of the ICL (ACD-ICL), and the distance between the ICL and the crystalline lens (ICL-L) at the central and peripheral regions of the eye. For each eye, the ICL was in contact with the iris, but it was never in contact with the crystalline lens. At baseline, the mean distance between the ICL and the crystalline lens was 0.609 ± 0.165 mm at the central horizontal meridian, 0.588 ± 0.157 mm at the central vertical meridian, 0.281 ± 0.106 mm at the peripheral temporal sulcus, and 0.290 ± 0.098 mm at the peripheral nasal sulcus. After instillation of pilocarpine, a significant decrease in ICL-L was accompanied by a significant reduction in ACD-L and an increase in ACD-ICL (P<0.01). There were no significant changes in the control eyes (P>0.05). The central ICL-L reduction in the study group was significantly larger than that in the control group (P<0.01), but the peripheral ICL-L changes in the study group were not significantly different from those in the controls (P>0.05). During pharmacologic accommodation, the ICL and the crystalline lens came closer as the ICL was pushed backward by the iris as a result of pupillary constriction

  13. Dense opacification of the optical component of a hydrophilic acrylic intraocular lens: a clinicopathological analysis of 9 explanted lenses.

    PubMed

    Werner, L; Apple, D J; Kaskaloglu, M; Pandey, S K

    2001-09-01

    To report clinical, pathological, histochemical, ultrastructural, and spectrographic analyses of explanted hydrophilic acrylic intraocular lenses (IOLs) obtained from patients who had visual disturbances caused by postoperative opacification of the lens optic. Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA, and Ege University, Alsancak Izmir, Turkey. Nine hydrophilic IOLs (SC60B-OUV, MDR Inc.) were explanted from 9 patients with decreased visual acuity. Most patients became symptomatic approximately 24 months after uneventful phacoemulsification and IOL implantation. Opacification was noted and appeared clinically to be associated with a fine granularity within the substance of the IOL optic. The IOLs were forwarded to the center and examined by gross and light microscopy. Full-thickness cut sections of the optics were stained with 1% alizarin red and the von Kossa method (special stains for calcium). Some were submitted for scanning electron microscopy and energy dispersive x-ray spectroscopy. Microscopic analyses revealed multiple fine, granular deposits of variable sizes within the lens optics, usually distributed in a line parallel to the anterior and posterior curvatures of the optic, with a clear zone just beneath the optic surface. The deposits stained positive with alizarin red and the von Kossa method. Energy dispersive x-ray spectroscopy of the internal substance of sectioned IOLs demonstrated the presence of calcium within the deposits. This is the first clinicopathological report of optic opacification occurring with this hydrophilic acrylic IOL model. Studies of similar cases with this lens should be done to determine the incidence and possible mechanisms of the phenomenon.

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

    PubMed

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

    2017-08-01

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

  15. Experimentally observe the effect of spherical aberration on diffractive intraocular lens using adaptive optics

    NASA Astrophysics Data System (ADS)

    Guo, Huanqing; DeLestrange, Elie

    2015-03-01

    We first investigated the similarity in optical quality of a batch of diffractive intraocular lenses (DIOLs), providing experimental evidence for one DIOL as representative of a batch. Using adaptive optics, we then evaluated one DIOL under different levels of Zernike spherical aberration (SA) by applying both a point spread function test and a psychophysical visual acuity test. We found that for small aperture size SA has the effect of shifting the through-focus curve of DIOL. Also, for a relatively large aperture size, it has different effects on the di