Influence of applied corneal endothelium image segmentation techniques on the clinical parameters.

The corneal endothelium state is verified on the basis of an in vivo specular microscope image from which the shape and density of cells are exploited for data description. Due to the relatively low image quality resulting from a high magnification of the living, non-stained tissue, both manual and automatic analysis of the data is a challenging task. Although, many automatic or semi-automatic solutions have already been introduced, all of them are prone to inaccuracy. This work presents a comparison of four methods (fully-automated or semi-automated) for endothelial cell segmentation, all of which represent a different approach to cell segmentation; fast robust stochastic watershed (FRSW), KH method, active contours solution (SNAKE), and TOPCON ImageNET. Moreover, an improvement framework is introduced which aims to unify precise cell border location in images pre-processed with differing techniques. Finally, the influence of the selected methods on clinical parameters is examined, both with and without the improvement framework application. The experiments revealed that although the image segmentation approaches differ, the measures calculated for clinical parameters are in high accordance when CV (coefficient of variation), and CVSL (coefficient of variation of cell sides length) are considered. Higher variation was noticed for the H (hexagonality) metric. Utilisation of the improvement framework assured better repeatability of precise endothelial cell border location between the methods while diminishing the dispersion of clinical parameter values calculated for such images. Finally, it was proven statistically that the image processing method applied for endothelial cell analysis does not influence the ability to differentiate between the images using medical parameters.

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

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.

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

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.

Visual outcome three and six months after implantation of Acri.LISA 366D lenses.

PURPOSE: To evaluate 3 and 6 months binocular visual outcomes after microincision cataract surgery (MICS) with implantation of multifocal, hybrid Acri.LISA 366D 10OLs. MATERIAL AND METHODS: Three and six months after bilateral MICS with Acri.Lisa 366D implantation, 40 eyes of 20 patients were evaluated for surgical induced astigmatism (SIA--vector analysis), binocular UDVA, UNVA and UIVA (logMAR), spectacle independence, contrast sensitivities (CS-CSV-1000), subjective symptoms, patient satisfaction (Type Questionnaire) and complications. RESULTS: Three and six months after surgery, SIA was equal 0.55 D and 0.58 D subsequently. Three months postoperatively mean binocular UDVA did not differ significantly from the six-month follow-up (-0.10 +/- 0.17 versus -0.14 +/- 0.11; p = NS). All patients had very good spectacle-free visual function at all distances and were totally spectacle independent. Mesopic distance and photopic distance and near CS were within normal age-matched limits at both follow-ups and did not change during observation time. A low degree of glare/halo was detected in 75% of subjects. Overall patient satisfaction was very high (9.05/10). There were no postoperative complications. CONCLUSIONS: Multifocal Acri.LISA 366D IOL implantation in selected cataract patients provides a very good visual outcome, a high level of patient satisfaction and spectacle-free visual function. microincision cataract surgery, Acri.Lisa 3660 101 implantation, visual outcome.

Visual outcomes three and six months after implantation of diffractive and refractive multifocal IOL combinations.

PURPOSE: To evaluate 3 and 6 months binocular visual outcomes after cataract surgery using a multifocal IOL "mix and match" approach, with a refractive (ReZoom) IOL in the dominant eye and a diffractive (Tecnis) IOL in the fellow eye. MATERIAL AND METHODS: Three and 6 months after bilateral cataract surgery, 40 eyes of 20 patients were evaluated for binocular UDVA, UNVA and UIVA (logMAR), spectacle independence, contrast sensitivities (CS), stereoscopic vision, subjective symptoms, patient satisfaction and complications. RESULTS: Three months after surgery mean binocular UDVA did not differ from the six-month follow-up (-0.13 +/- 0.08 vs. -0.18 +/- 0.08; p = NS ). All patients achieved binocular UNVA of 0.0 at both follow-ups. Mean binocular UIVA improved significantly from 0.06 to 0.01 (p<0.027), 6 months after surgery. All patients had very function at good visual all distances and were totally spectacle independent. CS under various conditions was within normal age-matched limits at both follow-ups. For some spatial frequencies six months postoperative results were significantly better than for the 3 months follow-up (p<0.05). Stereoscopic vision was normal. A low degree of glare/halo was detected in 75% of subjects. Overall patient satisfaction was very high (9.6/10). There were no postoperative complications. CONCLUSIONS: Mixing and matching multifocal IOLs in selected cataract patients provides an excellent visual outcome, a high level of patient satisfaction and spectacle-free visual function. A period of neuroadaptation lasting at least six months is necessary to obtain better visual function results.

Cataract surgery with bilateral multifocal ReZoom intraocular lens implantation--comparison of 3 and 12 month follow-up.

PURPOSE: To evaluate the visual outcome, spectacles independence, contrast sensitivity (CS), subjective symptoms, patient satisfaction and complications three and 12 months after cataract surgery with bilateral ReZoom multifocal refractive intraocular lens (IOL) implantation. PATIENTS AND METHODS: This study comprised 40 eyes of selected 20 patients who had uneventful cataract surgery with bilateral implantation of ReZoom (AMO) multifocal IOL. Three and 12 months after bilateral surgery binocular uncorrected, the best corrected distance, near and uncorrected intermediate visual acuities (VA), spectacle independence, the best corrected binocular distance (with and without glare), near photopic CS, subjective symptoms, patient satisfaction and complications were evaluated. RESULTS: Three and 12 months after surgery all patients had binocular uncorrected distance visual acuity (VA) of 0.5 or better; the best corrected distance VA was 1.0 in all cases. Three months after surgery, the mean binocular uncorrected intermediate VA was J4.10. The mean binocular uncorrected and the best corrected near VA were J3.10 and J1.70 respectively. Total spectacle independence and independence for distance, intermediate and near vision were achieved in 65%, 100%, 95% and 70% of patients respectively. The best corrected binocular distance and near CS were within normal limits. The most frequent subjective symptoms were mild glare and halo (65%--13/20 of patients).Total vision satisfaction was very high (9.6/ 10). There were no postoperative complications. One year after surgery, statistically significant improvement occurred in the best distance corrected near VA (p < 0.04), photopic distance best corrected CS without glare for 12 cycl/deg (p < 0.03) and in the level perception of glare/halo (p < 0.02) in comparison to the results from 3 months follow-up. The rest of analyzed parameters was unchanged. No complications were noticed except posterior capsule opacification in four patients one year after surgery who needed YAG laser treatment. CONCLUSION: Bilateral ReZoom multifocal IOL implantation was effective in selected cataract patients, providing very good uncorrected distance, intermediate, and near visual acuities as well as very high level of patient satisfaction. Longer than three months of the neuroadaptation time after bilateral surgery is necessary to obtain significantly better visual function results.