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1.
J Refract Surg ; 37(11): 768-774, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34756136

RESUMO

PURPOSE: To assess patient satisfaction and quality of life after refractive lens exchange with a trifocal intraocular lens (IOL). METHODS: Consecutive patients who underwent refractive lens exchange with the AT LISA tri or AT LISA tri toric IOL (Carl Zeiss Meditec AG) at one of five surgical centers were surveyed for their quality of life and satisfaction after surgery using a standardized questionnaire. Patient responses were compared to patient characteristics such as age, sex, axial lengths, and preoperative refraction. RESULTS: A total of 102 patients with 204 treated eyes were included in the analysis. The mean age was 54.6 ± 5.2 years. A total of 172 eyes were hypermetropic, 3 were emmetropic, and 25 were myopic, with a mean preoperative refractive error of 0.93 ± 2.17 diopters. Reported postoperative satisfaction was as follows: 81.4% stated that their expectations were completely met and 17.6% stated that they were partially met. Self-reported refractive error quality of life improved significantly in all queried areas of life. Most frequently reported postoperative limitations were driving at night and driving in bad weather conditions. Halos were reported by 91 (90.1%) patients. CONCLUSIONS: Patient satisfaction and self-reported quality of life after refractive lens exchange with the AT LISA tri or AT LISA tri toric IOL was high. Glare and halos remain the only significant drawback of the procedure, leading to 40% of patients experiencing difficulties in night driving. Preoperative communication of these drawbacks is obligatory to avoid postoperative disappointment. [J Refract Surg. 2021;37(11):768-774.].


Assuntos
Lentes Intraoculares , Facoemulsificação , Humanos , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente , Satisfação do Paciente , Satisfação Pessoal , Desenho de Prótese , Pseudofacia , Qualidade de Vida , Refração Ocular , Estudos Retrospectivos , Acuidade Visual
2.
J Refract Surg ; 37(11): 754-758, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34756144

RESUMO

PURPOSE: To compare the accuracy of the Barrett Universal II, Emmetropia Verifying Optical (EVO), Haigis, Kane, and SRK/T formulas for intraocular lens power calculation in patients with high axial myopia. METHODS: In this retrospective study, 175 eyes (175 patients) that underwent uneventful cataract surgery were enrolled. According to the axial length (AL), the eyes were divided into long AL (26 ⩽ AL < 28 mm), super long AL (28 ⩽ AL < 30 mm), and extremely long AL (⩾ 30 mm). The mean absolute prediction errors (MAE) 3 months postoperatively and the percentage of eyes within different prediction error were compared, followed by subgroup analysis. RESULTS: The MAE and percentage of eyes within ±0.50 diopters (D) of the five formulas were as follows: Barrett Universal II (0.342, 74.9%), EVO 2.0 (0.314, 82.3%), Haigis (0.336, 74.9%), Kane (0.318, 78.9%), and SRK/T (0.398, 69.7%) (P = .552 and .071, respectively). Although no significant difference was found among the five formulas in the super and extremely long AL groups (P = .792 and .227, respectively), the EVO 2.0 formula achieved the highest accuracy (88.9%, 72 of 81) in the long AL group (P = .049). Moreover, the accuracy of the EVO 2.0 and Haigis formulas was stable, regardless of AL. The SRK/T formula showed a negative trend in the long and super long AL groups, whereas the Barrett Universal II, Kane, and SRK/T formulas showed positive trends in the extremely long AL group. CONCLUSIONS: Overall, the EVO 2.0 and Kane formulas achieved better results in patients with high axial myopia, whereas the other three formulas showed slightly poor outcomes. [J Refract Surg. 2021;37(11):754-758.].


Assuntos
Lentes Intraoculares , Miopia , Facoemulsificação , Biometria , Humanos , Implante de Lente Intraocular , Miopia/cirurgia , Óptica e Fotônica , Refração Ocular , Estudos Retrospectivos
3.
Arch Soc Esp Oftalmol (Engl Ed) ; 96 Suppl 1: 38-51, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34836587

RESUMO

Congenital aniridia is a rare genetic disease associated with mutations in the PAX6 gene. Changes in the lens in aniridia can be alterations of size and shape, of position - which generally reveal zonular weakness and determines subluxation of the lens - and mainly changes in transparency, cataracts, with variable morphology of polar, cortical, subcapsular, lamellar, and more rarely, nuclear cataract. Visual acuity and quality of vision in patients with congenital aniridia complicated by cataracts can be improved by carefully planned surgery, when lack of media transparency justifies surgical indication. Most patients have some improvement in visual acuity and quality of retinal image. Cataract surgery with aniridia is complicated by pathological changes due to the underlying cause of the aniridia. Challenges include corneal opacification, friable capsule and, above all, iris and pupil reconstruction. It can also determine late complications, such as secondary glaucoma or deterioration of pre-existent glaucoma, and corneal endothelial decompensation. After crystalline lens surgery in these patients, either by cataract or dislocation, for visual rehabilitation there are various techniques such as keratopigmentation, prosthetic iris devices or Morcher intraocular lenses with a black diaphragm. An appropriate individualised surgical plan should be selected depending on patient and surgical experience, in order to minimise complications and give the best chance of postoperative success.


Assuntos
Aniridia , Cristalino , Lentes Intraoculares , Aniridia/genética , Humanos , Implante de Lente Intraocular , Estudos Retrospectivos
4.
Arch Soc Esp Oftalmol (Engl Ed) ; 96 Suppl 1: 68-73, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34836591

RESUMO

OBJECTIVE: The perform pre-clinical testing using optical design tools to simulate the optical quality of a smart artificial iris platform encapsulated in a scleral contact lens. These tools allow us to generate aniridia eye models and evaluate different metrics of visual quality and retinal illumination based on the aperture of the artificial iris based on liquid crystals. METHOD: The OCT imaging technique was used to measure the geometry of the anterior segment in a patient with aniridia and, from these data, the eye model was generated with the Zemax optical design program and specific programs developed in Matlab. Ocular aberrations were calculated and the visual function of the anirida eye model was evaluated in three scenarios: (i) without optical correction, (ii) with correction with a commercial scleral contact lens, and (iii) with correction with an optical lens. Intelligent contact based on artificial iris. RESULTS: Optical quality in patients with aniridia is limited by the magnitude of high-order aberrations. Conventional scleral contact lens design accurately corrects for blur but is unable to compensate for high-order ocular aberrations, especially spherical aberrations. The artificial iris-based smart contact lens design enables virtually all high-order aberrations to be compensated with active control of the pupillary diameter (activation of liquid crystal cells based on ambient lighting). In addition to minimizing high-order aberrations, reducing the pupil size would increase the depth of focus. CONCLUSIONS: This article demonstrates by means of optical simulations the concept of an intelligent artificial iris platform encapsulated in a scleral contact lens and its possible application in patients with aniridia. Furthermore, it allows us to anticipate possible visual results in clinical trials with healthy patients (after application of mydriatic agents) and in patients with aniridia. The results demonstrate a better visual quality and a decrease in retinal illumination.


Assuntos
Aniridia , Lentes de Contato , Lentes Intraoculares , Aniridia/terapia , Humanos , Iris , Acuidade Visual
5.
Yonsei Med J ; 62(12): 1117-1124, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34816642

RESUMO

PURPOSE: To evaluate the accuracy of the Kane formula for intraocular lens (IOL) power calculation in comparison with existing formulas by incorporating optional variables into calculation. MATERIALS AND METHODS: This retrospective review consisted of 78 eyes of patients who had undergone uneventful phacoemulsification with intraocular implantation at Severance Hospital in Seoul, Korea between February 2020 and January 2021. The Kane formula was compared with six of the existing IOL formulas (SRK/T, Hoffer-Q, Haigis, Holladay1, Holladay2, Barrett Universal II) based on the mean absolute error (MAE), median absolute error (MedAE), and the percentages of eyes within prediction errors of ±0.25D, ±0.50D, and ±1.00D. RESULTS: The Barrett Universal II formula demonstrated the lowest MAEs (0.26±0.17D), MedAEs (0.28D), and percentage of eyes within prediction errors of ±0.25D, ± 0.50D, and ±1.00D, although there was no statistically significant difference between Barrett Universal II-SRK/T (p=0.06), and Barrett Universal II-Kane formula (p<0.51). Following the Barrett Universal II formula, the Kane formula demonstrated the second most accurate formula with MAEs (0.30±0.19D) and MedAEs (0.28D). However, no statistical difference was shown between Kane-Barrett Universal II (p=0.51) and Kane-SRK/T (p=0.14). CONCLUSION: Although slightly better refractory outcome was noted in the Barrett Universal II formula, the performance of the Kane formula in refractive prediction was comparable in IOL power calculation, marking its superiority over many conventional IOL formulas, such as HofferQ, Haigis, Holladay1, and Holladay2.


Assuntos
Lentes Intraoculares , Facoemulsificação , Biometria , Humanos , Implante de Lente Intraocular , Óptica e Fotônica , Refração Ocular , Estudos Retrospectivos
6.
J Refract Surg ; 37(10): 674-679, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34661472

RESUMO

PURPOSE: To investigate the preoperative factors affecting visual acuity after the implantation of a diffractive multifocal intraocular lens. METHODS: This study evaluated 774 eyes of 774 patients who underwent cataract surgery with TECNIS Multifocal ZLB00 lens (Johnson & Johnson Surgical Vision) implantation. Anterior segment optical coherence tomography (CASIA2; Tomey Corporation) was performed as a part of the preoperative eye examination. Sex, age, axial length, and CASIA2 parameters, such as crystalline lens diameter and lens tilt relative to the corneal topographic axis, were investigated. The eyes considered were classified into good (20/20 or better) or poor (worse than 20/20) far vision groups based on corrected distance visual acuity, and good (20/25 or better) or poor (worse than 20/25) near vision groups based on distance-corrected near visual acuity, respectively. Preoperative characteristics of both groups were compared to determine factors affecting postoperative visual acuity. RESULTS: Multivariate logistic regression analysis revealed that older age (P < .001), a short axial length (P = .010), and a large lens tilt (P < .001) were associated with poor near vision. There was no significant difference between the two far vision groups. There was a significant negative correlation between lens tilt and axial length (r = -0.513, P < .001). CONCLUSIONS: The results of this study suggest that age, axial length, and lens tilt to the corneal topographic axis may predict poor visual acuity after the implantation of a diffractive multifocal intraocular lens. Eyes with a short axial length tended to have a large degree of lens tilt and should be considered particularly carefully. [J Refract Surg. 2021;37(10):674-679.].


Assuntos
Lentes Intraoculares , Lentes Intraoculares Multifocais , Facoemulsificação , Idoso , Humanos , Implante de Lente Intraocular , Acuidade Visual
7.
J Refract Surg ; 37(10): 680-685, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34661474

RESUMO

PURPOSE: To compare the accuracy of the Kane, Hill-RBF 2.0, Barrett Universal II (BUII), and Emmetropia Verifying Optical (EVO) formulas in calculating intraocular lens power in extremely myopic eyes. METHODS: A total of 1,054 highly myopic eyes were included and divided into three groups according to axial length: control (⩾ 26 to < 28 mm), long (⩾ 28 to < 30 mm), and extreme axial length (⩾ 30 mm) groups. Prediction accuracies of the four formulas were compared and factors influencing the refractive errors were evaluated. RESULTS: The Hill-RBF 2.0 formula generated the largest percentage of eyes with refractive errors within ±0.50 and ±1.00 D (71.44% and 94.59%, respectively, compared to 63.38% and 92.31% for the Kane, 61.76% and 94.02% for the BUII, and 59.01% and 87.57% for the EVO formulas; P < .001). The mean absolute errors of the Kane, Hill-RBF 2.0, BUII, and EVO formulas were 0.46 ± 0.38, 0.40 ± 0.39, 0.44 ± 0.30, and 0.58 ± 0.68 D (P < .001). In the long axial length group, the Hill-RBF 2.0 formula had the smallest MAE (all P < .001), whereas the extreme axial length group only had a smaller MAE than the Kane and EVO formulas (both P < .001). The accuracy of the Kane and Hill-RBF 2.0 formulas was affected by corneal curvature and A-constant; the accuracy of the BUII and EVO formulas was affected by corneal curvature, axial length, and A-constant. CONCLUSIONS: The Hill-RBF 2.0 formula outperformed all three other formulas in eyes with axial lengths ⩾ 28 to < 30 mm, and outperformed the Kane and EVO formulas in eyes with axial lengths of 30 mm or greater. [J Refract Surg. 2021;37(10):680-685.].


Assuntos
Lentes Intraoculares , Miopia , Biometria , Emetropia , Humanos , Refração Ocular
8.
Klin Monbl Augenheilkd ; 238(10): 1058-1064, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34662920

RESUMO

BACKGROUND: Subluxation of the crystalline lens in childhood confronts the surgeon with a dilemma: to operate or to wait and see. Surgery is usually not performed when the subluxation is still limited. However, postponing the surgery increases the surgical difficulty as the capsular bag becomes more difficult to use as a means of support for the intraocular lens (IOL). A large number of children already present a pronounced subluxation at first presentation. In this paper, we describe a technique to optimise centration and fixation of the bag-in-the-lens (BIL) IOL in children younger than 7 years of age with congenital ectopia lentis. METHODS: Between October 2019 and December 2020, we performed lens extraction using a combination of bean-shaped segments to support the BIL IOL and a 6 - 0 polypropylene loop fixated at the sclera, following the Yamane technique, for the purpose of centration. We used this technique for seven eyes of four patients. The patients were between 2 and 6 years old; 3 boys and 1 girl. A definite diagnosis of Marfan syndrome was made for two children; for the other two, there was no proven underlying pathology. The luxation was upwards in all cases. The degree of luxation was severe in all eyes. The preoperative refraction values showed high astigmatism values for all eyes, ranging from 6.5 to 11.25 dioptres. Three out of the four patients were myopic, ranging from - 1.5 to - 9 dioptres. RESULTS: The surgery could be performed without major complications in all eyes. Good centration was obtained, which remained stable in the postoperative period. Refraction improved with greatly diminished degrees of astigmatism (ranging from 0.25 to 3 dioptres) and myopia (spheres ranging from - 2 to + 1.75 dioptres). CONCLUSION: Our novel technique incorporated the BIL technique with the addition of bean-shaped segments and a polypropylene 6/0 suture fixated at the sclera. In this way, we were able to obtain good centration and stability of the implanted IOL, as well as a good refractive outcome in all cases.


Assuntos
Ectopia do Cristalino , Lentes Intraoculares , Criança , Pré-Escolar , Ectopia do Cristalino/diagnóstico , Ectopia do Cristalino/cirurgia , Feminino , Humanos , Implante de Lente Intraocular , Masculino , Estudos Retrospectivos , Acuidade Visual
9.
Vestn Oftalmol ; 137(5. Vyp. 2): 209-216, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34669329

RESUMO

Studying the modern capabilities of femtosecond laser in the treatment of complicated cataracts is a topical problem in cataract surgery. PURPOSE: To develop a technique for femtosecond laser-assisted phacoemulsification of hypermature cataract in patients with degree I-II lens subluxation. MATERIAL AND METHODS: Phacoemulsification of hypermature cataract with comorbid lens subluxation was performed in 78 patients (78 eyes) divided into two groups. In the 1st group (45 eyes), capsulorhexis was performed using a femtosecond laser. Patients of the 2nd group (33 eyes) underwent manual capsulorhexis. The study assessed the possible frequency of using modern methods of capsular bag fixation and complete all-in-the-bag intraocular lens (IOL) implantation, as well as the number of various types of intraoperative capsular bag ruptures. RESULTS: In all patients of the 1st group, capsulorhexis of the correct round shape and the required diameter was achieved, allowing the use of modern methods of fixation and centering of the capsular bag. Insignificant tear of the edge of the capsulorhexis after IOL implantation was detected only in 1 (2.2%) patient. Vitreous prolapse was noted in 1 (2.2%) case. In the 2nd group, manual technique resulted in oval capsulorhexis with a smooth edge, allowing the use of modern methods of fixation of the capsular bag only in 7 (21.2%) cases. Vitreous prolapse was noted in 4 (12.1%) cases. The complete in-the-bag IOL implantation was possible in 44 (97.8%) cases in the 1st group and only in 7 (21.2%) in the 2nd group. CONCLUSION: The use of femtosecond laser in patients with hypermature cataract and lens subluxation allows achieving capsulorhexis of ideally round shape with a smooth edge. This creates the necessary conditions for the use of modern methods of fixation of the capsular bag and provides the possibility of complete all-in-the-bag IOL implantation.


Assuntos
Catarata , Subluxação do Cristalino , Lentes Intraoculares , Facoemulsificação , Capsulorrexe , Catarata/complicações , Catarata/diagnóstico , Humanos , Lasers , Implante de Lente Intraocular , Subluxação do Cristalino/diagnóstico , Subluxação do Cristalino/etiologia , Subluxação do Cristalino/cirurgia , Facoemulsificação/efeitos adversos
10.
BMC Ophthalmol ; 21(1): 365, 2021 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-34656091

RESUMO

BACKGROUND: To compare clinical outcomes and optical performance of a new monofocal with enhanced intermediate function intraocular lenses (IOLs) with that of conventional monofocal IOLs. METHODS: Sixty eyes of 30 patients who underwent phacoemulsification with bilateral implantation of the ICB00 (15 patients) or ZCB00 (15 patients) IOLs were enrolled. Binocular corrected distance visual acuity (CDVA), distance corrected near visual acuity (DCNVA), and distance corrected intermediate visual acuity (DCIVA) were measured at 4 weeks after surgery. Patient satisfaction for overall, near, intermediate, and distance vision were assessed. The binocular defocus curves were measured. The root mean square of modulation transfer function (MTFRMS) was measured in the optical bench study. RESULTS: The mean binocular DCIVA was significantly better in the ICB00 group (0.01 logMAR) compared to the ZCB00 group (0.13 logMAR), but CDVA and DCNVA were not. The patient satisfaction for near and intermediate vision was significantly higher in the ICB00 group compared to the ZCB00. However, there was no difference in patient satisfaction for overall and distance vision between two groups. The defocus curves showed that mean visual acuity of the ICB00 group was significantly better than that of the ZCB00 group at between - 1.00 D to - 3.00 D of defocus. The ICB00 IOL had higher MTFRMS values at between - 0.50 D to - 2.00 D of defocus compared to the ZCB00 IOL. CONCLUSIONS: The ICB00 IOL provides better binocular intermediate vision and higher satisfaction for near and intermediate vision than the ZCB00 IOL while maintaining excellent distance vision.


Assuntos
Lentes Intraoculares , Facoemulsificação , Estudos de Casos e Controles , Humanos , Implante de Lente Intraocular , Satisfação do Paciente , Desenho de Prótese , Pseudofacia , Visão Binocular , Acuidade Visual
11.
BMC Ophthalmol ; 21(1): 367, 2021 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-34663265

RESUMO

BACKGROUND: Capsule contraction syndrome (CCS) after cataract surgery causes intraocular lens (IOL) haptic flexion and IOL optic displacement in most former reports. However, there are few reports on CCS-induced deformation of the IOL optic. We report two cases of CCS after cataract surgery in highly myopic eyes and describe a previously unreported "double arch" complication. CASE PRESENTATION: Two patients with history of high myopia had cataract surgery with hydrophilic acrylic plate haptic IOLs implanted in their eyes. CCS with arch shape deformation of the pupil as well as the optic of the IOL were noticed in both cases after three months, which induced refractive changes and corrected distance visual acuity (CDVA) deterioration. Visual acuity of the patients was restored by replacing the IOL from the capsular bag to the ciliary sulcus and the following neodymium: YAG (Nd:YAG) laser capsulotomy. We propose that such "double arch" change brought by CCS is related to the plate-haptic design of the IOL and the incomplete overlap between the capsular opening and the IOL optic. CONCLUSIONS: We recommend careful IOL selection and proper capsulorhexis in patients with high myopia or with other risk factors of CCS. Early diagnosis and timely treatment of CCS are critical to prevent visual symptoms and further ocular complications.


Assuntos
Opacificação da Cápsula , Lentes Intraoculares , Miopia , Opacificação da Cápsula/cirurgia , Capsulorrexe , Humanos , Implante de Lente Intraocular , Miopia/complicações , Miopia/cirurgia
12.
BMC Ophthalmol ; 21(1): 364, 2021 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-34645396

RESUMO

BACKGROUND: To evaluate the effects of pretreatment for dry eye disease (DED) on the accuracy of intraocular lens (IOL) power calculation. METHODS: Patients who underwent uneventful cataract surgery were included in the study. IOL power was determined using the SRK/T and Barrett Universal II (Barrett) formulas. The patients were divided into non-pretreatment and pretreatment groups, and those in the pretreatment group were treated with topical 0.5% loteprednol etabonate and 0.05% cyclosporin A for 2 weeks prior to cataract surgery. Ocular biometry was performed in all groups within 2 days before surgery. The mean prediction error, mean absolute error (MAE), and proportions of refractive surprise were compared between the non-pretreatment and pretreatment groups at 1 month postoperatively. Refractive surprise was defined as MAE ≥ 0.75D. RESULTS: In a total of 105 patients, 52 (52 eyes) were in the non-pretreatment group and 53 (53 eyes) in the pretreatment group. The MAE was 0.42 ± 0.33, 0.38 ± 0.34 (SRK/T, Barrett) and 0.23 ± 0.19, 0.24 ± 0.19 in the non-pretreatment and pretreatment groups, respectively (p < 0.001/=0.008). The number of refractive surprises was also significantly lower in the pretreatment group. [non-pretreatment/pretreatment: 9/2 (SRK/T); 8/1 (Barrett); p = 0.024/0.016]. Pretreatment of DED was related to a reduction in postoperative refractive surprise. [SRK/T/Barrett: OR = 0.18/0.17 (95% CI: 0.05-0.71/0.05-0.60), p = 0.014/0.006]. CONCLUSIONS: The accuracy of IOL power prediction can be increased by actively treating DED prior to cataract surgery.


Assuntos
Síndromes do Olho Seco , Lentes Intraoculares , Facoemulsificação , Biometria , Humanos , Implante de Lente Intraocular , Óptica e Fotônica , Refração Ocular , Estudos Retrospectivos
13.
Arch Soc Esp Oftalmol (Engl Ed) ; 96(10): 527-544, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34620483

RESUMO

BACKGROUND AND OBJECTIVE: The implantation of multifocal intraocular lens (IOL) has increased in recent years, allowing patients to achieve good quality vision at all distances, independence from use of glasses, and consequently, an increase in quality of life. The main purpose of this study was to analyse the links between publications and authors via citation networks, as well to as identify the different research areas and determine the most cited publications. MATERIAL AND METHODS: The publication search was performed through the Web of Science database, using the terms «Multifocal intraocular lens¼, «Bifocal intraocular lens¼, «Trifocal intraocular lens¼, «Diffractive intraocular lens¼, «Refractive intraocular lens¼, «Accommodative intraocular lens¼ and «Extended depth of focus intraocular lens¼, for a time interval from 1989 to August 2020. The software used to analyse the publications was the Citation Network Explorer. RESULTS: A total of 1293 publications were found, with 11,730 citations generated in the network, and 2019 had the highest number of publications of any year. The most cited publication was «European multicenter study of the AcrySof ReSTOR apodized diffractive intraocular lens¼ by Kohnen et al., published in 2006. Four groups about different research areas in this field were found using the Clustering functionality: visual quality, IOL designs, ocular aberrations, or defocus curves. CONCLUSIONS: The citation network offers an objective and comprehensive analysis of the main articles on the different designs and classes of multifocal IOL.


Assuntos
Lentes Intraoculares , Lentes Intraoculares Multifocais , Humanos , Implante de Lente Intraocular , Estudos Multicêntricos como Assunto , Estudos Prospectivos , Qualidade de Vida , Acuidade Visual
15.
J Cataract Refract Surg ; 47(11): e40-e43, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34675165

RESUMO

An incomplete dislocated intraocular lens (IOL) is often treated with IOL exchange because the IOL subluxates posteriorly during surgery and makes it difficult to fixate the IOL in situ. A trocar blade used for 23-gauge vitrectomy was used to lift and stabilize the IOL-capsular complex. The IOL can then be fixated using a suture loop fixation technique, which was originally limited to patients with decentered IOL. The advantage of this technique is that it allows the remaining zonular fibers and IOL to be preserved. The modified technique using a trocar blade to assist scleral fixation allows the incomplete dislocated IOL to be retrieved and fixated with a simplified surgical procedure.


Assuntos
Implante de Lente Intraocular , Lentes Intraoculares , Humanos , Estudos Retrospectivos , Esclera/cirurgia , Instrumentos Cirúrgicos , Técnicas de Sutura
16.
Transl Vis Sci Technol ; 10(12): 25, 2021 10 04.
Artigo em Inglês | MEDLINE | ID: mdl-34665235

RESUMO

Purpose: More than a dozen studies have investigated whether blue-light filtering (BLF) intraocular lens (IOL) implants influence color vision, generally finding they do not. These studies have not tested color vision per se; rather, they have measured color vision deficiencies or chromatic discrimination. Here, we used additive trichromatic colorimetry to assess color appearance in participants with BLF and clear IOL. Methods: Seventy-six participants were recruited from two populations: older participants (n = 52) with BLF and clear IOL (n = 98 eyes; M = 67.33 ± 7.48 years; 58.8% female; 25.5% non-White), and young adult control participants (n = 24; M = 21.0 ± 5.13 years; 70.8% female; 41.5% non-White). Participants used a custom-built tricolorimeter to mix three primaries until a perceived perfect neutral white was achieved. Color appearance, expressed as chromaticity coordinates, was measured with a spectral radiometer (ILS950). Results: Between subjects, the BLF IOL chromaticity coordinates (x = 0.34, y = 0.35, u' = 0.21, v' = 0.48) were not significantly different from the clear IOL (x = 0.34, y = 0.33, u' = 0.22, v' = 0.48). BLF and clear IOL were also not different within-contralateral subjects (n = 21; BLF x = 0.34, y = 0.33, u' = 0.22, v' = 0.47; clear x = 0.34, y = 0.33, u' = 0.21, v' = 0.48). Both IOL groups differed from young adults (v'[0.45; P = 0.001], x[0.31; P = 0.008], and y[ 0.30, P < 0.000], but not u'[0.21]). Conclusions: One advantage of geometric representation of color space is the ability to specify the appearance (rather than spectral composition) of any light mixture by specific coordinates. Using this system, only minor differences in color appearance were found between a BLF, clear IOL, and young natural lens. Translational Relevance: When color perception is directly measured, the BLF and clear IOL are not meaningfully different.


Assuntos
Visão de Cores , Lentes Intraoculares , Facoemulsificação , Feminino , Humanos , Implante de Lente Intraocular , Luz , Masculino
17.
BMC Ophthalmol ; 21(1): 379, 2021 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-34696772

RESUMO

BACKGROUND: This study was designed to evaluate visual, refractive and safety outcomes in eyes after they underwent phacoemulsification and implantation of a preloaded monofocal hydrophobic acrylic intraocular lens. METHODS: This was a single center observational study conducted at Ashford and St Peter's Hospitals NHS Foundation Trust, United Kingdom. Patients were included if they had cataract extraction with in-the-bag implantation of the EyeCee® One preloaded intraocular lens from August to October 2019. Pre-operative, surgery-related and 2 weeks and 3 months post-operative data was collected. Surgeons at this trust were then asked to complete a feedback form to evaluate their experience of implanting the EyeCee® One. RESULTS: One hundred fifty-two eyes were included in the study. Ninety-four (62%) of these eyes had cataract but no concomitant ocular pathology that could potentially affect visual acuity. Three months post-operatively, 98.7% of all eyes had monocular CDVA ≤0.3 logMAR. 100% of the eyes without concomitant ocular pathology achieved this target. The mean CDVA of all eyes in this study improved from 0.43 ± 0.43 logMAR pre-operatively, to 0.05 ± 0.11 logMAR post-operatively (p < 0.05). The mean sphere and spherical equivalent values showed significant improvements (p < 0.05) and (p < 0.05). There were no intraoperative complications and 1.3% of patients reported complications 2 weeks post-operatively. All of the participating surgeons said they would use the EyeCee® One again with 64% providing an overall rating of 'excellent' for their experience of implanting this intraocular lens. CONCLUSIONS: This study indicates excellent post-operative visual acuity and refractive outcomes in eyes after EyeCee® One implantation. This is accompanied with very little risk of intraoperative and post-operative complications.


Assuntos
Extração de Catarata , Lentes Intraoculares , Facoemulsificação , Humanos , Implante de Lente Intraocular , Refração Ocular
18.
Indian J Ophthalmol ; 69(11): 3190-3193, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34708770

RESUMO

Purpose: To calculate the intraocular lens power and to determine the relationship between ocular biometry and severity of diabetic retinopathy (DR) in patients with type II diabetes mellitus. Methods: The study group included 150 type II diabetic subjects with DR. The control group consisted of 150 type II diabetic subjects having no DR. Axial length (AL), corneal power, and anterior chamber depth were measured using LenStar. DR and diabetic macular edema were classified according to International DR Classification. Crystalline lens power was calculated using Barrett Universal II formula. AL to corneal radius ratio was calculated. Chi-square test was used for categorical variables. Results: In multivariate logistic models adjusting for age, sex, glycosylated hemoglobin, duration of diabetes, Mean age of patients in the study group was 62.45 ± 4.85 years, whereas in the control group, it was 63.37 ± 7.29 years. Of the eyes with DR, 117, 76, 69, and 38 had mild NPDR, moderate NPDR, severe NPDR, and PDR, respectively. The difference in the mean duration of diabetes mellitus and glycosylated hemoglobin in both study and control groups was found to be statistically significant. A progressive decrease in the mean AL and the anterior chamber depth was observed with increasing severity of DR, and difference was statistically significant. There was a progressive increase in intraocular lens power with increasing severity of DR, and difference was found to be statistically significant. Conclusion: In persons with diabetes mellitus, globe elongation plays quite an important role in protective effects against DR, with contribution from intraocular lens power and other refractive components.


Assuntos
Diabetes Mellitus Tipo 2 , Retinopatia Diabética , Lentes Intraoculares , Edema Macular , Idoso , Biometria , Diabetes Mellitus Tipo 2/complicações , Retinopatia Diabética/complicações , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/epidemiologia , Humanos , Pessoa de Meia-Idade
20.
J Cataract Refract Surg ; 47(11): 1436-1440, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34675151

RESUMO

PURPOSE: To evaluate the associations between anterior segment parameters and the rotational stability of a plate-haptic toric intraocular lens (IOL). SETTING: Eye and Ear, Nose, Throat Hospital of Fudan University. DESIGN: Retrospective case series. METHODS: Patients who underwent uneventful phacoemulsification and plate-haptic toric IOL (AT TORBI 709M IOL) implantation were included. Preoperative axial length (AL) and anterior segment parameters, including the white-to-white (WTW) distance, anterior chamber depth (ACD), lens thickness (LT), and anterior segment length (ASL; the sum of ACD and LT) were recorded. IOL rotation, residual astigmatism (RAS), and visual acuity were evaluated 1 month postoperatively. The associations between the anterior segment parameters and IOL rotation were evaluated. RESULTS: A total of 102 eyes of 102 patients were included. The mean AL was 26.43 ± 2.65 mm (range 21.71-34.60 mm). The mean IOL rotation was 4.59 ± 3.18 degrees, and RAS was 0.62 ± 0.39 D postoperatively. No correlation was detected between AL, ACD, or LT and the rotation of the plate-haptic toric IOL (all P > .05). However, its rotation correlated positively with the WTW distance (r = 0.250, P = .011) and ASL (r = 0.214, P = .030). Backward stepwise multiple linear regression revealed that the WTW distance (ß = 2.142, P = .014) and ASL (ß = 2.060, P = .037) were independent predictors of plate-haptic toric IOL rotation. CONCLUSIONS: Plate-haptic toric IOLs rotate more in eyes with larger WTW distances and longer ASLs; therefore, toric IOL implantation should be performed with caution in eyes with these characteristics.


Assuntos
Astigmatismo , Lentes Intraoculares , Facoemulsificação , Astigmatismo/cirurgia , Humanos , Implante de Lente Intraocular , Estudos Prospectivos , Refração Ocular , Estudos Retrospectivos
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