Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 16.146
Filtrar
1.
Rom J Ophthalmol ; 66(1): 89-96, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35531451

RESUMO

We present the difficulties in choosing the right IOL, when facing a great variability of the keratometric measurements, in the case of a patient operated for epiretinal membrane and lamellar macular hole, who developed complicated cataract in the operated eye. Upon commencing the biometric measurements, inconsistency in keratometric values led to further investigations. Repeated placido disc topography initially showed corneal ectasia, which posed a problem on selecting the right type of intra-ocular lens. Ocular surface pathology was suspected, and after treatment, the topography was repeated with a Scheimpflug topographer, that showed an improved keratometric profile. The surgical solution was to implant an aspheric monofocal IOL, in the bag, with extended depth of focus that enhances intermediate vision, disregarding the previous keratometric measurements. Refractive and functional outcomes were good. In cases of biometric measurements that show inconsistency in keratometric values, ocular surface disease as well as corneal ectasia should be taken into consideration. The right implant should not be chosen based on a single measurement, but rather several measurements should be made and compared and the choice should not be made before treating the ocular surface.


Assuntos
Lentes Intraoculares , Facoemulsificação , Córnea/patologia , Topografia da Córnea , Dilatação Patológica/patologia , Dilatação Patológica/cirurgia , Humanos , Implante de Lente Intraocular , Lentes Intraoculares/efeitos adversos , Refração Ocular
2.
Zhonghua Yan Ke Za Zhi ; 58(5): 334-339, 2022 May 11.
Artigo em Chinês | MEDLINE | ID: mdl-35511659

RESUMO

Objective: To investigate the influence of residual astigmatism on the postoperative visual acuity in cataract patients with implantation of an extended depth of focus intraocular lens (IOL). Methods: Retrospective cohort study. A total of 56 eyes of 56 cataract patients who underwent phacoemulsification combined with extended depth of focus IOL implantation from January 2019 to December 2020 at Eye & ENT Hospital of Fudan University were included. There were 29 males and 27 females in all patients, and the age was (65±9) years. Patients were divided into two groups according to their postoperative residual astigmatism: low astigmatism group (<0.75 D, 28 eyes) and high astigmatism group (0.75 to 1.50 D, 28 eyes). At 3 months after surgery, measurements were completed, including postoperative uncorrected distance (5 m) visual acuity, uncorrected intermediate (80 cm) visual acuity, uncorrected near (40 cm) visual acuity, best corrected visual acuity (all the visual acuity was converted to the logarithm of the minimum angle of resolution visual acuity), defocus curves, quick contrast sensitivity function, wavefront aberration, and VF-14 questionnaire scores. The independent samples t-test and Mann-Whitney U test were used for data analysis. Results: The low astigmatism group and high astigmatism group's uncorrected distance visual acuity [M (Q1, Q3)] were 0.05 (-0.06, 0.10), 0.08 (0.00, 0.22), their uncorrected intermediate visual acuity were 0.11 (0.00, 0.20), 0.14 (0.10, 0.21), their uncorrected near visual acuity were 0.28 (0.20, 0.32), 0.26 (0.20, 0.30), and their best corrected visual acuity were 0.17 (0.05, 0.30), 0.14 (0.04, 0.22), respectively. The differences were not statistically significant (all P>0.05). No significant difference was found in the defocus curves from +1.00 to -4.00 D, at intervals of +0.50 D, between the two groups (all P>0.05). No significant difference was found in the quick contrast sensitivity of low, middle and high frequency of dark vision between the low astigmatism group and high astigmatism group (all P>0.05), and the area under Log contrast sensitivity function of the two groups were 0.87±0.28 and 0.77±0.30 (P>0.05). The total whole-eye aberrations were 0.59±0.18 and 0.74±0.51, and the total higher-order aberrations were 0.30±0.13 and 0.37±0.25 in the two groups at 4.0-mm pupil diameter. The differences were not statistically significant when the total whole-eye aberration, total higher-order aberration, coma, cloverleaf aberration, and spherical aberration were compared (all P>0.05). The differences of the total VF-14 visual scores, near visual acuity scores and the distance visual acuity scores of the two groups were not statistically significant (all P>0.05). Conclusion: Cataract patients with residual postoperative astigmatism 0.75 to 1.50 D can obtain as good visual quality as those with postoperative residual astigmatism<0.75 D after implantation of an extended depth of focus IOL.


Assuntos
Astigmatismo , Catarata , Lentes Intraoculares , Facoemulsificação , Idoso , Astigmatismo/cirurgia , Catarata/terapia , Progressão da Doença , Feminino , Humanos , Implante de Lente Intraocular , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos
3.
Zhonghua Yan Ke Za Zhi ; 58(5): 371-372, 2022 May 11.
Artigo em Chinês | MEDLINE | ID: mdl-35511663

RESUMO

A 6-year-old boy with blurred vision for 18 months was diagnosed as bilateral spherophakia and ectopia lentis. He received lensectomy and implantation of an iris-claw intraocular lens in the posterior chamber in both eyes. Good visual results were achieved, and there were no complications during the two-year follow-up.


Assuntos
Ectopia do Cristalino , Cristalino , Lentes Intraoculares , Criança , Ectopia do Cristalino/cirurgia , Seguimentos , Humanos , Implante de Lente Intraocular , Masculino , Complicações Pós-Operatórias , Estudos Retrospectivos , Acuidade Visual
4.
PLoS One ; 17(5): e0267352, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35511906

RESUMO

BACKGROUND: To investigate modern nonlinear iterative strategies for formula constant optimisation and show the application and results from a large dataset using a set of disclosed theoretical-optical lens power calculation concepts. METHODS: Nonlinear iterative optimisation algorithms were implemented for optimising the root mean squared (SoSPE), the mean absolute (SoAPE), the mean (MPE), the standard deviation (SDPE), the median (MEDPE), as well as the 90% confidence interval (CLPE) of the prediction error (PE), defined as the difference between postoperative achieved and formula predicted spherical equivalent power of refraction. Optimisation was performed using the Levenberg-Marquardt algorithm (SoSPE and SoAPE) or the interior point method (MPE, SDPE, MEDPE, CLPE) for the SRKT, Hoffer Q, Holladay 1, Haigis, and Castrop formulae. The results were based on a dataset of measurements made on 888 eyes after implantation of an aspherical hydrophobic monofocal intraocular lens (Vivinex, Hoya). RESULTS: For all formulae and all optimisation metrics, the iterative algorithms showed a fast and stable convergence after a couple of iterations. The results prove that with optimisation for SoSPE, SoAPE, MPE, SDPE, MEDPE, and CLPE the root mean squared PE, mean absolute PE, mean PE, standard deviation of PE, median PE, and confidence interval of PE could be minimised in all situations. The results in terms of cumulative distribution function are quite coherent with optimisation for SoSPE, SoAPE, MPE and MEDPE, whereas with optimisation for SDPE and CLPE the standard deviation and confidence interval of the PE distribution could only be minimised at the cost of a systematic offset in mean and median PE. CONCLUSION: Nonlinear iterative techniques are capable of minimising any statistical metrics (e.g. root mean squared or mean absolute error) of any target parameter (e.g. PE). These optimisation strategies are an important step towards optimising for the target parameters which are used for evaluating the performance of lens power calculation formulae.


Assuntos
Lentes Intraoculares , Facoemulsificação , Comprimento Axial do Olho , Biometria/métodos , Implante de Lente Intraocular , Óptica e Fotônica , Refração Ocular , Estudos Retrospectivos
5.
Sci Rep ; 12(1): 7357, 2022 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-35513494

RESUMO

To compare the predictive refractive accuracy of intraoperative aberrometry (ORA) to the preoperative Barrett True-K formula in the calculation of intraocular lens (IOL) power in eyes with prior refractive surgery undergoing cataract surgery at the Loma Linda University Eye Institute, Loma Linda, California, USA. We conducted a retrospective chart review of patients with a history of post-myopic or hyperopic LASIK/PRK who underwent uncomplicated cataract surgery between October 2016 and March 2020. Pre-operative measurements were performed utilizing the Barrett True-K formula. Intraoperative aberrometry (ORA) was used for aphakic refraction and IOL power calculation during surgery. Predictive refractive accuracy of the two methods was compared based on the difference between achieved and intended target spherical equivalent. A total of 97 eyes (69 patients) were included in the study. Of these, 81 eyes (83.5%) had previous myopic LASIK/PRK and 16 eyes (16.5%) had previous hyperopic LASIK/PRK. Median (MedAE)/mean (MAE) absolute prediction errors for preoperative as compared to intraoperative methods were 0.49 D/0.58 D compared to 0.42 D/0.51 D, respectively (P = 0.001/0.002). Over all, ORA led to a statistically significant lower median and mean absolute error compared to the Barrett True-K formula in post-refractive eyes. Percentage of eyes within ± 1.00 D of intended target refraction as predicted by the preoperative versus the intraoperative method was 82.3% and 89.6%, respectively (P = 0.04). Although ORA led to a statistically significant lower median absolute error compared to the Barrett True-K formula, the two methods are clinically comparable in predictive refractive accuracy in patients with prior refractive surgery.


Assuntos
Catarata , Hiperopia , Ceratomileuse Assistida por Excimer Laser In Situ , Lentes Intraoculares , Miopia , Facoemulsificação , Aberrometria/métodos , Biometria/métodos , Humanos , Hiperopia/cirurgia , Miopia/cirurgia , Óptica e Fotônica , Refração Ocular , Estudos Retrospectivos
6.
Indian J Ophthalmol ; 70(5): 1586-1592, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35502031

RESUMO

Purpose: To evaluate the agreement between the biometric measurements used to calculate the size of the implantable collamer lenses (ICL) with different technologies: swept-source optical coherence tomography, spectral domain optical coherence tomography, and Scheimpflug tomography. Methods: This retrospective observational study included subjects undergoing refractive surgery with posterior chamber phakic IOL implantation to correct their myopia. The anterior chamber depth (ACD) and the horizontal white to white (WTW) or the angle to angle (ATA) distance were measured with the following four devices: the IOLMaster 700 biometer (Carl Zeiss Meditec, Jena, Germany), based on swept-source optical coherence tomography; the Cirrus and Visante optical coherence tomographs (Carl Zeiss Meditec) based on low-coherence interferometry; and the Pentacam rotating Scheimpflug camera (Oculus, Wetzlar, Germany). Results: In the horizontal corneal diameter measurements, there were statistically significant differences between Pentacam-IOLMaster 700 pair (P < 0.001) and Pentacam-Visante pair (P < 0.001). WTW from CIRRUS showed the lowest correlation when paired with Pentacam and IOLMaster 700 (R2 = 0.452 and 0.385 for Visante and R2 = 0.494 and 0.426 for Cirrus). Regarding the linear correlation of the ACD measurements, all pairs of devices were statistically significant and all of them showed a very good correlation index. Conclusion: There is a good agreement between the different devices under evaluation for ACD measurements. As for WTW, the values measured with the different devices showed large discrepancies with low correlation levels, especially when comparing the tomographs with the other devices under evaluation.


Assuntos
Câmara Anterior , Lentes Intraoculares , Câmara Anterior/anatomia & histologia , Câmara Anterior/diagnóstico por imagem , Câmara Anterior/cirurgia , Comprimento Axial do Olho , Biometria/métodos , Humanos , Reprodutibilidade dos Testes
8.
Indian J Ophthalmol ; 70(5): 1617-1625, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35502038

RESUMO

Purpose: Remnant lens epithelial cells (LECs) within the capsular bag (CB) undergo epithelial-to-mesenchymal transition (EMT) and acquire a myofibroblast phenotype, depositing extracellular matrix (ECM) components, leading to posterior capsular opacification (PCO). This study histopathologically analyzes the LEC-to-myofibroblast transition and de novo ECM component deposition (i.e., smooth muscle actin (SMA) and fibronectin (FN) expression) and determines the intraocular lens (IOL) and patient factors associated with these changes. Methods: In total, 190 CBs with IOLs were removed from donor eyes. Digital images were obtained, and PCO was graded using published software (ADOS, Medical Parachute). Automated immunohistochemistry was performed using anti-SMA to detect EMT and anti-FN to document ECM remodeling. Slides were digitized and analyzed using the Positive Pixel Count v9 algorithm. Linear regression and Poisson regression were performed (P < 0.05). Results: SMA positive expression decreased as the time of IOL implantation increased (P < 0.0001). Positivity of SMA and FN demonstrated a positive correlation (P = 0.0002). Controlling for confounding factors in Poisson regression, hydrophobic and hydrophilic materials showed higher FN and SMA expression when compared to silicone material lenses (FN; P = 0.018; P < 0.0001, SMA; P = 0.001; P = 0.003, respectively). The square optic design had 29% higher SMA positivity compared to the opti-edge design (P = 0.042). One-piece haptic lenses had higher SMA expression compared to three-piece haptic (P = 0.042). A higher risk of expression of SMA and FN was seen in patients with a history of smoking, hypertension, and glaucoma (P < 0.05). Conclusion: This study demonstrated that SMA and FN expression is different according to IOL design and patient factors, thus indicating that LEC changes depend on lens biocompatibility. Therefore, by analyzing the histopathological composition of PCO by using LECs, further insight into the characteristics of IOLs that are important for biocompatibility can be ascertained.


Assuntos
Opacificação da Cápsula , Cristalino , Lentes Intraoculares , Opacificação da Cápsula/diagnóstico , Opacificação da Cápsula/etiologia , Células Epiteliais/metabolismo , Humanos , Cristalino/patologia , Lentes Intraoculares/efeitos adversos , Software
11.
J Refract Surg ; 38(5): 304-309, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35536706

RESUMO

PURPOSE: To compare prediction error outcomes between the Optiwave Refractive Analysis System (ORA) (Alcon Laboratories, Inc) and two modern intraocular lens (IOL) formulas (Hill-RBF2.0 [HRBF] and Barrett Universal II [BUII]), and further analyze IOL selection in scenarios of disagreement between methods. METHODS: Patients with no previous history of corneal refractive surgery who underwent cataract extraction and had intraoperative aberrometry measurements between October 2016 and December 2019 were analyzed. The prediction error for the ORA, HRBF, and BUII were calculated based on the postoperative manifest refraction. Further analysis was performed evaluating prediction error for scenarios of disagreement between the three methods. RESULTS: After exclusions, 281 eyes were included. The mean absolute prediction errors were 0.28 diopters (D) (ORA), 0.31 D (HRBF), and 0.33 D (BUII) (P < .05). In instances when the IOL recommended by the ORA was in disagreement with what was selected preoperatively, there was no benefit when the lens recommended by the ORA was selected based on anecdotal experience. When further analyzing these instances of disagreement, selecting the ORA-recommended lens when it is higher in power results in improved refractive outcomes: the ORA resulted in more eyes within ±0.25 diopters (D) of predicted spherical error (65% ORA, 37% HRBF, 32% BUII; P = .004) and fewer hyperopic surprises (5% ORA, 15% HRBF, 24% BUII; P = .009). CONCLUSIONS: In normal eyes without previous corneal refractive surgery, intraoperative aberrometry is not different from to two modern preoperative IOL formulas. Placing the ORA-recommended lens when it is higher in power than that selected preoperatively results in better refractive outcomes. [J Refract Surg. 2022;38(5):304-309.].


Assuntos
Lentes Intraoculares , Miopia , Facoemulsificação , Aberrometria/métodos , Biometria/métodos , Humanos , Miopia/cirurgia , Óptica e Fotônica , Refração Ocular , Estudos Retrospectivos
12.
J Refract Surg ; 38(5): 298-303, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35536707

RESUMO

PURPOSE: To examine the accuracy of the cylinder power choice for toric intraocular lenses (IOLs) using the Goggin Nomogram, which adjusts anterior keratometric astigmatic power values for the likely effect of posterior corneal and non-corneal, non-lenticular astigmatism. METHODS: A consecutive, retrospective case series was based at the Queen Elizabeth Hospital and Ashford Advanced Eye Care in Adelaide, Australia. A total of 586 consecutive eyes of 586 patients underwent phacoemulsification surgery with implantation of a Zeiss AT TORBI 709MP or AT LISA Tri Toric 939 MP toric IOL, calculated using the Goggin Nomogram. The median absolute magnitude of error and geometric mean astigmatic correction index in consecutive eyes with toric IOL cylinder powers of 1.00 to 3.00 diopters (D) were analyzed. RESULTS: Overall, all eyes receiving IOL cylinder powers of 1.00 to 3.00 D inclusive had a median magnitude of error value of 0.19 D (IQR: 0.31) and astigmatic correction index value of 1.03 (IQR: 0.33). For eyes with with-the-rule, against-the-rule, and oblique astigmatism, the median magnitude of error was 0.18 D (interquartile range [IQR]: 0.29), 0.19 D (IQR: 0.31), and 0.17 D (IQR: 0.39), respectively, and the astigmatic correction index was 1.06 (IQR: 0.28), 1.01 (IQR: 0.35) and 1.08 (IQR: 0.32), respectively. CONCLUSIONS: Goggin Nomogram adjusted keratometry provided optimal refractive astigmatic outcome in IOL cylinder powers of 1.00 to 3.00 D in eyes with with-the-rule, against-the-rule, and oblique astigmatism. Goggin Nomogram adjusted keratometry compensates for both posterior corneal astigmatism and any other source of ocular astigmatism. [J Refract Surg. 2022;38(5):298-303.].


Assuntos
Astigmatismo , Lentes Intraoculares , Facoemulsificação , Astigmatismo/cirurgia , Biometria , Humanos , Implante de Lente Intraocular , Nomogramas , Refração Ocular , Estudos Retrospectivos
13.
BMJ Open Ophthalmol ; 7(1)2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35537030

RESUMO

OBJECTIVE: To report the long-term postoperative outcomes of transsclerally sutured intraocular lenses (IOLs), in which the haptics were correctly fixated into the ciliary sulcus using an auxiliary device and endoscope. METHODS AND ANALYSIS: Data were collected from eyes that were followed up for at least 12 months after ciliary sulcus suture fixation of an IOL using an auxiliary device for securely placing the IOL haptics to the ciliary sulcus, which was confirmed using intraoperative endoscopy in all cases. The corrected distance visual acuity (CDVA), refractive error, anterior chamber depth (ACD), IOL decentration and tilt, corneal endothelial cell density (CECD) and postoperative complications were recorded. ACD and IOL deviations were compared with those of normal controls after standard cataract surgery. RESULTS: A total of 146 eyes of 142 patients were included, with a mean follow-up period of 56.0±35.3 (range 12-174) months. Postoperative CDVA from 1 month to 8 years and final CDVA were significantly better, and the mean refraction error, ACD and CECD decline rate were -0.71±0.75 dioptre, 4.01±0.37 mm and -7.4%±16.0%, respectively. Compared with normal controls, ACD was not significantly different but the tilt and decentration were significantly different. The main postoperative complications included vitreous haemorrhage (24.0%), suture thread exposure (19.2%) and corectopia (18.5%). There were no cases of IOL dislocation due to suture breakage or postoperative endophthalmitis CONCLUSION: Long-term postoperative outcomes were favorable with good CDVA and without IOL dislocation and endophthalmitis. The significance and value of fixing haptics to the ciliary sulcus should be re-evaluated.


Assuntos
Endoftalmite , Lentes Intraoculares , Humanos , Implante de Lente Intraocular/efeitos adversos , Complicações Pós-Operatórias , Estudos Retrospectivos , Técnicas de Sutura
14.
Sci Rep ; 12(1): 7685, 2022 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-35538104

RESUMO

Opacification through calcification of hydrophilic acrylic intraocular lenses (IOL) is a severe complication after cataract surgery. Causing symptoms that range from glare through to severe vision loss, the only effective therapy is explantation of the opacified IOL so far. Although IOL calcification is a well-described phenomenon, its pathogenesis is not fully understood yet. The purpose of the current study was to develop a laboratory model to replicate IOL calcification. Calcification could be reproduced using a horizontal electrophoresis and aqueous solutions of calcium chloride and disodium hydrogen phosphate. The analysis of the in vitro calcified IOLs was performed using light microscopy, Alizarin Red and Von Kossa staining, scanning electron microscopy, energy dispersive x-ray spectroscopy and electron crystallography using transmission electron microscopy and electron diffraction. The presented laboratory model could be used to identify hydrophilic IOLs that are at risk to develop calcification and to assess the influence of associated risk factors. In addition, it can serve as a research tool to further understand this pathology.


Assuntos
Calcinose , Opacificação da Cápsula , Lentes Intraoculares , Facoemulsificação , Calcinose/patologia , Remoção de Dispositivo/efeitos adversos , Humanos , Lentes Intraoculares/efeitos adversos , Microscopia Eletrônica de Varredura , Facoemulsificação/efeitos adversos , Falha de Prótese
16.
Klin Monbl Augenheilkd ; 239(4): 490-493, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35472792

RESUMO

BACKGROUND: Marfan Syndrome is an autosomal dominant disease with multiple ocular abnormalities including ectopia lentis and a high incidence of rhegmatogenous retinal detachment (RRD). The management of RRD may be challenging in cases of aphakic patients with Marfan. PURPOSE: To report on the management of four cases of simultaneous RRD and aphakia with vitrectomy, silicone oil tamponade, and retropupillary iris-claw intraocular lens (IOL) implantation in patients with Marfan that have been operated at the Jules-Gonin Eye Hospital between 2019 and 2020. HISTORY AND SIGNS: Ages at presentation were 20, 30, 32, and 31 years, respectively. All patients had a history of extraction of a dislocated lens. None of the patients had a previous posterior vitrectomy. Two patients had records of previous measurements for IOL calculation by optical biometry (IOL Master, Carl Zeiss Meditec AG, Jena, Germany) about 1 year prior to the RRD development. In two cases, measurements for IOL calculation by optical biometry were based on the contralateral eye. THERAPY AND OUTCOME: All patients underwent 23 G vitrectomy, peripheral iridotomy, and retropupillary iris-claw IOL. No intraoperative complications were encountered. All patients had silicone oil tamponade, one of which required heavy silicone oil. Silicone oil was removed 3 months following primary surgery. Minimum follow-up was 1 year. The single surgery anatomic success rate was 100%. All patients had visual acuity of at least 0.8 at the last follow-up (1.25, 1.0, 0.8, and 0.8 respectively). The targeted refractive results were accurately achieved in all four cases postoperatively. One patient presented ocular hypertension 2 weeks after surgery due to presumed steroid response and was managed conservatively. None of the patients had silicone oil migration into the anterior chamber. CONCLUSION: Retropupillary iris-claw IOL implantation in cases of RRD and aphakia creates a barrier to tamponades from the posterior segment, effectively preventing them from entering the anterior segment of the eye. Therefore, the management of aphakia and retinal detachment with simultaneous vitrectomy and a retropupillary iris-claw IOL may be a successful strategy in reducing postoperative complications in patients with Marfan syndrome.


Assuntos
Afacia , Lentes Intraoculares , Síndrome de Marfan , Descolamento Retiniano , Afacia/complicações , Afacia/diagnóstico , Afacia/cirurgia , Humanos , Implante de Lente Intraocular/métodos , Síndrome de Marfan/complicações , Síndrome de Marfan/diagnóstico , Síndrome de Marfan/cirurgia , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/etiologia , Descolamento Retiniano/cirurgia , Estudos Retrospectivos , Óleos de Silicone , Vitrectomia/efeitos adversos
18.
BMJ Open Ophthalmol ; 7(1): e000941, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35372697

RESUMO

Objective: To assess agreement and repeatability of white-to-white (WTW) and anterior chamber depth (ACD), and agreement of implantable collamer lens (ICL) size using these measurements from different devices. Methods and analysis: A retrospective review of 83 eyes with ICL implantation (42 patients) was conducted. The agreement of WTW (measured with WaveLight Topolyzer and Orbscan IIz) and ACD (measured with WaveLight Oculyzer and Orbscan IIz) was analysed. Correlation of ICL sizes and difference of eyes with unacceptable vaults between two data sets (WaveLight platform; Topolyzer and Oculyzer and Orbscan IIz) were assessed. Results: Average WTW measured by Orbscan IIz and Topolyzer demonstrated good agreement (Ρ 0.884) with low systematic bias (-0.03±0.1 mm) and narrow 95% limits of agreement (LoA) of -0.28 to 0.22. Average ACD measured by Orbscan IIz and Oculyzer also showed good agreement (Ρ 0.903) with low systematic bias (-0.04±0.1 mm) and relatively narrow 95% LoA (0.2 to 0.12). ICL size selected according to two data sets showed moderate to strong level of agreement (Kappa=0.81). There was a statistically significant difference (p<0.001) in the proportion of eyes with unacceptable postoperative vaults when using the Wavelight platform data set (five eyes, 6.02%) and the Orbscan IIz data set (12 eyes, 14.46%). Conclusion: Although the agreement of WTW and ACD between devices was good, there was a significant difference in proportion of eyes with unacceptable postoperative vaults when using two data sets. Therefore, Topolyzer and Oculyzer might not be suitable for operating interchangeably with Orbscan IIz for ICL size selection.


Assuntos
Olho , Lentes Intraoculares , Humanos , Estudos Retrospectivos
19.
Klin Monbl Augenheilkd ; 239(4): 484-489, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35472791

RESUMO

PURPOSE: To compare the efficacy and safety of core vitrectomy and pars plana vitrectomy for lens exchange in patients with intraocular lens dislocation. METHODS: This is a retrospective study conducted at one eye center in Zurich, Switzerland. We reviewed 124 eyes with dislocated intraocular lens undergoing lens exchange carried out by two surgeons between 03/2016 and 12/2019 (45 months). Intraocular pressure (IOP) and best-corrected visual acuity (BCVA) were analyzed preoperatively and at 5 time points up to 12 months after lens exchange. Data on postoperative complications were collected. RESULTS: There were 124 eyes with intraocular lens dislocation that were referred for lens exchange. Of these eyes, 59 (48%) received core vitrectomy and 65 (52%) received pars plana vitrectomy with lens exchange. Glaucoma was more frequent in the core vitrectomy group (78%) than in the pars plana vitrectomy group (32%; p < 0.001). In the core vitrectomy group, 19 (32%) eyes presented with visual impairment, 17 (29%) eyes presented with high IOP alone, and 23 (39%) eyes presented with both at the same time prior to surgery. Mean preoperative IOP in the core vitrectomy group decreased from 22.4 ± 9.2 mmHg to 14.7 ± 3.1 mmHg 12 months after surgery (p < 0.001). Mean BCVA changed from 0.40 ± 0.41 logMAR preoperatively to 0.32 ± 0.37 logMAR at 12 months postoperatively (p = 0.598) in the core vitrectomy group. In the pars plana vitrectomy group, 44 (68%) eyes presented with a change in vision, 7 (11%) eyes presented with high IOP alone, and 14 (22%) eyes presented with pressure elevation and visual impairment at the visit prior to surgery. Mean preoperative IOP in the pars plana vitrectomy group decreased from 20.9 ± 8.3 mmHg to 15.1 ± 3.5 mmHg at 12 months after lens exchange (p < 0.001). Mean BCVA in the pars plana vitrectomy group was 0.57 ± 0.62 logMAR preoperatively and 0.22 ± 0.35 logMAR 12 months postoperatively (p < 0.001). Postoperative pressure decompensation occurred more frequently in the core vitrectomy group (20%) than in the pars plana vitrectomy group (6%; p = 0.018). There was no statistically significant difference for postoperative cystoid macular edema (p = 0.055), anisometropia (p = 0.986), and high astigmatism (p = 0.362). CONCLUSION: Core vitrectomy and pars plana vitrectomy with lens exchange are equally efficient and safe in the management of intraocular lens dislocation.


Assuntos
Subluxação do Cristalino , Lentes Intraoculares , Edema Macular , Humanos , Subluxação do Cristalino/diagnóstico , Subluxação do Cristalino/etiologia , Subluxação do Cristalino/cirurgia , Edema Macular/complicações , Estudos Retrospectivos , Acuidade Visual , Vitrectomia/efeitos adversos
20.
J Colloid Interface Sci ; 619: 348-358, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35398765

RESUMO

Due to development of surgical techniques and intraocular lens (IOL) implants, vision can often be restored in cataracts patients. However, posterior capsular opacification (PCO) has become the most common and challenging complication in cataracts surgery. While various approaches such as surface modification and drug prophylaxis have been investigated to prevent PCO development, there is no standard treatment that is sufficiently safe and effective to meet clinical demands. Near-infrared (NIR) light-triggered photothermal therapy is an attractive noninvasive treatment for PCO prophylaxis. We fabricated a new type of IOL with excellent biocompatibility, stability, and photothermal conversion property. Polyethyleneimine (PEI) and graphene oxide (GO) were layer-by-layer assembled on model polymethylmethacrylate and IOL substrates, and the thickness, surface roughness, and wettability of the substrates with different numbers of bilayers were evaluated. After the reduction of GO to reduced GO (rGO), a rGO/PEI multilayer thin film with good stability and photothermal conversion capability was obtained. The rGO/PEI multilayer coating was able to induce apoptosis in lens epithelium cells under 808-nm NIR laser irradiation in vitro. Finally, rGO@IOL was implanted into rabbit eyes, and the biocompatibility and ability to prevent PCO were evaluated for 5 weeks. The rGO@IOL implant exhibited excellent PCO prevention ability with the assistance of NIR irradiation and did not induce obvious pathological effects in surrounding healthy tissues. The rGO@IOL implant with good biocompatibility, good physicochemical stability, and excellent photothermal conversion property shows promise for clinical application in PCO prophylaxis.


Assuntos
Opacificação da Cápsula , Lentes Intraoculares , Animais , Opacificação da Cápsula/etiologia , Opacificação da Cápsula/prevenção & controle , Células Epiteliais , Grafite , Humanos , Lentes Intraoculares/efeitos adversos , Terapia Fototérmica , Coelhos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...