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Sorkin N, Zadok R, Giacomo S, Kan-Tor Y, Benjamini Y, Levinger E, Bardugo J, Abulafia A. Comparison of IOL Power Prediction Accuracy between Two Swept-Source OCT Biometry Devices. Am J Ophthalmol 2024:S0002-9394(24)00160-0. [PMID: 38643892 DOI: 10.1016/j.ajo.2024.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 04/14/2024] [Accepted: 04/14/2024] [Indexed: 04/23/2024]
Abstract
PURPOSE To compare intraocular lens (IOL) power prediction accuracy of the Eyestar 900 (EyeS900) and the IOLMaster 700 (IOLM700) based on estimated and measured posterior corneal power DESIGN: Retrospective, inter-instrument reliability study METHODS: Setting: Institutional. PARTICIPANTS 225 eyes of 225 cataract surgery patients. MEASUREMENTS Patients underwent measurements by both devices preoperatively. MAIN OUTCOME MEASURES Spherical Equivalent Prediction Error (SEQ-PE), spread of the SEQ-PE (Precision) and the absolute SEQ-PE (accuracy) of each device using Barrett Universal II (BUII) formula with either estimated posterior keratometry (E-PK) or measured posterior keratometry (M-PK). RESULTS Trimmed mean SEQ-PEs of EyeS900 E-PK, EyeS900 M-PK, IOLM700 E-PK and IOLM700 M-PK were 0.03, 0.08, 0.02 and 0.08 D, respectively with no significant differences between EyeS900 E-PK and IOLM700 E-PK (p=0.31) as well as between EyeS900 M-PK and IOLM700 M-PK (p=0.31). Statistically significant SEQ-PE differences were found when E-PK and M-PK were compared, regardless of the device used, showing hyperopic SEQ-PE in M-PK calculations. Excellent correlation and agreement in SEQ-PE were found between the devices for both E-PK (p<0.001,r=0.848, mean bias:+0.01 D, 95% LOA of -0.32 to +0.34 D) and M-PK (p<0.001,r=0.776, mean bias:-0.01 D, 95% LOA of -0.42 to +0.39 D). No significant differences were found comparing absolute SEQ-PE and precision of the devices. CONCLUSION The Eyestar 900 and the IOLMaster 700 show comparable IOL power prediction accuracy by the BUII formula using either estimated or measured posterior keratometry. An adjusted lens factor may be required for BUII when utilizing measured posterior keratometry in both devices.
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Affiliation(s)
- Nir Sorkin
- Department of Ophthalmology, Tel Aviv Medical Center, Tel Aviv, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Rotem Zadok
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Yoav Kan-Tor
- The Alexander Grass Center for Bioengineering, School of Computer Science and Engineering, Hebrew University of Jerusalem, Israel
| | - Yuval Benjamini
- Department of Statistics and Data Science, The Hebrew University of Jerusalem, Israel
| | - Eliya Levinger
- Department of Ophthalmology, Tel Aviv Medical Center, Tel Aviv, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Judith Bardugo
- Department of Ophthalmology, Shaare Zedek Medical Center and the Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Adi Abulafia
- Department of Ophthalmology, Shaare Zedek Medical Center and the Hebrew University-Hadassah Medical School, Jerusalem, Israel
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Garzón N, Gómez-Pedrero JA, Albarrán-Diego C, Fernández-Núñez S, Villanueva Gómez-Chacón S, García-Montero M. Optical power profiles and aberrations of a non-diffractive wavefront-shaping extended depth of focus intraocular lens. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06469-y. [PMID: 38597962 DOI: 10.1007/s00417-024-06469-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/28/2024] [Accepted: 03/27/2024] [Indexed: 04/11/2024] Open
Abstract
PURPOSE This study is to evaluate the optical characteristics of a non-diffractive wavefront-shaping intraocular lens which incorporates surface refractive modifications for shaping the wavefront in order to achieve extended depth of focus (EDoF) and to assess whether the nominal power of this IOL influences the attainable add power. METHODS A commercially available optical bench NIMO TR1504 device (LAMBDA-X, Nivelles, Belgium) was employed to obtain full optical characterization of three non-diffractive EDoF intraocular lenses with + 10 D, + 20 D, and + 30 D powers. After NIMO measurements, data were computed using a custom-made MATLAB program (Mathworks, Inc., Natick, MA, USA) to evaluate the optical quality functions, such as the point spread function (PSF), wavefront profiles, and modulation transfer function (MTF) for two pupil sizes: 3 mm and 4.0 mm. RESULTS The non-diffractive EDoF intraocular lens showed a central serrated power profile behavior with additions of + 2.00 to + 2.50 D over the nominal power. Higher order aberrations were found to be driven mainly by the spherical aberration, with almost null comatic influence. Optical quality metrics showed good values, better for a 3 mm pupil compared to a 4.5 mm one, as expected. The three IOL powers tested showed a very similar behavior in terms of power and aberrometric profiles, with minimal to null differences related to the nominal power. CONCLUSION The non-diffractive wavefront-shaping EDoF intraocular lens achieves a near addition up to + 2.50 D aiming for an extended range of vision, almost independently of the base power.
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Affiliation(s)
- Nuria Garzón
- Dpto. de Optometría y Visión, Universidad Complutense de Madrid, Av. Arcos del Jalón 118, 28037, Madrid, Spain
| | | | - César Albarrán-Diego
- Dpto. de Óptica y Optometría y Ciencias de La Visión, Universitat de València, Doctor Moliner 50, Burjassot, 46100, Valencia, Spain.
| | - Sara Fernández-Núñez
- Dpto. de Óptica, Universidad Complutense de Madrid, Av. Arcos del Jalón 118, 28037, Madrid, Spain
| | | | - María García-Montero
- Dpto. de Optometría y Visión, Universidad Complutense de Madrid, Av. Arcos del Jalón 118, 28037, Madrid, Spain
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De Simone L, Mautone L, Aldigeri R, Gentile P, Ragusa E, Gozzi F, Bolletta E, Adani C, Vecchi M, Invernizzi A, Cimino L. Anterior Segment Optical Coherence Tomography in Uveitis-Glaucoma-Hyphema Syndrome. Ocul Immunol Inflamm 2024:1-7. [PMID: 38436932 DOI: 10.1080/09273948.2024.2323094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 02/21/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE Uveitis-Glaucoma-Hyphema (UGH) syndrome results from contact between the intraocular lens (IOL) and the iris or ciliary body, leading to uveal structure erosion and blood-aqueous barrier breakdown. Treatment involves various drugs, with IOL removal often being necessary. Diagnosis relies on clinical signs, but imaging techniques like ultrasound biomicroscopy (UBM) or anterior segment optical coherence tomography (AS-OCT) are crucial. AS-OCT accurately depicts IOL position and potential contact, emerging as a primary alternative to UBM in the diagnosis. Our study aimed to correlate AS-OCT findings with clinically detectable iris atrophy in pseudophakic patients with IOL-iris chafing and UGH syndrome. METHODS The study retrospectively analyzed patients diagnosed with UGH syndrome presenting at the Ocular Immunology Unit of Reggio Emilia, Italy, from January 2019 to August 2023. Patients' data were collected. Ophthalmological exams and imaging were performed. The peephole sign in AS-OCT images was evaluated. Statistical analyses were conducted, with a significance level of p ≤ 0.05. RESULTS The study reviewed 22 eyes of 22 patients with UGH syndrome. Four eyes were excluded, leaving 18 patients (8 females, 10 males). Common misdiagnoses included idiopathic anterior uveitis (55.5%) and herpetic anterior uveitis (16.7%). All patients had iris transillumination defects, mostly focal (77.8%). AS-OCT revealed IOL chafing in all the eyes, with peephole sign correlation. More peephole signs occurred with IOL in the sulcus (p-value = 0.08). CONCLUSION The study recommends AS-OCT for UGH syndrome confirmation and UBM when IOL-iris chafing is not observed on AS-OCT scans.
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Affiliation(s)
- L De Simone
- Ocular Immunology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - L Mautone
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - R Aldigeri
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - P Gentile
- Ocular Immunology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - E Ragusa
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
| | - F Gozzi
- Ocular Immunology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - E Bolletta
- Ocular Immunology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - C Adani
- Ocular Immunology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - M Vecchi
- Ophthalmology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - A Invernizzi
- Eye Clinic, Department of Biomedical and Clinical Science, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - L Cimino
- Ocular Immunology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, with Interest in Transplants, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
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Yusef YN, Yusef SN, Vvedenskiy AS, Ivanov MN, Alkharki L, Fokina ND. [Rotational technique for emulsification of soft lens nucleus]. Vestn Oftalmol 2024; 140:123-128. [PMID: 38739141 DOI: 10.17116/oftalma2024140022123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
Effective and atraumatic removal of a soft lens nucleus requires different surgical techniques compared to phacoemulsification of a dense nucleus. PURPOSE This study was conducted to develop a non-ultrasound technique for emulsification of a soft lens nucleus. MATERIAL AND METHODS Fifty-seven patients (57 eyes) underwent surgery. In 23 cases, early or immature cataracts were detected, and in 34 cases, lens removal was performed for refractive purposes in high myopia and complex myopic astigmatism. Phacoemulsifier Centurion Vision System (Alcon Laboratories, Inc., USA) was used for the surgery. Aspiration of soft lens nucleus was done using a rotational technique. The following aspects were evaluated in the course of the surgery: the volume of the required irrigation solution, and the frequency needing to involve ultrasound for complete emulsification of the lens nucleus. Intraoperative and postoperative complications were also assessed. RESULTS The surgery was uneventful in all cases. There were no violations of the integrity of capsulorhexis edge. The need for short pulses of minimal power ultrasound during the removal of the soft lens using this technique arose only in 11 (19.3%) cases. The effective ultrasound time was less than 1 second. The required volume of irrigation solution was 33.0 (24.0; 43.0) ml, which does not differ significantly from that in ultrasonic phacoemulsification. CONCLUSIONS The use of modern phacoemulsifiers providing a high vacuum level allows successful removal of a soft lens without using ultrasound, which prevents its negative impact on the ocular tissues. The use of adequate surgical techniques, including the optimal direction of rotation of the lens nucleus in the rotational technique, improves the efficiency of soft lens nucleus removal.
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Affiliation(s)
- Yu N Yusef
- Krasnov Research Institute of Eye Disease, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - S N Yusef
- Krasnov Research Institute of Eye Disease, Moscow, Russia
| | - A S Vvedenskiy
- Krasnov Research Institute of Eye Disease, Moscow, Russia
| | - M N Ivanov
- Krasnov Research Institute of Eye Disease, Moscow, Russia
| | - L Alkharki
- Krasnov Research Institute of Eye Disease, Moscow, Russia
| | - N D Fokina
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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5
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Yusef YN, Yusef SN, Vvedenskiy AS, Ivanov MN, Alkharki L, Fokina ND. [Surgical technique for aspiration of soft lens nucleus with preoperative femtosecond laser-assisted fragmentation]. Vestn Oftalmol 2024; 140:109-115. [PMID: 38739139 DOI: 10.17116/oftalma2024140022109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
Fragmentation and aspiration of soft cataracts require different surgical techniques and approaches compared to the removal of dense nuclei, including when using a femtosecond laser. PURPOSE This study was conducted to develop a non-ultrasound technique for aspiration of a soft lens nucleus after its preliminary femtosecond laser-assisted fragmentation. MATERIAL AND METHODS The study included 63 patients (63 eyes) aged 23 to 40 years who underwent surgery. In 27 cases, early or immature cataract was observed, and in 36 cases, cataract removal was performed for refractive purposes in high myopia and complex myopic astigmatism. The VICTUS femtosecond laser surgical system (Technolas Perfect Vision GmbH, Germany) was used for preliminary fragmentation of the lens nucleus. Surgeries were performed using the Centurion Vision System phacoemulsifier (Alcon Laboratories, Inc., USA). The volume of the required irrigation solution was evaluated during the surgery. Intraoperative and postoperative complications were assessed. RESULTS The surgery was performed without complications in all cases. Capsulorhexis edge was completely preserved along its entire circumference. The study showed the fundamental possibility of aspirating a cataract with a nucleus of grade I-II density without low-frequency ultrasound after preliminary femtosecond laser-assisted fragmentation of the nucleus with a "grid" pattern, which ensures minimal fragment size in the central zone of the nucleus. The volume of irrigation solution required for aspiration of the nucleus was 36.0 (27.0; 44.0) ml, which does not significantly differ from the volume of solution during ultrasound phacoemulsification of a nucleus of such density. CONCLUSIONS Femtosecond laser-assisted fragmentation of the lens nucleus with a "grid" pattern and phacoemulsifier systems with a high vacuum level allow effective aspiration of a soft lens without using low-frequency ultrasound.
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Affiliation(s)
- Yu N Yusef
- Krasnov Research Institute of Eye Disease, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - S N Yusef
- Krasnov Research Institute of Eye Disease, Moscow, Russia
| | - A S Vvedenskiy
- Krasnov Research Institute of Eye Disease, Moscow, Russia
| | - M N Ivanov
- Krasnov Research Institute of Eye Disease, Moscow, Russia
| | - L Alkharki
- Krasnov Research Institute of Eye Disease, Moscow, Russia
| | - N D Fokina
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Van Hoe W, Van Calster J, Jansen J, Vander Mijnsbrugge J, Delbecq AL, Fils JF, Stalmans P. Patient satisfaction after EDOF intraocular lens implantation in vitrectomized eyes. Graefes Arch Clin Exp Ophthalmol 2023; 261:3465-3474. [PMID: 37584791 DOI: 10.1007/s00417-023-06204-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 08/17/2023] Open
Abstract
PURPOSE To report patient satisfaction after unilateral/bilateral extended depth-of-focus (EDOF) intraocular lens (IOL) implantation in a young population after vitrectomy. METHODS Patients that underwent phaco-vitrectomy or phaco following vitrectomy with an AT LARA EDOF IOL, aged between 18 and 75 years, were asked to fill out a questionnaire to assess overall visual quality, near vision quality, and visual disturbances. The questionnaire was based on the Catquest, NAVQ, and APPLES questionnaires. RESULTS A total of 89 participants (average age 56.7 years) filled out the questionnaire of which 53.9% received a unilateral EDOF IOL. The most common indications for vitrectomy were retinal detachments (38.2%), floaters (36.0%), and epiretinal membranes (16.9%). The Catquest and NAVQ score respectively showed a good overall satisfaction (3.44/4.0), a good intermediate vision (3.55/4.0), and an average near vision (2.75/4.0). The APPLES score showed acceptable visual disturbances. There were no differences between the unilateral and bilateral group, except for a higher spectacle dependency in the unilateral group (40% vs. 10.6%). Participants that underwent vitrectomy in case of floaters reported lower satisfaction rates. Other variables, like the pre-operative refraction, had no impact on both satisfaction and visual disturbances. CONCLUSION Both unilateral and bilateral implantation of the AT LARA EDOF IOL showed a high satisfaction with no differences between both groups, except for a lower spectacle use in the latter. Hence, The AT LARA seems to be a possible choice in patients undergoing vitrectomy at a younger age, even for unilateral use.
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Affiliation(s)
- Willem Van Hoe
- Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium
| | | | - Joyce Jansen
- Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium
| | | | - Ann-Laure Delbecq
- Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium
| | | | - Peter Stalmans
- Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium.
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Van Severen V, Maaijwee KJM, Pennekamp CWA, Feenstra HMA, van Dijk EHC, Lindstedt EW, Bamonte G. Comparison of surgical outcomes of Carlevale sutureless scleral fixation and Artisan Aphakia intraocular lens. Acta Ophthalmol 2023. [PMID: 37877675 DOI: 10.1111/aos.15795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 07/26/2023] [Accepted: 09/18/2023] [Indexed: 10/26/2023]
Abstract
PURPOSE To compare intra- and postoperative results of sutureless scleral fixated Carlevale intraocular lens (IOL) with iris fixated Artisan IOL. METHODS Monocentre, retrospective analysis of refractive outcomes and intra- and postoperative complications of patients who received a Carlevale or Artisan IOL between January 2019 and March 2022. RESULTS 178 eyes of 169 patients were included (101 Carlevale and 77 Artisan IOLs). The standard follow-up time was 1 month. Two statistically significant differences were found: in the deviation of the postoperative spherical equivalent of the refraction from the preoperative chosen IOL target (p = 0.019; mean deviation was -0.46 in the Carlevale and 0.08 in the Artisan group), and the number of eyes with complications between the Carlevale and Artisan groups (p = 0.003; 33 in the Carlevale and 42 in the Artisan group). CONCLUSION The current study is the largest so far comparing both refractive outcomes and complications after implantation of Carlevale and Artisan IOL. The Carlevale IOL does not carry a greater complication risk on the short-term follow-up. This provides additional evidence that the Carlevale IOL has to be added to the armamentarium of the ophthalmic surgeon.
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Affiliation(s)
| | | | | | - H M A Feenstra
- Leiden University Medical Center, Leiden, The Netherlands
| | - E H C van Dijk
- Leiden University Medical Center, Leiden, The Netherlands
| | | | - G Bamonte
- HagaHospital, The Hague, The Netherlands
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Taliento C, Manservigi M, Tormen M, Cappadona R, Piccolotti I, Salvioli S, Scutiero G, Greco P. Safety of misoprostol vs dinoprostone for induction of labor: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2023; 289:108-128. [PMID: 37660506 DOI: 10.1016/j.ejogrb.2023.08.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/20/2023] [Accepted: 08/24/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVE Pharmacological agents such as prostaglandins (dinoprostone and misoprostol) are commonly used to reduce the duration of labor and promote vaginal delivery. However, key safety considerations with its use include an increased risk of uterine rupture, tachysystole and hyperstimulation of pregnant women, which could potentially lead to a non-reassuring fetal heart rate and to fetal hypoxemia. The aim of this systematic review was to assess maternal and fetal outcomes between misoprostol group (PGE1) and dinoprostone group (PGE2) STUDY DESIGN: We search on MEDLINE (PubMed), CINHAL (EBSCOhost), EMBASE, Scopus (Ovid), CENTRAL (January 1, 1998, to December 31, 2022). Patients were eligible if they presented at greater than 36 weeks gestation with an indication for induction of labor and a single live cephalic fetus. We conducted a meta-analysis of data for both primary (cesarean section rate, instrumental deliveries rate, tachysystole, uterine rupture, post-partum haemorrage; chorionamiositis) and secondary outcomes (Apgar at 5 min <7, meconium-stained liquor, NICU admission, infant death) using odds-ratio (OR) as a measure of effect-size. Risk of bias assessment was performed with RoB-I. We performed statistical analyses using Cochrane RevMan version 5.4 software. RESULTS We found 39 RCTs comparing the outcomes of interest between misoprostol and dinoprostone. The pooled effect showed no statistically significant difference between the two groups in terms of cesarean section rate [OR: 0.94; 95% CI 0.84-1.05], instrumental deliveries rate [OR: 1.04; 95% CI: 0.90-1.19; p = 0.62], tachysystole [OR: 1.21; 95% CI: 0.91-1.60; p = 0.19], post-partum hemorrhage [OR: 0.85; 95% CI: 0.62-1.15p = 0.30], chorioamnionitis [OR: 0.94; 95% CI: 0.76-1.17p = 0.59], Apgar at 5 min < 7 [OR: 0.83; 95% CI: 0.61-1.12, p = 0.21], meconium-stained liquor [OR: 1.11; 95% CI: 0.97-1.27p = 0.59], NICU admission group [OR: 0.91; 95% CI: 0.77-1.09], infant death [OR: 0.57; 95% CI: 0.22-1.44]. After performing a sub-group analysis based on the type of prostaglandins administrations (oral, vaginal gel, vaginal pessary), results did not change substantially. CONCLUSIONS This systematic review and meta-analysis demonstrate that misoprostol and dinoprostone appear to have a similar safety profile.
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Affiliation(s)
- Cristina Taliento
- Maternal and Child Department, Unit of Obstetrics and Gynecology, S. Anna University Hospital, Cona, Ferrara, Italy; Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
| | - Margherita Manservigi
- Maternal and Child Department, Unit of Obstetrics and Gynecology, S. Anna University Hospital, Cona, Ferrara, Italy; Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Mara Tormen
- Maternal and Child Department, Unit of Obstetrics and Gynecology, S. Anna University Hospital, Cona, Ferrara, Italy; Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Rosaria Cappadona
- Maternal and Child Department, Unit of Obstetrics and Gynecology, S. Anna University Hospital, Cona, Ferrara, Italy; Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Irene Piccolotti
- Maternal and Child Department, Unit of Obstetrics and Gynecology, S. Anna University Hospital, Cona, Ferrara, Italy; Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Stefano Salvioli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Sciences (DINOGMI), University of Genoa - Campus of Savona, Italy; Department of Neuroscience and Rehabilitation, University of Ferrara, Italy
| | - Gennaro Scutiero
- Maternal and Child Department, Unit of Obstetrics and Gynecology, S. Anna University Hospital, Cona, Ferrara, Italy; Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Pantaleo Greco
- Maternal and Child Department, Unit of Obstetrics and Gynecology, S. Anna University Hospital, Cona, Ferrara, Italy; Department of Medical Sciences, University of Ferrara, Ferrara, Italy
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Korpole NR, Kurada P, Kuzhuppilly NIR, Korpole MR. Comparison of clinical outcomes of Eyecryl toric and Alcon toric intra-ocular lenses - A real world study. Indian J Ophthalmol 2023; 71:2972-2977. [PMID: 37530267 PMCID: PMC10538847 DOI: 10.4103/ijo.ijo_3403_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 05/07/2023] [Accepted: 05/27/2023] [Indexed: 08/03/2023] Open
Abstract
Purpose To compare the visual outcomes and residual astigmatism following implantation of Eyecryl toric versus Alcon AcrySof IQ toric intra-ocular lenses (IOLs). Methods This retrospective, observational study included 143 eyes of 141 patients who underwent phaco-emulsification, followed by implantation of Eyecryl toric IOL (n = 83 eyes) or Alcon toric IOL (n = 60 eyes) in an eye hospital in South India from 2018 to 2021. At 1 month post-op, the uncorrected distance visual acuity (UCVA), best corrected distance visual acuity (BCVA), and residual astigmatism of the toric IOL were compared and analyzed. Results The mean pre-op corneal astigmatism was 2.02 ± 0.81 D and 1.70 ± 0.68 D in the Alcon and Eyecryl groups, respectively (P = 0.005). The mean post-op corneal astigmatism at 1 month was 0.50 ± 0.51 D and 0.36 ± 0.42 D in the Alcon and Eyecryl groups, respectively, with no statistically significant difference between them (P = 0.87). The mean post-op UCVA in logarithm of minimum angle of resolution (logMAR) at 1 month was similar between the groups at 0.17 ± 0.18 and 0.17 ± 0.16 in the Alcon and Eyecryl groups, respectively (P = 0.98). The mean post-op BCVA in logMAR at 1 month was 0.06 ± 0.09 and 0.03 ± 0.10 in the Alcon and Eyecryl groups, respectively (P = 0.02). Conclusion Both Eyecryl toric and Alcon AcrySof IQ toric IOLs showed comparable post-operative outcomes in terms of UCVA and residual astigmatism. The post-op BCVA was clinically similar between groups but statistically better in the Eyecryl toric group.
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Affiliation(s)
- Nilay Reddy Korpole
- Department of Ophthalmology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Padma Kurada
- Drishti Eye Centre, Plot No. 114A, Lane Opp. SBI, Srinagar Colony Main Road, Ameerpet, Hyderabad India
| | - Neetha I R Kuzhuppilly
- Department of Ophthalmology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Madhukar Reddy Korpole
- Drishti Eye Centre, Plot No. 114A, Lane Opp. SBI, Srinagar Colony Main Road, Ameerpet, Hyderabad India
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Giansanti F, Dragotto F, Nicolosi C, Alonzo L, Cifarelli L, Franco FGS, Vannozzi L, Abbruzzese G, Bacherini D, Virgili G. Enhancing Intermediate Vision in Patients Affected by Epiretinal Membrane Treated by Phaco-Vitrectomy. J Clin Med 2023; 12:5016. [PMID: 37568418 PMCID: PMC10420151 DOI: 10.3390/jcm12155016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND The aim of this research was to see if a refractive enhanced monofocal IOL (Eyhance IOL, IOL Abbott Medical Optics, Inc., Santa Ana, CA, USA) can provide better intermediate vision in patients undergoing phaco-vitrectomy due to cataract and epiretinal macular membrane (ERM). METHODS A nonrandomized prospective observational comparative study enrolled patients affected by cataract and ERM undergoing phaco-vitrectomy. A follow up of 6 months was established. Corrected and uncorrected visual acuity of both monocular and binocular types were assessed regarding intermediate and far distances. The CATQUEST 9-SF questionnaire was administered preoperatively and at the last follow-up. RESULTS Twenty-three eyes of twenty-three patients were enrolled, with 11 in the enhanced monofocal group. The uncorrected and corrected distance visual acuity after 6 months was not statistically different. Both monocular and binocular uncorrected intermediate visual acuity after 6 months were higher in the enhanced monofocal group (p < 0.001). The corrected intermediate visual acuity after 6 months was higher in the enhanced monofocal group (p = 0.01). The CATQUEST-9SF questionnaire showed significant differences in the variation between the preoperative condition and six-month postoperative results (p < 0.001). CONCLUSIONS This refractive enhanced monofocal IOL can provide better intermediate vision compared to a standard monofocal IOL in patients undergoing phaco-vitrectomy due to cataracts and ERM. Further studies are necessary to confirm these results.
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Affiliation(s)
| | - Francesco Dragotto
- Department of Neurosciences, Psychology, Drug Research and Child Health, Eye Clinic, University of Florence, AOU Careggi, 50121 Florence, Italy; (F.G.); (C.N.); (L.A.); (L.C.); (F.G.S.F.); (L.V.); (G.A.); (D.B.); (G.V.)
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11
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Lewin GA, Dixon CJ. Scleral fixation of a novel modified, injected canine intraocular lens by haptic capture, in 17 dogs. Vet Ophthalmol 2023. [PMID: 37410806 DOI: 10.1111/vop.13129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/14/2023] [Accepted: 06/16/2023] [Indexed: 07/08/2023]
Abstract
INTRODUCTION The aims of lens removal surgery are to re-establish or preserve both a clear visual axis and emmetropic vision. Trans-scleral intraocular lens (IOL) fixation has been described in cases where lens capsule instability precludes the insertion of a prosthetic intraocular lens into the lens capsule. Previous techniques have necessitated enlargement of the corneal incision to accommodate either a rigid polymethylmethacrylate IOL or an acrylic foldable IOL inserted using forceps. This paper reports the modification of an endocapsular IOL to be used as an injectable suture-fixated IOL introduced through a 2.8 mm corneal incision. MATERIALS AND METHODS All cases underwent lens extraction by phacoemulsification followed by removal of the unstable lens capsule. A PFI X4 IOL (Medicontur) was modified to create four open-loop haptics. The IOL was injected into the anterior chamber, each haptic was captured in a loop of suture introduced ab externo, and the lens was sutured with four-point fixation. RESULTS The results from 20 eyes in 17 dogs are reported. Over an average follow-up time of 14.5 months, vision was retained in 16/20 eyes. Vision was lost in four eyes due to corneal ulceration and ocular hypertension (1/20), retinal detachment (2/20), and Progressive Retinal Atrophy (1/20). CONCLUSIONS The modified PFI X4 proved suitable for injection and scleral fixation through a 2.8 mm corneal incision, with a success rate comparable to previously published techniques.
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12
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Narayanan N, Ravi P, Toshwani N. A long-term clinical outcome of Hoffmann pocket four-point scleral fixated intraocular lens implantation combined with penetrating keratoplasty - A single corneal surgeon's report. Indian J Ophthalmol 2023; 71:2722-2726. [PMID: 37417111 PMCID: PMC10491041 DOI: 10.4103/ijo.ijo_58_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 05/14/2023] [Accepted: 05/25/2023] [Indexed: 07/08/2023] Open
Abstract
Purpose To analyze retrospectively the outcomes of Hoffmann pocket scleral fixated intraocular lens implantation combined with penetrating keratoplasty at a tertiary institute by a single corneal surgeon. Methods Forty-two eyes of 42 patients, aged between 11 and 84 years, had a mean follow-up of 2 ± 2.216 years. Overall, five (11.9%) had congenital and 37 had acquired pathology, 15 were pseudophakic, 23 were aphakic, and four were phakic. The commonest indication was trauma in 19 (45.2%), and 21 had previous multiple surgeries including five retinal procedures. Results The grafts were clear in 20 (47.6%), they failed in 20, three had acute rejection, three were ectatic, two had infection, one had persistent edema, and one had endophthalmitis. The mean log of minimum angle of resolution (logMAR) best corrected visual acuity was 1.902 pre-op, 1.802 at the final follow-up, and 0.52 after excluding preexisting retinal pathologies. At the last follow-up, the vision improved in 18 (42.9%), maintained in 6, and worsened in 18, and three needed more than -5.00 D and seven needed more than -3.00 D cylinder correction. Five had glaucoma preoperatively, 10 developed the condition postoperatively, six needed cyclodestructive procedure, and three had valve surgery. Conclusion Advantages of this surgery are avoidance of additional sections to insert the lens, direct positioning of the lens in the posterior chamber, rotational stability of the lens from four-point fixation, and untouched conjunctiva over the scleral pockets. The fact that 20 had clear grafts and 18 visually improved, though two needed lens removal and one developed retinal detachment postsurgery is encouraging. More cases with longer follow-ups will help understand the technique better.
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Affiliation(s)
- Niveditha Narayanan
- Senior Consultant, Cornea and Refractive Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Pranessh Ravi
- Medical Research Foundation, Sankara Nethralaya, Nungambakkam, Chennai, Tamil Nadu, India
| | - Nikhil Toshwani
- Senior Consultant, Cornea and Refractive Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
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Gauvin M, Wallerstein A. mEYEstro software: an automatic tool for standardized refractive surgery outcomes reporting. BMC Ophthalmol 2023; 23:171. [PMID: 37085797 PMCID: PMC10120175 DOI: 10.1186/s12886-023-02904-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/04/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND Standardization for reporting medical outcomes enables clinical study comparisons and has a fundamental role in research reproducibility. In this context, we present mEYEstro, a free novel standalone application for automated standardized refractive surgery graphs. mEYEstro can be used for single and multiple group comparisons in corneal and intraocular refractive surgery patients. In less than 30 s and with minimal user manipulation, mEYEstro automatically creates the required journal standard graphs while simultaneously performing valid statistical analyses. RESULTS The software produces the following 11 standard graphs; Efficacy: 1. Cumulative uncorrected (UDVA) and corrected visual acuity (CDVA), 2. Difference between UDVA and CDVA, Safety: 3. Change in line of CDVA, Accuracy: 4. Spherical equivalent (SEQ) to intended target, 5. Attempted vs. achieved SEQ, 6. Defocus equivalent (DEQ) accuracy, 7. Refractive astigmatism accuracy, 8. Target-induced astigmatism vs. Surgically-induced astigmatism, 9. Correction index histogram, 10. Angle of error histogram, Stability: 11. SEQ stability over time. Percent proportions, means, standard deviations, Cohen's d effect sizes, and p-values are calculated and displayed on each graph. All graphs can be easily exported as high-resolution TIFF images for figures to use in scientific manuscripts and presentations. CONCLUSIONS mEYEstro software enables clinicians, surgeons, and researchers, to easily and efficiently analyze refractive surgery outcomes using the standardized methodology required by several peer-reviewed ophthalmology journals.
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Affiliation(s)
- Mathieu Gauvin
- Department of Ophthalmology & Visual Sciences, Faculty of Medicine, McGill University, Montreal, QC, Canada
- LASIK MD, 1250 Rene-Levesque Blvd W, MD Level, Montreal, QC, H3B 4W8, Canada
| | - Avi Wallerstein
- Department of Ophthalmology & Visual Sciences, Faculty of Medicine, McGill University, Montreal, QC, Canada.
- LASIK MD, 1250 Rene-Levesque Blvd W, MD Level, Montreal, QC, H3B 4W8, Canada.
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Beltraminelli T, Rizzato A, Toniolo K, Galli A, Menghini M. Comparison of visual performances of enhanced monofocal versus standard monofocal IOLs in a mini-monovision approach. BMC Ophthalmol 2023; 23:170. [PMID: 37085852 PMCID: PMC10120133 DOI: 10.1186/s12886-023-02920-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 04/11/2023] [Indexed: 04/23/2023] Open
Abstract
PURPOSE To compare visual performance and quality of life in patients who received either monofocal intraocular lenses (IOLs) or an enhanced monofocal IOL in a mini-monovision target approach. BACKGROUND Monofocal lenses are the most common intraocular IOLs employed during cataract surgery because of their relatively low cost and good performance for distance sight. However, these lenses, generally, do not exonerate patients from spectacle use for near or intermediate tasks. On the other hand, enhanced monofocal IOLs (e.g., Tecnis Eyhance®) feature optical properties providing patients with good intermediate visual outcomes. Satisfactory near visual acuity results, regardless of IOL type, may be achieved through mini-monovision. We assessed visual performance outcomes between these IOLs, in a mini-monovision approach. METHODS Retrospective case series of patients who underwent bilateral cataract surgery at our institution with implantation of Alcon SN60WF, J&J Tecnis DCB00 or J&J Tecnis Eyhance® DIB00 with a pre-operative mini-monovision target. The postoperative spherical equivalent was measured by a Nidek® auto-refractometer. Best-uncorrected binocular visual acuity (BUBVA) at far (3 m), intermediate (66 cm), and near (40 cm) distance and binocular contrast sensitivity (100%, 25%, and 5%, all at 1 m) were measured using Snellen and Pelli-Robson charts, respectively. Visual performance in daily life was evaluated with the Cataract VF-14 quality of life survey. RESULTS 71 patients (35 in the monofocal IOL and 37 enhanced IOL group) were enrolled. Patients implanted with enhanced IOL exhibited statistically significant better BUBVA results at 66 cm and 40 cm distances compared to patients in the monofocal group. Additionally, patients in the enhanced IOL group presented a better contrast sensitivity in lower contrast conditions (5%) than patients with monofocal IOL. The quality of life survey showed statistically significant higher scores in daily activities without spectacles for patients with enhanced IOL. CONCLUSION Enhanced monofocal IOLs, combined with a mini-monovision approach, provided patients with good visual performance at all tested distances, with superiority of enhanced monofocal IOLs at near and intermediate distances.
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Affiliation(s)
- Tim Beltraminelli
- Clinic of Ophthalmology, Institute of Clinical Neurosciences of Southern Switzerland (INSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland.
| | - Angelica Rizzato
- Clinic of Ophthalmology, Institute of Clinical Neurosciences of Southern Switzerland (INSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
| | - Katia Toniolo
- Clinic of Ophthalmology, Institute of Clinical Neurosciences of Southern Switzerland (INSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
| | - Andrea Galli
- Clinic of Ophthalmology, Institute of Clinical Neurosciences of Southern Switzerland (INSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
| | - Moreno Menghini
- Clinic of Ophthalmology, Institute of Clinical Neurosciences of Southern Switzerland (INSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
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Barraquer-Compte E, Rocha-de-Lossada C, Ferreiro-Vazquez T, Valvecchia G, Fernández J. Logistics description of a high yield cataract surgery non-profitable expedition. Arch Soc Esp Oftalmol (Engl Ed) 2023; 98:193-198. [PMID: 36801255 DOI: 10.1016/j.oftale.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 12/17/2022] [Indexed: 02/17/2023]
Abstract
PURPOSE To describe the logistics and methodology of a high yield surgical non-profitable campaign. METHODS A descriptive study based on previous non-profitable campaigns dedicated to cataract surgery. RESULTS The method is based on planification, finance acquisition, volunteer support, foreign affairs with the collaborating country where the surgeries are going to be performed, team organization, and overall, summoning all the stated items to materialize a global humanitarian campaign to eradicate cataracts by clinical and surgical procedures. CONCLUSIONS Blindness due to cataracts can be over-ruled. We consider that through our planification and methodology, other organizations may acquire some knowledge to improve their methodology and carry out similar volunteering surgical campaigns. Planification, coordination, financial aid, determination, and a strong will power are altogether compulsory for a successful non-profitable surgical campaign.
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Affiliation(s)
- E Barraquer-Compte
- Fundación Elena Barraquer, Barcelona, Spain; Centro de Oftalmología Barraquer, Barcelona, Spain
| | - C Rocha-de-Lossada
- Fundación Elena Barraquer, Barcelona, Spain; Qvision, VITHAS Hospital, Almería, Spain; Hospital Regional Universitario de Málaga, Málaga, Spain; Departamento de Cirugía, Área de Oftalmología, Universidad de Sevilla, Sevilla, Spain.
| | | | - G Valvecchia
- Fundación Elena Barraquer, Barcelona, Spain; Clínica de Ojos Quilmes, Quilmes, Buenos Aires, Argentina
| | - J Fernández
- Fundación Elena Barraquer, Barcelona, Spain; Qvision, VITHAS Hospital, Almería, Spain
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Liu L, Li X, Cao Q, Lian Z, Wu J, Jin G, Zheng D. A Modified Knotless Transscleral Intraocular Lens Fixation Technology for Congenital Ectopia Lentis. Ophthalmol Ther 2023; 12:99-110. [PMID: 36243894 PMCID: PMC9834442 DOI: 10.1007/s40123-022-00586-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 09/23/2022] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION This study aimed to compare modified knotless transscleral suture fixation of intraocular lens (IOL) with traditional transscleral suture fixation for adolescents and young patients with congenital ectopia lentis (CEL). METHODS This retrospective cohort study included 49 patients with CEL (60 eyes) who underwent surgery at the Zhongshan Ophthalmic Center. Improvements based on knotless Z-suture fixation technique were made to form a modified knotless method, in which thicker 8-0 polypropylene sutures were used, and double parallel scleral grooves were constructed behind the limbus instead of triangular lamellar scleral flaps to cover suture stitches. Modified knotless transscleral fixation of IOL was conducted on 30 eyes, and the other 30 eyes underwent traditional transscleral fixation surgery. Pre- and postoperative best-corrected visual acuity (BCVA), refractive error, astigmatism, other ocular parameters, and complications were statistically analyzed. RESULTS For patients in the modified knotless group, the mean cylindrical refractive error and astigmatism at 1 month and 3 months postoperative were lower (all P < 0.05), and the mean IOL tilt degree was smaller at 3 months postoperative (3.21° ± 2.13° vs. 5.65° ± 3.66°, P = 0.032). The incidence of suture exposure in the modified knotless group was also lower than in the controls (0 vs. 16.7%, P = 0.026). No group differences were observed in mean BCVA, spherical equivalent, or other ocular biometric parameters between groups. CONCLUSION Modified knotless technique was a valid method to achieve optimal IOL position and reduce postoperative astigmatism for adolescents and young patients with CEL. It effectively reduced the incidence of knot-related complications, greatly improved the postoperative comfort, and achieved aesthetic benefits.
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Affiliation(s)
- Liyan Liu
- grid.12981.330000 0001 2360 039XState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060 China
| | - Xuepei Li
- grid.12981.330000 0001 2360 039XState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060 China
| | - Qianzhong Cao
- grid.12981.330000 0001 2360 039XState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060 China
| | - Zhangkai Lian
- grid.12981.330000 0001 2360 039XState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060 China
| | - Jieyi Wu
- grid.12981.330000 0001 2360 039XState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060 China
| | - Guangming Jin
- grid.12981.330000 0001 2360 039XState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060 China
| | - Danying Zheng
- grid.12981.330000 0001 2360 039XState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060 China
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Ackerman M, Lawless M, Levitz L, Bhatt U, Reich JA, Sutton G, Roberts TV, Tenen A, Kaur A, Hodge C. Visual and Refractive Efficacy of Panoptix Toric Intraocular Lens in a Clinical Setting. Clin Ophthalmol 2022; 16:4227-4237. [PMID: 36567956 PMCID: PMC9785155 DOI: 10.2147/opth.s390980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/16/2022] [Indexed: 12/23/2022] Open
Abstract
Purpose Trifocal Intraocular Lenses (IOLs) were developed to provide patients with effective near, intermediate and distance vision, thus minimizing spectacle dependency. Residual astigmatism has previously been shown to impact unaided visual acuity across all distances; therefore, to optimise the expected outcomes, consideration of preoperative corneal astigmatism is essential. The purpose of this study was to provide a real-world, multi-site review of visual and refractive outcomes in eyes undergoing implantation with the Panoptix Trifocal toric IOL platform. Patients and Methods This study represents a two-fold approach. Patients who had previously undergone routine cataract removal and IOL insertion with the Panoptix Toric IOL were retrospectively analysed for routine efficacy and safety endpoints ("Retrospective Cohort"). Data was retrieved from the preoperative, surgical and postoperative visits (range 2-6 weeks). A further subset of patients undergoing lens removal and bilateral Panoptix Toric IOL insertion were identified at surgery ("Qualitative Cohort"). These patients underwent additional testing inclusive of quality of vision questionnaire and bilateral defocus curve. Results A total of 466 eyes of 254 patients were included in the retrospective cohort. Between 91% and 98% of eyes, respectively, were within 0.50D and 1.00D of target. Mean absolute difference from Spherical Equivalent (SE) target was 0.22 ± 0.24Ds. Following surgery, 94% of eyes demonstrated a refractive astigmatism of 0.50D or less. Further, 61% eyes achieved uncorrected distance visual acuity (UDVA) of 20/20 or better, increasing to 94% achieving 20/32 or better. Seventy percent of eyes unilaterally achieved N5 unaided and 66.0% achieved N8 or better at intermediate. In the qualitative cohort, no patient described any symptom as significant or requested explant. Conclusion In a real-world setting, the PanOptix toric trifocal IOL continues to demonstrate refractive accuracy and good visual performance at all focal distances. This IOL also exhibited good quality of vision, with minimally bothersome visual disturbances or photic phenomena.
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Affiliation(s)
- Mariska Ackerman
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Michael Lawless
- Vision Eye Institute, Sydney, New South Wales, Australia,Save Sight Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia,Correspondence: Michael Lawless, Vision Eye Institute, Level 3 270 Victoria Avenue, Chatswood, Sydney, NSW, 2067, Australia, Tel +61 2 9424 9999, Fax +61 2 9410 3000, Email
| | - Lewis Levitz
- Vision Eye Institute, Melbourne, Victoria, Australia
| | - Uday Bhatt
- Vision Eye Institute, Melbourne, Victoria, Australia
| | | | - Gerard Sutton
- Vision Eye Institute, Sydney, New South Wales, Australia,Save Sight Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Timothy V Roberts
- Vision Eye Institute, Sydney, New South Wales, Australia,Save Sight Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Abi Tenen
- Vision Eye Institute, Melbourne, Victoria, Australia
| | | | - Chris Hodge
- Vision Eye Institute, Sydney, New South Wales, Australia,Save Sight Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia,Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia,Macquarie University, Sydney, Australia
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Moshirfar M, Stapley SR, Corbin WM, Bundogji N, Conley M, Darquea IM, Ronquillo YC, Hoopes PC. Comparative Visual Outcome Analysis of a Diffractive Multifocal Intraocular Lens and a New Diffractive Multifocal Lens with Extended Depth of Focus. J Clin Med 2022; 11:jcm11247374. [PMID: 36555990 PMCID: PMC9781237 DOI: 10.3390/jcm11247374] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 12/02/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
This study compares the visual and refractive performance of the TECNIS Synergy (DFR00V-DFW150-225-300-375) multifocal intraocular lens (IOL) and the AcrySof IQ PanOptix (TFAT00-30-40-50-60) multifocal IOL. Patients who underwent phacoemulsification and cataract extraction and received either a multifocal Synergy or PanOptix IOL were included. Monocular uncorrected distance (UDVA), intermediate (UIVA), near (UNVA), and corrected distance (CDVA) visual acuities were assessed at three and six months postoperatively. Secondary outcome measures of photic phenomena were also assessed. A total of 140 patients (224 eyes) were included in this study, with 69 patients (105 eyes) in the Synergy group and 71 patients (119 eyes) in the PanOptix group. There were no statistically significant differences in UIVA or CDVA measurements across all time points. When assessing UDVA, at three months postoperatively, there were more eyes in the PanOptix group with vision better than 20/40 (p = 0.04). At three and six months postoperatively, the average UNVA was superior in the Synergy group (p = 0.01, 0.002). While the Synergy group reported more night vision disturbances at one and three months (p = 0.01, 0.03), the PanOptix group had more night vision disturbances at six months (p = 0.02). Although not statistically significant, the AcrySof IQ PanOptix multifocal IOL demonstrated better UDVA and UIVA sooner postoperatively than the TECNIS Synergy multifocal IOL. The Synergy IOL provided statistically better UNVA compared to the PanOptix IOL at three and six months postoperatively. Synergy patients reported more early photic phenomena than PanOptix patients, which later diminished.
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Affiliation(s)
- Majid Moshirfar
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT 84020, USA
- John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT 84112, USA
- Utah Lions Eye Bank, Murray, UT 84107, USA
- Correspondence: ; Tel.: +1-(801)-563-0200
| | - Seth R. Stapley
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ 85308, USA
| | - Wyatt M. Corbin
- Stritch School of Medicine, Loyola University Chicago, Chicago, IL 60153, USA
| | - Nour Bundogji
- John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT 84112, USA
| | - Matthew Conley
- School of Medicine, University of Utah, Salt Lake City, UT 84132, USA
| | - Ines M. Darquea
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT 84020, USA
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Guo D, Meng J, Zhang K, He W, Ma S, Lu ZL, Lu Y, Zhu X. Tolerance to lens tilt and decentration of two multifocal intraocular lenses: using the quick contrast sensitivity function method. Eye Vis (Lond) 2022; 9:45. [PMID: 36451233 PMCID: PMC9713962 DOI: 10.1186/s40662-022-00317-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/05/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Quick contrast sensitivity function (qCSF) method is an advanced quick method for contrast sensitivity function (CSF) evaluation. This study evaluated the contrast sensitivity (CS) of eyes undergoing cataract surgery with multifocal intraocular lens (IOL) implantation and its tolerance to IOL tilt and IOL decentration using the qCSF method. METHODS Patients undergoing uneventful phacoemulsification and a trifocal IOL (Zeiss AT LISA tri 839MP, Carl Zeiss, Germany) or an extended depth-of-focus (EDOF) IOL (Tecnis Symfony ZXR00, Johnson & Johnsons, USA) implantation were included. Monocular contrast sensitivity was measured using the qCSF method at one month post-surgery. IOL tilt and decentration were measured using an optical aberrometer (OPD-Scan III, NIDEK, Japan). RESULTS Seventy-two patients/eyes with the 839MP IOL and 64 patients/eyes with the ZXR00 IOL were included. Area under the log CSF (AULCSF) and CS acuity did not differ significantly between the two groups. The ZXR00 IOL group showed better CS at 1 cpd (1.137 ± 0.164 vs. 1.030 ± 0.183 logCS) and 1.5 cpd (1.163 ± 0.163 vs. 1.071 ± 0.161 logCS), while the 839MP IOL group had better CS at 6 cpd (0.855 ± 0.187 vs. 0.735 ± 0.363 logCS). In the 839MP IOL group, all CSF metrics were negatively correlated with IOL tilt (all P < 0.05), while in the ZXR00 IOL group, the CS at 3 cpd had no significant correlation with IOL tilt (P > 0.05). Among myopic eyes, fewer CSF metrics were negatively correlated with IOL tilt in the ZXR00 IOL group than in the 839MP IOL group. No significant correlation was found between CSF metrics and IOL decentration. CONCLUSIONS The ZXR00 and the 839MP IOL groups presented comparable CSF. CS was negatively correlated with IOL tilt, instead of decentration in multifocal IOLs, particularly among myopic eyes. The ZXR00 IOL had better tolerance to IOL tilt in myopic eyes.
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Affiliation(s)
- Dongling Guo
- grid.8547.e0000 0001 0125 2443Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Myopia, Fudan University, Shanghai, China ,grid.506261.60000 0001 0706 7839Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China ,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China ,grid.8547.e0000 0001 0125 2443State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Jiaqi Meng
- grid.8547.e0000 0001 0125 2443Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Myopia, Fudan University, Shanghai, China ,grid.506261.60000 0001 0706 7839Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China ,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China ,grid.8547.e0000 0001 0125 2443State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Keke Zhang
- grid.8547.e0000 0001 0125 2443Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Myopia, Fudan University, Shanghai, China ,grid.506261.60000 0001 0706 7839Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China ,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China ,grid.8547.e0000 0001 0125 2443State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Wenwen He
- grid.8547.e0000 0001 0125 2443Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Myopia, Fudan University, Shanghai, China ,grid.506261.60000 0001 0706 7839Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China ,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China ,grid.8547.e0000 0001 0125 2443State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Shiyu Ma
- grid.8547.e0000 0001 0125 2443Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Myopia, Fudan University, Shanghai, China ,grid.506261.60000 0001 0706 7839Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China ,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China ,grid.8547.e0000 0001 0125 2443State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Zhong-lin Lu
- grid.449457.f0000 0004 5376 0118Division of Arts and Sciences, NYU Shanghai, Shanghai, China ,grid.137628.90000 0004 1936 8753Center for Neural Science and Department of Psychology, New York University, New York, USA ,grid.449457.f0000 0004 5376 0118NYU-ECNU Institute of Brain and Cognitive Science at NYU Shanghai, Shanghai, China
| | - Yi Lu
- grid.8547.e0000 0001 0125 2443Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Myopia, Fudan University, Shanghai, China ,grid.506261.60000 0001 0706 7839Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China ,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China ,grid.8547.e0000 0001 0125 2443State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Xiangjia Zhu
- grid.8547.e0000 0001 0125 2443Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Myopia, Fudan University, Shanghai, China ,grid.506261.60000 0001 0706 7839Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China ,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China ,grid.8547.e0000 0001 0125 2443State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
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20
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Buckhurst PJ, Lau G, Williams JI, Packer M. Efficacy of a One-Piece Aberration Neutral Hydrophobic Acrylic Toric Intraocular Lens. Clin Ophthalmol 2022; 16:3763-3774. [PMID: 36411875 PMCID: PMC9675354 DOI: 10.2147/opth.s386551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 10/31/2022] [Indexed: 07/22/2023] Open
Abstract
PURPOSE To assess the refractive outcomes, intraocular centration and rotational stability of the enVista toric intraocular lens (IOL). PATIENTS AND METHODS This study was a prospective, multi-centre, double-masked, partially randomized and partially controlled clinical trial. A total of 191 participants were implanted with toric IOL (1.25, 2.00, or 2.75D) or non-toric IOL (control). The lowest range of corneal astigmatic eyes were randomized to 1.25D toric or control. Higher astigmatic powers were allocated to the treatment arm. Subjects were assessed immediately postoperatively, 1-2 (V1), 7-14 (V2), 30-60 (V3) and 120-180 (V4) days postoperatively. Unaided (UDVA) and distance corrected visual acuity (CDVA), manifest refraction and corneal curvature were assessed. Vector analysis was used to calculate surgically induced refractive correction (SIRC), correction ratio (CR), error magnitude (EM) and error vector (EV). Slit-lamp photography was used to measure centration and rotational stability. RESULTS UDVA was better in the low toric IOL group in comparison with the control group at V4 (p<0.001). There was an undercorrection in the control group, whereas the average CR for all toric subjects was 1.00 ± 0.32: V2, 0.98 ± 0.34: V3 and 0.98 ± 0.35: V4. The absolute IOL rotational stability in comparison to the position of the IOL at V1 was 1.35° ± 0.97°: V2, 1.35° ± 1.07°: V3 and 1.38° ± 1.25°: V4. Decentration was generally inferior (V1: 0.04 ± 0.22mm, V2: 0.05± 0.20mm, V3: 0.08 ± 0.22mm, V4: 0.04 ± 0.21mm) and nasal (V1: 0.19 ± 0.23mm, V2: 0.20 ± 0.20mm, V3: 0.20 ± 0.21mm, V4: 0.17 ± 0.22mm). CONCLUSION Participants with low levels of corneal astigmatism achieved superior vision and refractive outcomes in the low toric group over the control. Moderate and high levels of astigmatism achieved excellent refractive outcomes. The toric IOL demonstrated high levels of both rotational and centrational stability.
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Affiliation(s)
| | - George Lau
- Bausch and Lomb Surgical, Bausch and Lomb Bridgewater, New Jersey, NJ, USA
| | - Jon I Williams
- Bausch and Lomb Surgical, Bausch and Lomb Bridgewater, New Jersey, NJ, USA
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21
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Chauhan RA, Agrawal SO, Sawarkar RR, Agrawal S. Comparative study between conventional and 4 mm manual small-incision cataract surgery. Indian J Ophthalmol 2022; 70:3879-3882. [PMID: 36308119 PMCID: PMC9907262 DOI: 10.4103/ijo.ijo_1607_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose Comparative study of intraoperative and postoperative complications, visual outcomes, and cost-effectiveness between conventional and 4-mm manual small-incision cataract surgery with MVR blade. Methods In total, 600 patients having nuclear sclerosis grade I-IV were operated under peribulbar anesthesia and were divided into two groups of 300 each. In group A (300), conventional small-incision cataract surgery was done, whereas in group B (300), 4-mm manual small-incision cataract surgery was performed through a 4-mm sclerocorneal tunnel. A wire vectis was passed through the 4-mm incision below the nucleus to stabilize it, and a 20-G MVR blade was introduced from 11o'clock limbus and nucleus was bisected into two halves, which were removed through main incision. Cortical wash was given, and foldable IOL was implanted. Intraoperative and postoperative complications between the two groups were compared. Postoperative visual outcome and surgically induced astigmatism between the two groups was studied. Results The most common intraoperative complication was hyphema (11.33%) and irido-dialysis (8.00%), whereas postoperatively, striate keratopathy (36.33%) and hyphema (19.33%) were common. Short-term complications such as striate keratopathy, hyphema, and irido-dialysis were significantly more in group B, and long-term results in terms of visual outcome and surgically induced astigmatism were significantly less in group B. Conclusion Although intraoperative and short-term postoperative complications were observed more in 4-mm manual small-incision cataract surgery, it was found to be more effective in terms of surgically induced astigmatism and final visual outcome. In addition, it is cost-effective as compared to phacoemulsification.
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Affiliation(s)
- Ravi A Chauhan
- Department of Ophthalmology, Indira Gandhi Government Medical College, Nagpur, Maharashtra, India
| | - Sachin O Agrawal
- Department of Ophthalmology, Indira Gandhi Government Medical College, Nagpur, Maharashtra, India,Correspondence to: Dr. Sachin O Agrawal, Tower 4 – 502, Capitol Heights, Medical Square, Nagpur, Maharashtra, India. E-mail:
| | - Radhika R Sawarkar
- Department of Ophthalmology, Indira Gandhi Government Medical College, Nagpur, Maharashtra, India
| | - Sanjay Agrawal
- Department of PSM, Indira Gandhi Government Medical College, Nagpur, Maharashtra, India
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22
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D’Antin JC, Tresserra F, Barraquer RI, Michael R. Soemmerring's Rings Developed around IOLs, in Human Donor Eyes, Can Present Internal Transparent Areas. Int J Mol Sci 2022; 23:13294. [PMID: 36362082 PMCID: PMC9656497 DOI: 10.3390/ijms232113294] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 02/09/2024] Open
Abstract
Soemmerring's rings consist of a ring of lens epithelial derived cells that grow along the periphery of an aphakic lens capsule, or around an intraocular lens. These rings when visualized frontally, appear opaque, however, in some cases the cells that compose these rings are organized in the same fashion as those in normal transparent adult lenses. Thus, our purpose was to test whether any part of the adult Soemmerring's ring could be transparent and how this related to morphological factors. To study this, 16 Soemmerring's rings were extracted from donor eye globes. After imaging, they were thickly sectioned sagittally in order to analyze the degrees of transparency of different areas. All samples were also histologically analyzed using alpha smooth muscle actin, Vimentin, wheat germ agglutinin and DAPI. Our results showed that many samples had some transparent areas, mostly towards the center of their cross-section. Of the factors that we analyzed, only lens fiber organization at the bow region and an increased area of mature lens fiber cells had a significant relation to the degree of transparency at the center. Thus, we can conclude that as Soemmerring's rings mature, they can develop organized and transparent areas of lens cells.
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Affiliation(s)
- Justin Christopher D’Antin
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, 08021 Barcelona, Spain
- Centro de Oftalmología Barraquer, 08021 Barcelona, Spain
| | - Francesc Tresserra
- Department of Pathology, Institut Universitari Dexeus, 08028 Barcelona, Spain
| | - Rafael I. Barraquer
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, 08021 Barcelona, Spain
- Centro de Oftalmología Barraquer, 08021 Barcelona, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08017 Barcelona, Spain
| | - Ralph Michael
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, 08021 Barcelona, Spain
- Centro de Oftalmología Barraquer, 08021 Barcelona, Spain
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, 04109 Leipzig, Germany
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23
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Romero D, Escolano J, Fernández C, Martínez-Toldos JJ, Monera CE, Castilla G, Moyá A. The influence of the Artisan-Verisyse position on the postoperative outcomes: A systematic review and meta-analysis. Indian J Ophthalmol 2022; 70:3213-3221. [PMID: 36018090 DOI: 10.4103/ijo.ijo_880_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Iris-fixated intraocular lens (IOL) is considered a safe and effective option for the correction of aphakia in patients with insufficient capsular support. This systematic review aims to summarize the existing evidence about the Artisan/Verisyse IOLs and to assess the influence of the IOL position on the postoperative outcomes. Three different databases were used for this systematic review and metaanalysis (PubMED, Scopus, and Embase). We searched for case series or clinical trials comparing the prepupillary versus retropupillary Artisan/Verisyse implantation. The statistical analysis was performed with the programming language R (version 3.6.1 2019-07-05). The number of articles included in the meta-analysis was six, with 506 eyes included in total. We found no significant differences in postoperative corrected distance visual acuity (CDVA) (0.309 [0.089-0.528] vs. 0.32 [0.2-0.44]), spherical equivalent (SE) (0.0153 D [-0.362 to 0.393] vs. -0.329 D [-0.62 to - 0.038]), and central corneal cell density (CECD) (1669.85 cells [1605.949-2150.937] vs. 1635.99 cells [1413.64-1858.363]) between the prepupillary and the retropupillary implantation, respectively. There were no significant differences in the rates of cystoid macular edema (CME; 7.70% vs. 9.8%), pupil deformation (4.5% vs. 5.4% retropupillary), or IOL luxation (2.3% and 2.2%). We found little influence of the IOL position in the postoperative analyzed outcomes. Thus, the implant position should be based on the surgeon's technical experience. Double-blind randomized prospective studies would improve the available evidence on the best implant position for the Artisan/Verisyse IOL.
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Affiliation(s)
- Daniel Romero
- Department of Ophthalmology, General University Hospital of Elche, Elche, Alicante, Spain
| | - Jaime Escolano
- Department of Ophthalmology, General University Hospital of Elche, Elche, Alicante, Spain
| | - Cristian Fernández
- Department of Ophthalmology, General University Hospital of Elche, Elche, Alicante, Spain
| | | | - Carlos E Monera
- Department of Ophthalmology, General University Hospital of Elche, Elche, Alicante, Spain
| | - Germán Castilla
- Department of Ophthalmology, General University Hospital of Elche, Elche, Alicante, Spain
| | - Alejandro Moyá
- Department of Ophthalmology; Department of Statistics, General University Hospital of Elche, Elche, Alicante, Spain
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24
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Semiz F, Lokaj AS, Musa NH, Semiz CE, Demirsoy ZA, Semiz O. SMILE for the Treatment of Residual Refractive Error After Cataract Surgery. Ophthalmol Ther 2022; 11:1539-1550. [PMID: 35643966 PMCID: PMC9253212 DOI: 10.1007/s40123-022-00526-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/09/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION In the context of managing patients' expectations and satisfaction regarding visual acuity after cataract surgery, we aimed to investigate the improvement in visual acuity and patient satisfaction after small-incision lenticule extraction (SMILE) in pseudophakic (trifocal intraocular lens, IOL) patients with residual myopic refraction after cataract surgery. METHODS Seventy-six patients (82 eyes) who underwent cataract surgery with ZEISS AT LISA tri 839MP IOL implantation were included in this retrospective study. The included patients were 56-79 years old, wanted spectacle independence, and had preoperative myopic refraction between - 1.0 and - 2.25 diopters (D) and astigmatism between - 0.75 and - 1.75 D. The treatment status of these patients was defined as trifocal IOL (n = 82). SMILE was performed in patients who were dissatisfied after cataract surgery, and these patients were followed up for 1 year on average. We evaluated visual acuity and satisfaction and further examined laser vision correction and satisfaction levels in patients who were dissatisfied after trifocal IOL implantation. RESULTS The possible reasons for patient dissatisfaction were reading books, using a computer, and driving at night. After SMILE, the residual myopic refractive error (spherical) decreased significantly from - 2.08 ± 0.28 [- 2.25 to - 1.0] preoperatively to - 0.25 ± 0.20 - 0.5 to 0] 1 year postoperatively (p < 0.001). Additionally, the uncorrected distance visual acuity increased from 0.65 ± 0.08 [0.52-0.7] logMAR preoperatively to 0.09 ± 0.02 [0.05-0.1] logMAR at 1 month postoperatively (p < 0.001), 0.09 ± 0.02 [0.05-0.1] logMAR at 6 months postoperatively, and 0.06 ± 0.02 [0.05-0.1] logMAR at 12 months postoperatively (p < 0.001). Patient satisfaction measures after SMILE (reading, night driving, and using a computer) were significantly improved. CONCLUSION SMILE is a reliable method for treating residual refraction after cataract surgery, as it provides results in the shortest time without complications and increases patient satisfaction. TRIAL REGISTRATION The protocol was registered on clinicaltrials.gov (NCT04693663).
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Affiliation(s)
- Faruk Semiz
- Department of Ophthalmology, Eye Hospital, Prishtina, Kosova.
| | | | | | | | | | - Olcay Semiz
- Department of Ophthalmology, Eye Hospital, Prishtina, Kosova
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25
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Deshpande R, Satijia A, Dole K, Mangiraj V, Deshpande M. Effects on ocular aberration and contrast sensitivity after implantation of spherical and aspherical monofocal intraocular lens - A comparative study. Indian J Ophthalmol 2022; 70:2862-2865. [PMID: 35918931 PMCID: PMC9672777 DOI: 10.4103/ijo.ijo_19_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Purpose: Phacoemulsification with intraocular lens (IOL) implantation is the standard of care for cataractous eyes. Monofocal IOLs are spherical or aspheric. The aspheric design of IOLs reduces the spherical and higher-order aberrations and impacts contrast sensitivity post cataract surgery. There are some studies, but data in the Indian setting with the IOLs we used is lacking. We aimed to compare the effect of implantation of spheric and aspheric foldable intraocular lenses on postoperative quality of vision, spherical aberration, and contrast sensitivity. Methods: This prospective observational study was conducted at a tertiary care hospital with an ophthalmology specialty, data collection from January 2017 to May 2018 in 100 patients. Patients meeting the inclusion criteria were selected. Their preoperative and postoperative data were collected and divided into groups based on whether spherical or aspheric IOL was implanted after cataract surgery. Variables assessed were visual acuity on days 7 and 30, spherical aberrations, and contrast sensitivity was assessed at 1-month postoperative. Results: The mean age of the patients in this study was 64 ± 8 years with a majority of patients (60%) being females. There is no significant difference in postoperative visual acuity between the two groups. Internal SA was significantly lower (~50%) in eyes implanted with aspheric IOLs (P value = 0.004, 0.0001) compared with the spherical group. Contrast sensitivity of patients of the aspheric group was significantly better (P value <0.05). Conclusion: The optical design of the aspheric IOLs reduced spherical aberrations and increased contrast sensitivity.
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Affiliation(s)
- Rahul Deshpande
- Department of Oculoplasty and Ocular Oncology, PBMA's H.V.Desai Eye Hospital, Pune, Maharashtra, India
| | - Anuj Satijia
- Department of General Ophthalmology, PBMA's H.V.Desai Eye Hospital, Pune, Maharashtra, India
| | - Kuldeep Dole
- Department of Community Ophthalmology, PBMA's H.V.Desai Eye Hospital, Pune, Maharashtra, India
| | - Varsha Mangiraj
- Department of General Ophthalmology, PBMA's H.V.Desai Eye Hospital, Pune, Maharashtra, India
| | - Madan Deshpande
- Department of General Ophthalmology, PBMA's H.V.Desai Eye Hospital, Pune, Maharashtra, India
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26
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Giannikaki S, Douglas RH. Spectral transmittance of animal intraocular lenses in comparison with the spectral properties of their b iological lenses. Vet Ophthalmol 2022; 25:510-514. [PMID: 35909253 DOI: 10.1111/vop.13014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/28/2022] [Accepted: 07/14/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine the spectral transmittance of artificial intraocular lenses (IOLs) designed for various species (dog, cat, chinchilla, eagle, tiger) and compare them to the spectral properties of the biological lenses of these species. METHODS Twenty-seven IOLs were scanned with a spectrophotometer fitted with an integrating sphere. RESULTS All IOLs transmitted long wavelengths well before cutting off sharply at short wavelengths, with insignificant transmission below ca. 340 nm. In comparison with the IOLs, the biological lenses of the cat, dog, and probably the chinchilla transmitted significantly more short wavelengths. The spectral properties of the biological lenses of eagles and tigers, while uncertain, may be a closer match to the IOLs made for these species. CONCLUSION It is not known if there are any visual or behavioral consequences for animals caused by a mismatch between the spectral properties of their biological lenses and IOLs. However, following IOL implantation there might be a change in the perceived hue of objects due to the removal of UV wavelengths which form a normal part of the visible spectrum for these species and/or a decrease in sensitivity.
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Affiliation(s)
| | - Ronald H Douglas
- Division of Optometry and Visual Science, City, University of London, London, UK
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27
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Achiron A, Elhaddad O, Leadbetter D, Levinger E, Voytsekhivskyy O, Smith K, Avadhanam V, Darcy K, Tole D. Intraocular lens power calculation in patients with irregular astigmatism. Graefes Arch Clin Exp Ophthalmol 2022; 260:3889-3895. [PMID: 35776172 DOI: 10.1007/s00417-022-05729-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 05/07/2022] [Accepted: 06/07/2022] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Accurate intraocular lens (IOL) calculation in subjects with irregular astigmatism is challenging. This study evaluated the accuracy of using Scheimpflug-derived central 2-mm equivalent keratometry reading (EKR) values for IOL calculation in irregular astigmatism. METHODS This retrospective study included subjects (31 eyes of 30 patients) who underwent cataract surgery and IOL calculation using the 2-mm central EKR methods. We compared prediction error (PE) and absolute PE (APE) outcomes using SRK/T and Barrett Universal II formulas for keratometry data obtained from the IOLMaster 500 and Pentacam (anterior corneal sim k) devices. RESULTS Cataract surgery and IOL calculation using the 2-mm central EKR methods resulted in improved visual acuity (uncorrected: from 1.13 ± 0.38 to 0.65 ± 0.46 logMar, p < 0.01; best-corrected: from 0.45 ± 0.24 to 0.26 ± 0.20 logMar, p < 0.01) after surgery. The percentage of subjects with best-corrected visual acuity of 6/6 was 22%, < 6/9 was 58%, and < 6/12 was 71%. For both the SRK/T and the Barrett formulas, the PE was similar to those obtained by IOLMaster (> 0.14) but lower than those obtained by the anterior corneal sim k (p < 0.02). IOLMaster provided keratometry reading in only 23/31 (74.1%) of cases. CONCLUSIONS The use of Scheimpflug central 2-mm EKR for IOL calculation in irregular astigmatism was beneficial in terms of visual acuity improvement. It had comparable refractive prediction performance to the IOLMaster 500 and better than the anterior corneal sim K. The 2-mm EKR method can be used when IOLMaster cannot provide a reliable reading in abnormal corneas.
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Affiliation(s)
- Asaf Achiron
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Lower Maudlin St, Bristol, BS1 2LX, UK.
- Sourasky Tel-Aviv Medical Center and the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Omar Elhaddad
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Lower Maudlin St, Bristol, BS1 2LX, UK
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Duncan Leadbetter
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Lower Maudlin St, Bristol, BS1 2LX, UK
| | - Eliya Levinger
- Sourasky Tel-Aviv Medical Center and the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Katy Smith
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Lower Maudlin St, Bristol, BS1 2LX, UK
| | - Venkata Avadhanam
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Lower Maudlin St, Bristol, BS1 2LX, UK
| | - Kieren Darcy
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Lower Maudlin St, Bristol, BS1 2LX, UK
| | - Derek Tole
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Lower Maudlin St, Bristol, BS1 2LX, UK
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Schwarzenbacher L, Seeböck P, Schartmüller D, Leydolt C, Menapace R, Schmidt‐Erfurth U. Automatic segmentation of intraocular lens, the retrolental space and Berger's space using deep learning. Acta Ophthalmol 2022; 100:e1611-e1616. [PMID: 35343651 DOI: 10.1111/aos.15141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/15/2022] [Accepted: 03/15/2022] [Indexed: 12/11/2022]
Abstract
PURPOSE To develop and validate a deep learning model to automatically segment three structures using an anterior segment optical coherence tomography (AS-OCT): The intraocular lens (IOL), the retrolental space (IOL to the posterior lens capsule) and Berger's space (BS; posterior capsule to the anterior hyaloid membrane). METHODS An artificial intelligence (AI) approach based on a deep learning model to automatically segment the IOL, the retrolental space, and BS in AS-OCT, was trained using annotations from an experienced clinician. The training, validation and test set consisted of 92 cross-sectional OCT slices, acquired in 47 visits from 41 eyes. Annotations from a second experienced clinician in the test set were additionally evaluated to conduct an inter-reader variability analysis. RESULTS The AI model achieved a Precision/Recall/Dice score of 0.97/0.90/0.93 for IOL, 0.54/0.65/0.55 for retrolental space, and 0.72/0.58/0.59 for BS. For inter-reader variability, Precision/Recall/Dice values were 0.98/0.98/0.98 for IOL, 0.74/0.59/0.62 for retrolental space, and 0.58/0.57/0.57 for BS. No statistical differences were observed between the automated algorithm and the inter-reader variability for BS segmentation. CONCLUSION The deep learning model allows for fully automatic segmentation of all investigated structures, achieving human-level performance in BS segmentation. We, therefore, expect promising applications of the algorithm with particular interest in BS in automated big data analysis and real-time intra-operative support in ophthalmology, particularly in conjunction with primary posterior capsulotomy in femtosecond laser-assisted cataract surgery.
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Affiliation(s)
- Luca Schwarzenbacher
- Department of Ophthalmology and Optometry Medical University of Vienna Vienna Austria
| | - Philipp Seeböck
- Department of Ophthalmology and Optometry Medical University of Vienna Vienna Austria
| | - Daniel Schartmüller
- Department of Ophthalmology and Optometry Medical University of Vienna Vienna Austria
| | - Christina Leydolt
- Department of Ophthalmology and Optometry Medical University of Vienna Vienna Austria
| | - Rupert Menapace
- Department of Ophthalmology and Optometry Medical University of Vienna Vienna Austria
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Jiang Z, Zhang N, Dong J. Reversible deposition of inflammatory cells on the surface of an intraocular lens in a patient with uveitis: Case report and literature review. Eur J Ophthalmol 2022; 33:NP126-NP130. [PMID: 35243920 DOI: 10.1177/11206721221086156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The deposition of inflammatory cells on an intraocular lens (IOL) is a rare but potentially serious complication. We report a patient who presented with reversible severe deposition of inflammatory cells on the anterior surface of a hydrophobic IOL. CASE DESCRIPTION A 68-year-old woman with remissive uveitis presented with blurred vision in her right eye that persisted for 1 month. She had undergone cataract surgery and hydrophobic IOL (ZA9003, Johnson & Johnson Surgical Vision) implantation 3 months before presentation. Deposition of inflammatory cells was diagnosed by ocular examination. The IOL became transparent after 6 months of treatment with combined antibiotic/steroid eyedrops (tobramycin/dexamethasone eyedrops) and atropine. However, the cellular deposition recurred after either discontinuing the tobramycin/dexamethasone eyedrops or switching to steroid-only eyedrops (fluorometholone). Therefore, she was prescribed continuous tobramycin/dexamethasone eyedrops, twice-daily, and her IOL remained transparent at the time of submission of this article. CONCLUSIONS We have reported a case of reversible severe deposition of inflammatory cells on the anterior surface of a hydrophobic IOL in a patient with uveitis that was managed by continuous administration of combined antibiotic/steroid eyedrops. The morphology of the inflammatory cells deposits and the treatment differed from those of previously reported cases.
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Affiliation(s)
- Zhijian Jiang
- Department of Ophthalmology, 117880Shanghai Xuhui Central Hospital, Shanghai, China
| | - Nan Zhang
- Department of Ophthalmology, 117880Shanghai Xuhui Central Hospital, Shanghai, China
| | - Jianhong Dong
- Department of Ophthalmology, 117880Shanghai Xuhui Central Hospital, Shanghai, China
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Campos N, Loureiro T, Rodrigues-Barros S, Rita Carreira A, Moraes F, Carreira P, Machado I. Preliminary Clinical Outcomes of a New Enhanced Depth of Focus Intraocular Lens. Clin Ophthalmol 2022; 15:4801-4807. [PMID: 34992340 PMCID: PMC8714966 DOI: 10.2147/opth.s344379] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 11/19/2021] [Indexed: 11/27/2022] Open
Abstract
Purpose To assess the preliminary clinical outcomes and patient satisfaction of the new enhanced depth of focus (EDOF) LuxSmart™ intraocular lens IOL and to compare with a conventional monofocal IOL (Akreos™) in patients who had undergone bilateral cataract surgery. Methods Twelve patients underwent bilateral LuxSmart IOL implantation, and twelve underwent bilateral Akreos IOL implantation. Best-corrected distance (CDVA) and uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA) at 66cm, uncorrected near visual acuity (UNVA) at 40cm and defocus curve were assessed. Patients-reported visual function was inquired by Catquest-9SF. The presence of photic phenomena was evaluated. A p-value lower than 0.05 was considered for statistical significance. Results The mean IOL power was +21.90D in LuxSmart group and +22.30D in Akreos. Monocular UDVA (p = 0.32) and CDVA (p = 0.52) did not differ between groups. The average binocular UIVA (0.18 ± 0.12 logMAR vs. 0.30 ± 0.13 logMAR, p < 0.001) and UNVA (0.38 ± 0.14 logMAR vs. 0.44 ± 0.17 logMAR, p = 0.02) were higher in LuxSmart IOL group. No patients reported disabling photic phenomena in either group. Conclusion This study shows that new LuxSmart EDOF IOL achieved higher performance for intermediate and near vision compared with a conventional monofocal IOL, without increasing the risk of dysphotopsias. LuxSmart may be an attractive and safe option for patients who desire spectacle independence for distance and intermediate vision after cataract surgery.
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Affiliation(s)
- Nuno Campos
- Ophthalmology Department, Hospital Garcia de Orta, Almada, Portugal.,Ophthalmology Department, Hospital CUF, Lisboa, Portugal
| | - Tomás Loureiro
- Ophthalmology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Sandra Rodrigues-Barros
- Ophthalmology Department, Hospital Garcia de Orta, Almada, Portugal.,Ophthalmology Department, Hospital CUF, Lisboa, Portugal
| | | | - Filipe Moraes
- Ophthalmology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Pedro Carreira
- Ophthalmology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Inês Machado
- Ophthalmology Department, Hospital Garcia de Orta, Almada, Portugal.,Ophthalmology Department, Hospital CUF, Lisboa, Portugal
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Abstract
A novel polyolefin called poly(styrene-block-isobutylene-block-styrene) (“SIBS”) originated from Joseph P. Kennedy's laboratory at the University of Akron (Akron, Ohio, United States) and was developed as a biomaterial for long-term implant applications by the author. SIBS has no cleavable groups on its backbone or sidechains, is comprised predominantly of alternating secondary and quaternary carbons on its backbone, which prevents embrittlement and cracking under flexion, and undergoes multiple purification steps which renders it extremely biocompatible and well-suited for long-term applications in the eye. This article explores two ophthalmic devices; 1) the PRESERFLO® MicroShunt (Santen Pharmaceutical Co. Ltd., Osaka, Japan) made from SIBS that lowers intraocular pressure to thwart progression of vision loss from glaucoma, and 2) a novel intraocular lens (IOL) made from crosslinked polyisobutylene, which is under-development by Xi'an Eyedeal Medical Technology Co., Ltd. (Xi'an, China) that does not glisten nor cloud over time, as do most conventional IOLs. A novel class of ultra-biostable polyisobutylene-based biomaterials for long-term implant applications. A novel class of polyisobutylene-based biomaterials that is not bioactive and elicits minimal foreign body reaction. A device called the PRESERFLO® MicroShunt to treat glaucoma made from poly(styrene-block-isobutylene-block-styrene) (SIBS). A novel crosslinked polyisobutylene material for intraocular lens applications that eliminates glistenings and halos.
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Affiliation(s)
- Leonard Pinchuk
- Distinguished Research Professor of Biomedical Engineering, University of Miami, Biomedical Engineering Dept., 13704 SW 92nd Court, Miami, 33176, FL, United States.,Founder and Senior Vice President, InnFocus, Inc., a Santen company, Miami, FL, United States
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32
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Yusef YN, Vvedenskiy AS, Alhumidi K, Fokina ND, Demidov AL. [Surgical treatment of hypermature cataract in patients with lens subluxation and small pupil]. Vestn Oftalmol 2021; 137:175-180. [PMID: 34669325 DOI: 10.17116/oftalma2021137052175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Studying the possibilities of hybrid (femtosecond laser-assisted) phacoemulsification in complicated situations is a relevant problem in cataract surgery. PURPOSE To develop a technique for hybrid (femtosecond laser-assisted) phacoemulsification in patients with a combination of hypermature cataract, small pupil and lens subluxation. MATERIAL AND METHODS Hybrid (femtosecond laser-assisted) phacoemulsification of hypermature cataracts was performed in 36 patients (36 eyes) aged 63 to 78 years with grade I-II lens subluxation in combination with small pupil. The initial circular femtolaser capsulotomy was performed within the small pupil using the VICTUS system (Technolas Perfect Vision, Germany). After dilating the pupil with retractor hooks, the capsulorhexis was manually expanded to the required diameter. RESULTS In all cases, the resulting capsulorhexis had a regular round shape with a smooth edge, without radial ruptures. This made it possible to apply modern methods of fixation and centration of the capsular bag in case of lens subluxation and to perform intracapsular implantation of an intraocular lens (IOL). Complete intracapsular fixation of the IOL with optics edge fully covered by the edge of the capsulorhexis in the postoperative period was achieved in 34 (94.4%) cases. In 2 (5.6%) cases in the postoperative period, the edge of the capsulorhexis exceeded the edge of the IOL optics. The loss of corneal endothelial cells 3 months after surgery was 8.8±1.9%. CONCLUSION The use of the proposed combined technique of capsulorhexis made it possible to perform the most physiologically appropriate intracapsular IOL implantation in all patients with hypermature cataract, small pupil and lens subluxation.
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Affiliation(s)
- Yu N Yusef
- Research Institute of Eye Disease, Moscow, Russia
| | | | - K Alhumidi
- Research Institute of Eye Disease, Moscow, Russia
| | - N D Fokina
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - A L Demidov
- Research Institute of Eye Disease, Moscow, Russia
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Yusef YN, Yusef SN, Vvedenskiy AS, Ivanov MN, Alhumidi K, Dudieva FK. [Femtosecond laser-assisted phacoemulsification of hypermature cataract in patients with lens subluxation]. Vestn Oftalmol 2021; 137:209-216. [PMID: 34669329 DOI: 10.17116/oftalma2021137052209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
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.
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Affiliation(s)
- Yu N Yusef
- Research Institute of Eye Disease, Moscow, Russia
| | - S N Yusef
- Research Institute of Eye Disease, Moscow, Russia
| | | | - M N Ivanov
- Research Institute of Eye Disease, Moscow, Russia
| | - K Alhumidi
- Research Institute of Eye Disease, Moscow, Russia
| | - F K Dudieva
- Research Institute of Eye Disease, Moscow, Russia
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Sobczak AM, Bohaterewicz B, Fafrowicz M, Zyrkowska A, Golonka N, Domagalik A, Beldzik E, Oginska H, Rekas M, Bronicki D, Romanowska-Dixon B, Bolsega-Pacud J, Karwowski W, Farahani F, Marek T. Brain Functional Network Architecture Reorganization and Alterations of Positive and Negative Affect, Experiencing Pleasure and Daytime Sleepiness in Cataract Patients after Intraocular Lenses Implantation. Brain Sci 2021; 11:brainsci11101275. [PMID: 34679340 PMCID: PMC8533692 DOI: 10.3390/brainsci11101275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 12/20/2022] Open
Abstract
Background: Cataracts are associated with progressive blindness, and despite the decline in prevalence in recent years, it remains a major global health problem. Cataract extraction is reported to influence not only perception, attention and memory but also daytime sleepiness, ability to experience pleasure and positive and negative affect. However, when it comes to the latter, the magnitude and prevalence of this effect still remains uncertain. The current study aims to evaluate the hemodynamic basis of daytime sleepiness, ability to experience pleasure and positive and negative affect in cataract patients after the intraocular lens (IOL) implantation. Methods: Thirty-four cataract patients underwent resting-state functional magnetic resonance imaging evaluation before and after cataract extraction and intraocular lens implantation. Both global and local graph metrics were calculated in order to investigate the hemodynamic basis of excessive sleepiness (ESS), experiencing pleasure (SHAPS) as well as positive and negative affect (PANAS) in cataract patients. Results: Eigenvector centrality and clustering coefficient alterations associated with cataract extraction are significantly correlated with excessive sleepiness, experiencing pleasure as well as positive and negative affect. Conclusions: The current study reveals the hemodynamic basis of sleepiness, pleasure and affect in patients after cataract extraction and intraocular lens implantation. The aforementioned mechanism constitutes a proof for changes in functional network activity associated with postoperative vision improvement.
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Affiliation(s)
- Anna Maria Sobczak
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
- Correspondence: (A.M.S.); (B.B.)
| | - Bartosz Bohaterewicz
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
- Department of Psychology of Individual Differences, Psychological Diagnosis, and Psychometrics, Institute of Psychology, University of Social Sciences and Humanities, 03-815 Warsaw, Poland
- Correspondence: (A.M.S.); (B.B.)
| | - Magdalena Fafrowicz
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
| | - Aleksandra Zyrkowska
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
| | - Natalia Golonka
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
| | - Aleksandra Domagalik
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
| | - Ewa Beldzik
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
| | - Halszka Oginska
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
| | - Marek Rekas
- Ophthalmology Department, Military Institute of Medicine, 04-349 Warsaw, Poland; (M.R.); (D.B.)
| | - Dominik Bronicki
- Ophthalmology Department, Military Institute of Medicine, 04-349 Warsaw, Poland; (M.R.); (D.B.)
| | - Bozena Romanowska-Dixon
- Department of Ophthalmology and Ocular Oncology, Medical College, Jagiellonian University, 31-008 Kraków, Poland; (B.R.-D.); (J.B.-P.)
| | - Joanna Bolsega-Pacud
- Department of Ophthalmology and Ocular Oncology, Medical College, Jagiellonian University, 31-008 Kraków, Poland; (B.R.-D.); (J.B.-P.)
| | - Waldemar Karwowski
- Computational Neuroergonomics Laboratory, Department of Industrial Engineering & Management Systems, University of Central Florida, Orlando, FL 32816, USA; (W.K.); (F.F.)
| | - Farzad Farahani
- Computational Neuroergonomics Laboratory, Department of Industrial Engineering & Management Systems, University of Central Florida, Orlando, FL 32816, USA; (W.K.); (F.F.)
- Biostatistics Department, John Hopkins University, Baltimore, MD 21218, USA
| | - Tadeusz Marek
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Kraków, Poland; (M.F.); (A.Z.); (N.G.); (E.B.); (H.O.); (T.M.)
- Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
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Brar S, Ganesh S, Rp N, Cr R. Clinical Outcomes and Patient Satisfaction with a New Diffractive-Refractive Trifocal Intraocular Lens - A 12 Month Prospective Study. Clin Ophthalmol 2021; 15:3247-3257. [PMID: 34376969 PMCID: PMC8349194 DOI: 10.2147/opth.s320202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/05/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the clinical outcomes and patient satisfaction after implantation of Optiflex Trio, a new trifocal intraocular lens (IOL) following cataract surgery. Methods Patients undergoing phacoemulsification for age-related cataracts and who satisfy the eligibility criteria underwent bilateral implantation with Optiflex Trio trifocal IOL. At follow -up visits of 1, 3, 6, and 12 months, binocular uncorrected and corrected distance, intermediate and near visual acuity, reading performance, contrast sensitivity (CS) and patient satisfaction for dysphotopsia and spectacle independence were evaluated using questionnaires. Results A total of 54 eyes from 27 patients with mean age of 66.30±7.48 years were included in the study. At 12 months, 78% (n = 21) patients had binocular cumulative UDVA of 20/20 or better. Post-op SE refraction accuracy was within ±0.50 D for 93% (n = 50) eyes, and refractive cylinder accuracy was within ≤0.50 D in 94% (n = 51) eyes. The mean binocular UNVA was 0.01±0.05 LogMAR, and the mean UIVA at 60 and 80 cm was 0.07±0.06 and 0.03±0.05 LogMAR, respectively, at 12 months. Reading speeds at 40, 60 and 80 cm showed improvement overtime. No patient had complained of severe dysphotopsia, and none of the patients required glasses for any activity. No eye underwent YAG-laser capsulotomy for significant PCO at the end of mean follow-up. Conclusion After 12 months, Optiflex Trio trifocal IOL provided a complete visual restoration with good visual quality outcomes in terms of uncorrected distance, intermediate and near visual acuity. The incidence of dysphotopsia was low, and spectacle independence was high, resulting in good patient satisfaction. Trial Registry CTRI/2019/10/021647 (www.ctri.nic.in).
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Affiliation(s)
- Sheetal Brar
- Department of Phaco-Refractive Surgery, Nethradhama Super Speciality Eye Hospital, Jayanagar, Bengaluru, Karnataka, 560070, India
| | - Sri Ganesh
- Department of Phaco-Refractive Surgery, Nethradhama Super Speciality Eye Hospital, Jayanagar, Bengaluru, Karnataka, 560070, India
| | - Nikhil Rp
- Department of Phaco-Refractive Surgery, Nethradhama Super Speciality Eye Hospital, Jayanagar, Bengaluru, Karnataka, 560070, India
| | - Roopashree Cr
- Department of Phaco-Refractive Surgery, Nethradhama Super Speciality Eye Hospital, Jayanagar, Bengaluru, Karnataka, 560070, India
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Spadea L, Giannico MI, Formisano M, Alisi L. Visual Performances of a New Extended Depth-of-Focus Intraocular Lens with a Refractive Design: A Prospective Study After Bilateral Implantation. Ther Clin Risk Manag 2021; 17:727-738. [PMID: 34295162 PMCID: PMC8291859 DOI: 10.2147/tcrm.s320422] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 07/05/2021] [Indexed: 01/19/2023] Open
Abstract
Purpose The aim of the present study was to evaluate the visual outcome of a new extended depth-of-focus (EDOF) intraocular lens (IOL) after bilateral implantation. A qualitative and quantitative analysis was performed and data were compared with those given by other studies regarding multifocal IOLs, which have the same purpose of giving spectacle independence to the patients. Methods The study enrolled 40 eyes of 20 patients who underwent cataract surgery with bilateral implantation of an EDOF IOL (Evolve Soleko, Rome, Italy). The mean age was 74.5±9 years (range 59-83ys). Refractive outcomes and contrast sensitivity were evaluated preoperatively and at 6-month follow-up. We also examined reading speed, glare, halos, difficulties in the night driving, the requirement for spectacles, and overall satisfaction with vision. Two questionnaires were administered for this purpose. Results At 6 months, the percentage of eyes within ±0.50 diopters (D) from emmetropia was 82.5%. Of all patients, 90% were satisfied with their vision. The percentage of spectacle-free for near and distance vision patients was 70% and 95%, respectively. A postoperative binocular uncorrected 60cm intermediate visual acuity (UI60VA) of 0.2 logMAR or better was achieved in 92% of patients. Contrast sensitivity significantly improved postoperatively (p<0.001) and mean reading speed was good. Conclusion This new EDOF IOL seems to provide an effective alternative to patients who desire a spectacle-free lifestyle postoperatively. These lenses can supply a satisfactory distance, intermediate and near vision, and retain good contrast sensitivity, with most patients reporting excellent satisfaction.
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Affiliation(s)
- Leopoldo Spadea
- Eye Clinic, Policlinico Umberto 1, "Sapienza" University of Rome, Rome, Italy
| | | | - Martina Formisano
- Eye Clinic, Policlinico Umberto 1, "Sapienza" University of Rome, Rome, Italy
| | - Ludovico Alisi
- Eye Clinic, Policlinico Umberto 1, "Sapienza" University of Rome, Rome, Italy
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Abstract
BACKGROUND Patients with iris defects suffer from severe visual impairment, especially increased glare sensitivity, and cosmetic disturbances. This can constitute a great psychological strain for patients. In the recent past the treatment consisted of iris print contact lenses, sunglasses and simple iris prostheses. The indications for surgical treatment are colobomas of the iris, aniridia, traumatic iris defects and persistent mydriasis. The aim of this review article is to investigate the surgical approaches, complications, functional and aesthetic outcome after implantation of an individual artificial iris prosthesis made from silicone. OBJECTIVE Analysis of the literature on the topic of surgical iris reconstruction with an artificial iris in combination with the own experience in more than 120 patients treated by the author in the last 10 years. MATERIAL AND METHODS The custom-made flexible silicone iris prosthesis ArtificialIris (HumanOptics, Erlangen, Germany) assessed in this review is an innovative and versatile option for surgical treatment of iris defects. Patients were examined before and after iris reconstruction with respect to feasibility, complications and outcome. RESULTS Change of best corrected visual acuity, intraocular pressure, pupillary opening, glare, contrast sensitivity, endothelial cell count, anterior chamber depth, anterior chamber angle and patient satisfaction were assessed. Furthermore, complications and color match to the residual and fellow iris were assessed. CONCLUSION The implantation of an artificial iris is an effective option for the treatment of extensive traumatic iris defects and leads to an individual aesthetically appealing and good functional outcome as well as high patient satisfaction; however, this is an intervention that should not be underestimated because of a flat learning curve and various complications that can occur.
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Ning Y, Shao Y, Zhao J, Zhang J, Wang M, Qin Y. Stability of Various Types of Aspheric Intraocular Lenses After Implantation: A One-Year Retrospective Study. Int J Gen Med 2021; 14:2183-2190. [PMID: 34103973 PMCID: PMC8179812 DOI: 10.2147/ijgm.s301887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/28/2021] [Indexed: 11/23/2022] Open
Abstract
Objective The aim of the present study was to evaluate the stability of four different types of aspheric intraocular lenses (IOLs) after implantation. Methods This retrospective study included 124 eyes implanted with four different types of aspheric IOLs including a one-piece four-loop fixed hydrophilic acrylic IOL, a one-piece flat fixed acrylic IOL, a one-piece two-loop fixed acrylic IOL, and a three-piece two-loop fixed silicone IOL. IOL decentration, tilt, and ocular coma-like aberration (coma) at one-week, one-month, three-month, and one-year time points were evaluated postoperatively. Results IOL decentration, tilt, and coma in the AO, 36A, IQ, and KS-AiN implantation groups were statistically significantly different one week and one year postoperatively (p < 0.01). There were significant differences between each of the pairs of groups (p < 0.01), except for coma between the AO and 36A implantation groups one week postoperatively (p > 0.05). When comparing the different time points (ie, one week, one month, three months, and one year postoperatively), IOL decentration, tilt, and coma were significantly different in each group (p < 0.05). IOL decentration, tilt, and coma in each group increased over the period from one week to one year postoperatively. A positive linear correlation was observed between IOL decentration or tilt and coma one year postoperatively (p < 0.01). Conclusion One-piece multi-point fixed acrylic IOLs demonstrate better stability when compared with three-piece two-point fixed silicone IOLs. IOL decentration, tilt, and coma increase gradually over time. Ocular coma-like aberrations are influenced by the stability of IOLs.
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Affiliation(s)
- Yuan Ning
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Key Lens Research Laboratory of Liaoning Province, Shenyang, 110005, People's Republic of China
| | - Yushuang Shao
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Key Lens Research Laboratory of Liaoning Province, Shenyang, 110005, People's Republic of China
| | - Jiangyue Zhao
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Key Lens Research Laboratory of Liaoning Province, Shenyang, 110005, People's Republic of China
| | - Jinsong Zhang
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Key Lens Research Laboratory of Liaoning Province, Shenyang, 110005, People's Republic of China
| | - Mingwu Wang
- Department of Ophthalmology and Vision Science, The University of Arizona College of Medicine, Tucson, Arizona, 85711-1824, USA
| | - Yu Qin
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Key Lens Research Laboratory of Liaoning Province, Shenyang, 110005, People's Republic of China
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Bolletta E, Coassin M, Iannetta D, Mastrofilippo V, Aldigeri R, Invernizzi A, de Simone L, Gozzi F, De Fanti A, Cappella M, Adani C, Neri A, Moramarco A, De Maria M, Salvarani C, Fontana L, Cimino L. Cataract Surgery with Intraocular Lens Implantation in Juvenile Idiopathic Arthritis-Associated Uveitis: Outcomes in the Era of B iological Therapy. J Clin Med 2021; 10:2437. [PMID: 34072679 DOI: 10.3390/jcm10112437] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/21/2021] [Accepted: 05/29/2021] [Indexed: 12/24/2022] Open
Abstract
This study compared the outcomes of cataract surgery with intraocular lens (IOL) implantation in patients with juvenile idiopathic arthritis (JIA)-associated chronic anterior uveitis treated with antimetabolite drugs and systemic corticosteroids (Non-Biological Group) versus patients treated with antimetabolites and biological drugs (Biological Group). A cohort of patients with cataract in JIA-associated uveitis undergoing phacoemulsification with IOL implantation was retrospectively evaluated. The main outcome was a change in corrected distance visual acuity (CDVA) in the two groups. Ocular and systemic complications were also recorded. The data were collected preoperatively and at 1, 12, and 48 months after surgery. Thirty-two eyes of 24 children were included: 10 eyes in the Non-Biological Group and 22 eyes in the Biological Group. The mean CDVA improved from 1.19 ± 0.72 logMAR preoperatively to 0.98 ± 0.97 logMAR at 48 months (p = 0.45) in the Non-Biological Group and from 1.55 ± 0.91 logMAR preoperatively to 0.57 ± 0.83 logMAR at 48 months (p = 0.001) in the Biological Group. The postoperative complications, including synechiae, cyclitic membrane, IOL explantation, glaucoma, and macular edema, were not statistically different between the two groups. An immunosuppressive treatment with biological drugs can improve the visual outcome after cataract surgery in patients with JIA-associated uveitis, but it does not significantly reduce postoperative ocular complications.
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Arrigo A, Gambaro G, Fasce F, Aragona E, Figini I, Bandello F. Extended depth-of-focus (EDOF) AcrySof® IQ Vivity® intraocular lens implant: a real-life experience. Graefes Arch Clin Exp Ophthalmol 2021; 259:2717-22. [PMID: 34050809 DOI: 10.1007/s00417-021-05245-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/29/2021] [Accepted: 05/12/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE Extended depth-of-focus (EDOF) is a promising intraocular lens (IOL) technology for cataract surgery. The aim of the study was to report the real-life experience related to the implant of EDOF AcrySof® IQ Vivity® (Alcon Inc., USA) IOL. METHODS The study was designed as a interventional, prospective, case series with 3 months of follow-up. Patients needing cataract surgery, without any other kind of ocular diseases, were recruited and implanted with AcrySof® IQ Vivity® IOL. We evaluated the refractive success of this IOL through complete ophthalmologic assessments and the administration of the Quality of Vision test. The main outcome measures were the refractive outcome; far, intermediate, and near vision; and Quality of Vision score. RESULTS We included 108 eyes (54 patients; age 62 ± 5 years). Intra-operative and post-operative complications were 0%. Thirty out of 100 eyes (28%) required toric IOL. Best-corrected visual acuity improved from 0.4 ± 0.3 LogMAR to 0.0 ± 0.0 LogMAR (p < 0.01). Refractive outcome was very good for far and intermediate visions, whereas a spherical addition of at least + 1.0D was required for near vision. The mean Quality of Vision score was of 15.5 ± 6.5. The most complained visual disturbances were haloes and glares, although resulting well-tolerated. Dynamic pupillometry findings well-correlated with the amount of complained post-operative visual discomforts. CONCLUSIONS AcrySof® IQ Vivity® IOL is a well-tolerated choice to correct far and intermediate vision. Spectacles are needed to optimize near vision. Our data strongly suggest dynamic pupillometry as a useful investigation to optimize post-operative refractive success.
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Rathore A, Sharma R, Kar R, Tandon A, Suneja A, Guleria K. Role of Cervical Phosphorylated Insulin-Like Growth Factor-Binding Protein 1 (phIGFBP1) for Prediction of Successful Induction Among Primigravida with Prolonged Pregnancy. J Obstet Gynaecol India 2021; 71:38-44. [PMID: 33814797 DOI: 10.1007/s13224-020-01372-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 08/25/2020] [Indexed: 10/23/2022] Open
Abstract
Purpose of the Study To estimate and to compare the levels of cervical phIGFBP-1 among primigravida with prolonged pregnancy, with and without successful induction of labor (IOL). Methods A diagnostic study (cross-sectional study design) was conducted in our institution from November 2016 to April 2018 on 84 primigravida at ≥ 41 weeks with uncomplicated singleton pregnancy. The results were analyzed using SPSS software and receiver operating characteristics curves to determine the best cutoff using Youden Index. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive (+ LR) and negative likelihood ratio (- LR) were calculated. P value < 0.05 was considered significant. Logistic regression analysis was used to determine the predictive ability of the three markers for successful IOL. Results The cutoff level of phIGFBP-1, Bishop score (BS) and transvaginal cervical length (TVL) were 7.8 µg/l, 3 and 3.5 cm, respectively. The sensitivity, specificity, PPV, NPV, + LR and - LR of phIGFBP-1 (> 7.8 µg/l) were 0.87, 0.87, 0.89, 0.85, 6.76 and 0.15, respectively. Using logistic regression analysis, phIGFBP-1 was found to be the best predictor of successful IOL (OR 44.200; 95% CI 12.378-157.831, p < 0.001). Conclusion phIGFBP-1 is a strong independent predictor successful IOL as compared to TVL and BS in primigravida with prolonged pregnancy.
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Fairaq R, Almutlak M, Almazyad E, Badawi AH, Ahad MA. Outcomes and complications of implantable collamer lens for mild to advance keratoconus. Int Ophthalmol 2021; 41:2609-2618. [PMID: 33772698 DOI: 10.1007/s10792-021-01820-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 03/16/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the outcome and safety of implantable collamer lens (ICL; (Visian, STAAR Surgical, Monrovia, CA, USA) in mild to advance keratoconus patients with myopia and myopic astigmatism. METHODS This retrospective study evaluated all patients who underwent ICL implantation for the management of keratoconus at a tertiary care eye hospital from January 2012 to January 2018. The mean duration of follow-up was 15.3 months (range, 3.13 to 38.97 months). Data were collected on preoperative and postoperative uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), refraction was compared, and adverse effects were evaluated. RESULTS Thirty-two eyes (32 patients) were evaluated. The median CDVA was 20/30 preoperatively and 20/20 at last follow-up. The median UDVA was 20/25 at last follow-up. Thirteen patients (40.6%) had 20/20 UDVA in comparison to none at baseline. The median spherical equivalent in diopters (D) was -7.875 D (-4.125 to -10.0 D) preoperatively and decreased to -0.3125 D at last follow-up. The median manifest refractive cylinder was 3.00 D (2.25 to 5.25 D) preoperatively and decreased to 1.125 D postoperatively. Cylinder axis rotation of 10° or greater occurred in 3 eyes (9.375%) and required repositioning of the ICL. One patient (3%) developed nonvisually significant anterior subcapsular cataract. One ICL (3.125%) had to be explanted due to residual refractive error and unsatisfactory vision. CONCLUSION ICLs are a suitable refractive option for the correction of refractive error associated with stable, nonprogressive keratoconus even in advance cases. However, the risk of ICL rotation and subsequent repositioning remain. Careful patient selection is necessary for achieving good outcomes and mitigating intraoperative and postoperative complications.
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Affiliation(s)
- Rafah Fairaq
- Ophthalmology Department, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia.,Cornea and Anterior Segment Division, King Khaled Eye Specialist Hospital, Umm AlHamam AlGharbi, AlUrubah road, Riyadh, Saudi Arabia
| | - Mohammed Almutlak
- Cornea and Anterior Segment Division, King Khaled Eye Specialist Hospital, Umm AlHamam AlGharbi, AlUrubah road, Riyadh, Saudi Arabia
| | - Enmar Almazyad
- Cornea and Anterior Segment Division, King Khaled Eye Specialist Hospital, Umm AlHamam AlGharbi, AlUrubah road, Riyadh, Saudi Arabia
| | - Abdulrahman H Badawi
- Cornea and Anterior Segment Division, King Khaled Eye Specialist Hospital, Umm AlHamam AlGharbi, AlUrubah road, Riyadh, Saudi Arabia
| | - Muhammad Ali Ahad
- Cornea and Anterior Segment Division, King Khaled Eye Specialist Hospital, Umm AlHamam AlGharbi, AlUrubah road, Riyadh, Saudi Arabia.
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Khoramnia R, Yildirim TM, Baur I, Auffarth GU. Duet procedure to achieve reversible trifocality in a young patient with hereditary hyperferritinemia-cataract syndrome. Am J Ophthalmol Case Rep 2021; 21:101026. [PMID: 33615038 PMCID: PMC7881249 DOI: 10.1016/j.ajoc.2021.101026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 10/14/2020] [Accepted: 01/29/2021] [Indexed: 11/10/2022] Open
Affiliation(s)
- Ramin Khoramnia
- International Vision Correction Research Centre, Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Timur M Yildirim
- International Vision Correction Research Centre, Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Isabella Baur
- International Vision Correction Research Centre, Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Gerd U Auffarth
- International Vision Correction Research Centre, Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
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de Ortueta D. Transepithelial Photorefractive Keratektomy after a Clear Lens Exchange. Vision (Basel) 2021; 5:8. [PMID: 33546149 DOI: 10.3390/vision5010008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/30/2021] [Accepted: 02/02/2021] [Indexed: 11/17/2022] Open
Abstract
PURPOSE We evaluated the refractive visual outcomes and efficacy of Transepithelial Photorefractive Keratectomy (TransPRK) using Smart Pulse Technology with static and dynamic cyclotorsion and the AMARIS 1050 Hz RS laser platform from Schwind in the eyes after a refractive lens exchange. Setting/Venue: Aurelios Augenlaserzentrum, Recklinghausen. METHODS We retrospectively evaluated the data of 552 consecutive eyes treated with refractive lens exchange between 2016 and 2019. A total of 47 eyes (8.5%) required a touch up after the clear lens exchange. From 43 eyes of 43 patients, we obtained a minimum follow up of 3 months. In all cases, we performed a TransPRK with a minimum optical zone of 7.2 mm, centering the ablation on the vertex of the cornea. RESULTS The average age of the treated eyes was 57 years old, with a range between 48 and 68 years. The mean treated sphere was 0.42 diopters (D), with a range between -1.0 and +1.75 D. The mean astigmatism was 1.06 D. Postoperatively, after laser vision correction, we reduced the sphere to a mean of 0.11 D (range -0.5 to +0.75 D), and, postoperatively, the mean astigmatism was 0.25 D (range -0.75 to 0 D). The predictability for a spheric equivalent (SEQ) of 0.5 D was 91%, and for 1 D it was 100% of the cases. No eye lost more than one Snellen line. CONCLUSIONS TransPRK with smart pulse was predictable for correcting ametropia after Clear Lens Surgery.
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Fuest M, Plange N, Kuerten D, Schellhase H, Mazinani BAE, Walter P, Kohnen S, Widder RA, Roessler G. Intraocular lens power calculation for plus and minus lenses in high myopia using partial coherence interferometry. Int Ophthalmol 2021; 41:1585-92. [PMID: 33521894 DOI: 10.1007/s10792-020-01684-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 12/19/2020] [Indexed: 11/17/2022]
Abstract
Purpose We assessed the accuracy of lens power calculation in highly myopic patients implanting plus and minus intraocular lenses (IOL). Methods We included 58 consecutive, myopic eyes with an axial length (AL) > 26.0 mm, undergoing phacoemulsification and IOL implantation following biometry using the IOLMaster 500. For lens power calculation, the Haigis formula was used in all cases. For comparison, refraction was back-calculated using the Barrett Universal II (Barrett), Holladay I, Hill-RBF (RBF) and SRK/T formulae. Results The mean axial length was 30.17 ± 2.67 mm. Barrett (80%), Haigis (87%) and RBF (82%) showed comparable numbers of IOLs within 1 diopter (D) of target refraction. Visual acuity (BSCVA) improved (p < 0.001) from 0.60 ± 0.35 to 0.29 ± 0.29 logMAR (> 28-days postsurgery). The median absolute error (MedAE) of Barrett 0.49 D, Haigis 0.38, RBF 0.44 and SRK/T 0.44 did not differ. The MedAE of Haigis was significantly smaller than Holladay (0.75 D; p = 0.01). All median postoperative refractive errors (MedRE) differed significantly with the exception of Haigis to SRK/T (p = 0.6): Barrett − 0.33 D, Haigis 0.25, Holladay 0.63, RBF 0.04 and SRK/T 0.13. Barrett, Haigis, Holladay and RBF showed a tendency for higher MedAEs in their minus compared to plus IOLs, which only reached significance for SRK/T (p = 0.001). Barrett (p < 0.001) and RBF (p = 0.04) showed myopic, SRK/T (p = 002) a hyperopic shift in their minus IOLs. Conclusions In highly myopic patients, the accuracies of Barrett, Haigis and RBF were comparable with a tendency for higher MedAEs in minus IOLs. Barrett and RBF showed myopic, SRK/T a hyperopic shift in their minus IOLs.
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Ramamurthy D, Vasavada A, Padmanabhan P, Reddy JC, Shetty N, Dey A, Sudhir RR. Clinical Outcomes After Bilateral Implantation of a Trifocal Presbyopia-Correcting Intraocular Lens in an Indian Population. Clin Ophthalmol 2021; 15:213-225. [PMID: 33519183 PMCID: PMC7837564 DOI: 10.2147/opth.s279001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/15/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the effectiveness and safety of a presbyopia-correcting trifocal intraocular lens (IOL), AcrySof® IQ PanOptix® (TFNT00), in an Indian population. Patients and Methods This prospective, multicenter, observational, single-arm, post-marketing study included 67 patients undergoing cataract surgery with bilateral implantation of TFNT00 across five Indian sites. Postoperative outcomes were assessed at 3 months after second eye surgery. Effectiveness outcomes included: mean binocular and monocular visual acuity (VA) at distance (4 m), intermediate (60 cm), and near (40 cm); binocular defocus curve; manifest refraction; and subjective symptom questionnaire evaluation. Safety outcomes included the rate of ocular adverse events and mesopic contrast sensitivity. Results Mean binocular and monocular distance-corrected and uncorrected VAs of 0.1 logMAR or better (approximately 20/25 Snellen) were achieved at distance, intermediate, and near. Overall, ≥70% of patients achieved binocular 0.1 logMAR vision or better across all distances. TFNT00 maintained a mean VA of 0.1 logMAR or better at the defocus range of +0.5 diopters (D) to –2.5 D (200 cm to 40 cm). The subjective symptom questionnaire-assessed frequency of halo visual disturbances was low at Month 3; halos were reported “none of the time” to “only some of the time” in 86.6% of patients. The large majority of patients (98.5%) were “satisfied” or “very satisfied” with their near, intermediate, and distance vision at Month 3, and ≥94.0% of patients reported spectacle independence for tasks at all distances. The adverse event rate was low; no patients discontinued due to an adverse event. Conclusion TFNT00 provided a continuous range of vision of 20/25 or better for distance to near and performed effectively at an intermediate functional distance of 60 cm, resulting in high levels of spectacle independence and patient satisfaction. TFNT00 demonstrated a good safety profile and a low post-operative frequency of halo visual disturbances.
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Affiliation(s)
| | | | | | | | - Naren Shetty
- Narayana Nethralaya Eye Hospital, Rajajinagar, Bangalore, India
| | - Arindam Dey
- Alcon Laboratories (India) Private Ltd, Bangalore, India
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Naik M, Sethi H, Mehta A. Capsular bag phimosis. Am J Ophthalmol Case Rep 2020; 20:100999. [PMID: 33319123 PMCID: PMC7723765 DOI: 10.1016/j.ajoc.2020.100999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 10/28/2020] [Accepted: 11/29/2020] [Indexed: 11/26/2022] Open
Abstract
A 60year old male presented with insidious onset, gradually progressive, painless diminution of vision in the right eye since a year. He was operated for cataract about 7 years ago. However, details of surgery or intraocular lens (IOL) were unavailable. Fellow eye was unremarkable. Examination revealed a visual acuity of FC at 5 mts. Slit-lamp examination revealed a quiet anterior chamber without any cells-flare nor any posterior synechiae. Co-axial retro-illumination revealed an in-the-bag IOL, having both haptics folded on the optic with scarring and contraction of the capsular bag, most apparent in the centre. Fundus examination with indirect ophthamoloscopy was difficult owing to the media haze due to capsular scarring but retina was unremarkable as far as could be seen. A diagnosis of “Capsular Bag Phimosis”1,2,3,4 was made. An ASOCT demonstrated such severe moulding of the IOL that a simple YAG capsulotomy may have increased visual acuity but would have lead to severe image distortion, metamorphopsia and resultant aniseikonia. IOL was explanted alongwith the phimosed capsular bag and a Scleral-fixated IOL was placed to achieve a final BCVA 20/20P Snellen.
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Affiliation(s)
- Mayuresh Naik
- Department of Ophthalmology, H.I.M.S.R & H.A.H.C Hospital, Near GK-2, Alaknanda, New Delhi, 110062, India
| | - HarinderSingh Sethi
- Department of Ophthalmology, V.M.M.C & Safdarjung Hospital, Ring Road, Ansari Nagar, New Delhi, 110029, India
| | - Anuj Mehta
- Department of Ophthalmology, V.M.M.C & Safdarjung Hospital, Ring Road, Ansari Nagar, New Delhi, 110029, India
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Dowler KK, Middleton JR, Dufour S, Hood MA, Giuliano EA. Characterization of postoperative "fibrin web" formation after canine cataract surgery. Vet Ophthalmol 2020; 24:37-47. [PMID: 32981182 DOI: 10.1111/vop.12830] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 08/28/2020] [Accepted: 09/02/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE To describe the occurrence and associated factors for "fibrin web" (FW) formation following phacoemulsification in dogs. METHODS A retrospective review of medical records of all dogs undergoing phacoemulsification (MU-Veterinary Health Center, 2014-2018) was conducted to associate FW formation with signalment, systemic co-morbidities, cataract stage, surgeon (resident vs faculty), phacoemulsification time, IOL, and intracameral injections including viscoelastic type. Both univariate and multivariate statistical analyses were performed to evaluate associations among variables with FW formation. RESULTS Data from 398 eyes on 201 dogs were included; 4 left eyes (4 dogs) developed presumptive endophthalmitis and were excluded from further analysis. Forty-eight eyes did not have cataract surgery. Hence, 350 eyes on 201 dogs were included in the analyses. Among these, 84 eyes (59 dogs) developed a FW. Univariate analyses showed that the odds of FW increased with age and phacoemulsification time. Additionally, FW web was associated lens type, lens brand, and viscoelastic type. Multivariate analyses showed that when comparing lens types in combination with a particular viscoelastic, viscoelastic impacted the estimated prevalence of FW formation the most. In contrast, when the data were analyzed by lens brand, lens brand impacted prevalence more than viscoelastic type. Diabetes mellitus was not associated with FW formation. CONCLUSIONS Based on the available data, intraocular lens implantation, viscoelastic type, dog age, and phacoemulsification time were associated with FW formation. Diabetes mellitus, gender, cataract stage, surgeon, intracameral injections other than viscoeleastic, and intra- and postoperative complications were not associated with FW formation.
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Affiliation(s)
- Kourtney K Dowler
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - John R Middleton
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Simon Dufour
- Department of Pathology and Microbiology, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Margaret A Hood
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Elizabeth A Giuliano
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
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Black D, Corbett D, Roberts TV, Cronin B, Smith PJ, Janakiraman DP, Jackson BE. Clinical Evaluation of a Novel Preloaded Intraocular Lens Delivery System During Routine Cataract Surgery. Clin Ophthalmol 2020; 14:2291-2300. [PMID: 32943830 PMCID: PMC7468508 DOI: 10.2147/opth.s260925] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 07/08/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the clinical handleability and acceptability of a novel preloaded intraocular lens (IOL) delivery system for implantation of the TECNIS ZCB00 IOL (Johnson & Johnson Surgical Vision, Inc., Santa Ana, CA, USA) during routine small-incision cataract surgery. Subjects and Methods In this prospective, open-label, noncomparative, unilateral or bilateral, multicenter study, adult subjects with unilateral or bilateral cataracts scheduled for IOL implantation were enrolled. Surgeons and surgical technicians completed per-eye day-of-surgery and end-of-surgical-day questionnaires. The primary endpoint of the study was the rate of acceptable overall clinical performance of the preloaded IOL delivery system. Other endpoints included additional responses from the questionnaires, preimplantation incision size, and safety. Results The study included 91 eyes that underwent cataract surgery and IOL implantation using the preloaded delivery system and were available for the 1-day postoperative visit. Five surgeons and 14 surgical technicians from four investigational sites participated in the study. The rate of acceptable overall clinical performance was 100% (91/91) of eyes, with most responses (78/91; 85.7%) being the highest possible rating of 5 (very satisfied). Favorable responses by most surgeons and surgical technicians regarding additional endpoints further highlighted the handleability and acceptability of the preloaded delivery system. No ocular adverse events or lens findings (ie, no cases of IOL instability, haptic breakage, IOL marking, or crimping) were reported. Conclusion The results of this study demonstrated that this preloaded IOL delivery system was safe and effective during routine small-incision cataract surgery. Trial Registration German Clinical Trials Register identifier, DRKS00014757.
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Affiliation(s)
- Daniel Black
- Sunshine Eye Clinic, Birtinya, Queensland, Australia
| | | | - Timothy V Roberts
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Vision Eye Institute, Sydney, New South Wales, Australia
| | - Brendan Cronin
- Queensland Eye Institute, South Brisbane, Queensland, Australia
| | - Pamela J Smith
- Johnson & Johnson Surgical Vision, Inc., Santa Ana, CA, USA
| | | | - Beth E Jackson
- Johnson & Johnson Surgical Vision, Inc., Santa Ana, CA, USA
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Mayer CS, Hoffmann AM, Prahs P, Reznicek L, Khoramnia R. Functional outcomes after combined iris and intraocular lens implantation in various iris and lens defects. BMC Ophthalmol 2020; 20:370. [PMID: 32933506 PMCID: PMC7493881 DOI: 10.1186/s12886-020-01621-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 08/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To assess the functional outcomes after combined iris and intraocular lens (IOL) repair in aniridia patients. METHODS Retrospective observational study in 59 aniridic and aphakic eyes for ArtificialIris (AI) and IOL reconstruction. The iris prostheses were placed together with the IOL in the capsular bag using an injection system or were fixed by transscleral suturing of the IOL and AI. The primary outcomes measured were visual acuity, contrast and glare sensitivity (Pelli-Robson chart for photopic and dark adaptometer for mesopic conditions), intraocular pressure, endothelial cell density (ECD) and patient impairment. RESULTS Blunt trauma (37 eyes) and penetrating injuries (16 eyes) were observed more frequently than congenital aniridia (1 eye), iatrogenic causes (1 eye), aniridic state after severe iritis (2 eyes) or iris tumor (2 eyes). Monocular CDVA improved significantly (p < 0.0001) from median 0.7 logMAR (0.0-1.98) to 0.3 logMAR (- 0.08-2.0). Median pupillary area could significantly (p < 0.0001) be reduced by 79.3% from 51.27 mm2 (17.91 to 98.23) to 8.81 mm2 (4.16 to 8.84). Median ECD decreased from 2646.0 mm2 to 2497.5 mm2 (p = 0.007). Contrast and glare sensitivity improved significantly (p = 0.008) in photopic light conditions from 0.9 (0.0-1.95) to 1.35 (0.0-1.8). Patients reported to be highly satisfied with the functional improvement. CONCLUSION The flexible ArtificialIris seems to be a safe and effective iris prosthesis in combination with an IOL having functionally and cosmetically exceptional reconstruction options.
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Affiliation(s)
- Christian S Mayer
- Department of Ophthalmology, University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.,Department of Ophthalmology, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Andrea M Hoffmann
- Department of Ophthalmology, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Phillipp Prahs
- Department of Ophthalmology, University of Regensburg, Regensburg, Germany
| | - Lukas Reznicek
- Department of Ophthalmology, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Ramin Khoramnia
- Department of Ophthalmology, University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
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