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Recurrent Acremonium infection in a kidney transplant patient treated with voriconazole: a case report Infecção recidivante por Acremonium em paciente transplantado renal tratado com voriconazol: relato de caso
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Felipe Francisco Tuon
Full Text Available Acremonium infection is rare and associated with immunosuppression. A case of recurrent cutaneous Acremonium infection after short term voriconazole use is described. Surgical resection was the definitive therapy. Oral voriconazole was used in the treatment of Acremonium infection, but recurrence was associated with short therapy. Prolonged antifungal therapy and surgical resection are discussed for the treatment of localized lesions.Infecção por Acremonium é rara e pode estar associada com imunossupressão. Descrevemos um caso de infecção recorrente de pele por Acremonium após tratamento breve com voriconazol. Ressecção cirúrgica foi o tratamento definitivo. Terapia prolongada com antifúngicos e ressecção cirúrgica são discutidas para o tratamento de doenças fúngicas localizadas.
Intraocular inflammation as the main manifestation of Rickettsia conorii infection
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Orduña A
Full Text Available Archimedes LD Agahan1,3, Jenice Torres1, Graciana Fuentes-Páez1, Hernan Martínez-Osorio1, Antonio Orduña2, Margarita Calonge11Ocular Immunology and Uveitis Unit, Institute of Applied Ophthalmobiology (IOBA, 2Microbiology Department, University of Valladolid, Valladolid, Spain; 3Department of Ophthalmology and Visual Sciences, University of the Philippines, Philippine General Hospital, Manila, PhilippinesObjective: To report the clinical features and management of seven cases of intraocular inflammation caused by Rickettsia infection and review published literature.Methods: Rickettsia conorii or Rickettsia spp. infection was diagnosed based on the following criteria: (1 positive serology according to the European Guidelines, (2 titer normalization after specific treatment, and (3 complete resolution of ophthalmic disease and accompanying symptoms after antibiotic therapy.Results: Seven patients were referred for uveitis of unknown etiology. All came from regions where Mediterranean spotted fever is prevalent. One patient met the European guidelines criteria for Rickettsia spp. infection, while the other six cases met the criteria for R. conorii infection. The main symptoms were visual loss, floaters, eye redness, photophobia, and ocular pain. Predominant ophthalmic signs included vasculitis, choroiditis, vitritis, and macular edema. All patients required antibiotic treatment that resulted in the remission of the infection. Doxycycline was the first choice and the only antibiotic used to treat four patients. One patient needed ciprofloxacin as a second antibiotic after not responding to doxycycline. Two patients had doxycycline as a second antibiotic after not responding primarily to sulfonamides (which had been given after 2–3 days of doxycycline gastric intolerance; one of these patients needed ciprofloxacin as a third antibiotic.Conclusion: Intraocular inflammation can occur as the main manifestation of Rickettsia conorii or Rickettsia spp
Catheter-Related Acremonium kiliense Fungemia in a Patient with Ulcerative Colitis under Treatment with Infliximab
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Fernando A. Díaz-Couselo
Full Text Available Acremonium spp. are filamentous, cosmopolitan fungi commonly isolated from plant debris and soil. They are infrequent pathogens in humans. Acremonium fungemia has been reported in neutropenic patients associated with central venous catheters and in nonneutropenic patients receiving long-term total parenteral nutrition. TNF-α blockade is associated with fungal infections, but no Acremonium spp. infection had been reported up to the present. In this paper, we present a patient with ulcerative colitis who developed Acremonium kiliense fungemia associated with infliximab therapy while receiving total parenteral nutrition. The patient was successfully treated with voriconazole. Acremonium sp. infection must be suspected as another cause of fungal infection in patients under treatment with infliximab.
ParasiticMeloidogyne and mutualisticAcremonium increase chitinase in tall fescue.
Roberts, C A; Marek, S M; Niblack, T L; Karr, A L
Tall fescue (Festuca arundinacea Schreb.) is a C-3 perennial grass noted for its persistence in harsh environments. Tall fescue persistence is enhanced byAcremonium coenophialum, a mutualistic fungal endophyte that increases resistance to drought, pathogens, and insects. This research was conducted to identify and elicit biochemical mechanism(s) that could account for tall fescue persistence. In initial studies, two cultivars known to differ in persistence were analyzed for chitinase, an antifungal hydrolase associated with disease resistance in other plants.Acremonium-infected Kentucky 31 (KY31), a persistent cultivar, and Johnstone, a nonpersistent cultivar, were inoculated with the parasitic nematode,Meloidogyne marylandi, grown for 50 days, and analyzed at 10-day intervals. Chitinase fluctuated throughout the 50-day period of seedling development, and activity was highest in the persistentAcremonium-infected KY31. In addition, chitinase was elicited by parasiticM. marylandi and expressed systemically. Subsequent studies were conducted to determine whether or not mutualisticAcremonium could increase chitinase activity. Genetically identical KY31, with and withoutAcremonium, were grown for 25 days and analyzed for chitinase at 5-day intervals. After 20 days,Acremonium-infected KY31 expressed more chitinase thanAcremonium-free KY31. We concluded that chitinase is related to tall fescue persistence; it was highest in the most persistent cultivar, increased under pathogen attack, and increased in the presence ofAcremonium, a symbiont known to enhance disease resistance.
Two rare cases of Acremonium acute endophthalmitis after cataract surgery in a tertiary care hospital.
Calderaro, Adriana; Motta, Federica; Larini, Sandra; Gorrini, Chiara; Martinelli, Monica; Piscopo, Giovanni; Benecchi, Magda; Arcangeletti, Maria Cristina; Medici, Maria Cristina; De Conto, Flora; Montecchini, Sara; Neri, Alberto; Scaroni, Patrizia; Gandolfi, Stefano; Chezzi, Carlo
This report describes two cases of Acremonium sp. endophthalmitis, occurring in two patients who underwent cataract surgery on the same day in the same operating room of our hospital ophthalmology clinic. Diagnosis of fungal endophthalmitis was established by the repeated isolation of the same fungal agent from vitreous washing, acqueous fluid and intraocular lens samples and by its identification on the basis of morphological and molecular features. The cases reported in this study emphasize the need for clinical microbiology laboratories to be prepared to face the diagnosis of uncommon infectious diseases such as exogenous fungal endophthalmitis by Acremonium, and to enhance the awareness of surgeons and clinicians of this occurrence.
Onicomicosis por Acremonium Kiliense Onychomycosis by Acremonium Kiliense
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M C Albrecht
Full Text Available El rol de los hongos filamentosos hilalinos no dermatofitos, como agentes causales de onicomicosis, ha sido documentado en las últimas tres décadas por diferentes autores y son considerados oportunistas emergentes. El objetivo de este trabajo es presentar un caso de onicomicosis producido por Acremonium kiliense, cuya evolución fue estudiada. Se presentó al laboratorio de micología un paciente de 18 años de edad de sexo femenino con traumatismo en la uña del primer dedo del pie derecho. Se tomaron muestras seriadas de la lesión para la observación microscópica directa con OHK 40% p/v y para cultivos en Agar Sabouraud, Agar Lactrimel y DTM (medio selectivo para dermatofitos y con las colonias recuperadas se efectuaron microcultivos. Se implementó tratamiento con ciclopirox laca al 8% combinado al principio con Itraconazol vía oral (100 mg/día, con buena evolución. Es importante tener en cuenta a estos hongos oportunistas como agentes etiológicos potenciales de micosis ungueales, en especial en pacientes inmunodeprimidos, ya que la afección ungueal puede ser la puerta de entrada para la diseminación de la infección.The role of non-dermatophytic hyaline filamentous fungi as agents of onychomycosis has been documented in the last three decades by different authors, who have considered these fungi emerging opportunists. A 18-year-old female patient with trauma to the first toenail of the right foot came to the mycology laboratory. Serial samples of the lesion were collected for direct microscopic observation using 40% (w/v potassium hydroxide (KOH and for culture in Sabouraud agar, Lactrimel agar and DTM (dermatophyte selective medium. Microcultures were grown from the colonies recovered. Treatment with 8% ciclopirox nail lacquer, combined at the beginning with oral administration of itraconazole (100 mg a day, was implemented with good evolution. It is important to consider these opportunist fungi as potential etiological agents
Role of intraocular Leptospira infections in the pathogenesis of Equine Recurrent Uveitis in the Southern United States
To investigate the role of intraocular leptospiral infections in horses with Equine Recurrent Uveitis (ERU) in the southern United States, blood and ocular fluid samples were collected from horses with a history and ocular findings consistent with ERU. Samples were also obtained from control horses ...
Experimental intraocular infection of exotic cockerels with field strain of velogenic Newcastle disease virus in Nigeria
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Samaila Jonathan Badau
Full Text Available Experimental intraocular (conjunctival infection of exotic cockerels with a new field strain of viscerotropic velogenic Newcastle Disease Virus (NDV was conducted to explore the concurrence of some pathological changes with humoral immune responses. After the NDV infection of 4-week-old cockerels, pathologic changes and antibody responses were observed. The clinical signs observed after the artificial inoculation included inappetence, depression, diarrhea, dyspnea, wing and leg paralysis, torticollis and weight loss. Morbidity due to the NDV was 100%, but mortality was 80% by day 18-21 post-infection. Early hyperthermia followed by terminal hypothermia, decreased packed cell volume (PCV, and 231.4 folds peak-antibody response were observed. Necrotic and/or inflammatory lesions were present in the proventriculus, intestine, liver, spleen, kidney and brain. Neurologic and digestive tract perturbations occurred in 10% and 85% of cases, respectively. The disease consistently caused stunted growth, decreased PCV, and necro-inflammatroy lesions concurrent with antibody response, suggesting probable involvement of immune-mediated mechanisms and cell membrane desialylation by viral neuraminidase in the pathogenesis.
Acremonium in fescue and ryegrass: boon or bane? A review.
Joost, R E
Acremonium coenophialum Morgan-Jones and Gams, an endophytic fungus commonly found in tall fescue (Festuca arundinacea Schreb.), has been identified as the cause of poor performance of beef cattle and horses on tall fescue. Ryegrass staggers, a neurological disorder of sheep, has been linked to the presence of a similar fungus, A. lolii Latch, Christensen and Samuels, in perennial ryegrass (Lolium perenne L.). Renovation of endophyte-infected (E+) pastures with endophyte-free (E-) cultivars of tall fescue or perennial ryegrass has resulted in improved animal performance, but productivity and stand persistence of the grasses have been reduced. Stand loss of E- tall fescue has been attributed to a number of stresses, including insect attack, disease, root predation by nematodes, and drought stress. The Acremonium endophyte has been observed to stimulate the tall fescue plant's production of chitinase, an enzyme associated with disease resistance. Nematode resistance, which can also be enhanced in E+ plants, has been attributed, in part, to thickening of the root endodermal layer. Drought stress has been identified as the most common cause of E- tall fescue stand loss in the eastern United States. Endophyte-infected tall fescue plants exhibit several adaptive morphological and physiological responses to drought stress compared with E- plants. Drought-induced leaf rolling, leaf senescence, stomatal closure, and osmotic adjustment are more prevalent in E+ than in E- plants and may be mediated through endophyte enhancement of the production of phytohormones such as abscisic acid. Endophyte-infected tall fescue plants have been shown to be more productive and competitive than E- plants through improvement of germination, tillering, and biomass production per tiller.(ABSTRACT TRUNCATED AT 250 WORDS)
Entomopathogenic Potential of Verticillium and Acremonium Species (Deuteromycotina: Hyphomycetes)
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Steenberg, Tove; Humber, Richard A
entomopathogen. The fungi were identified as Verticillium fusisporum, Veritcillium psalliotae, Verticillium lamellicola, and species of Acremonium. Isolates of these fungi were bioassayed against the sweet-potato whitefly (Bemisia tabaci) and against the housefly (Musca domestica) to examine...... their entomopathogenicity. A test was also conducted with a coleopteran (lesser mealworm, Alphitobius diaperinus) to further evaluate the host range for some of the fungi. V. lamellicola was not pathogenic to the two species of insects treated, while varying levels of pathogenicity were shown for the other species....... In general, V. lecanii was the most pathogenic species. Immature whiteflies appeared to be more susceptible to fungal infection than adult houseflies, and the host range for several of the fungi also included lesser mealworm....
Clinical experiences in fungal keratitis caused by Acremonium
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Kim SJ
Full Text Available Seong-Jae Kim,1,2 Yong-Wun Cho,1 Seong-Wook Seo,1,2 Sun-Joo Kim,2,3 Ji-Myong Yoo1,21Department of Ophthalmology, 2Gyeongsang Institute of Health Science, 3Department of Laboratory Medicine, Gyeongsang National University, College of Medicine, Jinju, KoreaPurpose: To report the predisposing risk factors, clinical presentation, management, and therapeutic outcomes of fungal keratitis caused by Acremonium.Methods: This is a retrospective study of cases with Acremonium fungal keratitis that presented to our tertiary referral center between January 2006 and August 2012. Patient demographic and clinical details were determined and reported.Results: Five cases of fungal keratitis from Acremonium species were identified in five patients (three males, two females. The mean age of the patients was of 73.4±5.46 years, with a mean follow-up time of 124±72 days. All patients had a history of corneal trauma with vegetable matter. Four cases were unresponsive to initial treatment (0.2% fluconazole, 0.15% amphotericin B and required topical 5% natamycin, and, in two out of five cases, topical 1% voriconazole.Conclusion: The most common risk factors for Acremonium fungal keratitis was ocular trauma. When a corneal lesion is found to be unresponsive to the initial treatment, we should consider adding or substituting topical natamycin or voriconazole for treatment.Keywords: Acremonium, fungal keratitis, natamycin, prognosis, voriconazole
海洋真菌BH0531代谢产物对感染根结线虫黄瓜保护酶的影响%Effects of metabolites derived from Acremonium sp. BH0531 on defense enzymes of cucumbers infected by root-knot nematode
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蔡爽; 刘晓霞; 申佩娟; 黄敏; 孟庆恒; 孙建华
枝顶孢霉(Acremonium sp.)BH0531已被证实是一株对根结线虫具有较好防治效果的海洋真菌。为探究其对根结线虫和黄瓜的作用机制,以根结线虫侵染后的黄瓜为材料,在土壤中分别加入质量浓度为5、10、20、40 mg · mL-1的BH0531发酵液40 mL,用等量清水作对照,测定了丙二醛、脯氨酸含量以及保护酶SOD、POD、CAT、PAL、PPO的比活力。结果表明,接种根结线虫30 d后,黄瓜叶片丙二醛和脯氨酸含量增加,发酵滤液能够显著降低其含量,能够有效缓解根结线虫对黄瓜植株造成的危害。SOD比活力显著提高,能够抵御活性氧带来的伤害;防御酶活力随时间动态变化,先升高后降低,POD、CAT、PAL和PPO比活力与未受根结线虫感染组对比均降低,但施用发酵液时,酶活力均显著提高,能够有效增强植株的抗性。%Acremonium sp. BH0531, a marine fungus, has been proved with definite control efficiency on root-knot nema⁃tode. To explore the mechanisms in nematode control and growth improvement of cucumbers, pot experiments were conduct⁃ed indoors to assess the effect of metabolites from BH0531 on physiological indexes and defense enzymes of cucumbers in⁃fected by root-knot nematode. Each pot was handled with 40 mL fermentation broth of BH0531 in different concentrations:5, 10, 20, 40 mg·mL-1, and the control was treated with water instead. Then the amounts of malondialdehyde (MDA) and pro⁃line were measured, so were the specific activities of SOD, POD, CAT, PAL and PPO. The results showed that nematode in⁃fection increased MDA and proline contents and caused damage in cucumbers, whereas the metabolites effectively reduced the amount of MDA and proline and nearly alleviated the damage. On the other hand, the significant improvement in specific activity of SOD offset the damage of active-oxygen. In short, compared to the control, root-knot nematode infection leads to
Effects of the fungal endophyte Acremonium coenophialum on nitrogen accumulation and metabolism in tall fescue
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Lyons, P.C. (Univ. of Georgia, Athens (USA)); Evans, J.J.; Bacon, C.W. (Department of Agriculture, Athens, GA (USA))
Infection by the fungal endophyte Acremonium coenophialum affected the accumulation of inorganic and organic N in leaf blades and leaf sheaths of KY31 tall fescue (Festuca arundinacea Schreb.) grown under greenhouse conditions. Total soluble amino acid concentrations were increased in either the blade or sheath of the leaf from infected plants. A number of amino acids were significantly increased in the sheath, but only asparagine increased in the blade. Infection resulted in higher sheath NH{sub 4}{sup +} concentrations, whereas NO{sub 3}{sup {minus}} concentrations decreased in both leaf parts. The effects on amino acid, NO{sub 3}{sup {minus}}, and NH{sub 4}{sup +} concentrations were dependent upon the level of N fertilization and were usually apparent only at the high rate (10 millimolar) of application. Administration of {sup 14}CO{sub 2} to the leaf blades increased the accumulation of {sup 14}C in their amino acid fraction but not in the sheaths of infected plants. This may indicate that infection increased amino acid synthesis in the blade but that translocation to the sheath, which is the site of fungal colonization, was not affected. Glutamine synthetase activity was greater in leaf blades of infected plants at high and low N rates of fertilization, but nitrate reductase activity was not affected in either part of the leaf. Increased activities of glutamine synthetase together with the other observed changes in N accumulation and metabolism in endophyte-infected tall fescue suggest that NH{sub 4}{sup +} reassimilation could also be affected in the leaf blade.
Antimicrobial activity of pyrrocidines from Acremonium zeae against endophytes and pathogens of maize.
Wicklow, Donald T; Poling, Stephen M
Acremonium zeae produces pyrrocidines A and B, which are polyketide-amino acid-derived antibiotics, and is recognized as a seedborne protective endophyte of maize which augments host defenses against microbial pathogens causing seedling blights and stalk rots. Pyrrocidine A displayed significant in vitro activity against Aspergillus flavus and Fusarium verticillioides in assays performed using conidia as inoculum, with pyrrocidine A being more active than B. In equivalent assays performed with conidia or hyphal cells as inoculum, pyrrocidine A revealed potent activity against major stalk and ear rot pathogens of maize, including F. graminearum, Nigrospora oryzae, Stenocarpella (Diplodia) maydis, and Rhizoctonia zeae. Pyrrocidine A displayed significant activity against seed-rotting saprophytes A. flavus and Eupenicillium ochrosalmoneum, as well as seed-infecting colonists of the phylloplane Alternaria alternata, Cladosporium cladosporioides, and Curvularia lunata, which produces a damaging leaf spot disease. Protective endophytes, including mycoparasites which grow asymptomatically within healthy maize tissues, show little sensitivity to pyrrocidines. Pyrrocidine A also exhibited potent activity against Clavibacter michiganense subsp. nebraskense, causal agent of Goss's bacterial wilt of maize, and Bacillus mojaviense and Pseudomonas fluorescens, maize endophytes applied as biocontrol agents, but were ineffective against the wilt-producing bacterium Pantoea stewartii.
Recombinant Acremonium chrysogenum strains for the industrial production of cephalosporin.
Díez, B; Mellado, E; Fouces, R; Rodríguez, M; Barredo, J L
Conventional strain improvement programs based on random mutagenesis and rational screening have meant valuable results to the antibiotic producing companies. The development of recombinant DNA techniques and their applications to the industrially-used cephalosporin-producing fungus Acremonium chrysogenum has provided a new tool, complementary to classical mutation, promoting the design of alternative biosynthetic pathways making it possible to obtain new antibiotics and to improve cephalosporin production. Yield increases have been achieved by increasing the dosage of the biosynthetic genes cefEF (deacetoxycephalosporin C expandase/hydroxylase) and cefG (deacetylcephalosporin C acetyltransferase) or enhancing the oxygen uptake by expressing a bacterial oxygen-binding heme protein (Vitreoscilla hemoglobin). New biosynthetic capacities such as the production of 7-aminocephalosporanic acid (7-ACA) or penicillin G have been achieved through the expression of the foreign genes dao (D-amino acid oxidase) coupled with cephalosporin acylase or penDE(acyl-CoA:6-APA acyltransferase) respectively. Confined manipulation of the above-mentioned recombinant strains must be performed according to standing rules.
Effects of the endophyte Acremonium alternatum on oilseed rape (Brassica napus development and clubroot progression
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Full Text Available The clubroot pathogen Plasmodiophora brassicae infects economically important Brassica crops such as oilseed rape and vegetable brassicas. Clubroot results in abnormally growing roots and restricts the flow of water and nutrients to the upper plant parts, thereby inducing wilting. Yield loss affects about half the percentage of infected plants. Due to its complex and well-adapted life cycle the pathogen is difficult to control by chemical and cultural means and therefore continues to spread around the globe. Infested fields can no longer be used effectively for cultivation of crop plants for at least the next ten years. Despite costly breeding of resistant cultivars, recent research leans towards alternative, low-impact and environmentally friendly methods to control clubroot. To this end we have previously identified the endophyte Acremonium alternatum, a known biological control agent in several countries, to show promising antagonistic effects in clubroot-infected A. thaliana and Chinese cabbage (Brassica rapa. Here, we will describe its effect on the growth, development and clubroot control of oilseed rape (Brassica napus. While the clubroot symptoms were not clearly reduced after co-inoculation with A. alternatum and P. brassicae on oilseed rape roots, the aboveground plant parts were delayed in senescence and produced more seeds, which is indicative of an increase in yield after A. alternatum treatment. The long-term goal of this work is to contribute to a fundamental understanding of endophyte-plant interactions and an effective reduction of clubroot to be used in integrated pest management for oilseed rape and other cabbage varieties.
Bilateral Primary Intraocular Lymphoma
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Mehrdad Karimi
Full Text Available Purpose: To report a case of bilateral primary intraocular lymphoma. Case report: A 33-year-old man presented with bilateral blurred vision since two years ago. Examination revealed large keratic precipitates, anterior chamber reaction, posterior subcapsular cataracts, and vitreous infiltration. After a short trial of topical and periocular steroids, diagnostic 25-gauge pars plana vitrectomy was performed and cytologic evaluation of the aspirate confirmed a diagnosis of intraocular lymphoma. The patient was subsequently managed with intravitreal methotrexate in both eyes and responded favorably. Central nervous system workup for lymphoma was negative. Conclusion: Primary intraocular lymphoma should be considered in young adults suffering from chronic recalcitrant panuveitis.
Combination of intracameral and intrastromal voriconazole in the treatment of recalcitrant Acremonium fungal keratitis.
Haddad, Randa S; El-Mollayess, Georges M
We present a report of a 28-year-old female with fungal keratitis due to Acremonium that was unresponsive to full medical therapy over 3 weeks. The patient was treated with superficial keratectomy, intrastromal and intracameral voriconazole injections. There was a marked clinical improvement beginning on day 3 post-therapy that was sustained until the last follow-up at 6 months. This is the first case of fungal keratitis due to Acremonium treated by a combination of intrastromal and intracameral voriconazole. This cost-effective treatment modality proved to be significant in impeding the progression of this potentially blinding disease and improving visual prognosis.
Effect of simulated acid rain on the mutualism between tall fescue (Festuca arundinacea) and an endophytic fungus (Acremonium coenophialum)
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Cheplick, G.P. (Univ. of Wisconsin, Whitewater (United States))
Biotic interactions between plants and microorganisms have the potential to be affected by acidic precipitation. I examined the effect of simulated sulfuric acid rain on the mutualism between a perennial forage grass (Festuca arundinacea) and a fungal endophyte (Acremonium coenophialum). Acid water was supplied as mists sprayed onto leaf surfaces or as water added to the soil for two groups in a greenhouse: one group had high levels of endophyte infection, while the other was predominantly noninfected. Control plants received distilled water (pH 6), while others received sulfuric acid water at pH 4.5 or pH 3. Plants were harvested after 4, 6, 8, and 23 wk. Leaf endophyte infection intensity as measured by hyphal counts was not affected by acid water treatment. Root mass and root: shoot ratios generally decreased with increasing acidity of both foliar sprays and soil water, but shoot mass was mostly not affected. There was a significant pH x infection interaction for plants exposed to acidic foliar sprays for 4 wk; root and shoot mass decreased with acidity, but only for infected plants. It was found that acid rain may be deleterious to tall fescue growth at specific stages of development, but biomass production in response to acid rain is not likely to be influenced by fungal endophytes within mature plants. 55 refs., 2 figs., 3 tabs.
眼内异物手术感染的危险因素及预防对策%Risk factors and prevention countermeasures of postoperative infection after intraocular foreign body extraction
Institute of Scientific and Technical Information of China (English)
Objective To investigate postoperative infection risk factors after intraocular foreign body extraction and to discus its countermeasures of prevention.Methods Totally 246 eyes of 246 cases who underwent intraocular foreign body removal surgery were reviewed retrospectively, which were in patient department cases from June 2012 to May 2014.The risk factors and preventive measures of postoperative infection were analyzed.Results Postoperative infection occurred in 2 cases of 246 cases (246 eyes).Conclusion The risk factors of postoperative infection included unenough hand disinfection of surgeon staffs, unstandardized aseptic technique, unstrictly access limitation to operating room, diagnosis, untimely surgery, underlying disease and the decreased patient's body resistance.The early diagnosis, accurate location of foreign body, early operation, strict surgical environment, and aseptic manipulation are the effective ways to prevent postoperative infection in patients with intraocular foreign body.%目的 探讨眼内异物患者手术感染危险因素及预防对策.方法 分析2012年6月至2014年5月住院的246例(246只眼)眼内异物摘出手术感染的危险因素,并据之提出预防对策.结果 246例(246只眼)眼内异物摘出手术中2例(0.81%)发生眼内感染.结论 手术者手消毒不到位、手术中无菌技术操作不规范、未严格执行手术室人员限入制度、诊断或手术不及时、患者自身基础疾病,以及机体抵抗力下降等是引起眼内异物手术感染的重要因素.早期明确诊断、准确异物定位、尽早进行手术、严密控制手术环境、严格无菌操作等能有效防止眼内异物患者手术感染的发生.
Pseudophakia and intraocular pressure.
Radius, R L; Schultz, K; Sobocinski, K; Schultz, R O; Easom, H
We studied the change in intraocular pressure in 373 consecutive eyes undergoing cataract extraction with intraocular lens implantation between Jan. 1, 1981, and May 31, 1982. There was a mean increase in intraocular pressure of 0.1 mm Hg following this surgery. This increase, however, was not statistically significant (P greater than .5). There was a mean rise in pressure of 0.8 mm Hg in the eyes undergoing intracapsular surgery and a mean fall in pressure of 0.6 mm Hg in the eyes undergoing extracapsular surgery (P less than .05). The change in pressure was unrelated to age, surgeon, or lens type. The results of a separate analysis of 16 eyes with a preoperative diagnosis of glaucoma and eight eyes with ocular hypertension were similar.
Viabilidade, confirmação taxonômica e detecção enzimática de espécies de Acremonium preservadas sob óleo mineral na Coleção de Culturas University Recife Mycology Viability, taxonomic confirmation and enzymatic detection of Acremonium species preserved under mineral oil in the URM Culture Collection
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Suellen Carvalho de Moura Braz
Full Text Available Enzimas hidrolíticas secretadas por fungos têm um papel importante na patogenicidade das infecções. Objetivando avaliar a atividade enzimática foram testados 31 isolados de Acremonium mantidos na Coleção de Culturas University Recife Mycology. Fragmentos das culturas foram transferidos para caldo glicosado para reativação e posterior crescimento em meio ágar batata dextrose, para verificar viabilidade, pureza e confirmação taxonômica pela observação das características macroscópicas e microscópicas. Para detecção enzimática foram utilizados substratos de caseína do leite e gelatina para protease, amido para amilase e lecitina de soja para fosfolipase. Das 31 culturas, 26 (83,9% mantiveram-se viáveis e 24 (92,3% foram confirmadas taxonomicamente. Das 24 culturas, 12 (50% apresentaram atividade proteásica, duas (16,7% em caseína do leite, uma (8,3% em gelatina e nove (75% em ambos os substratos; 16 (66,7% degradaram amido. Nenhuma cultura apresentou atividade fosfolipásica. Conclui-se que espécies de Acremonium são capazes de produzir enzimas envolvidas na patogenicidade das infecções fúngicas.Hydrolytic enzymes secreted by fungi play an important role in the pathogenesis of infection. With the aim of evaluating the enzymatic activity, 31 isolates of Acremonium stored in the University of Recife Mycology (URM Culture Collection were tested. Culture fragments were transferred to glycoside broth for reactivation and further growth in potato dextrose agar medium in order to investigate viability and purity and to confirm the taxonomy through observing the macroscopic and microscopic characteristics. To detect enzymes, milk casein and gelatin were used as substrates for proteinase, starch for amylase and soy lecithin for phospholipase. Among the 31 cultures, 26 (83.9% remained viable and 24 (92.3% were confirmed taxonomically. Out of these 24 cultures, 12 (50% presented proteinase activity, of which two (16.7% were on
Environmental standards for intraocular lens implantation.
Crawford, B A; Kaufman, D V
Successful implantation of prosthetic devices depends upon their freedom from postoperative inflammation and infection. Techniques and lessons learned in orthopaedic and other implant surgery should be applied to intraocular lens implantation. The avoidance of contamination by particles and micro-organisms is one essential principle of the surgical procedure. Practical steps are described to reduce both types of contamination. These measures taken together are recommended for adoption as a standard of environmental safety for lens implantation.
Opaque intraocular lens implantation
Yusuf IH; Patel CK
Imran H Yusuf, CK Patel The Oxford Eye Hospital, West Wing, John Radcliffe Hospital, Headley Way, Headington, Oxford, United KingdomWe read with great interest the recent article by Lee et al,1 who described their clinical experience with three patients who underwent primary implantation of Morcher (Stuttgart, Germany) occlusive intraocular lenses (IOLs) across a variety of neuro-ophthalmic indications. We hope to offer some further insight into these clinical observations in the context of o...
Gonnermann, Johannes
There is a wide range of alternative fixation techniques of intraocular lenses in the absence of adequate capsular support, such as angle- or iris-supported anterior chamber lenses and intra- / transsclerally-fixated (suture, fibrin glue, etc.) and iris-supported posterior chamber lenses. All procedures have different advantages and disadvantages depending on the anatomical situation and integrity of the capsular bag complex and the neighboring structures such as the iris, sclera and corneal ...
Phakic Intraocular lens- a review
Cruz, Francisco Miguel
Introduction: Intraocular refractive procedures with the implantation of a Phakic Intraocular lens have become a safe efficient and predictable alternative for treating high ametropias when the use of corneal photoablative procedures is not possible. The implantation of Phakic intraocular lens preservs the accomodative function,is a reversable refractive procedure, with minimal induction of higher order aberrations compaed with corneal photoablative procedures. Methods: An analytical review o...
Energy Technology Data Exchange (ETDEWEB)
Salazar, M.A.; Foreman, L.R.
This invention describes a method for fabricating an intraocular lens made from clear Teflon{trademark}, Mylar{trademark}, or other thermoplastic material having a thickness of about 0.025 millimeters. These plastic materials are thermoformable and biocompatable with the human eye. The two shaped lenses are bonded together with a variety of procedures which may include thermosetting and solvent based adhesives, laser and impulse welding, and ultrasonic bonding. The fill tube, which is used to inject a refractive filling material is formed with the lens so as not to damage the lens shape. A hypodermic tube may be included inside the fill tube. 13 figs.
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Salazar, Mike A. (Albuquerque, NM); Foreman, Larry R. (Los Alamos, NM)
This invention describes a method for fabricating an intraocular lens made rom clear Teflon.TM., Mylar.TM., or other thermoplastic material having a thickness of about 0.025 millimeters. These plastic materials are thermoformable and biocompatable with the human eye. The two shaped lenses are bonded together with a variety of procedures which may include thermosetting and solvent based adhesives, laser and impulse welding, and ultrasonic bonding. The fill tube, which is used to inject a refractive filling material is formed with the lens so as not to damage the lens shape. A hypodermic tube may be included inside the fill tube.
Intraocular foreign body removal: Case report
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Kovačević Igor
Full Text Available Introduction. An intraocular foreign body may traumatize the eye mechanically, introduce infection or exert other toxic effects on the intraocular structures. Removal of a metallic intraocular foreign bodies (IOFB use an internal (vitrectomy followed by forceps or internal magnet use or external approach (large electromagnet. Outline of Cases. A 51-year-old man sustained injury of the left eye by a metal foreign body. On admission visual acuity was normal (VOS=1.0 and intraocular tension was within normal limits (TOS=10 mmHg. Nasal scleral entry wound was noticed. Ultrasound of the left eye was done, which confirmed existence of IOFB laying nasally, next to the ciliary body. Extraction of IOFB with a big electric magnet was done. Visual acuity on discharge was the same (VOS=1.0. Another man, aged 30 years, came to the clinic after injury of the left eye by a foreign body. On admission visual acuity was VOS=L+P+ (light and projection, TOS=44 mmHg (higher, traumatic cataract, scleral entry wound, corneal edema, existence of IOFB and initial endophtalmitis. Lensectomia and vitrectomia via pars plana with IOFB extraction were done. Visual acuity on discharge was VOS=5/60 with +6.50 Dsph = 0.3-0.4; TOS=17 mmHg. Conclusion. Magnet removal is indicated in patients when IOFB is laying free in the vitreous body or stopped near the entry wound during injury without other complications. Internal approach - pars plana vitrectomy with forceps removal is used when IOFB is stuck either on the peripheral or posterior part of the retina or if there are some of aforementioned complications.
The Structure of manganese oxide formed by the fungus Acremonium sp. strain KR21-2
Saratovsky, Ian; Gurr, Sarah J.; Hayward, Michael A.
Manganese oxides are observed to form by the oxidation of aqueous solutions of Mn(II) catalyzed by the action of microorganisms. In contrast to the widely studied material produced by bacteria, manganese oxide phases produced by the action of fungi have received only limited attention. A detailed study of the MnO x material produced by the action of the fungus Acremonium KR21-2, utilizing X-ray diffraction, XANES, EXAFS and transmission electron microscopy is reported. The MnO x material is produced as small crystalline particles which adopt a todorokite-like tunnel structure, in striking contrast to previously reported microbial MnO x materials which adopt layered birnessite-type structures. ICPMS measurements reveal there are no templating metal ions present in the fungally mediated MnO x material, in contrast to analogous bacterially mediated material, suggesting these cations play a critical role in determining the structure of the material precipitated. A phylogenetic analysis places KR21-2 with other Acremonium species in the Hypocreales.
Drug-Eluting Intraocular Lenses
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Angel Concheiro
Full Text Available Notable advances in materials science and in surgical techniques make the management of cataract by replacement of the opaque crystalline with an intraocular lens (IOL, one of the most cost-effective interventions in current healthcare. The usefulness and safety of IOLs can be enhanced if they are endowed with the ability to load and to sustain drug release in the implantation site. Drug-eluting IOLs can prevent infections and untoward reactions of eye tissues (which lead to opacification and also can act as drug depots for treatment of several other ocular pathologies. Such a myriad of therapeutic possibilities has prompted the design of drug-IOL combination products. Several approaches are under study, namely combination of the IOL with an insert in a single device, soaking in drug solutions, impregnation using supercritical fluids, coating with drug/polymer layers, and covalent grafting of the drug. The advantages/limitations of each technique are discussed in the present review on selected examples. Although more in vivo data are required, the information already available proves the interest of some approaches in ocular therapeutics.
A Battle in a Kernel: Molecular Exploration of Antagonisms between Two Maize Endophytes, Fusarium verticillioides and Acremonium zeae
Fusarium verticillioides (Fv) is a prevalent seed-borne maize endophyte capable of causing severe kernel rot and fumonisin mycotoxin contamination. Within maize kernels, Fv is primarily confined to the pedicel, while another seed-borne fungal endophyte, Acremonium zeae (Az), is observed in embryos. ...
Expression of the transporter encoded by the cefT gene of Acremonium chrysogenum increases cephalosporin production in Penicillium chrysogenum
Nijland, Jeroen G.; Kovalchuk, Andriy; van den Berg, Marco A.; Bovenberg, Roel A. L.; Driessen, Arnold J. M.
By introduction of the cefEF genes of Acremonium chrysogenum and the cmcH gene of Streptomyces clavuligerus, Penicillium chrysogenum can be reprogrammed to form adipoyl-7-amino-3-carbamoyloxymethyl-3-cephem-4-carboxylic acid (ad7-ACCCA), a carbamoylated derivate of adipoyl-7-aminodeacetoxy-cephalosp
21 CFR 886.3600 - Intraocular lens.
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Intraocular lens. 886.3600 Section 886.3600 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Prosthetic Devices § 886.3600 Intraocular lens. (a) Identification. An intraocular lens is a device made of materials...
Study on Titanium Nitride Film Modified for Intraocular Lens
Institute of Scientific and Technical Information of China (English)
Objective:To study the characteristics of the intraocular lens using ion beam sputtering depositing titanium nitride thin film on the intraocular lens(IOLs).Methods:To deposite titanium nitride thin film on the top of intraocular lens by ion beam sputtering depositing.We analyzed the surface morphology of intraocular lens through SEM and AFM.We detected intraocular lens resolution through the measurement of intraocular lens.Biocompatibility of intraocular lens is preliminary evaluated in this test.Results:T...
EFECTO TÓXICO DE Acremonium zeae EN POLLOS DE ENGORDA EN INICIACIÓN
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Alma S\\u00E1nchez-Bautista
Full Text Available El objetivo de este trabajo fue determinar si Acremonium zeae afecta el desarrollo de pollos de engorde. En el Colegio de Postgraduados, Campus Montecillo, en el Estado de México de agosto a diciembre de 2010, se realizó un experimento con pollos recién nacidos bajo un diseño experimental completamente al azar con cinco dietas (tratamientos y cinco repeticiones, cada una constó de cinco pollos. Los animales fueron alimentados durante tres semanas con cada una de las dietas, en las que se adicionaron porcentajes de avena contaminada con A. zeae en sustitución del maíz. Los tratamientos fueron: T1, 0% avena contaminada: 100% de maíz; T2, 25% avena contaminada: 75% de maíz; T3, 50% avena contaminada: 50% de maíz; T4, 75% avena contaminada: 25% de maíz; y, T5, 100% avena contaminada: 0% de maíz. Durante tres semanas cada siete días se registró el incremento en peso de los pollos y el consumo de alimento. Hubo efecto negativo en el peso a partir de la segunda semana de alimentación, con una composición de dieta elaborada con un mínimo de 50% de avena contaminada con el hongo.
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M.Prasad Naidu
Full Text Available Azo dyes, based on aromatic amines, may contain these amines as impurities introduced during the manufacturing process. Aromatic amines may also be present as a result of thermal or photochemical degradation of azo dyes. The more stable derivatives contain two aryl groups. As a consequence of ?-delocalization, aryl azo compounds have vivid colors, especially reds, oranges, and yellows. Therefore, they are used as dyes, and are commonly known as azo dyes, an example of which is Disperse Orange. Some azo compounds, eg. methyl orange, are used as acid-base indicators due to the different colors of their acid and salt forms. The development of azo dyes was an important step in the development of the chemi azo colorants range in shade from greenish yellow to orange, red, violet and brown. The colours depend largely on the chemical constitution, whereas different shades rather depend on the physical properties. However, the important disadvantage limiting their commercial application is that most of them are red and none are green. The inoculum was prepared by adding 10ml of saline to the culture tube, which contain the Acremoniumchrysogenum. The present study designed to study the degradation of common laboratory dyes using fungi, acremonium chrysogenum. The dye selected was procion red. The selected dye procion red can be toxic in its secondary reactive form so there is a great need of them to be removed from the environment.
Uveitis in Thailand : emphasis on clinical patterns and novel developments in diagnostics using intraocular fluid analysis
Pathanapitoon, K.
In this thesis, we report on the so far unknown causes of uveitis in Thailand and describe their clinical manifestations. We found out that intraocular infections were the second most common cause of blindness and low vision in a tertiary center in northern Thailand. These infections predominantly c
MRI and intraocular tamponade media
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Manfre, I. (Dept. of Neuroradiology, Inst. of Neurosurgery, Univ. of Catania (Italy)); Fabbri, G. (Dept. of Neuroradiology, Inst. of Neurosurgery, Univ. of Catania (Italy)); Avitabile, T. (Inst. of Ophthalmology, Univ. of Catania (Italy)); Biondi, P. (Inst. of Ophthalmology, Univ. of Catania (Italy)); Reibaldi, A. (Inst. of Ophthalmology, Univ. of Catania (Italy)); Pero, G. (Dept. of Neuroradiology, Inst. of Neurosurgery, Univ. of Catania (Italy))
Thirteen patients who underwent surgery for retinal detachment and injection of intraocular tamponade media (silicone oil, flurosilicone oil, or perfluoro-carbon liquid) underwent magnetic resonance imaging (MRI), using spin-echo T1- and T2-weighted images. The ophthalmic tamponade media showed different signal intensity, according to their chemical structure. Unlike ophthalmoscopy or ultrasonography, MRI showed no oil-related artefact, making possible recognition of recurrent retinal detachment. (orig.)
Overlooked retained intraocular foreign body
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Adžić-Zečević Antoaneta
Full Text Available Introduction. The most common cause for litigation against ophthalmologists in a trauma case is a missed intraocular foreign body (IOFB. IOFBs cause internal eye damage, but some will come to rest in the posterior segment of the eye. Case report. We presented a 57-year-old male who was referred to the ophthalmologist due to decreased visual acuity in his left eye. Slit lamp examination of his left eye showed no pathological findings. Goldmann contact lens examination showed IOFB which was lying in the vitreous body in the inferior-temporal region. Retinal rupture was noticed at 7 o'clock. The optical coherence tomography (OCT examination was performed and it showed atrophic macular area as well as decreased peripapillar retinal fiber layers thickness. Ultrasound showed the IOFB in vitreous body cavity. History revealed that the patient had an accidental trauma, 48 years ago, when an old bomb from World War II (WWII exploded. Due to the decrease in visual acuity and fibrosis of the vitreous body surgical intervention was performed on his left eye (phacoemulsification with intraocular lens implantation, pars plana vitrectomy and instrumental extraction of foreign body. Conclusion. The intraocular foreign body (IOFB was asymptomatic for 48 years. Symptoms depend on material and localization of the foreign body and the type of injury.
Intraocular lens with accommodation capacity
Dorronsoro, Carlos; Alejandre, Nicolás; Bekesi, Nandor; Marcos, Susana
Intraocular lens with accommodation capacity comprising a first optical member (1) having a dynamic optical power, to which a second optical member (2) with a fixed optical power is affixed, in such a manner that at least a central part of each of one of one of the curved surfaces (2a, 2b) of the second optical member (2) and of at least one of the surfaces (1a, 1b) of the first optical member (1) are in contact with each other, the second optical member (2) and the first optical member (1) p...
Formation of new lipoaminopeptides, acremostatins A, B, and C, by co-cultivation of Acremonium sp. Tbp-5 and Mycogone rosea DSM 12973.
Degenkolb, Thomas; Heinze, Stephan; Schlegel, Brigitte; Strobel, Gary; Gräfe, Udo
Formation of new lipoaminopeptides, acremostatins A, B, and C, was observed during co-cultivation of Acremonium sp. Tbp-5 and Mycogone rosea DSM 12973. Thus, co-cultivation of microorganisms producing related products could be suggested as a suitable way towards diversification of microbial structures.
Tinting of intraocular lens implants
Energy Technology Data Exchange (ETDEWEB)
Zigman, S.
Intraocular lens (IOL) implants of polymethyl methacrylate (PMMA) lack an important yellow pigment useful as a filter in the visual process and in the protection of the retina from short-wavelength radiant energy. The ability to produce a yellow pigment in the PMMA used in IOL implants by exposure to near-ultraviolet (UV) light was tested. It was found that the highly cross-linked material in Copeland lens blanks was tinted slightly because of this exposure. The absorptive properties of lens blanks treated with near-UV light in this way approached that of the absorptive properties of human lenses. This finding shows that it is possible to alter IOL implants simply so as to induce a pale-yellow pigment in them to improve the visual process and to protect the retinas of IOL users.
Direct ethanol production from glucose, xylose and sugarcane bagasse by the corn endophytic fungi Fusarium verticillioides and Acremonium zeae.
de Almeida, Maíra N; Guimarães, Valéria M; Falkoski, Daniel L; Visser, Evan M; Siqueira, Germano A; Milagres, Adriane M F; de Rezende, Sebastião T
Production of ethanol with two corn endophytic fungi, Fusarium verticillioides and Acremonium zeae, was studied. The yield of ethanol from glucose, xylose and a mixture of both sugars were 0.47, 0.46 and 0.50g/g ethanol/sugar for F. verticillioides and 0.37, 0.39 and 0.48g/g ethanol/sugar for A. zeae. Both fungi were able to co-ferment glucose and xylose. Ethanol production from 40g/L of pre-treated sugarcane bagasse was 4.6 and 3.9g/L for F. verticillioides and A. zeae, respectively, yielding 0.31g/g of ethanol per consumed sugar. Both fungi studied were capable of co-fermenting glucose and xylose at high yields. Moreover, they were able to produce ethanol directly from lignocellulosic biomass, demonstrating to be suitable microorganisms for consolidated bioprocessing.
Intraocular cilia associated with perforating injury
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Gopal Lingam
Full Text Available Purpose: To report a case series of penetrating injury complicated by occurrence of intraocular cilia. Methods: Retrospective analysis of charts of 11 eyes of 11 patients with penetrating injury and intraocular cilia, presenting between September 1978 and November 1998. Ten eyes underwent surgery for trauma-related problems such as cataract, vitritis, retinal detachment etc., at which time intraocular cilia were removed. One eye did not have surgery and continues to harbour cilia at the posterior perforation site. Results: Metallic wire was responsible for injury in 6 of 11 eyes with intraocular cilia. Five eyes had significant intraocular inflammation. The cilia were located in the anterior segment in 4 eyes; in the posterior segment in 6 eyes and in both in one eye. At the last follow up, 72.7% had 6/18 or better vision. Poor vision in the rest was due to recurrent retinal detachment (2 eyes and macular scarring (1 eye. Conclusion: Intraocular cilia are more commonly associated with injury by a metallic wire. The presentation and management of an injured eye does not seem to be influenced by the presence of cilia in the eye.
The genetics of intraocular pressure.
Ojha, Pallavi; Wiggs, Janey L; Pasquale, Louis R
Glaucoma is a leading cause of irreversible blindness. Intraocular pressure (IOP) is the only modifiable risk factor for glaucoma, yet there is little known about the molecular events that regulate IOP. Genetic and genomic studies have helped identify genes that influence IOP and could lead to the identification of biological pathways that serve as targets for novel pressure-modifying therapies. Genetic linkage studies resulted in the identification of several genes that cause Mendelian (autosomal dominant or autosomal recessive) forms of high-pressure glaucoma, including MYOC. PITX2, FOXC1, and CYP1B1. Classical twin studies suggest that IOP is a heritable trait. More recently, genome-wide association studies (GWAS) have shown that common genetic variants in the GAS7 and TMCO1 genomic regions are associated with elevated IOP. TMCO1 has also been associated with primary open-angle glaucoma in patients with advanced disease. A further study identifying additional genes contributing to IOP will be necessary to fully define the underlying genetic architecture of IOP.
Surface Modification of Intraocular Lenses
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Qi Huang
Full Text Available Objective: This paper aimed to review the current literature on the surface modification of intraocular lenses (IOLs. Data Sources: All articles about surface modification of IOLs published up to 2015 were identified through a literature search on both PubMed and ScienceDirect. Study Selection: The articles on the surface modification of IOLs were included, but those on design modification and surface coating were excluded. Results: Technology of surface modification included plasma, ion beam, layer-by-layer self-assembly, ultraviolet radiation, and ozone. The main molecules introduced into IOLs surface were poly (ethylene glycol, polyhedral oligomeric silsesquioxane, 2-methacryloyloxyethyl phosphorylcholine, TiO 2 , heparin, F-heparin, titanium, titanium nitride, vinyl pyrrolidone, and inhibitors of cytokines. The surface modification either resulted in a more hydrophobic lens, a more hydrophilic lens, or a lens with a hydrophilic anterior and hydrophobic posterior surface. Advances in research regarding surface modification of IOLs had led to a better biocompatibility in both in vitro and animal experiments. Conclusion: The surface modification is an efficient, convenient, economic and promising method to improve the biocompatibility of IOLs.
Endophthalmitis due to an intra-ocular linear foreign body in a cat
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Esmeralda Delgado
Full Text Available Case summary An unusual case of an intraocular linear foreign body that migrated from the oral cavity, causing a severe endophthalmitis, in a cat is described. A 2-year-old female domestic shorthair cat presented with signs of infection from the left eye that had begun 2 weeks previously. Despite having been prescribed oral and topical antibiotics, there was a progressive worsening of the clinical signs. On ophthalmic examination the cat presented with severe endophthalmitis, secondary glaucoma and exposure keratitis of the left eye. Radiography demonstrated the presence of an intraocular linear metallic foreign body compatible with a sewing needle. During enucleation, when the globe was extracted, the sewing needle stayed in the orbit. When the needle was pulled away, a piece of thread was also retrieved, which demonstrated that the linear foreign body had migrated retrogradely from the oral cavity to the orbit through the pterygopalatine fossa. Surgical recovery was uneventful. Relevance and novel information Intraocular foreign bodies may present in a variety of ways, which may hinder their clinical detection. The management and prognosis depend on the composition and location of the foreign body, as well as the possible presence of secondary infection. To the author's knowledge, this is the first time that a case of severe endophthalmitis following retrograde intraocular migration of a linear foreign body from the oral cavity to the orbit through the pterygopalatine fossa in a cat has been reported.
Triple procedure in posterior segment intraocular foreign body
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Azad Rajvardhan
Full Text Available Three patients with intraocular foreign bodies and traumatic cataracts underwent single stage pars plana lensectomy with anterior capsule preservation, vitrectomy, removal of the foreign body, and intraocular lens implantation. The preserved anterior capsule permitted support for the placement of an intraocular lens in the posterior chamber in the ciliary sulcus. The procedure enabled early visual rehabilitation. This procedure seems useful in the management of posterior segment intraocular foreign body associated with cataract.
Late opacification of a hydrophilic acrylic intraocular lens
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Al-Bdour Muawyah
Full Text Available Cataract extraction and intraocular lens implantation is considered to be a safe procedure in most cases. However, the new advances in the surgical technique namely phacoemulsification and hence the increased use of foldable intraocular lenses have given rise to new complications including late opacification of intraocular lenses. In this case we report late opacification of a foldable hydrophilic acrylic intraocular lens and the surgical technique for its exchange.
Phakic Pattern Pseudoexfoliation Material Accumulation on Intraocular Lens Surface
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Emre Güler
Full Text Available Pseudophakic pseudoexfoliation is the accumulation of pseudoexfoliation material on the intraocular lens. Most of the cases have showed scattered flecks of pseudoexfoliation material on the surface of the intraocular lens. However, the phakic pattern consisting of classic three-zone on the intraocular lens is rarely observed. In this case report, we describe a phakic pattern pseudoexfoliation material on the intraocular lens surface 8 years after cataract extraction. (Turk J Ophthalmol 2014; 44: 156-7
Phakic Pattern Pseudoexfoliation Material Accumulation on Intraocular Lens Surface
Emre Güler; Aylin Tenlik; Tuba Kara Akyüz
Pseudophakic pseudoexfoliation is the accumulation of pseudoexfoliation material on the intraocular lens. Most of the cases have showed scattered flecks of pseudoexfoliation material on the surface of the intraocular lens. However, the phakic pattern consisting of classic three-zone on the intraocular lens is rarely observed. In this case report, we describe a phakic pattern pseudoexfoliation material on the intraocular lens surface 8 years after cataract extraction. (Turk J Ophthalm...
21 CFR 886.4300 - Intraocular lens guide.
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Intraocular lens guide. 886.4300 Section 886.4300 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4300 Intraocular lens guide. (a) Identification. An intraocular lens guide is a device...
Bartonella and intraocular inflammation: a series of cases and review of literature
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Kalogeropoulos C
Full Text Available Chris Kalogeropoulos1, Ioannis Koumpoulis1, Andreas Mentis2, Chrisavgi Pappa1, Paraskevas Zafeiropoulos1, Miltiadis Aspiotis11Department of Ophthalmology, Medical School, University of Ioannina, Greece; 2Laboratory of Medical Microbiology, Hellenic Pasteur Institute, Athens, GreecePurpose: To present various forms of uveitis and/or retinal vasculitis attributed to Bartonella infection and review the impact of this microorganism in patients with uveitis.Methods: Retrospective case series study. Review of clinical records of patients diagnosed with Bartonella henselae and Bartonella quintana intraocular inflammation from 2001 to 2010 in the Ocular Inflammation Department of the University Eye Clinic, Ioannina, Greece. Presentation of epidemiological and clinical data concerning Bartonella infection was provided by the international literature.Results: Eight patients with the diagnosis of Bartonella henselae and two patients with B. quintana intraocular inflammation were identified. Since four patients experienced bilateral involvement, the affected eyes totaled 14. The mean age was 36.6 years (range 12–62. Uveitic clinical entities that we found included intermediate uveitis in seven eyes (50%, vitritis in two eyes (14.2%, neuroretinitis in one eye (7.1%, focal retinochoroiditis in one eye (7.1%, branch retinal vein occlusion (BRVO due to vasculitis in one eye (7.1%, disc edema with peripapillary serous retinal detachment in one eye (7.1%, and iridocyclitis in one eye (7.1%. Most of the patients (70% did not experience systemic symptoms preceding the intraocular inflammation. Antimicrobial treatment was efficient in all cases with the exception of the case with neuroretinitis complicated by anterior ischemic optic neuropathy and tubulointerstitial nephritis.Conclusion: Intraocular involvement caused not only by B. henselae but also by B. quintana is being diagnosed with increasing frequency. A high index of suspicion is needed because the
Associations with intraocular pressure across Europe
DEFF Research Database (Denmark)
Khawaja, Anthony P; Springelkamp, Henriët; Creuzot-Garcher, Catherine
Raised intraocular pressure (IOP) is the most important risk factor for developing glaucoma, the second commonest cause of blindness globally. Understanding associations with IOP and variations in IOP between countries may teach us about mechanisms underlying glaucoma. We examined cross-sectional...
Intraocular Silicone Oil Masquerading as Terson Syndrome
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Navid Elmi Sadr
Full Text Available Introduction. Terson syndrome is described as intraocular hemorrhage in association with any type of intracranial hemorrhage and is associated with higher mortality rate and vision loss. Intraocular hemorrhage in Terson syndrome may be diagnosed using computed tomography but there are false positive results. Silicone oil which is widely used for internal tamponade of complicated retinal detachments has high attenuation on computed tomography and hyperintensity on T1-weighted magnetic resonance imaging that can mimic intraocular hemorrhage. This report shows that silicone oil is another origin of false positive results in interpreting CT findings for detecting Terson syndrome. Case Report. A 71-year-old diabetic woman presented with loss of consciousness. Brain computed tomography revealed right cerebellar hemorrhage and ventricular hemorrhage and hyperdensity in vitreous cavity of the left eye that was initially interpreted as vitreous hemorrhage. Terson syndrome was the initial diagnosis but ophthalmoscopic examination and brain MRI showed that the left eye had silicone oil tamponade. Conclusion. Without knowing the history of previous vitreoretinal surgery, CT scan findings of intraocular silicone oil may be interpreted as vitreous hemorrhage. In patients with concomitant intracranial hemorrhage, it can masquerade as Terson syndrome.
Intraocular lens in a fighter aircraft pilot.
Loewenstein, A; Geyer, O; Biger, Y; Bracha, R; Shochat, I; Lazar, M.
A pseudophakic pilot of the Israeli air force flying an F-15 (Eagle) aircraft was followed up for three years. He experienced about 100 flying hours, 5% of the time under high g stress. The intraocular lens did not dislocate and no complications were observed. It seems that flying high performance fighter aircraft is not contraindicated in pseudophakic pilots.
Closed intraocular microsurgery in ocular trauma.
Kanski, J J
A series of 53 eyes that had suffered severe trauma was treated by closed intraocular microsurgery with vitreous cutters. The cases were divided into three categories: (a) anterior segment reconstruction for traumatic cataracts and post-traumatic pupillary membranes, (b) vitreous haemorrhage with and without retinal detachment, and (c) traumatically dislocated lenses.
Characterizing intraocular tumors with photoacoustic imaging
Xu, Guan; Xue, Yafang; Gursel, Zeynep; Slimani, Naziha; Wang, Xueding; Demirci, Hakan
Intraocular tumors are life-threatening conditions. Long-term mortality from uveal melanoma, which accounts for 80% of primary intraocular tumors, could be as high as 25% depending on the size, ciliary body involvement and extraocular extension. The treatments of intraocular tumors include eye-sparing approaches such as radiotherapy and thermotherapy, and the more aggressive enucleation. The accurate diagnosis of intraocular tumors is thereby critical in the management and follow-up of the patients. The diagnosis of intraocular tumors is usually based on clinical examination with acoustic backscattering based ultrasonography. By analyzing the high frequency fluctuations within the ultrasound (US) signals, microarchitecture information inside the tumor can be characterized. However, US cannot interrogate the histochemical components formulating the microarchitecture. One representative example is the inability of US imaging (and other contemporary imaging modalities as well) in differentiating nevoid and melanoma cells as the two types of cells possesses similar acoustic backscattering properties. Combining optical and US imaging, photoacoustic (PA) measurements encode both the microarchitecture and histochemical component information in biological tissue. This study attempts to characterize ocular tumors by analyzing the high frequency signal components in the multispectral PA images. Ex vivo human eye globes with melanoma and retinoblastoma tumors were scanned using less than 6 mJ per square centimeters laser energy with tunable range of 600-1700 nm. A PA-US parallel imaging system with US probes CL15-7 and L22-14 were used to acquire the high frequency PA signals in real time. Preliminary results show that the proposed method can identify uveal melanoma against retinoblastoma tumors.
Characterization of the lys2 gene of Acremonium chrysogenum encoding a functional alpha-aminoadipate activating and reducing enzyme.
Hijarrubia, M J; Aparicio, J F; Casqueiro, J; Martín, J F
A 5.2-kb NotI DNA fragment isolated from a genomic library of Acremonium chrysogenum by hybridization with a probe internal to the Penicillium chrysogenum lys2 gene, was able to complement an alpha-aminoadipate reductase-deficient mutant of P. chrysogenum (lysine auxotroph L-G-). Enzyme assays showed that the alpha-aminoadipate reductase activity was restored in all the transformants tested. The lys2-encoded enzyme catalyzed both the activation and reduction of alpha-aminoadipic acid to its semialdehyde, as shown by reaction of the product with p-dimethylaminobenzaldehyde. The reaction required NADPH, and was not observed in the presence of NADH. Sequence analysis revealed that the gene encodes a protein with relatively high similarity to members of the superfamily of acyladenylate-forming enzymes. The Lys2 protein contained all nine motifs that are conserved in the adenylating domain of this enzyme family, a peptidyl carrier domain, and a reduction domain. In addition, a new NADP-binding motif located at the N-terminus of the reduction domain that may form a Rossmann-like betaalphabeta-fold has been identified and found to be shared by all known Lys2 proteins. The lys2 gene was mapped to chromosome I (2.2 Mb, the smallest chromosome) of A. chrysogenum C10 (the chromosome that contains the "late" cephalosporin cluster) and is transcribed as a monocistronic 4.5-kb mRNA although at relatively low levels compared with the beta-actin gene.
The Visual Effects of Intraocular Colored Filters
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Billy R. Hammond
Full Text Available Modern life is associated with a myriad of visual problems, most notably refractive conditions such as myopia. Human ingenuity has addressed such problems using strategies such as spectacle lenses or surgical correction. There are other visual problems, however, that have been present throughout our evolutionary history and are not as easily solved by simply correcting refractive error. These problems include issues like glare disability and discomfort arising from intraocular scatter, photostress with the associated transient loss in vision that arises from short intense light exposures, or the ability to see objects in the distance through a veil of atmospheric haze. One likely biological solution to these more long-standing problems has been the use of colored intraocular filters. Many species, especially diurnal, incorporate chromophores from numerous sources (e.g., often plant pigments called carotenoids into ocular tissues to improve visual performance outdoors. This review summarizes information on the utility of such filters focusing on chromatic filtering by humans.
Bilateral Pseudoexfoliation Deposits on Intraocular Lens Implants
Elena Bonafonte Marquez; Sergio Bonafonte Royo
We present a rare case of bilateral pseudoexfoliative deposits on both intraocular lens (IOL) implants in an 83-year-old woman with no other associated pathology, 5 years after cataract surgery. Pseudoexfoliation syndrome is the most common cause of secondary open-angle glaucoma worldwide and these deposits are usually found on the natural lens. The fact that pseudoexfoliative deposits have been found on IOL implants implies the need for a thorough examination in pseudophakic patients, for i...
Introduction to the development of intraocular lens
Li, Yifan; Peng, Runling; Hu, Shuilan; Wei, Maowei; Chen, Jiabi
In order to cure the cataract disease or injuries in eyes, intraocular lens(IOL) has been studied all the time to replace the crystalline lens in human eyes. Researches on IOL are started early from 19th century, and it develops greatly in the hundreds years after. This article introduces several main kinds of IOLs that appear in the development history of IOL, and raises the double-liquid zoom IOL based on electrowetting, which will be the trend of IOL study.
[A universal laser for intraocular treatment].
Pomerantzeff, O; Vallat, M; Pankratov, M M; Pflibsen, K P; Schepens, C L
The creation of a single apparatus incorporating the different lasers applicable to intraocular pathology derives from the idea of possessing the means, with one device, of objectively comparing the effects and parameters of various lasers in order to pursue a more precise line of treatment. This has led to our fabrication of the universal intraocular laser. The word universal means the ability of the machine to act on each kind of intraocular tissues with all of the various infrared or other-colored radiations, as well as with different modalities. The unit is transportable. It only requires a source of electric power (110 or 220 V) and includes an independent cooling system. The Nd: YAG laser has selectable operating parameters: pulsed or continuous excitation, Q-switched or mode-locked mode, mirror or fiber optic transmission. It is used also as the basic system of the coloured module. The colour module can provide the three clinically useful radiations: green, red, yellow. The green (532 nm) is obtained by transmission of the I.R. beam brought a birefringent crystal (KTP). Red (650 nm) and yellow (575 nm) come from two incorporated dye lasers excited by the green radiation.
File list: DNS.Oth.50.AllAg.Lenses,_Intraocular [Chip-atlas[Archive
Lifescience Database Archive (English)
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File list: DNS.Oth.20.AllAg.Lenses,_Intraocular [Chip-atlas[Archive
Lifescience Database Archive (English)
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File list: DNS.Oth.05.AllAg.Lenses,_Intraocular [Chip-atlas[Archive
Lifescience Database Archive (English)
Full Text Available DNS.Oth.05.AllAg.Lenses,_Intraocular mm9 DNase-seq Others Lenses, Intraocular http:...//dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/DNS.Oth.05.AllAg.Lenses,_Intraocular.bed ...
File list: DNS.Oth.10.AllAg.Lenses,_Intraocular [Chip-atlas[Archive
Lifescience Database Archive (English)
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... Infections Adenovirus Bronchiolitis Campylobacter Infections Cat Scratch Disease Cellulitis Chickenpox Chlamydia Cold Sores Common Cold Coxsackievirus Infections Croup Cytomegalovirus (CMV) Dengue Fever Diphtheria E. Coli ...
Comparative Evaluation of Handheld Robot-Aided Intraocular Laser Surgery
Yang, Sungwook; MacLachlan, Robert A.; Martel, Joseph N.; Lobes, Louis A.; Riviere, Cameron N.
This paper presents robot-aided intraocular laser surgery using a handheld robot known as Micron. The micromanipulator incorporated in Micron enables visual servoing of a laser probe, while maintaining a constant distance of the tool tip from the retinal surface. The comparative study was conducted with various control methods for evaluation of robot-aided intraocular laser surgery. PMID:27019653
Implantable intraocular pressure monitoring systems: Design considerations
Arsalan, Muhammad
Design considerations and limitations of implantable Intraocular Pressure Monitoring (IOPM) systems are presented in this paper. Detailed comparison with the state of the art is performed to highlight the benefits and challenges of the proposed design. The system-on-chip, presented here, is battery free and harvests energy from incoming RF signals. This low-cost design, in standard CMOS process, does not require any external components or bond wires to function. This paper provides useful insights to the designers of implantable wireless sensors in terms of design choices and associated tradeoffs. © 2013 IEEE.
How to measure intraocular pressure: applanation tonometry
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Nick Astbury
Full Text Available Unless there is a contraindication (e.g. trauma or corneal ulcer, all adults attending an eye unit should have their intraocular pressure (IOP measured. Many people with glaucoma have no symptoms and do not know they have the condition. All children who have had cataract surgery should also have their IOP measured at every follow-up visit, if possible. Finding glaucoma early allows treatment to be given which will preserve sight. Although elevated IOP is not the only sign of glaucoma, measuring it is simple and quick to do. Applanation tonometry, using a Goldmann tonometer at a slit lamp, is the preferred method (the 'gold standard'.
Bilateral Pseudoexfoliation Deposits on Intraocular Lens Implants
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Elena Bonafonte Marquez
Full Text Available We present a rare case of bilateral pseudoexfoliative deposits on both intraocular lens (IOL implants in an 83-year-old woman with no other associated pathology, 5 years after cataract surgery. Pseudoexfoliation syndrome is the most common cause of secondary open-angle glaucoma worldwide and these deposits are usually found on the natural lens. The fact that pseudoexfoliative deposits have been found on IOL implants implies the need for a thorough examination in pseudophakic patients, for it could be the only sign of secondary glaucoma.
[Drug delivery systems for intraocular applications].
Bourges, J-L; Touchard, E; Kowalczuk, L; Berdugo, M; Thomas-Doyle, A; Bochot, A; Gomez, A; Azan, F; Gurny, R; Behar-Cohen, F
Numerous drug delivery systems (DDSs) can be used as intraocular tools to provide a sustained and calibrated release for a specific drug. Great progress has been made on the design, biocompatibility, bioavailability, and efficacy of DDSs. Although several of them are undergoing clinical trials, a few are already on the market and could be of a routine use in clinical practice. Moreover, miniaturization of the implants makes them less and less traumatic for the eye tissues and some DDSs are now able to target certain cells or tissues specifically. An overview of ocular implants with therapeutic application potentials is provided.
Out-of-the-bag intraocular lens dislocation: outcomes of posterior chamber intraocular lens exchange, risk factors, and prevention
Institute of Scientific and Technical Information of China (English)
ZHENG Dan-ying; CHEN Li-na; SUN Yi; SHAO Ying-feng; LIANG Jing-li; LIU Yi-zhi
Background Dislocation of posterior chamber intraocular lens is one of the most common complications of intraocular lens implantation. Lens exchange is an effective solution to this unsatisfactory status. This study was conducted to analyze the possible predisposing factors for out-of-the-bag posterior chamber intraocular lens dislocation and to study the outcomes of lens exchange surgery.Methods Thirty-six consecutive patients (36 eyes) with out-of-the-bag intraocular lens dislocation who underwent posterior chamber intraocular lens exchange in Zhongshan Ophthalmic Center of Sun Yat-sen University (Guangdong,China) from January 2003 to October 2009 were included. A 6-month follow-up was completed. The causes for out-of-the-bag intraocular lens dislocation and visual outcomes of posterior chamber intraocular lens exchange were analyzed. The out-of-the-bag intraocular lens dislocation was diagnosed on the basis of the findings from slit-lamp microscope and B-ultrasound. The dislocated intraocular lens was explanted. Reimplantation of a new posterior chamber intraocular lens was performed in each case using standardized surgical procedures.Results In this study, a total of thirty-six consecutive patients (36 eyes) with out-of-the-bag intraocular lens dislocation underwent posterior chamber intraocular lens exchange surgery. Causes for out-of-the-bag intraocular lens dislocation included posterior capsule rupture during the initial cataract extraction procedure (23 eyes, 63.8%), trauma (5 eyes,13.9%), neodymium-doped yttrium aluminium garnet (Nd:YAG) laser-induced dislocation (2 eyes, 5.6%), the status after vitrectomy (2 eyes, 5.6%) and unidentifiable etiology (4 eyes, 11.1%). Symptoms of these patients mainly included decrease in visual acuity (17 cases, 47.2%), blurred vision (16 cases, 44.4%), glare (1 case, 2.8%), diplopia (1 case,2.8%), and halo (1 case, 2.8%). Intraocular lens dislocation into the posterior vitreous cavity (29 eyes, 80.5%), anterior chamber (1
Severe South American ocular toxoplasmosis is associated with decreased Ifn-γ/Il-17a and increased Il-6/Il-13 intraocular levels.
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Alejandra de-la-Torre
Full Text Available In a cross sectional study, 19 French and 23 Colombian cases of confirmed active ocular toxoplasmosis (OT were evaluated. The objective was to compare clinical, parasitological and immunological responses and relate them to the infecting strains. A complete ocular examination was performed in each patient. The infecting strain was characterized by genotyping when intraocular Toxoplasma DNA was detectable, as well as by peptide-specific serotyping for each patient. To characterize the immune response, we assessed Toxoplasma protein recognition patterns by intraocular antibodies and the intraocular profile of cytokines, chemokines and growth factors. Significant differences were found for size of active lesions, unilateral macular involvement, unilateral visual impairment, vitreous inflammation, synechiae, and vasculitis, with higher values observed throughout for Colombian patients. Multilocus PCR-DNA sequence genotyping was only successful in three Colombian patients revealing one type I and two atypical strains. The Colombian OT patients possessed heterogeneous atypical serotypes whereas the French were uniformly reactive to type II strain peptides. The protein patterns recognized by intraocular antibodies and the cytokine patterns were strikingly different between the two populations. Intraocular IFN-γ and IL-17 expression was lower, while higher levels of IL-13 and IL-6 were detected in aqueous humor of Colombian patients. Our results are consistent with the hypothesis that South American strains may cause more severe OT due to an inhibition of the protective effect of IFN-γ.
Severe South American Ocular Toxoplasmosis Is Associated with Decreased Ifn-γ/Il-17a and Increased Il-6/Il-13 Intraocular Levels
de-la-Torre, Alejandra; Sauer, Arnaud; Pfaff, Alexander W.; Bourcier, Tristan; Brunet, Julie; Speeg-Schatz, Claude; Ballonzoli, Laurent; Villard, Odile; Ajzenberg, Daniel; Sundar, Natarajan; Grigg, Michael E.
In a cross sectional study, 19 French and 23 Colombian cases of confirmed active ocular toxoplasmosis (OT) were evaluated. The objective was to compare clinical, parasitological and immunological responses and relate them to the infecting strains. A complete ocular examination was performed in each patient. The infecting strain was characterized by genotyping when intraocular Toxoplasma DNA was detectable, as well as by peptide-specific serotyping for each patient. To characterize the immune response, we assessed Toxoplasma protein recognition patterns by intraocular antibodies and the intraocular profile of cytokines, chemokines and growth factors. Significant differences were found for size of active lesions, unilateral macular involvement, unilateral visual impairment, vitreous inflammation, synechiae, and vasculitis, with higher values observed throughout for Colombian patients. Multilocus PCR-DNA sequence genotyping was only successful in three Colombian patients revealing one type I and two atypical strains. The Colombian OT patients possessed heterogeneous atypical serotypes whereas the French were uniformly reactive to type II strain peptides. The protein patterns recognized by intraocular antibodies and the cytokine patterns were strikingly different between the two populations. Intraocular IFN-γ and IL-17 expression was lower, while higher levels of IL-13 and IL-6 were detected in aqueous humor of Colombian patients. Our results are consistent with the hypothesis that South American strains may cause more severe OT due to an inhibition of the protective effect of IFN-γ. PMID:24278490
[Iritis with destabilization of the intraocular pressure due to dislocation of a posterior chamber intraocular lens].
Handzel, D M
This report concerns the case of a 67-year-old male patient who underwent uncomplicated phacoemulsification with implantation of a posterior chamber intraocular lens (IOL). After an interval of 2 months the patient developed iritis together with an uncontrollable increase in intraocular pressure. After a detailed examination a dislocated haptic of the IOL was identified as the cause of the symptoms. The dislocation had led to uveitis-glaucoma-hyphema syndrome although no hemorrhage was observed. In addition to this complication the haptic had arroded the zonular complex which made implantation of an anterior chamber lens necessary. Although improvements in operating techniques, lens materials and designs have been made uveitis-glaucoma-hyphema syndrome has to be kept in mind. Surgical intervention is the only therapeutic option.
Lente intra-ocular multifocal difrativa apodizada: resultados Diffractive apodized multifocal intraocular lens: results
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Virgilio Centurion
Full Text Available OBJETIVO: Mostrar os resultados visuais e refracionais com lente intra-ocular multifocal difrativa apodizada. MÉTODOS: Estudo de 100 olhos de 50 pacientes com catarata, submetidos à facoemulsificação com implante bilateral de lente intra-ocular (LIO multifocal difrativa apodizada. Foi avaliada a acuidade visual binocular sem e com correção para longe e perto, a previsibilidade refracional e a freqüência de uso de óculos. RESULTADOS: A acuidade visual sem correção para longe foi de e " 20/30 em 97,56% dos olhos operados e e" J2 em 100%, sendo que 82% dos pacientes nunca usam óculos e 16% usam de forma esporádica. CONCLUSÃO: A LIO multifocal difrativa apodizada mostrou ser uma opção previsível, reproduzível e segura na correção dos vícios de refração para longe e perto durante a cirurgia da catarata, permitindo elevado índice de independência ao uso de óculos.OBJECTIVE: To show visual and refraction results using multifocal diffractive apodized intraocular lens. METHODS: The study of 100 eyes of 50 patients with cataract, submitted to phacoemulsification with bilateral implant of multifocal diffractive apodized intraocular lens (IOL. Binocular visual acuity was evaluated with and without correction for near and distance, and refraction previsibility and frequency of wearing glasses. RESULTS: Visual acuity without correction for distance was e" 20/30 in 97.56% of eyes operated on and e" J2 in 100%, of these 82% of patients never wear glasses and 16% wear glasses sporadically. CONCLUSION: Multifocal diffractive apodized IOL proved to be a foreseeable option, reproducible and safe in the correction of refraction errors for distance and near during cataract surgery, enabling a high rate of independence from the use of glasses.
MicroRNA profiling in intraocular medulloepitheliomas.
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Deepak P Edward
Full Text Available To study the differential expression of microRNA (miRNA profiles between intraocular medulloepithelioma (ME and normal control tissue (CT.Total RNA was extracted from formalin fixed paraffin embedded (FFPE intraocular ME (n=7 and from age matched ciliary body controls (n=8. The clinical history and phenotype was recorded. MiRNA profiles were determined using the Affymetrix GeneChip miRNA Arrays analyzed using expression console 1.3 software. Validation of significantly dysregulated miRNA was confirmed by quantitative real-time PCR. The web-based DNA Intelligent Analysis (DIANA-miRPath v2.0 was used to perform enrichment analysis of differentially expressed (DE miRNA gene targets in Kyoto Encyclopedia of Genes and Genomes (KEGG pathway.The pathologic evaluation revealed one benign (benign non-teratoid, n=1 and six malignant tumors (malignant teratoid, n=2; malignant non-teratoid, n = 4. A total of 88 miRNAs were upregulated and 43 miRNAs were downregulated significantly (P<0.05 in the tumor specimens. Many of these significantly dysregulated miRNAs were known to play various roles in carcinogenesis and tumor behavior. RT-PCR validated three significantly upregulated miRNAs and three significantly downregulated miRNAs namely miR-217, miR-216a, miR-216b, miR-146a, miR-509-3p and miR-211. Many DE miRNAs that were significant in ME tumors showed dysregulation in retinoblastoma, glioblastoma, and precursor, normal and reactive human cartilage. Enriched pathway analysis suggested a significant association of upregulated miRNAs with 15 pathways involved in prion disease and several types of cancer. The pathways involving significantly downregulated miRNAs included the toll-like receptor (TLR (p<4.36E-16 and Nuclear Factor kappa B (NF-κB signaling pathways (p<9.00E-06.We report significantly dysregulated miRNAs in intraocular ME tumors, which exhibited abnormal profiles in other cancers as well such as retinoblastoma and glioblastoma. Pathway analysis
Intraocular Implants for the Treatment of Autoimmune Uveitis
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Darren J. Lee
Full Text Available Uveitis is the third leading cause of blindness in developed countries. Currently, the most widely used treatment of non-infectious uveitis is corticosteroids. Posterior uveitis and macular edema can be treated with intraocular injection of corticosteroids, however, this is problematic in chronic cases because of the need for repeat injections. Another option is systemic immunosuppressive therapies that have their own undesirable side effects. These systemic therapies result in a widespread suppression of the entire immune system, leaving the patient susceptible to infection. Therefore, an effective localized treatment option is preferred. With the recent advances in bioengineering, biodegradable polymers that allow for a slow sustained-release of a medication. These advances have culminated in drug delivery implants that are food and drug administration (FDA approved for the treatment of non-infectious uveitis. In this review, we discuss the types of ocular implants available and some of the polymers used, implants used for the treatment of non-infectious uveitis, and bioengineered alternatives that are on the horizon.
Intraocular lens employed for cataract surgery
Roszkowska, A. M.; Torrisi, L.
The aim of this paper is to illustrate the techniques of cataract surgery with implantation of intraocular lenses and some physical properties of the used materials. The new technology, coupled with extensive experience and the studied cases, permits to increase the standardization and accuracy of the engravings, by reducing the use and handling of surgical instruments inside the eye. At present it is possible to replace the cataract with crystalline lenses based on biopolymers such as PMMA, silicone, acrylic hydrophilic and hydrophobic acrylic. These materials are increasingly able to replace the natural lens and to ensure the fully functional of the eye. The role of femtosecond lasers in cataract surgery, to assist or replace several aspects of the manual cataract surgery, are discussed.
Primary orbital neuroblastoma with intraocular extension
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Muthukrishnan Vallinayagam
Full Text Available Neuroblastoma is an undifferentiated malignancy of primitive neuroblasts. Neuroblastoma is among the most common solid tumors of childhood. Orbital neuroblastoma is typically a metastatic tumor. In this case report, we describe a 2-year-old child with a rapidly progressing orbital tumor. Computed tomography revealed an orbital mass lesion with extraocular and intraocular components. An incisional biopsy was done, and a histopathological examination showed features suggestive of neuroblastoma. Systemic workup including ultrasonography of the abdomen, chest roentgenogram, whole body computed tomography, and bone scintigraphy showed no evidence of systemic involvement. The diagnosis of primary orbital neuroblastoma was made, and the child was subjected to chemotherapy followed by rapid melting of the tumor. Neuroblastoma should be considered in the differential diagnosis of childhood orbital tumors.
Mechanical properties of intra-ocular lenses
Ehrmann, Klaus; Kim, Eon; Parel, Jean-Marie
Cataract surgery usually involves the replacement of the natural crystalline lens with a rigid or foldable intraocular lens to restore clear vision for the patient. While great efforts have been placed on optimising the shape and optical characteristics of IOLs, little is know about the mechanical properties of these devices and how they interact with the capsular bag once implanted. Mechanical properties measurements were performed on 8 of the most commonly implanted IOLs using a custom build micro tensometer. Measurement data will be presented for the stiffness of the haptic elements, the buckling resistance of foldable IOLs, the dynamic behaviour of the different lens materials and the axial compressibility. The biggest difference between the lens types was found between one-piece and 3-piece lenses with respect to the flexibility of the haptic elements
Intraocular Lens Calcification; a Clinicopathologic Report
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Mozhgan Rezaei-Kanavi
Full Text Available
PURPOSE: To describe the clinical and pathological features of a case of hydrogel intraocular lens (IOL calcification. CASE REPORT: A 48-year-old man underwent explantation of a single-piece hydrophilic acrylic intraocular lens in his left eye because of decreased visual acuity and milky white opalescence of the IOL. The opacified lens was exchanged uneventfully with a hydrophobic acrylic IOL. Gross examination of the explanted IOL disclosed opacification of the optic and haptics. Full-thickness sections of the lens optic were stained with hematoxylin and eosin (H&E, von Kossa and Gram Tworts'. Microscopic examination of the sections revealed fine and diffuse basophilic granular deposits of variable size within the lens optic parallel to the lens curvature but separated from the surface by a moderately clear zone. The deposits were of high calcium content as evident by dark brown staining with von Kossa. Gram Tworts' staining disclosed no microorganisms. CONCLUSION: This report further contributes to the existing literature on hydrogel IOL calcification.
Intraocular pressure in Japanese diabetic patients
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Matsuoka M
Full Text Available Masato Matsuoka,1 Nahoko Ogata,2 Kayako Matsuyama,1 Tadanobu Yoshikawa,1 Kanji Takahashi31Department of Ophthalmology, Kansai Medical University, Takii Hospital, Osaka, 2Department of Ophthalmology, Nara Medical University, Nara, 3Department of Ophthalmology, Kansai Medical University, Hirakata Hospital, Osaka, JapanBackground: To determine whether the intraocular pressure (IOP in diabetic patients is significantly different from that in nondiabetic patients.Methods: The medical records of all patients who were initially examined in the Department of Ophthalmology, Kansai Medical University, Takii Hospital were reviewed. At the initial examination, patients had a detailed interview and underwent a comprehensive ophthalmic examinations. All patients were over 20 years of age and did not have glaucoma.Results: A total of 703 patients were evaluated. The mean (±standard error IOP of the diabetic patients was 15.5 ± 0.2 mmHg (n = 206, and was significantly higher than the 14.0 ± 0.1 mmHg (n = 497 in the nondiabetic patients (P < 0.0001. The IOP was negatively correlated with age (r = –0.202; P = 0.024 in the diabetic patients and was weakly but significantly correlated with the glycosylated hemoglobin (HbA1c level (r = 0.240; P = 0.015 in the group with diabetic retinopathy.Conclusion: The significantly higher IOP in diabetic patients and positive correlation of IOP with HbA1c levels in patients with diabetic retinopathy indicate that IOP in diabetic patients is higher, especially in those with poor control of diabetes.Keywords: diabetes mellitus, diabetic retinopathy, intraocular pressure, open-angle glaucoma
Patient acceptability of the Tecnis® multifocal intraocular lens
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Sood P
Full Text Available Priyanka Sood1, Maria A Woodward21Emory Eye Center, Atlanta, GA, USA; 2Kellogg Eye Center, Ann Arbor, MI, USAAbstract: Cataract surgery has evolved. The goal of the surgeon includes both restoration of vision and refinement of vision. Patients' desire for spectacle independence has driven the market for presbyopia-correcting cataract surgery and development of novel intraocular lens (IOL designs. The Tecnis® Multifocal Intraocular Lens incorporates an aspheric, modified anterior prolate IOL with a diffractive multifocal lens design. The design aims to minimize spherical aberration and improve range of focus. The purpose of this review is to assess patient acceptability of the Tecnis® multifocal intraocular lens.Keywords: Tecnis®, intraocular lens, multifocal, presbyopia
Application of Foldable Intraocular Lens in Multiple Types of Cataract
Institute of Scientific and Technical Information of China (English)
Songtao Yuan; Qinghuai Liu; Qing Jiang; Nanrong Yuan
Objective: To evaluate the clinical results of implantation of foldable intraocular lens inmultiple types of cataract.Methods: This retrospective study comprised 162 eyes of 148 patients undergoingphacoemulsification and implantation of foldable intraocular lens, some of whom under-went combined pars plana vitrectomy or trabeculectomy or silicone oil removal. Theperiod of follow-up was from 3 months to 17 months.Results: There is slight reaction postoperatively in all cases. The postoperative uncorrectedvisual acuites was from 0. 05 to 1.2, patient with 0.6 or above acuity were 70.98%. Aneodymium: YAG capsulotomy was required in 5 eyes. Posterior capsule ruptured in 1eyes, and a PMMA intraocular lens was implanted in ciliary sulcus. In one eye, a lenswas removed because of recurrence of retina detachment.Conclusions: The application of foldable intraocular lens in multiple types of cataract issafe, and there is a slight postoperative reaction. less complications , and fast visualacuity recovery.
[Intraocular lens implantation in developmental lens disorders in children].
Kanigowska, Krystyna; Grałek, Mirosława; Kepa, Beata; Chipczyńska, Barbara
The pediatric cataract surgery in eyes with developmental disorders, stay with still considerable challenge. At children, the lasting vision development extorts necessity quick settlement of refraction defect formed after operation. The intraocular lens old boy with cataract in microspherophakia and 12 years old boy with cataract in lens with coloboma. One-piece flexible and rigid PMMA intraocular lens was placed with success at posterior chamber without scleral fixations and without using capsular tension ring in this cases. After 3 years of observation there were no decentration or dislocation of intraocular lens in both children. Authors concluded that in some cases posterior chamber intraocular lens implantation despite defective zonular or capsular support, can make up the effective method of surgical treatment without risk of early dislocation.
Intraocular nematode with diffuse unilateral subacute neuroretinitis: case report
Zakariah Sakinah; Said Mariyani; Alwi Azma-Azalina; Yusoff Munira,; Ghani Zulkifli; Zunaina Embong
Abstract Background Live intraocular nematode is a rare occurrence. Nematode can migrate actively within the eye, creating visual symptoms and damaging ocular tissue. Case presentation A 26-year old man presented with painless reduced vision of the left eye for one week duration. It was associated with floaters. Visual acuity on the left eye was hand movement. Anterior segment examination was normal with normal intra-ocular pressure. Fundus examination showed a live nematode lying subretinall...
Softec HD hydrophilic acrylic intraocular lens: biocompatibility and precision
Ladan Espandar; Shameema Sikder; Majid Moshirfar
Ladan Espandar1, Shameema Sikder2, Majid Moshirfar31Department of Ophthalmology, Tulane University, New Orleans, LA, USA; 2Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA; 3John A Moran Eye Center, University of Utah, Salt Lake City, UT, USAAbstract: Intraocular lens development is driven by higher patient expectations for ideal visual outcomes. The recently US Food and Drug Administration-approved Softec HD™ lens is an aspheric, hydrophilic acrylic intraocular le...
Patient acceptability of the Tecnis® multifocal intraocular lens
Woodward, Maria; Sood,Priyanka
Priyanka Sood1, Maria A Woodward21Emory Eye Center, Atlanta, GA, USA; 2Kellogg Eye Center, Ann Arbor, MI, USAAbstract: Cataract surgery has evolved. The goal of the surgeon includes both restoration of vision and refinement of vision. Patients' desire for spectacle independence has driven the market for presbyopia-correcting cataract surgery and development of novel intraocular lens (IOL) designs. The Tecnis® Multifocal Intraocular Lens incorporates an aspheric, modified anter...
Anterior segment intraocular metallic foreign body causing chronic hypopyon uveitis
Mete, Güler; Turgut, Yılmaz; Osman, Arslanhan; Gülşen, Ülkü; Hakan, Artaş
Intraocular foreign body (IOFB) is a common association of penetrating ocular trauma. Early diagnosis and removal of IOFBs especially if they are metallic is very important to determine further management and the final result of treatment. Missed IOFB may present in different clinical aspects that may limit its detection and symptoms may only become apparent after a prolonged period of time. We report a case of a missed metallic intraocular foreign body in the anterior chamber over a 2-year p...
Fungal infection of mantis shrimp (Oratosquilla oratoria) caused by two anamorphic fungi found in Japan.
Duc, Pham Minh; Hatai, Kishio; Kurata, Osamu; Tensha, Kozue; Yoshitaka, Uchida; Yaguchi, Takashi; Udagawa, Shun-ichi
Two fungal pathogens of the mantis shrimp (Oratosquilla oratoria) in Yamaguchi and Aichi Prefectures, Japan are described as the new species Plectosporium oratosquillae and Acremonium sp. (a member of the Emericellopsis marine clade). Both fungi infect the gills of the mantis shrimp, which become brown or black due to melanization. The former species is characterized by its slow growth on artificial seawater yeast extract peptone glucose (PYGS) agar, pale yellow to pale orange or grayish yellow colonies, short cylindrical solitary phialides with a wavy tip, and one-celled ellipsoidal conidia. Although lacking the two-celled conidia demonstrated by the type species Plectosporium tabacinum, the taxonomic placement of the new species was confirmed by DNA sequence analysis of the internal transcribed spacer (ITS) region of ribosomal DNA (ITS1, 5.8S rDNA and ITS2). Acremonium sp., the other causal pathogen, differs from P. oratosquillae by its fast growth on PYGS agar, pale orange to salmon-colored colonies, long, slender conidiophores consisting of solitary phialides with tips lacking an undulate outline, and typically cylindrical conidia. Analysis of ITS and beta-tubulin gene sequences placed this fungus within the phylogenetically distinct Emericellopsis (anam. Acremonium) marine clade. Various physiological characteristics of both pathogens were also investigated. This is the first report of a fungal infection found on the mantis shrimp in Japan.
Relation between intraocular pressure and size of transverse sinuses
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Kantarci, Mecit; Onbas, Omer; Alper, Fatih; Okur, Adnan [Atatuerk University, Department of Radiology, Medical Faculty, Erzurum (Turkey); Dane, Senol; Gumustekin, Kenan [Atatuerk University, Department of Physiology, Medical Faculty, Erzurum (Turkey); Aslankurt, Murat [Atatuerk University, Department of Ophtalmatology, Medical Faculty, Erzurum (Turkey); Yazici, Ahmet Taylan [Beyoglu Goez Egitim ve Arastirma Hastanesi, Istanbul (Turkey)
There are asymmetries in the sizes of transverse sinus and intraocular pressure. The purpose of this study was to investigate possible relationships between the asymmetry of transverse sinuses in TOF MR venography and intraocular pressures of right and left eyes. In this study, subjects were 63 male and 42 female medical school students, aged 18-21 years (mean{+-}SD; 19.72{+-}0.67 years). Subjects with neurological and ophthalmologic disease, particularly dural sinus thrombosis, myopia, trauma and glaucoma, were excluded the study. Subjects were divided into five groups according to the magnitudes of the right- and left-transverse sinuses in MR venography results. There is a functional relation between intraocular pressures of the right and left eyes and asymmetry of the transverse sinus. If the transverse sinus on one side is larger and its venous drainage is greater, the intraocular pressure of the eye on this side is lower. It can be speculated that the transverse sinus size may be associated with pathogenesis of diseases with increased intraocular pressure such as glaucoma. We aim to determine the relation between the size and drainage of transverse sinuses in TOF MR venography and intraocular pressure in patients with open-angle glaucoma in our next study. (orig.)
Calcification of intraocular implant lens surfaces.
Wu, Wenju; Guan, Xiangying; Tang, Ruikang; Hook, Daniel; Yan, Wenyan; Grobe, George; Nancollas, George H
Calcification of octacalcium phosphate [Ca8H2(PO4)6 x 5H2O, OCP] on differently packaged "Ultem" and "Surefold" intraocular implant lens surfaces has been studied in vitro in solutions supersaturated with respect to OCP at pH = 7.10 and 37 degrees C. No mineral deposition was observed on the lenses packaged in Ultem vials even after treatment with behenic acid, one of the fatty acids identified on explanted lenses. Following treatment with behenic acid, nucleation of OCP occurred on the lenses from Surefold vials, which incorporate silicone gaskets; induction periods preceding calcification were about 6 h. No mineralization was found on the lenses in vials with other gasket materials, including polytetrafluoroethylene, fluorocarbon elastomer, and polypropylene. The results of this study indicate that both silicone and fatty acids such as behenic acid play important roles in inducing the in vivo calcification of OCP on IOL lenses; all of the lens treatment steps were necessary for nucleation induction.
A study of brachytherapy for intraocular tumor
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Ji, Yung Hoon; Lee, Dong Han; Ko, Kyung Hwan; Lee, Tae Won; Lee, Sung Koo; Choi, Moon Sik [Korea Cancer Center Hospital of Korea Atomic Energy Research Institute, Seoul (Korea, Republic of)
Our purpose of this study is to perform brachytherapy for intraocular tumor. The result were as followed. 1. Eye model was determined as a 25 mm diameter sphere. Ir-192 was considered the most appropriate as radioisotope for brachytherapy, because of the size, half, energy and availability. 2. Considering the biological response with human tissue and protection of exposed dose, we made the plaques with gold, of which size were 15 mm, 17 mm and 20 mm in diameter, and 1.5 mm in thickness. 3. Transmission factor of plaques are all 0.71 with TLD and film dosimetry at the surface of plaques and 0.45, 0.49 at 1.5 mm distance of surface, respectively. 4. As compared the measured data for the plaque with Ir-192 seeds to results of computer dose calculation model by Gary Luxton et al. and CAP-PLAN (Radiation Treatment Planning System), absorbed doses are within {+-}10% and distance deviations are within 0.4 mm. Maximum error is -11.3% and 0.8 mm, respectively. 7 figs, 2 tabs, 28 refs. (Author).
Surgical management of intraocular lens dislocations
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Adem Gul
Full Text Available ABSTRACTPurpose:To report and compare the surgical, visual, and anatomical outcomes following treatment of dislocated intraocular lenses (IOLs.Methods:The medical records of 28 eyes of 28 patients were evaluated. Age, gender, pre-and postoperative best-corrected visual acuity (BCVA, surgical methods, and complications were recorded.Results:Pre-and postoperative BCVA ranged from counting fingers to 20/32 and from counting fingers to 20/25, respectively. Late-onset dislocations were the most frequently observed complication. The most frequent surgical method was IOL repositioning in 15 of 28 patients, followed by IOL exchange in 11 patients, and IOL removal in 2 patients. Only 1 patient required surgical re-intervention with IOL capture.Conclusions:Visual acuity improved following the use of either IOL repositioning or IOL exchange. No superiority of one method over the other was observed. In the present retrospective case series, management of dislocated IOLs with repositioning or exchange of the primary implant conferred comparable surgical and visual outcomes.
... Does My Child Need? How to Safely Give Acetaminophen Is It a Cold or the Flu? Is the Flu Vaccine a Good Idea for Your Family? Too Late for the Flu Vaccine? Common Childhood Infections Can Chronic Ear Infections Cause Long-Term Hearing Loss? Chickenpox Cold Sores Common Cold Diarrhea Fever and ...
Intraocular complications of IFN-a and ribavirin therapy in patients with chronic viral hepatitis C
Institute of Scientific and Technical Information of China (English)
Damien Sene; Valerie Touitou; Bahram Bodaghi; David Saadoun; Gabriel Perlemuter; Nathalie Cassoux; Jean-Charles Piette; Phuc Le Hoang; Patrice Cacoub
We report a panel of severe inflammatory and vascular intraocular disorders occurring during interferon-alpha (IFN-a) treatment in eight hepatitis C virus (HCV)-infected patients. These events include three cases of Vogt-Koyanagi-Harada like (VKH) disease (an association of panuveitis, retinal detachment, ear and meningeal detachment and skin and hair changes), two cases of central retinal vein occlusion, one case of central retinal artery occlusion, one case of severe hypertensive retinopathy and one case of bilateral ischemic optic neuropathy with severe visual impairment. Rare as they are, such severe ophthalmological complications require a close follow-up of HCV-infected patients under IFN-a treatment with ophthalmological monitoring if any ocular manifestation occurs.
[Intraocular Pressure Sensor Based on a Contact Lens].
Guo, Xuhong; Pet, Weihua; Yao, Zhaolin; Chen, Yuanfang; Hu, Xiaohui; Chen, Hongda; Zhu, Jingyuan; Wu, Huijuan
Intraocular pressure detection has a great significance for understanding the status of eye health, prevention and treatment of diseases such as glaucoma. Traditional intraocular pressure detection needs to be held in the hospital. It is not only time-consuming to doctors and patients, but also difficult to achieve 24 hour-continuous detection. Microminiaturization of the intraocular pressure sensor and wearing it as a contact lens, which is convenient, comfortable and noninvasive, can solve this problem because the soft contact lens with an embedded micro fabricated strain gauge allows the measurement of changes in corneal curvature to correlate to variations of intraocular pressure. We fabricated a strain gauge using micro-electron mechanical systems, and integrated with the contact lens made of polydimethylsiloxane (PDMS) using injection molding. The experimental results showed that the sensitivity was 100. 7 µV/µm. When attached to the corneal surface, the average sensitivity of sensor response of intraocular pressure can be 125.8 µV/mm Hg under the ideal condition.
Effects of 2-alkynyladenosine derivatives on intraocular pressure in rabbits.
Konno, Takashi; Ohnuma, Shin-ya; Uemoto, Kazuhiro; Uchibori, Takehiro; Nagai, Akihiko; Kogi, Kentaro; Endo, Kazuki; Hosokawa, Tomokazu; Nakahata, Norimichi
We evaluated the activities of 2-alkynyladenosine derivatives, relatively selective adenosine A2 receptor agonists, in the intraocular pressure regulation in rabbits. An adenosine A2 receptor agonist 2-[p-(2-carboxyethyl)phenylethylamino]-5'-N-ethylcarboxamidoadenosine (CGS-21680) decreased intraocular pressure, while another A2 receptor agonist 2-(phenylamino)adenosine transiently increased it. The first group of 2-alkynyladenosine derivatives (1-hexyn-1-yl derivatives) caused a transient increase followed by decrease in intraocular pressure, while the second group (1-octyn-1-yl and 6-cyano-1-hexyn-1-yl derivatives) only decreased it. The second group is also effective in the ocular hypertensive models induced by water-loading and alpha-chymotrypsin. The outflow facility was increased by a 1-octyn-1-yl derivative. Both increase and decrease in intraocular pressure induced by 2-alkynyladenosine derivatives were inhibited by an adenosine A2 receptor antagonist 3,7-dimethyl-1-propargylxanthine, but not by an adenosine A1 receptor antagonist 8-cyclopentyl-1,3-dipropyl xanthine. These findings suggest that 2-alkynyladenosine derivatives may affect intraocular pressure via adenosine A2 receptor, and 2-alkynyladenosine derivative-induced ocular hypotension is due to the increase of outflow facility.
Effects of environmental heat and intake of tall fescue seed infested with Acremonium coenophialum on the acid-base status of young bulls.
Wallace, L L; Vogt, D W; Lipsey, R J; Garner, G B; Cornell, C N
Effects of high environmental temperature and dietary intake of tall fescue (Festuca arundinacea) seed containing the endophyte Acremonium coenophialum on bovine acid-base status were studied using 3 groups of bull calves (2 Simmental, 1 Angus). Experimental animals were housed in controlled-climate chambers and subjected to gradual increases in environmental temperature, first while being fed an endophyte-free diet and then while being fed a diet containing 17% endophyte-infested fescue seed. Marked acid-base disturbances were not observed in any animals. In general, Pco2, HCO3-, base excess, and arterial blood pH values were reduced in response to heat stress, both with endophyte-free and endophyte-containing diets. In most individuals anion gap increased. These results reflected metabolic compensation for mild chronic alveolar hyperventilation and retention of organic acids. These findings suggest that, under conditions similar to those found during the summer in central Missouri, normal cattle should not be at great risk of developing respiratory alkalosis or other severe acid-base disturbances as a result of heat stress and/or intake of tall fescue endophyte.
New trends in intraocular lens imaging
Millán, María S.; Alba-Bueno, Francisco; Vega, Fidel
As a result of modern technological advances, cataract surgery can be seen as not only a rehabilitative operation, but a customized procedure to compensate for important sources of image degradation in the visual system of a patient, such as defocus and some aberrations. With the development of new materials, instruments and surgical techniques in ophthalmology, great progress has been achieved in the imaging capability of a pseudophakic eye implanted with an intraocular lens (IOL). From the very beginning, optical design has played an essential role in this progress. New IOL designs need, on the one hand, theoretical eye models able to predict optical imaging performance and on the other hand, testing methods, verification through in vitro and in vivo measurements, and clinical validation. The implant of an IOL requires a precise biometry of the eye, a prior calculation from physiological data, and an accurate position inside the eye. Otherwise, the effects of IOL calculation errors or misplacements degrade the image very quickly. The incorporation of wavefront aberrometry into clinical ophthalmology practice has motivated new designs of IOLs to compensate for high order aberrations in some extent. Thus, for instance, IOLs with an aspheric design have the potential to improve optical performance and contrast sensitivity by reducing the positive spherical aberration of human cornea. Monofocal IOLs cause a complete loss of accommodation that requires further correction for either distance or near vision. Multifocal IOLs address this limitation using the principle of simultaneous vision. Some multifocal IOLs include a diffractive zone that covers the aperture in part or totally. Reduced image contrast and undesired visual phenomena, such as halos and glare, have been associated to the performance of multifocal IOLs. Based on a different principle, accommodating IOLs rely on the effort of the ciliary body to increase the effective power of the optical system of the
Epithelial Downgrowth after Intraocular Surgery Treated with Intracameral 5-Fluorouracil
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Nina Ni
Full Text Available Purpose. To present the clinical and histopathologic correlation of two cases of epithelial downgrowth (EDG after prior intraocular surgery. Methods. Observational case reports. Results. We present two cases of EDG occurring after intraocular surgery. In both cases, after two anterior chamber injections of 5-fluorouracil (5FU, the area of EDG initially regressed. In Case 1, a limited area of EDG eventually recurred, and penetrating keratoplasty with cryotherapy was curative. In Case 2, subsequent corneal edema required Descemet-stripping automated endothelial keratoplasty, and the patient remained clinically free of EDG without further treatment. Conclusion. Intracameral 5FU may have a role in the treatment of EDG after intraocular surgery, though its precise utilization and impact remain to be defined.
Penetrating Scleral Injury with Intraocular Foreign Body. A Case Report
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Anay Martínez Díaz
Full Text Available Ocular trauma is a health problem in the world today and a common cause of visual impairment leading to severe sequelae and psychological disorders. The case of a 46-year-old male patient who attended the Ophthalmology emergency services of the Dr. Gustavo Aldereguía Lima University General Hospital of Cienfuegos, recounting that while hammering iron on iron he felt that something entered his right eye, is presented. He suffered from pain, tearing, red eye and blurred vision. A penetrating scleral injury with an intraocular foreign body was diagnosed. Its study was conducted through biomicroscopy, orbital x-ray and ocular ultrasound. Surgical treatment by extracapsular lens extraction with intraocular lens implantation was performed using Blumenthal technique and pars plana approach for removal of the intraocular foreign body.
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Retropupillary iris claw intraocular lens implantation in aphakia for dislocated intraocular lens
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Faria MY
Full Text Available Mun Yueh Faria,1–3 Nuno Pinto Ferreira,1–3 Joana Medeiros Pinto,1–3 David Cordeiro Sousa,1–3 Ines Leal,1–3 Eliana Neto,1–3 Carlos Marques-Neves1–3 1Centro de Estudos da Visão, Universidade de Lisboa, 2Department of Ophthalmology, Hospital de Santa Maria, 3Faculty of Medicine, University of Lisbon, Lisbon, Portugal Background: Nowadays, dislocated intraocular lenses (IOLs and inadequate capsular support are becoming a challenge for every ophthalmic surgeon. Explantation of dislocated IOL and iris claw IOL (ICIOL are the techniques that have been used in our ophthalmic department. The aim of this study is to report our technique for retropupillar ICIOL.Methods: This study is a retrospective case series. A total of 105 eyes with dislocated IOL from the patients at the Department of Ophthalmology in Santa Maria Hospital, a tertiary reference hospital in Lisbon, Portugal, from January 2012 until January 2016, had been analyzed. Of these 105 eyes, 66 eyes had dislocated one-piece IOL and 39 eyes had dislocated three-piece IOL. The latter underwent iris suture of the same IOL and were excluded from this study. The remaining 66 eyes with dislocated one-piece IOL underwent pars plana vitrectomy, that is, explantation of dislocated IOL through corneal incision and an implantation of retropupillary ICIOL. Operative data and postoperative outcomes included best corrected visual acuity, IOL position, intraocular pressure, pigment dispersion, clinical signs of endothelial cell loss, and anterior chamber depth.Results: The mean follow-up was 23 months (range: 6–48 months. The mean preoperative best corrected visual acuity was 1.260±0.771 logMAR, and postoperative best corrected visual acuity was 0.352±0.400 logMAR units. Mean vision gain was 0.909 logMar units. The patients had the following complications: 1 retinal detachment was found in one patient, 2 corneal edema was found in three patients, 3 high intraocular pressure was observed in
Retropupillary iris claw intraocular lens implantation in aphakia for dislocated intraocular lens
Faria, Mun Yueh; Ferreira, Nuno Pinto; Pinto, Joana Medeiros; Sousa, David Cordeiro; Leal, Ines; Neto, Eliana; Marques-Neves, Carlos
Background Nowadays, dislocated intraocular lenses (IOLs) and inadequate capsular support are becoming a challenge for every ophthalmic surgeon. Explantation of dislocated IOL and iris claw IOL (ICIOL) are the techniques that have been used in our ophthalmic department. The aim of this study is to report our technique for retropupillar ICIOL. Methods This study is a retrospective case series. A total of 105 eyes with dislocated IOL from the patients at the Department of Ophthalmology in Santa Maria Hospital, a tertiary reference hospital in Lisbon, Portugal, from January 2012 until January 2016, had been analyzed. Of these 105 eyes, 66 eyes had dislocated one-piece IOL and 39 eyes had dislocated three-piece IOL. The latter underwent iris suture of the same IOL and were excluded from this study. The remaining 66 eyes with dislocated one-piece IOL underwent pars plana vitrectomy, that is, explantation of dislocated IOL through corneal incision and an implantation of retropupillary ICIOL. Operative data and postoperative outcomes included best corrected visual acuity, IOL position, intraocular pressure, pigment dispersion, clinical signs of endothelial cell loss, and anterior chamber depth. Results The mean follow-up was 23 months (range: 6–48 months). The mean preoperative best corrected visual acuity was 1.260±0.771 logMAR, and postoperative best corrected visual acuity was 0.352±0.400 logMAR units. Mean vision gain was 0.909 logMar units. The patients had the following complications: 1) retinal detachment was found in one patient, 2) corneal edema was found in three patients, 3) high intraocular pressure was observed in twelve patients, 4) subluxation of the IOL was observed in one patient, and 5) macular edema was found in three eyes. Conclusion The results demonstrate that retropupillary ICIOL is an easy and effective method for the correction of aphakia in patients not receiving capsule support. The safety of this procedure must be interpreted in the context
Comparison of shape recovery ratios in various intraocular lens haptics.
Kimura, W; Kimura, T; Sawada, T; Kikuchi, T; Toda, H; Yamada, Y; Nagai, H
Since understanding the mechanical properties of intraocular lens (IOL) haptic materials can minimize decentration after surgery, we have examined shape recovery ratios of various intraocular lens haptics (polypropylene [PP], polyvinylidene fluoride [PVDF], extruded poly(methyl methacrylate) [PMMA]) currently on the market under conditions that approximate clinical use. The results using various Ascon lens-holding forceps and compression tests, during which the lenses were held in a cylindrical holder for seven days, one month, and three months, indicated that PVDF haptics had better shape recovery capability than PP and extruded three-piece PMMA haptics.
Polyvinylidene Flouride Polymer Applied in an Intraocular Pressure Sensor
González Morán, Carlos Omar; González Ballesteros, Rubén; Rodríguez Guzmán, Maria Dolores Alicia; Suaste Gómez, Ernesto
An indentation intraocular pressure sensor (IIOPS) was designed and manufactured. It is based on piezoelectric polyvinylidene fluoride (PVDF) films. This sensor will help in the detection and diagnosis of intraocular pressure (IOP) in eye diseases like glaucoma. The pressure in the normal aqueous and vitreous phases is, on average, 15.5 mmHg and up of 21 mmHg when glaucoma exists. The proposed IIOPS offers a measurement range from 10-29 mmHg with a resolution of 1 mmHg and an accuracy of ± 0.025.
The control of aniseikonia after intraocular lens implantation.
Hillman, J S; Hawkswell, A
This paper reports a study of postoperative refraction and eikonometry of 50 patients who had unilateral cataract extraction with implantation of a pupil-supported intraocular lens. The mean postoperative aniseikonia (+/- SD) was 1.97 (+/- 1.82). A statistically significant relationship was shown between anisometropia and aniseikonia. Despite aniseikonia of up to 7.8 per cent there were no diplopia problems as the visual system exhibits a high degree of tolerance. It is concluded that aniseikonia can be controlled to within clinically acceptable limits by the simple calculation of intraocular lens power for isometropia.
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Virginia Vanzzini Zago
Full Text Available This is a retrospective, and descriptive study about the support that the laboratory of microbiology aids can provide in the diagnosis of ocular infections in patients whom were attended a tertiary-care hospital in México City in a 10-year-time period. We describe the microbiological diagnosis in palpebral mycose; in keratitis caused by Fusarium, Aspergillus, Candida, and melanized fungi; endophthalmitis; one Histoplasma scleritis and one mucormycosis. Nowadays, ocular fungal infections are more often diagnosed, because there is more clinical suspicion and there are easy laboratory confirmations. Correct diagnosis is important because an early medical treatment gives a better prognosis for visual acuity. In some cases, fungal infections are misdiagnosed and the antifungal treatment is delayed.
Effects of angiotensin, vasopressin and atrial natriuretic peptide on intraocular pressure in anesthetized rats
Palm, D. E.; Shue, S. G.; Keil, L. C.; Balaban, C. D.; Severs, W. B.
The effects of atrial natriuretic peptide (ANP), vasopressin (AVP) and angiotensin (ANG) on blood and intraocular pressures of pentobarbital anesthetized rats were evaluated following intravenous, intracerebroventricular or anterior chamber routes of administration. Central injections did not affect intraocular pressure. Equipressor intravenous infusions of ANG raised, whereas AVP decreased, intraocular pressure. Direct infusions of a balanced salt solution (0.175 microliter/min) raised intraocular pressure between 30 and 60 min. Adding ANG or ANP slightly reduced this solvent effect but AVP was markedly inhibitory. An AVP-V1 receptor antagonist reversed the blunting of the solvent-induced rise by the peptide, indicating receptor specificity. Acetazolamide pretreatment lowered intraocular pressure, but the solvent-induced rise in intraocular pressure and inhibition by AVP still occurred without altering the temporal pattern. Thus, these effects appear unrelated to aqueous humor synthesis rate. The data support the possibility of intraocular pressure regulation by peptides acting from the blood and aqueous humor.
Intraocular lens explantation or exchange: indications, postoperative interventions, and outcomes
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Refik Oltulu
Full Text Available ABSTRACT Purpose: To analyze the indications for explantation or exchange of intraocular lenses (IOLs, which were originally implanted for the correction of aphakia during cataract extraction. Methods: All cases that involved intraocular lens explantation or exchange in one institution between January 2008 and December 2014 were analyzed retrospectively. Results: In total, 93 eyes of 93 patients were analyzed. The median time interval between implantation and explantation of the anterior chamber intraocular lenses (AC IOL and posterior chamber intraocular lenses (PC IOL was 83.40 ± 83.14 months (range: 1-276 months and 55.14 ± 39.25 months (range: 1-168 months, respectively. Pseudophakic bullous keratopathy (17 eyes, 38.6% and persistent iritis (12 eyes, 27.8% in the AC IOL group and dislocation or decentration (30 eyes, 61.2% and incorrect IOL power (nine eyes, 18.4% in the PC IOL group were the most common indications for explantation of IOLs. The mean logMAR best corrected visual acuity (BCVA improved significantly from 1.30 preoperatively to 0.62 postoperatively in the PC IOL group (p<0.001 but did not improve significantly in the AC IOL group (p=0.186. Conclusions: The primary indication for IOL explantation or exchange was pseudophakic bullous keratopathy in the AC IOL group and was dislocation or decentration in the PC IOL group. PC IOL explantation or exchange is safe and improves visual acuity.
Secondary implantation of a double intraocular lens after penetrating keratoplasty.
Gayton, J L
Penetrating keratoplasty (PKP) patients often have severe, visually disabling refractive errors. Astigmatism can be addressed by refractive surgery; however, correcting hyperopia is more problematic. Although pseudophakic PKP patients can have a lens exchange, it can be traumatic in this population. In this pseudophakic PKP patient, I added a second posterior chamber intraocular lens, correcting the hyperopia and resolving visual complaints.
Development of a ciliary muscle-driven accommodating intraocular lens
Hermans, Erik A.; Terwee, Thom T.; Koopmans, Steven A.; Dubbelman, Michiel; van der Heijde, Rob G. L.; Heethaar, Rob M.
PURPOSE: To develop a ciliary muscle-driven accommodating intraocular lens (IOL) that has a large and predictable range of variable power as a step toward spectacle independence. SETTING: Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, The Netherlands. METHODS:
Unexplained heterochromia. Intraocular foreign body demonstrated by computed tomography.
Barr, C C; Vine, A K; Martonyi, C L
Standard radiographic techniques are often inadequate in demonstrating the presence and location of intraocular foreign bodies. Computerized axial tomography was used to confirm the presence of a metallic foreign body in a patient with heterochromia iridis and suspected ocular siderosis in whom no foreign material was found by conventional examination methods.
Liquid-crystal intraocular adaptive lens with wireless control
Simonov, A.N.; Vdovine, G.V.; Loktev, M.
We present a prototype of an adaptive intraocular lens based on a modal liquid-crystal spatial phase modulator with wireless control. The modal corrector consists of a nematic liquid-crystal layer sandwiched between two glass substrates with transparent low- and high-ohmic electrodes, respectively.
Use of betaxolol in the reduction of elevated intraocular pressure.
Radius, R L
Forty eyes in 20 patients with elevated intraocular pressure were treated with either a 0.125% betaxolol ophthalmic solution or a placebo. After 2, 4, and 6 weeks of twice-daily therapy, the eyes receiving the betaxolol had a mean percent reduction in IOP greater than that in the eyes treated only with the drug vehicle (placebo). Both solutions were well tolerated.
Trabeculectomy for traumatic hyphema with increased intraocular pressure.
Graul, T A; Ruttum, M S; Lloyd, M A; Radius, R L; Hyndiuk, R A
We reviewed the medical records of 11 consecutive patients who underwent trabeculectomy with anterior chamber washout and peripheral iridectomy as the primary surgical treatment for traumatic hyphema that was unresponsive to medical management. The mean intraocular pressure before surgery was 48 mm Hg. In ten of the patients the intraocular pressure was lowered to 21 mm Hg or lower after surgery and remained below that level up to the most recent follow-up visit, which ranged from eight to 97 months. One patient required a topical beta-blocker and oral acetazolamide to lower pressure to this level after surgery. Eight patients had visual acuity of 20/60 or better at last follow-up. Corneal blood staining occurred in eight patients. Compared with other techniques for surgical management of traumatic hyphema, trabeculectomy provides a means to keep intraocular pressure lowered while the remaining blood is clearing from the anterior chamber. Trabeculectomy with anterior chamber washout and peripheral iridectomy appears to be a safe and reliable procedure in the management of traumatic hyphemas in which medical management fails to control intraocular pressure.
A UV-hardening lacquer material based on polyurethane, used in Philips compact disc lens systems, was tested as suitable material for low-cost intraocular lenses (IOLs). A slightly changed composition (code number I-0.5A) came out as the best and was subsequenly tested, with reference to poly(methyl
Combined aniridic intraocular lens implantation and vitreoretinal surgery
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Mehta Hitendra
Full Text Available A 45-year-old man presented with post-traumatic aniridia. We describe the combined surgery done to treat both aniridia and epiretinal membrane simultaneously. A combined aniridia intraocular lens and vitreoretinal surgery was done. The case report highlights the advantage of combined surgery in terms of cost factor and surgical time.
Microscopic and spectroscopic investigation of an explanted opacified intraocular lens
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Simon, V., E-mail: email@example.com [Babeş-Bolyai University, Faculty of Physics and Interdisciplinary Research Institute on Bio-Nano-Sciences, 400084 Cluj-Napoca (Romania); Radu, T.; Vulpoi, A. [Babeş-Bolyai University, Faculty of Physics and Interdisciplinary Research Institute on Bio-Nano-Sciences, 400084 Cluj-Napoca (Romania); Rosca, C. [Optilens Clinic of Ophthalmology, 400604 Cluj-Napoca (Romania); Eniu, D. [Iuliu Haţieganu University of Medicine and Pharmacy, Department of Molecular Sciences, 400349 Cluj-Napoca (Romania)
Highlights: • Changes on intraocular lens (IOL) surface after implantation. • Partial opacification of IOL central area. • Elemental composition on IOL surface prior to and after implantation. • First XPS depth profiling examination of the opacifying deposits. • Cell-mediated hydroxyapatite structuring. - Abstract: The investigated polymethylmethacrylate intraocular lens explanted an year after implantation presented a fine granularity consisting of ring-like grains of about 15 μm in diameter. In order to evidence the changes occurred on intraocular lens relative to morphology, elemental composition and atomic environments, microscopic and spectroscopic analyses were carried out using scanning electron microscopy (SEM), Fourier transform infrared (FTIR), energy-dispersive X-ray (EDS), and X-ray photoelectron (XPS) spectroscopies. The results revealed that the grains contain hydroxyapatite mineral phase. A protein layer covers the lens both in opacified and transparent zones. The amide II band is like in basal epithelial cells. The shape and size of the grains, and the XPS depth profiling results indicate the possibility of a cell-mediated process involving lens epithelial cells which fagocitated apoptotic epithelial cells, and in which the debris derived from cell necrosis were calcified. To the best of our knowledge, this is the first investigation on explanted intraocular lenses using XPS depth profiling in order to examine the inside of the opacifying deposits.
Controversies in intraocular lens implantation in pediatric uveitis.
Phatak, Sumita; Lowder, Careen; Pavesio, Carlos
Cataract is one of the most common and visually debilitating complications of pediatric uveitis. It develops as a consequence of chronic inflammation and steroid use and is seen most often in juvenile idiopathic arthritis (JIA)-associated uveitis. Cataract extraction with intraocular lens (IOL) insertion has been carried out with a measure of success in non-uveitic pediatric eyes, but in cases of uveitis, multiple factors affect the final outcome. Chronic inflammation and its sequelae such as band keratopathy, posterior synechiae, and cyclitic membranes make surgical intervention more challenging and outcome less certain. Postoperative complications like increased inflammation, glaucoma, posterior capsular opacification, retrolental membranes, and hypotony may compromise the visual outcome. Early refractive correction is imperative in pediatric eyes to prevent amblyopia. The use of contact lenses and intraocular lenses in pediatric uveitic eyes were fraught with complications in the past. Surgical interventions such as vitreo-lensectomy followed by contact lens fitting and small incision cataract surgery followed by different types of intraocular lenses have been utilized, and many reports have been published, albeit in small patient groups. This review analyzes and discusses the existing literature on intraocular lens implantation in cases of pediatric uveitic cataract surgery.
Cerebral migration of intraocular silicone oil: an MRI study
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Kiilgaard, Jens Folke; Milea, Dan; Løgager, Vibeke;
for retinal detachment. Methods: Nineteen patients included in this study were referred for silicone oil removal after uncomplicated retinal detachment surgery using internal silicone oil tamponade. Patients with a previous history of intraocular silicone oil, glaucoma or optic pit were excluded. After...
Intraocular inflammation following endotamponade with high-density silicone oil.
Theelen, T.; Tilanus, M.A.D.; Klevering, B.J.
BACKGROUND: The use of a mixture of silicone oil and partially fluorinated alkanes (high-density silicone oil) has recently been suggested as intraocular tamponade in complicated retinal detachment of the inferior quadrants. We describe a series of patients who developed a clinical picture resemblin
Effect of chymase on intraocular pressure in rabbits.
Konno, Takashi; Maruichi, Midori; Takai, Shinji; Oku, Hidehiro; Sugiyama, Tetsuya; Uchibori, Takehiro; Nagai, Akihiko; Kogi, Kentaro; Ikeda, Tsunehiko; Miyazaki, Mizuo
Chymase is a chymotrypsin-like serine protease that is stored exclusively in the secretory granules of mast cells and converts big endothelins to endothelin-1 (1-31). The aim of this study was to evaluate the effect of chymase on intraocular pressure in rabbits. Chymase injection (3 and 10 mU) resulted in a trend toward increased intraocular pressure and a significant increase in intraocular pressure at a dose of 10 mU compared with the control. A specific chymase inhibitor, Suc-Val-Pro-Phe(P)(OPh)(2), attenuated the ocular hypertension induced by chymase. Endothelin-1 (1-31) also caused ocular hypertension, which was inhibited by a selective endothelin ET(A) receptor antagonist, cyclo(D-Asp-Pro-D-Val-Leu-D-Trp) (BQ-123). Moreover, chymase-induced ocular hypertension was inhibited by BQ-123. These results suggest that chymase influences the regulation of intraocular pressure, and it is likely that the formation of endothelin-1 (1-31) and subsequent activation of endothelin ET(A) receptors are involved in the development of ocular hypertension induced by chymase.
Interactions between biofilms and the environment. FEMS Microbiol Rev. 1997;20:291–303. 4. Webb LX, Wagner W, Carroll D, et al. Osteomyelitis and...treatment of osteomyelitis . Biomed Mater. 2008;3: 034114. 6. Gristina AG. Biomaterial-centered infection: microbial adhesion versus tissue integration...vertebral osteomyelitis . Spine. 2007;32: 2996–3006. 15. Beckham JD, Tuttle K, Tyler KL. Reovirus activates transforming growth factor ß and bone
The use of pneumatic retinopexy to delay surgical repair of a retinal detachment associated with the ganciclovir intraocular device.
McAuliffe, P F; Heinemann, M H
Rhegmatogenous retinal detachments are associated with cytomegalovirus (CMV) retinitis and the use of the ganciclovir intraocular device. Pars plana vitrectomy with silicone oil tamponade is the preferred technique to repair such detachments. The authors describe the use of pneumatic retinopexy as part of a treatment strategy in the management of multiple retinal detachments in a patient with CMV retinitis treated with ganciclovir implants. Pneumatic retinopexy may benefit patients when the causative retinal break is superior and is located in an area of retina uninvolved with CMV infection, because it can be used to delay surgical intervention.
Comparison of a new-generation sectorial addition multifocal intraocular lens and a diffractive apodized multifocal intraocular lens.
Linden, J.W.M. van der; Velthoven, M. van; Meulen, I. van der; Nieuwendaal, C.; Mourits, M.; Lapid-Gortzak, R.
PURPOSE: To compare visual, refractive, and satisfactory outcomes between a new-generation sectorial addition multifocal intraocular lens (IOL) (Lentis Mplus LS-312; study group) and a diffractive apodized multifocal IOL (Restor SN6AD1; control group). SETTING: Private practice, Driebergen, and Depa
Misdiagnosis induced intraocular lens dislocation in anterior megalophthalmos
Institute of Scientific and Technical Information of China (English)
WANG Qi-wei; XU Wen; ZHU Ya-nan; LI Jin-yu; ZHANG Li; YAO Ke
Anterior megalophthalmos (AM) is an uncommon developmental anomaly of the anterior segment of the eye with a constellation of findings that includes enlarged cornea,deep anterior chamber,posterior positioning of the iris and lens,iris stroma atrophy,hypoplasia of iris dilator,pupil displacement,large capsular bag,lens subluxation,prematurely cataract and the tendency to retinal detachment.AM,especially when symptoms are mild,is not an easy disease to diagnose.We present 3 AM cases that were misdiagnosed as congenital cataract with weak zonule and megalocornea.Intraocular lenses (IOLs) dislocated after standard cataract surgeries and subsequent surgery (replacing the dislocated IOLs with iris-claw intraocular lenses) achieved satisfactory outcome.Although rare,AM should be included in the differential diagnosis of enlarged cornea and we recommend implanting Artisan lens in AM patients.
Intraocular lens exchange-removing the optic intact
Lee, Matthew Hao; Webster, Diane Lesley
Current practice for intraocular lens (IOL) exchange is to cut the optic of the posterior chamber intraocular lens (PCIOL) prior to removing it. Great care must be taken during this maneuver to avoid a posterior capsular tear. Removing the haptics from the fibrosed capsule can also be hazardous, as it may result in zonular stress and dehiscence. A technique is described for performing foldable (one-piece acrylic) IOL removal without cutting the optic. Careful visco-dissection of the haptics with a low viscosity ophthalmic viscosurgical device (OVD) in the fibrosed peripheral capsular tunnel avoids zonular or capsular stress. Internal wound enlargement permits foldable IOL removal in one piece, whilst preserving a self-sealing sutureless corneal wound. This technique may enhance the safety and efficacy of foldable IOL exchange. PMID:27366699
Foldable micro coils for a transponder system measuring intraocular pressure
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Ullerich, S.; Schnakenberg, U. [Technische Hochschule Aachen (Germany). Inst. of Materials in Electrical Engineering 1; Mokwa, W. [Technische Hochschule Aachen (Germany). Inst. of Materials in Electrical Engineering 1]|[Fraunhofer Inst. of Microelectronic Circuits and Systems, Duisburg (Germany); Boegel, G. vom [Fraunhofer Inst. of Microelectronic Circuits and Systems, Duisburg (Germany)
A foldable transponder system consisting of a chip and a micro coil for measuring intraocular pressure continuously is presented. The system will be integrated in the haptic of a soft artificial intraocular lens. Calculations of planar micro coils with 6 mm and 10.3 mm in diameter show the limits for planar coils with an outer diameter of 6 mm. For the realisation of the transponder system a 20 {mu}m thick coil with an outer diameter of 10.3 mm, an inner diameter of 7.7 mm, 16 turns and a gap of 20 {mu}m between the windings was selected. Measurements show a good agreement between calculated and measured values. Wireless pressure measurements were carried out showing a linear behaviour of the output signal with respect to the applied pressure. (orig.)
Intraocular lens exchange-removing the optic intact.
Lee, Matthew Hao; Webster, Diane Lesley
Current practice for intraocular lens (IOL) exchange is to cut the optic of the posterior chamber intraocular lens (PCIOL) prior to removing it. Great care must be taken during this maneuver to avoid a posterior capsular tear. Removing the haptics from the fibrosed capsule can also be hazardous, as it may result in zonular stress and dehiscence. A technique is described for performing foldable (one-piece acrylic) IOL removal without cutting the optic. Careful visco-dissection of the haptics with a low viscosity ophthalmic viscosurgical device (OVD) in the fibrosed peripheral capsular tunnel avoids zonular or capsular stress. Internal wound enlargement permits foldable IOL removal in one piece, whilst preserving a self-sealing sutureless corneal wound. This technique may enhance the safety and efficacy of foldable IOL exchange.
[Treatment of primary retinal detachment. Minimal extraocular or intraocular?].
Kreissig, I
The developments in treatment modalities for a primary retinal detachment over the last 70 years have been reviewed. There was a change from a surgery limited to the area of the break to a form of prophylactic surgery including the extent of the detachment. In between Rosengren had limited the treatment to the break with an intraocular gas bubble. A change was brought about by Custodis in 1953 who limited surgery to the break and omitted drainage. This procedure had serious postoperative complications which were eliminated by Lincoff by developing the cryosurgical detachment operation which was subsequently refined to extraocular minimal surgery. The ultimate realization of a minimal extraocular approach was the operation with a temporary balloon. Two additional intraocular procedures evolved, pneumatic retinopexy and primary vitrectomy, following one or the other pattern of treatment. With all four methods reattachment can result in 94-99% of the cases but differences can be seen in the morbidity and rate of reoperations.
Early-onset Pseudoexfoliation Syndrome following Multiple Intraocular Procedures
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Heydar Amini
Full Text Available Purpose: To present early-onset ocular manifestations of pseudoexfoliation syndrome in young patients who had undergone multiple intraocular procedures. Methods: This is an observational case series, introducing four cases with histories of multiple intraocular procedures for glaucoma. Results: All reported cases demonstrated typical manifestations of pseudoexfoliation unilaterally in the eye that had undergone multiple surgeries. The diagnosis of pseudoexfoliation was made prior to the age of 50 in all subjects and the earliest manifestation was at the age of 18 in a case with primary congenital glaucoma Conclusion: The role of multiple surgical procedures, in addition to genetic predisposition, should be further investigated as a possible inciting factor predisposing to pseudoexfoliation in younger individuals.
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Full Text Available BACKGROUND: The maintenance of intraocular pressure forms the mainstay of anesthetic management of intraocular surgery. It is desirable to achieve a normal or reduced intraocular pressure before the eye is opened to avoid expulsive hemorrhage and ocular disruption at the time of incision. Therefore the ideal anesthetic technique for intraocular surgery should produce a moderate reduction in intraocular pressure, or maintain intraocular pressure at near normal values and avoid marked fluctuations during surgery (George et al, 1979. The use of suxamethonium is associated with significant rise in intraocular pressure with a peak increase between 2 and 4 minutes following administration and return to base line value after 6 minutes. The outcome of eye surgery, particularly when there is globe injury depends to a large extent on good control of intraocular pressure not only during maintenance, but also at induction of anesthesia. This is usually achieved by use of non-depolarizing muscle relaxant. Pancuronium when used in relatively larger doses is known to have a faster onset of action and also the block may be prolonged. Vecuronium is intermediate acting and free of cardiovascular and other side effects even when used in larger doses. ABACKGROUND: The maintenance of intraocular pressure forms the mainstay of anesthetic management of intraocular surgery. It is desirable to achieve a normal or reduced intraocular pressure before the eye is opened to avoid expulsive hemorrhage and ocular disruption at the time of incision. Therefore the ideal anesthetic technique for intraocular surgery should produce a moderate reduction in intraocular pressure, or maintain intraocular pressure at near normal values and avoid marked fluctuations during surgery (George et al, 1979. The use of suxamethonium is associated with significant rise in intraocular pressure with a peak increase between 2 and 4 minutes following administration and return to base line value
Applications of polymers in intraocular drug delivery systems
Alhalafi, Ali Mohammed
We are entering a new era of ophthalmic pharmacology where new drugs are rapidly being developed for the treatment of anterior and posterior segment of the eye disease. The pharmacokinetics of drug delivery to the eye remains a very active area of ophthalmic research. Intraocular drug delivery systems allow the release of the drug, bypassing the blood-ocular barrier. The main advantage of these preparations is that they can release the drug over a long time with one single administration. These pharmaceutical systems are of great important in the treatment of the posterior segment diseases, and they can be prepared from biodegradable or nonbiodegradable polymers. Biodegradable polymers have the advantage of disappearing from the site of action after releasing the drug. The majority of intraocular devices are prepared from nonbiodegradable polymers, and they can release controlled amounts of drugs for months. Nonbiodegradable polymers include silicone, polyvinyl alcohol, and ethylene-vinyl acetate. The polymers usually employed to prepare nanoparticles for the topical ophthalmic route are poly (acrylic acid) derivatives (polyalquilcyanocrylates), albumin, poly-ε-caprolactone, and chitosan. Dendrimers are a recent class of polymeric materials with unique nanostructure which has been studied to discover their role in the delivery of therapeutics and imaging agents. Hydrogels are polymers that can swell in aqueous solvent system, and they hold the solvents in a swollen cross-linked gel for delivery. This review exhibits the current literature regarding applications of polymers in ophthalmic drug delivery systems including pharmacokinetics, advantages, disadvantages, and indications aimed to obtain successful eye therapy. Method of Literature Search: A systematic literature review was performed using PubMed databases into two steps. The first step was oriented to classification of intraocular polymers implants focusing on their advantages and disadvantages. The second
Quantification of intraocular surgery motions with an electromagnetic tracking system.
Son, Ji; Bourges, Jean-Louis; Culjat, Martin O; Nistor, Vasile; Dutson, Erik P; Carman, Gregory P; Hubschman, Jean Pierre
Motion tracking was performed during a combined phacoemulsification (PKE) and pars plana vitrectomy (PPV) procedure on a pig eyeball. The UCLA Laparoscopic Training System (UCLA-LTS), which consists of electromagnetic sensors attached to the surgical tools to measure three-dimensional spatial vectors, was modified to enable quantification of intraocular surgery motions. The range of motion and time taken to complete the given task were successfully recorded.
Applications of polymers in intraocular drug delivery systems
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Ali Mohammed Alhalafi
Full Text Available We are entering a new era of ophthalmic pharmacology where new drugs are rapidly being developed for the treatment of anterior and posterior segment of the eye disease. The pharmacokinetics of drug delivery to the eye remains a very active area of ophthalmic research. Intraocular drug delivery systems allow the release of the drug, bypassing the blood–ocular barrier. The main advantage of these preparations is that they can release the drug over a long time with one single administration. These pharmaceutical systems are of great important in the treatment of the posterior segment diseases, and they can be prepared from biodegradable or nonbiodegradable polymers. Biodegradable polymers have the advantage of disappearing from the site of action after releasing the drug. The majority of intraocular devices are prepared from nonbiodegradable polymers, and they can release controlled amounts of drugs for months. Nonbiodegradable polymers include silicone, polyvinyl alcohol, and ethylene-vinyl acetate. The polymers usually employed to prepare nanoparticles for the topical ophthalmic route are poly (acrylic acid derivatives (polyalquilcyanocrylates, albumin, poly-μ-caprolactone, and chitosan. Dendrimers are a recent class of polymeric materials with unique nanostructure which has been studied to discover their role in the delivery of therapeutics and imaging agents. Hydrogels are polymers that can swell in aqueous solvent system, and they hold the solvents in a swollen cross-linked gel for delivery. This review exhibits the current literature regarding applications of polymers in ophthalmic drug delivery systems including pharmacokinetics, advantages, disadvantages, and indications aimed to obtain successful eye therapy. Method of Literature Search: A systematic literature review was performed using PubMed databases into two steps. The first step was oriented to classification of intraocular polymers implants focusing on their advantages and
Composition of intraocular foreign bodies: experimental study of ultrasonographic presentation
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Márcio Augusto Nogueira Costa
Full Text Available PURPOSE: To investigate the reliability of ultrasound in determining the size and identify the sonographic features and artifacts generated by intraocular foreign bodies of different materials. METHODS: Experimental study using 36 enucleated porcine eyes. Fragments of nine different compositions (wood, glass, plastic, cardboard, iron, aluminum, lead, powder and concrete and similar dimensions (4 mm were implanted via scleral incision into the vitreous cavity of 36 porcine eyes, four eyes were used for each material. Ultrasound examination was performed in all eyes using the contact technique, conductive gel and 10-MHz transducer (EZScan, Sonomed. RESULTS: Considering the material fragments of gunpowder, lead, concrete, aluminum, wood and glass, the size determined by ultrasound was considered statistically similar to the actual size. The material iron presented ultrasound-determined dimension statistically smaller than its actual size. Cardboard and plastic materials showed ultrasound-determined measurements far greater than the actual. All fragments of intraocular foreign bodies demonstrated hyper-reflective interfaces, irrespective of their composition. Whereas the artifacts generated by different materials, it was found that the materials iron, aluminum and lead showed reverberation of great extent. The material wood showed no reverberation. The length of the reverberation artifact for the materials iron, glass, aluminum and cardboard was lower when compared to other materials. All materials presented posterior shadowing artifact, with the exception of aluminum. CONCLUSION: Ultrasonography was considered a reliable technique to determine the size of intraocular foreign bodies in pigs, with little influence caused by its composition. Ultrasound artifacts generated were considered material-dependent and can assist the examiner to identify the nature of a foreign body of unknown etiology. Ultrasonography aided the surgeon to identify, locate and
Validation of sensor for postoperative positioning with intraocular gas
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Brodie FL
Full Text Available Frank L Brodie,1 Kelly Y Woo,2 Ashwin Balakrishna,2 Hyuck Choo,2 Robert H Grubbs2 1Department of Ophthalmology, University of California San Francisco, San Francisco, 2Department of Medical Engineering, California Institute of Technology, Pasadena, CA, USA Purpose: Surgical repair of retinal attachment or macular hole frequently requires intraocular gas. This necessitates specific postoperative positioning to improve outcomes and avoid complications. However, patients struggle with correct positioning. We have developed a novel sensor to detect the position of the gas bubble in the eye and provide feedback to patients in real time. In this paper, we determine the specificity and sensitivity of our sensor in vitro using a model eye. Methods: We assessed the reliability of our sensor to detect when a gas bubble has deviated off a model retinal break in a model eye. Various bubble sizes representing the intraocular kinetics of sulfur hexafluoride gas and varying degrees of deviation from the correct position were tested using the sensor attached to a mannequin head with a model eye. Results: We recorded 36 data points. The sensor acted appropriately in 33 (91.7% of them. The sensor triggered the alarm every time the bubble deviated off the break (n=15, sensitivity =100%. However, it triggered the alarm (falsely 3/21 times when the bubble was correctly positioned over the retinal break (specificity =86%. Conclusion: Our device shows excellent sensitivity (100% and specificity (86% in detecting whether intraocular gas is tamponading a retinal break in a model eye. Keywords: postoperative positioning, intraocular gas, vitrectomy, retinal detachment, macular hole, pneumatic retinopexy
Visual functional changes during acute elevation of intraocular pressure
Institute of Scientific and Technical Information of China (English)
Tian-De SHOU
Glaucoma is closely related to elevation of intraocular pressure (IOP). Many studies have done on the effect of chronic elevation of IOP on the retina and optic nerve, but less attention was paid to the effect of acute elevated IOP. Here we briefly review experimental studies on functional changes of the visual system from the retina to the visual cortex under acute elevated IOP condition, which is similar to that of acute primary angle-closure glaucoma.
Intraocular gnathostomiasis: A rare case report from Central India
Rawat, Preeti; Gautam, Manushree; Jain, Nikhila C; Jain, Rajdeep
We report the first case of intraocular gnathostomiasis from Central India. A 29-year-old male from Indore, Madhya Pradesh, presented with pain and redness of the right eye since 1 month. Slit lamp examination revealed anterior uveitis, multiple iris atrophic patches, and a live worm hooked on iris. The worm was removed through a small sclerocorneal tunnel. Microscopy confirmed Gnathostoma spinigerum. The patient was treated with oral albendazole and steroids. The case is reported because of its rarity. PMID:27146938
Comparison of visual performance of multifocal intraocular lenses with same material monofocal intraocular lenses.
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Tomofusa Yamauchi
Full Text Available PURPOSE: To compare the visual performance of multifocal intraocular lenses (IOLs and monofocal IOLs made of the same material. METHODS: The subjects included patients implanted with either Tecnis® monofocal IOLs (ZA9003 or ZCB00 or Tecnis® multifocal IOLs (ZMA00 or ZMB00 bilaterally. We conducted a retrospective study comparing the two types of IOLs. The multifocal group included 46 patients who were implanted with Tecnis® multifocal IOLs bilaterally. The monofocal group was an age- and sex-matched control group, and included 85 patients who were implanted with Tecnis® monofocal IOLs bilaterally. Lens opacity grading, the radius of corneal curvature, corneal astigmatism, axial length and the refractive status were measured preoperatively. Pupil size, ocular aberrometry, distance, intermediate and near visual acuity, contrast sensitivity with and without glare and the responses to a quality-of-vision questionnaire were evaluated pre- and postoperatively. RESULTS: The uncorrected near visual acuity was significantly better in the multifocal group, whereas both the corrected intermediate and near visual acuity were better in the monofocal group. Contrast sensitivity (with and without glare was significantly better in the monofocal group. The rate of spectacle dependency was significantly lower in the multifocal group. There were no significant differences between the two groups regarding most items of the postoperative quality-of-vision questionnaire (VFQ-25, with the exception that the patients in the monofocal group reported fewer problems with nighttime driving. CONCLUSIONS: The multifocal IOLs used in this study reduced spectacle dependency more so than monofocal IOLs and did not compromise the subjective visual function, with the exception of nighttime driving.
[The efficacy of treating patients with intraocular hemorrhages with emoxypin].
Mokhammad, I; Cherkasov, I S
Emoxipin, a home-made preparation approved by the Pharmacological Committee for clinical usage in 1986, is a retinal protector. Its usage is indicated for treatment of chorioretinitis, diabetic retinopathy, thrombosis of retinal vessels as well as to protects the retina from a damaging action of light of high intensity. In order to study therapeutic effectiveness of emoxipin in intraocular hemorrhages of different genesis, the preparation was used subconjunctivally, 0.5 ml of a 1% solution daily for 10-15 days. Emoxipin was used in 29 patients (29 eyes) with intraocular hemorrhages, of them, due to contusion of the eye--in 19, hypertonic disease--in 6, thrombosis of the central retinal vein--in 2, after intraocular operations--in 2 patients. As a result of the treatment, partial or almost total resolution of hemorrhages and a rise of visual acuity of different degree were recorded in all patients. Before treatment, visual acuity was from light perception to 0.04 in 26 eyes, from 0.09 to 0.3 in 3 eyes. After treatment, it rose to 0.1-0.2 in 12 eyes, to 0.3-1.0--in 17 eyes.
Removal of Intralenticular Magnetic Foreign Bodies with Intraocular Magnet
Institute of Scientific and Technical Information of China (English)
Yiwen Luo; Zhenfang Wang; Xiaofeng Lin; Shuying Hu
Purpose: To investigate the possibility of conservation of the lens after removal of intralenticular magnetic foreign bodies with intraocular magnet.Methods: Intralenticular magnetic foreign bodies of 15 patients were removed by using an intraocular magnet. The lens of each injury eye was conserved. Follow-up observation of these cases ranged from one to four years.Results: The intralenticular magnetic foreign bodies of 15 patients were successfully removed.The lens of each injury eye was conserved and the transparence of the lens was properly maintained. Sizes of these foreign bodies were measured, ranging from 0.3 mm to 3mm in diameter. The follow-up observation showed that the corrected visual acuity of 14 cases was not changed after operation.Conclusions: The intraocular magnet is very helpful for removal of magnetic foreign bodies from the transparent lens. This magnet allows removing of the foreign body by the surgeon and no damage to the lens was induced during the operation. Thus, maintenance of visual acuity of most of the patients can be achieved.
Intraocular nematode with diffuse unilateral subacute neuroretinitis: case report
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Zakariah Sakinah
Full Text Available Abstract Background Live intraocular nematode is a rare occurrence. Nematode can migrate actively within the eye, creating visual symptoms and damaging ocular tissue. Case presentation A 26-year old man presented with painless reduced vision of the left eye for one week duration. It was associated with floaters. Visual acuity on the left eye was hand movement. Anterior segment examination was normal with normal intra-ocular pressure. Fundus examination showed a live nematode lying subretinally at the macular area with macular oedema and multifocal chorioretinal lesions at peripheral retina. There was no vitritis, vasculitis or any retinal hemorrhage. Systemic examination revealed normal findings and laboratory studies only showed leucocytosis with normal eosinophil count and negative serum toxocara antibody. The diagnosis of introcular nematode with diffuse unilateral subacute neuroretinitis was made. He was treated with oral anti-helminths and a course of oral steroid at a reducing dose. The nematode had died evidenced by its immobility during the treatment and finally disintegrated, leaving macular oedema with mottling appearance and mild hyperpigmentation. Multifocal chorioretinal lesions had also resolved. However despite treatment his visual acuity during follow-up had remained poor. Conclusions Cases of intraocular nematode, though not commonly encountered, continue to present the ophthalmologist with the problem of diagnosis and management and hence poorer prognosis to the patient.
Microscopic and spectroscopic investigation of an explanted opacified intraocular lens
Simon, V.; Radu, T.; Vulpoi, A.; Rosca, C.; Eniu, D.
The investigated polymethylmethacrylate intraocular lens explanted an year after implantation presented a fine granularity consisting of ring-like grains of about 15 μm in diameter. In order to evidence the changes occurred on intraocular lens relative to morphology, elemental composition and atomic environments, microscopic and spectroscopic analyses were carried out using scanning electron microscopy (SEM), Fourier transform infrared (FTIR), energy-dispersive X-ray (EDS), and X-ray photoelectron (XPS) spectroscopies. The results revealed that the grains contain hydroxyapatite mineral phase. A protein layer covers the lens both in opacified and transparent zones. The amide II band is like in basal epithelial cells. The shape and size of the grains, and the XPS depth profiling results indicate the possibility of a cell-mediated process involving lens epithelial cells which fagocitated apoptotic epithelial cells, and in which the debris derived from cell necrosis were calcified. To the best of our knowledge, this is the first investigation on explanted intraocular lenses using XPS depth profiling in order to examine the inside of the opacifying deposits.
Posterior chamber phakic intraocular lens implantation for high myopia
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沈晔; 杜持新; 顾扬顺; 王竞
Objective To evaluate the efficacy, safety and stability of posterior chamber phakic intraocular lens (PIOLs) implantation for the correction of high myopia.Methods Thirty-nine eyes of twenty patients with high myopia (between-11.75 and-25.75 diopters) had a posterior chamber PIOL (Staar ICL) implanted. During 6-48 months' follow-up, visual acuity, refraction, intraocular pressure (IOP), corneal reaction and space between crystal lens and intraocular lens (IOLs) were tested.Results Successful implantation was achieved in all patients. Visual acuity without correction greater than 0.5 was found in 34 eyes at 1 day and 3 months postoperatively. Thirty-five eyes maintained a low negative power of refraction (-1.42±1.32 doipters), which did not prevent the patients from most of their daily activities. During 3-48 months' follow-up, refraction was stable and no cornea edema and glaucoma was found. Two eyes of one patient had corticosteroid glaucoma and another eye showed cataractogenesis under anterior capsular membrane.Conclusion Posterior chamber PIOL implantation is predictable, safe, and effective in the correction of high myopia, and its indications should be carefully selected.
Bilateral spontaneous dislocation of posterior chamber intraocular lens in a patient with gyrate atrophy
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Michael Kinori
Full Text Available We report a patient with gyrate atrophy, a rare metabolic disease, who had bilateral late spontaneous posterior dislocation of in-the-bag posterior chamber intraocular lens (PCIOL. He underwent pars plana vitrectomy, PCIOL retrieval and anterior chamber intraocular lens implantation in both eyes. This report may imply that patients with gyrate atrophy are at risk for spontaneous dislocation of intraocular lenses.
Sutureless, Glueless, Scleral Fixation of Single-Piece and Toric Intraocular Lens: A Novel Technique.
Kelkar, Aditya; Shah, Rachana; Kelkar, Jai; Kelkar, Shreekant; Arora, Ekta
Sutureless, glueless, scleral fixation of an intraocular lens is a known technique of fixing a lens in the scleral pockets. However, this technique is applied to single-piece and toric lenses instead of 3-piece lenses, allowing the advantage of the use of premium lenses in patients with poor capsular support. Favourable results without complications of pigment dispersion, iris transillumination defects, dysphotopsia, elevated intraocular pressure, intraocular hemorrhage and cystoid macular edema with a well-centered, stable intraocular lens have been observed in the 3-month postoperative period in both cases.
Coculture with intraocular lens material-activated macrophages induces an inflammatory phenotype in lens epithelial cells.
Pintwala, Robert; Postnikoff, Cameron; Molladavoodi, Sara; Gorbet, Maud
Cataracts are the leading cause of blindness worldwide, requiring surgical implantation of an intraocular lens. Despite evidence of leukocyte ingress into the postoperative lens, few studies have investigated the leukocyte response to intraocular lens materials. A novel coculture model was developed to examine macrophage activation by hydrophilic acrylic (poly(2-hydroxyethyl methacrylate)) and hydrophobic acrylic (polymethylmethacrylate) commercial intraocular lens. The human monocytic cell line THP-1 was differentiated into macrophages and cocultured with human lens epithelial cell line (HLE-B3) with or without an intraocular lens for one, two, four, or six days. Using flow cytometry and confocal microscopy, expression of the macrophage activation marker CD54 (intercellular adhesion molecule-1) and production of reactive oxygen species via the fluorogenic probe 2',7'-dichlorodihydrofluorescein diacetate were examined in macrophages. α-Smooth muscle actin, a transdifferentiation marker, was characterized in lens epithelial cells. The poly(2-hydroxyethyl methacrylate) intraocular lens prevented adhesion but induced significant macrophage activation (p intraocular lens), while the polymethylmethacrylate intraocular lens enabled adhesion and multinucleated fusion, but induced no significant activation. Coculture with either intraocular lens increased reactive oxygen species production in macrophages after one day (p intraocular lens, with hydrophilic surfaces inducing higher activation than hydrophobic surfaces. These findings provide a new method of inquiry into uveal biocompatibility, specifically through the quantification of cell-surface markers of leukocyte activation.
Optical bench performance of a novel trifocal intraocular lens compared with a multifocal intraocular lens
Lee, Shinwook; Choi, Myoung; Xu, Zaiwei; Zhao, Zeyu; Alexander, Elsinore; Liu, Yueai
Purpose The purpose of this study is to compare the optical characteristics of the novel PanOptix presbyopia-correcting trifocal intraocular lens (IOL) and the multifocal ReSTOR +3.0 D IOL, through in vitro bench investigations. Methods The optical characteristics of AcrySof® IQ PanOptix™ (PanOptix) and AcrySof® IQ ReSTOR +3.0 D (ReSTOR +3.0 D) IOLs were evaluated by through-focus Badal images, simulated headlight images, and modulation transfer function (MTF) measurements which determine resolution, photic phenomena, and image quality. Through-focus Badal images of an Early Treatment of Diabetic Retinopathy Study chart were recorded at both photopic and mesopic pupil sizes. Simulated headlight images were taken on an MTF bench with a 50-μm pinhole target and a 5.0 mm pupil at the distance focus of the IOL. MTF curves were measured with a 3.0 mm pupil, and spatial frequencies equivalent to 20/40 and 20/20 visual acuities were recorded to illustrate the through-focus MTF curves. Far-, intermediate-, and near-focus MTF values were obtained. Results Bench Badal image testing and MTF measurements showed that PanOptix has a near focus at a distance of 42 cm and an additional intermediate focus at a distance of about 60 cm. The near focus for ReSTOR +3.0 D is at 45 cm. PanOptix and ReSTOR +3.0 D have comparable photopic distances and near MTF values. Additionally, PanOptix provided a substantial continuous range of vision from distance to intermediate and to near compared with ReSTOR +3.0 D. The halo propensity for PanOptix was slightly higher than that for ReSTOR +3.0 D. Conclusion Laboratory-based in vitro simulations showed that PanOptix trifocal IOL has comparable resolution and image quality performance in distance and near foci compared with ReSTOR +3.0 D IOL. PanOptix showed better resolution and image quality performance at the intermediate focus than ReSTOR +3.0 D IOL. PMID:27330273
Extracapsular cataract extraction : the fate of retained lens material and intraocular lenses
J.P. Kappelhof (Johan)
textabstractThe aim of this study was to examine the fate of the lens material that remains in the eye after an extracapsular cataract extraction both with and without insertion of an intraocular lens. Apart from this, the development of precipitates on the intraocular lenses was morphologically inv
Vitreoretinal Surgery for Intraocular Lens Dislocated into the Vitreous Cavity
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Dilek Özçelik Soba
Full Text Available Objectives: To investigate the sex, age, accompanying eye examination findings, and the outcomes of vitreoretinal surgery (VRS for intraocular lens (IOL dislocated into the vitreous cavity. Materials and Methods: The medical records of 30 patients who underwent VRS for IOL dislocation into the vitreous cavity were retrospectively analyzed in this study. Preoperative and postoperative visual acuity, intraocular pressure, biomicroscopic, and posterior segment examination findings were assessed. Results: The average age of the patients was 63.1 (range: 38-83 years. Twenty-one patients were male (70% and 9 patients were female (30%. As etiologic causes, 18 cases (60% had late spontaneous dislocation, 5 cases (16.6% had dislocation after phacoemulsification surgery, 4 cases (13.3% had trauma, 2 cases (6.6% had previously undergone vitrectomy, and 1 case (3.3% had undergone YAG laser capsulotomy. VRS including 23-gauge triamcinolone-assisted pars plana vitrectomy, intraocular lens extraction, posterior hyaloid membrane removing, endolaser photocoagulation, and fluid-air exchange was performed. Posterior chamber IOL implantation on to the anterior capsule in 13 cases (43.3%, anterior chamber IOL implantation in 10 cases (33.3%, and scleral fixated posterior IOL implantation in 4 cases (13.3% were performed. The corrected visual acuity recorded at the last follow-up was better than the first visit in 23 cases (76.6%, the same in 5 eyes (16.6%, and worse in 2 eyes (6.6%. Conclusion: VRS combined IOL implantation is a successful surgery method for IOL dislocated into the vitreous cavity and can avoid poor visual outcomes. (Turk J Ophthalmol 2015; 45: 56-9
Clinical analysis of suprachoroidal hemorrhage complicated by intraocular surgery
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Man-Hong Li
Full Text Available AIM:To explore clinical characteristics of supracho-roidal hemorrhage(SCHcomplicated by intraocular surgery and to observe visual prognosis. METHODS:A total of 13 eyes(13 caseswith SCH related to intraocular surgery from June 2005 to June 2015 were included and respectively studied. The age of our cases ranged from 22 to 76. Of all, 4 eyes(31%were concomitant with hypertension, 6 eyes(46%with high myopia and 6 eyes(46%with oculi hypertonia, respectively. Intraoperative expulsive SCH occurred in 8 eyes, while postoperative delayed SCH in 5 eyes. The most SCH(7 eyeshappened during the surgery of removing silicone oil, 4 eyes with SCH were related to extracapsular cataract extraction(ECCE, 1 SCH eye was complicated by ECCE combined with trabeculectomy and 1 SCH eye by lensectomy and vitrectomy. As for treatment, 5 eyes took medication alone, 4 eyes were performed drainage sclerotomy and gas tamponade, while the other 4 eyes were accomplished vitrectomy with adjunctive perfluoro-carbon liquids and silicone oil tamponade. RESULTS:At the 10-month of follow-up, all eyes with SCH were resolved. Except 1 eye with no light perception owing to abandoning treatment, the sights of the other 12 eyes were between light perception and 0.4. CONCLUSION:SCH complicated by intraocular surgery was rare but with devastating outcome. Aged patients, hypertension, high myopia and oculi hypertonia may be risk factors. In addition, surgical methods in the early years were likely correlated to the occurrence of SCH. Certain sight of the patients with SCH may be maintained after positive treatment.
UV solid state laser ablation of intraocular lenses
Apostolopoulos, A.; Lagiou, D. P.; Evangelatos, Ch.; Spyratou, E.; Bacharis, C.; Makropoulou, M.; Serafetinides, A. A.
Commercially available intraocular lenses (IOLs) are manufactured from silicone and acrylic, both rigid (e.g. PMMA) and foldable (hydrophobic or hydrophilic acrylic biomaterials), behaving different mechanical and optical properties. Recently, the use of apodizing technology to design new diffractive-refractive multifocals improved the refractive outcome of these intraocular lenses, providing good distant and near vision. There is also a major ongoing effort to refine laser refractive surgery to correct other defects besides conventional refractive errors. Using phakic IOLs to treat high myopia potentially provides better predictability and optical quality than corneal-based refractive surgery. The aim of this work was to investigate the effect of laser ablation on IOL surface shaping, by drilling circular arrays of holes, with a homemade motorized rotation stage, and scattered holes on the polymer surface. In material science, the most popular lasers used for polymer machining are the UV lasers, and, therefore, we tried in this work the 3rd and the 5th harmonic of a Q-switched Nd:YAG laser (λ=355 nm and λ=213 nm respectively). The morphology of the ablated IOL surface was examined with a scanning electron microscope (SEM, Fei - Innova Nanoscope) at various laser parameters. Quantitative measurements were performed with a contact profilometer (Dektak-150), in which a mechanical stylus scanned across the surface of gold-coated IOLs (after SEM imaging) to measure variations in surface height and, finally, the ablation rates were also mathematically simulated for depicting the possible laser ablation mechanism(s). The experimental results and the theoretical modelling of UV laser interaction with polymeric IOLs are discussed in relation with the physical (optical, mechanical and thermal) properties of the material, in addition to laser radiation parameters (laser energy fluence, number of pulses). The qualitative aspects of laser ablation at λ=213 nm reveal a
First reported case of intraocular Gnathostoma spinigerum in Cambodia.
Hem, S; Tarantola, A; Chheang, R; Nop, P; Kerléguer, A
A live intraocular nematode was identified from a 37 year-old man presented with iritis, pain, redness, lacrimation, swelling, vision loss and intermittent blindness during many hours per day of the left eye. By using slit lamp examination, a worm was removed from iris in an ophthalmology outpatient department setting and sent to the Medical Microbiology Laboratory, Institut Pasteur du Cambodge. Gnathostoma spinigerum was identified, based on its typical morphology via microscopic examination. Based on our diagnosis, the patient was treated by oral albendazole and responded well to this therapy.
Repositioning a decentered intraocular lens with 4 haptics.
Liu, Jiewei; Liu, Wenjie; Jia, Yading; Al-Mohtaseb, Zaina N; Wang, Li
We describe a technique to reposition a decentered 4-haptic intraocular lens (IOL). Using an ophthalmic viscosurgical device, the haptic with the worst distortion is dissected from the capsular bag and pulled outside the bag. The opposite haptic (180 degrees away) is also dissected and placed in front of the anterior capsule. The remaining 2 haptics are left in the capsular bag. With this repositioning, the 2 haptics in the bag limit the IOL movement, the 2 haptics outside the bag are no longer distorted, and the IOL is centered. We present 2 cases in which this technique was used to reposition decentered 4-haptic IOLs.
Effect of transscleral neodymium: YAG cyclophotocoagulation on intraocular lenses
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Blomquist, P.H.; Gross, R.L.; Koch, D.D. (Baylor College of Medicine, Houston, TX (USA))
A neodymium: YAG laser operating in the thermal mode was used to irradiate isolated intraocular lenses (IOLs) and to perform transscleral cyclophotocoagulation on pseudophakic autopsy eyes to investigate the potential damage to IOL haptics such irradiation may cause. In the isolated IOLs, 70 mJ of energy deformed and partially melted both polymethylmethacrylate (PMMA) and polypropylene haptics. One of the capsular-fixated PC-IOL haptics in an autopsy eye partially melted when irradiated with the maximum energy level (8.8 J), with the aiming beam focused 1 mm posterior to the limbus and maximal posterior focus offset.
Delayed Hyphema after Posterior Chamber Intraocular Lens Implantation
Institute of Scientific and Technical Information of China (English)
A56-year-old man with senile cataract in the left eye underwent extracapsularcataract extraction(ECCE)and posteriorchamber intraocular lens(IOL)implanta-tion on December 19,1988.A 13D J-loopplannar lens was inserted in the ciliary sul-cus.The operation was successful with mildpostoperative response.His corrected visionwas 20/20. He had a follow-up examination onMarch 20,1989.No complication was notedand his vision retained 20/20.In theevening of the same day,the patient sud-denly felt discomfortable and...
Akreos Adapt AO Intraocular Lens Opacification: A Case Report
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Matteo Forlini
Full Text Available A 79-year-old hyperglycemic patient was referred to the 'Santa Maria delle Croci' Hospital, Ravenna, Italy. He presented with visual impairment in the right eye. Four years ago, he had had an uneventful cataract surgery in the right eye. We observed an opacification of the intraocular lens (IOL causing significant visual disturbance. The IOL was exchanged. Unfortunately, pathologic analysis was not performed. Patient-related factors such as hyperglycemia and hypertension might have been responsible for the opacification. To our knowledge, there is only one previous report of opacification of the Akreos Adapt AO IOL.
Technology needs for the development of the accommodative intraocular lens
Nishi, Okihiro
Refilling the lens capsule while preserving capsular integrity offers the potential to restore ocular accommodation. There are two persisting problems in capsular bag refilling for possible clinical application: Leakage of the injectable material through the capsular opening and capsular opacification. Numerous attempts for solving these cardinal problems have not been proven to be clinically applicable. Recently, we developed a novel capsular bag refilling procedure using a novel accommodative intraocular lens that serves as an optic as well as a plug for sealing the capsular opening. The procedure and the results of monkey experiments will be presented.
Unilateral Crystalline Vitreoretinopathy: A Rare Entity Associated with Intraocular Inflammation
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Kaustubh B. Harshey
Full Text Available A 31-year-old Indian male presented with floaters and diminution of vision in the right eye. Ocular examination showed features of old anterior uveitis with posterior subcapsular cataract and fine, refractile crystals in the vitreous cavity and on the retinal surface. A thorough workup for all known causes of crystalline retinopathy was inconclusive. Unilateral crystalline retinopathy has been sparingly reported. This is the first report of unilateral, crystalline vitreoretinopathy in the absence of any demonstrable and known cause for intraocular crystals.
How to measure intraocular pressure: Schiötz tonometry
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Sue Stevens
Full Text Available If glaucoma is diagnosed early, treatment can then be given that may preserve vision. Although raised intraocular pressure (IOP is not the only sign of glaucoma, the IOP should be checked routinely on all adults attending eye care facilities. Applanation tonometry (as described in Issue 64, December 2007 is the most accurate method to measure IOP, but Schiötz tonometry is also a useful screening test. If Schiötz tonometry reveals a high IOP, this result should be checked and confirmed by applanation tonometry and the patient referred to the senior clinician at the eye clinic.
Risk factors for intraocular penetration of caterpillar hair in Ophthalmia Nodosa: A retrospective analysis
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Sengupta Sabyasachi
Full Text Available We report risk factors associated with intraocular penetration of caterpillar hair seen at our institute from January 2005 to December 2007. Records of all patients with caterpillar hair induced ophthalmitis (CHIO were retrospectively reviewed for clinical characteristics, anatomic location of lodgment of the caterpillar hair, treatment methods, and outcomes. Out of a total of 544 cases of CHIO, 19 eyes (seven in the anterior chamber and 12 in the posterior segment experienced intraocular penetration (3.5%. The presence of deep intracorneal hair (80 cases, 14.7% was found to be the only risk factor for intraocular penetration ( P < 0.001. The removal of intracorneal hair was possible in only 29 out of 80 eyes (36% and this was associated with a significantly reduced risk of intraocular penetration ( P = 0.022. Patients with retained intracorneal hairs should be counseled regarding risk of intraocular penetration and closely followed up for at least six months.
Pigment dispersion syndrome associated with intraocular lens implantation: a new surgical technique
Jordana, M Isabel Canut; Formigó, Daniel Pérez; González, Rodrigo Abreu; Reus, Jeroni Nadal
Aims We report the case of a myopic patient who, after intraocular lens transplant in the posterior chamber, suffered elevated intraocular pressure due to pigment dispersion, with recurrent episodes of blurred vision. The patient was treated with a new surgical technique that can avoid potential iridolenticular contact. Methods Complete ophthalmologic examination and optical coherence tomography (OCT) of the anterior segment were performed. Results Contact between the pigmentary epithelium and the iris with an intraocular lens was revealed by utrasound biomicroscopy and OCT. In this case, Nd:YAG laser iridotomy and laser iridoplasty were not effective for iridolenticular separation and control of the pigment dispersion. We propose a new technique: stitches on the surface of the iris to obtain good iridolenticular separation and good intraocular pressure control. Conclusion Stitches on the iris surface should be considered as optional therapy in pigmentary glaucoma secondary to intraocular lens implantation. This surgical technique can avoid potential iridolenticular contacts more definitively. PMID:21151331
Ultrasound Biomicroscopy of Iris-claw Phakic Intraocular Lens Implantation
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Ayong Yu; Zhende Lin; Xiaoyu Cai; Xiuqi Chen; Shuke Luo; Yonghua Li
Purpose: To study in situ the intraocular position of iris-claw phakic intraocular lens (ICPIOL) in myopic eyes using ultrasound biomicroscopy (UBM).Methods: UBM echograms of the anterior segment were taken preoperatively and 62to 115 days postoperatively in 6 eyes implanted with the Verisys ICPIOL (AMO). The echograms were assessed for the effect of the ICPIOL on iris tissue.Results: The preoperative distance between the corneal endothelium and the lens ranged from 2.96 to 3.09 mm, and the postoperative distance between the ICPIOL and the corneal endothelium, from 1.86 to 2.03 mm. The distance between the lens and the posterior surface of the ICPIOL ranged from 0.61 to 0.76 mm. The distance between the superior, inferior optic edge and the iris ranged from 0.49 to 1.00 mm,0.21 to 0.51 mm respectively. The shortest distance between the ICPIOL haptics and the angle of anterior chamber ranged from 1.25 to 1.65 mm. The indentation of iris tissue by the ICPIOL haptics without pigmentary dispersion and distortion of posterior curvature of iris was observed.Conclusion: Adequate space is maintained between the Verisyse myopic ICPIOL and the corneal endothelium, angle, and crystalline lens. Haptic indentation of the iris without pigment erosion and distortion of iris curvature is noted. The ICPIOL implanted in phakic eyes is a safe alternative for treatment of high myopia.
Intraocular lenses and clinical treatment in paediatric cataract
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Camila Ribeiro Koch Pena
Full Text Available Pediatric cataract is the most common treatable cause of blindness in children. Prevalence, etiology and morphology vary with the socioeconomic development. The treatment goal is to reduce amblyopia, being difficult management especially in unilateral cases. The decision on aphakia or primary intraocular lens should be individualized as well as correction with contact lens or spectacles. The intraocular lens single-piece hydrophobic acrylic are the most implanted in children and the preferably is in the capsular bag. The Sanders-Retzlaff-Kraff theoretic (SRK/T stressing that is described as more predictable, following Holladay I and SRK II and the recommendation is to under correction +6.0 or +8.0 dioptrias expecting the growth of the eye. The posterior capsule opacity is the most frequent complication and varies with the material choice of the lens. Glaucoma is the most serious postoperative complication and depends on the timing of the surgery, primary lens implantation and time of post surgical follow-up. The adherence to occlusion therapy with patching is critical to the visual prognosis and is determined by the child's age and laterality of the cataract. There was significant improvement in the surgery and in IOLs, however the final visual prognosis is still not desirable.
Biomechanics of Schlemm's canal endothelium and intraocular pressure reduction.
Stamer, W Daniel; Braakman, Sietse T; Zhou, Enhua H; Ethier, C Ross; Fredberg, Jeffrey J; Overby, Darryl R; Johnson, Mark
Ocular hypertension in glaucoma develops due to age-related cellular dysfunction in the conventional outflow tract, resulting in increased resistance to aqueous humor outflow. Two cell types, trabecular meshwork (TM) and Schlemm's canal (SC) endothelia, interact in the juxtacanalicular tissue (JCT) region of the conventional outflow tract to regulate outflow resistance. Unlike endothelial cells lining the systemic vasculature, endothelial cells lining the inner wall of SC support a transcellular pressure gradient in the basal to apical direction, thus acting to push the cells off their basal lamina. The resulting biomechanical strain in SC cells is quite large and is likely to be an important determinant of endothelial barrier function, outflow resistance and intraocular pressure. This review summarizes recent work demonstrating how biomechanical properties of SC cells impact glaucoma. SC cells are highly contractile, and such contraction greatly increases cell stiffness. Elevated cell stiffness in glaucoma may reduce the strain experienced by SC cells, decrease the propensity of SC cells to form pores, and thus impair the egress of aqueous humor from the eye. Furthermore, SC cells are sensitive to the stiffness of their local mechanical microenvironment, altering their own cell stiffness and modulating gene expression in response. Significantly, glaucomatous SC cells appear to be hyper-responsive to substrate stiffness. Thus, evidence suggests that targeting the material properties of SC cells will have therapeutic benefits for lowering intraocular pressure in glaucoma.
Posterior Iris Fixated Intraocular Lens for Pediatric Traumatic Cataract
Kavitha, V.; Balasubramanian, Preethi; Heralgi, Mallikarjun M.
Purpose: To evaluate the postoperative visual outcomes and complications of posterior iris fixated intraocular lens (IFIOL) implantation for pediatric traumatic cataract. Methods: A retrospective clinical audit was performed of all the pediatric traumatic cataract patients who underwent lens removal and iris fixated lens implantation due to inadequate capsular support with or without corneal tear repair between January 2009 and December 2013. Data were collected and analyzed on the preoperative and postoperative visual outcomes and complications. Results: Twenty-five children (25 eyes; 21 males and 4 females) were enrolled with the mean age of 11 ± 4.0 years. There were 72% of eyes that underwent primary cataract removal with IFIOL implantation. Twenty-eight percent of eyes underwent corneal tear repair prior to intraocular lens (IOL) implantation. Preoperative best corrected visual acuity (BCVA) was hand motion in 32% eyes, counting fingers in 24%, and perception of light in 44%. Postoperative BCVA of 0-0.2 logarithm of minimum angle of resolution was reported in the 64% of eyes. One eye developed secondary glaucoma, one eye underwent re-enclavation, and none developed retinal complications. Conclusion: Posterior IFIOL implantation resulted in an improved visual outcome, low incidence of postoperative complications, and is a good alternative to other IOL, in the cases of pediatric traumatic cataract without adequate capsular support. PMID:27162456
Analyses of ERG in a patient with intraocular lymphoma
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Chieko Yasuda
Full Text Available Chieko Yasuda, Shinji Ueno, Mineo Kondo, Nagako Kondo, Chang-Hua Piao, Hiroko TerasakiDepartment of Ophthalmology, Nagoya University School of Medicine, Nagoya, JapanPurpose: To follow the changes in the electroretinograms (ERGs in a patient with primary intraocular lymphoma (PIOL who had a complete remission after chemotherapy. Methods: ERGs were recorded in a 41-year-old woman with PIOL during and after complete remission with chemotherapy. The patient was diagnosed with PIOL from both the ocular signs and the medical history of cranial lymphoma.Results: The ERGs were depressed in the subject. The amplitudes of the bright white flash b-waves were smaller than the a-waves, resulting in a "negative type" ERG. Six weeks after the beginning of chemotherapy, the ocular changes had resolved, and the ERGs, although not of the "negative type", still showed signs that the amplitude had not returned to normal levels.Conclusion: The negative type ERGs indicated that the inner retina had been damaged to a greater extent than the outer retina. In the convalescent stage, when the ocular manifestations were resolved, the ERGs were still not fully recovered. Although only one case was studied, we suggest that ERGs can be used to evaluate and follow patients with a PIOL.Keywords: electroretinogram, primary intraocular lymphoma, uveitis masquerade syndrome
Multifocal Toric Intraocular Lens for Traumatic Cataract in a Child
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Yanfeng Zeng
Full Text Available A child suffering from traumatic cataract and corneal astigmatism of 2.14 D had a phacoemulsification operation and implantation of a ReSTOR Toric intraocular lens (IOL to correct the astigmatism. The primary outcome measurements were the uncorrected distance visual acuity (UDVA, uncorrected near vision at 40 cm, intraocular pressure, spherical equivalent refraction, residual astigmatism, corneal astigmatism, presence of unusual optical phenomena, and use of spectacles. At 7 months postoperatively, UDVA was maintained between 16/20 and 24/20, near vision was between J1 and J3, residual spherical refraction was 0–0.37 D, and residual refractive cylinder was between 0 and 0.67 D. A multifocal toric IOL can provide the possibility of satisfactory vision for both distant and near conditions without the use of spectacles to meet children's needs when studying and doing sports. Additionally, binocular vision can be reconstructed. This intervention, therefore, seems to be a satisfactory alternative.
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Rekha R.
Full Text Available AIM To investigate the amount of intraocular pressure asymmetry between fellow eyes in patients with and without primary open angle glaucoma. MATERIALS AND METHODS This was a retrospective case control study conducted at a tertiary care hospital of Central India. A single pre-treatment IOP of the primary open angle glaucoma patients was recorded from the Glaucoma Clinic data from Jan 2013 to Dec 2013. The inter-eye IOP asymmetry of these cases was compared with normal subjects without primary open angle glaucoma (POAG. RESULTS There were 84 (POAG glaucoma patients and 168 control subjects in the study. It was observed that 23.8% patients suffering from glaucoma had an asymmetry of 2 mmHg while 20.23% had no asymmetry. Asymmetry as high as >20 mmHg was also seen in glaucomatous patients. Intraocular pressure asymmetry was a significant factor for having glaucoma (Odds ratio, 18.89%; P<0.001. CONCLUSION Inter-eye asymmetry of IOP is a common finding in patients with POAG. There is a direct relationship between the amount of IOP asymmetry between the fellow eyes and the likelihood of having glaucoma.
Diffractive multifocal intraocular lens interferes with intraoperative view
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Mami Yoshino
Full Text Available Mami Yoshino1, Makoto Inoue1,2, Nae Kitamura1, Hiroko Bissen-Miyajima11Department of Ophthalmology, Tokyo Dental College Suidobashi Hospital, Tokyo, Japan; 2Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, JapanAbstract: We report an unusual finding during vitreous surgery in an eye implanted with a diffractive multifocal intraocular lens (IOL. A 70-year-old woman reported gradual visual deterioration to 20/40 in the left eye two and a half years after uneventful cataract surgery with implantation of a diffractive multifocal IOL. Funduscopic examination showed an epiretinal membrane (ERM in the left eye. Increased macular traction was believed to cause the visual deterioration. Vitreous surgery with removal of the ERM was performed and triamcinolone acetonide (TA was injected intravitreally to visualize the residual vitreous cortex. Although the ERM was peeled successfully, the ability to focus on the vitreoretinal interface through the IOL required great effort with decreased contrast sensitivity and ghost images of the intravitreal TA crystals. The vision improved to 20/25 4 months postoperatively. Macular surgery can be performed in an eye with a diffractive multifocal IOL; however, decreased contrast sensitivity and ghost images may interfere with the intraoperative view through the diffractive IOL in complicated cases.Keywords: diffractive multifocal intraocular lens, intraoperative view
An examination of the hypothesis that intraocular pressure elevation episodes can have prognostic significance in glaucoma suspects.
McMonnies, Charles
The efficacy of intraocular pressure reduction in retarding the progression of glaucoma has been demonstrated. This review examines the potential for prognostic advantage for glaucoma suspects in reducing their optic nerve head exposure to elevated intraocular pressure associated with activities which have been shown to elevate intraocular pressure. In this observational study, patients examined at the Centre for Eye Health (University of New South Wales) with a diagnosis of glaucoma suspect were surveyed to determine their histories for participation in activities which are known to elevate intraocular pressure. The evidence regarding the pathological significance of these sources of elevation in susceptible patients was examined. Apart from the universality of sleep-related intraocular pressure elevations, the histories from 183 confirmed glaucoma suspects indicate a wide range and variation in frequency of participation in other intraocular pressure elevating activities. A reduction in exposure to elevated intraocular pressure may improve the prognosis for glaucoma suspects. Additional patient specific assessment of the results of this screening could provide an indication of the degree (frequency, intensity level and duration) of exposure to elevated intraocular pressure. Such information may provide the basis for improving a patient's prognosis by helping them to identify opportunities to reduce such exposure to elevated intraocular pressure. Any benefit of reduction of such exposure appears likely to be greater if activities which elevate intraocular pressure are of long duration, occur frequently, occur over a long period of time, and/or involve high levels of intraocular pressure elevation.
Survey of Intraocular Antibiotics Prophylaxis Practice after Open Globe Injury in China.
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Bingsheng Lou
Full Text Available To elucidate the Chinese practice of intraocular antibiotics administration for prophylaxis after open globe injury.A cross-sectional questionnaire survey was performed online by scanning a Quickmark (QR code with smartphones at the 20th Chinese National Conference of Ocular Trauma in November 2014.A total of 153 (30.6% of all participators at the conference responded. Of the respondents, 20.9% were routinely administered with prophylactic intraocular injection of antibiotics at the conclusion of the primary eye repair, and 56.9% were used only in cases with high risk of endophthalmitis development. The intraocular route of delivery was mainly included with intracameral injection (47.9% and intravitreal injection (42.0%. Cephalosporins (53.8% and vancomycin (42.0% were the main choices of antibiotic agents, followed by fluoroquinolones (24.3%, and aminoglycosides (13.4%. Only 21.9% preferred a combination of two or more two drugs routinely. In addition, significantly more respondents from the referral eye hospital (92.7% replied using intraocular antibiotics injection for prophylaxis compared to those respondents from the primary hospital (69.4% (p = 0.001, Fisher's exact test.Intraocular antibiotics injection for post-traumatic endophthalmitis prophylaxis is widely used in China. However, the choice of antibiotic agents and the intraocular route of delivery vary. A well-designed clinical trial is needed to establish a standardized protocol of intraocular antibiotics administration for post-traumatic endophthalmitis prophylaxis.
Professor Peter Choyce: an early pioneer of intraocular lenses and corneal/refractive surgery.
Pandey, Suresh K; Apple, David J
Professor Peter Choyce, FRCS, DOMS, MS, was one of the pioneers of intraocular lens implant surgery. He developed an interest in artificial lens implantation following cataract surgery, a procedure that was widely criticized by the ophthalmic establishment in the UK, Europe, North America and other countries. Owing to the opposition to the intraocular lenses, Peter Choyce together with Sir Harold Ridley co-founded the International Intraocular Implant Club in 1966, which was responsible for the gradual acceptance of artificial lens implantation. Peter Choyce developed several models of intraocular lens, but did not patent the majority of them. The Choyce Mark IX, manufactured by Rayner Intraocular Lenses, became the first US Food and Drug Administration-approved intraocular lens in 1981. A review of Peter Choyce's record confirms a significant number of original innovations in the field of anterior segment surgery, including many procedures taken for granted today, but not associated with his name. These include early work on both kerato- and intraocular lens-refractive procedures, keratoprosthesis, pioneering paediatric implant procedures and others. Unfortunately his tenacious adherence to anterior chamber lens technology, while in general clinically sound, caused many to question his influence and hence he remained poorly understood even until after his death. He passed away on 8 August 2001 after a long fight with colon cancer. In this article, we provide evidence and elaborate Peter Choyce's accomplishments, which places him as one of the most innovative ophthalmologist in his surgical field in the twentieth century.
Immediate effect of intravitreal injection of bevacizumab on intraocular pressure
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Lemos-Reis R
Full Text Available Ricardo Lemos-Reis,1 Nuno Moreira-Gonçalves,1 António B Melo,1 Ângela M Carneiro,1,2 Fernando M Falcão-Reis1,2 1Department of Ophthalmology of Hospital de São João, Porto, Portugal; 2Department of Sense Organs, Faculty of Medicine, University of Porto, Porto, Portugal Purpose: To investigate the immediate effect of intravitreal injection of bevacizumab on intraocular pressure (IOP. Methods: This was a prospective and nonrandomized study. A total of 291 eyes with macular edema or active choroidal neovascularization were submitted to a single 1.25 mg (0.05 mL bevacizumab intravitreal injection. Intraocular pressure was measured with an Icare® tonometer immediately before and after injection in a seated position. The presence of subconjunctival reflux was recorded. The fellow eye served as the control.Results: Mean preoperative IOP was 18.0±5.9 mmHg in the treated eye versus 16.9±6.0 mmHg in the fellow eye. Mean postoperative IOP was 42.1±14.5 mmHg in the treated eye versus 17.5±6.0 mmHg in the fellow eye. The IOP variation was statistically significant in both cases and controls (P<0.001 and P=0.003, respectively, and this increase was higher in cases than in controls (P<0.001. Postoperative IOPs higher than 50 mmHg were achieved in 32.0% of the eyes. Subconjunctival reflux was present in 21.3% and determined a lower IOP rise (P<0.001. Tested variables (glaucoma, phakic status, and sex did not have a statistically significant effect on IOP rise or subconjunctival reflux. Conclusion: IOP increases with intravitreal bevacizumab injection, reaching 50 mmHg or more in about one third of patients. A higher IOP is expected if no subconjunctival reflux occurs. The baseline IOP does not influence the incidence of subconjunctival reflux. The clinical relevance of these facts has yet to be clarified. Keywords: bevacizumab, intraocular pressure, intravitreal injection, Icare®
Results of Iris-Claw Intraocular Lens Implantation in Aphakia
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Mehmet Tahir Şam
Full Text Available Objectives: To evaluate the visual outcomes and complications of iris-claw intraocular lenses (ICIOL implanted in cases of aphakia or in cataract surgery with insufficient capsule support. Material and Method: In this retrospective study, we reviewed the medical records of 34 eyes of 34 patients who had undergone ICIOL implantation with a minimum follow-up of 12 months in Bucak State Hospital and in a private hospital between November 2007 and November 2012. Results: Twenty-one eyes with complicated cataract accompanied by zonular deficiency, 8 eyes with aphakia, and 5 eyes with dislocated IOL were operated and ICIOL implanted. Mean preoperative BCVA was 1.46±1.05 LogMAR and postoperative BCVA was 0.20±0.21 LogMAR. There was an improvement in visual acuity in 31 eyes of the 34 patients, and 29 of them had a visual acuity better than 6/12 postoperatively. Mean postoperative spherical equivalent (SE was -0.76±0.94 D, and deviation from estimated SE was -0.26±0.94 D. Mean preoperative astigmatism was -1.36±0.77 Cyl D and mean postoperative astigmatism was -0.98±0.82 Cyl D. In second postoperative month, one case had a pupillary block glaucoma due to the closure of peripheral iridotomy, and after ND-YAG laser treatment, intraocular pressure return to normal value. One eye had iris pigment precipitates on the ICIOL in early postoperative period, and in one case, there was a pupillary ovalization. Three months after a cataract surgery, retinal detachment developed in one eye of a patient who had a history of severe ocular trauma; anterior vitrectomy and ICIOL implantation were performed. Visual acuity remained unchanged after a successful pars plana vitrectomy operation. Conclusion: Iris-claw lenses provide fairly good visual outcomes in aphakic eyes without capsular support and in challenging cataract cases with zonular deficiency. They are safe regarding complications when compared to other alternative intraocular lens implantation methods
Optical quality of toric intraocular lens implantation in cataract surgery
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Xian-Wen; Xiao; Jing; Hao; Hong; Zhang; Fang; Tian
AIM: To analyze the optical quality after implantation of toric intraocular lens with optical quality analysis system.METHODS: Fifty-two eyes of forty-four patients with regular corneal astigmatism of at least 1.00 D underwent implantation of Acry Sof toric intraocular lens, including T3 group 19 eyes, T4 group 18 eyes, T5 group 10 eyes,T6 group 5 eyes. Main outcomes evaluated at 3mo of follow-up, included uncorrected distance visual acuity(UDVA), corrected distance visual acuity(CDVA), residual refractive cylinder and intraocular lens(IOL) axis rotation.Objective optical quality were measured using optical quality analysis system(OQAS Ⅱ, Visiometrics, Spain),included the cutoff frequency of modulation transfer function(MTFcutoff), objective scattering index(OSI),Strehl ratio, optical quality analysis system value(OV)100%, OV 20% and OV 9% [the optical quality analysis system(OQAS) values at contrasts of 100%, 20%, and 9%].RESULTS: At 3mo postoperative, the mean UDVA and CDVA was 0.18 ±0.11 and 0.07 ±0.08 log MAR; the mean residual refractive cylinder was 0.50 ±0.29 D; the mean toric IOL axis rotation was 3.62 ±1.76 degrees, the mean MTFcutoff, OSI, Strehl ratio, OV 100%, OV 20% and OV9% were 22.862 ±5.584, 1.80 ±0.84, 0.155 ±0.038, 0.76 ±0.18,0.77±0.19 and 0.78±0.21. The values of UDVA, CDVA, IOL axis rotation, MTFcutoff, OSI, Strehl ratio, OV100%,OV20% and OV9% depending on the power of the cylinder of the implantation were not significantly different(P >0.05), except the residual refractive cylinder(P <0.05).CONCLUSION: The optical quality analysis system was useful for characterizing the optical quality of Acry Sof toric IOL implantation. Implantation of an Acry Sof toric IOL is an effective and safe method to correct corneal astigmatism during cataract surgery.
Magnetic resonance imaging diagnosis of intraocular lenses. Die kernspintomographische Diagnostik der Hinterkammerlinse
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Tosch, U. (Strahlenklinik und Poliklinik, Universitaetsklinik Rudolf Virchow, Berlin (Germany)); Bleckmann, H. (Strahlenklinik und Poliklinik, Universitaetsklinik Rudolf Virchow, Berlin (Germany)); Kaczmarek, U. (Strahlenklinik und Poliklinik, Universitaetsklinik Rudolf Virchow, Berlin (Germany))
Intraocular lenses were investigated by MRI to obtain information about the quality of this method. In experimental studies, seven lenses of between 0 and 30 diopters were visualized. By MRI it was possible to differentiate the various diameters of lenses. It was not possible to discriminate the material of the intraocular lenses. After these first studies the eyes of two corpses and eight patients were investigated. Because of the resolution of MRI it was possible to tell the diopter of implanted lenses. However, by use of MRI in the regular position, a tilting or decentration of the intraocular lens was demonstrated. (orig.)
Bionic intraocular lens with variable focus and integrated structure
Liang, Dan; Wang, Xuan-Yin; Du, Jia-Wei; Xiang, Ke
This paper proposes a bionic accommodating intraocular lens (IOL) for ophthalmic surgery. The designed lens has a solid-liquid mixed integrated structure, which mainly consists of a support ring, elastic membrane, rigid lens, and optical liquid. The lens focus can be adjusted through the deformation of the lens front surface when compressed. The integrated structure of the IOL is presented, as well as a detailed description of the lens materials and fabrication process. Images under different radial pressures are captured, and the lens deformation process, accommodating range, density, and optical property are analyzed. The designed lens achieves a 14.6 D accommodating range under a radial pressure of 51.4 mN and a 0.24 mm alteration of the lens outer radius. The deformation property of the lens matches well with the characteristic of the eye and shows the potential to help patients fully recover their vision accommodation ability after the cataract surgery.
The accute effects of resistance exercise on intraocular pressure
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Vieira Geraldo Magela
Full Text Available PURPOSE: To study intraocular pressure (IOP variations in healthy volunteers after weight lifting, in the supine position. METHODS: A descriptive study was designed. Thirty-four individuals were preselected for this study, and a group of 25 volunteers fulfilled the inclusion criteria for joining the initial phase of this research. All of them were healthy without glaucoma. They were asked to lift an 85% top load in the supine position for 8 times. IOP was measured before and after the exercise. Student's t test was used to analyze the IOP variations. RESULTS: A small, but significant IOP decrease (1.61 mmHg was obtained after exposing 25 individuals (49 eyes to a specific physical effort. CONCLUSIONS: After a session of weight lifting in the supine position with 85% top load for 8 repetitions, there is a small, but significant IOP decrease.
Opacificação tardia de lente intra-ocular de polimetilmetacrilato (PMMA: relato de caso Late opacification of a polymethylmethacrylate (PMMA intraocular lens: case report
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Otacílio de Oliveira Maia Júnior
Full Text Available O implante das lentes intra-oculares foi grande avanço na reabilitação visual de pacientes submetidos à cirurgia de extração da catarata. Contudo, os materiais utilizados na fabricação destas lentes, apesar de terem boa biocompatibilidade, são passíveis de alterações posteriores ao implante. No presente estudo, os autores relatam um caso raro de opacificação tardia de lente de polimetilmetacrilato, material inerte e bem tolerado intra-ocularmente, discutindo aspectos importantes no manejo desta complicação, bem como indicação de explante e substituição da lente.The use of intraocular lenses was a great advance in visual recovery after cataract surgery. Although usually with good biocompatibility, some alterations in the intraocular lens material may occur after implantation. Polymethylmethacrylate was the first intraocular lens material to be used on a large scale and assumed to be inert and well-tolerated. We present a rare case of late opacification of a polymethylmethacrylate lens, discussing important aspects of its management such as the indication for intraocular lens exchange.
Intraocular penetration of sequentially instilled topical moxifloxacin, gatifloxacin, and levofloxacin
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Koji Sugioka
Full Text Available Koji Sugioka1, Masahiko Fukuda1, Shohei Komoto1, Motoki Itahashi1, Masakazu Yamada2, Yoshikazu Shimomura11Department of Ophthalmology, Kinki University School of Medicine, Osaka-Sayama City, Osaka, Japan; 2Division for Vision Research, National Institute of Sensory Organs, National Tokyo Medical Center, Tokyo, JapanPurpose: The objective of the study was to compare the intraocular penetration levels of the newer fluoroquinolones, moxifloxacin, gatifloxacin, and levofloxacin in the rabbit's cornea, aqueous humor, and conjunctiva after topical instillation.Methods: 0.5% moxifloxacin, 0.3% gatifloxacin, and 0.5% levofloxacin were instilled in random sequence in both eyes of nine New Zealand White rabbits at two-minute intervals. Instillation was repeated every 15 minutes for a total of three drops of each fluoroquinolone per eye. Three additional animals had only moxifloxacin instilled bilaterally using the same schedule. Sixty minutes after the final instillation, the rabbits were sacrificed for determination of corneal, aqueous humor, and conjunctival fluoroquinolone concentrations using highperformance liquid chromatography.Results: Moxifloxacin achieved significantly higher concentrations than levofloxacin and gatifloxacin in the cornea (P = 0.0102 and P = 0.0006, respectively, aqueous humor (P = 0.0015 and P < 0.0001, respectively, and conjunctiva (P = 0.0191 and P = 0.0236, respectively. Conclusions: 0.5% moxifloxacin eyedrops provided superior intraocular penetration in rabbits' eyes compared with the two other fluoroquinolones, 0.5% levofloxacin and 0.3% gatifloxacin.Keywords: fluoroquinolone, gatifloxacin, levofloxacin, moxifloxacin, penetration, rabbit
Design of a Test Bench for Intraocular Lens Optical Characterization
Alba-Bueno, Francisco; Vega, Fidel; Millán, María S.
The crystalline lens is the responsible for focusing at different distances (accommodation) in the human eye. This organ grows throughout life increasing in size and rigidity. Moreover, due this growth it loses transparency through life, and becomes gradually opacified causing what is known as cataracts. Cataract is the most common cause of visual loss in the world. At present, this visual loss is recoverable by surgery in which the opacified lens is destroyed (phacoemulsification) and replaced by the implantation of an intraocular lens (IOL). If the IOL implanted is mono-focal the patient loses its natural capacity of accommodation, and as a consequence they would depend on an external optic correction to focus at different distances. In order to avoid this dependency, multifocal IOLs designs have been developed. The multi-focality can be achieved by using either, a refractive surface with different radii of curvature (refractive IOLs) or incorporating a diffractive surface (diffractive IOLs). To analyze the optical quality of IOLs it is necessary to test them in an optical bench that agrees with the ISO119679-2 1999 standard (Ophthalmic implants. Intraocular lenses. Part 2. Optical Properties and Test Methods). In addition to analyze the IOLs according to the ISO standard, we have designed an optical bench that allows us to simulate the conditions of a real human eye. To do that, we will use artificial corneas with different amounts of optical aberrations and several illumination sources with different spectral distributions. Moreover, the design of the test bench includes the possibility of testing the IOLs under off-axis conditions as well as in the presence of decentration and/or tilt. Finally, the optical imaging quality of the IOLs is assessed by using common metrics like the Modulation Transfer Function (MTF), the Point Spread Function (PSF) and/or the Strehl ratio (SR), or via registration of the IOL's wavefront with a Hartmann-Shack sensor and its
Design of a Test Bench for Intraocular Lens Optical Characterization
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Alba-Bueno, Francisco; Vega, Fidel; Millan, Maria S, E-mail: firstname.lastname@example.com, E-mail: email@example.com, E-mail: email@example.com [Departamento de Optica y Optometria, Universidad Politecnica de Cataluna, C/ Violinista Vellsola 37, 08222 Terrassa (Spain)
The crystalline lens is the responsible for focusing at different distances (accommodation) in the human eye. This organ grows throughout life increasing in size and rigidity. Moreover, due this growth it loses transparency through life, and becomes gradually opacified causing what is known as cataracts. Cataract is the most common cause of visual loss in the world. At present, this visual loss is recoverable by surgery in which the opacified lens is destroyed (phacoemulsification) and replaced by the implantation of an intraocular lens (IOL). If the IOL implanted is mono-focal the patient loses its natural capacity of accommodation, and as a consequence they would depend on an external optic correction to focus at different distances. In order to avoid this dependency, multifocal IOLs designs have been developed. The multi-focality can be achieved by using either, a refractive surface with different radii of curvature (refractive IOLs) or incorporating a diffractive surface (diffractive IOLs). To analyze the optical quality of IOLs it is necessary to test them in an optical bench that agrees with the ISO119679-2 1999 standard (Ophthalmic implants. Intraocular lenses. Part 2. Optical Properties and Test Methods). In addition to analyze the IOLs according to the ISO standard, we have designed an optical bench that allows us to simulate the conditions of a real human eye. To do that, we will use artificial corneas with different amounts of optical aberrations and several illumination sources with different spectral distributions. Moreover, the design of the test bench includes the possibility of testing the IOLs under off-axis conditions as well as in the presence of decentration and/or tilt. Finally, the optical imaging quality of the IOLs is assessed by using common metrics like the Modulation Transfer Function (MTF), the Point Spread Function (PSF) and/or the Strehl ratio (SR), or via registration of the IOL's wavefront with a Hartmann-Shack sensor and its
A previsibilidade biométrica nas lentes intra-oculares multifocais Biometric predictability in multifocal intraocular lens
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Augusto Cézar Lacava
Full Text Available OBJETIVO: Apresentar a previsibilidade biométrica, avaliando a refração pós-operatória e acuidade visual (AV, em olhos submetidos a implante de lente intra-ocular multifocal. MÉTODOS: Estudo retrospectivo em 88 olhos de 50 pacientes, submetidos à facoemulsificação com implante de lentes multifocais, de três marcas comerciais ReSTOR, ReZoom e Tecnis. No exame biométrico foram utilizados a biometria óptica ou biometria por interferometria de baixa coerência, associada ao uso de tomógrafo de segmento anterior e à fórmula biométrica Holladay II. Com a refração pós-operatória, acuidade visual e a dioptria da LIO implantada, segundo a fórmula Holladay II, calculamos o valor da lente intra-ocular (LIO a ser implantada caso utilizássemos as fórmulas SRKT e Haigis. Os resultados foram avaliados por métodos estatísticos. RESULTADOS: Todos os olhos obtiveram AV igual ou maior a 20/40 e J3 sem correção. As fórmulas Holladay II, SRKT e Haigis apresentaram performance semelhante em todos os grupos de olhos. CONCLUSÃO: A utilização de novas tecnologias, como a biometria óptica e fórmulas de última geração, favorecem a obtenção do resultado refracional almejado com grande previsibilidade.PURPOSE: To present biometric predictability, evaluating postoperative refraction and visual acuity in eyes submitted to multifocal intraocular lens implantation. METHODS: Retrospective study in 88 eyes of 50 patients, submitted to phacoemulsification with multifocal lens implant of three commercial brands: ReSTOR, ReZoom and Tecnis. For biometric examination were used: optic biometry associated to the use of tomography of anterior segment and Holladay II biometric formula. With postoperative refraction, visual acuity and implanted IOL, according to Holladay II formula, we calculated the value of IOL to be implanted in case we used SRKT and Haigis formulas. The results were evaluated according to statistical methods. RESULTS: All eyes
Posterior Segment Intraocular Foreign Body: Extraction Surgical Techniques, Timing, and Indications for Vitrectomy
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Dante A. Guevara-Villarreal
Full Text Available Ocular penetrating injury with Intraocular Foreign Body (IOFB is a common form of ocular injury. Several techniques to remove IOFB have been reported by different authors. The aim of this publication is to review different timing and surgical techniques related to the extraction of IOFB. Material and Methods. A PubMed search on "Extraction of Intraocular Foreign Body," "Timing for Surgery Intraocular Foreign Body," and "Surgical Technique Intraocular Foreign Body" was made. Results. Potential advantages of immediate and delayed IOFB removal have been reported with different results. Several techniques to remove IOFB have been reported by different authors with good results. Conclusion. The most important factor at the time to perform IOFB extraction is the experience of the surgeon.
The Experimental Study on Implantation of Intraocular Lens in Different Animals
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WANGGui-qin; PENGXiu-jun; GUHan-qing
To prevent the complications in cataract surgeries, the eyes of rabbits and monkeys were implanted with intraocular lens for 360 days. Methods: The eyes of the rabbits were performed with phacoemulsification and soft intraocular lens implantation. The eyes of the monkeys were performed with extracapsular cataract extraction and hard intraocular lens implantation. Results: The postoperative reactions included corneal edema, anterior chamber exudation, posterior capsule opacification and so on. The complications in the eyes of the rabbits were more than that in the eyes of the monkeys. Conclusion: The different postoperative reactions happened in different animals. In clinical the choice of the operative method and intraocular lens depended on the case in order to acquire the best sight.
New Management of Malignant Glaucoma by Phacoemulsification with Posterior Chamber Foldable Intraocular Lens Implantation
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GeJian; GuoY
Objective:To investigate the feasibility of phacoemulsification with posterior chamber foldable intraocular lens implantation in the management of malignant glaucoma. Patients and Methods:Fourteen patients with malignant glaucoma diagnosed in the Department of Glaucoma were enrolled in the study.12 patients developed malignant glaucoma after filtration surgery.1 developed after peripheral iridectomy.1 patient developed malignant glaucoma without any clear cause.Cataract phacoemulsification was performed.Posterior chamber intraocular foldable lens was implanted in 10 cases of patients.Results:All 14 patients were cured wiht normal intraocular pressure,normal anterior chamber depth and increased visual acuity.Conclusion:Phacoemulsification with posterior chamber foldable intraocular lens implantation is a good alternative in treating malignant glaucoma.
Intraocular Foreign Body. A Case Presentation Cuerpo extraño intraocular. Presentación de un caso
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Inés Zamora Galindo
Full Text Available
Eye trauma is a common cause of visual impairment, mainly of monocular blindness in 33 to 40% of cases. The case of a 40 years old female patient of rural origin, who attended Ophthalmology consultation at the Dr. Gustavo Aldereguía Lima General University Hospital because of blurry vision in her right eye three months after a trauma, is presented. An accurate medical record, ophthalmologic examination and appropriate diagnostic methods allowed identifying an intraocular foreign body. The patient underwent surgery and evolved favorably. Her best corrected visual acuity is 0.7 in the right eye and 1.0 in the left eye.
Los traumatismos oculares son una causa común de deficiencia visual, principalmente de ceguera monocular en el 33 al 40 % de los casos. Se presenta el caso de un paciente de 40 años y procedencia rural, que acudió a consulta de Oftalmología del Hospital General Universitario Dr. Gustavo Aldereguía Lima por presentar visión borrosa del ojo derecho, tres meses después de haber sufrido un traumatismo. Una correcta anamnesis, examen oftalmológico y métodos diagnósticos adecuados lograron la identificación de un cuerpo extraño intraocular. El paciente fue sometido a cirugía y evolucionó favorablemente; su agudeza visual mejor corregida es de 0,7 en el ojo derecho y de 1,0 en el izquierdo.
Implanting two posterior chamber intraocular lenses in a case of microphthalmos.
Gayton, J L; Sanders, V N
A 31-year-old male with bilateral microphthalmos and a history of severe refractive amblyopia presented with early nuclear sclerosis. Intraocular lens calculations determined the patient would need about a 46.0 diopter power intraocular lens in both eyes to achieve satisfactory vision postoperatively. When no manufacturer could or was willing to make such a high-power lens, we chose to implant two lenses in each eye. The patient is satisfied with his postoperative vision and overall outcome.
New two-point scleral-fixation technique for foldable intraocular lenses with four hollow haptics.
Liu, He-Ting; Jiang, Zheng-Xuan; Tao, Li-Ming
The study was to report a new two-point scleral-fixation technique for foldable intraocular lenses with four haptics. Lenses were slid into the anterior chamber from a 2.8 mm corneal incision and fixed under two sclera flaps at two opposite points. The postoperative best-corrected visual acuities (BCVAs) of all patients were significantly better than their preoperative BCVA. The results demonstrate that two-point, scleral fixations of foldable, intraocular lenses might be practicable and effective.
Influence of untreated chronic plastic iridocyclitis on intraocular pressure in leprosy patients.
Karaçorlu, M A; Cakiner, T; Saylan, T
The intraocular pressures of a total of 286 eyes of patients with lepromatous and borderline lepromatous leprosy who never had regular ophthalmological care or local eye treatment were measured. The patients were categorised according to the type of leprosy they had, and the eyes were categorised as without or with chronic plastic iridocyclitis. In patients with lepromatous and borderline lepromatous types of leprosy the intraocular pressure was significantly lower in eyes with chronic plasti...
Implante de lente intra-ocular dobrável acrílica em crianças Acrylic foldable intraocular lens implantation in children
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Antonio Jordão Jr.
Full Text Available Objetivos: Avaliar o uso de lentes intra-oculares dobráveis de acrílico na correção da afacia infantil. Métodos: Dez olhos de 10 pacientes com idades entre 3 e 9 anos portadores de catarata infantil foram operados e receberam o implante de lente intra-ocular dobrável de acrílico. Os pacientes foram acompanhados por um período que variou de 6 a 20 meses. Resultados: Após a medida da acuidade visual de todos no último retorno, encontramos uma melhora significativa em cinco pacientes. Em nenhum dos casos houve opacificação da cápsula posterior no período observado ou qualquer outra complicação pós-operatória. Conclusão: Apesar da pequena casuística, os resultados sugerem que o uso de lentes intra-oculares acrílicas proporciona a manutenção da transparência do eixo visual a curto e médio prazos.Purpose: To evaluate the results of the implantation of acrylic foldable intraocular lenses in children. Methods: Ten eyes from 10 children aged 3 to 9 years with infantile cataracts were operated and received an acrylic intraocular lens implantation. Follow-up ranged from 6 to 20 months after surgery. Results: The patients had their visual acuity measured at the last visit and a significant improvement in all but one patient was found. There was no posterior capsule opacification or any other surgical complication in this period. Conclusions: Although the number of cases is small, the results suggest that the use of acrylic intraocular lens provides a very good transparency of the visual axis in the short and medium term after surgery.
A case of Alagille syndrome complicated by intraocular lens subluxation and rhegmatogenous retinal detachment
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Fukumoto M
Full Text Available Masanori Fukumoto, Tsunehiko Ikeda, Tetsuya Sugiyama, Mari Ueki, Takaki Sato, Eisuke Ishizaki Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan Abstract: This case report describes a case of Alagille syndrome with developing intraocular lens subluxation and rhegmatogenous retinal detachment 4 years after cataract surgery. A 15-year-old female patient with Alagille syndrome-associated cataracts in both eyes underwent phacoemulsification aspiration and intraocular lens implantation. Four years postoperative, intraocular lens subluxation developed in her left eye. For treatment, extraction of the dislocated intraocular lens, anterior vitrectomy, and intraocular lens fixation was performed. Three weeks later, the patient developed rhegmatogenous retinal detachment, which was well-treated by pars plana vitrectomy. Cataract surgery needs to be performed carefully in patients with Alagille syndrome due to the weakness of the zonule of Zinn. Careful postoperative observation is necessary for patients with Alagille syndrome who have undergone intraocular surgery in order to facilitate early detection of a possible rhegmatogenous retinal detachment. Keywords: Alagille syndrome, cataract, retina, surgery
Effect of phacoemulsification, intraocular lens implantation, and trabeculectomy on angle-closure glaucoma merged with cataract
Institute of Scientific and Technical Information of China (English)
Qun Wu; Li-Li Hao; Wen-Xuan Tao; Chun-Xiang Liu
Objective:To explore the clinical effect of phacoemulsification, intraocular lens implantation, and trabeculectomy in the treatment of angle-closure glaucoma merged with cataract. Methods:A total of 80 patients with angle-closure glaucoma merged with cataract who were admitted in our hospital from May, 2015 to May, 2016 were included in the study and randomized into the observation group and the control group. The patients in the control group were given phacoemulsification and intraocular lens implantation. On this basis, the patients in the observation group were given trabeculectomy. The vision, intraocular pressure, central anterior chamber depth, and visual field before operation, 1 week, 1 month, and 3 months after operation in the two groups were detected.Results: In the control group, 1 month after operation, while in the observation group, 1 week after operation, the vision was significantly improved, the intraocular pressure was significantly reduced, the central anterior chamber depth was significantly increased, and the average visual field defect value and average standard deviation value were significantly improved when compared with before operation (P<0.05); moreover, the improved degree in the observation group was significantly superior to that in the control group (P<0.05).Conclusions:Phacoemulsification, intraocular lens implantation, and trabeculectomy in the treatment of angle-closure glaucoma merged with cataract can effectively increase the central anterior chamber depth, reduce the intraocular pressure, and improve the vision; therefore, it deserves to be widely recommended in the clinic.
Intraocular pressure variations during zygomatic fracture reduction and fixation: a clinical study.
LENUS (Irish Health Repository)
Murray, Dylan J
BACKGROUND: The reduction of midface fractures has been associated with the rare but devastating complication of blindness. An increase in intraocular pressure is important in the mechanism of blindness in this setting. In this study, the authors assessed the intraocular pressure in patients who underwent zygomatic fracture reduction (with or without fixation). METHODS: Using applanation tonometry, 29 patients underwent intraocular pressure measurements before, during, and after fracture fixation. The contralateral pressures were measured and used as the control. RESULTS: There were 29 patients with a mean age of 35 years, and the mean time to surgery was 5 days. Preoperatively, all patients had normal intraocular pressures and normal visual acuity. All patients underwent a Gillies lift and 18 patients required open reduction and fixation of the frontozygomatic suture (n = 4) or the infraorbital margin (n = 2), and the remainder (n = 12) required fixation of both points. There was no statistically significant increase in the intraocular pressures following the reduction of uncomplicated zygomatic fractures. Statistically significant pressure reductions were noted immediately after reduction and fixation. CONCLUSIONS: The surgical reduction of uncomplicated zygomatic fractures has no adverse effect on the intraocular pressure. It is the authors\\' opinion that adjunctive measures to reduce the pressures are unnecessary.
Pigment dispersion syndrome associated with intraocular lens implantation: a new surgical technique
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M Isabel Canut Jordana
Full Text Available M Isabel Canut Jordana1, Daniel Pérez Formigó1, Rodrigo Abreu González2, Jeroni Nadal Reus11Barraquer Ophthalmology Centre, Barcelona, Spain; 2University Hospital of La Candelaria, Tenerife, SpainAims: We report the case of a myopic patient who, after intraocular lens transplant in the posterior chamber, suffered elevated intraocular pressure due to pigment dispersion, with recurrent episodes of blurred vision. The patient was treated with a new surgical technique that can avoid potential iridolenticular contact.Methods: Complete ophthalmologic examination and optical coherence tomography (OCT of the anterior segment were performed.Results: Contact between the pigmentary epithelium and the iris with an intraocular lens was revealed by utrasound biomicroscopy and OCT. In this case, Nd:YAG laser iridotomy and laser iridoplasty were not effective for iridolenticular separation and control of the pigment dispersion. We propose a new technique: stitches on the surface of the iris to obtain good iridolenticular separation and good intraocular pressure control.Conclusion: Stitches on the iris surface should be considered as optional therapy in pigmentary glaucoma secondary to intraocular lens implantation. This surgical technique can avoid potential iridolenticular contacts more definitively.Keywords: pigmentary glaucoma, intraocular lens, optical coherence tomography, laser
Effect of lateral temporal corneal incision for intraocular pressure and tear film stability in cataract patients
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Ying Wang
Full Text Available AIM: To investigate therapeutic effect of lateral temporal corneal incision phacoemulsification combined with intraocular lens(IOLon cataract and its effect on intraocular pressure(IOPand tear film. METHODS: The clinical data of patients with cataract who received treatment in our hospital from March 2014 to December 2015 were retrospectively analyzed. According to the location of the incision, they were divided into temporal corneal incision group and upper corneal incision group. We observed the incidence of complications of the two groups, compared the intraocular pressure, visual acuity, refraction and tear film break-up time of the two groups before and after surgery. RESULTS: The operation time and postoperative pain score of the two groups had no significant difference(P>0.05. The IOP and visual acuity between the two groups before operation had no significant difference(P>0.05. At the intraocular pressure of the two groups was lower than that before operation, and the visual acuity was higher than before operation, and the changes of the anterior lateral incision group were more obvious(PPCONCLUSION: The temporal corneal incision phacoemulsification combined with intraocular lens implantation has a good therapeutic effect on cataract patients, can effectively improve the intraocular pressure and tear film stability, improve eye function, promote the recovery of the body after surgery.
A possible coincidence of cytomegalovirus retinitis and intraocular lymphoma in a patient with systemic non-Hodgkin's lymphoma
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Svozílková Petra
Full Text Available Abstract Purpose To present a possible coincidence of cytomegalovirus retinitis and intraocular lymphoma in a patient with systemic non-Hodgkin's lymphoma. Case presentation A 47-year-old woman presented with decreased visual acuity associated with white retinal lesions in both eyes. A history of pneumonia of unknown aetiology closely preceded the deterioration of vision. Five years previously the patient was diagnosed with follicular non-Hodgkin's lymphoma. She was treated with a chemotherapy regimen comprised of cyclophosphamide, adriamycin, vincristin, and prednisone with later addition of the anti-CD20 antibody rituximab. She experienced a relapse 19 months later with involvement of the retroperitoneal lymph nodes, and commenced treatment with rituximab and 90Y-ibritumomab tiuxetan. A second relapse occurred 22 months after radioimmunotherapy and was treated with a combination of fludarabine, cyclophosphamide, and mitoxantrone followed by rituximab. The patient experienced no further relapses until the current presentation (April, 2010. Pars plana vitrectomy with vitreous fluid analysis was performed in the right eye. PCR testing confirmed the presence of cytomegalovirus in the vitreous. Atypical lymphoid elements, highly suspicious of malignancy were also found on cytologic examination. Intravenous foscarnet was administered continually for three weeks, followed by oral valganciclovir given in a dose of 900 mg twice per day. In addition, the rituximab therapy continued at three monthly intervals. Nevertheless, cessation of foscarnet therapy was followed by a recurrence of retinitis on three separate occasions during a 3-month period instigating its reinduction to the treatment regime after each recurrence. Conclusions Cytomegalovirus retinitis is an opportunistic infection found in AIDS patients as well as in bone marrow and solid organ transplant recipients being treated with systemic immunosuppressive drugs. This case presents a less
Classification of intraocular lens and its intraocular biocompatibility%人工晶体分类及其在眼内的生物相容性
Institute of Scientific and Technical Information of China (English)
目的:通过手术摘除自身浑浊晶体,植入人工晶体是治疗白内障的惟一有效措施.文章总结人工晶体材料的研究进展,为今后的临床应用和研究提供参考.方法:应用计算机检索1997/2009 Medline数据库、中国期刊网和万方数据库、SpringerLink数据库和ScienceDirect数据库.结果:共有25篇文章符合纳入标准.文章主要从人工晶体的发展现状、分类、生物相容性、人工晶体的并发症和发展趋势进行阐述.人工晶体按照硬度,可以分为硬质人工晶体和软性人工晶体.丙烯酸人工晶体比硅凝胶人工晶体的生物相容性更好.人工晶状体脱位是白内障摘除联合人工晶状体植入术后较常见的并发症之一.注入式人工晶体材料是今后研究的方向.结论:人工晶体植入眼内作为一种异物,机体对此产生反应是机体正常的防御现象.人工晶体材料和设计应充分的考虑人工晶体的生物相容性、术后视功能、调节功能、光保护等方面性能.保证术后的疗效和减少并发症的发生,使白内障患者获得更高质量的视力康复.%OBJECTIVE: The sole effective measure for cataract is replaced the epinephelos lens with intraocular lens. So, in this paper, we summarize the research process of intraocular lens, which can provide a reference for further study. METHODS: Medline, China Journal Net, Wanfang Data, SpringerLink, and ScienceDirect database were computer retrieved from 1997 to 2009. RESULTS: A total of 25 papers were included. All the papers were explained intraocular lens from the aspect of current situation, complication following implantation, and develop tendency. According to hardness, intraocular lens can be divided into hard intraocular lens and soft intraocular lens. Acrylic intraocular lenses showed better biocompatibility than the silicone intraocular lenses. In addition, the common complication following implantation was dislocation of lens. Therefore
Vitrectomy combined with intraocular tamponade postoperative intraocular pressure changes%玻璃体切除联合眼内填充术后眼压变化
Institute of Scientific and Technical Information of China (English)
吴娜; 张红
Objective To observe the posterior vitrectomy combined with intraocular tamponade in early postoperative intraocular pressure changes and to explore the pathogenesis of early high intraocular pressure. Methods On 119 eyes of 132 patients in Ophthalmological Center of Tianjin Medical University line vitrectomy in patients with clinical data analysis of high intraocular pressure, the diagnostic criteria for non contact tonometer is greater than or equal to 24 mm Hg, analysis of vitrectomy combined with different intraocular tamponade postoperative intraocular high incidence and trend. Resuis In 50 eyes in the occurrence of postoperative early elevated intraocular pressure, incidence rates for37. 88%. The sili-cone oil tamponade group, C2F6group, C3F8Group filling filling and simple phaco group, its early postoperative intraocular high morbidity rates were48% ,41.18% ,57.14% ,11.76% , the group compare (χ2 = 14.395, r =3, P =0.002) .with statistical significance. Conclusion Early postoperative intraocular pressure elevation is posterior vitrectomy postoperative common complications, posterior vitrectomy combined with intraocular inert gas or silicone oil tamponade are increased intraocular hypertension risk factors.%目的 观察后部玻璃体切除(PPV)联合眼内填充物术后早期眼压变化规律并探讨早期高眼压的发病机制.方法 对119例(132只眼)在天津医科大学眼科中心行后部PPV患者的临床资料进行分析,高眼压的诊断标准为非接触式眼压计测量眼压≥24 mm Hg,分析了玻璃体切除联合不同眼内填充物术后高眼压的发病率及变化趋势.结果 有50只眼术后发生早期眼压升高,发病率为37.88%.其中硅油填充组、C2F6填充组、C3F8填充组及单纯玻切组,其术后早期高眼压的发病率分别为48%、41.18%、57.14%、11.76%,各组间比较(x2=14.395,r=3,P=0.002),有统计学意义.结论 术后早期高眼压是后部PPV术后常见的并发症,后部PPV联�
Clinical study of customized aspherical intraocular lens implants
Institute of Scientific and Technical Information of China (English)
Lie-Xi; Jia; Zhao-Hui; Li
AIM:To compare if there is an improvement in visual functions with age-related cataracts between patients receiving a aspherical intraocular lens(IOL) based on corneal wavefront aberration and patients randomly assigned lenses.METHODS:A total of 124 eyes of 124 patients with age-related cataracts were placed in experimental group and a group receiving randomly assigned(RA) lenses.The experimental group was undergone Pentacam corneal spherical aberration measurement before surgery; the targeted range for residual total spherical aberration after surgery was set to 0-0.3 μm. Patients with a corneal spherical aberration <0.3 μm were implanted with a zero-spherical aberration advanced optics(AO) aspherical IOL and patients with an aberration ≥0.3 μm received a Tecnis Z9003 aspherical lens in experimental group. RA patients were randomly implanted with an AO lens or a Tecnis Z9003 lens. Three months after surgery total spherical aberration, photopic/mesopic contrast sensitivities, photopic/mesopic with glare contrast sensitivities, and logMAR vision were measured.RESULTS:Statistical analysis on logMAR vision showed no significant difference between two groups(P =0.413). The post-surgical total spherical aberration was 0.126 ±0.097 μm and 0.152 ±0.151 μm in the experimental and RA groups, respectively(P =0.12). The mesopic contrast sensitivities at spatial frequencies of 6,12 and 18 c/d in the experimental group were significantly higher than of the RA group(P =0.00; P =0.04;P =0.02). The mesopic with glare contrast sensitivity in the experimental group at a spatial frequency of 18 c/d was also significantly higher vs the RA group(P =0.01).CONCLUSION:Pre-surgical corneal spherical aberration measurement in cataract patients followed bycustomized selection of aspherical IOL implants improved mesopic contrast sensitivities at high spatial frequencies, and thus is a superior strategy compared to the random selection of aspherical intraocular lens implants.
Capsular Outcomes After Pediatric Cataract Surgery Without Intraocular Lens Implantation
Tan, Xuhua; Lin, Haotian; Lin, Zhuoling; Chen, Jingjing; Tang, Xiangchen; Luo, Lixia; Chen, Weirong; Liu, Yizhi
Abstract The objective of this study was to investigate capsular outcomes 12 months after pediatric cataract surgery without intraocular lens implantation via qualitative classification and quantitative measurement. This study is a cross-sectional study that was approved by the institutional review board of Zhongshan Ophthalmic Center of Sun Yat-sen University in Guangzhou, China. Digital coaxial retro-illumination photographs of 329 aphakic pediatric eyes were obtained 12 months after pediatric cataract surgery without intraocular lens implantation. Capsule digital coaxial retro-illumination photographs were divided as follows: anterior capsule opening area (ACOA), posterior capsule opening area (PCOA), and posterior capsule opening opacity (PCOO). Capsular outcomes were qualitatively classified into 3 types based on the PCOO: Type I—capsule with mild opacification but no invasion into the capsule opening; Type II—capsule with moderate opacification accompanied by contraction of the ACOA and invasion to the occluding part of the PCOA; and Type III—capsule with severe opacification accompanied by total occlusion of the PCOA. Software was developed to quantitatively measure the ACOA, PCOA, and PCOO using standardized DCRPs. The relationships between the accurate intraoperative anterior and posterior capsulorhexis sizes and the qualitative capsular types were statistically analyzed. The DCRPs of 315 aphakic eyes (95.8%) of 191 children were included. Capsular outcomes were classified into 3 types: Type I—120 eyes (38.1%); Type II—157 eyes (49.8%); Type III—38 eyes (12.1%). The scores of the capsular outcomes were negatively correlated with intraoperative anterior capsulorhexis size (R = −0.572, P < 0.001), but no significant correlation with intraoperative posterior capsulorhexis size (R = −0.16, P = 0.122) was observed. The ACOA significantly decreased from Type I to Type II to Type III, the PCOA increased in size from Type I to Type
Functionalised polysiloxanes as injectable, in situ curable accommodating intraocular lenses.
Hao, Xiaojuan; Jeffery, Justine L; Wilkie, John S; Meijs, Gordon F; Clayton, Anthony B; Watling, Jason D; Ho, Arthur; Fernandez, Viviana; Acosta, Carolina; Yamamoto, Hideo; Aly, Mohamed G M; Parel, Jean-Marie; Hughes, Timothy C
The aged eye's ability to change focus (accommodation) may be restored by replacing the hardened natural lens with a soft gel. Functionalised polysiloxane macromonomers, designed for application as an injectable, in situ curable accommodating intraocular lens (A-IOL), were prepared via a two-step synthesis. Prepolymers were synthesised via ring opening polymerisation (ROP) of octamethylcyclotetrasiloxane (D(4)) and 2,4,6,8-tetramethylcyclotetrasiloxane (D(4)(H)) in toluene using trifluoromethanesulfonic acid (TfOH) as catalyst. Hexaethyldisiloxane (HEDS) was used as the end group to control the molecular weight of the prepolymers, which were then converted to macromonomers by hydrosilylation of the SiH groups with allyl methacrylate (AM) to introduce polymerisable groups. The resulting macromonomers had an injectable consistency and thus, were able to be injected into and refill the empty lens capsular bag. The macromonomers also contained a low ratio of polymerisable groups so that they may be cured on demand, in situ, under irradiation of blue light, in the presence of a photo-initiator, to form a soft polysiloxane gel (an intraocular lens) in the eye. The pre-cure viscosity and post-cure modulus of the polysiloxanes, which are crucial factors for an injectable, in situ curable A-IOL application, were controlled by adjusting the end group and D(4)(H) concentrations, respectively, in the ROP. The macromonomers were fully cured within 5 min under light irradiation, as shown by the rapid change in modulus monitored by photo-rheology. Ex vivo primate lens stretching experiments on an Ex Vivo Accommodation Simulator (EVAS) showed that the polysiloxane gel refilled lenses achieved over 60% of the accommodation amplitude of the natural lens. An in vivo biocompatibility study in rabbits using the lens refilling (Phaco-Ersatz) procedure demonstrated that the soft gels had good biocompatibility with the ocular tissue. The polysiloxane macromonomers meet the targeted
Successful toric intraocular lens implantation in a patient with induced cataract and astigmatism after posterior chamber toric phakic intraocular lens implantation: a case report
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Kamiya Kazutaka
Full Text Available Abstract Introduction We report the case of a patient in whom simultaneous toric phakic intraocular lens removal and phacoemulsification with toric intraocular lens implantation were beneficial for reducing pre-existing astigmatism and acquiring good visual outcomes in eyes with implantable collamer lens-induced cataract and astigmatism. Case presentation A 53-year-old woman had undergone toric implantable collamer lens implantation three years earlier. After informed consent was obtained, we performed simultaneous toric implantable collamer lens removal and phacoemulsification with toric intraocular lens implantation. Preoperatively, the manifest refraction was 0, -0.5 × 15, with an uncorrected visual acuity of 0.7 and a best spectacle-corrected visual acuity of 0.8. Postoperatively, the manifest refraction was improved to 0, -0.5 × 180, with an uncorrected visual acuity of 1.2 and a best spectacle-corrected visual acuity of 1.5. No vision-threatening complications were observed. Conclusion Toric intraocular lens implantation may be a good surgical option for the correction of spherical and cylindrical errors in eyes with implantable collamer lens-induced cataract and astigmatism.
Effect of four different intraocular lenses on posterior capsule opacification
Institute of Scientific and Technical Information of China (English)
Rahmi; Duman; Fatih; Karel; Pelin; ?zyol; Can; Ates
AIM: To evaluate the impact of 4 different intraocular lenses(IOLs) on posterior capsule opacification(PCO) by comparing the neodymium: yttrium-aluminum-garnet(Nd:YAG) laser capsulotomy rates.METHODS: This retrospective study included 4970 eyes of 4013 cataract patients who underwent phacoemulsification and IOL implantation between January 2000 and January 2008 by the same surgeon at one clinic. Four different IOLs were assessed. The outcome parameter was the incidence of Nd:YAG laser posterior capsulotomies.· RESULTS: An Nd:YAG laser posterior capsulotomy was performed in 153(3.07%) of the 4970 eyes. The mean follow-up time was 84 mo for all of the IOL groups. The percentage of eyes developing PCO was significantly greater for the acrylic hydrophilic IOLs than for the hydrophobic IOLs, although eyes with acrylic hydrophilic IOLs did not require Nd:YAG laser capsulotomy as soon as eyes with acrylic hydrophobic IOLs. There was no difference between the long-term PCO rates when 1-and 3-piece acrylic hydrophobic IOLs were compared or when IOLs made of the same material but with different haptic angles were compared.· CONCLUSION: In this study, eyes with acrylic hydrophilic IOLs were more likely to develop PCO than those with acrylic hydrophobic IOLs. The lens design(1-piece versus 3-piece and varying haptic angles) did not affect the PCO rate.
Sulcus Fixation of Foldable Intraocular Lenses Guided by Ultrasound Biomicroscopy
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Shasha Gao
Full Text Available Background. To evaluate the clinical efficacy of suture fixation of foldable intraocular lens (IOL in ciliary sulcus guided by ultrasound biomicroscopy (UBM. Methods. Thirty-five eyes of 32 cases needing suture fixation of foldable IOL in ciliary sulcus in our hospital were collected and divided into two groups: group A and group B. In group A, UBM was performed on 19 eyes of 17 cases before surgery to locate the projection position of ciliary sulcus in iris surface. In group B, the traditional sulcus fixation of IOL was performed on 16 eyes of 15 cases. The inserting position of needles, the haptics position of IOL and the IOL tilt, and decentration were observed by UBM examination 3 months after the surgery. Meanwhile, the vision and contrast sensitivity were analysed. Results. The differences in inserting position of the needle, the IOL tilt and decentration, the ratio of IOL haptics in sulcus, and uncorrected visual acuity were statistically significant (P0.05. Conclusions. Sulcus fixation of foldable IOL aided by UBM can increase the accuracy of IOL haptics implanted into ciliary sulcus and reduce the IOL tilt and decentration.
Spontaneous Scleral Perforation of an Anterior Chamber Intraocular Lens
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Oriel Spierer
Full Text Available A routine eye examination of a 69-year-old man revealed a scleral perforation of one of the haptics of the anterior chamber intraocular lens (AC IOL which had been implanted many years ago. The patient was asymptomatic with good visual acuity. His history was negative for any trauma, eye rubbing, topical corticosteroid use, or autoimmune disease. The horizontal and vertical white-to-white diameters of the cornea in the right eye were 11.5 and 10.5 mm, respectively. Anterior segment optical coherence tomography showed the anterior chamber length to be 12.28 mm horizontally and 10.63 mm vertically. The patient underwent an IOL exchange, and the length of the explanted AC IOL was measured to be 12 mm. We speculate that the AC IOL, which was vertically aligned, was oversized. This case demonstrates the need for proper sizing and positioning of an AC IOL. In complex cases where AC IOL may be used, measuring the horizontal and vertical lengths of the anterior chamber by anterior segment optical coherence tomography prior to surgery may be useful.
Reverse Optic Capture to Stabilize a Toric Intraocular Lens
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Howard V. Gimbel
Full Text Available Purpose: To describe a technique for stabilizing a rotationally unstable toric intraocular lens (IOL. Method: Case report and literature review. Results: Surgical technique and long-term follow-up for a patient who underwent repositioning and stabilization of a mobile 1-piece acrylic toric IOL using reverse optic capture (ROC are described. This patient presented with early, more than 70° off-axis rotation. The IOL was repositioned but was very mobile within the bag and tended to rotate off-axis; hence, it was stabilized in the desired position by capturing the optic through the anterior continuous curvilinear capsulorhexis, leaving the haptics in the bag. The immediate and 2-year postoperative follow-up revealed a stable and on-axis IOL with no visual, refractive or ocular complications. Conclusions: ROC is a useful and safe technique to address the problem of toric IOLs that tend to rotate at the time of surgery or are not stable postoperatively.
Aerobic exercise and intraocular pressure in normotensive and glaucoma patients
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Chatzibalis Theodosios
Full Text Available Abstract Background With the increasing number of people participating in physical aerobic exercise, jogging in particular, we considered that it would be worth knowing if there are should be limits to the exercise with regard to the intraocular pressure (IOP of the eyes. The purpose of this study is to check IOP in healthy and primary glaucoma patients after aerobic exercise. Methods 145 individuals were subdivided into seven groups: normotensives who exercised regularly (Group A; normotensives in whose right eye (RE timolol maleate 0.5% (Group B, latanoprost 0.005% (Group C, or brimonidine tartrate 0.2% (Group D was instilled; and primary glaucoma patients under monotherapy with β-blockers (Group E, prostaglandin analogues (Group F or combined antiglaucoma treatment (Group G instilled in both eyes. The IOP of both eyes was measured before and after exercise. Results A statistically significant decrease was found in IOP during jogging. The aerobic exercise reduces the IOP in those eyes where a b-blocker, a prostaglandin analogue or an α-agonist was previously instilled. The IOP is also decreased in glaucoma patients who are already under antiglaucoma treatment. Conclusion There is no ocular restriction for simple glaucoma patients in performing aerobic physical activity.
Spontaneous Scleral Perforation of an Anterior Chamber Intraocular Lens
Spierer, Oriel; O'Brien, Terrence P.
A routine eye examination of a 69-year-old man revealed a scleral perforation of one of the haptics of the anterior chamber intraocular lens (AC IOL) which had been implanted many years ago. The patient was asymptomatic with good visual acuity. His history was negative for any trauma, eye rubbing, topical corticosteroid use, or autoimmune disease. The horizontal and vertical white-to-white diameters of the cornea in the right eye were 11.5 and 10.5 mm, respectively. Anterior segment optical coherence tomography showed the anterior chamber length to be 12.28 mm horizontally and 10.63 mm vertically. The patient underwent an IOL exchange, and the length of the explanted AC IOL was measured to be 12 mm. We speculate that the AC IOL, which was vertically aligned, was oversized. This case demonstrates the need for proper sizing and positioning of an AC IOL. In complex cases where AC IOL may be used, measuring the horizontal and vertical lengths of the anterior chamber by anterior segment optical coherence tomography prior to surgery may be useful. PMID:27462251
Spontaneous Scleral Perforation of an Anterior Chamber Intraocular Lens.
Spierer, Oriel; O'Brien, Terrence P
A routine eye examination of a 69-year-old man revealed a scleral perforation of one of the haptics of the anterior chamber intraocular lens (AC IOL) which had been implanted many years ago. The patient was asymptomatic with good visual acuity. His history was negative for any trauma, eye rubbing, topical corticosteroid use, or autoimmune disease. The horizontal and vertical white-to-white diameters of the cornea in the right eye were 11.5 and 10.5 mm, respectively. Anterior segment optical coherence tomography showed the anterior chamber length to be 12.28 mm horizontally and 10.63 mm vertically. The patient underwent an IOL exchange, and the length of the explanted AC IOL was measured to be 12 mm. We speculate that the AC IOL, which was vertically aligned, was oversized. This case demonstrates the need for proper sizing and positioning of an AC IOL. In complex cases where AC IOL may be used, measuring the horizontal and vertical lengths of the anterior chamber by anterior segment optical coherence tomography prior to surgery may be useful.
Sulcus Fixation of Foldable Intraocular Lenses Guided by Ultrasound Biomicroscopy.
Gao, Shasha; Qin, Tingyu; Wang, Shengnan; Lu, Yong
Background. To evaluate the clinical efficacy of suture fixation of foldable intraocular lens (IOL) in ciliary sulcus guided by ultrasound biomicroscopy (UBM). Methods. Thirty-five eyes of 32 cases needing suture fixation of foldable IOL in ciliary sulcus in our hospital were collected and divided into two groups: group A and group B. In group A, UBM was performed on 19 eyes of 17 cases before surgery to locate the projection position of ciliary sulcus in iris surface. In group B, the traditional sulcus fixation of IOL was performed on 16 eyes of 15 cases. The inserting position of needles, the haptics position of IOL and the IOL tilt, and decentration were observed by UBM examination 3 months after the surgery. Meanwhile, the vision and contrast sensitivity were analysed. Results. The differences in inserting position of the needle, the IOL tilt and decentration, the ratio of IOL haptics in sulcus, and uncorrected visual acuity were statistically significant (P 0.05). Conclusions. Sulcus fixation of foldable IOL aided by UBM can increase the accuracy of IOL haptics implanted into ciliary sulcus and reduce the IOL tilt and decentration.
Soft wearable contact lens sensor for continuous intraocular pressure monitoring.
Chen, Guo-Zhen; Chan, Ion-Seng; Leung, Leo K K; Lam, David C C
Intraocular pressure (IOP) is a primary indicator of glaucoma, but measurements from a single visit to the clinic miss the peak IOP that may occur at night during sleep. A soft chipless contact lens sensor that allows the IOP to be monitored throughout the day and at night is developed in this study. A resonance circuit composed of a thin film capacitor coupled with a sensing coil that can sense corneal curvature deformation is designed, fabricated and embedded into a soft contact lens. The resonance frequency of the sensor is designed to vary with the lens curvature as it changes with the IOP. The frequency responses and the ability of the sensor to track IOP cycles were tested using a silicone rubber model eye. The results showed that the sensor has excellent linearity with a frequency response of ∼8 kHz/mmHg, and the sensor can accurately track fluctuating IOP. These results showed that the chipless contact lens sensor can potentially be used to monitor IOP to improve diagnosis accuracy and treatment of glaucoma.
Customized computer models of eyes with intraocular lenses
Rosales, P.; Marcos, S.
We compared experimental wave aberrations in pseudophakic eyes with aspheric intraocular lenses (IOLs) to simulate aberrations from numerical ray tracing on customized computer eye models using corneal topography, angle λ, ocular biometry, IOL geometry, and IOL tilt and decentration measured on the same eyes. We found high correlations between real and simulated aberrations even for the eye with only the cornea, and these increased on average when the IOL geometry and position were included. Relevant individual aberrations were well predicted by the complete eye model. Corneal spherical aberration and horizontal coma were compensated by the IOL, and in 58.3% of the cases IOL tilt and decentration contributed to compensation of horizontal coma. We conclude that customized computer eye models are a good representation of real eyes with IOLs and allow understanding of the relative contribution of optical, geometrical and surgically-related factors to image quality. Corneal spherical aberration is reduced by aspheric IOLs, although other corneal high order aberrations are still a major contributor to total aberrations in pseudophakic eyes. Tilt and decentration of the IOLs represent a relatively minor contribution of the overall optical quality of the eye.
Determination of scattering in intraocular lenses by spectrophotometric measurements.
Artigas, José M; Felipe, Adelina; Navea, Amparo; García-Domene, M Carmen; Pons, Álvaro; Mataix, Jorge
This study presents a method for measuring scattering in explanted intraocular lenses (IOLs). Currently, determining scattering in IOLs is usually performed by Scheimpflug cameras and the results are expressed in the units used by this apparatus. The method we propose uses a spectrophotometer and this makes it possible to measure the total transmission of the IOL by using an integrating sphere; the direct transmission is determined by the double-beam mode. The difference between these two transmissions gives a value of the scattering in percentage values of light lost. In addition, by obtaining the spectral transmission curve, information about the most scattered wavelengths is also obtained. The IOL power introduces errors when directly measured, particularly with high powers. This problem can be overcome if a tailor-made cuvette is used that shortens the distance between the IOL and the condensing lens of the spectrophotometer when the IOL powers are below 24 diopters. We checked the effectiveness of this method by measuring the scattering of three explanted IOLs from cornea donors. This method, however, does not make it possible to ascertain whether the scattering measured is caused by surface light scattering or internal light scattering.
Prognostic Factor Analysis of Intraocular Pressure with Neovascular Glaucoma.
Nakano, Satoko; Nakamuro, Takako; Yokoyama, Katsuhiko; Kiyosaki, Kunihiro; Kubota, Toshiaki
Purpose. To perform multivariate analysis for identifying independent predictors of elevated intraocular pressure (IOP) with neovascular glaucoma (NVG), including antivascular endothelial growth factor (VEGF) intravitreal injections. Methods. We retrospectively reviewed 142 NVG patients (181 eyes) with ischemic retinal diseases [proliferative diabetic retinopathy (PDR) in 134 eyes, retinal vein occlusion (RVO) in 29, and ocular ischemic syndrome in 18]. We analyzed age, gender, initial/final LogMAR VA, initial/final IOP, extent of iris and/or angle neovascularization, treatments, preexisting complications, concurrent medications, and follow-up duration. Results. The mean follow-up duration was 23.8 ± 18.8 months. At the final follow-up, 125 (72.3%) eyes had IOP ≤ 21 mmHg. NVG patients with RVO had a higher degree of angle closure and higher IOP. NVG with PDR had better IOP and LogMAR VA. Angle closure had the greatest impact on final IOP. Greater than 90% of patients treated with trabeculectomy with mitomycin C (LEC) had persistent declines in IOP (≤21 mmHg). Stand-alone and combination anti-VEGF therapies were not associated with improved long-term prognosis of IOP. Conclusions. Angle closure was found to have the greatest effect on NVG-IOP prognosis. When target IOP values are not obtained after adequate PRP with or without anti-VEGF, early LEC may improve the prognosis of IOP.
Prognostic Factor Analysis of Intraocular Pressure with Neovascular Glaucoma
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Satoko Nakano
Full Text Available Purpose. To perform multivariate analysis for identifying independent predictors of elevated intraocular pressure (IOP with neovascular glaucoma (NVG, including antivascular endothelial growth factor (VEGF intravitreal injections. Methods. We retrospectively reviewed 142 NVG patients (181 eyes with ischemic retinal diseases [proliferative diabetic retinopathy (PDR in 134 eyes, retinal vein occlusion (RVO in 29, and ocular ischemic syndrome in 18]. We analyzed age, gender, initial/final LogMAR VA, initial/final IOP, extent of iris and/or angle neovascularization, treatments, preexisting complications, concurrent medications, and follow-up duration. Results. The mean follow-up duration was 23.8 ± 18.8 months. At the final follow-up, 125 (72.3% eyes had IOP ≤ 21 mmHg. NVG patients with RVO had a higher degree of angle closure and higher IOP. NVG with PDR had better IOP and LogMAR VA. Angle closure had the greatest impact on final IOP. Greater than 90% of patients treated with trabeculectomy with mitomycin C (LEC had persistent declines in IOP (≤21 mmHg. Stand-alone and combination anti-VEGF therapies were not associated with improved long-term prognosis of IOP. Conclusions. Angle closure was found to have the greatest effect on NVG-IOP prognosis. When target IOP values are not obtained after adequate PRP with or without anti-VEGF, early LEC may improve the prognosis of IOP.
Photoacoustic imaging features of intraocular tumors: Retinoblastoma and uveal melanoma
Xu, Guan; Xue, Yafang; Özkurt, Zeynep Gürsel; Slimani, Naziha; Hu, Zizhong; Wang, Xueding; Xia, Kewen; Ma, Teng; Zhou, Qifa; Demirci, Hakan
The purpose of this study is to examine the capability of photoacoustic (PA) imaging (PAI) in assessing the unique molecular and architectural features in ocular tumors. A real-time PA and ultrasonography (US) parallel imaging system based on a research US platform was developed to examine retinoblastoma in mice in vivo and human retinoblastoma and uveal melanoma ex vivo. PA signals were generated by optical illumination at 720, 750, 800, 850, 900 and 950 nm delivered through a fiber optical bundle. The optical absorption spectra of the tumors were derived from the PA images. The optical absorption spectrum of each tumor was quantified by fitting to a polynomial model. The microscopic architectures of the tumors were quantified by frequency domain analysis of the PA signals. Both the optical spectral and architectural features agree with the histological findings of the tumors. The mouse and human retinoblastoma showed comparable total optical absorption spectra at a correlation of 0.95 (p<0.005). The quantitative PAI features of human retinoblastoma and uveal melanoma have shown statistically significant difference in two tailed t-tests (p<0.05). Fully compatible with the concurrent procedures, PAI could be a potential tool complementary to other diagnostic modalities for characterizing intraocular tumors. PMID:28231293
Hypobaric Hypoxia: Effects on Intraocular Pressure and Corneal Thickness
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Marcella Nebbioso
Full Text Available Objective. The purpose of this study focused on understanding the mechanisms underlying ocular hydrodynamics and the changes which occur in the eyes of subjects exposed to hypobaric hypoxia (HH to permit the achievement of more detailed knowledge in glaucomatous disease. Methods. Twenty male subjects, aged 32±5 years, attending the Italian Air Force, were enrolled for this study. The research derived from hypobaric chamber, using helmet and mask supplied to jet pilotes connected to oxygen cylinder and equipped with a preset automatic mixer. Results. The baseline values of intraocular pressure (IOP, recorded at T1, showed a mean of 16±2.23 mmHg, while climbing up to 18,000 feet the mean value was 13.7±4.17 mmHg, recorded at T2. The last assessment was performed returning to sea level (T4 where the mean IOP value was 12.8±2.57 mmHg, with a significant change (P<0.05 compared to T1. Pachymetry values related to corneal thickness in conditions of hypobarism revealed a statistically significant increase (P<0.05. Conclusions. The data collected in this research seem to confirm the increasing outflow of aqueous humor (AH in the trabecular meshwork (TM under conditions of HH.
Macroglobulinemia de Waldenström com hemorragia intra-ocular Waldenström's macroglobulinaemia with intraocular hemorrhage
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João J. Nassaralla Júnior
Full Text Available O objetivo deste trabalho é relatar um caso de macroglobulinemia de Waldenström com envolvimento retiniano e da circulação coroidiana, com boa resposta ao tratamento. O desenho é um caso controle intervencional. Um homem de 47 anos foi encaminhado para o serviço de hematologia para avaliação de anemia e linfadenopatia inguinal. O diagnóstico de macroglobulinemia de Waldenström foi feito com base nos achados clínicos e laboratoriais. O paciente desenvolveu hemorragia intra-ocular sem associação com hipertensão e com fatores de coagulação normais. Exame fundoscópico revelou retardamento na circulação coriorretiniana, microaneurismas, e telangiectasias no pólo posterior. Angiografia fluorescente demonstrou o prolongamento do tempo da circulação coroidiana, tempo de trânsito arteriovenoso também prolongado, e áreas de não perfusão capilar. Estes resultados foram acompanhados por uma elevação acentuada da IgM. A maioria dos achados oculares foi revertida com a plasmaférese. A macroglobulinemia de Waldenström pode envolver a retina e a circulação coroidiana, porém pode ser reversível com o tratamento apropriado.The aim of this work is to report a case of Waldenström's Macroglobulinaemia involving both retinal and choroidal circulation that resolved after treatment. The design is an interventional case report. A 47-year old male was admitted for evaluation of anaemia, and groin lymphadenopathy. A diagnosis of Waldenström's macroglobulinaemia was made based on clinical and laboratory findings. The patient developed intraocular hemorrhage without associated hypertension and with normal coagulation profile. A funduscopic examination revealed marked dilation and beading of the venous system, microaneurysms, and telangiectatic capillary beds in the posterior pole. A fluorescein angiography showed delayed choroidal filling, prolonged arteriovenous transit time and areas of capillary non-perfusion. These findings were
Clinical Analysis of Early and Mid-late Elevated Intraocular Pressure after Silicone Oil Injection
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Lifei Wang; Jingjiang Liu; Tianxiang Lu
Purpose:To discuss the incidence and clinical features of early and mid-late elevated intraocular pressure after pars plana vitrectomy and silicone oil injection, and to evaluate the clinical management of eyes with secondary glaucoma. Methods:.This was an observational consecutive case series of 691 eyes in 679 patients who were treated with pars plana vitrectomy and silicone injection...The diagnostic criteria of early elevated intraocular pressure after silicone oil injection was ≥21 mmHg two weeks after surgery, while mid-late ele-vated intraocular pressure was ≥21 mmHg after two weeks. The incidence and clinical management of elevated intraocular pressure were analyzed. Results: In total, 211 of 691 eyes (30.54%) developed ele-vated intraocular pressure two weeks after pars plana vitrecto my and silicone injection. Of the 211 eyes, 101 eyes (47.87%) had ocular inflammation, 64 eyes (30.33%) showed hyphema, 35 eyes(16.59%) had silicone oil in the anterior chamber, 6 eyes. (2.84% ).had excess silicone oil injected,.and 5 eyes (2.37%).had rubeosis irides. Eighty three of 691 eyes (12.01%). developed elevated intraocular pressure after two weeks..Of these 83 eyes, 25 eyes (30.12%) had rubeosis irides,.16 eyes (19.27%) had issues related to topic steroid therapy,.13 eyes . (15.66%).had a papillary block,.silicone oil in the anterior chamber,10 eyes (12.05%) had a silicone emulsion,.10 eyes (12.05% ).had peripheral anterior synchiae,.and 9 eyes (10.84%).had silicone oil in the anterior chamber..All eyes with elevated intraocular pressure were treated with antiglau-coma medications and surgeries. Conclusion:.The reasons for elevated intraocular pressure dif-fered between early and mid-late after pars plana vitrectomy and silicone oil injection. The elevated intraocular pressure can be controlled effectively by immediate diagnosis and proper treatment with medicine and operation.
Effects of phacoemulsification on the intraocular pressure and corneal endothelial cells of the patients with glaucoma
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Ye Zhao; Zhi-Feng Liu
Objective:To explore the intraocular pressure and corneal endothelial cells integrity changes in cataract phacoemulsification after anti-glaucoma surgery.Methods:Phacoemulsification was performed in 102 patients (118 eyes) with cataract after anti-glaucoma surgery and the intraocular pressure and corneal endothelial cell integrity changes of patients were observed at Day 1 and 3, first week and first month before and after surgery, including central corneal endothelial cell density, average cell area (AVE), cell area of coefficient of variation (CV) and central corneal thickness (CCT).Results:The intraocular pressure was elevated, the central endothelial cell density was reduced, the AVE, the CV and CTT thicken were increased at Day 1 and 3, first week and first month after surgery. The difference compared with preoperative was statistically significant. The intraocular pressure and CTT almost recovered to preoperative levels in 1 month after cataract phacoemulsification and the difference was not statistically significant; while the central endothelial cell density was still decreased and AVE and CV were still increased and the difference of these indexes and the coefficient of the patients was statistically significant compared with before surgery.Conclusions:For the patients with anti-glaucoma after cataract phacoemulsification, intraocular pressure and endothelial cell integrity change was initially observed at Day 1 after surgery, whereas they can almost return to the preoperative level in a month after surgery.
Electrochemical lysis at the stage of endoresection for large posterior intraocular tumors
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Yu. A. Belyy
Full Text Available Purpose: to design the new combined technique of endoresection with intraoperative intraocular electrochemical lysis at the tumor destruction stage for large posterior intraocular tumors.Methods: 3 patients (3 eyes with large choroidal melanomas t3N0M0 (tumor thickness — 8-10 mm, base diameter — 13-15 mm, juxtapapillary localization. Mean age was 55.4 years old. Endoresection with intraoperational intraocular electrochemical lysis of the tumor was performed. Electrochemical lysis was performed with use of the technical unit ECU 300 (Soering, Germany and the original method of combined intratumoral positioning of two platinum electrodes: anode and cathode.Results: the tumor was removal completely in all 3 cases. the anatomical retinal reattachment was reached in all patients. Sclera was safe in all 3 cases. Visual acuity was not changed (NLP. At the place of the removal tumor a surgical choroidal coloboma without pigmentation all over scleral bed and periphery was shown in all cases in distant postoperative period (from 1.5 to 3 years. No local recurrences or metastasis were revealed in all patients.Conclusion: Further investigations in clinical group are necessarily to determinate the real possibilities of the combined method and the indications for endoresection with intraoperative intraocular electrochemical lysis for large intraocular tumors.
Effect of lens status on intraocular pressure in siliconized eyes
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Mohalhal AA ,El Shazly MI ,Ghalwash DA
Full Text Available Ahmed A Mohalhal, Malak I El Shazly, Dalia A GhalwashKasr El Aini Hospital, Cairo University, Cairo, EgyptPurpose: To evaluate the effect of lens status on intraocular pressure (IOP in siliconized eyes and also on the emulsification of silicone oil.Patients and methods: A total of 31 eyes of 31 patients with retinal detachment were operated on with pars plana vitrectomy and silicone oil injection: 16 phakic (Group A and 15 pseudophakic (Group B. During the 6-month follow-up period, IOP was measured: 1 day postoperative, then at 1 week, 1 month, 2 months, 3 months, and 6 months postoperative. At the end of the follow-up period, gonioscopy was carried out to check emulsified silicone at the anterior chamber angle and also the presence of emulsified silicone on the back of the cornea when the patient was lying down.Results: There was no significant difference between both groups until the first week (P value = 0.15. Starting from the first month, the difference was statistically significant, with mean IOPs in Groups A and B of 14.9 mmHg and 18.2 mmHg, respectively, up to the sixth month (P value = 0.002, with a mean IOP in Groups A and B of 14.4 mmHg and 19.4 mmHg, respectively. Emulsified silicone was clinically stated in twelve cases (80% in Group B and in three cases (19% in Group A.Conclusion: There is a higher incidence of increased IOP and emulsification of silicone oil in pseudophakic eyes than in phakic eyes.Keywords: vitrectomy, siliconized eyes, emulsification, lens status
Psychophysical Vision Simulation of Diffractive Bifocal and Trifocal Intraocular Lenses
Brezna, Wolfgang; Lux, Kirsten; Dragostinoff, Nikolaus; Krutzler, Christian; Plank, Nicole; Tobisch, Rainer; Boltz, Agnes; Garhöfer, Gerhard; Told, Reinhard; Witkowska, Katarzyna; Schmetterer, Leopold
Purpose The visual performance of monofocal, bifocal, and trifocal intraocular lenses was evaluated by human individuals using a vision simulator device. This allowed investigation of the visual impression after cataract surgery, without the need actually to implant the lenses. Methods The randomized, double-masked, three-way cross-over study was conducted on 60 healthy male and female subjects aged between 18 and 35 years. Visual acuity (Early Treatment Diabetic Retinopathy Study; ETDRS) and contrast sensitivity tests (Pelli-Robson) under different lighting conditions (luminosities from 0.14–55 cd/m2, mesopic to photopic) were performed at different distances. Results Visual acuity tests showed no difference for corrected distance visual acuity data of bi- and trifocal lens prototypes (P = 0.851), but better results for the trifocal than for the bifocal lenses at distance corrected intermediate (P = 0.021) and distance corrected near visual acuity (P = 0.044). Contrast sensitivity showed no differences between bifocal and trifocal lenses at the distant (P = 0.984) and at the near position (P = 0.925), but better results for the trifocal lens at the intermediate position (P = 0.043). Visual acuity and contrast sensitivity showed a strong dependence on luminosity (P < 0.001). Conclusions At all investigated distances and all lighting conditions, the trifocal lens prototype often performed better, but never worse than the bifocal lens prototype. Translational Relevance The vision simulator can fill the gap between preclinical lens development and implantation studies by providing information of the perceived vision quality after cataract surgery without implantation. This can reduce implantation risks and promotes the development of new lens concepts due to the cost effective test procedure. PMID:27777828
Early clinical outcome with a new monofocal microincision intraocular lens.
Toygar, Baha; Yabas Kiziloglu, Ozge; Toygar, Okan; Hacimustafaoglu, Ali Murat
The purpose of this study was to evaluate the early visual and refractive outcomes of a new aspheric monofocal microincision intraocular lens (IOL). This retrospective case series included eyes of patients who underwent implantation of a microincision IOL following 1.8 mm manual coaxial microincision cataract surgery and who attended regular postoperative follow-up visits on the first week and first, third, and sixth months. The postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refraction and predictability, intraoperative and postoperative complications, posterior capsule opacification (PCO), IOL centration, and surgically induced astigmatism (SIA) were evaluated. Sixty-three eyes of 38 patients ranging in age from 51 to 86 were included in the study. The mean preoperative BCVA was 0.52 ± 0.42 logMAR. At the postoperative sixth month, the mean postoperative UCVA and BCVA were 0.12 ± 0.11 and 0.01 ± 0.03 logMAR, respectively. The mean postoperative spherical equivalent refraction (SER) was -0.30 ± 0.49 D. The SER was within ± 1.00 D of the attempted correction in 95.2 % of the eyes. The mean SIA measured with vector analysis was 0.45 ± 0.28 D. Mild PCO was observed in 9 eyes (14.7 %) with none requiring Nd:Yag laser capsulotomy. On centration analysis, the IOL was found to be 0.26 mm on average to the supero-nasal position. The aspheric microincision IOL was safely implanted and provided satisfactory visual and refractive outcomes in the early postoperative period.
Retreatments after multifocal intraocular lens implantation: an analysis
Gundersen, Kjell Gunnar; Makari, Sarah; Ostenstad, Steffen; Potvin, Rick
Purpose To determine the incidence and etiology of required retreatment after multifocal intraocular lens (IOL) implantation and to evaluate the methods and clinical outcomes of retreatment. Patients and methods A retrospective chart review of 416 eyes of 209 patients from one site that underwent uncomplicated cataract surgery with multifocal IOL implantation. Biometry, the IOL, and refractive data were recorded after the original implantation, with the same data recorded after retreatment. Comments related to vision were obtained both before and after retreatment for retreated patients. Results The multifocal retreatment rate was 10.8% (45/416 eyes). The eyes that required retreatment had significantly higher residual refractive astigmatism compared with those who did not require retreatment (1.21±0.51 D vs 0.51±0.39 D, P<0.01). The retreatment rate for the two most commonly implanted primary IOLs, blended bifocal (10.5%, 16/152) and bilateral trifocal (6.9%, 14/202) IOLs, was not statistically significantly different (P=0.12). In those requiring retreatment, refractive-related complaints were most common. Retreatment with refractive corneal surgery, in 11% of the eyes, and piggyback IOLs, in 89% of the eyes, was similarly successful, improving patient complaints 78% of the time. Conclusion Complaints related to ametropia were the main reasons for retreatment. Residual astigmatism appears to be an important determinant of retreatment rate after multifocal IOL implantation. Retreatment can improve symptoms for a high percentage of patients; a piggyback IOL is a viable retreatment option. PMID:27041983
Energy Efficiency of a New Trifocal Intraocular Lens
Vega, F.; Alba-Bueno, F.; Millán, M. S.
The light distribution among the far, intermediate and near foci of a new trifocal intraocular lens (IOL) is experimentally determined, as a function of the pupil size, from image analysis. The concept of focus energy efficiency is introduced because, in addition to the theoretical diffraction efficiency of the focus, it accounts for other factors that are naturally presented in the human eye such as the level of spherical aberration (SA) upon the IOL, light scattering at the diffractive steps or the depth of focus. The trifocal IOL is tested in-vitro in two eye models: the aberration-free ISO model, and a so called modified-ISO one that uses an artificial cornea with positive spherical SA in instead. The SA upon the IOL is measured with a Hartmann-Shack sensor and compared to the values of theoretical eye models. The results show, for large pupils, a notorious reduction of the energy efficiency of the far and near foci of the trifocal IOL due to two facts: the level of SA upon the IOL is larger than the value the lens is able to compensate for and there is significant light scattering at the diffractive steps. On the other hand, the energy efficiency of the intermediate focus for small pupils is enhanced by the contribution of the extended depth of focus of the near and far foci. Thus, while IOLs manufacturers tend to provide just the theoretical diffraction efficiency of the foci to show which would be the performance of the lens in terms of light distribution among the foci, our results put into evidence that this is better described by using the energy efficiency of the foci.
Intraocular lens exchange for high myopia in pseudophakic children.
Kraus, C L; Trivedi, R H; Wilson, M E
PurposeThe purpose of this study was to examine the preoperative factors and postoperative outcomes following intraocular lens (IOL) exchange for high myopia in pseudophakic children.MethodsThe medical records of all patients undergoing IOL exchange for high myopia were retrospectively reviewed.ResultsA total of 15 eyes were identified that had undergone an IOL exchange for myopic shift. Average age of cataract extraction (CE) was 5.4 months. In all, 10/15 had a unilateral cataract. IOL exchange usually occurred at an average of 6 years following cataract surgery. The average spherical equivalent (SE) of the refractive error at that time was -9.6 D. Following IOL exchange, SE was -1.3 D. A two-line reduction in best-corrected visual acuity was observed in 1/13 of our patients for whom pre- and post-exchange data were available. The average axial length (AL) of the eye undergoing the IOL exchange was 24.0 mm, average AL in the non-operative eye was 22.1 mm. On average, the operative eyes grew 4.4 mm and the non-operative eyes 3.02 mm. No adverse events were seen in the operative eyes.ConclusionYounger age at the time of CE creates a greater likelihood of AL elongation and predisposes a child to myopic shift. IOL exchange should be considered an option to reduce anisometropia and associated aniseikonia to improve visual outcomes. Successful visual rehabilitation and predictable post-exchange refractions were seen with our patients.
Long-term heavy silicone oil intraocular tamponade.
Dooley, Ian J; Duignan, Emma S; Kilmartin, Dara J
Heavy silicone oil tamponade is intended to be temporary, but may occasionally be indefinite in patients who refuse, or are deemed unsuitable for, further surgery. The aim of this study is to compare the outcomes of patients with temporary versus indefinite heavy silicone oil intraocular tamponade. This retrospective, comparative case series identified 75 patients who underwent heavy silicone oil instillation (Oxane HD) over a 6 year period (2006-2012) in one institution. Thirty-nine patients had temporary heavy oil tamponade and 36 patients had indefinite tamponade. The majority (68 %) of patients had a history of previous vitreoretinal surgery prior to oil instillation and 66.7 % had pre-existing proliferative vitreoretinopathy (PVR). The mean final logMAR best corrected visual acuity (BCVA) was significantly better in the temporary tamponade group (1.34 ± 0.66) than the indefinite tamponade group 1.82 ± 0.64 (p = 0.003). Ambulatory BCVA (≥ 4/200) was retained in 76.3 % of temporary tamponade patients versus 54.3 % of indefinite tamponade patients (p = 0.093). Successful retinal reattachment was significantly more likely in temporary tamponade patients (92.3 %) than indefinite tamponade patients (75 %; p = 0.04). Complications in the patients with indefinite heavy silicone oil tamponade included redetachment (38.9 %), corneal pathology (13.8 %), secondary glaucoma (11.1 %) and anterior segment emulsification (8.3 %).While temporary tamponade patients had better outcomes than those with indefinite tamponade, the majority of indefinite tamponade patients still retained ambulatory vision in the affected eye. Indefinite heavy silicone oil tamponade remains a viable option for those who cannot undergo removal of oil surgery.
Effects of fasting on intraocular pressure in a black population
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Mustapha B Hassan
Full Text Available Introduction: There is a dearth of literature available on the effects of fasting on Intraocular pressure (IOP among all races and worldwide. Objectives : To determine the effects of fasting on IOP in a black African population. Materials and Methods: A population-based survey utilizing multistage random sampling techniques was carried out among healthy adult Muslims who were examined before and during Ramadan fast in Osogbo, Nigeria. Demographics were obtained, visual acuities, clinical examination of both eyes, and IOPs were done. Weights and waist circumference were measured. Data were analyzed using Statistical Package for Social Sciences ( SPSS Version 16. Analysis generated frequencies and cross tabulations, whereas statistical significant values were derived using paired sample t-test and P < 0.05. Results: A total of 60 subjects with 120 eyes were examined. Mean age was 42.3 years standard deviation (SD 16.7, and the male to female ratio was 3:2. Majority were professionals (33.3%. Only 18.3% had less than secondary school education. Over 90% had normal vision (6/5-6/18. Before and during fasting, the mean weights were 65.92 kg SD 12.98 and 65.29 kg SD 12.41 with a reduction of 0.63 kg SD 3.82 (P = 0.214, 95% confidence interval (CI: 0.372-1.626; and the mean waist circumference was 87.20 cm SD 12.39 and 81.78 cm SD 11.65 (P = 0.000, 95% CI 4.128-6.720, respectively. Mean IOPs were 15.98 mmHg SD 3.11 and 14.08 mmHg SD 2.71 before and during fasting, respectively (P = 0.000, 95% CI 0.98558-2.82798. Conclusions: The study shows that fasting significantly reduced IOP in an ocularly healthy black African population.
Intraocular caspofungin: in vitro safety profile for human ocular cells.
Kernt, M; Kampik, A
Endogenous Candida endophthalmitis is sight-threatening, difficult to treat and sometimes leads to loss of the eye. Only a few therapeutic agents are available for its treatment. Caspofungin is the first of a new class of antifungal drugs (echinocandins) with a high activity against Candida species, the most common pathogens found in endogenous endophthalmitis. This study investigates the safety profile of caspofungin for intraocular application in a cell-culture model. Endothelial toxicity of caspofungin was evaluated in cultured human corneas. Possible toxic effects of caspofungin (5-300 μg ml(-1)) in corneal endothelial cells (CEC), primary human trabecular meshwork cells (TMC) and primary human retinal pigment epithelium (RPE) cells were evaluated after 24 h and under conditions of inflammatory stress by treatment with tumour necrosis factor-alpha (TNF-α), lipopolysaccharides (LPS) or interleukin-6 (IL-6) and hydrogen peroxide (H(2)O(2)). Toxicity was evaluated by tetrazolium dye-reduction assay; cell viability was quantified by a microscopic live-dead assay. No corneal endothelial toxicity could be detected after 30 days of treatment with 75 μg ml(-1) of caspofungin. Concentrations up to 75 μg ml(-1) had no influence on CEC, TMC or RPE cell proliferation, or on cell viability when administered for 24 h. Exposure to H(2)O(2) did not increase cellular toxicity of caspofungin at concentrations of 5-50 μg ml(-1). After preincubation with TNF-α, LPS or IL-6 for 24 h followed by treatment with caspofungin for 24 h, no significant decrease in cell proliferation or viability was observed. This study showed no significant toxicity for caspofungin on CEC, TMC or RPE cells, or human corneal endothelium when administered in therapeutic concentrations up to 50 μg ml(-1).
Blood pressure modifies retinal susceptibility to intraocular pressure elevation.
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Zheng He
Full Text Available Primary open angle glaucoma affects more than 67 million people. Elevated intraocular pressure (IOP is a risk factor for glaucoma and may reduce nutrient availability by decreasing ocular perfusion pressure (OPP. An interaction between arterial blood pressure and IOP determines OPP; but the exact contribution that these factors have for retinal function is not fully understood. Here we sought to determine how acute modifications of arterial pressure will affect the susceptibility of neuronal function and blood flow to IOP challenge. Anaesthetized (ketamine:xylazine Long-Evan rats with low (∼60 mmHg, sodium nitroprusside infusion, moderate (∼100 mmHg, saline, or high levels (∼160 mmHg, angiotensin II of mean arterial pressure (MAP, n = 5-10 per group were subjected to IOP challenge (10-120 mmHg, 5 mmHg steps every 3 minutes. Electroretinograms were measured at each IOP step to assess bipolar cell (b-wave and inner retinal function (scotopic threshold response or STR. Ocular blood flow was measured using laser-Doppler flowmetry in groups with similar MAP level and the same IOP challenge protocol. Both b-wave and STR amplitudes decreased with IOP elevation. Retinal function was less susceptible to IOP challenge when MAP was high, whereas the converse was true for low MAP. Consistent with the effects on retinal function, higher IOP was needed to attenuated ocular blood flow in animals with higher MAP. The susceptibility of retinal function to IOP challenge can be ameliorated by acute high BP, and exacerbated by low BP. This is partially mediated by modifications in ocular blood flow.
Intraocular lens implantation for the treatment of astigmatism%人工晶状体植入术矫正散光
Institute of Scientific and Technical Information of China (English)
施俊廷; 徐雯
Refractive intraocular lens surgery can be used for the treatment of moderate and high regular astigmatism.Refractive intraocular lens surgery includes aphakic intraocular lens surgery and phakic intraocular lens surgery.In phakic intraocular lens surgery two types of intraocular lenses are used:iris-claw intraocular lens and posterior chamber intraocular lens.The purpose of this article is to review current knowledge of surgical treatments of astigmatism with a particular focus on toric implantable collamer lenses.%人工晶状体(IOL)植入术能矫正中、高度规则散光.矫正散光的IOL植入术可分为无晶状体眼及有晶状体眼的环曲面IOL植入两类,其中有晶状体眼的环曲面IOL又可分为虹膜夹持型及后房型.本文旨在介绍IOL矫正散光的手术治疗方法,并着重介绍有晶状体眼植入后房型IOL矫正屈光不正合并散光的治疗技术.
[Intraocular lenses for the correction of refraction errors. Part 1: phakic anterior chamber lenses].
Kohnen, T; Baumeister, M; Cichocki, M
In this overview, the current status of intraocular lens surgery to correct refractive error is reviewed. The interventions are divided into additive surgery with intraocular lens implantation without extraction of the crystalline lens (phakic intraocular lens, PIOL) or the removal of the crystalline lens with implantation of an IOL (refractive lens exchange, RLE). Phakic IOLs are constructed as angle-supported or iris-fixated anterior chamber lenses and posterior chamber lenses that are fixated in the ciliary sulcus. The implantation of phakic IOLs has been demonstrated to be an effective, safe, predictable and stable procedure to correct higher refractive errors. Complications are rare and differ for the three types of PIOL; for anterior chamber lenses these are mainly pupil ovalization and endothelial cell loss.
Influence of untreated chronic plastic iridocyclitis on intraocular pressure in leprosy patients.
Karaçorlu, M A; Cakiner, T; Saylan, T
The intraocular pressures of a total of 286 eyes of patients with lepromatous and borderline lepromatous leprosy who never had regular ophthalmological care or local eye treatment were measured. The patients were categorised according to the type of leprosy they had, and the eyes were categorised as without or with chronic plastic iridocyclitis. In patients with lepromatous and borderline lepromatous types of leprosy the intraocular pressure was significantly lower in eyes with chronic plastic iridocylitis 10.1 (3.6) mmHg than in both unaffected eyes 11.0 (3.2) mmHg and control eyes 13.5 (2.5) mmHg. It has been shown that chronic plastic iridocyclitis which remains untreated for years results in a lower intraocular pressure than normal.
Laser-triggered intraocular implant to induce photodynamic therapy for posterior capsule opacification prevention.
Zhang, Zhaoguo; Huang, Wenyong; Lei, Ming; He, Yuanfeng; Yan, Mina; Zhang, Xuefei; Zhao, Chunshun
Posterior capsule opacification (PCO) is one of the main reasons for loss of vision again after cataract surgery. In this study, intraocular lenses were modified with indocyanine green (ICG) and sealed up with PLGA to form long-term intraocular implants (ICG-IOL). When triggered by laser, ICG-IOL would induce photodynamic therapy (PDT). In-vitro cell viability assay and scratch wound healing assay demonstrated that ICG-IOL could effectively inhibit HLEpiC proliferation and migration without causing damage to the cells far away from it. Laser attenuation test indicated that ICG-IOL could be applied in vivo. In-vivo pharmacodynamics and safety study showed that ICG-IOL could significantly prevent the occurrence of PCO and was safe for intraocular normal tissue. All these results suggested that ICG-IOL would be a very promising candidate for PCO prevention.
Modified Scleral Flap Incision to Reduce Corneal Astigmatisn after Intraocular Lens Implantation
Institute of Scientific and Technical Information of China (English)
YizhiLiu; ShaozhenLi
Purpose:To investigate a simple method during extracapsular cataract extraction with posteior chamber intraocular lens implantation in order to reduce surgically induced corneal astig-matism.Methods:A modified scleral flap incision was used in the extracapsular cataract extraction with intraocular lens implantation and the postoperative changes in conreal astigmatism was observed.Results:The peak value of postoperative corneal astigmatism was3.60D,and the corneal astigmatism regression was 2.11D,surgically induced astigmatism was less significant in modified scleral flap incision group than that in convention-al limbal incison group(P<0.05).Conclusions:The modified scleral flap inciston is an ideal incision for cataract ex-traction with intraocular lens implantation when phacoemulsifier is not avaliable.Eye Science1995;11:136-139.
Spatiotemporal alterations of presynaptic elements in the retina after high intraocular pressure
Institute of Scientific and Technical Information of China (English)
Jufang Huang; Lihong Zhou; Hui Wang; Jia Luo; Kun Xiong; Leping Zeng; Dan Chen
A rat model of acute high intraocular pressure was established by injecting saline into the anterior chamber of the left eye. Synaptophysin expression was increased in the inner plexiform layer at 2 hours following injury, and was widely distributed in the outer plexiform layer at 3–7 days, and then decreased to the normal level at 14 days. This suggests that expression of this presynaptic functional protein experienced spatiotemporal alterations after elevation of intraocular pressure. There was no significant change in the fluorescence intensity and distribution pattern for synapse-associated protein 102 following elevated intraocular pressure. Synapse-associated protein 102 immunoreactivity was confined to the outer plexiform layer, while synaptophysin immunoreactivity spread into the outer plexiform layer and the outer nuclear layer at 3 and 7 days following injury. These alterations in presynaptic elements were not accompanied by changes in postsynaptic components.
Role of interferon-γ and cytotoxic T lymphocytes in intraocular tumor rejection.
Ligocki, Ann J; Brown, Joseph R; Niederkorn, Jerry Y
The eye is normally an immunosuppressive environment. This condition is better known as immune privilege and protects the eye from immune-mediated inflammation of tissues that cannot regenerate. However, immune privilege creates a dilemma for the eye when intraocular neoplasms arise. In some cases, immune privilege is suspended, resulting in the immune rejection of intraocular tumors. This study employed a mouse model in which interferon-γ-dependent intraocular tumor rejection occurs. We tested the hypothesis that this rejection requires interferon-γ for the generation and functional capacity of cytotoxic T lymphocyte-mediated rejection of intraocular tumors. Tumors grew progressively in the eyes of interferon-γ knockout mice, even though the mice generated tumor-specific cytotoxic T lymphocyte responses in the periphery. However, interferon-γ knockout mice rejected tumors that were introduced into extraocular sites. Subcutaneous tumor immunization before intraocular challenge led to tumor rejection and preservation of the eye in wild-type mice. By contrast, tumors grew progressively in the eyes of interferon-γ knockout mice despite their ability to generate peripheral tumor-specific cytotoxic T lymphocytes as well as the capacity of CD8(+) T cells to enter the eye as shown by the presence of CD8 and perforin message and CD3(+)CD8(+) leukocytes within the tumor-bearing eye. We found that cytotoxic T lymphocytes generated in wild-type mice and adoptively transferred into interferon-γ knockout mice mediated the rejection of intraocular tumors in interferon-γ knockout hosts. The results indicate that interferon-γ is critical for the initial priming and differentiation of cytotoxic T lymphocytes residing in the periphery to produce the most effect antitumor function within the eye.
A study of patient satisfaction after cataract surgery with implantation of different types of intraocular lenses
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Wei Ching-Kuo
Full Text Available Abstract Background The implementation of capitated payment has driven medical institutions through developing balance billing for medical services. By exploring the patients' decision-making factors on different self-pay items, a reference for the pricing and sales strategy for the related products can be formed. The major purposes of this study were to analyze the determinants of preoperative selection and postoperative satisfaction with implantation of different types of intraocular lenses in cataract surgery. Methods This cross-sectional study consisted of 127 patients that were 50 years of age and older, and who had phacoemulsification with intraocular lens implantation in both eyes. Data were collected by using a structured questionnaire. The following parameters were measured: access to medical care, attitude towards receiving medical products at one's own expense, overall patient satisfaction and postoperative visual clarity. Results The results showed that the patient's gender, educational level and economic status influenced the type of intraocular lens chosen. Patients in the insurance group cared about access to medical care, and patients in the balance billing group cared about product differentiation. ANOVA results showed no statistically significant differences in the overall satisfaction of the patients among the groups with different types of intraocular lenses. Patients that received cataract surgery with implantation of multifocal intraocular lenses had better vision when trying to view smaller objects and when looking at objects under strong light. Conclusions Manufacturers should increase the number of differences between their products, and health care providers can then recommend the appropriate intraocular lens in accordance with the needs or demands of their patients, and also by keeping in mind the financial constraints of their patients.
Ophthalmic viscosurgical device backflow into cartridge during intraocular lens insertion using injectors
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Matsuura K
Full Text Available Kazuki Matsuura,1 Yoshitsugu Inoue2 1Nojima Hospital, 2Tottori University, Kurayoshi City, Tottori, Japan Background: The purpose of this study was to assess the risk of intraocular contamination caused by intraocular lens (IOL insertion with injectors by observing the dynamics of an ophthalmic viscosurgical device (OVD. Methods: Each type of injector was equipped with a colored OVD and IOL, and a 2 mm length from the tip of the cartridge was replaced with a colored OVD. The various combinations of IOLs and injectors used were: a three-piece shaped IOL, VA60BBR + TypeE1 (HOYA incision size 2.5 mm; group A, n=5; a single-piece IOL, 251+ iSert micro, preloaded (HOYA, incision size 2.2 mm; group G, n=5; and a single-piece IOL, SN6CWS preloaded (Alcon, incision size 2.7 mm; group C, n=5. Results: In group A, the intraocular OVD instantly flowed backward into the injector, whereas the colored OVD was pushed backward deep inside the cartridge without flowing into the eye. In group B, the backflow of the intraocular OVD into the injector was limited, resulting in the influx of a large amount of the colored OVD into the eye along with the IOL. In group C, as in group A, a large amount of the intraocular OVD flowed backward into the injector. Consequently, a small amount of the colored OVD flowed into the eye. Conclusion: The tip of the injector and OVD could be contaminated because the surgical field cannot be completely sterile, even after preoperative disinfection. Our experiments revealed that OVD backflow into the injector cavity occurs during IOL insertion, and this phenomenon may have minimized intraocular contamination. However, small-diameter cartridges along with plate-type haptics allow insufficient OVD backflow, resulting in intraocular influx of the contaminated OVD. Surgeons have to be notified that intraoperative bacterial contamination can occur even after IOL insertion using injectors. Keywords: intraocular lens insertion
Symbolic algebra approach to the calculation of intraocular lens power following cataract surgery
Hjelmstad, David P.; Sayegh, Samir I.
We present a symbolic approach based on matrix methods that allows for the analysis and computation of intraocular lens power following cataract surgery. We extend the basic matrix approach corresponding to paraxial optics to include astigmatism and other aberrations. The symbolic approach allows for a refined analysis of the potential sources of errors ("refractive surprises"). We demonstrate the computation of lens powers including toric lenses that correct for both defocus (myopia, hyperopia) and astigmatism. A specific implementation in Mathematica allows an elegant and powerful method for the design and analysis of these intraocular lenses.
Comparison of visual outcomes after implantation of diffractive trifocal toric intraocular lens and a diffractive apodized bifocal toric intraocular lens
Gundersen, Kjell Gunnar; Potvin, Rick
Purpose The aim of this study was to compare a new diffractive trifocal toric lens with an apodized diffractive bifocal toric lens in terms of refractive and visual acuity (VA) outcomes, including low-contrast VA (LCVA), as well as the patient's visual function 3 months after implantation. Patients and methods This is a randomized prospective study involving bilateral implantation of a trifocal toric or a bifocal toric lens. At 3 months postoperatively, the subject's vision was tested both uncorrected and with his/her best distance correction at: distance (4 m), intermediate (63 cm), and near (40 cm). Binocular defocus curves were measured with no correction and with the subject's best distance correction in place. Quality of vision was measured using the National Eye Institute Visual Function Questionnaire. Results A total of 22 patients were enrolled (eleven in each group). There was no statistically significant difference in the absolute change in measured rotation between 1 month and 3 months postoperatively between the two intraocular lens (IOL) groups (P=0.98). At 3 months, the postoperative refraction and distance VA by eye were similar between groups. There was no statistically significant difference in the measured LCVA between groups (P=0.39). The defocus curve showed that at 67 cm, the trifocal toric lens had statistically significantly better VA when compared to the bifocal toric lens. There were no statistically significant differences by group for any of the National Eye Institute Visual Function Questionnaire scores (P>0.26 in all cases). Conclusion The trifocal toric IOL improved the intermediate vision without negatively impacting visual function and distance, near, or low-contrast VA when compared to a bifocal toric IOL. The toric component of the trifocal lens effectively reduced astigmatism and provided good rotational stability. PMID:27051269
Sensitivity of the corneal-plane refractive compensation to change in power and axial position of an intraocular lens
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W. F. Harris
Full Text Available If an intraocular lens is displaced or if its power is changed what are the consequences for the refractive compensation of the eye? Gaussian optics is used to obtain explicit formulae for the sensitivityof the corneal-plane refractive compensation (also called the refraction, refractive state, etc to change in power and axial displacement of a thin intraocular lens implanted in a simple eye. In particular, for a pseudophakic Gullstrand simplified eye with intraocular lens placed 5 mm behind the cornea the sensitivity to errors in the power of the intraocular lens is about 71 . 0 − 71 for an intraocular lens of power for an intraocular lens of power 20 D, that is, the refractive compensation decreases by about 0.71 dioptres per dioptre increase in the power of the intraocular lens. More generally the sensitivity is approximately ( m 0037 . 0 63 . 0 F − − 0.63 ( 003 . 0 63 . 0 − − (0.0037mF where FI is the power of the intraocular lens. Also for Gullstrand's simplified eye the sensitivity of refractive compensation to axial displacement of the intraocular lens is approximately linear in FI about (64D FI, in fact. That is, for each dioptre of the power of the intraocular lens the refractive compensation increases by about 0.064 dioptres per millimetre of axial displacement towards the retina.
Study on preparation and regeneration condition of protoplasts of Cephalosporium acremonium and transformation of plasmid DNA with vgb gene%顶头孢霉原生质体制备、再生及带vgb基因的质粒DNA转化条件的研究
Institute of Scientific and Technical Information of China (English)
戴秀君; 马文婵; 李术娜; 王全; 李红亚; 朱宝成
The formation and regeneration conditions of Cephalosporium acremonium protoplast were studied. The optimum conditions of protoplast preparation were as follow: After Cephalosporium acremonium mycelium has been cultivated for 110 -120 h on peptone medium, using enzyme 1%snailase+1% cellulase("Onozoka R - 10") to digest the cell wall for 3. 5 h at 30 ℃ , the number of protoplast reaches about 2. 377 × 10~7 per milliliter. Meanwhile the regeneration was tested on solid media containing KC (0. 6 mol/L KCl+25 mmol/L CaCL_2 · 2H_2O) as osmotic stabilizer, the regeneration ratio is about 40%. Then the constructed shuttle plasmid pMK4 - LV was transformed into protoplasts by using electroporation method. The recombi-nant was obtained. Successfully. The transfer ratio is about 10 recombinants/μg DNA. The vgb gene was testified to have been recombined into the Cephalosporium acremonium genome through the PCR amplification.%对头孢菌素C的工业生产菌种顶头孢霉(Cephalosporium acremonium)原生质体形成和再生条件进行了研究.优化后的制备及再生条件为:在蛋白胨固体培养基上培养110~120 h的菌丝体,30 ℃条件下经1%蜗牛酶和1%纤维素酶混合液酶解3.5 h,原生质体得率最高可达2.377×10~7 个/mL;在以KC(0 6 mol/L KCl+25 mmol/L CaCl_2·2H_2O)为渗透压稳定剂的再生培养基上进行培养,再生率可达40%.用pMK4-LV质粒通过电击法对原生质体进行转化,成功得到了重组子,转化率约为10 个转化子/μg质粒DNA.转化子的 PCR鉴定结果表明,外源基因已转入顶头孢霉基因组.
Comparison of two optical biometers in intraocular lens power calculation
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Sheng Hui
Full Text Available Aims: To compare the consistency and accuracy in ocular biometric measurements and intraocular lens (IOL power calculations using the new optical low-coherence reflectometry and partial coherence interferometry. Subjects and Methods: The clinical data of 122 eyes of 72 cataract patients were analyzed retrospectively. All patients were measured with a new optical low-coherence reflectometry system, using the LENSTAR LS 900 (Haag Streit AG/ALLEGRO BioGraph biometer (Wavelight., AG, and partial coherence interferometry (IOLMaster V.5.4 [Carl Zeiss., Meditec, AG] before phacoemulsification and IOL implantation. Repeated measurements, as recommended by the manufacturers, were performed by the same examiner with both devices. Using the parameters of axial length (AL, corneal refractive power (K1 and K2, and anterior chamber depth (ACD, power calculations for AcrySof SA60AT IOL were compared between the two devices using five formulas. The target was emmetropia. Statistical analysis was performed using Statistical Package for the Social Sciences software (SPSS 13.0 with t-test as well as linear regression. A P value < 0.05 was considered to be statistically significant. Results: The mean age of 72 cataract patients was 64.6 years ± 13.4 [standard deviation]. Of the biometry parameters, K1, K2 and [K1 + K2]/2 values were significantly different between the two devices (mean difference, K1: −0.05 ± 0.21 D; K2: −0.12 ± 0.20 D; [K1 + K2]/2: −0.08 ± 0.14 D. P <0.05. There was no statistically significant difference in AL and ACD between the two devices. The correlations of AL, K1, K2, and ACD between the two devices were high. The mean differences in IOL power calculations using the five formulas were not statistically significant between the two devices. Conclusions: New optical low-coherence reflectometry provides measurements that correlate well to those of partial coherence interferometry, thus it is a precise device that can be used for the
Toric intraocular lens orientation and residual refractive astigmatism: an analysis
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Potvin R
Full Text Available Rick Potvin,1 Brent A Kramer,2 David R Hardten,3 John P Berdahl4 1Science in Vision, Akron, NY, 2University of Iowa Carver College of Medicine, Iowa City, IA, 3Minnesota Eye Consultants, Minnetonka, MN, 4Vance Thompson Vision, Sioux Falls, SD, USA Purpose: To analyze intraocular lens (IOL orientation data from an online toric back-calculator (astigmatismfix.com for determining if differences were apparent by lens type.Methods: A retrospective review of astigmatismfix.com toric back-calculations that included IOL identification and intended orientation axis.Results: Of 12,812 total validated calculation records, 8,229 included intended orientation and lens identification data. Of the latter, 5,674 calculations (69% involved lenses oriented 5° or more from their intended position. Using estimated toric lens usage data, the percentage of lenses with orientation ≥5° from intended was 0.89% overall, but the percentage varied significantly between specific toric lens brands (P<0.05. The percentage of back-calculations related to lenses that were not oriented as intended was also statistically significantly different by lens brand (P<0.05. When IOLs were misoriented, they were significantly more likely to be misoriented in a counterclockwise direction (P<0.05. This was found to be due to a bias toward counterclockwise orientation observed with one specific brand, a bias that was not observed with the other three brands analyzed here.Conclusion: The percentage of eyes with lens orientation ≥5° from intended in the Toric Results Analyzer data set was <1% of toric IOLs in general, with the relative percentage of Tecnis® Toric IOLs significantly higher than AcrySof® Toric IOLs. Both of these had higher rates than the Staar® Toric and Trulign® Toric lenses, with the availability of higher Tecnis and AcrySof cylinder powers a likely contributing factor. The AcrySof Toric IOL appears to be less likely than the Tecnis Toric IOL to cause residual
Effect of pegaptanib sodium 0.3 mg intravitreal injections (Macugen) in intraocular pressure
DEFF Research Database (Denmark)
Boyer, David S; Goldbaum, Mauro; Leys, Anita M
OBJECTIVE: To assess the rate of pegaptanib-associated sustained intraocular pressure (IOP) elevation. METHODS: A posthoc analysis was conducted on all IOP measurements, except the immediate 30-min postinjection, from all subjects randomised to pegaptanib 0.3 mg or sham injections continuously in...
Intraocular and extraocular hemorrhage associated with ligature release of non-valved glaucoma drainage implant
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Michelle Go
Conclusions: and importance: This is the first report of a rare occurrence of intraocular and extraocular hemorrhage associated following spontaneous release of ligature of a non-valved glaucoma drainage implant. The presumed mechanism was sudden shallowing of the anterior chamber resulting in the tube irritating uveal vasculature. We do not have an explanation for the extraocular blood.
BACKGROUND: Phakic anterior chamber lenses is one of the modalities used to correct high myopia, We report the initial results of our prospective study on the Worst myopia claw intraocular lens (IOL) that is fixated to the anterior iris, METHODS: We studied 35 eyes in 18 patients with a preoperative
Bilateral transient pupil closure after iris supported intraocular lens implantation in a case with Marfan syndrome
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Necip Kara
Full Text Available A 16-year-old woman presented with Marfan syndrome and bilateral ectopia lentis. The surgical treatment including removal of the crystalline lens and implantation of an iris-supported intraocular lens in both eyes at a week interval. Postoperatively, the biomicroscopic examination showed total pupil closure bilaterally. After the topical tropicamide treatment, the pupil returned to normal shape.
Implantation of Artisan toric phakic intraocular lens following Intacs in a patient with keratoconus.
Kamburoğlu, Günhal; Ertan, Aylin; Bahadir, Mehmet
We report a 24-year-old man with bilateral keratoconus in whom Intacs (Addition Technology, Inc.) were implanted in both eyes. The procedure was followed by Artisan toric phakic intraocular lens (Ophtec) implantation to correct the residual myopic and astigmatic refractive error.
An Intraocular Camera for Retinal Prostheses: Restoring Sight to the Blind
Stiles, Noelle R. B.; McIntosh, Benjamin P.; Nasiatka, Patrick J.; Hauer, Michelle C.; Weiland, James D.; Humayun, Mark S.; Tanguay, Armand R., Jr.
Implantation of an intraocular retinal prosthesis represents one possible approach to the restoration of sight in those with minimal light perception due to photoreceptor degenerating diseases such as retinitis pigmentosa and age-related macular degeneration. In such an intraocular retinal prosthesis, a microstimulator array attached to the retina is used to electrically stimulate still-viable retinal ganglion cells that transmit retinotopic image information to the visual cortex by means of the optic nerve, thereby creating an image percept. We describe herein an intraocular camera that is designed to be implanted in the crystalline lens sac and connected to the microstimulator array. Replacement of an extraocular (head-mounted) camera with the intraocular camera restores the natural coupling of head and eye motion associated with foveation, thereby enhancing visual acquisition, navigation, and mobility tasks. This research is in no small part inspired by the unique scientific style and research methodologies that many of us have learned from Prof. Richard K. Chang of Yale University, and is included herein as an example of the extent and breadth of his impact and legacy.
Iris-fixated anterior chamber phakic intraocular lens for myopia moves posteriorly with mydriasis.
Cruysberg, L.P.J.; Doors, M.; Berendschot, T.T.; Brabander, J. De; Webers, C.A.; Nuijts, R.M.
PURPOSE: To elucidate the physiological characteristics of eyes implanted with iris-fixated anterior chamber phakic intraocular lenses (pIOLs), which are increasingly being used for the correction of higher myopic and hyperopic refractive errors. METHODS: In a case series of 20 patients (39 eyes), t
Evaluation of Different Power of Near Addition in Two Different Multifocal Intraocular Lenses
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Ugur Unsal
Full Text Available Purpose. To compare near, intermediate, and distance vision and quality of vision, when refractive rotational multifocal intraocular lenses with 3.0 diopters or diffractive multifocal intraocular lenses with 2.5 diopters near addition are implanted. Methods. 41 eyes of 41 patients in whom rotational +3.0 diopters near addition IOLs were implanted and 30 eyes of 30 patients in whom diffractive +2.5 diopters near addition IOLs were implanted after cataract surgery were reviewed. Uncorrected and corrected distance visual acuity, intermediate visual acuity, near visual acuity, and patient satisfaction were evaluated 6 months later. Results. The corrected and uncorrected distance visual acuity were the same between both groups (p=0.50 and p=0.509, resp.. The uncorrected intermediate and corrected intermediate and near vision acuities were better in the +2.5 near vision added intraocular lens implanted group (p=0.049, p=0.005, and p=0.001, resp. and the uncorrected near vision acuity was better in the +3.0 near vision added intraocular lens implanted group (p=0.001. The patient satisfactions of both groups were similar. Conclusion. The +2.5 diopters near addition could be a better choice in younger patients with more distance and intermediate visual requirements (driving, outdoor activities, whereas the + 3.0 diopters should be considered for patients with more near vision correction (reading.
Fifty-year follow-up and Strampelli anterior chamber intraocular lens.
Oakley, Carmen L; Nigro, Matthew A; Vote, Brendan J
The Strampelli anterior chamber intraocular lens was created in 1953, and was primarily used to treat myopia and aphakia. Due to the positioning of the lens, it was associated with a number of complications, and was later modified to decrease the rate of significant complications, including endothelial cell loss. This paper describes a 62-year-old man, who has had a Strampelli intraocular lens (IOL) in situ for 52 years, with relatively few complications. The case provides a framework for reflection on the significant advances in the development of IOLs since the Strampelli era. The Strampelli anterior chamber intraocular lens was created in 1953, and was primarily used to treat myopia and aphakia. Due to the positioning of the lens, it was associated with a number of complications, and was later modified to decrease the rate of significant complications, including endothelial cell loss. This paper describes a 62-year-old man, who has had a Strampelli intraocular lens (IOL) in situ for 52 years, with relatively few complications. The case provides a framework for reflection on the significant advances in the development of IOLs since the Strampelli era.
A rapid method for measuring intraocular lens power in vitro with a focimeter.
García-Domene, Mari Carmen; Díez-Ajenjo, María Amparo; Peris-Martínez, Cristina; Navea, Amparo; Artigas, José María
In this paper we describe a new method for measuring the intraocular lens (IOL) power using a focimeter, a negative ophthalmic lens and a saline solution (0.9% NaCl). To test this we measured the power of 58 different IOLs and we compared them with the power stated by the manufacturer. Despite the limitations, the results show a good correlation.
Case of late-onset corneal decompensation after iris-fixated phakic intraocular lens implantation.
Eijden, R. van; Vries, N.E. de; Cruysberg, L.P.J.; Webers, C.A.; Berenschot, T.; Nuijts, R.M.
A 48-year-old myopic patient with bilateral anterior chamber depth of 3.1 mm and endothelial cell density (ECD) of 2525 cells/mm(2) and 2638 cells/mm(2) preoperatively had bilateral implantation of an Artisan iris-fixated phakic intraocular lens (pIOL). Five years postoperatively, unilateral corneal
Comparison of ocular straylight after implantation of multifocal intraocular lenses
Łabuz, Grzegorz; Reus, Nicolaas J; van den Berg, Thomas J T P
UNLABELLED: A comprehensive review of the effect of multifocal intraocular lens (IOL) designs on postoperative ocular straylight was performed. Studies reporting straylight values obtained with the natural pupil using the C-Quant device after uneventful multifocal IOL implantation were included. The
Comparison of a hydrophilic and a hydrophobic apodized diffractive multifocal intraocular lens.
Linden, J.W.M. van der; Meulen, I.J. van der; Mourits, M.P.; Lapid-Gortzak, R.
To compare outcomes between a new design apodized diffractive hydrophilic multifocal intraocular lens (IOL) (Seelens MF; study group), and a well-known apodized diffractive hydrophobic multifocal IOL (SN6AD1; control group). A comparative case series comparing refractive and visual outcomes at dista
Clinical comparison of the optical performance of aspheric and spherical intraocular lenses
van Gaalen, Kim W.; Koopmans, Steven A.; Jansonius, Nomdo M.; Kooijman, Aart C.
PURPOSE: To compare the optical performance of aspheric Tecnis ZA9003 and spherical Sensar AR40e intraocular lenses (IOLs). SETTING: Laboratory of Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. METHODS: An aspheric IOL was implan
23-gauge Transconjunctival Sutureless Vitrectomy in Eyes with Posteriorly Dislocated Intraocular Lens after Cataract Surgery
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Fatih Horozo¤lu
Full Text Available Purpose: To evaluate the outcomes of 23-gauge (23-G transconjunctival sutureless vitrectomy (TSV in eyes with posteriorly dislocated intraocular lens (IOL after cataract surgery. Material and Method: In this retrospective study, we evaluated 6 eyes of 6 consecutive cases with posteriorly dislocated intraocular lens after cataract surgery between April 2007 and November 2010. Visual acuity, intraocular pressure, detailed fundus examination and details of surgery were recorded. Results: The mean age of the patients was 64.7 years and the mean follow-up was 5.5 months (3-12 months. All eyes received 23-G TSV. Dislocated IOL was removed from the vitreous and implanted into ciliary sulcus in 2 eyes (33.3% with polymethylmetacrilate IOL and in 4 eyes (66.7% with 3-piece hydrophilic acrylic IOL. In 5 of the 6 eyes (83.7%, visual acuity improved postoperatively. In one eye (16.7%, elevation of intraocular pressure was observed postoperatively and controlled by topical treatment. Discussion: 23-G TSV surgery may be used in eyes with posteriorly IOLs after cataract surgery. Studies with a larger number of patients would better demonstrate the efficacy of this method. (Turk J Ophthalmol 2011; 41: 213-6
Common Genetic Determinants of Intraocular Pressure and Primary Open-Angle Glaucoma
van Koolwijk, Leonieke M. E.; Ramdas, Wishal D.; Ikram, M. Kamran; Jansonius, Nomdo M.; Pasutto, Francesca; Hysi, Pirro G.; Macgregor, Stuart; Janssen, Sarah F.; Hewitt, Alex W.; Viswanathan, Ananth C.; ten Brink, Jacoline B.; Hosseini, S. Mohsen; Amin, Najaf; Despriet, Dominiek D. G.; Willemse-Assink, Jacqueline J. M.; Kramer, Rogier; Rivadeneira, Fernando; Struchalin, Maksim; Aulchenko, Yurii S.; Weisschuh, Nicole; Zenkel, Matthias; Mardin, Christian Y.; Gramer, Eugen; Welge-Luessen, Ulrich; Montgomery, Grant W.; Carbonaro, Francis; Young, Terri L.; Bellenguez, Celine; McGuffin, Peter; Foster, Paul J.; Topouzis, Fotis; Mitchell, Paul; Wang, Jie Jin; Wong, Tien Y.; Czudowska, Monika A.; Hofman, Albert; Uitterlinden, Andre G.; Wolfs, Roger C. W.; de Jong, Paulus T. V. M.; Oostra, Ben A.; Paterson, Andrew D.; Mackey, David A.; Bergen, Arthur A. B.; Reis, Andre; Hammond, Christopher J.; Vingerling, Johannes R.; Lemij, Hans G.; Klaver, Caroline C. W.; van Duijn, Cornelia M.
Intraocular pressure (IOP) is a highly heritable risk factor for primary open-angle glaucoma and is the only target for current glaucoma therapy. The genetic factors which determine IOP are largely unknown. We performed a genome-wide association study for IOP in 11,972 participants from 4 independen
Comparative evaluation of intraocular pressure changes subsequent to insertion of laryngeal mask airway and endotracheal tube.
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Ghai B
Full Text Available AIMS: To evaluate the intraocular pressure and haemodynamic changes subsequent to insertion of laryngeal mask airway and endotracheal tube. SUBJECTS AND METHODS: The study was conducted in 50 adult patients. A standard general anaesthesia was administered to all the patients. After 3 minutes of induction of anaesthesia baseline measurements of heart rate, non-invasive blood pressure and intraocular pressure were taken following which patients were divided into two groups: laryngeal mask airway was inserted in group 1 and tracheal tube in group 2. These measurements were repeated at 15-30 second, every minute thereafter up to 5 minutes after airway instrumentation. RESULTS: A statistically significant rise in heart rate, systolic blood pressure, diastolic blood pressure and intraocular pressure was seen in both the groups subsequent to insertion of laryngeal mask airway or endotracheal tube. Mean maximum increase was statistically more after endotracheal intubation than after laryngeal mask airway insertion. The duration of statistically significant pressure responses was also longer after endotracheal intubation. CONCLUSION: Laryngeal mask airway is an acceptable alternative technique for ocular surgeries, offering advantages in terms of intraocular pressure and cardiovascular stability compared to tracheal intubation.
The case for intraocular delivery of PPAR agonists in the treatment of diabetic retinopathy.
LENUS (Irish Health Repository)
Treacy, Maxwell P
Systemic therapeutics targeting the peroxisome proliferator-activated receptors have been found to be beneficial in the treatment of diabetic retinopathy. In this paper, we provide a rationale for the use of these therapeutics as intraocular agents. In addition, we introduce the peroxisome proliferator-activated receptors and describe their functions in response to the drugs.
Associations with intraocular pressure across Europe: The European Eye Epidemiology (E3) Consortium
A.P. Khawaja (Anthony); H. Springelkamp (Henriët); Creuzot-Garcher, C. (Catherine); C. Delcourt (Cécile); Hofman, A. (Albert); R. Höhn (René); O. Iglesias (Oriol); R.C.W. Wolfs (Roger); J.-F. Korobelnik (Jean-François); Silva, R. (Rufino); F. Topouzis (Fotis); K.M. Williams (Katie M.); A. Bron (Alain); G.H.S. Buitendijk (Gabrielle); Cachulo, M.L. (Maria da Luz); A. Cougnard-Grégoire (Audrey); J.-F. Dartigues; C.J. Hammond (Christopher J.); A.F.H. Pfeiffer (Andreas); Salonikiou, A. (Angeliki); van Duijn, C.M. (Cornelia M.); J.R. Vingerling (Hans); R.N. Luben (Robert); Mirshahi, A. (Alireza); Lamparter, J. (Julia); C.C.W. Klaver (Caroline); Jansonius, N.M. (Nomdo M.); P.J. Foster (Paul); On behalf of the European Eye Epidemiology (E³) Consortium,; Acar, N. (Niyazi); Anastosopoulos, E. (Eleftherios); Azuara-Blanco, A. (Augusto); A.A.B. Bergen (Arthur); G. Bertelsen (Geir); Binquet, C. (Christine); Bird, A. (Alan); L. Bretillon (Lionel); Bron, A. (Alain); Buitendijk, G. (Gabrielle); U. Chakravarthy (Usha); Chakravarthy, U. (Usha); Chan, M. (Michelle); Chang, P. (Petrus); Colijn, A. (Annemarie); Cougnard-Grégoire, A. (Audrey); C. Creuzot-Garcher (Catherine); Cumberland, P. (Philippa); Cunha-Vaz, J. (José); V. Daien (Vincent); G. Deak (Gabor); C. Delcourt (Cécile); Delyfer, M.-N. (Marie-Noëlle); Hollander, A. (Anneke den); Dietzel, M. (Martha); M.G. Erke (Maja Gran); S. Fauser (Sascha); Finger, R. (Robert); A.E. Fletcher (Astrid E.); P.J. Foster (Paul J.); Founti, P. (Panayiota); Göbel, A. (Arno); T.G.M.F. Gorgels (Theo); J. Grauslund (Jakob); Grus, F. (Franz); C.J. Hammond (Christopher); C. Helmer (Catherine); H.-W. Hense (Hans-Werner); Hermann, M. (Manuel); R. Hogg (Ruth); Hogg, R. (Ruth); Holz, F. (Frank); C. Hoyng (Carel); N.M. Jansonius (Nomdo); S.F. Janssen (Sarah); A.P. Khawaja (Anthony P.); Klaver, C. (Caroline); J.-F. Korobelnik (Jean-François); Lamparter, J. (Julia); Le Goff, M. (Mélanie); Leal, S. (Sergio); Lechanteur, Y. (Yara); T. Lehtimäki (Terho); A.J. Lotery (Andrew); Leung, I. (Irene); Mauschitz, M. (Matthias); Merle, B. (Bénédicte); E. Midena (Edoardo); Midena, E. (Edoardo); Miotto, S. (Stefania); A. Mirshahi (Alireza); Mohan-Saïd, S. (Sadek); Muldrew, A. (Alyson); Mueller, M. (Michael); Nunes, S. (Sandrina); K. Oexle (Konrad); T. Peto (Tünde); S. Piermarocchi (Stefano); E. Prokofyeva (Elena); J.S. Rahi (Jugnoo); O. Raitakari (Olli); Ribeiro, L. (Luisa); Rougier, M.-B. (Marie-Bénédicte); Sahel, J. (José); Salonikiou, A. (Aggeliki); Sanchez, C. (Clarisa); S. Schmitz-Valckenberg (Steffen); C.M.C. Schweitzer (C. M C); Segato, T. (Tatiana); Shehata, J. (Jasmin); Silva, R. (Rufino); Silvestri, G. (Giuliana); Simader, C. (Christian); E.H. Souied (Eric); Springelkamp, H. (Henriet); Tapp, R. (Robyn); Topouzis, F. (Fotis); V.J.M. Verhoeven (Virginie); Von Hanno, T. (Therese); Vujosevic, S. (Stela); K.M. Williams (Katie M.); C. Wolfram (Christian); Yip, J. (Jennifer); Zerbib, J. (Jennyfer); Zwiener, I. (Isabella)
textabstractRaised intraocular pressure (IOP) is the most important risk factor for developing glaucoma, the second commonest cause of blindness globally. Understanding associations with IOP and variations in IOP between countries may teach us about mechanisms underlying glaucoma. We examined cross-
Intravitreal Ampicillin Sodium for Antibiotic-Resistant Endophthalmitis: Streptococcus uberis First Human Intraocular Infection Report
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Raul Velez-Montoya
Full Text Available Purpose. To describe the clinical characteristics, diagnosis, and treatment with intravitreal ampicillin sodium of a postoperative endophthalmitis case due to Streptococcus uberis; an environmental pathogen commonly seen in mastitis cases of lactating cows. Methods. Case Report. A 52-year-old, Hispanic diabetic patient who suddenly developed severe pain and severe loss of vision, following vitrectomy. Results. The patient was diagnosed with postoperative endophthalmitis secondary to a highly resistant strain of Streptococcus uberis that did not respond to intravitreal antibiotics. He was treated with an air-fluid interchange, anterior chamber washout, intravitreal ampicillin sodium (5 mg/0.1 mL, and silicon oil tamponade (5000 ck. The eye was anatomically stabilized, though there was no functional recovery. Conclusion. Streptococcus uberis is an uncommon pathogen to the human eye, which has unique features that help the strain in developing resistance to antibiotics. While treatment with intravitreal ampicillin is feasible, there are still concerns about its possible toxicity.
Reference intervals for intraocular pressure measured by rebound tonometry in ten raptor species and factors affecting the intraocular pressure.
Reuter, Anne; Müller, Kerstin; Arndt, Gisela; Eule, Johanna Corinna
Intraocular pressure (IOP) was measured with the TonoVet rebound tonometer in 10 raptor species, and possible factors affecting IOP were investigated. A complete ophthalmic examination was performed, and IOP was assessed in 2 positions, upright and dorsal recumbency, in 237 birds belonging to the families Accipitridae, Falconidae, Strigidae, and Tytonidae. Mean IOP values of healthy eyes were calculated for each species, and differences between families, species, age, sex, left and right eye, as well as the 2 body positions were evaluated. Physiologic fluctuations of IOP were assessed by measuring IOP serially for 5 days at the same time of day in 15 birds of 3 species. Results showed IOP values varied by family and species, with the following mean IOP values (mm Hg +/- SD) determined: white-tailed sea eagle (Haliaeetus albicilla), 26.9 +/- 5.8; red kite (Milvus milvus), 13.0 +/- 5.5; northern goshawk (Accipiter gentilis), 18.3 +/- 3.8; Eurasian sparrowhawk (Accipiter nisus), 15.5 +/- 2.5; common buzzard (Buteo buteo), 26.9 +/- 7.0; common kestrel (Falco tinnunculus), 9.8 +/- 2.5; peregrine falcon, (Falco peregrinus), 12.7 +/- 5.8; tawny owl (Strix aluco), 9.4 +/- 4.1; long-eared owl (Asio otus), 7.8 +/- 3.2; and barn owl (Tyto alba), 10.8 +/- 3.8. No significant differences were found between sexes or between left and right eyes. In goshawks, common buzzards, and common kestrels, mean IOP was significantly lower in juvenile birds than it was in adult birds. Mean IOP differed significantly by body position in tawny owls (P = .01) and common buzzards (P = .04). By measuring IOP over several days, mean physiologic variations of +/- 2 mm Hg were detected. Differences in IOP between species and age groups should be considered when interpreting tonometric results. Physiologic fluctuations of IOP may occur and should not be misinterpreted. These results show that rebound tonometry is a useful diagnostic tool in measuring IOP in birds of prey because it provides rapid
Intraocular pressure-lowering effect of oral paracetamol and its in vitro corneal penetration properties
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Mohamed N
Full Text Available Nabiel Mohamed, David MeyerDivision of Ophthalmology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town, South AfricaBackground: Several studies have confirmed the ability of cannabinoids to reduce intraocular pressure. Experimental data recently demonstrated unequivocally that the analgesic effect of paracetamol is due to its indirect action on cannabinoid receptors. The question then arises as to whether paracetamol can reduce intraocular pressure via its effect on intraocular cannabinoid receptors.Methods: A 2-week, prospective, randomized, controlled, single-center, parallel-group pilot study was carried out to determine the efficacy and safety of paracetamol 1 g orally administered every 6 hours in adult patients with primary or secondary open angle glaucoma as compared with topical levobunolol 0.5% twice a day. Patient well-being was closely monitored throughout the study and focused on hepatic safety in accordance with Drug-Induced Liver Injury Network criteria. The in vitro diffusion kinetics of acetaminophen in a phosphate-buffered solution in rabbit and human corneas was also investigated, with the view to a topical application.Results: Eighteen adult patients were enrolled in the study, with nine in the topical levobunolol group and nine in the oral paracetamol group. In the levobunolol group, the mean reduction in intraocular pressure at day 7 was 7.5 mmHg (P < 0.008 and at day 14 was 9.1 mmHg (P < 0.005, from a mean baseline intraocular pressure of 29.6 mmHg. The corresponding figures for the paracetamol group were 8.8 mmHg (P < 0.0004 at day 7 and 6.5 mmHg (P < 0.004 at day 14, from a mean baseline intraocular pressure of 29.4 mmHg. Both study regimens were well tolerated. No serious treatment-related adverse events were reported in either of the treatment groups. Liver function tests, systolic/diastolic blood pressure, or heart rate remained unchanged in both groups during the 2 weeks of the study. In
Hyperbaric oxygen treatment for experimental intraocular hypertension in rats: An electroretinogram detection
Institute of Scientific and Technical Information of China (English)
Junhui Yi; Zhengrong Peng; Qiuli Liu; Zhongqi Wu
BACKGROUND: Hyperbaric oxygen (HBO) is used for treating glaucoma, and affirmative curative effect has been obtained. HBO can sensitively reflect the obviously heightened b wave of electroretinogram (ERG)of injured tissue.OBJECTIVE: To observe the effect of HBO treatment on retinal function of rats with acute experimental intraocular hypertension with ERG.DESIGN: Randomized controlled experiment.SETTING: Department of Ophthalmology, Third Xiangya Hospital, Central South University; Department of Hyperbaric Oxygen, Xiangya Hospital, Central South University; Department of Anatomy, Xiangya Hospital, Central South University.MATERIALS: Eighteen adult healthy Wistar rats, of either gender, weighing from 150 to 250 g, were provided by the Animal Room of Central South University. Type YLCO. 5/Ⅰ A baby hyperbaric oxygen chamber, type LMS-2A two-channel physiological recorder, type BG-1 retina exposure system, Jiangwan type Ⅰ stereotaxis instrument.METHODS: This experiment was carried out in the Central South University between March and September 2006. Eighteen healthy Wistar rats were made into models of acute experimental intraocular hypertension. Then, they were divided into two groups: model group and HBO treatment group, with 9 in each group. Following 7 days of HBO treatment, the rats in HBO treatment group were placed in Type YLCO. 5/Ⅰ A baby hyperbaric oxygen chamber, which was pressurized with pure oxygen( volume fraction 0.825 ± 0.025).The treatment pressure was 0.2 MPa. The rats in HBO treatment group daily inhaled HBO for 80 minutes within 7 days; Rats in the model group were untouched. The performance of eyes was observed under the status of intraocular hypertension. ERG was recorded before, during and 7 days after modeling,meanwhile, the recovery rate of b wave from ERG was calculated. Recovery rate of b wave from ERG=(amplitude of b wave 7 days after modeling/amplitude of b wave before modeling)× 100%.MAIN OUTCOME MEASURES: ① Performance of eyes
Experimental differentiation of intraocular masses using ultrahigh-field magnetic resonance imaging--a case series.
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Karen Falke
Full Text Available PURPOSE: The case reports presented here were compiled to demonstrate the potential for improved diagnosis and monitoring of disease progress of intraocular lesions using ultrahigh-field magnetic resonance microscopy (MRM at 7.1 Tesla. METHODS: High-resolution ex vivo ocular magnetic resonance (MR images were acquired on an ultrahigh-field MR system (7.1 Tesla, ClinScan, Bruker BioScan, Germany using a 2-channel coil with 4 coil elements and T2-weighted turbo spin echo (TSE sequences of human eyes enucleated because of different intraocular lesions. Imaging parameters were: 40×40 mm field of view, 512×512 matrix, and 700 µm slice thickness. The results were correlated with in vivo ultrasound and histology of the enucleated eyes. RESULTS: Imaging was performed in enucleated eyes with choroidal melanoma, malignant melanoma of iris and ciliary body with scleral perforation, ciliary body melanoma, intraocular metastasis of esophageal cancer, subretinal bleeding in the presence of perforated corneal ulcer, hemorrhagic choroidal detachment, and premature retinopathy with phthisis and ossification of bulbar structures. MR imaging allowed differentiation between solid and cystic tumor components. In case of hemorrhage, fluid-fluid levels were identified. Melanin and calcifications caused significant hypointensity. Microstructural features of eye lesions identified by MRM were confirmed by histology. CONCLUSION: This study demonstrates the potential of MRM for the visualization and differential diagnosis of intraocular lesions. At present, the narrow bore of the magnet still limits the use of this technology in humans in vivo. Further advances in ultrahigh-field MR imaging will permit visualization of tumor extent and evaluation of nonclassified intraocular structures in the near future.
亲水性丙烯酸酯人工晶状体植入后的生物相容性和并发症%Hydrophilic acrylic intraocular lens:biocompatibility and complications following implantation
Institute of Scientific and Technical Information of China (English)
魏芬; 艾明
BACKGROUND:Hydrophilic acrylic materials with good biocompatibility have been widely used in clinic. However, there are some problems about the biocompatibility and safety of hydrophilic acrylic intraocular lens after long-term clinical application. OBJECTIVE:To discuss the biocompatibility and stability issues and corresponding processing methods after hydrophilic acrylic intraocular lens implantation. METHODS:A computer-based search of Wanfang and PubMed database was performed for articles related to clinical application of hydrophilic acrylic intraocular lens published from 2005 to 2014. The keywords were "hydrophilic acrylic,intraocular lens" in Chinese and English, respectively. A total of 618 articles were initialy retrieved, and finaly 35 articles were included in result analysis. RESULTS AND CONCLUSION:As the hydrophilic acrylic intraocular lens is foldable, a smal incision is required for implantation and the operation is simple that cause less damage to the patients. In addition, the hydrophilic acrylic intraocular lens has poor bacterial and inflammatory cel adhesion, which leads to a low probability of infective endophthalmitis after implantation. But there is a high incidence of posterior capsule opacification as wel as some refractive errors and visual quality problems after implantation. Taken together, to solve these problems depends on the continuous improvements and updates of intraocular lens materials and designs.%背景:亲水性丙烯酸酯材料的生物相容性良好,在临床得到广泛的应用。但随着亲水性丙烯酸酯人工晶状体临床应用的时间延长,其长期的生物相容性及稳定性问题逐渐显现。目的:讨论亲水性丙烯酸酯人工晶状体植入后的生物相容性及稳定性问题和处理方法。方法:应用计算机检索万方数据库及PubMed数据库2005至2014年与亲水性丙烯酸酯人工晶状体临床应用相关的文献,中文检索词为"亲水性丙烯酸酯�
Ocular Salvage and Vision Preservation Using a Topotecan-Based Regimen for Advanced Intraocular Retinoblastoma.
Brennan, Rachel C; Qaddoumi, Ibrahim; Mao, Shenghua; Wu, Jianrong; Billups, Catherine A; Stewart, Clinton F; Hoehn, Mary Ellen; Rodriguez-Galindo, Carlos; Wilson, Matthew W
Purpose To evaluate topotecan-based therapy for advanced intraocular retinoblastoma. Patients and Methods Twenty-seven patients with bilateral retinoblastoma (male patients, n = 14; median age, 8.4 months) received chemotherapy: two courses of topotecan plus vincristine followed by three alternating administrations of carboplatin and vincristine for two courses and topotecan plus vincristine for one course, with optional periocular carboplatin. Focal therapy was applied after cycle 2. Event-free survival was defined as avoidance of external-beam radiotherapy (EBRT) and enucleation. Results Of 54 eyes, 42 were Reese-Ellsworth group IV to V, and 37 were International Classification of Retinoblastoma group C to E. Eleven eyes were enucleated: one at diagnosis, nine with progressive disease including three eyes treated with EBRT, and one that developed neovascular glaucoma after completion of therapy. One patient was removed from protocol with prolonged infection in course 1; 26 patients (51 eyes) were analyzed. At 10 years, cumulative incidence of EBRT was 5.9% (SE ± 3), and event-free survival was 69.2% (SE ± 27.2). Ocular survival for Reese-Ellsworth group IV to V eyes was 77.5% (SE ± 21.2); it was 74.3% (SE ≥ 18.8) for International Classification group C to E eyes. Vision testing (median age, 7 years; range, 5 to 10 years) documented 20/70 vision or better in one eye of 23 patients; 19 (76%) of 25 patients demonstrated 20/40 vision or better in one eye. All patients experienced thrombocytopenia (41 episodes in 275 courses; 15%). There were 29 episodes of febrile neutropenia (10%). Grade 3 diarrhea was present in nine of 27 patients, and one patient had an allergic reaction to carboplatin. All patients are alive at median follow-up 7.4 years (range, 2.7 to 10 years). Conclusion Topotecan combined with vincristine, carboplatin, and aggressive focal therapies is an effective regimen for the treatment of advanced retinoblastoma and results in globe salvage with
Keratitis by Aspergillus flavus infection after cataract surgery
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João Luiz Pacini Costa
Full Text Available ABSTRACT We report a case of keratis infection after cataract phacoemulsification with intraocular lens implantation in a 65-year-old female patient. The patient initially underwent cataract surgery on the right eye. Intraocular inflammation appeared on the second post-operative day and was initially treated as Toxic Anterior Segment Syndrome (TASS. The inflammation was reduced and vision improved initially but very aggressive and progressive keratitis destroyed the cornea due to the delay in correct diagnosis. Aspergillus flavus was isolated from a biopsy.The infection was treated with antifungal agents and loss of the eye was avoided by total corneal transplantation associated with Gundersen conjunctiva cover. To restore the lost vision, a second penetrating corneal graft with removal of the conjunctiva cover was performed 17 months later. The final best-corrected vision was 20/40 but prognosis for long-term graft survival is poor.
Placement of a collagen glaucoma drainage device to control intraocular pressure and chronic iritis secondary to juvenile rheumatoid arthritis.
Price, Francis W; Ziemba, Steven L
A patient with juvenile rheumatoid arthritis and chronic iritis is reported with intraocular pressure near 30 mm Hg and previous episodes of intraocular pressure as high as 50 mm Hg despite maximally tolerated medical therapy. Because of the potential risk involved with a full-thickness filtration procedure, it was decided that a nonpenetrating deep sclerectomy would be appropriate, followed by placement of a collagen glaucoma drainage device to maintain aqueous outflow. Immediately postoperatively, intraocular pressure was stabilized. At 24 months postoperatively, intraocular pressure was well controlled at 15 mm Hg with patient receiving only Lotemax. No significant complications were noted at any point in the postoperative course. Because of the patient's predisposition for serious complications frequently associated with trabeculectomy, nonpenetrating deep sclerectomy with the collagen glaucoma drainage device was an effective alternative for this patient.
[The effect of crystalline lens extraction on intraocular pressure in patients with primary open-angle glaucoma].
Macarie, S; Macarie, Daniela
This issue presents the results of a study on patients with cataract and primary open angle glaucoma who suffered lens extraction for cataract. We analise the effects of the lens extraction on the level of intraocular pressure at this patients.
Comparison of the Retinal Straylight in Pseudophakic Eyes with PMMA, Hydrophobic Acrylic, and Hydrophilic Acrylic Spherical Intraocular Lens
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Ya-wen Guo
Full Text Available Purpose. To investigate the intraocular straylight value after cataract surgery. Methods. In this study, 76 eyes from 62 patients were subdivided into three groups. A hydrophobic acrylic, a hydrophilic acrylic, and a PMMA IOL were respectively, implanted in 24 eyes, 28 eyes, and 24 eyes. Straylight was measured using C-Quant at 1 week and 1 month postoperatively in natural and dilated pupils. Results. The hydrophilic acrylic IOLs showed significantly lower straylight values than those of the hydrophobic acrylic IOLs in dilated pupils at 1 week and 1 month after surgery (P0.05. Moreover, no significant difference was found in straylight between natural and dilated pupils in each group at 1 week and 1 month postoperatively (P>0.05. Conclusions. Although the hydrophobic acrylic IOL induced more intraocular straylight, straylight differences among the 3 IOLs were minimal. Pupil size showed no effect on intraocular straylight; the intraocular straylight was stable 1 week after surgery.
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Geórgia Nadalini Rodrigues
Full Text Available Canine transmissible venereal tumor (TVT is a round cell neoplasm occurring on the external genital mucosa of male and female dogs. Transmission is by cell implantation during coitus, licking, or other interaction between an affected dog and a susceptible host. Metastasis of the tumor rarely occurs. This report describes an unusual presentation of TVT with intraocular involvement and inguinal lymph nodes metastasis. The subject was a six-year-old, intact, male, Brazilian Terrier dog with a history of abnormal masses in the right eye, penis and several subcutaneous nodules in the inguinal area. Histopathological examination of the eye specimens as well as cytologic examination of penile mass and subcutaneous nodules revealed similar findings. The examination revealed round cells containing a large nuclei with prominent, central located nucleoli and a pale cytoplasm containing few small, clear round vacuoles. Histologically, the subcutaneous nodules in the inguinal area were lymph nodes. The diagnosis of TVT with intraocular involvement and lymph nodes metastasis was based on clinical, cytologic and histopathologic findings.Tumor venéreo transmissível (TVT é uma neoplasia de células redondas que acomete a mucosa genital externa de cães, machos e fêmeas. A transmissão decorre da implantação de células tumorais durante o coito, brigas ou interações entre animais portadores e susceptíveis. Existem relatos referindo-se a localizações atípicas do TVT, mas metástases raramente ocorrem. O presente relato descreve um caso incomum de TVT, com acometimento intra-ocular e metástases nos linfonodos ingüinais, num cão Terrier Brasileiro, com seis anos de idade. O animal apresentava massas anormais de tecido no olho direito, extremidade do pênis e aumento de volume de linfonodos da região ingüinal. A histopatologia do globo ocular e as citologias da massa peniana e dos nódulos subcutâneos evidenciaram aspectos citológicos semelhantes
Aderência in vitro do Staphylococcus epidermidis e da Pseudomonas alcaligenes em lentes intra-oculares In vitro adherence of Staphylococcus epidermidis and Pseudomonas alcaligenes to intraocular lenses
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Patrícia Ioschpe Gus
Full Text Available OBJETIVO: Quantificar e comparar a aderência in vitro das bactérias Staphylococcus epidermidis e Pseudomonas alcaligenes em diferentes tipos de lentes intra-oculares (LIOs. MÉTODOS: Quatorze lentes intra-oculares foram usadas no experimento. Quatro de polimetilmetacrilato (PMMA, quatro de silicone, quatro de hidrogel e duas de acrílico. Oito lentes intra-oculares foram colocadas em oito tubos de ensaio contendo 4 ml de suspensão de Pseudomonas alcaligenes, e seis lentes intra-oculares foram colocadas em seis tubos de ensaio contendo 4 ml de suspensão de Staphylococcus epidermidis. A concentração do caldo utilizada para o teste de aderência foi de 10(8 unidades formadoras de colônias por mililitro (CFU/mL que corresponde a 0,5 na escala de McFarland. As lentes foram incubadas a 37° por duas horas. Após, foram removidas dos caldos e enxaguadas em água destilada estéril por duas vezes. As lentes foram cultivadas em placas de ágar-sangue a 35-37° e evaliadas a cada 24h por um período de 72h. Nas amostras que tiveram crescimento bacteriano, foram contadas as colônias utilizando os métodos convencionais de laboratório. Todos os ensaios foram executados em duplicata. RESULTADOS: A aderência do Staphylococcus epidermidis nas lentes de PMMA foi menor se comparada com as de silicone e de hidrogel. A aderência daPseudomonas alcaligenes nas lentes de hidrogel foi menor se comparada com as de silicone, PMMA e acrílico. CONCLUSÃO: Os resultados sugerem que a aderência do Staphylococcus epidermidis e da Pseudomonas alcaligenes nas lentes intra-oculares é influenciada pelo tipo de material da lente e pela espécie do microorganismo. A aderência bacteriana pode ter papel importante na patogenicidade da endoftalmite pós-cirurgia de catarata.PURPOSE: To quantify and compare the in vitro adherence of Staphylococcus epidermidis and Pseudomonas alcaligenes to different intraocular lenses (IOLs. METHODS: Fourteen intraocular lenses were
Bottom-up fabrication of zwitterionic polymer brushes on intraocular lens for improved biocompatibility
Han, Yuemei; Xu, Xu; Tang, Junmei; Shen, Chenghui; Lin, Quankui; Chen, Hao
Intraocular lens (IOL) is an efficient implantable device commonly used for treating cataracts. However, bioadhesion of bacteria or residual lens epithelial cells on the IOL surface after surgery causes postoperative complications, such as endophthalmitis or posterior capsular opacification, and leads to loss of sight again. In the present study, zwitterionic polymer brushes were fabricated on the IOL surface via bottom-up grafting procedure. The attenuated total reflection-Fourier transform infrared and contact angle measurements indicated successful surface modification, as well as excellent hydrophilicity. The coating of hydrophilic zwitterionic polymer effectively decreased the bioadhesion of lens epithelial cells or bacteria. In vivo intraocular implantation results showed good in vivo biocompatibility of zwitterionic IOL and its effectiveness against postoperative complications. PMID:28053528
Cluster headache: interictal asymmetric increment in intraocular pressure elicited by Valsalva manoeuvre.
Barriga, F J; Sánchez-del-Río, M; Barón, M; Dobato, J l; Gili, P; Yangüela, J; Bueno, A; Pareja, J A
Changes in intraocular pressure (IOP) elicited by a Valsalva manoeuvre were studied in 11 male patients (mean age 39.8 years) suffering from episodic cluster headache (CH), and 12 healthy male controls (mean age 39.9 years). The tests were performed at rest and while exhaling hard through a mouthpiece connected to a mercury manometer. In the CH group, during symptomatic periods, between attacks, Valsalva manoeuvre elicited an asymmetric increase in IOP with significantly higher values on the symptomatic side (P = 0011), whereas no asymmetric increments in IOP were found during asymptomatic periods. Outside the cluster period the IOP values both baseline and with Valsalva manoeuvre did not differ from controls. The increment in IOP took place within a few seconds, as in spontaneous CH attacks, thus pointing to a rapid increase in intraocular blood volume or vasodilatation. These findings may reflect a latent increased vascular reactivity of the symptomatic orbit during CH period.
Closure of a persistent cyclodialysis cleft using the haptics of a normal-sized intraocular lens.
Shentu, Xingchao; Zhu, Yanan; Tang, Yelei
A 50-year-old man suffering from hypotony in the right eye caused by a traumatic cyclodialysis and complicated by a choroidal detachment and cataract was treated in our clinic. After an unsuccessful direct cyclopexy, phacoemulsification was performed and a normal-sized single-piece polymethyl methacrylate posterior chamber intraocular lens (PMMA PCIOL) was inserted into the ciliary sulcus, with the haptic rotated toward the cyclodialysis cleft. Postoperatively, the corrected visual acuity improved to 20/20, and the intraocular pressure returned to normal. Ultrasound biomicroscopy showed the closure of the cleft. Phacoemulsification with a normal-sized PMMA PCIOL inserted into the ciliary sulcus is a safe, effective and technically simple surgical treatment for small cyclodialysis induced hypotony complicated by cataract. Internal compression of the cleft by the haptic of a normal sized IOL along with postoperative inflammation led to scarring and closure of the cleft.
Effects of intraocular mescaline and LSD on visual-evoked responses in the rat.
Eells, J T; Wilkison, D M
The effects of mescaline and LSD on the flash-evoked cortical potential (FEP) were determined in unrestrained rats with chronically-implanted electrodes. Systemic administration of mescaline or LSD significantly attenuated the primary component of the FEP at three stimulus intensities with the greatest effect observed 60-90 minutes following drug administration. The magnitude and specificity of the effects of these agents on the primary response suggest that they produce deficits in conduction through the retino-geniculato-cortical system. The serotonin receptor antagonists, cyproheptadine and methysergide, antagonized the mescaline-induced depression of the FEP in accordance with neurochemical and behavioral evidence that mescaline acts as a partial agonist on serotonin receptors. Topical or intraocular administration of atropine antagonized the actions of systemically-administered mescaline. In addition, intraocular administration of mescaline or LSD attenuated the FEP indicative of an action of these hallucinogens on visual processing in the retina which is modulated by muscarinic receptor activity.
Implantation of iris-claw Artisan intraocular lens for aphakia in Fuchs′ heterochromic iridocyclitis
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Ahmad Kheirkhah
Full Text Available Implantation of iris-claw Artisan intraocular lens (IOL is a surgical option for correction of aphakia; however, these IOLs have not been used in eyes with uveitis including Fuchs′ heterochromic iridocyclitis (FHI due to possible risk of severe postoperative intraocular inflammation. In the case reported here, we secondarily implanted an Artisan IOL in a 28-year-old man with FHI who had aphakia with no capsular support due to a previous complicated cataract surgery. Enclavation was easily performed and no intraoperative complication was noted. Postoperative course was uneventful with no significant anterior chamber inflammation during 12 months of follow-up. Although there were few deposits on the IOL surface, the patient achieved a best-corrected visual acuity of 20/20 without developing glaucoma or other complications. Therefore, Artisan IOL may be considered for correction of aphakia in patients with FHI. However, studies on large number of patients are required to evaluate safety of the procedure.
Delivery of Intraocular Triamcinolone Acetonide in the Treatment of Macular Edema
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Brent Siesky
Full Text Available Macular edema (ME is one of the eventual outcomes of various intraocular and systemic pathologies. The pathogenesis for ME is not yet entirely understood; however, some of the common risk factors for its development have been identified. While this investigation will not discuss the numerous etiologies of ME in detail, it appraises the two most widely studied delivery modalities of intraocular corticosteroids in the treatment of ME—intravitreal injection (IVI and sub-Tenon's infusion (STI. A thorough review of the medical literature was conducted to identify the efficacy and safety of IVI and STI, specifically for the administration of triamcinolone acetonide (TA, in the setting of ME in an attempt to elucidate a preferred steroid delivery modality for treatment of ME.
The Changes of Quality of Life in the Patients after Phacoemulsification with Intraocular Lens Implantation
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Jiewei Liu; Jingjing Xu; Mingguang He
Purpose: To investigate the improvement and maintenance of the quality of life in the patients after phacoemulsification with intraocular lens implantation.Methods :The study population consisted of 116 patients receiving phacoemulsification with intraocular lens implantation. They were interviewed using the quality of life questionnaire, and the clinical outcomes were evaluated before surgery and at 1 week, 1month, 3 months, 6 months after surgery respectively.Results:Patients reported similar scores of quality of life and all the four subscales among 1-week, 1-month , 3-month and 6-month follow-up visit after surgery, all of which were higher than the scores before surgery.Conclusion: Patients receiving phacoemulsification reported rapid improvement in quality of life after surgery, and the quality of life scores were not changed significantly from 1week to 6 months after surgery.
Biocompatibility of intraocular lens materials%人工晶体材料的生物相容性特征★
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王洋; 韩宏光
BACKGROUND: The visual recovery and complications of the cataract patients are various after different intraocular lens materials implantation, so the selection of appropriate intraocular lens materials is the key of the research. OBJECTIVE: To investigate the properties and biocompatibility of intraocular lens materials. METHODS: The materials were classified according to the hardness and location of the intraocular lens after implantation in order to analyze the pros and cons of the intraocular lens thus guiding the patients to select the appropriate intraocular lens for implantation. The properties and biocompatibility of the commonly used intraocular lens materials were evaluated. RESUTLS AND CONCLUSION: Polymethylmethacrylate intraocular lens is the first choice of rigid material, but it cannot tolerate autoclaving. Acrylic intraocular lens is the soft and foldable intraocular lens that has the similar optical and biological properties with polymethylmethacrylate intraocular lens, and it can improve the visual acuity after implantation with less complications. Posterior capsular opacification is the most important indicator for biocompatibility evaluation which is related with the material and design of intraocular lens. The stability of intraocular lens in the capsular bag is also the indicator to evaluate the biocompatibility. The material properties, biocompatibility, and visual function should be taking into consideration in the design and selection of intraocular lens materials. Guarantee the efficacy after intraocular lens implantation and reduce the incidence of complications, so that to get vision rehabilitation for the cataract patients.% 背景:白内障患者植入不同材料人工晶体治疗后的视力恢复情况和并发症有所不同,选择适宜的人工晶体材料是研究的关键。目的:探讨人工晶体材料的特征和生物相容性。方法:按人工晶体的硬度和植入后不同位置将材料进行分类�
Management of posteriorly dislocated endocapsular tension ring and intraocular lens complex.
Deka, Satyen; Deka, Amarendra; Bhattacharjee, Harsha
We report a case of late posteriorly dislocated endocapsular tension ring (ECR) and intraocular lens (IOL) complex into the vitreous cavity that behaved as a single 13 mm disc. A 3-port pars plana vitrectomy was performed, and perfluorocarbon liquid was used to retrieve the ECR-IOL complex to the retropupillary area. A 3-point scleral fixation was performed to reposition the inseparable ECR-IOL complex.
Characteristics of Optic Nerve Damage Induced by Chronic Intraocular Hypertension in Rat
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Jiantao Wang; Jian Ge; A.A. Sadun; T.T. Lam
Purpose:To set up the Sharma's chronic intraocular hypertension model and investigate the intraocular pressure (lOP) as well as the optic nerve damage of this model in rat.Methods:The operations of the chronic intraocular hypertension model were performed as described by Sharma in 60 male Lewis albino rats. IOP was measured using the TonoPen XL immediately after surgery and then at 5 day, 2 week or 4 week intervals. Cresyl violet staining of whole-mounted retinas was used to label retinal ganglion cells (RGCs),then RGCs were counted. Paraphenylenediamine (PPD) staining was performed in the semi-thin cross sections of optic nerve of rat, in order to know whether the axons of optic nerve were degenerated or not. Results:There were 47 rats with higher IOP after the episcleral veins cauterized in 60rats. The ratio of elevated IOP was 78.3%. The IOPs were stable in 4 weeks. After cresyl violet staining, the RGCs loss was 11.0% and 11.3% was found in the central and peripheral retina respectively after 2 weeks of increased IOP. After 4 weeks of increased lOP, the loss of RGCs was 17% for the central retina and 24.6% for the peripheral retina. In the retinas without higher IOP, there was no loss of RGCs. PPD staining showed that optic nerve of rat with about 5.3% damage of axons located at the superior temporal region. Region of affected optic nerve 1 mm posterior to the globe by light microscope showed evidence of damaged axons with axonal swelling and myelin debris.Conclusion:Sharma's chronic intraocular hypertension model is a reproducible and effective glaucoma model, which mimics human glaucoma with chronically elevation IOP and induced RGCs loss and damage of optic nerve. Eye Science 2004;20:25-29.
Changes in intraocular pressure following administration of suxamethonium and endotracheal intubation: Influence of dexmedetomidine premedication
Chandan Kumar Pal; Manjushree Ray; Anjana Sen; Bimal Hajra; Dipankar Mukherjee; Anil Kumar Ghanta
Background: Use of suxamethonium is associated with an increase in intraocular pressure (IOP) and may be harmful for patients with penetrating eye injuries. The purpose of our study was to observe the efficacy of dexmedetomidine for prevention of rise in IOP associated with the administration of suxamethonium and endotracheal intubation. Methods: Sixty-six American Society of Anaesthesiologists I or II patients undergoing general anaesthesia for non-ophthalmic surgery were included in this ra...
Evaluation of in vitro glistening formation in hydrophobic acrylic intraocular lenses
Thomes BE; Callaghan TA
Brett E Thomes, Thomas A CallaghanAlcon Research Ltd (A Novartis Company), Fort Worth, TX, USAPurpose: To evaluate the impact of continuous manufacturing process improvements on glistening formation in AcrySof hydrophobic acrylic intraocular lenses (IOLs) by comparing lenses manufactured in 2003 with lenses manufactured in 2012.Methods: Glistenings were experimentally created as aqueous-filled microvacuoles utilizing an accelerated laboratory method by immersing the lens in water at 45&de...
Correlation of the intraocular pressure with increased intracranial pressure in rabbits
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Eskandari H
Full Text Available Although measurement of intracranial pressure by noninvasive methods has been suggested, but mainly invasive methods are used for this purpose-Increase in episcleral venous pressure can be expected to result in a linear increase in intraocular pressure. Congested oculat veins with capillary leakage and hemorrhage are seen when the ICP is increased, thus theoretically measurement of intraocular pressure can be a procedure for estimation of the ICP. This study was performed to find whether there is andy relationship between intraocular pressure and ICP, so we used 12 albino rabbits in two divided groups. Our study was not designed to elucidate the mechanism of change but merely to record any changes observed. All measures except an increase in ICP were applied on the test group as well as on the control group. After general anesthesia with the combination of ketamin, rampune, and pentobarbital a burr hole was made in the lambda region of the skull and a cannula was placed in the subdural space. The ICP in the test group increased up to 15 mmHg and was constant throughout the experiment. Intraocular pressure was measured by Schiotz tonometers afte general anesthesia, after cannulation of the skull, and immediately after increasing the ICP which was repated in 15 minutes interval for 4 hours. There was no statistical difference between the two groups (P:0.997 . results show that neither cannulation nor general anesthesia for 4 hours produce alteration in IOP in the control group nor increasing of the ICP to level of 15 mmHg produces any alteration in IOP on the test group.
[Iris suture fixation of posterior-chamber elastic intraocular lens in ligament apparatus laxity].
Pashtaev, N P; Bat'kov, E N; Zotov, V V
An original MIOL-23 multifocal elastic intraocular lens (IOL) was used to operate 5 eyes with acquired lens dislocation and traumatic cataract. By making self-sealing tunnel incision, ILO was implanted into the capsular sac and sutured to the iris. MIOL-23 implantation caused an increase in mean visual acuity. The IOL took up a correct position. Elastic IOL implantation with iris suture fixation is an efficient and safe mode of additional ILO support.
Congenital cataract surgery with intraocular lens implantation in microphthalmic eyes: visual outcomes and complications
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Marcelo Carvalho Ventura
Full Text Available PURPOSE: To report the visual outcomes and complications of congenital cataract surgery with primary intraocular lens implantation in microphthalmic eyes of children younger than 4 years of age. METHODS:This retrospective interventional case series included 14 microphthalmic eyes from 10 children who underwent congenital cataract surgery with primary intraocular lens implantation younger than 4 years of age. Seven patients had bilateral cataracts (11 eyes met the study's inclusion criteria and 3 patients had unilateral cataract. Patients' medical charts were reviewed to obtain information regarding the preoperative and postoperative ophthalmological examination. Main outcome measures were intraocular pressure (IOP, best-corrected visual acuity, and intraoperative and postoperative complications. RESULTS: Mean age at the time of surgery was 21.7 ± 2.9 months. Mean ocular axial length was 19.2 ± 0.9 mm. Mean preoperative IOP was 9.7 ± 1.7 mmHg and 10.3 ± 3.1 mmHg on final follow-up (P=0.18. There were no intraoperative complications. Two (15.4% eyes developed secondary visual axis opacification, of which only one needed to be reoperated due to significantly decreased vision (0.5 logMAR. Preoperative and postoperative best-corrected visual acuity was 2.09 ± 0.97 logMAR and 0.38 ± 0.08 logMAR in bilateral cases and 1.83 ± 1.04 logMAR and 0.42 ± 0.13 logMAR in unilateral cases, respectively. CONCLUSION: Primary intraocular lens implantation in congenital cataract surgery in microphthalmic eyes resulted in a significant best-corrected visual acuity improvement with no intraoperative complications and minimal postoperative complications.
Surgical management of spontaneous in-the-bag intraocular lens and capsular tension ring complex dislocation
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Uzeyir Gunenc
Full Text Available We describe a technique to manage late spontaneous intraocular lens (IOL and capsular tension ring (CTR dislocation within the intact capsular bag. The subluxated IOL and CTR complex can be positioned in a closed chamber and fixed to the pars plana at both 3 and 9 o′clock quadrants with the presented ab externo direct scleral suturation technique which provides an easy, safe and effective surgical option for such cases.
Comparison of 20% sulfur hexafluoride with air for intraocular tamponade in Descemet membrane endothelial keratoplasty (DMEK
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Benjamin Botsford
Full Text Available ABSTRACT Purpose: To compare the effect of 20% sulfur hexafluoride (SF6 with that of air on graft detachment rates for intraocular tamponade in Descemet membrane endothelial keratoplasty (DMEK. Methods: Forty-two eyes of patients who underwent DMEK by a single surgeon (A.S.J. at Wilmer Eye Institute between January 2012 and 2014 were identified; 21 received air for intraocular tamponade and the next consecutive 21 received SF6. The main outcome measure was the graft detachment rate; univariate and multivariate analyses were performed. Results: The graft detachment rate was 67% in the air group and 19% in the SF6 group (p<0.05. No complete graft detachments occurred, and all partial detachments underwent intervention with injection of intraocular air. The percentages of eyes with 20/25 or better vision were not different between the groups (67% vs. 71%. Univariate analysis showed significantly higher detachment rates with air tamponade (OR, 8.50; p<0.005 and larger donor graft size (OR, 14.96; p<0.05. Multivariate analysis with gas but not graft size included showed that gas was an independent statistically significant predictor of outcome (OR, 6.65; p<0.05. When graft size was included as a covariate, gas was no longer a statistically significant predictor of detachment but maintained OR of 7.81 (p=0.063 similar to the results of univariate and multivariate analyses without graft size. Conclusion: In comparison with air, graft detachment rates for intraocular tamponade in DMEK were significantly reduced by 20% SF6.
New Management of Angle-closure Glaucoma by Phacoemulsification with Foldable Posterior Chamber Intraocular Lens Implantation
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Jian Ge; Yan Guo; Yizhi Liu; Mingkai Lin; Yehong Zhuo; Bing Chen; Xiuqi Chen
Objective: To investigate the management of angle-closure glaucoma by phacoemulsification with foldable posterior chamber intraocular lens (PC-IOL) implantation. Design: Retrospective, noncontrolled interventional case series.Participants: In 36 eyes with angle-closure glaucoma (ACG), there were 18 eyes with primary acute angle-closure glaucoma (PACG), 14 eyes with primary chronic angle-closure glaucoma (PCCG), 3 eyes with secondary acute angle-closure glaucoma (SACG) and 1 eye with secondary chronic angle-closure glaucoma (SCCG).Intervention: Phacoemulsification with posterior chamber intraocular lens implantation.Main Outcome Measures: Postoperative visual acuity, IOP, axial anterior chamber depth.Results: After a mean postoperative follow-up time of 8.81 ± 7.45 months, intraocular pressure was reduced from a preoperative mean of 23.81 ± 17.84 mmHg to a postoperative mean of 12.54 ± 4. 73 mmHg ( P = 0. 001 ). Mean anterior chamber depth was 1.75 ± 0.48 mm preoperatively and 2.29 ± 0.38 mm postoperatively ( P = 0. 000).Best spectacle-corrected visual acuity in 36 eyes ranged from 0. 01 to 0. 7 (20/200 to 20/30) postoperatively, which was better than preoperative VA ranging from hand movement to 0.4 (20/50) ( P= 0. 000).Conclusion: Phacoemulsification with posterior chamber foldable intraocular lens implantation can be a good alternative in treating angle-closure glaucoma. Eye Science 2000; 16:22 ~ 28.
New Management of Angle-closure Glaucoma by Phacoemulsification with Folable Posterior Chamber Intraocular Lens Implantation
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JianGE; YanGuo; 等
Objective:To investigate the management of angle-closure glaucoma by phacoemulsification with foldable posterior chamber intraocular lens (PC-IOIL)implantation.Design:Retrospective,noncontrolled interventional case series.Participants:In 36 eyes with angle -closure glaucoma(ACG).there were 18eyes with primary acute angle-closure glaucoma(PACG),14 eyes with primary chonic angle -closure glaucoma(PCCG),3 eyes with secondary acute angle-closure glaucoma (SACG) and 1 eye with secondary chronic angle -closure glaucoma(SCCG).Intervention:Phacoemulsification with posterior chamber intraocular lens implantation.Main Outcome Measures:Postoperative visual acuity,IOP,axial anterior chamber depth.Results:After a mean postoperative follow -time of 8.81±7.45 months,intraocular pressure was reduced from a preoperative mean of 23.81±17.84 mmHg to a postoperative mean of 12.54±4.73mmHg(P=0.001).Mean anterior chamber depth was 1.75±0.48 mm preoiperatively and 2.29±0.38mm postoperatively(P-0.000).Best spectacle-corrected visual acuity in 36 eyes ranged from 0.01 to 0.7(20/200 to 20/30)postoperatively,which was better than preoperative VA ranging from hand movement to 0.4(20/50)(P=0.000).Conclusion:Phacoemulsification with posterior chamber foldable intraocular lens implantation can be a good alternative in treating angle-closure glaucoma.Eye Science2000;16:22-28.
Opportunistic ocular infections in AIDS
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Shikha Baisakhiya DOMS; FGO
As the number of HIV infected patients is multiplying exponentially day by day so are the associated ocular complications.The increasing longevity of individuals with HIV disease has resulted in greater numbers of pa-tients with ocular opportunistic infection.By the means of this article we describe various opportunistic ocular infections in AIDS and their clinical manifestations,discussed under four headings;1 )adnexal manifestation;2)anterior segment manifestation;3)posterior segment manifestation;4)neuro ophthalmic manifestation . Herpes zoster ophthalmicus,molluscum contagiosum and Kaposi sarcoma are common adnexal manifestations. Molluscum contagiosum being the commonest.Varicella Zoster Virus (VZV)and herpes simplex virus (HSV) most commonly cause infectious keratitis in HIV-positive patients .As compared to the immunocompetent indi-viduals the frequency of bacterial and fungal keratitis is not more in HIV patients,but it tends to be more se-vere.Posterior segment structures involved in HIV-positive patients include the retina,choroid,and optic nerve head.The herpesvirus family is implicated most commonly in infections of the retina and choroid in HIV positive patients.CMV is the most common cause of retinitis and the commonest intraocular infection in AIDS. Atypical presentations resistance to conventional treatment and higher rate of recurrence make the diagnosis and therapeutic intervention more difficult and challenging.In addition,in one eye,several infections may occur at the same time,rendering the situation more difficult.
Two-photon absorption induced drug delivery from polymeric intraocular lenses
Hampp, Norbert A.; Kim, Hee-Cheol; Kreiling, Stefan; Hesse, Lutz; Greiner, Andreas
Secondary cataracts are quite often observed after implantation of polymeric intraocular lenses. The reason for this complication is that lens epithelial cells remain in the capsular bag when the natural lens is removed. They begin proliferation and cause secondary cataracts. It is not desireable to add cell toxic agents at the time of the implantation because wound healing is negatively affected. We have developed polymeric intraocular lenses which are equipped with a drug depot which may be released non-invasively through photochemical treatment. In the example presented the drug is 5-fluoruracil (5FU) which is covalently bound to the polymer. Deliberation of 5FU from the polymer is done photochemically. Since light is transmitted permanently through the artificial intraocular lens and wearing of special glasses by the patient should be omitted conventional photochemistry is not a suitable tool for the drug release. The polymer-5FU linkage is designed in a way that it has a high two-photon absorption cross-section. Two-photon absorption is used to selectively release 5FU from the lens. The one-photon reaction is blocked since the cornea does absorb UV light. The principle shown here is not limited to 5FU but may be applied to other drugs also.
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Syamala Devi
Full Text Available Intra-ocular pressure (IOP in normal individuals varies throughout the night and day. The diurnal variation for normal eyes is between 3 and 6mmHg and the variation may increase in glaucomatous eyes. Hence, the present effort is to investigate the effect of moderate exercise on intraocular pressure changes. IOP was measured before and after exercise in 100 subjects (50M, 50F with no ocular abnormality with ages ranging from 18-21 years by using Schiotz tonometer. Weight, height and body mass index, were recorded. The results obtained were compared between before-and-after-exercise of the subjects. The data were presented as the mean ± SD, Student's t-test was used to calculate significance between means. The IOP showed a statistically significant fall following moderate exercise. The mean IOP significantly decreased (p0.05 decreased after 60 minutes of aerobic exercise. Gender wise comparison of intraocular pressure both before and after exercise did not reveal much significance. Physical exercise, such as jogging, walking and bicycle riding, could be suggested as a complimentary therapy in addition to the pharmaceutical and surgical therapies available for glaucoma patients, even though the mechanism for lowering IOP is not clear enough.
Clinical Observation of 126 Cases of Sutureless Phacoemulsification with PMMA Intraocular Lens Implantation
Institute of Scientific and Technical Information of China (English)
Yanshuang Yan; Zhengxing Mao
Objective: To observe the safety and effect of sutureless phacoemulsification with PMMA intraocular lens (IOL) implantation.Methods: One-hundred and twenty-six cases (126 eyes) of sutureless phacoemulsification with PMMA intraocular lens (IOL) implantation were retrospected and evaluated. The surgeries were performed through a limbal tunnel incision. PMMA IOLs with 5.5mm or 6.0mm in diameter were implanted.Results: The follow-up was 3~20 months. Visual acuity of 0. 5 or better was obtained in 120 cases (95.2%), and that of 1.0 or better was obtained in 89 cases (70. 6% ).Intra-operative complications included posterior capsule rupture in 9 cases (7. 1% ) and iris injury in 7 cases(5.6% ). Postoperative complications included early corneal edema in 96 cases(76.2% ), transient intraocular pressure elevation in 5 cases(4. 3%),remnant of cortex in 1 case and leakage of incision in 1 case. M1 were properly managed with good results.Conclusion: Sutureless phacoemulsification with PMMA IOL implantation is safe even in grass-root hospitals where cataracts are harder.
Two cases of uveitis masquerade syndrome caused by bilateral intraocular large B-cell lymphoma
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Jovanović Svetlana
Full Text Available Introduction. Sometimes it is not easy to clinically recognize subtle differences between intraocular lymphoma and noninfectious uveitis. The most common lymphoma subtype involving the eye is B-cell lymphoma. Case report. We presented two patients aged 59 and 58 years with infiltration of the subretinal space with a large B-cell non-Hodgkin intraocular lymphoma. The patients originally had clinically masked syndrome in the form of intermediate uveitis. As it was a corticosteroid-resistant uveitis, we focused on the possible diagnosis of neoplastic causes of this syndrome. During hospitalization, the neurological symptoms emerged and multiple subretinal changes accompanied by yellowish white patches of retinal pigment epithelium with signs of vitritis, which made us suspect the intraocular lymphoma. Endocranial magnetic resonance imaging established tumorous infiltration in the region of the left hemisphere of the cerebellum. The histopathological finding confirmed the diagnosis of large B-cell non-Hodgkin lymphoma of risk moderate degree, immunoblast - centroblast cytological type. The other patient had clinical chronic uveitis accompanied by yellowish shaped white echographic changes of the retina and localized changes in the level of the subretina. The diagnosis of lymphoma was made by brain biopsy. Conclusion. Uveitis masquerade syndrome should be considered in all patients over 40 years with idiopathic steroid-resistant uveitis. Treatment begun on time can affect the course and improve the prognosis of uveitis masquerade syndrome (UMS and systemic disease.
Retropupillary Fixation of Iris-Claw Intraocular Lens for Aphakic Eyes in Children.
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Martina Brandner
Full Text Available To report outcome, complications and safety of retropupillary fixated iris-claw intraocular lenses in a pediatric population.Retrospective study.Ten consecutive pediatric patients (15 eyes underwent placement of retropupillary fixated iris-claw intraocular lenses between October 2007 and July 2013 at the Department of Ophthalmology, Medical University Graz and General Hospital Klagenfurt, Austria. Postoperative visual acuity and complications were analyzed.Median final best-corrected visual acuity improved by 0.12 logMAR from preoperative baseline. Mean postoperative spherical equivalent was -0.05 ± 1.76 D. No serious complications were observed intra- or postoperatively during the entire follow-up period of up to 40 months. One patient experienced a haptic disenclavation with IOL subluxation immediately after a car accident.Our study demonstrates that iris-claw intraocular lens implantation behind the iris is safe in children with lack of capsular support and yields excellent visual outcome with low complication rate.
Intraocular lens power estimation by accurate ray tracing for eyes underwent previous refractive surgeries
Yang, Que; Wang, Shanshan; Wang, Kai; Zhang, Chunyu; Zhang, Lu; Meng, Qingyu; Zhu, Qiudong
For normal eyes without history of any ocular surgery, traditional equations for calculating intraocular lens (IOL) power, such as SRK-T, Holladay, Higis, SRK-II, et al., all were relativley accurate. However, for eyes underwent refractive surgeries, such as LASIK, or eyes diagnosed as keratoconus, these equations may cause significant postoperative refractive error, which may cause poor satisfaction after cataract surgery. Although some methods have been carried out to solve this problem, such as Hagis-L equation[1], or using preoperative data (data before LASIK) to estimate K value[2], no precise equations were available for these eyes. Here, we introduced a novel intraocular lens power estimation method by accurate ray tracing with optical design software ZEMAX. Instead of using traditional regression formula, we adopted the exact measured corneal elevation distribution, central corneal thickness, anterior chamber depth, axial length, and estimated effective lens plane as the input parameters. The calculation of intraocular lens power for a patient with keratoconus and another LASIK postoperative patient met very well with their visual capacity after cataract surgery.
Stereoselectivity of satropane, a novel tropane analog, on iris muscarinic receptor activation and intraocular hypotension
Institute of Scientific and Technical Information of China (English)
Liang ZHU; Hong-zhuan CHEN; Li-min YANG; Yong-yao CUI; Pei-li ZHENG; Yin-yao NIU; Hao WANG; Yang LU; Qiu-shi REN; Pi-jing WEI
Aim: To study the stereoselectivity of satropane (3-paramethylbenzene sulfonyloxy-6-acetoxy tropane), a novel tropane analog, on iris muscarinic receptor activation and intraocular hypotension. Methods: The assays for radioligand-receptor binding, the contractile responses of isolated iris muscle, the miosis response, and the intraocular hypotension of the enantiomers of satropane were investigated. Results: In the binding analysis, S(-)satropane (lesatropane) completely com-peted against the [3H]quinuclydinyl benzilate-labeled ligand at muscarinic recep-tors in the iris muscle, whereas R(+)satropane failed to completely compete. In an isolated iris contractile assay, R,S(±)satropane and S(-)satropane produced a concentration-dependent contractile response with similar efficacy and potency to that of carbachol. R(+)satropane did not induce any contractile response. In the pupil diameter measurement assay in vivo, S(-)satropane induced miosis much more effectively than pilocarpine, while R(+)satropane failed to produce any miosis. In the water loading-induced and methylcellulose-induced ocular hypertensive models, S(-)satropane, but not R(+)satropane, significantly suppressed intraocu-lar pressure at a much lower concentration than pilocarpine. Conclusion: The ago-nistic and hypotensive properties of satropane on rabbit eyes are stereoselective, with the S(-)isomer being its active form.
Acute Central Retinal Artery Occlusion Associated with Intraocular Silicone Oil Tamponade
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Mehmet Yasin Teke
Full Text Available Many systemic and ocular factors may cause acute central retinal artery occlusion (CRAO. Herein, we aimed to describe a case of CRAO due to intraocular silicone oil (SO tamponade. To the best of our knowledge, a case like our has not been reported previously. A 58-yearold male patient had undergone combined pars plana vitrectomy-lensectomy and intraocular SO for lens luxation and vitreus hemorrhage associated with a blunt ocular trauma in his right eye. Two weeks after the surgery, he presented with acute vision loss in the same eye. He was diagnosed with acute CRAO and it should be related with mechanical press or raised intraocular pressure (IOP associated with SO. He was treated by partial removal of SO immediately. In spite of the regression of retina edema, his visual acuity did not improve due to optic atrophy. SO may cause CRAO due to raised IOP and/or its mechanical pressure and this complication must be kept in mind. (Turk J Oph thal mol 2012; 42: 238-40
Optical aberrations of intraocular lenses measured in vivo and in vitro
Barbero, Sergio; Marcos, Susana; Jiménez-Alfaro, Ignacio
Corneal and ocular aberrations were measured in a group of eyes before and after cataract surgery with spherical intraocular lens (IOL) implantation by use of well-tested techniques developed in our laboratory. By subtraction of corneal from total aberration maps, we also estimated the optical quality of the intraocular lens in vivo. We found that aberrations in pseudophakic eyes are not significantly different from aberrations in eyes before cataract surgery or from previously reported aberrations in healthy eyes of the same age. However, aberrations in pseudophakic eyes are significantly higher than in young eyes. We found a slight increase of corneal aberrations after surgery. The aberrations of the IOL and the lack of balance of the corneal spherical aberrations by the spherical aberrations of the intraocular lens also degraded the optical quality in pseudophakic eyes. We also measured the aberrations of the IOL in vitro, using an eye cell model, and simulated the aberrations of the IOL on the basis of the IOL's physical parameters. We found a good agreement among in vivo, in vitro, and simulated measures of spherical aberration: Unlike the spherical aberration of the young crystalline lens, which tends to be negative, the spherical aberration of the IOL is positive and increases with lens power. Computer simulations and in vitro measurements show that tilts and decentrations might be contributors to the increased third-order aberrations in vivo in comparison with in vitro measurements.
Lente intra-ocular opaca em diplopia intratável: relato de caso Opaque intraocular lens in intractable diplopia: case report
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Fernanda Teixeira Krieger
Full Text Available Diplopia intratável tem sido descrita em várias situações. Métodos convencionais como prismas e correção cirúrgica do estrabismo falham em neutralizá-la. O objetivo do trabalho é documentar o caso de uma paciente com estrabismo de longa data, cuja diplopia deteriorou-se ao longo dos anos, e não foi possível resolução com cirurgia, prisma, e oclusão com óculos e lente de contato com pupila opaca. A paciente foi então submetida à facoemulsificação com implante de lente intra-ocular opaca que atingiu o objetivo desejado.Intractable diplopia has been described in many situations but poor results are the rule with standard treatment modalities. The authors report a case of a woman with long-standing strabismus and diplopia who failed to improve following surgery, prism, and occlusive spectacles or contact lenses. Then, she was submitted to phacoemulsification and opaque intraocular lens implantation, which successfully neutralized diplopia.
Prevalence of bacterial pathogens causing ocular infections in South India
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Ramesh S
Full Text Available Background / Aims: The eye may be infected from external sources or through intra-ocular invasion of micro-organisms carried by the blood stream. This study was undertaken to isolate and identify the specific bacterial pathogens causing ocular infections and to determine their in-vitro antibacterial susceptibilities to commonly used antibacterial agents. Materials and Methods: A retrospective analysis of all patients with clinically diagnosed bacterial ocular infections such as blepharitis, conjunctivitis, internal and external hordeolum, suppurative scleritis, canaliculitis, keratitis, dacryocystitis, preseptal cellulitis, endophthalmitis and panophthalmitis presenting between January 2005 and December 2005 was performed. Extra-ocular and intra-ocular specimens were collected and were subjected to direct microscopy and culture. Results: A total of 756 patients with bacterial ocular infections were analyzed, of which 462(61% eyes had adnexal bacterial infection, 217(28.7% had corneal infection, 6 (0.8% had scleral involvement and the remaining 71(9.39% eyes had infection of the intra-ocular tissues. The predominant bacterial species isolated was S. aureus (195 of 776; 25% followed by S. pneumoniae (169 of 776; 21.78% and coagulase negative staphylococci (142 of 776; 18.3%. The largest number of gram-positive isolates were susceptible to cefazolin (545 of 624; 87.34%, chloramphenicol (522 of 624; 83.65% and gatifloxacin (511 of 624; 81.89% and gram-negative isolates were to amikacin (127 of 136; 93.38%, gatifloxacin (125 of 136; 91.91% and ofloxacin (119 of 136; 87.5%, while aerobic actinomycetes were to amikacin (100%, gatifloxacin (14 of 16; 87.5%, chloramphenicol (14 of 16; 87.5% and ofloxacin (13 of 16; 81.25%. Conclusions: S. aureus frequently causes infections of eyelids and conjunctiva, S. pneumoniae of lacrimal apparatus and cornea and coagulase negative staphylococci causes intra-ocular infections. Of all routinely used antibacterials
Visual performance after the implantation of a new trifocal intraocular lens
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Vryghem JC
Full Text Available Jérôme C Vryghem,1,2 Steven Heireman1,21Brussels Eye Doctors, Brussels, Belgium; 2Clinique Saint-Jean, Brussels, BelgiumPurpose: To evaluate the subjective and objective visual results after the implantation of a new trifocal diffractive intraocular lens.Methods: A new trifocal diffractive intraocular lens was designed combining two superimposed diffractive profiles: one with +1.75 diopters (D addition for intermediate vision and the other with +3.50 D addition for near vision. Fifty eyes of 25 patients that were operated on by one surgeon are included in this study. The uncorrected and best distance-corrected monocular and binocular, near, intermediate, and distance visual acuities, contrast sensitivity, and defocus curves were measured 6 months postoperatively. In addition to the standard clinical follow-up, a questionnaire evaluating individual satisfaction and quality of life was submitted to the patients.Results: The mean age of patients at the time of surgery was 70 ± 10 years. The mean uncorrected and corrected monocular distance visual acuity (VA were LogMAR 0.06 ± 0.10 and LogMAR 0.00 ± 0.08, respectively. The outcomes for the binocular uncorrected distance visual acuity were almost the same (LogMAR −0.04 ± 0.09. LogMAR −010 ± 0.15 and 0.02 ± 0.06 were measured for the binocular uncorrected intermediate and near VA, respectively. The distance-corrected visual acuity was maintained in mesopic conditions. The contrast sensitivity was similar to that obtained after implantation of a bifocal intraocular lens and did not decrease in mesopic conditions. The binocular defocus curve confirms good VA even in the intermediate distance range, with a moderate decrease of less than LogMAR 0.2 at −1.5 D, with respect to the best distance VA at 0 D defocus. Patient satisfaction was high. No discrepancy between the objective and subjective outcomes was evidenced.Conclusion: The introduction of a third focus in diffractive multifocal
The relationship between cytokine level and nitric oxide content in aqueous humor after intraocular lens implantation
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AIM: To investigate the relationship between cytokine level and nitric oxide (NO) content in aqueous humor after intraocular lens implantation. METHODS: All New Zealand rabbits were divided randomly into three groups: (1) control group, (2) extracapsular cataract extraction group (ECCE), (3) extracapsular cataract extraction and posterior chamber intraocular lens implantation group (ECCE+IOL). The inflammation of all experimental rabbit eyes, including cornea edema and anterior chamber exudation were observed via zoom-photo slitlamp microscope 1,3,7,14,30 d postoperation. Meanwhile, aqueous humor was drawn for white blood cell (WBC) counting and classifying, and for NO-2/NO-3 and cytokine assay, including interleukin-2(IL-2), tumour necrosis factor-α(TNF-α). Statistics were taken by SPSS softwear. RESULTS: (1) Total WBC in aqueous humor were higher and anterior chamber exudation were more severe in ECCE+IOL group than that in ECCE group and control group. (2) The level of IL-2 and TNF-α and the content of NO-2/NO-3 in aqueous humor of ECCE+IOL group were higher than that in ECCE group and control group 1-14 d postoperation respectively, and it increased to peak value at 3-7 d postoperation and decreased gradually after two weeks postoperation. (3) The change regularity of IL-2, TNF-α and NO-2/NO-3 in each group were basically similar, i.e. when the level of cytokine (IL-2 and TNF-α) was normal, the content of NO-2/NO-3 was normal too, when the level of cytokine (IL-2 and TNF-α) increased, the content of NO-2/NO-3 increased too. CONCLUSION: The intraocular inflammation after ECCE+IOL was more severe than that after simple ECCE. NO, IL-2 and TNF-α play an important role in intraocular inflammation after intraocular lens implantation. The changes of IL-2 and TNF-α level was closely related with NO content in aqueous humor.
Prótese intra-ocular de resina acrílica em cães e gatos Acrylic resin intraocular prosthesis in dogs and cats
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S.C. Rahal
Full Text Available Foram atendidos no Hospital Veterinário da Faculdade de Medicina Veterinária e Zootecnia da Unesp - Campus de Botucatu, 11 animais (oito cães e três gatos, com alterações oftálmicas unilaterais graves que levaram à perda total da função ocular (protrusão de globo com injúria nervosa e estrutural, perfurações de córnea com perda de conteúdo intra-ocular e endoftalmites, entre outras. Os animais, com idades entre dois meses e 10 anos, foram submetidos à evisceração e posterior inclusão de esfera de resina acrílica (metilmetacrilato na capa córneo-escleral ou escleral. As esferas foram previamente confeccionadas e esterilizadas por autoclavagem. No pós-operatório foram utilizados antiinflamatórios e antibioticoterapia tópica combinada ou não a sistêmica. O período de observação variou de 2 meses a 3 anos e os aspectos avaliados foram secreção ocular, blefarospasmo, sinais de desconforto e estética. Obtiveram-se resultados satisfatórios em oito casos. Concluiu-se que a resina acrílica pode ser uma alternativa para uso como inclusão em cavidade anoftálmica.Eleven animals (eight dogs and three cats, aged between two months and ten years were referred to the Veterinary Hospital of Faculty of Veterinary Medicine and Animal Science - Unesp, Botucatu, Brazil. These animals presented severe unilateral ophthalmic changes that lead to a total loss of ocular function, such as prolapsed eyes with nervous and structural injury, corneal damage with loss of intraocular contents or endophthalmitis among others. They were submitted to evisceration followed by the insertion of an acrylic resin prosthesis (methylmethacrylate in the corneoscleral or scleral shell. The spheres were previously made and sterilized by autoclave. The postoperative medical therapy included topical and systemic broad-spectrum antibiotics for seven days and anti-inflammatory drugs. The follow-up time varied from two months to three years. The evaluated
Aderência bacteriana in vitro a lentes intra-oculares de polimetilmetacrilato e de silicone In vitro bacterial adherence to silicone and polymetylmethacrylate intraocular lenses
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Claudete Inês Locatelli
Full Text Available OBJETIVOS: Verificar a aderência bacteriana a lentes intra-oculares de silicone e de polimetilmetacrilato como possível fator de risco no desenvolvimento de endoftalmite pós-operatória, utilizando-se um modelo in vitro com três microrganismos potencialmente patogênicos. MÉTODOS: As análises foram realizadas com cepas de Staphylococcus aureus ATCC 29213, Staphylococcus epidermidis (amostra clínica e Pseudomonas aeruginosa ATCC 27853 incluindo a determinação de curvas de crescimento, testes para verificação de produção de cápsula, avaliação da hidrofobicidade, testes de aderência a diferentes materiais, microscopia óptica, microscopia eletrônica de varredura e microscopia de força atômica. RESULTADOS: A produção de cápsula e a aderência das três diferentes cepas não mostraram qualquer relação com a quantidade de microrganismos; em relação às lentes intra-oculares de polimetilmetacrilato e de silicone, não houve diferença estatisticamente significativa na aderência de S. aureus e S. epidermidis; P. aeruginosa foi o microrganismo mais aderente a ambos os materiais. A microscopia eletrônica de varredura confirmou estes achados em relação à aderência, ao peso que a microscopia de força atômica evidenciou a produção de biofilme pelas cepas de S. aureus, S. epidermidis e P. aeruginosa. CONCLUSÕES: Constatou-se, in vitro, que os materiais analisados não diferiram com relação à taxa de aderência bacteriana, porém, P. aeruginosa apresentou maior eficiência de adesão entre as bactérias testadas. Todas as cepas produziram biofilme. Silicone foi o material mais hidrofóbico, quando comparado ao polimetilmetacrilato.PURPOSE: To evaluate bacterial adherence to silicone and polymetylmethacrylate (PMMA intraocular lenses as a risk factor for postsurgery endophthalmitis by using an in vitro model with three potentially pathogenic microorganisms. METHODS: In vitro experiments were carried out with the
Correlation between diurnal variation of intraocular pressure, ocular pulse amplitude and corneal structural properties Correlação entre a variação diurna da pressão intraocular, amplitude de pulso e propriedades estruturais corneanas
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Flávia Silva Villas-Bôas
Full Text Available PURPOSE: The purpose of this study was to evaluate the fluctuation of intraocular pressure measurements obtained by Goldmann applanation tonometry, dynamic contour tonometry, and corneal compensated non-contact tonometry during office hours in glaucoma and healthy participants. This study also aims at correlating the intraocular pressure fluctuations with fluctuations of corneal hysteresis, central corneal thickness, mean central corneal curvature and ocular pulse amplitude. METHODS: A total of 12 controls (24 eyes and 21 patients (38 eyes with open-angle glaucoma were recruited. Intraocular pressure measured by Goldmann applanation tonometry, dynamic contour tonometry and corneal compensated non-contact tonometry, ocular pulse amplitude, central corneal curvature and thickness, corneal hysteresis, and resistance factor were obtained at intervals of 2 hours, between 9 AM and 5 PM. RESULTS: Intraocular pressure fluctuated significantly throughout the day in controls and glaucoma individuals with all tonometers (POBJETIVO: Avaliar a flutuação das medidas da pressão intraocular obtidas pela tonometria de aplanação de Goldmann, tonometria de contorno dinâmico e pela tonometria de não-contato com compensação corneana durante o período ambulatorial, em participantes com glaucoma e saudáveis. Esse estudo também correlacionou as flutuações da pressão intraocular com as flutuações da histerese corneana, espessura corneana central, média da curvatura corneana central e amplitude de pulso ocular. MÉTODOS: Um total de 12 controles (24 olhos e 21 pacientes com glaucoma de ângulo aberto (38 olhos foram selecionados. A pressão intraocular medida pela tonometria de aplanação de Goldmann, tonometria de contorno dinâmico e tonometria de não-contato com compensação corneana, amplitude de pulso ocular, a curvatura central e espessura corneanas, a histerese corneana e o fator de resistência foram medidos em intervalos de 2 horas, entre 9
Inadvertent implantation of a reversed-optic Tecnis ZM900 multifocal intraocular lens: case report Implante invertido da lente intraocular Tecnis ZM900 multifocal: relato de caso
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Wilson Takashi Hida
Full Text Available A 51-year-old woman with age-related cataract had an uneventful phacoemulsification and a Tecnis ZM900 multifocal intraocular lens (IOL implantation in both eyes. During IOL implantation in the left eye, the optic was unintentionally reversed in the bag and left that way. The refraction surprise was not significant and six months postoperatively the corrected distance visual acuity in both eyes was 20/20 and neither complained of visual discomfort. In conclusion, we found that a reversed-optic Tecnis multifocal IOL in the present case resulted in good final visual acuity without significant differences in aberrations compared to the other eye, and a conservative management can be taken as a safe option.Paciente de 51 anos, sexo feminino, apresentando catarata foi submetida a cirurgia de facoemulsificação com implante de lente intraocular (LIO multifocal Tecnis ZM900 em ambos os olhos (AO. Durante a implantação da LIO no olho esquerdo, a lente foi inadvertidamente implantada invertida e deixada dessa maneira. Seis meses pós-operatório a surpresa refracional não se mostrou significativa e a acuidade visual corrigida era de 20/20 em AO, sem nenhuma queixa de desconforto visual. Em conclusão, no presente caso, o implante de uma LIO Tecnis multifocal invertida resultou em boa acuidade visual final e sem diferenças significativas na aberrometria em comparação ao olho contralateral, tendo sido possível conduzir o caso de maneira conservadora.
Iris Claw versus Scleral Fixation Intraocular Lens Implantation during Pars Plana Vitrectomy
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Fereydoun Farrahi
Full Text Available Purpose: To compare the outcomes of iris claw anterior chamber intraocular lens (ICACIOL with that of scleral fixation posterior chamber intraocular lens (SF-PCIOL implantation during pars plana vitrectomy (PPV as initial surgery to correct aphakia. Methods: Twelve patients with complicated cataract surgery or trauma who had suffered nucleus, whole crystalline lens or intraocular lens (IOL drop into the vitreous cavity, and undergone PPV with IC-ACIOL implantation over a period of one year were evaluated for the purpose of this study. Uncorrected visual acuity (UCVA, best corrected visual acuity (BCVA, central corneal thickness (CCT, spherical equivalent (SE refractive error, astigmatism and complications were recorded. The results were compared to outcomes of another group of 13 patients who had previously undergone PPV with SF-PCIOL implantation. Results: Mean improvement of UCVA was greater in IC-ACIOL eyes as compared to the SF-PCIOL group (-1.17±0.28 versus -0.89±0.21 logMAR, P=0.01, corresponding values for postoperative BCVA were 0.24±0.17 and 0.44±0.22 logMAR (P=0.041, respectively. Average postoperative SE was comparable in the IC-ACIOL and SFPCIOL groups at 0.6±1.03 and 0.56±1.23 diopters, respectively (P=0.290. However, 10 (83.3% IC-ACIOL eyes versus 6 (46.1% SF-PCIOL eyes had SE within 1 diopter of emmetropia (P=0.048. Mean postoperative increase in CCT was comaparble between the study groups (P=0.126. Conclusion: In the absence of sufficient capsular support, the use of an IC-ACIOL for correction of aphakia during PPV can be a good alternative and seems to entail better visual outcomes as compared to SF-PCIOL.
Causes and correction of dissatisfaction after implantation of presbyopia-correcting intraocular lenses
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Gibbons A
Full Text Available Allister Gibbons, Tayyeba K Ali, Daniel P Waren, Kendall E Donaldson Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA Purpose: The purpose of this study was to assess the causes and possible solutions for patient dissatisfaction after the implantation of presbyopia-correcting intraocular lenses (IOLs. Methods: This study was a retrospective review of clinical records. All patients who were seen between January 2009 and December 2013 whose primary reason for consultation was dissatisfaction with visual performance after presbyopia-correcting IOL implantation were included in the study. A single treating physician, who determined the most probable cause of dissatisfaction, decided which interventions to pursue following the initial consultation. Results: Data from 74 eyes of 49 patients were analyzed. The most common cause for complaint was blurry or foggy vision both for distance and near (68%. Complaints were most frequently attributed to residual refractive error (57% and dry eye (35%. The most common interventions pursued were treatment of refractive error with glasses or contact lenses (46% and treatment for dry eye (24%. Corneal laser vision correction was done in 8% of eyes; 7% required an IOL exchange. After the interventions, 45% of patients had completed resolution of symptoms, 23% of patients were partially satisfied with the results, and 32% remained completely dissatisfied with the final results. Conclusion: The most identifiable causes of dissatisfaction after presbyopia-correcting IOL implantation are residual refractive error and dry eye. Most patients can be managed with conservative treatment, though a significant number of patients remained unsatisfied despite multiple measures. Keywords: intraocular lens, cataract, presbyopia, multifocal intraocular lens
Primary Posterior Chamber Intraocular Lens Implantation in Traumatic Cataract With Posterior Capsule Breaks
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YupingZou; WenhuiYang
Background:In patients with incomplete posterior capsule support,posterior chamber intraocular lenses(PC-IOLs)were implanted with both haptics transs-cleral fixation.This causes more damage to the eye and may result in more com-plications,In patients with small posterior breaks,non-fixation or single haptic fixation may be adequate.Methods:Thiry-two consecutive patients of traumatic cataract with posterior capsule breaks caused by penetrating eye trauma were retospected.Posterior chamber intraocular lenses were implanted in all these patients with three tech-niques,ie,without fixation,with single haptic fixation and with both haptics fixation .The selection of the technique was based on the position and size of the posterior capsule.The follow-up period was 21days to 28months(mean,15.2months).Results:Intra-operative problems included ciliary body bleeding(Two patents,6.25%)and enlargement of posterior capsule breaks(2patients,6.25).Postoperative visual acuity was0.5or better(Corrected)in28case(87.5%)and 0.1-0.4in four patients(12.5%),Postoperative complications included hyphema(6eyes,18.8%),transient intraocular pressure elevation(6eyes,18.8%),transient hypotention(7eyes,21.8%).Postoperative IOL position were good except one case of IOL tilt.No pupillary capture or endophthalmitis was found.Conclusions:Not all PC-IOLs have to be fixed by two haptics.In patients with small posterior capsule breaks,PC-IOLmay not be fixed or fixed by only one haptics.Eye Science1995;11:140-142.
Toric markers-assisted implantation of the scleral-fixated intraocular lens
Song, Hu-Ping; Tian, Bing-Yu; Peng, Jing
AIM To evaluate the efficacy of toric intraocular lens markers-assisted implantation of the scleral-fixated intraocular lens (SFIOL). METHODS From October 2010 to December 2013, all patients who had undergone secondary SFIOL implantation were assigned to group 1 and 2, in group 1 SFIOL was performed with the assist of radial keratotomy (RK)-marker, and in group 2 SFIOL was performed with the assisted of toric intraocular lens markers (T-and axis markers). Patients' demographic data and information on baseline preoperative visual acuity, indication for surgery and latest postoperative visual acuity were collected and analyzed. The haptic and optic positions were determined by ultrasound biomicroscopy. The optic tilt angle and decentration distance were measured. RESULTS The study evaluated 43 eyes of 43 patients ranging in age from 3 to 66y. Group 1 comprised 24 eyes (24 patients) and group 2, 19 eyes (19 patients). Uncorrected reoperative acuity was improved on all the eyes postoperatively. The improved postoperative acuity was significantly more in group 2 than that in group 1 (1.11±0.38 vs 0.82±0.45 logMAR; F=4.85, P=0.03). Ultrasonic biomicrograph examination showed that the rate of haptic asymmetry was significantly higher in group 1 (42%, 10/24) than that in group 2 (11%; 2/19) (Chi square=3.68, P=0.04). The mean tilted degree in group 1 was significantly higher than that in group 2 (P=0.04). Mean decentration distance in group 1 was greater than that in group 2 (P=0.03). CONCLUSION During SFIOL the toric markers help the surgeon identify the placement of fixation more precisely than that with the use of RK marker. PMID:27672593
Evaluation of the diurnal intraocular pressure fluctuations and blood pressure under dehydration due to fasting
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Gonen Baser
Full Text Available Introduction: This study aimed to investigate the diurnal intraocular pressure fluctuations under dehydration conditions and the relationship between the intraocular pressure fluctuations and blood pressure. Methods: The intraocular pressures (IOP, body weights, as well as systolic and diastolic blood pressures (SBP, DBP of 36 fasting healthy volunteers were recorded at 8:00 a.m. and 5:00 p.m. in the Ramadan of 2014 and two weeks after it. The data were analyzed using paired Student's t-test and Pearson correlation analysis. Results: As the results demonstrated, the mean diurnal IOP differences of IOP, SBP, DBP, and weight were 2.67±1.33 mmHg, 9.44±8.02 mmHg, 3.33±5.94 mmHg, and 0.90±0.46 kg during the fasting period, respectively. In addition, the mean diurnal IOP differences of IOP, SBP, DBP, and weight were -0.33±1.4 mmHg (P=0.001, 0.55±7.25mmHg (P=0.003, -3.33±5.94 mmHg (P=0.001, and 0.12±0.45 kg (P=0.001 during the control period, respectively. There was a moderate correlation between the diurnal IOP and SBP differences (r=0.517, P=0.028. Conclusion: Based on the findings of the current study, the total fluid volume might have a more dominant effect on IOP peaks than the sympathetic system activity. Furthermore, the SBP was found to correlate with the IOP.
Effect of phacoemulsification combined with intraocular lens implantation on diabetic cataract treatment
Institute of Scientific and Technical Information of China (English)
Wei Gao; Chao Zhang; Li Jia; Hong Tang
Objective:To observe the effect of phacoemulsification combined with intraocular lens implantation on inflammatory factors, oxidative stress reaction and the hemorheology in patients with diabetic cataract, for helping clinical treatment of patients with diabetic cataract. Methods: A total of 160 diabetic cataract patients in our hospital were selected and randomly divided into observation group and control group, each group were 80 cases, control group was treated with conventional therapy, observation group was treated with phacoemulsification combined with intraocular lens implantation based on conventional therapy, the changes of inflammatory factors, oxidative stress reaction and the hemorheology were detected before and after treatment.Results: The difference of inflammatory factors, oxidative stress reaction and the hemorheology in the two groups before treatment was not statistically significant (P>0.05). Inflammatory factors (IL-2, IL-6, hs-CRP and TNF-α), MDA in both groups after treatment significantly increased compared with that before treatment.; oxidative stress reaction parameters (CAT, SOD, GSH-Px), hemorheology parameters (WHV, WLV, PV) in both groups after treatment significantly decreased compared with that before treatment. Changes in PCV and FIB in two groups after treatment was not statistically significant compared with that before treatment (P>0.05). MDA, Inflammatory factors (IL-2, IL-6, , hs-CRP and TNF-α) and hemorheology parameters (WHV, WLV, PV) in observation group after treatment decreased more significantly than that in control group (P0.05). Conclusions:Phacoemulsification combined with intraocular lens implantation could improve inflammatory factors, oxidative stress reaction parameters and hemorheology parameters in diabetic cataract patients, and help clinical treatment of diabetic cataract patients.
Treatment of cytomegalovirus retinitis with an intraocular sustained-release ganciclovir implant
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Muccioli C.
Full Text Available The objective of this prospective study was to evaluate the efficacy and complications of the use of an intraocular sustained-release ganciclovir implant for the treatment of active cytomegalovirus (CMV retinitis in AIDS patients. Thirty-nine eyes of 26 patients were submitted to ocular surgery. All patients underwent complete ocular examination before and after surgery. The surgical procedure was always done under local anesthesia using the same technique. The mean time for the surgical procedure was 20 min (range, 15 to 30 min. The average follow-up period was 3.7 months. Of all patient, only 4 presented recurrence of retinitis after 8, 8, 9 and 2 months, respectively. Three of them received a successful second implant. All 39 eyes of the 26 patients presented healing of retinitis as shown by clinical improvement evaluated by indirect binocular ophthalmoscopy and retinography. Retinitis healed within a period of 4 to 6 weeks in all patients, with clinical regression signs from the third week on. Six (15.4% eyes developed retinal detachment. None of the patients developed CMV retinitis in the contralateral eye. The intraocular implant proved to be effective in controlling the progression of retinitis for a period of up to 8 months even in patients for whom systemic therapy with either ganciclovir or foscarnet or both had failed. The intraocular sustained-release ganciclovir implant proved to be a safe new procedure for the treatment of CMV retinitis, avoiding the systemic side effects caused by the intravenous medications and improving the quality of life of the patients.
Densiron® 68 as an intraocular tamponade for complex inferior retinal detachments
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Hussain RN
Full Text Available Rumana N Hussain, Somnath BanerjeeLeicester Royal Infirmary, Leicester, UKIntroduction: Densiron® 68 is a high-density liquid used to tamponade inferior retinal detachments. We present a case series of 12 patients treated with Densiron as an intraocular tamponade agent.Methods: A retrospective analysis of 12 eyes in 12 patients was carried out. The primary endpoint was anatomic reattachment of the retina following removal of Densiron oil.Results: All patients had inferior detachments; 33% had associated proliferative vitreoretinopathy (PVR. Densiron was utilized as a primary agent in five patients (42%; the remaining patients had prior unsuccessful surgery for retinal reattachment, including pars plana vitrectomy, cryotherapy, laser, encirclement, gas (C3F8 or C2F6, or silicone oil. Eleven patients (91% had successful reattachment of the retina at 3 months following removal of Densiron; one patient had extensive PVR, total retinal detachment, preretinal macula fibrosis, and chronic hypotony, and surgical intervention was unsuccessful. Six patients (50% had raised intraocular pressure (IOP, resolving in the majority of cases following Densiron removal; two patients had long-term raised IOP requiring topical or surgical therapy. Of the six phakic patients, 50% developed significant cataract in the operated eye. Of those with successful retinal reattachment, visual outcome was variable, with 36% patients gaining two to four lines on Snellen, 27% remaining objectively the same, and 36% losing one to two lines.Conclusion: The anatomic success rate is high (91% in patients requiring Densiron tamponade for inferior retinal detachments with or without evidence of PVR either as a primary or secondary intervention. A common complication is raised IOP; however, this most often resolves following removal of the oil.Keywords: intraocular tamponade, silicone oil, retinal detachment, retinal reattachments
A time-delay calibrated method for cornea hysteresis and intraocular pressure measurement
Wang, Kuo-Jen; Tsai, Che-Liang; Wang, Wai; Hsu, Long; Hsu, Ken-Yuh
The presence of cornea hysteresis (CH) in characterizing the intraocular pressure (IOP) of a human eye deteriorates the accuracy of IOP. To suppress CH, the pressure gauge of a tonometer must be located as close as possible to the cornea. However, this arrangement is unpractical because appropriate working distance to the cornea is required. In this paper, a time-delay calibrated (TDC) method is proposed to counteract the undesired effect of CH in characterizing the IOP. Employing this TDC method, the CH approaches to zero for most eyes measured.
Estudio de la supervivencia de pacientes con Melanoma Uveal de Una Unidad Referencial de tumores Intraoculares
El melanoma uveal es el tumor intraocular primario maligno más frecuente en el adulto con supervivencia aproximada del 50% a los 10 años. El pronóstico está influenciado por características raciales y geográficas y son muy escasas las publicaciones de series del sur de Europa por lo que es posible que la supervivencia es estas poblaciones sea diferente. * Objetivos: Estudiar las características epidemiológicas, y la supervivencia de una serie de pacientes con melanoma uveal en una unidad de r...
Pars plana cicatrization of sewn-in posterior chamber intraocular lens haptics.
McDermott, M L; Puklin, J E
The authors describe the unexpected finding of cicatrization of posterior chamber lens haptics to the pars plana. This was found during removal of a secondary, transscleral sewn-in pseudophakos during a retinal reattachment procedure. Ophthalmic history and intraoperative photography revealed pars plana cicatrization of haptics. Despite removal of trans-scleral prolene fixation sutures and application of gentle traction, the posterior chamber lens haptics remained firmly adherent to pars plana retina. The haptics were amputated to prevent significant chorioretinal damage. The conventional belief that all sewn-in posterior chamber intraocular lenses cause little or no scarring response around the haptics may be unfounded.
The Comprehensive Control of Astigmatism during and Following Intraocular Lens Implantation.
Institute of Scientific and Technical Information of China (English)
The operating corneoloscope and Terry operative keratometer were used respectively in 29 and 34 eyes during the intraocular lens implantation to measure the corneal astigmatism qualitatively or quantitatively,so that the tension of incision closure could be adjusted. The surgically induced astigmatism in qualitative group two weeks after the operation was 3. 5 ± 1. 70 D and that in quantitative group was 2. 56±1. 60 D. There were 55.17% and 38. 24% of the eyes with over 2. 00 D corneal astigmatism in qu...
An investigation on dysphotopsia of a sigma-edged intraocular lens
Institute of Scientific and Technical Information of China (English)
Zhishan Gao; Meimei Kong; Xinhua Li; Lei Chen; Rihong Zhu
@@ A sigma-edged design of intraocular lens (IOL) is proposed to minimize the reflected glare images associated with the edge. The optimal sigma inverse edge is investigated when pupil diameter is 5.0 mm by the established Escudero-Sanz's wide angle model. The non-sequential ray tracing program of Zemax-EE (Zemax Development Corp., San Diego, USA) is used to investigate the sigma edge of reducing the potential for edge glare phenomena. The results show that sigma-edged design can significantly reduce the reflected glare intensity on retina if the angle of its inverse edge is taken from 20 to 70 degrees.
Intraocular lens confusions: a preventable "never event" - The Royal Victorian Eye and Ear Hospital protocol.
Zamir, Ehud; Beresova-Creese, Katarina; Miln, Linda
Intraocular lens (IOL) confusions and errors are among the most common postoperative adverse events. Errors may occur at any stage from the decision to operate to the insertion of the IOL. The most common errors occur during IOL selection pre-operative preparation (anaesthesia given before recognition that the intended IOL is not available), or intraoperatively (wrong IOL implanted because of confusion in the operating room). We review the mechanisms of errors reported in the literature and describe the experience at The Royal Victorian Eye and Ear Hospital. We also describe the implementation of an error-detection protocol and provide qualitative data on its performance.
Retropupillary iris-claw intraocular lens in ectopia lentis in Marfan syndrome
Faria, Mun Yueh; Ferreira, Nuno; Neto, Eliana
Objective To report visual outcomes, complication rate, and safety of retropupillary iris-claw intraocular lens (ICIOL) in ectopia lentis in Marfan syndrome (MFS). Design Retrospective study. Methods Six eyes of three MFS patients with ectopia lentis underwent surgery for subluxation lens and retropupillary ICIOL implantation from October 2014 to October 2015 at the Department of Ophthalmology, Santa Maria Hospital in Lisbon, Portugal. Demographics, preoperative and postoperative best-corrected visual acuity (BCVA), and intraocular pressure were evaluated. Endothelium cell count was assessed using specular microscopy; anterior chamber depth was measured using Pentacam postoperatively; and intraocular lens position was viewed by ultrasound biomicroscopy. All patients were female; mean age was 20±14.264 years (range: 7–38 years). Results The average follow-up period was 6.66 months (range: 4–16 months). Preoperative BCVA was 0.568±0.149 logMAR units, and postoperative BCVA was 0.066±0.121 logMAR units. The mean BCVA gain was −0.502±0.221 on the logMAR scale. Postoperative average astigmatism and intraocular pressure were 1.292±0.697 mmHg (range: 0.5–2.25 mmHg) and 16 mmHg (range: 12–18 mmHg), respectively. The average endothelial cell density decreased from 3,121±178 cells/mm2 before surgery to 2,835±533 cells/mm2 after surgery (measured at last follow-up visit) and in the last follow-up, representing an average endothelial cell loss of 9.16%. Mean anterior chamber depth was 4.01 mm (±0.77 mm), as measured by Pentacam. No complications were found intra- or postoperatively in any of the six studied eyes. Conclusion Retropupillary ICIOL implantation is a safe and effective procedure in the treatment of aphakia in MFS eyes, without capsular support after surgery for ectopia lens. The six eyes that underwent lensectomy and retropupillary ICIOL implantation have had excellent visual outcomes with no complications so far. PMID:27382335
Fungal endophthalmitis caused by Paecilomyces variotii, in an immunocompetent patient, following intraocular lens implantation
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Anita K
Full Text Available We report the case of a 70-year-old man who was admitted for anterior endophthalmitis following an intraocular lens implantation. He had developed a fluffy growth resembling a fungal mass on the iris of the right eye. The mass was removed and sent for fungal studies to our department. Direct microscopy revealed hyphae. Further studies helped identify the fungus to belong to genus Paecilomyces. This is a rare case of fungal endophthalmitis caused by Paecilomyces variotii in an immunocompetent person.
Toxic Anterior Segment Syndrome after Foldable Artiflex Iris-Fixated Phakic Intraocular Lens Implantation
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Lucien A. M. van Philips
Full Text Available Toxic anterior segment syndrome (TASS developed in four cases after uneventful implantation of a foldable iris-fixated phakic intraocular lens (pIOL. Two cases occurred sequentially in one patient. The TASS subsided without complications in all cases after intensive topical steroid treatment. A multitude of possible causes is considered for the occurrence of these TASS cases. From the sterilization and cleaning of surgical instruments to the possibility of endotoxines in ophthalmic viscosurgical devices (OVD. These rare cases should alert the surgeon to the possibility of TASS after pIOL implantation.
Experimentally observe the effect of spherical aberration on diffractive intraocular lens using adaptive optics
Guo, Huanqing; DeLestrange, Elie
We first investigated the similarity in optical quality of a batch of diffractive intraocular lenses (DIOLs), providing experimental evidence for one DIOL as representative of a batch. Using adaptive optics, we then evaluated one DIOL under different levels of Zernike spherical aberration (SA) by applying both a point spread function test and a psychophysical visual acuity test. We found that for small aperture size SA has the effect of shifting the through-focus curve of DIOL. Also, for a relatively large aperture size, it has different effects on the distant and near foci.
Influence of ocular longitudinal chromatic aberration on the selection of aspheric intraocular lenses.
Hong, Xin; Choi, Myoung
Polychromatic defocus could affect the optimal residual spherical aberration that could yield the best image quality for patients with intraocular lenses (IOLs). Modulation transfer functions (MTFs) were generated using a model that included polychromatic defocus. The maximum MTF volume occurred at + 0.05 μm of overall ocular spherical aberration. For 3 case studies, the optimal overall ocular spherical aberration was ~0.05 μm more positive with the contribution of polychromatic defocus than without it. Overall, the model indicated that image quality was usually best when IOLs allowed overall ocular spherical aberration that was slightly positive, rather than strongly positive, zero, or negative.
Carbachol as miotic agent in intra-ocular lens implant surgery
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Agarwal Jitendra
Full Text Available The intra cameral use of 0.025% carbachol as a miotic agent in anterior chamber intraocular lens im-plant surgery us reported in 15 cases. Carbachol produced prompt and effective moisis and was found to be harmless and non-irritating to the anterior chamber structures. A rebound dialatation of the pipit was noticed in the post operative period in 3 of our first 5 cases where only carbachol was used. For prolonged miosis instillation of a more powerful miotic like pilocarpine is recommended at the completion of surgery:
Twenty-four-hour intraocular pressure patterns in a symptomatic patient after ab interno trabeculotomy surgery
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Mansouri K
Full Text Available Kaweh Mansouri,1 Felipe A Medeiros,2 Robert N Weinreb2 1Glaucoma Sector, Department of Ophthalmology, Geneva University Hospitals, Geneva, Switzerland; 2Hamilton Glaucoma Center and Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA Abstract: We report the results of repeated ambulatory continuous 24-hour intraocular pressure (IOP monitoring with a contact lens sensor (CLS in a glaucoma patient with ocular pain after ab interno trabeculotomy (Trabectome™ surgery. Our findings show that a combined prostaglandin–pilocarpine treatment reduced nighttime IOP peaks and relieved the patient's symptoms. Keywords: 24-hour, Trabectome contact lens sensor, prostaglandin–pilocarpine treatment
Residual aniseikonia among patients fitted with one or two intraocular lenses (pseudophakic corrections)
Lakshminarayanan, V; Enoch, J M; Knowles, R A
In the presence of one or two intraocular lenses (IOL's; pseudophakic corrections) or in the presence of naturally occurring or developmental anisometropia (due to a tumescent cataract) some induced or residual refractive aniseikonia is usually encountered. We wish to call this problem to the attention of the optometric practitioner. We provide a discussion of the resultant aniseikonia and simple rules of thumb for management of such patients with refractive aniseikonia. Aniseikonia in these patients may be less important than once had been suggested, but certainly it is more significant than it is currently being considered. Use of personal computers to calculate this aniseikonia makes appropriate correction relatively easy and readily applicable.
Comparison of Trans-scleral Fixation of PMMA and Foldable Intraocular Lens in Children
Institute of Scientific and Technical Information of China (English)
Yuping Zou; Zhende Lin; Bo Feng; Shaozhen Li
Purpose: To observe the difference of the effects of PMMA and foldable intraocular lenses (IOLs) trans-sclerally fixed in pediatric eyes. Methods: Thirty-two children (43 eyes) who had undergone trans-scleral fixation of IOL were retrospected, of whom 5 children were implanted PMMA IOL in both eyes, 6children were implanted PMMA IOL in one eye and foldable IOL in the other eye, 12children were implanted foldable IOL in one eye and 9 chilrden were implanted PMMA IOL in one eye. Mean age was 5.3 years ( range 2.5 ~ 12 years ). Twelve children had traumatic cataract and the others congenital cataract before lens extraction. Results: Foldable group (18 eyes ): Mean follow-up was 12.1 months. Visual acuity (VA): compared with the best corrected VA before IOL fixation, postoperative best corrected VA improved in 16 eyes, remained unchanged in 2 eyes. In 14 eyes, one or two stitches were needed to seal the incision. Complications: Severe anterior chamber reaction was seen in 3 eyes. Intraocular bleeding was found in 3 eyes. IOL decentration was detected in 1 eye. Iris capture of IOL was seen in one eye. PMMA group (25 eyes ):Mean follow-up was 20.3 months. Visual acuity (VA): compared with the best corrected VA before IOL fixation, postoperative best corrected VA improved in 19 eyes,remained unchanged in 5 eyes and got worse in one eye. In 24 eyes, one to three stitches were needed to seal the incision. Complications: Severe anterior chamber reaction was seen in 5 eyes. Intraocular bleeding was found in 4 eyes. IOL decentration was seen in one eye. Iris capture of IOL was seen in 3 eyes. Intraocular pressure elevated in one eye. Conclusion: Our study shows that trans-scleral fixation of IOL is a safe procedure in pediatric eyes. Foldable IOL showed similar effect compared with PMMA IOL in pediatric trans-scleral fixation. Eye Science 2001; 17:61 ~ 64.
Diseño y evaluación de perfiles de lentes intraoculares
El uso de lentes intraoculares (LIOs) monofocales, bifocales y acomodativas es una estrategia para restaurar el poder refractivo en los ojos tratados de las cataratas. Con el fin de comprender y mejorar la percepción visual de las escenas tridimensionales, abordamos el estudio de los diseños de las LIOs y evaluamos in vitro su desempeño. Inicialmente, proponemos dos diseños alternativos que compensan la falta de la acomodación, expandiendo la profundidad de foco del ojo. Los diseños se basan ...
Innovative confocal laser method for exact dioptric power measurement of intraocular lens implants Invited Paper
Institute of Scientific and Technical Information of China (English)
Ilko K. Ilev; Robert W. Faaland; Do-Hyun Kim; Robert H. James; Don Calogero
We present a novel confocal laser method (CLM) for precise testing of the dioptric power of both positive and negative intraocular lens (IOL) implants. The CLM principle is based on a simple fiber-optic confocal laser design including a single-mode fiber coupler that serves simultaneously as a point light source used for formation of a collimated Gaussian laser beam, and as a highly sensitive confocal point receiver. The CLM approach provides an accurate, repeatable, objective, and fast method for IOL dioptric power measurement over the range from 0 D to greater than =t=30 D under both dry and in-situ simulated conditions.
Toric Intraocular Lenses in the Correction of Astigmatism During Cataract Surgery
DEFF Research Database (Denmark)
Kessel, Line; Andresen, Jens; Tendal, Britta
TOPIC: We performed a systematic review and meta-analysis to evaluate the benefit and harms associated with implantation of toric intraocular lenses (IOLs) during cataract surgery. Outcomes were postoperative uncorrected distance visual acuity (UCDVA) and distance spectacle independence. Harms were...... literature search in the Embase, PubMed, and CENTRAL databases within the Cochrane Library. We included randomized clinical trials (RCTs) if they compared toric with non-toric IOL implantation (± relaxing incision) in patients with regular corneal astigmatism and age-related cataracts. We assessed the risk...
The Clinical Analysis of Secondary Glaucoma Following Posterior Chamber Intraocular Lens Implantation
Institute of Scientific and Technical Information of China (English)
We present 14 patients with secondary gluacoma following the implantation of a posterior chamber intraocular lens (lOLs). All patients were u-nilateral gluacoma , which developed within 1 month following the IOL implantation in 10 cases, and from 1 to 3 years in 4 cases. The angle of anterior chamber was open in 8 patients, and close in 6 ones. Seven patients required treatment of antiglaucomatous medicine; 4 patients underwent laser indecto-my and 3 patients required antiglaucoma surgery. The results s...
Unusual intraocular foreign bodies after an explosion: patient's hand bone fragments.
Sonmez, Murat; Duzgun, E; Yildirim, Y; Ayata, A; Unal, M H
A 26-year-old Turkish Army soldier underwent full ophthalmoscopic examination after a penetrating ocular injury in the left eye due to the accidental explosion of a detonating fuse during handling. Visual acuity of the left eye was hand motion level. Funduscopy revealed foreign bodies suspended in the vitreous gel and accompanying vitreous haemorrhage. B-scan ultrasonography, CT of the orbits and microscopic examination of the intraocular foreign bodies (IOFBs) were performed prior to removal of bone fragments and pars plana vitrectomy. The IOFBs were fragments of the patients' bone tissue. Bone fragments from victim's body may cause IOFBs after an explosion in military personnel.
The heritability of glaucoma-related traits corneal hysteresis, central corneal thickness, intraocular pressure, and choroidal blood flow pulsatility.
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Ellen E Freeman
Full Text Available PURPOSE: The purpose of this work was to investigate the heritability of potential glaucoma endophenotypes. We estimated for the first time the heritability of the pulsatility of choroidal blood flow. We also sought to confirm the heritability of corneal hysteresis, central corneal thickness, and 3 ways of measuring intraocular pressure. METHODS: Measurements were performed on 96 first-degree relatives recruited from Maisonneuve-Rosemont Hospital in Montreal. Corneal hysteresis was determined using the Reichert Ocular Response Analyser. Central corneal thickness was measured with an ultrasound pachymeter. Three measures of intraocular pressure were obtained: Goldmann-correlated and corneal compensated intraocular pressure using the Ocular Response Analyser, and Pascal intraocular pressure using the Pascal Dynamic Contour Tonometer. The pulsatility of choroidal blood velocity and flow were measured in the sub-foveolar choroid using single-point laser Doppler flowmetry (Oculix. We estimated heritability using maximum-likelihood variance components methods implemented in the SOLAR software. RESULTS: No significant heritability was detected for the pulsatility of choroidal blood flow or velocity. The Goldman-correlated, corneal compensated, and Pascal measures of intraocular pressure measures were all significantly heritable at 0.94, 0.79, and 0.53 after age and sex adjustment (p = 0.0003, p = 0.0023, p = 0.0239. Central corneal thickness was significantly heritable at 0.68 (p = 0.0078. Corneal hysteresis was highly heritable but the estimate was at the upper boundary of 1.00 preventing us from giving a precise estimate. CONCLUSION: Corneal hysteresis, central corneal thickness, and intraocular pressure are all heritable and may be suitable as glaucoma endophenotypes. The pulsatility of choroidal blood flow and blood velocity were not significantly heritable in this sample.
Implante de lente intra-ocular dobrável acrílica em crianças
Jordão Jr.,Antonio; Romão,Erasmo
Objetivos: Avaliar o uso de lentes intra-oculares dobráveis de acrílico na correção da afacia infantil. Métodos: Dez olhos de 10 pacientes com idades entre 3 e 9 anos portadores de catarata infantil foram operados e receberam o implante de lente intra-ocular dobrável de acrílico. Os pacientes foram acompanhados por um período que variou de 6 a 20 meses. Resultados: Após a medida da acuidade visual de todos no último retorno, encontramos uma melhora significativa em cinco pacientes. Em nenhum ...
Influencia de las medidas queratométricas en el cálculo de la potencia de lentes intraoculares
Mateo Pérez, Verónica; Camps Sanchis, Vicente Jesús; Piñero Llorens, David Pablo; Fez Saiz, Dolores de
PROPÓSITO: Determinar la influencia del error cometido en el cálculo de la potencia corneal queratométrica en el cálculo de la potencia de una lente intraocular. MÉTODO: Se analiza el error que se comete cuando se calcula la potencia de la lente intraocular utilizando la potencia corneal calculada por el método de Gauss ó por medio de un índice queratométrico (nk), y se analiza las dependencias con los radios de la cara anterior (r1c) y posterior (r2c) de la cornea, de la razón k, del modelo ...
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Glišić Selimir
Full Text Available Cataract surgery and intraocular lens power calculation is challenging in patients with anterior megalophthalmos and cataract, with postoperative refractive surprise frequently reported. Deep anterior chamber in these patients substantially influence effective lens position. To minimize possibility of refractive surprise, we used Haigis formula that takes into account anterior chamber depth in the lens power calculation for our patient. Cataract was managed by phakoemulsification with standard intraocular lens implanted in the capsular bag. Postoperatively, satisfying refractive result was achieved and refractive surprise was avoided.
A Case of Intraocular Erosion and Intrusion by an Arruga Suture
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Takakuni Kitagaki
Full Text Available Purpose: To report a case of intraocular erosion and intrusion by an Arruga suture. Case Report: This study involved a 62-year-old male who had undergone scleral buckling surgery 40 or more years ago at another hospital for rhegmatogenous retinal detachment, as well as trabeculectomy 20 years ago for primary open-angle glaucoma, in his left eye at the same hospital. However, he recently became aware of blurred vision in that eye. Upon examination, iritis was observed in the anterior portion of his left eye, as well as a great number of pigment cell keratoprecipitates on the posterior surface of the cornea. In the ocular fundus, extensive atrophy of the retinal pigment epithelium and partial hyperpigmentation was observed, accompanied by subretinal strands, yet the retina remained attached. Around the entire peripheral area of the retina we observed a ring-shaped protrusion, but we also saw a shiny, filamentous material in the vitreous cavity that penetrated the sclera and choroid, completely extending from the 4- to 8-o'clock position of the scleral buckle protrusion. To treat the iritis in the patient's left eye, we began to administrate low-concentration steroid eye drops, after which the inflammation disappeared. Conclusion: In this study, we experienced a case of intraocular erosion and intrusion by an Arruga suture, and opted to treat the patient with steroid eye drops and conservative follow-up observations unless retinal redetachment and/or vitreous hemorrhage occurs.
A Case of Intraocular Erosion and Intrusion by an Arruga Suture
Kitagaki, Takakuni; Morishita, Seita; Kohmoto, Ryohsuke; Fukumoto, Masanori; Suzuki, Hiroyuki; Sato, Takaki; Kobayashi, Takatoshi; Kida, Teruyo; Nakajima, Masayuki; Ikeda, Tsunehiko
Purpose To report a case of intraocular erosion and intrusion by an Arruga suture. Case Report This study involved a 62-year-old male who had undergone scleral buckling surgery 40 or more years ago at another hospital for rhegmatogenous retinal detachment, as well as trabeculectomy 20 years ago for primary open-angle glaucoma, in his left eye at the same hospital. However, he recently became aware of blurred vision in that eye. Upon examination, iritis was observed in the anterior portion of his left eye, as well as a great number of pigment cell keratoprecipitates on the posterior surface of the cornea. In the ocular fundus, extensive atrophy of the retinal pigment epithelium and partial hyperpigmentation was observed, accompanied by subretinal strands, yet the retina remained attached. Around the entire peripheral area of the retina we observed a ring-shaped protrusion, but we also saw a shiny, filamentous material in the vitreous cavity that penetrated the sclera and choroid, completely extending from the 4- to 8-o'clock position of the scleral buckle protrusion. To treat the iritis in the patient's left eye, we began to administrate low-concentration steroid eye drops, after which the inflammation disappeared. Conclusion In this study, we experienced a case of intraocular erosion and intrusion by an Arruga suture, and opted to treat the patient with steroid eye drops and conservative follow-up observations unless retinal redetachment and/or vitreous hemorrhage occurs. PMID:27099609
Dosimetry and treatment planning of Occu-Prosta I-125 seeds for intraocular lesions
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Chaudhari Suresh
Full Text Available Intraocular malignant lesions are frequently encountered in clinical practice. Plaque brachytherapy represents an effective means of treatment for intraocular lesions. Recently Radiopharmaceutical Division, BARC, Mumbai, has indigenously fabricated reasonable-cost I-125 sources. Here we are presenting the preliminary experience of dosimetry of sources, configuration of treatment planning system (TPS and quality assurance (QA for eye plaque therapy with Occu-Prosta I-125 seeds, treated in our hospital, for a patient with ocular lesions. I-125 seeds were calibrated using well-type chamber. BrachyVision TPS was configured with Monte Carlo computed radial dose functions and anisotropy functions for I-125 sources. Dose calculated by TPS at different points in central axis and off axis was compared with manually calculated dose. Eye plaque was fabricated of 17 karat pure gold, locally. The seeds were arranged in an outer ring near the edge of the plaque and in concentric rings throughout the plaque. The sources were manually digitized on the TPS, and dose distribution was calculated in three dimensions. Measured activity using cross-calibrated well-type chamber was within ±10% of the activity specified by the supplier. Difference in TPS-calculated dose and manually calculated dose was within 5%. Treatment time calculated by TPS was in concordance with published data for similar plaque arrangement.
Solid Lipid Nanoparticles Improve the Diclofenac Availability in Vitreous after Intraocular Injection
Abrishami, Majid; Vakili Ahrari Roodi, Mohammad
Purpose. In order to improve the drug availability after intravitreal administration, solid lipid nanoparticles (SLNs) containing diclofenac were prepared. Methods. In this experimental study, 18 albino rabbits were included. In right and left eyes of all rabbits, SLNs containing diclofenac and commercial form of diclofenac (0.3 mg drug) were intravitreally injected, respectively. One, four, twelve, twenty-four, and forty-eight hours after injection, vitreous and aqueous humor samples were obtained in all cases. Then, the concentration of diclofenac sodium was evaluated in all samples. Results. Size of nanoparticles was around 170 nm after preparation. Drug concentration in eyes injected with SLNs was significantly higher than left eyes injected with commercial formulation up to 4 hours after intravitreal injection (p < 0.05). Diclofenac was quantified in samples up to 48 hours after intraocular injection. Four hours after intravitreal injection, the concentration of diclofenac in vitreous and aqueous humor of eyes receiving SLNs was, respectively, 2.5 and 6.5 times higher than eyes injected with commercial form of drug. Conclusions. Here, we demonstrate the potential of SLNs as a carrier of diclofenac for intraocular injection in order to prevent the systemic effects of the drug, increase the injection intervals, and improve the patient compliance. PMID:27803815
Transconjunctival sutureless intrascleral intraocular lens fixation using intrascleral tunnels guided with catheter and 30-gauge needles.
Takayama, Kohei; Akimoto, Masayuki; Taguchi, Hogara; Nakagawa, Satoko; Hiroi, Kano
We invented a new method for fixing an intraocular lens (IOL) in the scleral tunnel without using a wide conjunctival incision. Modified bent catheter needles were used to penetrate the IOL haptics through the sclerotomy sites. The IOL haptics were inserted into 30-guage (G) scleral tunnels guided by double 30-G needles piercing the sclera. All procedures were performed through the conjunctiva without wide incision. The procedure does not require special forceps, trocars or fibrin glue, only catheter and 30-G needles. The aid of an assistant was not required to support the IOL haptic. The procedures were easily learnt based on our previous method. As with other transconjunctival sutureless surgeries, patients feel less discomfort and the conjunctiva can be conserved for future glaucoma surgery. Complications included two cases of vitreous haemorrhage (16.7%), and one case each of postoperative hypotony, and iris capture (8.3%). Astigmatism induced by intraocular aberration was the same as we reported previously. Our method for fixing the IOL into the scleral tunnel is innovative, less expensive, less invasive and quick. This modified method is a good alternative for fixing IOL haptics into the sclera.
Customized toric intraocular lens implantation for correction of extreme corneal astigmatism due to corneal scarring
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R Bassily
Full Text Available R Bassily, J LuckOphthalmology Department, Royal United Hospital, Combe Park, Bath, UKAbstract: A 76-year-old woman presented with decreased visual function due to cataract formation. Twenty-five years prior she developed right sided corneal ulceration that left her with 10.8 diopters (D of irregular astigmatism at 71.8° (steep axis. Her uncorrected visual acuity was 6/24 and could only ever wear a balanced lens due to the high cylindrical error. Cataract surgery was planned with a custom designed toric intraocular lens (IOL with +16.0 D sphere inserted via a wound at the steep axis of corneal astigmatism. Postoperative refraction was -0.75/+1.50 × 177° with a visual acuity of 6/9 that has remained unchanged at six-week follow-up with no IOL rotation. This case demonstrates the value of high power toric IOLs for the correction of pathological corneal astigmatism.Keywords: intraocular lens, corneal ulceration, visual acuity, scarring
A retrospective analysis of the first Indian experience on Artisan phakic intraocular lens
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Senthil Sirisha
Full Text Available Purpose: To evaluate the efficacy, safety, predictability and stability of implanting a polymethylmethacrylate phakic intraocular lens (PIOL in high myopia. Materials and Methods: A retrospective analysis of the data of patients who underwent Artisan phakic IOL implantation between 2002 and 2003 with a follow-up of at least 24 months. Results: An Artisan myopia lens was implanted in 60 eyes of 36 patients with preoperative myopia ranging from -5.0 to -24.0 D. Mean patient age was 22.6 years. Mean spherical equivalent of manifest refraction stabilized by the first postoperative week. At three months follow-up, 54 eyes (90% had a postoperative refraction within ± 1D emmetropia and 45 eyes (75% had uncorrected visual acuity of 20/40 or better. Seven eyes (11.6% had loss of one Snellen line and none had loss of two Snellen lines or more at three months. The mean endothelial cell loss was 3.8% at three months, 5.2% at six months, 5.25% at 12 months and 6.38% at two years, which was not significant. Postoperative complications included anterior chamber reaction in two eyes (3.3%, rise in intraocular pressure in six eyes (10% and dislocation of PIOL in two eyes (3.3%. Conclusion: Implantation of Artisan myopia lens to correct high myopia resulted in a stable and fairly predictable refractive outcome with few complications. Significant endothelial damage was not detected in two years of follow-up.
Iris-claw intraocular lens implantation: Anterior chamber versus retropupillary implantation
Helvacı, Sezer; Demirdüzen, Selahaddin; Öksüz, Hüseyin
Purpose: To compare the outcomes of anterior chamber and retropupillary implantation of iris-claw Artisan intraocular lenses (IOL). Design: Prospective, randomized, single-blinded study. Patients and Methods: Forty eyes of forty aphakic patients were enrolled. Patients were randomized into two groups. Each group includes twenty patients. Group 1 received anterior chamber Artisan IOL implantation. Group 2 received retropupillary Artisan IOL implantation. Preoperative and postoperative corrected distance visual acuity (CDVA), intraocular pressure (IOP), and all complications were noted and compared at 6 months follow-up. Results: Each two groups obtained a significant improvement in CDVA (P < 0.05). Four patients in Group 1 and five patients in Group 2 had significant but nonpermanent increase at IOP values. There were one and two pupillary irregularity in Group 1 and Group 2, respectively. In one patient, a shallow and inferior located retinal detachment were encountered in anterior chamber group. Conclusions: The results were not significantly different between the two fixation techniques for iris-claw lens. The surgery procedure is dependent to surgeon experience and eye's conditions. PMID:26953023
Hydrophilic Acrylic Intraocular Lens Opacification after Descemet Stripping Automated Endothelial Keratoplasty
Norouzpour, Amir; Zarei-Ghanavati, Siamak
Purpose: To report hydrophilic acylic intraocular lens (IOL) opacification after Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) in an eye with multiple prior intraocular surgeries and iatrogenic aniridia. Case Report: A 34-year-old woman with history of penetrating keratoplasty (PKP) for advanced keratoconus and subsequent Urrets-Zavalia Syndrome (UZS) underwent phacoemulsification and hydrophilic acrylic IOL implantation for her cataract. In order to control post-PKP glaucoma, multiple glaucoma surgeries including two glaucoma drainage implants were performed. As the original corneal graft failed, the patient subsequently underwent re-PKP. Four years later, she underwent DSAEK for treatment of the second graft failure. Ten months after DSAEK, a double semi-circular pattern of IOL opacification was observed on the anterior surface of the IOL. The patient did not report any complaints and we decided not to exchange the IOL. Conclusion: In an eye with UZS and iatrogenic aniridia, IOL opacification may result from direct contact between the IOL surface and exogenous air. Aniridia can be a risk factor for development of IOL opacification after DSAEK. Further studies are required to confirm this hypothesis. PMID:27413506
The Relation of the Location of Haptics of Posterior Chamber Intraocular Lenses and Peripheral Anterior Synechia
Institute of Scientific and Technical Information of China (English)
RuiduanLiao; ShaozhenLi
Purpose:To investigate the occurrence,outcome and influencial factors of the pe-ripheral anterior synechia(PAS)following implantation of posterior chamber in-traocular lenses for finding a way to reduce thePAS.Subjects;40 eyes of 38senile cataract patients with normal chamber angle and in-traocular pressue(IOP)preoperatively were examined.Methods:Extracapsular cataract extraction was performed under microscope with insertion of a posterior chamber lens implant vaulted anteriorly by 10°.Go-nioscopy and slit-lamp examination and photography of the operated eyes were performed 3to 6months postoperatively.Results:PAS were found in 20(50%)of the 40eyes.Among the 20eyes with PAS the locations of 23haptics in17eyes corresponded with those of the PAS.PAS were seen more frequently with vertically sulcus-fixated haptics than with the horizontally capsular-fixated haptics.showing a significant difference(P<0.05).88%of the eyes withPAS had pupillary edformation,but their visual acuities and IOP were not affected.Conclusions:PAS is more likely to occur with vertically sulcus-fixated IOL.Rotat-ing the capsular-fixated haptics to the horizontal position may reduce the inci-dence of PAS.Gonioscopy should be a routine follow-up examination.
Sutureless intrascleral intraocular lens fixation with lamellar dissection of scleral tunnel
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Kawaji T
Full Text Available Takahiro Kawaji,1,2 Tomoki Sato,2 Hidenobu Tanihara11Department of Ophthalmology, Faculty of Life Sciences, Kumamoto University, Chuo-ku, 2Sato Eye & Internal Medicine Clinic, Kumamoto, JapanPurpose: To report the results of sutureless scleral fixation of a posterior chamber intraocular lens (IOL by using our developed simple technique.Methods: We retrospectively reviewed the medical records of 48 eyes of 47 patients who underwent sutureless intrascleral IOL fixation by using our modified technique. A 25-gauge microvitreoretinal knife was used to perform sclerotomies and create limbus-parallel scleral tunnels with lamellar dissection in which the haptics were fixed.Results: The IOLs were fixed and centered well. The mean follow-up period was 26.7 months. Postoperative complications included smooth vitreous hemorrhage in four eyes (8.3%, cystoid macular edema in two eyes (4.2%, and iris capture of the IOL in two eyes (4.2%. No other complications, such as breakage of the IOL, spontaneous IOL dislocation, or retinal detachment, were detected during the follow-up period.Conclusion: The lamellar dissection of the limbus-parallel scleral tunnel can simplify the forceps-assisted introduction of the haptics into the scleral tunnel, and this technique seemed to be safe.Keywords: intraocular lenses, ophthalmologic surgical procedures, intrascleral fixation, sutureless fixation
Implantation of foldable posterior chamber intraocular lens in aphakic vitrectomized eyes without capsular support
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Gurkan Erdogan
Full Text Available ABSTRACT Purpose: To evaluate the outcomes of three different surgical techniques for foldable posterior chamber intraocular lens (PCIOL implantation in vitrectomized eyes without capsular support. Methods: A total of 60 patients with aphakic and vitrectomized eyes without capsular support were enrolled. All patients underwent three-piece foldable PCIOL implantation into the posterior chamber through a small corneal incision. Transscleral fixation (TSF, iris fixation (IF, and intrascleral tunnel fixation (ISF surgical techniques were performed. Results: Postoperative PCIOL subluxation or dislocation occurred in one case in the TSF group and two cases in the ISF group. Intraoperative PCIOL dislocation occurred in two patients in the IF group. The incidence of temporary postoperative complications, such as mild intraocular hemorrhage and cystoid macular edema, was higher in the ISF group. No statistically significant difference in PCIOL-related astigmatism was observed between groups. Visual acuity improved in all groups. Conclusions: Postoperative outcomes were comparable between TSF, IF, and ISF for PCIOL in vitrectomized eyes without capsular support.
Tafluprost once daily for treatment of elevated intraocular pressure in patients with open-angle glaucoma
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Liu Y
Full Text Available Yang Liu, Weiming MaoDepartment of Cell Biology and Anatomy, North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TXAbstract: Glaucoma is a leading cause of visual loss worldwide. Current antiglaucoma therapy focuses on lowering intraocular pressure to a safe level. In recent years, prostaglandin analogs have become the first-line agents for treating open angle glaucoma. Tafluprost, which was first reported in 2003, is a novel prostaglandin analog, and has been shown to be a potent ocular hypotensive agent in a number of preclinical and clinical studies. Also, its unique preservative-free formulation helps to decrease preservative-associated ocular disorders and improve patient compliance. In this review, studies from 2003 to 2012 focusing on the structure, metabolism, efficacy, and safety of tafluprost are summarized. These studies suggested that application of tafluprost once daily is a safe and effective treatment for patients with open angle glaucoma.Keywords: tafluprost, prostaglandin analog, glaucoma, intraocular pressure, preservative-free formulation
Spectral analysis and comparison of mineral deposits forming in opacified intraocular lens and senile cataractous lens
Lin, Shan-Yang; Chen, Ko-Hwa; Lin, Chih-Cheng; Cheng, Wen-Ting; Li, Mei-Jane
This preliminary report was attempted to compare the chemical components of mineral deposits on the surfaces of an opacified intraocular lens (IOL) and a calcified senile cataractous lens (SCL) by vibrational spectral diagnosis. An opacified intraocular lens (IOL) was obtained from a 65-year-old male patient who had a significant decrease in visual acuity 2-years after an ocular IOL implantation. Another SCL with grayish white calcified plaque on the subcapsular cortex was isolated from a 79-year-old male patient with complicated cataract after cataract surgery. Optical light microscope was used to observe both samples and gross pictures were taken. Fourier transform infrared (FT-IR) and Raman microspectroscopic techniques were employed to analyze the calcified deposits. The curve-fitting algorithm using the Gaussian function was also used to quantitatively estimate the chemical components in each deposit. The preliminary results of spectral diagnosis indicate that the opacified IOL mainly consisted of the poorly crystalline, immature non-stoichiometric hydroxyapatite (HA) with higher content of type B carbonated apatites. However, the calcified plaque deposited on the SCL was comprised of a mature crystalline stoichiometric HA having higher contents of type A and type B carbonate apatites. More case studies should be examined in future.
Study on intra-ocular lens aberration measurement in-air
Wang, Yuanyuan; Chen, Jiaojie; Fen, Haihua; Hu, Chuan; Li, Yiyi
In clinical ophthalmology, the wavefront aberration of human eyes is expressed by Zernike polynomial after cataract surgery and intraocular lens implantation, the human eyes aberration will change. The problem of objective evaluation of wavefront aberration introduced by the Intra-ocular (IOL) in-vivo remains unsolved. This paper introduced the measurement principal of IOL wavefront aberration with expression by Zernike polynominal in air. A Hartmann-Shack wavefront sensor system was constructed to measure the wavefront of IOL and to get the corresponding grid patterns. After a series of computer image processing steps, 7th order with 35 items Zernike coefficients was obtained. The IOL of 20.0D power was measured 5 times by this system to get the spherical aberration about 6.73+/-0.02μm, demonstrating the good repeatability of the system. Ten IOLs with the same 20.0D power but difference in surface curvature were chosen for measurement. The spherical aberration observed were in the range of 2.74μm-11.26μm. These results are valuable for the optical design of IOLs and the aberration analysis of human eyes post-operation.
Aniseikonia for near vision with unilateral aphakia corrected by intraocular lenses.
Ivashina, A I
1. Our methods for calculation of aniseikonia for near vision allow one to determine it in every patient with an intraocular lens. 2. With an eye with an artificial lens there is a correlation between the amount of accommodation used by the phakic eye and aniseikonia changes subject to the distance from the object. Calculations for aniseikonia for near vision in 43 patients showed that with accommodation used by the normal eye aniseikonia was increased by 3.0% to 7.8% as compared with aniseikonia for distance. With accommodation of the phakic eye lacking, aniseikonia for near vision did not differ much from its value for distance. 3. Calculations for aniseikonia for near vision showed the advantage of intraocular lens implantation for obtaining iso-iconia for distance or tolerable aniseikonia not more than 2.5% to 3.0%. 4. For obtaining iso-iconia for near vision it is necessary to correct the phakic eye to switch off its accommodation partially or completely (with emmetropia, correction +2.0D for near vision).
Design and evaluation of an intraocular B-scan OCT-guided 36-gauge needle
Shen, Jin H.; Joos, Karen M.
Optical coherence tomography imaging is widely used in ophthalmology and optometry clinics for diagnosing retinal disorders. External microscope-mounted OCT operating room systems have imaged retinal changes immediately following surgical manipulations. However, the goal is to image critical surgical maneuvers in real time. External microscope-mounted OCT systems have some limitations with problems tracking constantly moving intraocular surgical instruments, and formation of absolute shadows by the metallic surgical instruments upon the underlying tissues of interest. An intraocular OCT-imaging probe was developed to resolve these problems. A disposable 25-gauge probe tip extended beyond the handpiece, with a 36-gauge needle welded to a disposable tip with its end extending an additional 3.5 mm. A sealed 0.35 mm diameter GRIN lens protected the fiber scanner and focused the scanning beam at a 3 to 4 mm distance. The OCT engine was a very high-resolution spectral-domain optical coherence tomography (SDOCT) system (870 nm, Bioptigen, Inc. Durham, NC) which produced 2000 A-scan lines per B-scan image at a frequency of 5 Hz with the fiber optic oscillations matched to this frequency. Real-time imaging of the needle tip as it touched infrared paper was performed. The B-scan OCT-needle was capable of real-time performance and imaging of the phantom material. In the future, the B-scan OCT-guided needle will be used to perform sub-retinal injections.
Implantes biodegradáveis destinados à administração intra-ocular Biodegradable implants for intraocular drug delivery
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Sílvia Ligório Fialho
Full Text Available O tratamento de doenças oculares que acometem o vítreo e a retina tem sido um problema devido à dificuldade de penetração das drogas no segmento posterior do bulbo ocular. A administração de colírios apresenta efeito terapêutico mínimo nessa região do olho, que, geralmente, é mantido com a administração de doses freqüentes do medicamento. Uma alternativa seria a injeção intra-ocular; entretanto, a rápida circulação sangüínea nesses locais promove uma redução da meia-vida das drogas, diminuindo, rapidamente, suas concentrações a níveis subterapêuticos. Visando a obtenção de níveis terapêuticos adequados de drogas no segmento posterior do bulbo ocular por longos períodos, sistemas de liberação poliméricos implantados intravítreo estão sendo investigados para o tratamento de várias doenças vítreo-retinianas. Esses implantes são preparados a partir de diferentes polímeros, os quais podem ser biodegradáveis ou não biodegradáveis. Os polímeros derivados dos ácidos lático e glicólico têm se revelados bastante promissores devido, principalmente, às suas características de biocompatibilidade e biodegradabilidade. De acordo com os estudos realizados até o momento, os implantes podem se apresentar na forma de bastão, de discos ou de membranas e ser obtidos pelos métodos de moldagem, de extrusão ou de preparação de filmes. O presente artigo objetiva uma revisão de literatura abordando o tema e os principais estudos relacionados com a utilização de implantes poliméricos como sistemas transportadores de drogas para aplicação intra-ocular.The treatment of vitreoretinal disorders has been problematic because it is difficult to gain access to the posterior segment of the eye. Topical instillation of eye drops has little therapeutic effect on posterior structures which cannot be maintained without frequent administration. Intraocular injections could be an alternative, but the fast flowing blood
Rubeosis capsulare: um caso incomum de rubeosis iridis em paciente com implante de lente intra-ocular - Relato de caso
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Rosa Alexandre A. Marques
Full Text Available Os autores relatam o caso raro de paciente diabético com rubeosis iridis submetido à cirurgia de catarata com implante de lente intra-ocular, em que houve o crescimento de neovasos na cápsula posterior do cristalino.
New approach: removal of silicone oil and trocar assisted sutureless scleral fixated intraocular lens implantation at the same session
Institute of Scientific and Technical Information of China (English)
Yuksel; Totan; Remzi; Karadag
Dear Sir,Iam Dr.Remzi Karadag,from the Department of Ophthalmology,Istanbul Medeniyet University School of Medicine,Istanbul,Turkey.I write to present two case reports of removal of silicone oil and trocar assisted sutureless scleral fixated intraocular lens implantation at the same session.
Application of polymerase chain reaction to differentiate herpes simplex virus 1 and 2 serotypes in culture negative intraocular aspirates
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Shyamal G
Full Text Available Purpose: To standardize and apply a polymerase chain reaction (PCR on the glycoprotein D gene to differentiate Herpes simplex virus (HSV 1 & 2 serotypes in culture negative intraocular specimens. Methods: Twenty-one intraocular fluids collected from 19 patients were subjected to cultures for HSV and uniplex PCR (uPCR for DNA polymerase gene. To differentiate HSV serotypes, as 1 & 2, a seminested PCR (snPCR targeting the glycoprotein D gene was standardised and applied onto 21 intraocular fluids. The specificity of the snPCR was verified by application onto ATCC strains of HSV 1 and 2, clinical isolates and DNA sequencing of the amplified products. All specimens were also tested for the presence of cytomegalovirus (CMV and varicella zoster virus (VZV by nucleic acid amplification methods. Results: Four of the 21 intraocular fluids were positive for HSV by uPCR. snPCR detected HSV in three additional specimens (total of seven specimens, and identified three as HSV 1 and four as HSV 2. DNA sequencing of PCR products showed 100% homology with the standard strains of HSV 1 and 2 respectively. None of the samples were positive in culture. Among the other patients, CMV DNA was detected in two and VZV DNA in five others. Conclusions: The standardized snPCR can be applied directly onto the culture negative specimens for rapid differentiation of HSV serotypes.
In-the-bag decentration of a hydrophilic radially asymmetric multifocal intraocular lens secondary to capsule contraction.
Linden, J.W.M. van der; Meulen, I.J. van der; Mourits, M.P.; Lapid-Gortzak, R.
We report a case of in-the-bag decentration and tilt of a hydrophilic rotationally asymmetric multifocal intraocular lens (IOL) of the M Plus type secondary to capsule contraction. After uneventful surgery and follow-up for 3 months, progressive decentering and tilting of the IOL secondary to capsul
Effect of altered eating habits and periods during Ramadan fasting on intraocular pressure, tear secretion, corneal and anterior chamber parameters
Kerimoglu, H.; Ozturk, B.; Gunduz, K.; Bozkurt, B.; Kamis, U.; Okka, M.
Purpose To determine whether altered eating habits and periods, especially the pre-dawn meal, during Ramadan fasting have any significant effect on intraocular pressure (IOP), tear secretion, corneal and anterior chamber parameters. Methods IOP, basal tear secretion (BTS), reflex tear secretion (RTS
Intraocular degradation behavior of crosslinked and linear poly(trimethylene carbonate) and poly(D,L-lactic acid)
Jansen, Janine; Koopmans, Steven A.; Los, Leonoor I.; van der Worp, Roelofje J.; Podt, Johanna G.; Hooymans, Johanna M. M.; Feijen, Jan; Grijpma, Dirk W.
The intraocular degradation behavior of poly(trimethylene carbonate) (PTMC) networks and poly(-D,L-lactic acid) (PDLLA) networks and of linear high molecular weight PTMC and PDLLA was evaluated. PTMC is known to degrade by enzymatic surface erosion in vivo, whereas PDLLA degrades by hydrolytic bulk
Development of a Loop-Mediated Isothermal Amplification Assay Targeting the mpb64 Gene for Diagnosis of Intraocular Tuberculosis
Balne, Praveen Kumar; Barik, Manas Ranjan; Sharma, Savitri
A loop-mediated isothermal amplification (LAMP) assay targeting the mpb64 gene for the diagnosis of intraocular tuberculosis was highly specific (100%), sensitive (85.7%), rapid, and easy to perform. The LAMP assay can be an alternative to conventional PCR for the diagnosis of ocular tuberculosis in resource-limited settings. PMID:23966513
新型多焦点人工晶状体临床应用的研究进展%Clinical application of new types of multifocal intraocular lens
Institute of Scientific and Technical Information of China (English)
张景尚; 万修华
近年来新型多焦点人工晶状体(IOL)如非球面多焦点IOL、Toric多焦点IOL和非球面Toric多焦点IOL等的不断问世及临床应用,更好地改善了白内障患者术后的生活视力、工作视力以及生存质量.对于新型多焦点IOL的适应证应严格掌握,以使患者术后获得最佳效果.%In recent years new types of multifocal intraocular lens have been developed,such as aspheric multifocal intraocular lens,Toric multifocal intraocular lens and aspheric Toric multifocal intraocular lens and so on.The vision in life and work and the quality of life in patients with cataract were significantly improved after phacoemulsification with the new types of multifocal intraocular lens.At the same time there should be a strict indications for the new types of multifocal intraocular lens,so as to make the cataract patients implanted multifocal intraocular lens getting the best visual quality.
Prevention of postoperative infections in ophthalmic surgery
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Ram Jagat
Full Text Available Postoperative endophthalmitis is a serious, vision-threatening complication of intraocular surgery. Better instrumentation, surgical techniques, prophylactic antibiotics and better understanding of asepsis have significantly reduced the incidence of this complication. Postoperative endophthalmitis may occur as an isolated event or as a cluster infection. Topical antibiotics, preoperative periocular preparation with povidone-iodine combined with a sterile operating room protocol significantly reduce the incidence of isolated postoperative endophthalmitis. The role of antibiotics in the irrigating fluid and subconjunctival antibiotics remains controversial. Cluster infections on the other hand are more likely to occur due to the use of contaminated fluids/viscoelastics or a breach in operating room asepsis. Prevention of postoperative endophthalmitis requires strict adherence to operating room norms, with all involved personnel discharging their assigned roles faithfully.
Remifentanil-Ketamine versus Fentanyl-Ketamine sedation in patients undergoing phacoemulsification with topical anesthesia: comparison of intraocular pressure changes and sedation quality
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Bahram Soleymani
Full Text Available BACKGROUND: Narcotics and sedatives can reduce intraocular pressure. This study was performed to evaluate the effect of remifentanil plus ketamine on intraocular pressure and sedation quality in comparison with fentanyl plus ketamine during and after operation in patients undergoing phacoemulsification with topical anesthesia.METHODS: Forty four patients were randomized into two groups to receive either a continuous infusion of remifentanil (0.2 µg/kg/min for 4 min and then 0.1 µg/kg/min: Group R, n=22 or bolus intravenous fentanyl (1.5 µg/kg: Group F, n=22 for sedation. Patients in both groups received low dose ketamine (0.15 mg/kg intravenously. Topical anesthesia was performed using tetracaine 0.5% eye drop in both eyes. Intraocular pressure was measured in non-operative eye before sedation (baseline, 2 minutes after sedation, before intraocular lens insertion, at the end of operation and 15 minutes after the end of operation using Schiötz tonometer. Sedation, cooperation, satisfaction and pain scores and also postoperative nausea and vomiting were recorded in all patients. Surgeon satisfaction scores were evaluated at the end of operation.RESULTS: The intraocular pressure did not differ significantly between the two groups throughout the study. The mean (SD intraocular pressures 2 minutes after sedation, before intraocular lens insertion, at the end of operation and 15 minutes after the end of operation in recovery room were all less than that of baseline in both groups, but the baseline value was decreased only significantly (P CONCLUSIONS: Combination of remifentanil infusion and intravenous ketamine did not offer any advantages over the combination of intravenous fentanyl and ketamine in order to prevent intraocular pressure rising during phacoemulsification. The lower incidence of postoperative nausea and vomiting and higher rate of appropriate sedation in fentanyl group suggested fentanyl as a more suitable medication for systemic
Intraocular Lens Multifocality Combined with the Compensation for Corneal Spherical Aberration:A New Concept ofPresbyopia-CorrectingIntraocular Lens
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Reiner Friedrich
Full Text Available The outcomes of a prospective consecutive study aimed at evaluating the visual and refractive benefit after cataract surgery with the implantation of the aspheric diffractive multifocal intraocular lens (IOL Tecnis ZMB00 (Abbott Medical Optics are reported. A total of 31 eyes of 19 patients (age range, 40 to 81 years underwent phacoemulsification surgery with implantation of this aspheric multifocal IOL. At 6 months after surgery, postoperative spherical equivalent was within ±1.00 D in 96.8% of eyes, with 94.7% of patients presenting a postoperative binocular far LogMAR uncorrected visual acuity (UCVA of 0.1 or better. Far best-corrected distance VA improved significantly (p < 0.01, with postoperative values of 0.1 or better in 96.8% of eyes. Postoperative near UCVA was 0.10 (equivalent to J1 or better in 93.55% of eyes. Furthermore, the IOL power was found to be very poorly correlated with the postoperative far LogMAR (r = 0.13 and near UCVA (r = 0.13. In conclusion, the aspheric diffractive multifocal IOL Tecnis ZMB00 provides a restoration of the far and near visual function after phacoemulsification surgery for cataract removal or presbyopia correction, which is predictable and independent from the optical power of the implanted IOL.
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Intraocular and extraocular cameras for retinal prostheses: Effects of foveation by means of visual prosthesis simulation
McIntosh, Benjamin Patrick
Blindness due to Age-Related Macular Degeneration and Retinitis Pigmentosa is unfortunately both widespread and largely incurable. Advances in visual prostheses that can restore functional vision in those afflicted by these diseases have evolved rapidly from new areas of research in ophthalmology and biomedical engineering. This thesis is focused on further advancing the state-of-the-art of both visual prostheses and implantable biomedical devices. A novel real-time system with a high performance head-mounted display is described that enables enhanced realistic simulation of intraocular retinal prostheses. A set of visual psychophysics experiments is presented using the visual prosthesis simulator that quantify, in several ways, the benefit of foveation afforded by an eye-pointed camera (such as an eye-tracked extraocular camera or an implantable intraocular camera) as compared with a head-pointed camera. A visual search experiment demonstrates a significant improvement in the time to locate a target on a screen when using an eye-pointed camera. A reach and grasp experiment demonstrates a 20% to 70% improvement in time to grasp an object when using an eye-pointed camera, with the improvement maximized when the percept is blurred. A navigation and mobility experiment shows a 10% faster walking speed and a 50% better ability to avoid obstacles when using an eye-pointed camera. Improvements to implantable biomedical devices are also described, including the design and testing of VLSI-integrable positive mobile ion contamination sensors and humidity sensors that can validate the hermeticity of biomedical device packages encapsulated by hermetic coatings, and can provide early warning of leaks or contamination that may jeopardize the implant. The positive mobile ion contamination sensors are shown to be sensitive to externally applied contamination. A model is proposed to describe sensitivity as a function of device geometry, and verified experimentally. Guidelines are
Effects of different levels of intraocular stray light on kinetic perimetry findings.
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Kazunori Hirasawa
Full Text Available To evaluate the effect of different levels of intraocular stray light on kinetic perimetry findings.Twenty-five eyes of 25 healthy young participants were examined by automated kinetic perimetry (Octopus 900 using Goldmann stimuli III4e, I4e, I3e, I2e, and I1e. Each stimulus was presented with a velocity of 3°/s at 24 meridians with 15° intervals. Four levels of intraocular stray light were induced using non-white opacity filter (WOF filters and WOFs applied to the clear plastic eye covers of the participants. The visual acuity, pupil diameter, isopter area, and kinetic sensitivity of each meridian were analyzed for each WOF density.Visual acuity deteriorated with increasing WOF densities (p < 0.01. With a visual acuity of 0.1 LogMAR units, the isopter areas for III4e, I4e, I3e, I2e, and I1e decreased by -32.7 degree2 (-0.2%, -255.7 degree2 (-2.6%, -381.2 degree2 (-6.2%, -314.8 degree2 (-12.8%, and -59.2 degree2 (-15.2%, respectively; kinetic sensitivity for those stimuli decreased by -0.1 degree (-0.1%, -0.8 degree (-1.4%, -1.6 degree (-3.7%, -2.7 degree (-9.7%, and -1.7 degree (-16.2%, respectively. The pupil diameter with each WOF density was not significantly different.Kinetic perimetry measurements with a high-intensity stimulus (i.e., III4e were unaffected by intraocular stray light. In contrast, measurements with the I4e, I3e, I2e, and I1e stimuli, especially I2e and I1e, were affected. Changes in the shape of the isopter resulting from opacity must be monitored, especially in cases of smaller and lower-intensity stimuli.
Features of YAG-laser treatment of posterior capsule opacification in eyes with intraocular comorbidities ext
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O. I. Borzunov
Full Text Available Purpose: is to evaluate the effectiveness of YAG laser posterior lens capsule dissection in patients with secondary cataract with concurrent intraocular pathology. Patients and methods: retro- and prospective analysis of the results of the YAG — laser treatment of secondary cataract in the 196 eyes, including the intraocular concomitant pathology (myopia, glaucoma, age-related macular degeneration, diabetic retinopathy, retinitis pigmentosa operated retinal detachment, chronic uveitis in remission, peripheral chorioretinal degeneration. Effectiveness of treatment was evaluated by checking visual acuity and dynamics of complaints as aberration, glare, distortion in the central field of view without proper disease of the macula. Complex preoperative studies included: refractometry, visometry with correction, perimetry, tonometry, biomicroscopy, ophthalmoscopy, ultrasound examination of the eyeball (if necessary. The examination results should demonstrate convincing evidence that posterior capsular opacification is the main reason for the decrease of visual acuity. Results:, Visual acuity, at average increased from 0.4‑0.6 to 0.8‑1.0 in 50 cases after dissection, Visual acuity improved to 2‑3 lines in 66‑4–5, 24‑6‑7 lines in 74 cases. Visual acuity remains the same, but contrast sensitivity was increased in 6 cases. The IOL location after disruption was evaluated by β-scanning and biomicroscopy. In case of the initial correct IOL position in all 195 (100 % cases, there were no dislocation in the postoperative period. Complications that can be identified were single microcraters on the IOL surface in cases of its full contact with the posterior capsule. These injuries did not affect the visual functions.Conclusion: YAG -Laser dissection of secondary cataract is effective, less traumatic, and the optimal treatment of secondary cataract, including patients with concomitant intraocular pathology, and helps to avoid over
Effect of aspherical and yellow tinted intraocular lens on blue-on-yellow perimetry Efeito das lentes intraoculares asféricas e com pigmentação amarela na campimetria azul-amarelo
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Rodrigo França de Espíndola
Full Text Available PURPOSE: To investigate the possible effect of aspherical or yellow tinted intraocular lens (IOL on contrast sensitivity and blue-on-yellow perimetry. METHODS: This prospective randomized bilateral double-masked clinical study included 52 patients with visually significant bilateral cataracts divided in two groups; 25 patients (50 eyes received aspherical intraocular lens in one eye and spherical intraocular lens in the fellow eye; and 27 patients (54 eyes received ultraviolet and blue light filter (yellow tinted IOL implantation in one eye and acrylic ultraviolet filter IOL in the fellow eye. The primary outcome measures were contrast sensitivity and blue-on-yellow perimetry values (mean deviation [MD] and pattern standard deviation [PSD] investigated two years after surgery. The results were compared intra-individually. RESULTS: There was a statistically significant between-group (aspherical and spherical intraocular lens difference in contrast sensitivity under photopic conditions at 12 cycles per degree and under mesopic conditions at all spatial frequencies. There were no between-group significant differences (yellow tinted and clear intraocular lens under photopic or mesopic conditions. There was no statistically significant difference between all intraocular lens in MD or PSD. CONCLUSION: Contrast sensitivity was better under mesopic conditions with aspherical intraocular lens. Blue-on-yellow perimetry did not appear to be affected by aspherical or yellow tinted intraocular lens. Further studies with a larger sample should be carried out to confirm or not that hypotheses.OBJETIVO: Investigar a possibilidade de efeitos na sensibilidade ao contraste e nos resultados da campimetria azul-amarelo com implante de uma lente intraocular (LIO asférica ou de pigmentação amarela. MÉTODOS: Trata-se de um estudo prospectivo, randomizado, duplo-mascarado, envolvendo 52 pacientes portadores de catarata senil bilateral, divididos em dois grupos; 25
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Hookworm disease; Ground itch; Ancylostoma duodenale infection; Necator americanus infection; Parasitic infection - hookworm ... The infection is caused by infestation with any of the following ... Ancylostoma duodenale Ancylostoma ceylanicum Ancylostoma ...
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Full Text Available Triamcinolone is a corticosteroid that is used to treat many ophthalmic diseases . Recently, its use has been advocated to aid in visualization of transparent tissue in ophthalmic surgery. It can be used in anterior segment surgery to help manage vitreous loss during complicated cataract surgery. It has been used to visualize the posterior cortical vitreous during pars plana vitrectomy. In addition, it can be useful in the visualization and peeling of the internal limiting membrane. Triamcinolone has been advocated in surgical repair of proliferative vitreoretinopathy both for its visualizing properties and its anti-inflammatory properties. Overall, triamcinolone use in surgery is safe with low incidence of complications including elevated intraocular pressure, cataract and endophthalmitis.
Pars plana vitrectomy with posterior iris claw implantation for posteriorly dislocated nucleus and intraocular lens
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Kishor B Patil
Full Text Available We evaluated the safety and efficacy of pars plana vitrectomy (PPV with primary posterior iris claw intraocular lens (IOL implantation in cases of posterior dislocation of nucleus and IOL without capsular support. This was a retrospective interventional case series. Fifteen eyes underwent PPV with primary posterior iris claw IOL implantation performed by a single vitreoretinal surgeon. The main outcome measures were changes in best corrected visual acuity and anterior and posterior segment complications. A total of 15 eyes were included in this study. Eight had nucleus drop, three had IOL drop during cataract surgery and four had traumatic posterior dislocation of lens. The final postoperative best corrected visual acuity was 20/60 or better in 11 patients. This procedure is a viable option in achieving good functional visual acuity in eyes without capsular support.
Surface PEGylation of intraocular lens for PCO prevention: An in vivo evaluation.
Xu, Xu; Tang, Jun-Mei; Han, Yue-Mei; Wang, Wei; Chen, Hao; Lin, Quan-Kui
Posterior capsular opacification (PCO) is a common complication in cataract surgery. The development of PCO is attributed to the combination of adhesion, migration, proliferation, and transdifferentiation of the residual lens epithelial cells (LEC) onto the interface of intraocular lens (IOL) material and lens posterior, in which the initial adhesion is the beginning step and plays important roles. In the present study, hydrophilic polyethylene glycol (PEG) was immobilized onto IOL surface via plasma-aided chemical grafting procedure. The attenuated total reflection - Fourier transform infrared (ATR-FTIR) and contact angle (CA) - measurements indicate the successful surface PEGylation, as well as the excellent hydrophilicity of the surfaces. Compared with pristine IOL, the PEGylation does not influent its optical property, whereas the initial adhesion of LEC is greatly inhibited. In vivo ocular implantation results show that the PEGylated IOL presents good in vivo biocompatibility, and can effectively prevent the PCO development.
Anterior chamber fixation of a posterior chamber intraocular lens: A novel technique
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A Sahap Kükner
Full Text Available We aimed to evaluate the implantation of a posterior chamber intraocular lens (IOL in the anterior chamber (AC with the haptics passing through two iridectomies to the posterior chamber. A total of 33 eyes of 33 patients with inadequate posterior capsular support due to either previous aphakia or posterior capsular rupture during cataract extraction were included in the study. A double iridectomy was performed on all patients using a vitrectomy probe on the midperiphery of the iris. IOLs were implanted in the AC, and the haptics were passed through the iridectomies to the posterior chamber. The mean follow-up time was 25.3 months. AC hemorrhage occurred in five patients during the iridectomy procedure. Corneal edema was detected in eight of 14 patients with primary IOL insertions. Haptic dislocation was detected in only one patient. This technique may be a good alternative to scleral-fixated IOL implantation in eyes with aphakia.
AcrySof toric intraocular lens for post-keratoplasty astigmatism
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Nishant Gupta
Full Text Available We report a 63-year-old male who had undergone left eye optical penetrating keratoplasty for central leucomatous corneal opacity 10 years earlier. The eye had clear donor graft with residual astigmatism of −6.50 diopter cylinder (DC at 30°. The patient underwent clear corneal phacoemulsification with implantation of +6.0 D spherical equivalent AcrySof SN60T9 intraocular lens (IOL. Postoperatively, at 10 months, the patient had distance corrected visual acuity of 20/30 with −2.00 DC at 20°. AcrySof toric IOL offers an effective treatment option for post-keratoplasty high corneal astigmatism in patients with cataract.
Cuerpo extraño intraocular. Presentación de un caso
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Inés Zamora Galindo
Full Text Available Los traumatismos oculares son una causa común de deficiencia visual, principalmente de ceguera monocular en el 33 al 40 % de los casos. Se presenta el caso de un paciente de 40 años y procedencia rural, que acudió a consulta de Oftalmología del Hospital General Universitario Dr. Gustavo Aldereguía Lima por presentar visión borrosa del ojo derecho, tres meses después de haber sufrido un traumatismo. Una correcta anamnesis, examen oftalmológico y métodos diagnósticos adecuados lograron la identificación de un cuerpo extraño intraocular. El paciente fue sometido a cirugía y evolucionó favorablemente; su agudeza visual mejor corregida es de 0,7 en el ojo derecho y de 1,0 en el izquierdo.
Nocturnal blood pressure and intraocular pressure measurement in glaucoma patients and healthy controls.
Follmann, P; Palotás, C; Süveges, I; Petrovits, A
Daytime and nocturnal intraocular pressure (IOP) values and systemic blood pressure (BP) values were compared in 60 non-glaucomatous controls, 54 glaucoma patients with normal visual field, and 46 glaucoma patients with visual field loss. The daytime IOP was measured with a Goldmann applanation tonometer and the nocturnal IOP with a Bio-Rad-Tono-Pen 2. The BP was measured with either a mercury manometer or with a Meditech ABPM-02 Ambulatory Blood Pressure Monitor, which took BP readings at 60 minute intervals. A tendency towards increasing IOP and decreasing BP was detected in the non-glaucomatous controls, within normal limits, and pathological changes of IOP and BP were observed with a significantly high occurrence (5% > P > 2%; Pearson's chi 2-test) in the glaucoma group with visual field loss.
Haptic Breakage after Transscleral Fixation of a Single-Piece Acrylic Intraocular Lens
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Hiroki Tanaka
Full Text Available Purpose: To report the case of a patient with a damaged haptic of an acrylic intraocular lens (IOL after transscleral IOL fixation. Methods: This is a retrospective and descriptive case report. Results: A 40-year-old man presented with sudden visual loss in the left eye. He had undergone phacoemulsification/aspiration and IOL implantation 3 years previously and IOL repositioning with transscleral fixation 2 years before the initial visit. His visual acuity was 0.3 in the left eye due to corneal edema caused by a foreign body, i.e., the severed haptic tip of the single-piece acrylic IOL, which was surgically removed. The IOL itself was tilted and therefore explanted. The surface of the tip of the haptic suggested that the monofilament suture thread had exerted continuous force across the haptic. Conclusions: The haptics of acrylic IOLs can be damaged after transscleral fixation.
Location and composition of haptics of posterior chamber intraocular lenses. Histopathologic study of postmortem eyes.
McDonnell, P J; Champion, R; Green, W R
Of 110 eyes with posterior chamber intraocular lenses (IOLs) examined postmortem, 37% had both haptics outside of the capsular bag; 57% had one haptic in the capsular bag and the other haptic outside of the bag. Typically, these optics were decentered by 1 to 2 mm. Only six eyes (5%) had both haptics within the capsular bag. Erosion into the ciliary sulcus produced obliteration of the major arterial circle of the iris in 12 eyes (11%). The local tissue response to eroding haptics was similar for haptics composed of polypropylene and haptics composed of polymethylmethacrylate (PMMA). The authors found considerable discrepancy between the actual location of haptics and the surgeon's desired location (i.e., capsular bag or ciliary sulcus). Most of these cases were clinically successful.
Spontaneous fracture of an implanted posterior chamber polyimide intraocular lens haptic: A case report
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Haemin Kang
Full Text Available A 57-year-old male patient visited our clinic for decreased visual acuity in the right eye for 10 days. He denied any trauma history, but recalled that the symptom developed after straining. He had undergone uncomplicated phacoemulsification and posterior chamber intraocular lens (IOL implantation in the bag of the right eye 11 years ago. The IOL was a three-piece silicone polyimide-haptics design. On slit-lamp examination, the IOL optic and proximal part of nasal fractured haptic were found in the anterior chamber. The distal part of fractured haptic was observed in the capsular bag. He underwent IOL exchange. The fracture site of the haptic was near the optic-haptic junction. This is the unique case report of a spontaneous fracture of an implanted posterior chamber polyimide IOL haptic, which implies the possibility of IOL haptic fracture in various haptic materials.
Morphological Findings of Intraocular Lens with Haptics Detached from Optics Following Cataract Surgery.
Suzuki, Yukihiko; Suzuki, Kaori; Metok, Tomomi; Nakazawai, Mitsuru
A 55-year-old woman was treated using phacoemulsification, aspiration, and intraocular lens (IOL) implantation. Three months after surgery, the optical zone of the anterior capsule was completely closed due to strong capsular contractions. As the two haptics were found to be completely detached from the optics, the IOL was subsequently extracted and morphologically examined. Although the optics and haptics of the IOL when viewed with a stereomicroscope appeared to have no marked damage on their surfaces, an ultra-structural examination showed that a portion of the acrylic optics on the detached surface was defective. We considered that the IOL haptics might have become detached from the optics due to continuous force from postoperative capsular contractions.
IgG4-related intraocular inflammation masquerading as ciliary body melanoma in a young girl
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Dipankar Das
Full Text Available Immunoglobulin G4 (IgG4-related diseases affects various tissues and organs of the human body. Orbital, adnexal, and scleral inflammations were already reported in the medical literature. To the best of our knowledge, we report the first case of intraocular IgG4-associated inflammatory mass in the ciliary body mimicking as a melanoma in a 23-year-old female from Northeast India. Characteristic histopathology, immunohistochemistry in the tissue, protein chemistry, and raised serum IgG4 were supportive for the diagnosis. As this newly diagnosed disease has multi-organ affection and little is known about its pathogenesis particularly in eye and adnexa, the present case will open many challenges in clinico-pathological diagnosis and research in the future.
Corneal injection track: an unusual complication of intraocular lens implantation and review
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Julie; Y.C.Lok; Alvin; L.Young
Phacoemulsification is the main gold standard for cataract operation in the developed world together with foldable intraocular lens(IOL) implantation by injection,allowing for stable wound construction and less postoperative astigmatism. It is a safe procedure with high success rate with the advancement in machines,improvement of IOL injection systems and further maturation of surgeons' techniques. Despite the large number of operations performed every day, foldable IOL injection leading to an intra-stromal corneal track is a very rare complication. We report a case of this unusual finding in a 70-year-old gentleman who has undergone cataract operation in November 2011 in our hospital and will review on the complications related to foldable IOL injection.
Optimizing distance image quality of an aspheric multifocal intraocular lens using a comprehensive statistical design approach.
Hong, Xin; Zhang, Xiaoxiao
The AcrySof ReSTOR intraocular lens (IOL) is a multifocal lens with state-of-the-art apodized diffractive technology, and is indicated for visual correction of aphakia secondary to removal of cataractous lenses in adult patients with/without presbyopia, who desire near, intermediate, and distance vision with increased spectacle independence. The multifocal design results in some optical contrast reduction, which may be improved by reducing spherical aberration. A novel patent-pending approach was undertaken to investigate the optical performance of aspheric lens designs. Simulated eyes using human normal distributions were corrected with different lens designs in a Monte Carlo simulation that allowed for variability in multiple surgical parameters (e.g. positioning error, biometric variation). Monte Carlo optimized results indicated that a lens spherical aberration of -0.10 microm provided optimal distance image quality.
A truly knotless technique for scleral fixation of intraocular lenses: Two-year results
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Naresh K Yadav
Full Text Available Scleral fixated intraocular lens (SFIOL is a safe and effective option for managing optical aphakia. Suture related complications like suture erosion, suture breakage, endophthalmitis, etc. are unique to SFIOL. The knots can be covered by partial thickness flaps or they can be rotated into scleral tissues without flaps to reduce the complications. We performed a recently described novel technique which obviates the need for knot and scleral flaps in securing the SFIOL. This novel 2-point Ab externo knotless technique may reduce the knot related problems. Twenty-three eyes undergoing this knotless SFIOL procedure were analyzed for intraoperative and postoperative complications. Twenty-two eyes either maintained or improved on their preoperative vision. All patients had a minimum follow-up of 24 months.
[The growth behavior of mouse fibroblasts on intraocular lens surface of various silicone and PMMA materials].
Kammann, J; Kreiner, C F; Kaden, P
Experience with intraocular lenses (IOL) made of PMMA dates back ca. 40 years, while silicone IOLs have been in use for only about 10 years. The biocompatibility of PMMA and silicone caoutchouc was tested in a comparative study investigating the growth of mouse fibroblasts on different IOL materials. Spectrophotometric determination of protein synthesis and liquid scintillation counting of DNA synthesis were carried out. The spreading of cells was planimetrically determined, and the DNA synthesis of individual cells in direct contact with the test sample was tested. The results showed that the biocompatibility of silicone lenses made of purified caoutchouc is comparable with that of PMMA lenses; there is no statistically significant difference. However, impurities arising during material synthesis result in a statistically significant inhibition of cell growth on the IOL surfaces.
Inadvertent implantation of a reversed-optic Tecnis ZM900 multifocal intraocular lens: case report
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Wilson Takashi Hida
Full Text Available A 51-year-old woman with age-related cataract had an uneventful phacoemulsification and a Tecnis ZM900 multifocal intraocular lens (IOL implantation in both eyes. During IOL implantation in the left eye, the optic was unintentionally reversed in the bag and left that way. The refraction surprise was not significant and six months postoperatively the corrected distance visual acuity in both eyes was 20/20 and neither complained of visual discomfort. In conclusion, we found that a reversed-optic Tecnis multifocal IOL in the present case resulted in good final visual acuity without significant differences in aberrations compared to the other eye, and a conservative management can be taken as a safe option.
Temporary marked impairment of visual acuity in a case of intraocular malignant lymphoma during radiation therapy
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Miyao, Yoko; Tada, Rei; Koizumi, Noriko; Yamada, Hideaki; Kinoshita, Shigeru [Kyoto Prefectural Univ. of Medicine (Japan); Ikeda, Tsunehiko
A 56-year-old female was referred to us for blurring of both eyes since 2 years before. She had been diagnosed as chronic uveitis and responded poorly to systemic and topical corticosteroid. Her corrected visual acuity was 0.8 right and 0.5 left. Systemic studies, including magnetic resonance imaging and gadolinium scintigraphy, were negative. Vitreous biopsy led to the diagnosis of malignant lymphoma originating from the eye. Seven days after initiation of radiation at the daily doses of 2 Gy, massive subretinal infiltration developed in her right eye forming a niveau. Systemic prednisolone induced resolution of exudate with improved visual acuity to 1.0 13 days later. This cases illustrates that radiation may induce temporary aggravation of intraocular malignant lymphoma and that it may undergo resolution following systemic corticosteroid. (author)
Evaluation of intraocular lens implant location in the eyeball basing on the Purkinje images
Jóźwik, A.; Siedlecki, D.; Zajac, M.
Intraocular lens (IOL) is an artificial implant substituting natural crystalline lens which is non-transparent due to cataract. Incorrect location of the IOL in the eyeball (e.g. its shift or tilt) causes significant deterioration of patient's vision. The analysis of Purkinje images (i.e. reflections from successive refracting surfaces in the eye) enables to determine the real IOL location and thus helps in evaluating the retinal image quality. The experimental setup for Purkinje images recording consists of illuminator, composed of a number of infrared LEDs, telecentric lens and detector (CCD camera). Analysis of mutual position of particular reflections enables to evaluate the lens location in respect to the corneal axis. The actual measurements are realized on artificial eye model, what allows to estimate the precision of the algorithm applied in the calculations. In the future the experimental set-up will be adapted to measure the eyes of real patients.
Cell adhesion of F{sup +} ion implantation of intraocular lens
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Li, D.J. E-mail: email@example.com; Cui, F.Z.; Gu, H.Q
The cell adhesion of ion implanted polymethylmethacrylate (PMMA) intraocular lens was studied using cultured cells in vitro. F{sup +} ion implantation was performed at the energies of 40, 60, 80, 100 keV with the fluences ranging from 5x10{sup 13} to 1x10{sup 15} ions/cm{sup 2} at room temperature. The cell adhesion tests gave interesting results that the number of the neutral granulocytes and the macrophages adhering on surface were reduced significantly after ion implantation. The optimal fluence was about 4x10{sup 14} ions/cm{sup 2}. The hydrophobicity imparted to the lens surface was also enhanced. The results of X-ray photoelectron spectroscopy analysis indicated that ion implantation resulted in the cleavage of some pendant groups, the oxidation of the surface, and the formation of some new chemical bonds, which was probably the main reason for the cell adhesion change.
Raised intraocular pressure as a potential risk factor for visual loss in Leber Hereditary Optic Neuropathy.
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Anais Thouin
Full Text Available Leber Hereditary Optic Neuropathy (LHON is an important cause of inherited mitochondrial blindness among young adults. The majority of patients carry one of three mitochondrial DNA (mtDNA point mutations: m.3460G>A, m.11778G>A and m.14484T>C, all of which affect critical complex I subunits of the mitochondrial respiratory chain. LHON is characterised by marked incomplete penetrance, clearly implying that the mtDNA mutation is insufficient on its own to trigger retinal ganglion cell dysfunction and visual loss. In this case series of three affected patients harbouring the m.11778G>A mutation, we provide evidence suggesting that raised intraocular pressure could be a risk factor triggering visual loss in at-risk LHON carriers.
Combined transscleral fixation of an artificial iris prosthesis with an intraocular lens
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Uzeyır Gunenc
Full Text Available ABSTRACT Post-traumatic aniridia combined with aphakia may be seen after globe injury. Aside from esthetic aspects, partial or total loss of the iris tissue may also be related to various degrees of glare and photophobia. Such patients suffer from severe visual impairment secondary to aphakia. Herein we describe a novel surgical technique for the management of an aphakic eye with traumatic aniridia for a patient who underwent transscleral fixation of a custom-tailored artificial iris prosthesis combined with a rigid intraocular lens (IOL. Tight suturing of the IOL haptic eyelets on the silicone iris prosthesis and fixation of such a complex to the scleral wall may provide excellent cosmetic and functional outcomes in aphakic eyes with aniridia.
Raised intraocular pressure as a potential risk factor for visual loss in Leber Hereditary Optic Neuropathy.
Thouin, Anais; Griffiths, Philip G; Hudson, Gavin; Chinnery, Patrick F; Yu-Wai-Man, Patrick
Leber Hereditary Optic Neuropathy (LHON) is an important cause of inherited mitochondrial blindness among young adults. The majority of patients carry one of three mitochondrial DNA (mtDNA) point mutations: m.3460G>A, m.11778G>A and m.14484T>C, all of which affect critical complex I subunits of the mitochondrial respiratory chain. LHON is characterised by marked incomplete penetrance, clearly implying that the mtDNA mutation is insufficient on its own to trigger retinal ganglion cell dysfunction and visual loss. In this case series of three affected patients harbouring the m.11778G>A mutation, we provide evidence suggesting that raised intraocular pressure could be a risk factor triggering visual loss in at-risk LHON carriers.
A Circadian and Cardiac Intraocular Pressure Sensor for Smart Implantable Lens.
Donida, Achille; Di Dato, Giuseppe; Cunzolo, Paolo; Sala, Marco; Piffaretti, Filippo; Orsatti, Paolo; Barrettino, Diego
This paper presents a new system to measure the Intraocular Pressure (IOP) with very high accuracy (0.036 mbar) used for monitoring glaucoma. The system not only monitors the daily variation of the IOP (circadian IOP), but also allows to perform an spectral analysis of the pressure signal generated by the heartbeat (cardiac IOP). The system comprises a piezoresistive pressure sensor, an application-specific integrated circuit (ASIC) to read out the sensor data and an external reader installed on customized glasses. The ASIC readout electronics combines chopping modulation with correlated double sampling (CDS) in order to eliminate both the amplifier offset and the chopper ripple at the sampling frequency. In addition, programmable current sources are used to compensate for the atmospheric pressure ( 800-1200 mbar ) and the circadian component (± 7 mbar) thus allowing to read out the very weak cardiac signals (± 1.6 mbar) with a maximum accuracy of 0.036 mbar.
The Management of a Patient with Elevated Intraocular Pressure Resistant to Medical Treatment: Anterior Chamber Irrigation
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Abdullah Beyoğlu
Full Text Available A 7-year-old male patient was medically treated in another center for hyphema which occurred after blunt trauma to his right eye. He was admitted to our clinic when his visual acuity decreased after being discharged. Biomicroscopic examination revealed total hyphema. Intraocular pressure (IOP was 48 mm Hg in the right eye with Goldmann applanation tonometry. Since IOP could not be managed by medical therapy and there was no regression in hyphema, anterior chamber was irrigated. As in our case, it should not be forgotten that re-hemorrhage may occur in the first week of hyphema during childhood. Moreover, surgical treatment should be considered when hemorrhage does not regress with medical treatment, increased IOP persists, and when there is a risk of corneal endothelial staining (corneal blood staining. (Turk J Ophthalmol 2014; 44: 400-2
Eye models for the prediction of contrast vision in patients with new intraocular lens designs
Piers, Patricia A.; Sverker Norrby, N. E.; Mester, Ulrich
Theoretical calculations of the polychromatic modulation transfer function (MTF) and wave-front aberration were performed with physiological eye models. These eye models have an amount of spherical aberration that is representative of a normal population of pseudophakic eyes implanted with two different types of intraocular lens (IOL) made from high-refractive-index silicone. These theoretical calculations were compared with the measured contrast sensitivity function (CSF) under mesopic lighting conditions and with wave-front aberration (obtained with a Hartmann-Shack wave-front sensor) collected from 37 patients bilaterally implanted with the same types of lens. The relationships between the ocular wave-front aberration and the MTF predicted by the eye models and the CSF and the ocular wave-front aberration measured in eyes implanted with IOLs were investigated. The predicted improvements in MTF and wave-front aberration correlated well with the improvements measured in practice. Physiological eye models are therefore useful tools for IOL design.
Optical ensemble analysis of intraocular lens performance through a simulated clinical trial with ZEMAX.
Zhao, Huawei
A ZEMAX model was constructed to simulate a clinical trial of intraocular lenses (IOLs) based on a clinically oriented Monte Carlo ensemble analysis using postoperative ocular parameters. The purpose of this model is to test the feasibility of streamlining and optimizing both the design process and the clinical testing of IOLs. This optical ensemble analysis (OEA) is also validated. Simulated pseudophakic eyes were generated by using the tolerancing and programming features of ZEMAX optical design software. OEA methodology was verified by demonstrating that the results of clinical performance simulations were consistent with previously published clinical performance data using the same types of IOLs. From these results we conclude that the OEA method can objectively simulate the potential clinical trial performance of IOLs.
Mouse model of sustained elevation in intraocular pressure produced by episcleral vein occlusion.
Ruiz-Ederra, Javier; Verkman, A S
We have developed an inducible mouse model of glaucoma based on episcleral vein cauterization (EVC). Intraocular pressure (IOP) elevation in adult mice was produced by cauterizing three episcleral veins. Serial IOP measurements were done by induction-impact tonometry. IOP was significantly elevated by 104+/-20% in 20 out of 23 mice (87%) within the first day after EVC, and remained elevated for 4 weeks, with mean IOP 94% higher in EVC-treated vs. contralateral control eyes. Aqueous outflow blockade was verified from the IOP response to pulsed fluid infusions into the anterior chamber. Retinal ganglion cell (RGC) loss, determined by retrograde labelling using Fluoro-Gold applied to the superior colliculous, was approximately 20% at 2 weeks after EVC. We conclude that episcleral vein occlusion in mice produces significant and sustained elevation in IOP associated with increased outflow resistance and RGC loss, and thus may be useful to model glaucoma in genetically modified and drug-treated mice.
[Surface modification of poly methyl methacrylate intraocular lens by alpha-allyl glucoside].
Qu, Chao; Yao, Ke; Kou, Ruiqiang; Xu, Zhikang
A method for improving the biocompatibility of the intraocular lens (IOL) and reducing the cell attachment was adopted in this study. The alpha-Allyl glucoside was used for the surface modification of the poly methyl methacrylate (PMMA) IOL by way of plasma-induced in situ polymerization. The surfaces of the control and treatment IOLs were characterized by contact angle estimation and ESCA techniques. The resolution, diopter and anti-fatigue of loops were determined by physical and optical methods. Cell attachment on the surfaces was examined by light microscopy. The results indicated that all of the treatment groups had excellent physical and optical properties. The modification with the use of alpha-Allyl glucoside could improve the hydrophilicity of the anterior surface of the PMMA IOLs and reduce the cell attachment.
Simultaneous bilensectomy and endothelial keratoplasty for angle-supported phakic intraocular lens-induced corneal decompensation
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Vikas Mittal
Full Text Available A 40-year-old lady presented with severe endothelial cell loss in both eyes 14 years after angle-supported phakic intraocular lens (AS PIOL implantation. The left eye had severe corneal edema with bullous keratopathy. The right eye had markedly reduced endothelial cell count (655 cells/mm 2 although the cornea was clear. She underwent simultaneous bilensectomy (AS PIOL explantation and phacoemulsification and Descemet′s stripping and endothelial keratoplasty (DSEK in the left eye. Explanted AS PIOL was identified as ZSAL-4 (Morcher, Stuttgart, Germany model. Corneal edema cleared completely in 2 months with a best corrected visual acuity (-2.25 D sph of 20/60. No intervention was done in the right eye. The present case illustrates that AS PIOL-induced endothelial decompensation can be effectively managed by simultaneous bilensectomy and endothelial keratoplasty.
Spectral-domain optical coherence tomographic and fundus autofluorescence findings in eyes with primary intraocular lymphoma
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Egawa M
Full Text Available Mariko Egawa, Yoshinori Mitamura, Yuki Hayashi, Takeshi NaitoDepartment of Ophthalmology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, JapanBackground: The purpose of this study was to evaluate the findings on spectral-domain optical coherence tomography (SD-OCT and fundus autofluorescence (FAF in three eyes with primary intraocular lymphoma (PIOL.Methods: The medical records of three eyes from three patients with biopsy-proven PIOL and retinal infiltrations were reviewed. The SD-OCT and fluorescein angiographic findings were evaluated in the three eyes and FAF images in two eyes.Results: The PIOL in the three patients was monocular. Vitreous opacities and retinal infiltrations were observed in the three eyes, and iritis was present in two eyes. The cytologic diagnosis was class V in two eyes and class III in one eye. The interleukin-10/interleukin-6 ratio was >1.0 in the vitreous and aqueous humor of the three eyes. The FAF images for two eyes showed abnormal granular hyperautofluorescence and hypoautofluorescence which were the reverse of the pattern in the fluorescein angiographic images. In all three eyes, SD-OCT showed hyper-reflective infiltrations at the level of the retinal pigment epithelium (RPE, a separation of the Bruch membrane from the RPE, damage to the RPE, disruption of the photoreceptor inner segment/outer segment junction, and multiple hyper-reflective signals in the inner retina.Conclusion: Because of the characteristic FAF and SD-OCT findings in these eyes with PIOL, we suggest that these noninvasive methods may be used for a rapid diagnosis of PIOL and also for understanding the pathology of PIOL.Keywords: spectral-domain optical coherence tomography, fundus autofluorescence, primary intraocular lymphoma
Flexible Toric Iris Claw Phakic Intraocular Lens Implantation for Myopia and Astigmatism
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Mohammad Ghoreishi
Full Text Available Purpose: To assess the visual and refractive outcomes of flexible toric iris claw phakic intraocular lens implantation for correction of moderate to high myopia with astigmatism. Methods: In this non-randomized prospective study, 31 eyes of 18 patients including 8 male and 10 female subjects with mean age of 27.62±5.53 (range 19 to 38 years with moderate to high myopia and astigmatism underwent toric Artiflex (Ophtec BV, Groningen, Netherlands phakic intraocular lens (PIOL implantation. Uncorrected distance visual acuity (UDVA and corrected distance visual acuity (CDVA were measured in logarithm of minimum angle of resolution (logMAR notations. Manifest refraction, safety, efficacy, predictability and complications were measured 6 months after surgery. Results: Pre-operatively, mean spherical equivalent (SE refractive error was -9.68±1.92 (range -14.00 to -6.00 diopter (D and mean cylinder was -2.79±1.06 (range -4.75 to -1.00 D. After a minimum of 6 months, mean SE was -0.38±0.27 (range -0.87 to 0.00 D and mean cylinder was -0.66±0.43 (range -1.50 to 0.00 D. SE was within 0.50 D of emmetropia in 63.8% and within 1.0 D of target refraction in 100% of eyes. UDVA was equal or better than 20/20 in 45.1% of eyes while CDVA was equal or better than 20/20 in 67.7%; 83.8% of eyes gained 1 or more Snellen lines of CDVA after surgery. No serious complications occurred in this series of cases. Conclusions: Implantation of the toric Artiflex PIOL is a safe and effective procedure for correction of moderate to high myopia with astigmatism.
Body position and intraocular pressure fluctuation%体位与眼压波动
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柯瑞莉; 李金瑛
眼压较大波动是造成青光眼视神经损伤的重要因素,而眼压波动受多重因素影响,体位是其中之一.本文通过介绍体位变化时间对眼压的影响、连续体位变化对眼压的影响、不同卧位对眼压的影响、倒立举重等对眼压的影响、正常人与青光眼患者体位变化眼压比较等来阐述体位变化与眼压的关系,从上巩膜静脉压、血压、眼内容物与前房深度、眼灌注压、激素等五个方面解释体位变化如何影响眼压,并阐述了体位影响眼压的意义.%The fluctuation of intraocular pressure(IOP) is an important factor causing glaucomatous optic nerve injury,and posture is one of the most important factors affecting IOP.The effects of body posision on IOP is receiving more and more attention.This article reviews the research progress about the posture impacts on IOP.The objective is to explain the relationship between position change and IOP by presenting the effects of postural changing time,continuous postural change,different supine position,handstand and weightlifling,and summarize how the postural change affect the IOP from five aspects:episcleral venous pressure,blood pressure,intraocular contents and anterior chamber depth,ocular perfusion pressure,and the change of adrenalin.
Acute effects of consumption of energy drinks on intraocular pressure and blood pressure
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Ilechie AA
Full Text Available A Alex Ilechie, Sandra TettehDepartment of Optometry, University of Cape Coast, GhanaBackground: Energy drinks contain a wide variety of ingredients including caffeine, for which there have been conflicting reports regarding its effects on intraocular pressure (IOP and blood pressure. The aim of this study was to investigate the acute effects of an energy drink (Red Bull® on the IOP and blood pressure of healthy young adults.Methods: Thirty healthy university students of either gender, aged 18–30 (mean 23.20 ± 2.81 years were randomly selected to participate in this study. The subjects were randomly divided into two groups (experimental and control and were asked to abstain from caffeine for 48 hours prior to and during the study. Baseline IOP and blood pressure were measured. The experimental group (n = 15 consumed one can of the energy drink (containing 85 mg of caffeine in 250 mL and measurements were repeated at 30, 60, and 90 minutes, while the control group drank 250 mL of water and were tested over the same time period.Results: When compared with baseline, a significant decrease (P < 0.05 in mean IOP at 60 and 90 minutes was observed in the experimental group. There was no corresponding change in systolic or diastolic blood pressure.Conclusion: Our results suggest that energy drinks (ie, Red Bull produce a significant reduction in IOP but have no effect on blood pressure. These findings may be interpreted as reflecting the effect of the combination of caffeine and taurine in the Red Bull energy drink. This effect may result from the known hypotensive effect of taurine, and warrants further study.Keywords: acute effect, intraocular pressure, blood pressure, glaucoma, caffeine, taurine
Wavefront analysis and modulation transfer function of three multifocal intraocular lenses
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Santhiago Marcony
Full Text Available Purpose: To evaluate wavefront performance and modulation transfer function (MTF in the human eye after the implantation of diffractive or refractive multifocal intraocular lenses (IOLs. Materials and Methods: This was a prospective, interventional, comparative, nonrandomized clinical study. Uncorrected distance and near visual acuity, and wavefront analysis including MTF curves (iTrace aberrometer, Tracey Technologies, Houston, TX, USA were measured in 60 patients after bilateral IOL implantation with 6 months of follow-up. Forty eyes received the diffractive ReSTOR (Alcon, 40 eyes received the refractive ReZoom (Advanced Medical Optics and 40 eyes, the Tecnis ZM900 (Advanced Medical Optics. The comparison of MTF and aberration between the intraocular lenses was performed using analysis of variance (ANOVA, followed by the Dunn test when necessary. Results: The mean uncorrected distance visual acuity was similar in all three groups of multifocal IOLs. The ReSTOR group provided better uncorrected near visual acuity than the ReZoom group ( P < 0.001, but similar to the Tecnis group. Spherical aberration was significantly higher in the ReZoom group ( P = 0.007. Similar MTF curves were found for the aspheric multifocal IOL Tecnis and the spheric multifocal IOL ReSTOR, and both performed better than the multifocal IOL ReZoom in a 5 mm pupil ( P < 0.001 at all spatial frequencies. Conclusions: Diffractive IOLs studied presented similar MTF curves for a 5 mm pupil diameter. Both diffractive IOLs showed similar spherical aberration, which was significantly better with the full-diffractive IOL Tecnis than with the refractive IOL ReZoom.
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Full Text Available : OBJECTIVE: To evaluate the visual and refractive outcomes of phacoemulsification with intraocular lens (IOL implantation in highly myopic eyes and to assess the intraoperative and postoperative complications. SETTINGS: Tertiary care Centre Ranchi, India. METHODS: Consecutive patients with high myopia were retrospectively studied for outcomes and complications after phacoemulsification and IOL implantation. RESULTS: The study included 125 eyes of 89 patients (53 females and 36 males with a mean age of 56.01±9.51 years and mean follow-up of 19.45±4.07 months. The mean axial length was 29.58±2.57mm and power of the IOL ranged from −4.00 D to + 17.00 D. The mean preoperative logMAR Best corrected visual acuity (BCVA was 0.82±0.26 which improved to 0.38±0.29 at one month and to 0.43±0.33 at last follow-up, the improvement in vision was statistically significant (P<0.0001, paired t test. Postoperatively, 80 eyes (64% had a BCVA between 0.00 logMAR (20/20 and 0.30 logMAR (20/40. Pre-existing myopic chorioretinal degeneration (13.6% was most common factor causing decreased visual acuity. The mean spherical equivalent at one month postoperative was -0.06±1.28 D. The complications included posterior capsule rupture (5.6%, zonular dehiscence (1.6%, retinal detachment (1.6%, cystoid macular edema (8.8% and posterior capsule opacifications (10.4%. CONCLUSIONS: Phacoemulsification with intraocular lens implantation is a safe and effective procedure to improve patients visual acuity in those with high myopia.
One Year Follow-Up After Veriflex Phakic Intraocular Lenses Implantation for Correction of Myopia
Pjano, Melisa Ahmedbegovic; Biscevic, Alma; Grisevic, Senad; Pidro, Ajla; Ratkovic, Mirko; Bohac, Maja; Husovic, Amila Alikadic; Gojak, Refet
Objectives: The aim of this study was to evaluate visual and refractive outcomes after Veriflex phakic intraocular lenses (pIOL) implantation in moderately myopic eyes as well as postoperative complications. Methods: This prospective clinical study included 40 eyes of 26 patients which underwent implantation of Veriflex for correction of myopia from -6.00 to -14.50 diopters (D) in the Eye Clinic Svjetlost Sarajevo, from January 2011 to January 2014. Uncorrected distance visual acuity (UDVA), manifest residual spherical equivalent (MRSE), intraocular pressure (IOP), endothelial cell (EC) density were evaluated at one, three, six and 12 months. Other complications in postoperative period were evaluated. For statistical analysis SPSS for Windows and Microsoft Excel were used. Results: Out of 26 patients 14 had binocular and 12 monocular procedure, with mean age of 29.8±6.5 years. After 12 months mean UDVA was 0.73±0.20. Mean MRSE was -0.39±0.31D and 90% of eyes had MRSE within ±1D. EC loss was 7.18±4.33%. There was no significant change of IOP by the end of 12 months follow up period. The only intraoperative complication was hyphema and occurred in one eye. Few postoperative complications were: subclinical inflammation in three eyes (7,5%), pigment dispersion in four eyes (10%), ovalisation of papilla in 2 eyes (5%) and decentration of pIOL in 2 eyes (5%). Conclusion: Implantation of iris-claw phakic lenses Veriflex for treating moderately high myopia is a procedure with good visual and refractive results and few postoperative complications. PMID:27482131
Vision in semi-aquatic snakes: Intraocular morphology, accommodation, and eye: Body allometry
Plylar, Helen Bond
Vision in vertebrates generally relies on the refractive power of the cornea and crystalline lens to facilitate vision. Light from the environment enters the eye and is refracted by the cornea and lens onto the retina for production of an image. When an animal with a system designed for air submerges underwater, the refractive power of the cornea is lost. Semi-aquatic animals (e.g., water snakes, turtles, aquatic mammals) must overcome this loss of corneal refractive power through visual accommodation. Accommodation relies on change of the position or shape of the lens to change the focal length of the optical system. Intraocular muscles and fibers facilitate lenticular displacement and deformation. Snakes, in general, are largely unstudied in terms of visual acuity and intraocular morphology. I used light microscopy and scanning electron microscopy to examine differences in eye anatomy between five sympatric colubrid snake species (Nerodia cyclopion, N. fasciata, N. rhombifer, Pantherophis obsoletus, and Thamnophis proximus) from Southeast Louisiana. I discovered previously undescribed structures associated with the lens in semi-aquatic species. Photorefractive methods were used to assess refractive error. While all species overcame the expected hyperopia imposed by submergence, there was interspecific variation in refractive error. To assess scaling of eye size with body size, I measure of eye size, head size, and body size in Nerodia cyclopion and N. fasciata from the SLU Vertebrate Museum. In both species, body size increases at a significantly faster rate than head size and eye size (negative allometry). Small snakes have large eyes relative to body size, and large snakes have relatively small eyes. There were interspecific differences in scaling of eye size with body size, where N. fasciata had larger eye diameter, but N. cyclopion had longer eyes (axial length).
Gauge Transconjunctival Sutureless Vitrectomy in Eyes with Posteriorly Dislocated Intraocular Lens
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Hüseyin Dündar
Full Text Available Pur po se: To evaluate the efficacy and safety of 23-gauge (23G pars plana vitrectomy (PPV in dislocated intraocular lens (IOL cases: In early- and late-term follow-up. Ma te ri al and Met hod: In this retrospective study, the medical records of 17 patients who underwent 23 G PPV treatment for dislocated IOL between January 2009 and June 2011 were analyzed. Detailed ophthalmologic examination was performed in all patients; intraoperative and postoperative complications were recorded. Re sults: In this study, mean follow-up time was 9.0 (4-22 months and mean age was 60.8 (8-82 years. Mean time after cataract surgery was variable (mean of 28.3 (0-80 months. Four patients had trauma history, five patients had pseudoexfoliation syndrome, and two patients had pathologic myopia. Dislocated IOL was placed into the sulcus in nine patients (52.9%. In two cases (11.7%, the IOLs were removed, and the patients were left aphakic. In two cases out of other 6 (11.7%, the dislocated IOL was changed with scleral fixation lens, whereas in the other four cases (23.5%, IOL was changed with iris claw lens. One patient (5.8% remained at the same level of vision, while twelve (70.5% cases increased two or more lines in BCVA. The vision was decreased in two cases. Intraocular pressure elevation controlled by medication was observed in one case. For two days, hypotony was observed in one patient. Dis cus si on: 23 G PPV technique is an effective and safe method for removing and repositioning of dislocated IOL in the vitreous. (Turk J Ophthalmol 2013; 43: 99-102
Characteristics of Reversal Optic Cupping in Adults Glaucoma after Reduction of Intraocular Pressure
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LiangXu; LeiLiu
Purpose:According to Quigley's hypothesis the dense of connective tissue is the least and the pores of the lamina cribrosa are the largest at the superior and infe-rior poles of the lamina cribrosa,therefore they are the most vulnerable location to be involved in the characteristic glaucomatous optic nerve damage,To get clin-ical evidence for the hypltheses,the reversal of optic cup in adults glaucoma after reduction of intraocular pressure(IOP)was examined.Methods:The stereoscopic flicker comparison on with computerized image sys-tem was used to monitor the optic cup's changing,2 serial superposed stereo pairs were displayed alternatively and rapidly and the changing parts appeared moving Under the stereoscopic observation ,hthe changes of 3-dimention optic cup could be seen and the false positive phenomena caused by photographic angle variation,vascular pulsation could be differentiated from the characteristic change of the cup.Stereo fundus photographs were taken from 31eyes with hy-pertension glaucoma before and after treatment of reduction of IOPs which was either diamox administration or trabeculectomy.Results:the result showed that the reversal of optic cups after reduction of IOPs were mostly asymmetrical,especially at the inferior and/or superior poles.By multiple stepwise regression.it is known that the amount of the change is only correlated with the initial elevated IOP.Conclusions:The study indicated that it was the distortion and deformity of the lamina cribrosa leading to shearing stress that results in glaucomatous character-istic damage in structure and function.The individul tolerance of the lamina cribrosa to the high intraocular pressure and the locations of indivdual vulnerable at he optic nerve head are various.Eye Science1995;11:155-160.
Intracapsular dexamethasone implant in patients undergoing phacoemulsification and intraocular lens implantation
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Lucas Monferrari Monteiro Vianna
Full Text Available PURPOSE: To relate the outcomes of 7 eyes of 7 patients in which a dexamethasone 0.7 mg implant (Ozurdex® was placed inside the capsule bag after phacoemulsification and intraocular lens (IOL implantation and compare with the fellow eyes, that were operated by the same technique and received dexamethasone eyedrops in the post-operatory. METHODS: Report review of 7 eyes of 7 patients who received dexamethasone 0.7 mg implant after phacoemulsification and IOL, comparing them to the fellow eyes. All the patients underwent bilateral cataract surgery, with one month interval, by the same technique and by experienced surgeons, without complications. Post operatory medication consisted of moxifloxacin eye drops for all the 14 eyes and topic dexamethasone for the 7 eyes that did not received the implant. RESULTS: Nuclear cataract classification (according to LOCS III was 3.28 ± 0.69 in the implant eye group and 3.14 ± 0.83 in the fellow eye group. Postoperative best spectacle correct visual acuity (BSCVA was 0.85 ± 0.12 and 0.87 ± 0.13, respectively in the implant and fellow eye groups. The intraocular pressure remained stable and similar to the pre-operative measurements. Anterior chamber reaction and cornea edema were similar in both groups in the follow-up. Two of the four no sutured pellet migrated to the anterior chamber during the first post-operative week and had to be repositioned. Another no sutured pellet dislocated and remained partially inside the capsule bag. The 3 patients with IOL haptic-sutured pellet had no complications. CONCLUSIONS: In the present study, dexamethasone 0.7mg implant were effective in controlling the inflammation after phacoemulsification and IOL implantation, with no significant side effects.
Aquaporin deletion in mice reduces intraocular pressure and aqueous fluid production.
Zhang, Duo; Vetrivel, L; Verkman, A S
Aquaporin (AQP) water channels are expressed in the eye at sites of aqueous fluid production and outflow: AQP1 and AQP4 in nonpigmented ciliary epithelium, and AQP1 in trabecular meshwork endothelium. Novel methods were developed to compare aqueous fluid dynamics in wild-type mice versus mice lacking AQP1 and/or AQP4. Aqueous fluid production was measured by in vivo confocal microscopy after transcorneal iontophoretic introduction of fluorescein. Intraocular pressure (IOP), outflow, and anterior chamber compliance were determined from pressure measurements in response to fluid infusions using micropipettes. Aqueous fluid volume and [Cl(-)] were assayed in samples withdrawn by micropipettes. In wild-type mice (CD1 genetic background, age 4-6 wk), IOP was 16.0 +/- 0.4 mmHg (SE), aqueous fluid volume 7.2 +/- 0.3 microl, fluid production 3.6 +/- 0.2 microl/h, fluid outflow 0.36 +/- 0.06 microl/h/mmHg, and compliance 0.036 +/- 0.006 microl/mmHg. IOP was significantly decreased by up to 1.8 mmHg (P fluid production by up to 0.9 microl/h in age/litter-matched mice lacking AQP1 and/or AQP4 (outbred CD1 and inbred C57/bl6 genetic backgrounds). However, AQP deletion did not significantly affect outflow, [Cl(-)], volume, or compliance. These results provide evidence for the involvement of AQPs in intraocular pressure regulation by facilitating aqueous fluid secretion across the ciliary epithelium. AQP inhibition may thus provide a novel approach for the treatment of elevated IOP.
Desempenho visual após implante de uma lente intraocular asférica multifocal difrativa Visual performance after implantation of an aspheric multifocal diffractive intraocular lens
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Leonardo Akaishi
Full Text Available OBJETIVO: Avaliar a acuidade visual a distancia, intermediária e perto após o implante de uma lente intraocular (LIO asférica multifocal difrativa AcrySof® ReSTOR® SN6AD1. MÉTODOS: Estudo prospectivo de 50 pacientes com catarata submetidos à facoemulsificação e implante de LIO AcrySof® ReSTOR®. Foram avaliados acuidade visual sem correção (AVSC, acuidade visual com correção (AVCC para longe, acuidade visual para perto corrigida para longe (AVPC e acuidade visual intermediária corrigida para longe (AVIC. Um questionário de satisfação e fenômenos visuais foi administrado ao final do estudo. RESULTADO: Após três meses de cirurgia, a média das acuidades (logMAR era: AVSC, 0,05 ± 0,07; AVCC, 0,00 ± 0,01; AVPC, 0,00 ± 0,0, e AVIC, 0,15 ± 0,05. A AVCC e AVPC era de 20/25 ou melhor em todos os pacientes, sendo a AVIC J3 ou melhor em 83% dos pacientes. Pacientes relataram excelente desempenho visual nas questões relacionadas a atividades para distância, intermediário, e perto com pouca ou nenhuma dificuldade. Nenhum paciente relatou halos ou 'glare' severos, sendo os mesmos caracterizados entre nenhum a moderado. CONCLUSÃO: A LIO asférica AcrySof® ReSTOR® SN6AD1 mostrou excelentes resultados na visão para longe, perto e intermediário, além de apresentar uma baixa incidência de fenômenos visuais.PURPOSE: To evaluate distance, intermediate, and near vision after aspheric multifocal diffractive AcrySof® ReSTOR® SN6AD1 intraocular lens (IOL implantation. METHODS: Prospective study of 50 patients with cataract that had phacoemulsification and AcrySof® ReSTOR® IOL implantation. Uncorrected distance vision acuity (UDVA, corrected distance visual acuity (CDVA, distance-corrected near visual acuity (DCNVA, and distance-corrected intermediate visual acuity (DCIVA were measured postoperatively. A patient-satisfaction and visual phenomena questionnaire was administered at the end of the study. RESULTS: Three months
人工晶状体植入术后房角与眼压变化之间的相关性研究%Correlation of the anterior chamber angle and intraocular pressure changes after intraocular lens implantation
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刘玉青; 叶存喜; 刘玉霞; 戴冬姝; 冀向宁; 王静娴; 邹媛媛; 李坤; 王志学; 侯四清
目的 研究人工晶状体植入术后前房角宽度及眼压变化情况之间的相关性.方法 随机选取120例(137只眼)老年性白内障患者,于表麻下行透明角膜切口超声乳化白内障摘除人工晶状体植入术,保留手术过程顺利、后囊膜完整、人工晶状体植入囊袋中的病例作为研究对象.术前用超声生物显微镜(UBM)测量房角相关参数:房角开放距离(AOD500)、小梁虹膜夹角(TIA)、前房深度(ACD);用Goldmann眼压计测量眼压.分别于术后2周、1个月、3个月再用UBM及Goldmann眼压计复查如上参数;术前以前房角镜观察并记录房角形态并于术后1个月复查房角形态.结果 术前所测量的眼压与正常眼前节数据有显著性差异;术前所测量的ACD、AOD、TIA、眼压分别与术后2周、1个月、3个月复查数据进行多样本均数间的多重比较,均为P<0.05,均有显著性差异;术后2周、1个月、3个月时,AOD及眼压改变的量之间存在负相关;TIA夹角及眼压改变的量之间存在负相关.结论 (1)研究对象的ACD、AOD、TIA与正常眼前节相关数据比较,无显著性差异;但是,眼压较正常值稍高,提示部分患者有发生闭角型青光眼的潜在趋势.(2)超声乳化白内障摘除人工晶状体植入术后,前房深度及房角宽度显著增大,眼压显著降低,避免或减少了闭角型青光眼的发生机会.(3)AOD、TIA这2个变量与眼压这个变量间呈负相关.提示在老年人群中,AOD、TIA是影响眼压的重要因素.%Objective To study the correlation of anterior chamber angle and intraocular pressure changes after intraocular lens implantation. Methods 120 patients with cataract were randomly selected, anesthesized, and underwent phacoemulsification cataract extraction and intraocular lens implantation. The surgery went smoothly, the posterior capsule was intact, and intraocular lens was implanted in the capsular bag. Preoperative and postoperative measurement
Comparison of visual outcomes and subjective visual quality after bilateral implantation of a diffractive trifocal intraocular lens and blended implantation of apodized diffractive bifocal intraocular lenses
Gundersen, Kjell Gunnar; Potvin, Rick
Purpose To compare the visual acuity (VA) and quality of vision between bilateral implantation of a trifocal intraocular lens (IOL) and blended bifocal IOLs with an intermediate add in the dominant eye and a near add in the nondominant eye. Patients and methods Patients with either trifocal or blended bifocal IOLs implanted were recruited after surgery. Subjects returned for a single diagnostic visit between 3 and 24 months after surgery. VA was tested at various distances, including low-contrast acuity and acuity at their preferred reading distance. A binocular defocus curve was obtained, and subjective visual function and quality of vision were evaluated. Results Twenty-five trifocal subjects and 30 blended bifocal subjects were enrolled. There were no significant differences in low-contrast acuity, preferred reading distance, or acuity at that reading distance. Binocular vision at 4 m, 60 cm, and 40 cm was not statistically significantly different. The trifocal provided statistically significantly better visual acuity (P<0.05) at vergences from −0.5 to −1.5 D (from 2 m to 67 cm viewing distance, P<0.05). There was no statistically significant difference in the near vision subscale scores of the 39-question National Eye Institute Visual Function Questionnaire or the overall scores of the Quality of Vision questionnaire, though significantly more trifocal subjects reported that the observed visual disturbances were "bothersome" (P<0.05). Conclusion Both lens modalities provided subjects with excellent binocular near and distance vision, with similar low rates of visual disturbances and good reported functional vision. The trifocal IOL provided significantly better intermediate VA in the viewing distance range of 2 m to 67 cm, corresponding to viewing things such as a car dashboard or grocery shelf. VA was similar between groups at viewing distances from 60 to 40 cm, corresponding to computer or reading distance. PMID:27274184
The new factors defining variability of circadian's rhythms of intraocular and perfusion pressure of glaucoma patients
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N. A. Baranova
Full Text Available Currently, the most scientifically based local risk and progressive factors are elevated levels of intraocular pressure and its instability during the day, caused by local hydromechanical disturbances. However, the other factors affecting the circadian changes of intraocular pressure levels are still evaluated. It was found that light is one of the most important factors affecting the intensity of the cyclical fluctuations of various biological processes, including, and fluctuations of intraocular pressure. At the same time, glaucoma can lead to a variety of sleep disorders, due to a mismatch between cycles «sleep-wake». One if this reason is the death of retinal ganglion cells and their axons. Such damage indirectly lead to a decrease in production of the pigment melanopsin, which is located in the retina. It is not involved in the visual process, but ensures the implementation of circadian rhythms «sleep-wake» and mediated suppression of epiphyseal melatonin. Most likely, melatonin plays a protective role in the occurrence and progression of glaucoma, protecting retinal cells against free radicals and has a direct impact on the intraocular pressure level. Several studies have shown that the circadian change in intraocular pressure levels, and in particular, its substantial reduction, is influenced by melatonin. In this regard, glaucoma is a disease in which the death of retinal cells, including producing melanopsin, a unique opportunity to study violations of cyclic rhythms. Melatonin acts on such established risk factors and progression of glaucoma as hypertension and diabetes. There are published results of the use of melatonin agonists in the experiment and clinical practice. So, in addition to local and systemic hypotensive action, normalizes sleep patients. Data about the melatonin's effects on the direct and indirect reduction of intraocular pressure, neuroprotective effects and reducing symptoms of depression can
Effects of systemic domestic recombinant human erythropoietin on HIF-1α expression in the retina in a rabbit model of acute high intraocular pressure
Institute of Scientific and Technical Information of China (English)
Objective To observe the expression of hypoxia inducible factor-1α (HIF-1α) in the retina of rabbits with acute high intraocular pressure and to investigate the mechanism of systemic domestic recombinant human erythropoietin (rhEPO) protecting the retina from ischemia-reperfusion injury. Methods First,control group and model group were established in rabbit eyes. The acute high intraocular pressure model was established by saline perfusion into anterior chamber,and then hypodermic injection of domestic rhEP...
The Effect of Altitude on Intraocular Pressure in Vitrectomized Eyes with Sulfur Hexafluoride Tamponade by the Friedenwald Method: Rabbit Animal Model
Fromow-Guerra, Jans; Solís-Vivanco, Adriana; Perez-Reguera, Adriana; Quiroz-Mercado, Hugo; Meza-de Regil, Armando; Papa-Oliva, Gabriela; Morales-Cantón, Virgilio
The aim of this study is to assess the change in intraocular pressure after a road trip, in eyes with different levels of filling with gas tamponade. Five rabbit eyes were subject to pars plana vitrectomy and gas tamponade (filling percentage: 25%, 50%, and 100% of nonexpansile SF6, 100% saline solution, and 100% room air). A sixth eye was injected with 0.35 cc of undiluted SF6 without vitrectomy. Guided by global positioning system, they were driven to the highest point of the highway connecting Mexico City with Puebla city and back, stopping every 300 m to assess intraocular pressure. The rabbit's scleral rigidity and estimation for human eyes were done by using the Friedenwald nomogram. Maximum altitude was 3209 m (Δ949 m). There were significant differences in intraocular pressure on the rabbit eyes filled with SF6 at 100%, 50%, 25%, and 100% room air. Per every 100 m of altitude rise, the intraocular pressure increased by 1.53, 1.0046, 0.971, and 0.97 mmHg, respectively. Using the human Friedenwald rigidity coefficient, the human eye estimate for intraocular pressure change was 2.1, 1.8, 1.4, and 1.1 mmHg per every 100 m of attitude rise. Altitude changes have a significant impact on intraocular pressure. The final effect depends on the percentage of vitreous cavity fill and scleral rigidity. PMID:27957500
A randomised comparative study of the effect of Airtraq optical laryngoscope vs. Macintosh laryngoscope on intraocular pressure in non-ophthalmic surgery
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Bikramjit Das
Full Text Available BACKGROUND: We compared intraocular pressure changes following laryngoscopy and intubation with conventional Macintosh blade and Airtraq optical laryngoscope. METHODS: Ninety adult patients were randomly assigned to study group or control group. Study group (n = 45 - Airtraq laryngoscope was used for laryngoscopy. Control group (n = 45 - conventional Macintosh laryngoscope was used for laryngoscopy. Preoperative baseline intraocular pressure was measured with Schiotz tonometer. Laryngoscopy was done as per group protocol. Intraocular pressure and haemodynamic parameters were recorded just before insertion of the device and subsequently three times at an interval of one minute after insertion of the device. RESULTS: Patient characteristics, baseline haemodynamic parameters and baseline intraocular pressure were comparable in the two groups. Following insertion of the endotracheal tube with Macintosh laryngoscope, there was statistically significant rise in heart rate and intraocular pressure compared to Airtraq group. There was no significant change in MAP. Eight patients in Macintosh group had tongue-lip-dental trauma during intubation, while only 2 patients received upper airway trauma in Airtraq group. CONCLUSION: We conclude that Airtraq laryngoscope in comparison to Macintosh laryngoscope results in significantly fewer rises in intraocular pressure and clinically less marked increase in haemodynamic response to laryngoscopy and intubation.
The Influence of Central Corneal Thickness and Corneal Curvature and Axial Length on the Measurement of Intraocular Pressure
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Qing Li; Minru Li; Zhigang Fan; Ningli Wang
Purpose: To examine the influence of central corneal thickness (CCT), corneal curvature (CC), and axial length (AL) on intraocular pressure (IOP).Methods: Eighty-one clinically normal eyes were included in our study. The IOP, CCT, CC, AL were measured using a Goldmann applanation tonometer, optical pachymeter, keratometer and A-scan ultrasound biometer respectively in all subjects.Results: A highly significant positive correlation was identified between IOP and CCT. Linear regression analysis suggests that an increase in CCT of 0. 010 mm is associated with a 4. 946 mmHg increment in IOP. No significant positive correlation was identified between IOP and CC. P values are 0. 724 and 0.414 respectively for vertical and horizontal readings. A paradoxically reversed correlation was present between IOP and axial length.Conclusion: Corneal thickness is a very important confounding factor in the measurement of intraocular pressure, which warrants further attention in our clinical practice.
Small-aperture corneal inlay in presbyopic patients with prior phakic intraocular lens implantation surgery: 3-month results
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Huseynova T
Full Text Available Tukezban Huseynova,1 Tomomi Kanamori,1 George O Waring IV,2 Minoru Tomita1,3,4 1Shinagawa LASIK Center, Tokyo, Japan; 2Medical University of South Carolina, Charleston, SC, USA; 3Wenzhou Medical College, Wenzhou, People's Republic of China; 4Eye Can Cataract Surgery Center, Metro Manila, Philippines Abstract: We report a series of three case reports of KAMRA inlay implantation procedures in presbyopic patients with a history of prior phakic intraocular lens implantation surgery. Three-month results showed a two to five-line improvement for uncorrected near visual acuity. The absolute uncorrected near visual acuity change for case 1 was from J4 to J2, for case 2 was from J6 to J4, and for case 3 was from J10 to J5. No significant change of uncorrected distance visual acuity was observed in all three cases. Keywords: phakic intraocular lens, IOL, KAMRA, intracorneal inlay
Experimental study on cyclosporine A drug delivery system in prevention of posterior capsule opacification after intraocular lens implantation in rabbits
Institute of Scientific and Technical Information of China (English)
Objective To study the effect of cyclosporine A drug delivery system (CsA-DDS) on the prevention of posterior capsule opacification (PCO) after experimental intraocular lens implantation in rabbit eyes. Methods Twenty healthy New Zealand white rabbits, whose left eyes and right eyes were used respectively as experiment eyes and controls, were subjected to extracapsular lens extraction and artificial lens implantation. During the operation, CsA-DDS with poly (lactideco-glycolide) as carriers or empty DDS was...
Effect of prophylactic timolol 0.1% gel on intraocular pressure after an intravitreal injection of ranibizumab: a randomized study
Pece A; Allegrini D; Montesano G; Dimastrogiovanni AF
Alfredo Pece,1 Davide Allegrini,1 Giovanni Montesano,2 Andrea Fabio Dimastrogiovanni1 1Eye Clinic, Melegnano Hospital, Vizzolo Predabissi, 2Eye Clinic, San Paolo Hospital, Università di Milano, Milano, Italy Purpose: The purpose of this study is to make a prospective evaluation of the effect of timolol 0.1% eye gel on short-term intraocular pressure (IOP) after an intravitreal injection (IVI) of ranibizumab. Participants and methods: One hundred and fifty eyes of 150 IVI-na&i...
The effect of blue-blocking and neutral intraocular lenses on circadian photoentrainment and sleep one year after cataract surgery
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Brøndsted, Adam Elias; Haargaard, Birgitte; Sander, Birgit;
PURPOSE: To compare the long-term effect on circadian photoentrainment and sleep in patients implanted with neutral and blue-blocking intraocular lenses 1 year after cataract surgery. METHODS: Randomized, controlled trial involving 67 patients with age-related cataract. Intervention was cataract...... compared with neutral IOLs. Cataract surgery improved the response of ipRGCs and sleep quality. However, the effect of cataract surgery on sleep quality may be unrelated to circadian photoentrainment....
Comparison of Visual Quality after Implantation of Big Bag and Akreos Adapt Intraocular Lenses in Patients with High Myopia
Institute of Scientific and Technical Information of China (English)
Shengsheng Ma; Dongjian Zheng; Ling Lin; Fanjian Meng; Yonggang Yuan
Purpose: To compare vision quality following phacoemulsifi-cation cataract extraction and implantation of a Big Bag or Akreos Adapt intraocular lens (IOL) in patients diagnosed with high myopia complicated with cataract. Methods:.This was a randomized prospective control study. The patients with high myopia complicated with cataract , with axial length ≥28 mm,.and corneal astigmatism ≤1D were enrolled and randomly divided into the Big Bag and Akreos Adapt IOL groups. All patients underwent phacoemulsification cataract extraction and lens implantation..At 3 months after surgery,.intraocular high-order aberration was measured by a Tracey-iTrace wavefront aberrometer at a pupil diameter of 5 mm in an absolutely dark room and statistically compared be-tween two groups. The images of the anterior segment of eyes were photographed with a Scheimpflug camera using Penta-cam three-dimensional anterior segment analyzer..The tilt and decentration of the IOL were calculated by Image-pro plus 6.0 imaging analysis software and statistically compared between two groups. Results:.In total,.127 patients (127 eyes),..including 52 males and 75 females, were enrolled in this study. The total high-or-der aberration and coma in the Akreos Adapt group (59 eyes) were significantly higher compared with those in the Big Bag (P0.05). The horizontal and vertical decentration were significantly smaller in the Big Bag lens group than in the Akreos Adapt group (both P0.05). Conclusion:.Both Big Bag and Akreos Adapt IOLs possess relatively good intraocular stability implanted in patients with high myopia. Compared with the Akreos Adapt IOL, the Big Bag IOL presents with smaller intraocular high-order aberra-tion. Coma is the major difference between the two groups.
Ab-interno scleral suture loop fixation with cow-hitch knot in posterior chamber intraocular lens decentration
Ertugrul Can; Nurullah Koçak; Özlem Eski Yücel; Adem Gül; Hilal Eser Öztürk; Osman Sayin
Aim of Study: To describe a simplified ab-interno cow-hitch suture fixation technique for repositioning decentered posterior chamber intraocular lens (PC IOL). Materials and Methods: Two cases are presented with the surgical correction of decentered and subluxated IOL. Ab-interno scleral suture fixation technique with hitch-cow knot in the eye was performed with a ciliary sulcus guide instrument and 1 year follow-up was completed. Results: Both of the patients had well centered lenses postope...
Ocular bacterial flora, tear production, and intraocular pressure in a captive flock of Humboldt penguins (Spheniscus humboldti).
Swinger, Robert L; Langan, Jennifer N; Hamor, Ralph
The purpose of this study was to determine normal ocular surface bacterial flora, tear production, and intraocular pressure in a captive flock of Humboldt penguins, Spheniscus humboldti. Twenty-eight healthy penguins were studied and equally divided between fresh- and saltwater habitats. The population consisted of 15 female and 13 male penguins, ranging from 3-20 years of age. Following complete ophthalmic exam, 4 penguins with cataracts were removed from the study. Eight penguins from each habitat were randomly selected for ocular surface aerobic bacterial culture. Corynebacterium spp. and Staphylococcus spp. were the most common isolates. Twenty-five organisms consisting of 17 species, and 15 organisms consisting of 9 species, were identified in fresh- and saltwater groups, respectively. Tear production and intraocular pressures were evaluated on 24 penguins with normal ocular exams. The range and mean (+/- standard deviation) tear production, measured with the Schirmer tear test, was 1-12 mm/min and 6.45 mm/min +/- 2.9, respectively. The mean tear production for penguins housed in the freshwater habitat was greater (8.5 mm/min) than those in saltwater (4.8 mm/min). The range and mean (+/- standard deviation) intraocular pressure, measured by applanation tonometry using a Tono-Pen XL tonometer, was 10-27 mmHg and 20.36 mmHg +/- 4.1, respectively. This data should be utilized as a reliable resource for those involved in avian and zoo medicine.
Study on Processing Technology of Intraocular Lens%人工晶状体加工工艺研究
Institute of Scientific and Technical Information of China (English)
段振云; 解宝利; 张福利; 姜宝光
人工晶状体加工合格率低,已成为国际公认的加工技术难题.对人工晶状体超精密车削中采用的独特的插补路径进行了研究,并详细地分析了单晶金刚石车削加工时插补路径、对刀、刀尖圆弧半径对表面质量的影响,对提高人工晶状体加工质量具有重要意义.%Intraocular lens processing qualified rate low has become an internationally recognized technical problems.In this paper,the unique path interpolation used in the ultra-precision turning of the intraocular lens,and the detailed analysis of single crystal diamond turning interpolation path,tool,tool nose radius effects on surface quality.It is an important significance to improve the processing quality of intraocular lens.
Treatment of cystoid macular edema secondary to chronic non-infectious intermediate uveitis with an intraocular dexamethasone implant
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Julia Dutra Rossetto
Full Text Available ABSTRACT Purpose: To evaluate the use of a slow-release dexamethasone 0.7-mg intravitreal implant for cystoid macular edema (CME secondary to intermediate uveitis and refractory to systemic steroids. Methods: A retrospective study of the best-corrected visual acuity (BCVA, intraocular inflammation, intraocular pressure (IOP, fundus photography, optical coherence tomography (OCT, inflammation, and adverse reactions of five patients (women, mean age of 35 years with cystoid macular edema treated with a dexamethasone implant. Patients were evaluated in seven visits until the 150th day after the implant. Results: Four patients had bilateral pars planitis and one had bilateral intermediate uveitis associated with juvenile idiopathic arthritis. Six dexamethasone devices were implanted, under topical anesthesia (one each in six eyes, five patients. The mean follow-up time was 5 months. The best-corrected visual acuity improved in all eyes that received an implant, with five having improvements of two or more lines. Optical coherence tomography showed thinning of the macula in all eyes treated, and we saw a correlation between the best-corrected visual acuity and retinal thinning. No serious adverse events occurred and no significant increase in intraocular pressure was observed. Conclusions: Slow-release dexamethasone intravitreal implants can effectively treat CME secondary to intermediate uveitis and refractory to systemic steroids.
Comparison of visual outcomes and subjective visual quality after bilateral implantation of a diffractive trifocal intraocular lens and blended implantation of apodized diffractive bifocal intraocular lenses
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Gundersen KG
Full Text Available Kjell G Gundersen,1 Rick Potvin21IFocus Øyeklinikk AS, Haugesund, Norway; 2Science in Vision, Akron, NY, USAPurpose: To compare the visual acuity (VA and quality of vision between bilateral implantation of a trifocal intraocular lens (IOL and blended bifocal IOLs with an intermediate add in the dominant eye and a near add in the nondominant eye.Patients and methods: Patients with either trifocal or blended bifocal IOLs implanted were recruited after surgery. Subjects returned for a single diagnostic visit between 3 and 24 months after surgery. VA was tested at various distances, including low-contrast acuity and acuity at their preferred reading distance. A binocular defocus curve was obtained, and subjective visual function and quality of vision were evaluated.Results: Twenty-five trifocal subjects and 30 blended bifocal subjects were enrolled. There were no significant differences in low-contrast acuity, preferred reading distance, or acuity at that reading distance. Binocular vision at 4 m, 60 cm, and 40 cm was not statistically significantly different. The trifocal provided statistically significantly better visual acuity (P<0.05 at vergences from -0.5 to -1.5 D (from 2 m to 67 cm viewing distance, P<0.05. There was no statistically significant difference in the near vision subscale scores of the 39-question National Eye Institute Visual Function Questionnaire or the overall scores of the Quality of Vision questionnaire, though significantly more trifocal subjects reported that the observed visual disturbances were "bothersome" (P<0.05.Conclusion: Both lens modalities provided subjects with excellent binocular near and distance vision, with similar low rates of visual disturbances and good reported functional vision. The trifocal IOL provided significantly better intermediate VA in the viewing distance range of 2 m to 67 cm, corresponding to viewing things such as a car dashboard or grocery shelf. VA was similar between groups at
Adenine nucleotide effect on intraocular pressure: Involvement of the parasympathetic nervous system.
Peral, Assumpta; Gallar, Juana; Pintor, Jesús
Nucleotides are present in the aqueous humor possibly exerting physiological effects on intraocular pressure (IOP). To determine the effect of nucleotides such as ATP and its related derivatives on IOP, New Zealand white rabbits were used. IOP was measured in rabbits treated topically either with saline (control) or with a single dose (10 microg/microL) of adenine nucleotides (ATP, 2-meS-ATP, ATP-gamma-S, alpha,beta-meADP, alpha,beta-meATP and beta,gamma-meATP). Those nucleotides reducing IOP (alpha,beta-meATP and beta,gamma-meATP) were then tested in concentrations ranging from 1 to 100 microg/microL to obtain the IC(50) value. Several antagonists for the P2 and adenosine A1 receptors (all at 10 microg/microL) were assayed 30 min before the application of the hypotensive nucleotide beta,gamma-meATP. To see whether the nucleotide was acting directly on the structures involved in aqueous humor dynamics or on the autonomic nerves controlling IOP, animal denervation and sympathetic (yohimbine and ICI-118,551 at 10 microg/microL) and parasympathetic (atropine and hexametonium at 10 microg/microL) receptors' antagonists were used 30 min before the instillation of beta,gamma-meATP. alpha,beta-meATP and beta,gamma-meATP decreased IOP to 60% of control value (basal IOP=23.2+/-1.3 mmHg), with IC(50) of 1.59+/-0.21 microg/microLand 0.56+/-0.62 microg/microL, which corresponds to 3mM and 1mM respectively. Denervation completely abolished the effect of beta,gamma-meATP. Sympathetic antagonists did not modify the hypotensive effect of beta,gamma-meATP, but parasympathetic antagonists were able to abolish it. Among the series of adenine nucleotide tested, alpha,beta-meATP and beta,gamma-meATP presented hypotensive actions on IOP. beta,gamma-meATP seems to stimulate cholinergic terminals being its final effect the IOP reduction. Therefore, these two nucleotides are interesting pharmacological tools for those pathologies related with high intraocular pressure.
Associated depression in pseudophakic patients with intraocular lens with and without chromophore
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Mendoza-Mendieta ME
Full Text Available María Elena Mendoza-Mendieta, Ana Aurora Lorenzo-Mejía Association to Prevent Blindness in Mexico (APEC, Hospital "Dr Luis Sánchez Bulnes", Mexico City, Mexico Background: With aging, the crystalline lens turns yellowish, which increases the absorption of wavelengths in the blue electromagnetic spectrum, reducing their photoreception in the retina. Since these wavelengths are the main stimulus in the regulation of the circadian rhythm, progressive reduction in their transmission is associated with chronic sleep disturbances and depression in elderly patients. Cataract extraction improves circadian photoreception at any age. However, lenses that block blue waves have 27% to 38% less melatonin suppression than lenses that block only ultraviolet (UV rays. Purpose: To assess the depression symptoms in subjects who have had bilateral phacoemulsification and intraocular lens (IOL implants, one group with yellow chromophore IOLs and the other group with transparent IOLs were compared. Setting: Association to Prevent Blindness in Mexico (APEC, Hospital "Dr Luis Sánchez Bulnes". Design: This was an observational, cross-sectional, and single-center study. Materials and methods: Twenty-six subjects between 60 and 80 years of age, with a history of bilateral phacoemulsification and placement of the same type of IOL in both eyes from 4 to 12 months prior to the study, who attended the follow-up visits and agreed to participate in this study, and provided signed informed consent were included in the study. They were asked to answer the short version of the 15-item Geriatric Depression Scale. Results: The average age of the study participants was 72.5±5.94 years. The group without chromophore included 46.1% (n=12 of the patients and the group with chromophore included 53.9% (n=14 of the patients (P=0.088. Conclusion: In the group of patients with IOLs that block the passage of blue light, the depression rate was 21.4%, a rate similar to that
Desempenho visual dos pacientes pseudofácicos com diferentes lentes intraoculares
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Wilson Takashi Hida
Full Text Available OBJETIVO: Comparar a performance visual dos pacientes submetidos ao implante das lentes intraoculares multifocais difrativas Tecnis® MF ZM900, Acrysof® Restor® SN60D3, Acrysof® SN60WF e Acrysof® SN60AT. MÉTODOS: Estudo prospectivo comparativo, não randomizado, que incluiu 142 olhos de 71 pacientes com catarata, provenientes do ambulatório de oftalmologia do HC-FMUSP. A avaliação oftalmológica contou com medida da acuidade visual para longa, intermediária e curta distância, sem correção e com a melhor correção óptica, teste de sensibilidade ao contraste, pupilometria e análise de frente de onda por meio do aberrômetro. Todos os exames foram realizados com seis meses de pós-operatório. RESULTADOS: A média de idade dos pacientes foi de 60,7±6,6 anos no grupo Tecnis, 63,1±4,4 anos no grupo Restor e 63,7±4,2 anos no grupo monofocal (SN60AT no olho contralateral SN60WF. A acuidade visual para perto não corrigida e corrigida para longe foi estatisticamente superior nos grupos multifocal Restor e multifocal Tecnis em comparação ao grupo monofocal SN60AT/SN60WF (p<0,001. Não houve diferença estatística entre os grupos na comparação da acuidade visual para longe (p=0,56. A sensibilidade ao contraste fotópica monocular foi estatisticamente inferior nos grupos Restor e Tecnis (p<0,001. A SN60AT apresentou maior aberração esférica comparada a todas as outras lentes (p<0,001. A Tecnis se mostrou com menores valores médios de aberrações esféricas na comparação com a Restor (p<0.001. CONCLUSÃO: A Restor e Tecnis apresentaram melhor acuidade visual para perto do que o grupo monofocal SN60AT/SN60WF. Todas as lentes intraoculares promoveram boa visão para longe. O grupo da Tecnis apresentou melhor sensibilidade de contraste, menos aberrações ópticas e melhor visão intermediária que o grupo Restor.
Central corneal thickness and intraocular pressure in the Cameroonian nonglaucomatous population
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André Omgbwa Eballe
Full Text Available André Omgbwa Eballe1, Godefroy Koki2, Augustin Ellong2, Didier Owono2, Emilienne Epée2, Lucienne Assumpta Bella2, Côme Ebana Mvogo1, Jeanne Mayouego Kouam21Faculty of Medicine and Pharmaceuticals Sciences, University of Douala; 2Faculty of Medicine and Biomedical Sciences, University of Yaoundé, CameroonAim: We performed a prospective, analytical study from 01 January to 31 March 2009 in the Ophthalmology Unit of the Gyneco-Obstetric and Pediatric Hospital of Yaounde, aiming to determine the profile of central corneal thickness (CCT in the Cameroonian nonglaucomatous black population and its relationship with intraocular pressure (IOP.Results and discussion: Four hundred and eighty-five patients (970 eyes meeting our inclusion criteria were selected for this study. The average CCT was 529.29 ± 35.9 µm in the right eye (95% confidence interval [CI]: 526.09–532.49, 528.19 ± 35.9 µm in the left eye (95% CI: 524.99–531.40 and 528.74 ± 35.89 µm in both eyes (95% CI: 526.48–531.00, range 440 to 670 µm. The average IOP was 13.01 ± 2.97 mmHg in both eyes (95% CI: 12.82–13.19. A rise in CCT by 100 µm was followed by an increase in IOP of about 2.8 mmHg (95% CI: 2.3–3.6 for both eyes taken together. Linear regression analysis showed that corneal thickness was negatively correlated with age and IOP was positively related with age.Conclusion: CCT in the Cameroonian nonglaucomatous black population was found to be lower compared with CCT values in Caucasian and Asian populations. On the basis of reference values ranging between 527 and 560 µm, an adjustment of IOP values by a correction factor is required for many Cameroonian patients. This will improve the diagnosis and follow-up of glaucoma by helping to detect true ocular hypertension.Keywords: central corneal thickness, intraocular pressure, Cameroon
Long-term visual outcomes after Crystalens® HD intraocular lens implantation
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Karavitaki AE
Full Text Available Alexandra E Karavitaki, Ioannis G Pallikaris, Sophia I Panagopoulou, George A Kounis, George Kontadakis, George D KymionisInstitute of Vision and Optics, University of Crete, Crete, GreecePurpose: Our purpose was to evaluate the long-term visual outcomes after bilateral implantation of Crystalens® HD (Bausch and Lomb, Inc. accommodative intraocular lenses.Methods: In this study, 25 patients (50 eyes who underwent cataract surgery and bilateral Crystalens HD accommodative intraocular lens implantation were included. The Crystalens HD lens was implanted in the bag in both eyes, without any intra- or postoperative complications. The visual parameters measured before and after surgery were: uncorrected distance visual acuity, corrected distance visual acuity (CDVA (using the Early Diabetic Retinopathy Study [EDTRS] logMAR charts, uncorrected intermediate visual acuity, and uncorrected near visual acuity using a Birkhäuser reading chart, at a distance of 66 cm and 33 cm for intermediate and near vision, respectively, directly illuminated by a lamp of 60 watts. After surgery, the patients were evaluated at 1, 3, 6, 12, 24, and 36 months.Results: The mean age was 68.70±7.1 (range: 54 to 83 years. The mean follow-up was 42.72±0.49 (range: 42.33 to 43.27 months. The uncorrected distance visual acuity improved from 0.56±0.41 (range: 0 to 2 preoperatively to 0.19±0.13 (range: 0 to 0.38 (logMAR scale at the last follow-up visit, and the CDVA improved from 0.17±0.18 (range: 0 to 0.7 preoperatively to 0.05±0.05 (range: −0.02 to 0.22 at the last follow-up visit. No eyes lost lines of CDVA during the follow-up period, while 54% of patients gained one or more lines of CDVA. The uncorrected intermediate and near visual acuity was J2 or better in 71% and 69% of our patients, respectively.Conclusion: Crystalens HD implantation seems to provide an improvement in visual acuity for far, intermediate, and near distances.Keywords: presbyopia, accommodation
Capsular Outcomes After Pediatric Cataract Surgery Without Intraocular Lens Implantation: Qualitative Classification and Quantitative Measurement.
Tan, Xuhua; Lin, Haotian; Lin, Zhuoling; Chen, Jingjing; Tang, Xiangchen; Luo, Lixia; Chen, Weirong; Liu, Yizhi
The objective of this study was to investigate capsular outcomes 12 months after pediatric cataract surgery without intraocular lens implantation via qualitative classification and quantitative measurement.This study is a cross-sectional study that was approved by the institutional review board of Zhongshan Ophthalmic Center of Sun Yat-sen University in Guangzhou, China.Digital coaxial retro-illumination photographs of 329 aphakic pediatric eyes were obtained 12 months after pediatric cataract surgery without intraocular lens implantation. Capsule digital coaxial retro-illumination photographs were divided as follows: anterior capsule opening area (ACOA), posterior capsule opening area (PCOA), and posterior capsule opening opacity (PCOO). Capsular outcomes were qualitatively classified into 3 types based on the PCOO: Type I-capsule with mild opacification but no invasion into the capsule opening; Type II-capsule with moderate opacification accompanied by contraction of the ACOA and invasion to the occluding part of the PCOA; and Type III-capsule with severe opacification accompanied by total occlusion of the PCOA. Software was developed to quantitatively measure the ACOA, PCOA, and PCOO using standardized DCRPs. The relationships between the accurate intraoperative anterior and posterior capsulorhexis sizes and the qualitative capsular types were statistically analyzed.The DCRPs of 315 aphakic eyes (95.8%) of 191 children were included. Capsular outcomes were classified into 3 types: Type I-120 eyes (38.1%); Type II-157 eyes (49.8%); Type III-38 eyes (12.1%). The scores of the capsular outcomes were negatively correlated with intraoperative anterior capsulorhexis size (R = -0.572, P < 0.001), but no significant correlation with intraoperative posterior capsulorhexis size (R = -0.16, P = 0.122) was observed. The ACOA significantly decreased from Type I to Type II to Type III, the PCOA increased in size from Type I to Type II, and the PCOO increased
Intraocular pressure dynamics with prostaglandin analogs: a clinical application of water-drinking test
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Özyol P
Full Text Available Pelin Özyol,1 Erhan Özyol,1 Ercan Baldemir2 1Ophthalmology Department, 2Biostatistics Department, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey Aim: To evaluate the clinical applicability of the water-drinking test in treatment-naive primary open-angle glaucoma patients. Methods: Twenty newly diagnosed primary open-angle glaucoma patients and 20 healthy controls were enrolled in this prospective study. The water-drinking test was performed at baseline and 6 weeks and 3 months after prostaglandin analog treatment. Peak and fluctuation of intraocular pressure (IOP measurements obtained with the water-drinking test during follow-up were analyzed. Analysis of variance for repeated measures and paired and unpaired t-tests were used for statistical analysis. Results: The mean baseline IOP values in patients with primary open-angle glaucoma were 25.1±4.6 mmHg before prostaglandin analog treatment, 19.8±3.7 mmHg at week 6, and 17.9±2.2 mmHg at month 3 after treatment. The difference in mean baseline IOP of the water-drinking tests was statistically significant (P<0.001. At 6 weeks of prostaglandin analog treatment, two patients had high peak and fluctuation of IOP measurements despite a reduction in baseline IOP. After modifying treatment, patients had lower peak and fluctuation of IOP values at month 3 of the study. Conclusion: Peak and fluctuation of IOP in response to the water-drinking test were lower with prostaglandin analogs compared with before medication. The water-drinking test can represent an additional benefit in the management of glaucoma patients, especially by detecting higher peak and fluctuation of IOP values despite a reduced mean IOP. Therefore, it could be helpful as a supplementary method in monitoring IOP in the clinical practice. Keywords: glaucoma, intraocular pressure, water-drinking test, prostaglandin analog, intraocular pressure fluctuation
... Old Feeding Your 1- to 2-Year-Old Shigella Infections KidsHealth > For Parents > Shigella Infections Print A ... the Doctor en español Infecciones por Shigella About Shigella Shigella are bacteria that can infect the digestive ...
... infections may occur following surgery or spontaneously in patients with certain risk factors. Risk factors for spinal infections include poor nutrition, immune suppression, human immunodeficiency virus (HIV) infection, cancer, diabetes and obesity. Surgical risk factors ...
Avaliação da sensibilidade ao contraste e da estereopsia em pacientes com lente intra-ocular multifocal Contrast sensitivity and stereopsis in pseudophakic patients with multifocal intraocular lens
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Filipe de Oliveira
Full Text Available OBJETIVO: Avaliar a sensibilidade ao contraste e a acuidade estereoscópica em pacientes pseudofácicos, que receberam implante bilateral de lente intra-ocular multifocal. MÉTODOS: Prospectivamente foram realizados testes de sensibilidade ao contraste com o uso da tabela Pelli-Robson e teste de acuidade estereoscópica com emprego do Titmus Stereo Test, em 20 pacientes com implante bilateral de lente intra-ocular multifocal Acrysof Restor®, no pós-operatório de 1 a 2 meses e sem uso de qualquer correção óptica. RESULTADOS:O teste de sensibilidade ao contraste binocular demonstrou que 6 pacientes (30% apresentaram 1,80 unid. log, 13 (65% 1,65 e 1 (5% 1,50. No teste monocular, ocorreram as seguintes respostas: 17 pacientes (85% 1,65 unid. log e 3 (15% 1,50 para o teste do olho direito. O teste do olho esquerdo mostrou que 16 pacientes (80% apresentaram 1,65 unid. log e 4 (20% 1,50. A média e o desvio-padrão da sensibilidade ao contraste testada binocularmente foi 1,69 (±0,08, ao passo que monocularmente foi 1,63 (±0,05 para OD e 1,62 (±0,06 para OE. O teste de acuidade estereoscópica revelou que 12 pacientes (60% obtiveram 40", 6 (30% 50" e 2 (10% 60", com média de 45" e desvio-padrão de ±6,88". CONCLUSÃO: A lente intra-ocular empregada no estudo, proporcionou resultados de sensibilidade ao contraste e acuidade estereoscópica compatíveis e de acordo com critérios de normalidade estabelecidos anteriormente por outros estudos em grupos de pacientes fácicos e pseudofácicos, e portanto, impacto positivo na funcionalidade visual.PURPOSE: To evaluate the contrast sensitivity and stereopsis tests in patients who underwent bilateral implantation of multifocal intraocular lens. METHODS: Tests of contrast sensitivity using the Pelli-Robson chart and stereopsis evaluation with the Titmus Stereo Test were performed in 20 patients 30-60 days after the bilateral implantation of Acrysof Restor® multifocal intraocular lens. RESULTS: The
The potential of using biodegradable microspheres in retinal diseases and other intraocular pathologies.
Herrero-Vanrell, Rocío; Bravo-Osuna, Irene; Andrés-Guerrero, Vanessa; Vicario-de-la-Torre, Marta; Molina-Martínez, Irene Teresa
Pathologies affecting the posterior segment of the eye are one of the major causes of blindness in developed countries and are becoming more prevalent due to the increase in society longevity. Successful therapy of diseases affecting the back of the eye requires effective concentrations of the active substance maintained during a long period of time in the intraocular target site. Treatment of vitreoretinal diseases often include repeated intravitreous injections that are associated with adverse effects. Local administration of biodegradable microspheres offers an excellent alternative to multiple administrations, as they are able to deliver the therapeutic molecule in a controlled fashion. Furthermore, injection of microparticles is performed without the need for surgical procedures. As most of the retinal diseases are multifactorial, microspheres result especially promising because they can be loaded with more than one active substance and complemented with the inclusion of additives with pharmacological properties. Personalized therapy can be easily achieved by changing the amount of administered microspheres. Contrary to non-biodegradable devices, biodegradable PLA and PLGA microspheres disappear from the site of administration after delivering the drug. Furthermore, microspheres prepared from these mentioned biomaterials are well tolerated after periocular and intravitreal injections in animals and humans. After injection, PLA and PLGA microspheres suffer aggregation behaving like an implant. Biodegradable microspheres are potential tools in regenerative medicine for retinal repair. According to the reported results, presumably a variety of microparticulate formulations for different ophthalmic therapeutic uses will be available in the clinical practice in the near future.
Charles F. Prentice award lecture 2008: surgical correction of presbyopia with intraocular lenses designed to accommodate.
Schor, Clifton M
Surgical restoration of accommodation with accommodating intra-ocular lenses (A-IOLs) presents a complex set of problems involving the design of the prosthetic mechanism. A variety of designs are currently employed that either translate the A-IOL toward the cornea along the sagittal axis, shear two lens components laterally, or deform lens shape to change dioptric power of the eye during attempts to accommodate. Effective biomechanical properties (elasticity and viscosity) of these lenses depend on both material properties and structural design of the A-IOL. Inevitable mismatches between the neuromuscular control of accommodation and the effective biomechanical properties of the prosthetic lens could lead to either unstable oscillations or sluggishness of dynamic accommodation; however, optimal dynamic responses may possibly be restored by neural recalibration. A model of dynamic accommodation is used to predict the consequences of these mismatches on dynamic accommodation, and reverse engineering is used to test the feasibility of neuromuscular recalibration. Empirical measures verify that neuromuscular adaptation of dynamic accommodation is possible in response to optically simulated increases and decreases of ocular-lens stiffness. Other design issues for A-IOLs include stability of optical properties, aberrations and image quality, and interactions of restored accommodation with binocular eye alignment (the near response).
Higher order aberration comparison between two aspherical intraocular lenses: MC6125AS and Akreos advanced optics
Institute of Scientific and Technical Information of China (English)
Mohammad; Taher; Rajabi; Sara; Korouji; Mahgol; Farjadnia; Mohammad; Naderan; Mohammad; Bagher; Rajabi; Bahram; Khosravi; Seyed; Mehdi; Tabatabaie
AIM: To compare higher order aberrations in two aspherical intraocular lenses(IOLs): Akreos advanced optics(AO) and Dr. Schmidt Microcrystalline 6125 aspheric anterior surface(MC6125AS) with each other. METHODS: Forty eyes of 39 patients underwent phacoemulsification and Akreos AO and MC6125 AS were implanted in their eyes in a random manner. Three months post-operatively, higher order aberrations including spherical aberration, coma aberration, and total aberrations were measured and compared.RESULTS: The total aberration was 0.24±0.17 in eyes with Dr. Schmidt and 0.20 ±0.01 in eyes with Akreos AO(P =0.361). The mean of coma aberration was 0.17 ±0.21 and 0.09 ±0.86 in Dr. Schmidt and Akreos lenses,respectively(P =0.825). Total spherical aberration was almost the same in both groups(mean: 0.05, P =0.933).Best corrected visual acuity in Akreos AO(0.10±0.68) and Dr. Schmidt(0.09±0.67) did not differ significantly(P =0.700). CONCLUSION: There is no statistically significant difference in the higher order aberrations between these two aspherical lenses.
Causes and correction of dissatisfaction after implantation of presbyopia-correcting intraocular lenses
Gibbons, Allister; Ali, Tayyeba K; Waren, Daniel P; Donaldson, Kendall E
Purpose The purpose of this study was to assess the causes and possible solutions for patient dissatisfaction after the implantation of presbyopia-correcting intraocular lenses (IOLs). Methods This study was a retrospective review of clinical records. All patients who were seen between January 2009 and December 2013 whose primary reason for consultation was dissatisfaction with visual performance after presbyopia-correcting IOL implantation were included in the study. A single treating physician, who determined the most probable cause of dissatisfaction, decided which interventions to pursue following the initial consultation. Results Data from 74 eyes of 49 patients were analyzed. The most common cause for complaint was blurry or foggy vision both for distance and near (68%). Complaints were most frequently attributed to residual refractive error (57%) and dry eye (35%). The most common interventions pursued were treatment of refractive error with glasses or contact lenses (46%) and treatment for dry eye (24%). Corneal laser vision correction was done in 8% of eyes; 7% required an IOL exchange. After the interventions, 45% of patients had completed resolution of symptoms, 23% of patients were partially satisfied with the results, and 32% remained completely dissatisfied with the final results. Conclusion The most identifiable causes of dissatisfaction after presbyopia-correcting IOL implantation are residual refractive error and dry eye. Most patients can be managed with conservative treatment, though a significant number of patients remained unsatisfied despite multiple measures. PMID:27784985
Long-term Reliability of Diurnal Intraocular Pressure Patterns in Healthy Asians
Chun, Yeoun Sook; Park, In Ki; Shin, Ko Un
Purpose To determine the long-term repeatability of diurnal intraocular pressure (IOP) patterns in healthy Asian subjects without glaucoma. Methods Twenty-three eyes in 23 healthy Asian subjects without glaucoma underwent diurnal IOP measurements using Goldmann applanation tonometry every 2 hours from 9 AM to 11 PM during two visits that were 8 weeks apart. To validate repeatability between visits, we calculated intra-class correlation coefficients (ICCs) mean IOP, peak IOP, minimum IOP, and IOP fluctuation at each time point and expressed the results as the difference between peak IOP and minimum IOP or as the standard deviation of all diurnal IOP values in the diurnal IOP curve. Results IOP repeatability was excellent at all time points, with ICCs ranging from 0.812 to 0.946 (p 929). However, IOP fluctuations showed poor repeatability, with an ICC lower than 0.15. Conclusions Long-term repeatability of diurnal IOP patterns in healthy Asian subjects was excellent. These findings suggest that IOP measurements at standardized times of the day will be useful for assessing the effectiveness of glaucoma therapy.
Evaluation of pars plana sclera fixation of posterior chamber intraocular lens
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Fangju Han
Full Text Available Purpose: The purpose of this study was to evaluate the clinical efficacy and safety of modified posterior chamber intraocular lens (PCIOL implantation with transscleral fixation. Design and Setting: This is a study, which is conducted at Department of Ophthalmology, Jinan Eye Hospital, Jinan Second People′s Hospital. Materials and Methods: A total of 82 patients who were scheduled for sutured PCIOL were divided randomly into modified and conventional groups. The former underwent PCIOL through pars plana fixation with knot buried and without scleral flap and the latter underwent transscleral fixation of PCIOL in the ciliary sulcus. The main outcome measures included operative time, postoperative visual acuity, and postoperative complications. Results: The mean operative time of the modified group was 39.95 ± 5.87 min, which was significantly less than that of the conventional group (45.77 ± 5.21 min; P < 0.05. No difference was found in postoperative visual acuity between the two groups. There were no significant postoperative complications, including knot exposure, endophthalmitis, and retinal detachment in either group. The optical clamping of PCIOL was prone to occur in the conventional group. Conclusion: Modified sutured PCIOL implantation is a safe, effective, and feasible technique for the correction of aphakia in eyes without adequate posterior capsular support.
Ultrasound Biomicroscopy Comparison of Ab Interno and Ab Externo Intraocular Lens Scleral Fixation.
Horiguchi, Lie; Garcia, Patricia Novita; Malavazzi, Gustavo Ricci; Allemann, Norma; Gomes, Rachel L R
Purpose. To compare ab interno and ab externo scleral fixation of posterior chamber intraocular lenses (PCIOL) using ultrasound biomicroscopy (UBM). Methods. Randomized patients underwent ab externo or ab interno scleral fixation of a PCIOL. Ultrasound biomicroscopy was performed 3 to 6 months postoperatively, to determine PCIOL centration, IOL distance to the iris at 12, 3, 6, and 9 hours, and haptics placement in relation to the ciliary sulcus. Results. Fifteen patients were enrolled in the study. The ab externo technique was used in 7 eyes (46.6%) and the ab interno in 8 eyes (53.3%). In the ab externo technique, 14 haptics were located: 4 (28.57%) in the ciliary sulcus; 2 (14.28%) anterior to the sulcus; and 8 (57.14%) posterior to the sulcus, 6 in the ciliary body and 2 posterior to the ciliary body. In the ab interno group, 4 haptics (25.0%) were in the ciliary sulcus, 2 (12.50%) anterior to the sulcus, and 10 (75.0%) posterior to the sulcus, 4 in the ciliary body and 6 posterior to the ciliary body. Conclusions. Ab externo and ab interno scleral fixation techniques presented similar results in haptic placement. Ab externo technique presented higher vertical tilt when compared to the ab interno.
Comparison of shape recovery ratios of single-piece poly(methyl methacrylate) intraocular lens haptics.
Kimura, W; Kimura, T; Sawada, T; Kikuchi, T; Nagai, H; Yamada, Y
We studied shape recovery ratios of several single- and three-piece intraocular lens (IOL) haptics after conducting compression tests for various lengths of time. Results of the comparison of poly(methyl methacrylate) (PMMA) IOL haptics configured of a single piece and of three pieces showed a superior shape recovery ratio for single-piece haptics. Comparisons of the shape recovery ratios among single-piece PMMA haptics and conventional three-piece haptics made of polyvinylidene fluoride (PVDF), PMMA, and polypropylene (PP) revealed that the shape recovery ratio of single-piece PMMA haptics was higher than the ratios of the conventional three-piece PMMA and PP haptics. The ratios of two of three of the single-piece PMMA haptics, however, were lower than the ratios of three-piece PVDF haptics. The form and manufacturing procedures of haptics likely have a significant impact on the shape recovery ratio of haptics, even those made of the same material. Since decentration after IOL surgery could be caused by the condition of the patient's lenticular capsule and Zinn's zonule, it is difficult to conclude that the shape recovery ratio is the only factor in IOL stability. Nevertheless, this study indicates that IOL haptics that cause less decentration and have better mechanical properties should be developed.
Ultrasound Biomicroscopy Comparison of Ab Interno and Ab Externo Intraocular Lens Scleral Fixation
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Lie Horiguchi
Full Text Available Purpose. To compare ab interno and ab externo scleral fixation of posterior chamber intraocular lenses (PCIOL using ultrasound biomicroscopy (UBM. Methods. Randomized patients underwent ab externo or ab interno scleral fixation of a PCIOL. Ultrasound biomicroscopy was performed 3 to 6 months postoperatively, to determine PCIOL centration, IOL distance to the iris at 12, 3, 6, and 9 hours, and haptics placement in relation to the ciliary sulcus. Results. Fifteen patients were enrolled in the study. The ab externo technique was used in 7 eyes (46.6% and the ab interno in 8 eyes (53.3%. In the ab externo technique, 14 haptics were located: 4 (28.57% in the ciliary sulcus; 2 (14.28% anterior to the sulcus; and 8 (57.14% posterior to the sulcus, 6 in the ciliary body and 2 posterior to the ciliary body. In the ab interno group, 4 haptics (25.0% were in the ciliary sulcus, 2 (12.50% anterior to the sulcus, and 10 (75.0% posterior to the sulcus, 4 in the ciliary body and 6 posterior to the ciliary body. Conclusions. Ab externo and ab interno scleral fixation techniques presented similar results in haptic placement. Ab externo technique presented higher vertical tilt when compared to the ab interno.
Sutureless intrascleral intraocular lens fixation with lamellar dissection of scleral tunnel
Kawaji, Takahiro; Sato, Tomoki; Tanihara, Hidenobu
Purpose To report the results of sutureless scleral fixation of a posterior chamber intraocular lens (IOL) by using our developed simple technique. Methods We retrospectively reviewed the medical records of 48 eyes of 47 patients who underwent sutureless intrascleral IOL fixation by using our modified technique. A 25-gauge microvitreoretinal knife was used to perform sclerotomies and create limbus-parallel scleral tunnels with lamellar dissection in which the haptics were fixed. Results The IOLs were fixed and centered well. The mean follow-up period was 26.7 months. Postoperative complications included smooth vitreous hemorrhage in four eyes (8.3%), cystoid macular edema in two eyes (4.2%), and iris capture of the IOL in two eyes (4.2%). No other complications, such as breakage of the IOL, spontaneous IOL dislocation, or retinal detachment, were detected during the follow-up period. Conclusion The lamellar dissection of the limbus-parallel scleral tunnel can simplify the forceps-assisted introduction of the haptics into the scleral tunnel, and this technique seemed to be safe. PMID:26869757
Influence of surface light scattering in hydrophobic acrylic intraocular lenses on laser beam transmittance.
Shiraya, Tomoyasu; Kato, Satoshi; Minami, Keiichiro; Miyata, Kazunori
The aim of this study was to experimentally examine the changes in the transmittances of photocoagulation lasers when surface light scattering increases in AcrySof intraocular lenses (IOLs). SA60AT IOLs (Alcon) were acceleratingly aging for 0, 3, 5, and 10 years to simulate surface light scattering, and the surface light-scattering intensities of both IOL surfaces were measured using a Scheimpflug photographer. The powers of laser beams that passed from a laser photocoagulator through the aged IOLs were measured at 532, 577, and 647 nm. Changes in the laser power and transmittance with the years of aging and the intensities of surface light scattering were examined. Although the intensity of surface light scattering increased with the years of aging, the laser power did not change with the years of aging (P > 0.30, Kruskal-Wallis test). There were no significant changes in the laser transmittance with the years of aging or the laser wavelength (P > 0.30 and 0.57, respectively). The intensity of surface light scattering revealed no significant association with the laser transmittance at any wavelength (P > 0.37, liner regression). The increases in the surface light scattering of the AcrySof IOLs would not influence retinal photocoagulation treatments for up to 10 years after implantation.
Scleral Fixation of Posteriorly Dislocated Intraocular Lenses by 23-Gauge Vitrectomy without Anterior Segment Approach
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Jeroni Nadal
Full Text Available Background. To evaluate visual outcomes, corneal changes, intraocular lens (IOL stability, and complications after repositioning posteriorly dislocated IOLs and sulcus fixation with polyester sutures. Design. Prospective consecutive case series. Setting. Institut Universitari Barraquer. Participants. 25 eyes of 25 patients with posteriorly dislocated IOL. Methods. The patients underwent 23-gauge vitrectomy via the sulcus to rescue dislocated IOLs and fix them to the scleral wall with a previously looped nonabsorbable polyester suture. Main Outcome Measures. Best corrected visual acuity (BCVA LogMAR, corneal astigmatism, endothelial cell count, IOL stability, and postoperative complications. Results. Mean follow-up time was 18.8 ± 10.9 months. Mean surgery time was 33 ± 2 minutes. Mean BCVA improved from 0.30 ± 0.48 before surgery to 0.18 ± 0.60 (p=0.015 at 1 month, which persisted to 12 months (0.18 ± 0.60. Neither corneal astigmatism nor endothelial cell count showed alterations 1 year after surgery. Complications included IOL subluxation in 1 eye (4%, vitreous hemorrhage in 2 eyes (8%, transient hypotony in 2 eyes (8%, and cystic macular edema in 1 eye (4%. No patients presented retinal detachment. Conclusion. This surgical technique proved successful in the management of dislocated IOL. Functional results were good and the complications were easily resolved.
Lente intraocular multifocal refrativa: a performance visual e qualidade de vida em implantes bilaterais versus unilaterais
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Jorge Estefano Germano
Full Text Available OBJETIVO: O objetivo desse estudo é comparar acuidade visual, sensibilidade ao contraste, velocidade de leitura e a qualidade de vida pós-operatória de pacientes pseudofácicos unilaterais ou bilaterais com lentes intraoculares multifocais ReZoom. MÉTODOS: Estudo comparativo, prospectivo, não aleatório incluindo 38 olhos de 24 pacientes, separados em um grupo com implante bilateral (14 pacientes e outro com implante unilateral (10 pacientes. O exame oftalmológico completo incluiu acuidade visual não corrigida pré-operatória para perto, intermediário e para longe, acuidade visual com melhor correção, topografia corneal, sensibilidade ao contraste, velocidade de leitura e escala de satisfação realizado 60 dias após a cirurgia. A análise estatística foi realizada por meio dos testes de Kruskal-Wallis, Mann-Whitney e Qui-quadrado. RESULTADOS: Os resultados comparando função visual, sensibilidade ao contraste, velocidade de leitura e escala de satisfação foram semelhante entre os grupos. CONCLUSÃO: Não houve diferença estatística entre os resultados comparando função visual, sensibilidade ao contraste, velocidade de leitura e escala de satisfação entre os grupos.
Accuracy of Intraocular Lens Power Calculation Formulas for Highly Myopic Eyes
Zhang, Yichi; Liang, Xiao Ying; Liu, Shu; Lee, Jacky W. Y.; Bhaskar, Srinivasan; Lam, Dennis S. C.
Purpose. To evaluate and compare the accuracy of different intraocular lens (IOL) power calculation formulas for eyes with an axial length (AL) greater than 26.00 mm. Methods. This study reviewed 407 eyes of 219 patients with AL longer than 26.0 mm. The refractive prediction errors of IOL power calculation formulas (SRK/T, Haigis, Holladay, Hoffer Q, and Barrett Universal II) using User Group for Laser Interference Biometry (ULIB) constants were evaluated and compared. Results. One hundred seventy-one eyes were enrolled. The Barrett Universal II formula had the lowest mean absolute error (MAE) and SRK/T and Haigis had similar MAE, and the statistical highest MAE were seen with the Holladay and Hoffer Q formulas. The interquartile range of the Barrett Universal II formula was also the lowest among all the formulas. The Barrett Universal II formulas yielded the highest percentage of eyes within ±1.0 D and ±0.5 D of the target refraction in this study (97.24% and 79.56%, resp.). Conclusions. Barrett Universal II formula produced the lowest predictive error and the least variable predictive error compared with the SRK/T, Haigis, Holladay, and Hoffer Q formulas. For high myopic eyes, the Barrett Universal II formula may be a more suitable choice. PMID:27119018
Clinical Outcomes after Binocular Implantation of a New Trifocal Diffractive Intraocular Lens
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Florian T. A. Kretz
Full Text Available Purpose. To evaluate visual, refractive, and contrast sensitivity outcomes, as well as the incidence of pseudophakic photic phenomena and patient satisfaction after bilateral diffractive trifocal intraocular lens (IOL implantation. Methods. This prospective nonrandomized study included consecutive patients undergoing cataract surgery with bilateral implantation of a diffractive trifocal IOL (AT LISA tri 839MP, Carl Zeiss Meditec. Distance, intermediate, and near visual outcomes were evaluated as well as the defocus curve and the refractive outcomes 3 months after surgery. Photopic and mesopic contrast sensitivity, patient satisfaction, and halo perception were also evaluated. Results. Seventy-six eyes of 38 patients were included; 90% of eyes showed a spherical equivalent within ±0.50 diopters 3 months after surgery. All patients had a binocular uncorrected distance visual acuity of 0.00 LogMAR or better and a binocular uncorrected intermediate visual acuity of 0.10 LogMAR or better, 3 months after surgery. Furthermore, 85% of patients achieved a binocular uncorrected near visual acuity of 0.10 LogMAR or better. Conclusions. Trifocal diffractive IOL implantation seems to provide an effective restoration of visual function for far, intermediate, and near distances, providing high levels of visual quality and patient satisfaction.
Tram-Track Suture Technique for Pupillary Capture of a Scleral Fixated Intraocular Lens
Kim, Sung In; Kim, Kiseok
Purpose To report a new technique using tram-track suture for pupillary capture of a scleral fixated posterior chamber intraocular lens (PC-IOL) to reposition the tilted IOL. Methods In this prospective interventional case series, we describe a tram-track suture for pupillary capture of a scleral fixated PC-IOL. A long straight needle with double-armed 10-0 polypropylene is passed behind the iris and just above the optic portion (tilted forward) of the IOL. The other straight needle with double-armed 10-0 polypropylene is passed just below the optic portion (tilted backward) of the IOL. After the IOL is repositioned properly, the polypropylene sutures are gently pulled and tied. Results Four eyes of 4 patients underwent tram-track suture for pupillary capture of a scleral fixated PC-IOL. No intra- or postoperative complications were noted, and no pupillary captures were detected during the follow-up period. Conclusions The tram-track suture technique provides good centration and stability of a PC-IOL. This technique is an easy and effective way to reposition pupillary capture of an IOL. Further, it is also minimally invasive as it maintains a closed system. PMID:27462257
Visual outcomes and optical quality after implantation of a diffractive multifocal toric intraocular lens
Chen, Xiangfei; Zhao, Ming; Shi, Yuhua; Yang, Liping; Lu, Yan; Huang, Zhenping
Background: This study evaluated the visual function after implantation of a multifocal toric intraocular lenses (IOLs). Materials and Methods: This study involved 10 eyes from eight cataract patients with corneal astigmatism of 1.0 diopter (D) or higher who had received phacoemulsification with implantation of an AcrySof IQ ReSTOR Toric IOL. Six-month evaluations included visual acuity, spherical equivalent (SE), defocus curve, residual astigmatism, IOL rotation, contrast sensitivity (CS), wavefront aberrations, modulation transfer function (MTF), and patient satisfaction assessments. Results: At 6 months postoperatively, uncorrected distance visual acuity (logarithm of the minimum angle of resolution) was 0.09 ± 0.04, corrected distance visual acuity was 0.02 ± 0.11, and uncorrected near visual acuity was 0.12 ± 0.07. The mean SE was −0.095 ± 0.394 D (±0.50 D in 90%). Refractive astigmatism at the 6-month follow-up visit was significantly reduced to 0.35 ± 0.32 D from 1.50 ± 0.41 D presurgery (P 0.05). There was an increase in MTF results between preoperative and postoperative evaluations at all spatial frequencies. Conclusions: The diffractive multifocal toric IOL is able to provide a predictable astigmatic correction with apparently outstanding levels of optical quality after implantation. PMID:27221680
Calcium-phosphate deposits on a hydrophilic acrylic intraocular lens after silicon oil tamponade
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Rashid Alsaeidi
Full Text Available We report a 52-year-old man who underwent uncomplicated cataract operation and posterior chamber lens implantation (hydrophilic acrylic lens in his left eye 5 years prior to presentation. Two years after surgery he developed pseudophakic retinal detachment which was successfully treated with pars plana vitrectomy and silicon oil tamponade. The silicon oil was removed one year after surgery. A year later he complained of increasing blurred vision in the left eye. Clinical examination revealed vesicular alterations located superficially on the intraocular lens (IOL, which could not be removed by perflourocarbon-perflourohexloctane lavage. As the patient complained about increasing visual impairment, the IOL was removed. The IOL was investigated by electronmicroscopy and biochemical analysis. During electron microscopy and following biochemical analysis the observed alterations were identified as calcium-phosphate particles located on the superficial aspect of the IOL. The occurrence of calcium-phosphate deposits on a posterior chamber IOL after silicon oil tamponade is a rare complication and has not been described so far. As these deposits interfere with visual acuity, removal of the lens has to be considered.