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Biomedical subjects

C K Hitzenberger

Publications and source records attributed to C K Hitzenberger.

17 recordsLinked to original sources

Improved prediction of intraocular lens power using partial coherence interferometry.

PURPOSE: To evaluate the feasibility of using a new optical biometry technique, dual-beam partial coherence interferometry (PCI), to improve intraocular lens (IOL) power prediction in cataract surgery. SETTING: Department of Ophthalmology, Vienna General Hospital, and Institute of Medical Physics, University of Vienna, Vienna, Austria. METHODS: Preoperative axial length (AL) data obtained with PCI biometry and applanation ultrasound (US) biometry in 77 eyes of 51 patients was applied to 4 commonly used IOL power formulas. The refractive outcome and the mean absolute error (MAE) were calculated for each formula using both biometry methods. A linear multiple-regression model based on preoperative PCI biometry data was derived to predict the postoperative anterior chamber depth (ACD). The predictive power of this regression model was assessed by adding the predicted ACD to the SRK/T formula. Predicted residuals were calculated to evaluate the feasibility and stability of this modified IOL power formula. RESULTS: Using PCI instead of US biometry significantly improved the refractive outcome with all 4 IOL power formulas. The Holladay I and SRK/T formulas yielded an MAE of 0.44 diopter (D) using PCI AL data and 0.56 D and 0.57 D, respectively, using US biometry data. The SRK/T formula combined with the PCI regression model for postoperative ACD prediction performed slightly better (MAE 0.42 D) than the conventional SRK/T formula alone. Predicted residuals revealed an MAE of 0.46 D, proving the predictive performance of the new formula. CONCLUSIONS: Partial coherence interferometry biometry applied to several widely used IOL power formulas yielded significantly better IOL power prediction and therefore refractive outcome in cataract surgery than US biometry. Further improvement can be achieved by applying PCI to a modified SRK/T formula that predicts the postoperative ACD using PCI biometry data.

Biometry↗

Resolution-improved dual-beam and standard optical coherence tomography: a comparison.

BACKGROUND: The purpose of the study was to demonstrate the improved axial resolution and longitudinal stability of dual-beam optical coherence tomography (OCT) in comparison to conventional OCT setups used in commercially available OCT instruments. METHODS: The conventional OCT technique is based on an interferometric setup that is rather sensitive to axial eye motions. We have developed a special dual-beam OCT technique which eliminates the influence of axial eye motions. This is achieved by using the anterior corneal surface as the reference surface for the interferometric ranging. To improve the signal quality, the different wavefront curvatures of beams reflected at cornea and retina are matched by a diffractive optical element. To improve the axial resolution, a broadband synthesized light source with an effective bandwidth of 50 nm is used, and the group dispersion of the ocular media is compensated. Tomographic images were recorded in the fovea and the optic nerve head of healthy volunteers. For comparison purposes, approximately the same locations in the same eyes were imaged by a commercially available OCT instrument. RESULTS: Compared to the standard OCT technique, the dual-beam OCT images show considerably improved axial resolution. Especially in tomograms recorded at the fovea, dual-beam OCT resolves microstructural details that are not visible in the standard OCT images. Furthermore, the axial stability of dual-beam OCT enables the recording of exact geometrical contours of fundus layers. CONCLUSIONS: Dual-beam OCT is able to provide structural information on the ocular fundus that is not obtained with standard OCT. The long recording times of our instrument limit the transverse resolution to 100-150 microm at present.

Fovea Centralis↗

Changes in intraocular lens position after neodymium: YAG capsulotomy.

PURPOSE: To quantify changes in intraocular lens (IOL) position caused by neodymium: YAG (Nd:YAG) capsulotomy with 3 IOL styles. SETTING: Department of Ophthalmology, University of Vienna, Austria. METHODS: In a prospective study, anterior chamber depth (ACD) was measured by dualbeam partial coherence interferometry (PCI) in 32 pseudophakic eyes of 32 patients with posterior capsule opacification before and immediately after planned capsulotomy under mydriasis. Patients were divided into 3 groups with the following IOL styles: 1-piece poly(methyl methacrylate) (PMMA), 3-piece foldable, and plate haptic. RESULTS: The capsulotomy induced a backward IOL movement in all 32 eyes (mean 25 microns; range 9 to 55 microns). It was more pronounced in eyes with plate-haptic IOLs than in those with the other styles. Precision of ACD measurement by PCI was 4 microns. Changes in ACD correlated significantly with capsulotomy size but not with preoperative lens-capsule distance. CONCLUSION: Capsulotomy caused a backward movement of the IOL, which was more pronounced with plate-haptic IOLs than with 1-piece PMMA and 3-piece foldable IOLs. Since the magnitude of IOL movement in this study population was small, a hyperopic shift in refraction after capsulotomy will usually be small and not clinically relevant.

Adult↗

Investigation of dispersion effects in ocular media by multiple wavelength partial coherence interferometry.

We report on quantitative measurements of group refractive indices and group dispersion in water and in human ocular media such as the cornea, the aqueous humor, the lens, artificial intraocular lenses, as well as a total value averaged over the media along the axial eye length of normal subjects and pseudophakic patients in vivo using dual beam partial coherence interferometry. Different optical thickness values due to the dispersion of the cornea are demonstrated using two spectrally displaced light sources. The displacement can be used to indirectly calculate the group dispersion of the human cornea in the spectral region between 810 nm and 860 nm. If the object under investigation is dispersive, resolution is limited due to a broadening of the detected signals. This broadening increases with group dispersion, i.e., the extent to which the group refractive index of the medium varies with wavelength and thickness of the tissue under investigation as well as with the spectral bandwidth of the light source. Measurements of the group dispersion in the cornea, lens and vitreous of pseudophakic and normal human eyes, show that the cornea and the lens are more dispersive than water-by a factor of about 5 and 2, respectively-in the investigated spectral region. The cornea is approximately threefold more dispersive than the human crystalline lens, the aqueous humor is less dispersive than water and the group dispersion of all ocular components together, averaged over the axial length of normal and pseudophakic eyes, was only slightly higher compared to that of water. Since the highly dispersive cornea and lens together have only a thickness of about one sixth of that of the axial eye length, it seems that their contribution to the group dispersive effect along the whole axial eye length is only small.

Aqueous Humor↗

Partial coherence interferometry: a novel approach to biometry in cataract surgery.

PURPOSE: To compare biometry performed by an enhanced version of dual beam partial coherence interferometry and applanation ultrasound in a prospective study of 85 cataract eyes to improve refractive outcome of cataract surgery due to a more accurate calculation of intraocular lens power. METHODS: The SRK II formula using ultrasound biometry data was employed. Three months after surgery, partial coherence interferometry biometry was repeated and refractive outcome was determined. Preoperative partial coherence interferometry biometry data were used to determine the refractive power of the intraocular lenses retrospectively and to calculate the possible refractive outcome. RESULTS: Precision of partial coherence interferometry biometry was more than 10 times better than that of ultrasound. Therefore, the possible mean absolute error for postoperative refraction achieved with partial coherence interferometry biometry was 0.49 diopters (compared with 0.67 diopters with ultrasound biometry), resulting in an improvement of 27%. Axial eye length measured with the two techniques differed by a mean of 460 microm. The difference in lens thickness measured with partial coherence interferometry and ultrasound significantly correlated with cataract grade. A mean shortening of 120 microm of axial eye length following cataract surgery was also detected by partial coherence interferometry. CONCLUSIONS: The enhanced version of partial coherence interferometry offers biometry with unprecedented precision (<10 microm) and resolution (approximately 12 microm), therefore improving the refractive outcome in cataract surgery. This noninvasive technique provides a high degree of comfort for the patient, with no need for local anesthesia or pupil dilation and minimized risk of corneal infection.

Adult↗

High precision biometry of pseudophakic eyes using partial coherence interferometry.

PURPOSE: To investigate the applicability of the scanning version of dual-beam partial coherence interferometry (PCI) for measuring the anterior segment and axial length of pseudophakic eyes in a clinical setting and to determine the achievable precision with this biometry technique. SETTING: Department of Ophthalmology, Vienna General Hospital, and Institute of Medical Physics, University of Vienna, Austria. METHODS: Partial coherence interferometry was performed in 39 pseudophakic eyes of 39 patients after implantation of a foldable acrylic intraocular lens (IOL). RESULTS: Effective lens position (ELP), IOL thickness and lens-capsule distance (LCD) were determined with a precision of 2 to 3 microns; corneal thickness and axial eye length, with a precision of 0.8 and 5.0 microns, respectively. The mean ELP of the IOL was 4.093 mm +/- 0.290 (SD). In 7 eyes (18%), a positive LCD of 68 +/- 40 microns was detected with PCI. Mean corneal thickness was 526.4 +/- 31.5 microns; mean IOL thickness, 791.5 +/- 40.2 microns; and mean axial length, 23.388 +/- 0.824 mm. CONCLUSION: The scanning version of PCI enables high precision (< or = 5 microns) and high resolution (approximately 12 microns) biometry of pseudophakic eyes that is better than conventional ultrasound by a factor of more than 20. For the first time, positive LCD, a possible risk factor for posterior capsule opacification, could be detected and quantified. Furthermore, this technique offers a high degree of comfort for the patient since it is a noncontact method with no need for local anesthesia or pupil dilation and has a reduced risk of corneal infection.

Acrylates↗

Accurate determination of effective lens position and lens-capsule distance with 4 intraocular lenses.

PURPOSE: To measure effective lens position (ELP) of 4 intraocular lenses (IOLs) using high precision and high resolution dual-beam partial coherence interferometry (PCI) and to assess the tendency of these IOLs to produce a lens-capsule distance (LCD), a possible risk factor for posterior capsule opacification. SETTING: Department of Ophthalmology, Vienna General Hospital; Institute of Medical Physics, University of Vienna, Austria. METHODS: In a retrospective study, PCI was used to measure ELP and LCD in 139 pseudophakic eyes of 110 patients with 4 IOLs: acrylic 3-piece IOL (AcrySof MA60BM); silicone 3-piece IOL without a capsular tension ring (PhacoFlex SI30) and with a capsular tension ring (PhacoFlex SI30 and Morcher Type 14); silicone plate-haptic IOL (Staar AA4203VF); and a hydrogel plate-haptic IOL (logel 1103). RESULTS: The ELP and LCD were determined with a precision of approximately 3 to 4 microns. An LCD was detected in 21% eyes with the AcrySof, 20% of eyes with the SI30 without a capsular tension ring, 10% of eyes with a capsular tension ring, 21% of eyes with the Staar, and 17% of eyes with the logel. The LCDs detected by PCI, but not by slitlamp examination, were significantly smaller than those detected by both. CONCLUSION: The amount of LCD detected by PCI was approximately the same with all IOL types (approximately 20%) except the PhacoFlex SI30 with a capsular tension ring (10%).

Acrylates↗

Eye elongation during accommodation in humans: differences between emmetropes and myopes.

PURPOSE: The pathophysiology and pathogenesis of myopia are still a matter of controversy. Exaggerated longitudinal eye growth is assumed to play an important role in the development of myopia. A significant correlation between refraction and amount of near-work has been reported. However, current knowledge of changes of axial eye length with accommodation is limited because clinical ultrasound biometry does not provide the precision and resolution required to thoroughly investigate these phenomena. METHODS: Partial coherence interferometry (PCI), a noninvasive biometric technique, uses laser light with short coherence length in combination with interferometry to achieve precision in the micrometer to submicrometer range and resolution of 10 microm. In the present study this technique was used to investigate axial eye length changes in 11 emmetropic and 12 myopic eyes during monocular fixation at the far and near point. In 7 subjects, the contralateral eye has also been measured to investigate interocular differences in eye elongation. RESULTS: All investigated eyes elongated during accommodation. This elongation was more pronounced in emmetropes than in myopes (P < 0.001). Mean accommodation-induced eye elongations of 12.7 microm (range, 8.6-19.2 microm) and 5.2 microm (range, 2.1-9.5 microm), corresponding to a dioptric change of approximately -0.036 D and -0.015 D, were obtained for emmetropes and myopes. No significant difference in accommodative amplitudes between groups (5.1 +/- 1.2 D [range, 3.8-7.1 D] versus 4.1 +/- 2.0 D [range, 1.0-7.1 D]; P = 0.14) was detected. No significant interocular difference in accommodation-induced eye elongation was revealed (P = 0.86). Also, a mean backward movement of the posterior lens pole of 38 microm (range, 9-107 microm) was observed in both study groups. CONCLUSIONS: The detected eye elongation can be explained by the accommodation-induced contraction of the ciliary muscle, which results in forward and inward pulling of the choroid, thus decreasing the circumference of the sclera, and leads to an elongation of the axial eye length. Finally, it was demonstrated that PCI, in contrast to clinical ultrasound, is capable of characterizing eye length changes during accommodation in humans.

Accommodation, Ocular↗

Biometric investigation of changes in the anterior eye segment during accommodation.

Non-invasive biometry of the anterior structures of the human eye can be performed with unprecedented precision of 8-10 microns and a resolution of approximately 9 microns by partial coherence interferometry, which has the potential to assess the effect of cycloplegia on the ocular components of the anterior eye segment, to further improve the precision to 1-2 microns by the use of these agents and to quantify the amount of residual accommodations in different states of cycloplegia. In addition, the anterior chamber depth, the thickness of the crystalline lens, their changes during accommodation, as well as the movement of the anterior and posterior lens pole during accommodation can be quantified objectively and accurately to investigate the mechanism of accommodation.

Accommodation, Ocular↗

Submicrometer precision biometry of the anterior segment of the human eye.

PURPOSE: To demonstrate the feasibility of measuring the anterior structures of the human eye by partial coherence interferometry and to determine its precision for eyes under normal and cycloplegic conditions. METHODS: The dual-beam version of partial coherence interferometry, a recently developed noninvasive optical ranging technique, enables high resolution measurements of several intraocular distances with unprecedented precision. A modified, more sensitive scanning version of this technique was used to assess the central and peripheral corneal thickness, the anterior chamber depth, and the lens thickness of 20 healthy, emmetropic to moderately myopic eyes. Furthermore the anterior structures of three eyes were measured under cycloplegia (1% cyclopentolate) to investigate the influence on the precision of this technique after suppression of residual accommodations. RESULTS: The mean geometric precision (standard deviation) of the measurement of the central corneal thickness was 0.29 micron (range, 0.22 micron to 0.38 micron) and 0.43 micron (range, 0.27 micron to 0.56 micron) for the peripheral corneal thickness at a distance 2 mm from its apex. The precision for measuring the anterior chamber depth and the lens thickness for fixation at infinity was 8.7 microns (range, 3.9 microns to 16.8 microns) and 8.9 microns (rang, 2.9 microns to 14.4 microns) for noncycloplegic eyes and 1.9 microns (range, 1.7 microns to 2 microns) and 1.4 microns (range, 0.7 micron to 1.8 microns) for cycloplegic eyes, respectively. CONCLUSIONS: The dual-beam partial coherence interferometry enables fast, noninvasive, submicrometer precision biometry of the anterior segment of the eye. The precision of determining the anterior chamber depth and the lens thickness is more than one order of magnitude better than that of the currently used ultrasound and optical techniques, and it can be improved by a factor of 5 by using cycloplegia.

Adult↗

Interferometric measurement of corneal thickness with micrometer precision.

The recently developed partial coherence laser Doppler interferometry technique was improved to measure central and peripheral corneal thickness with high precision. Corneal thickness profiles were measured on 18 eyes of health, volunteer subjects. All of these eyes were measurable at angles (between visual axis and measuring direction) ranging from 20 degrees nasal to 25 degrees temporal. At larger angles (up to 35 degrees) only part of the eyes was measurable. The thickness profiles of the 18 corneas have a nearly perfectly parabolic shape within the measured region. The precision (standard deviation) was 1.6 microns for central measurements and decreased somewhat to about 3.5 microns at measuring angles in the range of 25 to 30 degrees. No significant interobserver variability was found on 14 eyes measured by three different observers. This study indicates that the new technique is likely to be superior to currently used ultrasound and conventional optical pachymetry techniques, especially for refractive procedures.

Cornea↗

Slit lamp laser Doppler interferometer.

A slit lamp laser interferometer is described for clinical in vivo eye length measurements. The basic components are a laser Doppler interferometer, a slit lamp attachment, and a commercial slit lamp. First measurements of the axial length of the eye yielded a standard deviation of 0.04 mm and less.

Eye↗

Measurement of the axial length of cataract eyes by laser Doppler interferometry.

PURPOSE: To examine the applicability of the recently developed laser Doppler interferometry technique for measuring the axial length of cataract eyes in a realistic clinical situation. To determine the performance of the instrument as a function of cataract grade. To compare the results to those of ultrasound methods. METHODS: A total of 196 cataract eyes of 100 patients were examined. The axial eye length was determined by laser Doppler interferometry and by two different ultrasound techniques, the applanation technique and the immersion technique. The cataract grade was determined by a commercial instrument that measures backscattered light. RESULTS: Laser Doppler interferometry worked very well except in the cases of the highest cataract grades (4% of the eyes of this study were not measurable because of a too-high lens density). Only 3.5% of the other eyes were not measurable because of fixation problems of the patients. The precision of laser Doppler interferometry is not influenced by the cataract grade (except the highest grade). The standard deviation of the geometric eye length is approximately 20 microns. Linear regression analysis revealed a very good correlation of laser Doppler interferometry and ultrasonic measurements, but a systematic difference was found. The eye lengths measured by laser Doppler interferometry were about 0.18 mm longer than those measured by the immersion technique and about 0.47 mm longer than those measured by the applanation technique. CONCLUSION: These differences are attributed to the laser Doppler interferometry results including the retinal thickness and indentation of the cornea by the applanation technique. The main advantages of the laser Doppler interferometry technique are high precision, high accuracy, and more comfort for the patient because it is a noncontact method, anesthesia is unnecessary, and the risk of corneal infection is avoided.

Adult↗

Measurement of corneal thickness by laser Doppler interferometry.

The laser Doppler interferometry (LDI) technique, which was recently developed for axial eye length measurement, has been modified to measure the corneal thickness of the human eye in vivo. High accuracy is achieved. The standard deviation of the technique is about 7 microns, and improvement by a factor of 5 is possible. First comparisons with a usual slit lamp pachometer show a general agreement but a systematic difference of about 20 microns. Possible reasons for this discrepancy are discussed. Finally, the new method is compared to standard optical and ultrasound pachometry from a theoretical point of view, and advantages and drawbacks of the various techniques are discussed.

Cornea↗

Optical measurement of the axial eye length by laser Doppler interferometry.

A new technique has been developed to determine the axial length of the human eye in vivo. Based on laser interferometry in conjunction with the Doppler technique, it uses partially coherent light. This new technique complies with laser safety regulations. High accuracy is achieved, the optical length (OL) can be determined within +/- 30 microns, and the reproducibility of the geometric eye length is greater than +/- 25 microns. Possible errors are discussed. First comparisons with the ultrasound technique yield good agreement for emmetropic subjects and for subjects with a myopia of up to 10 diopters. The advantages of the laser doppler interferometry (LDI) technique are high accuracy, high transversal resolution, and more comfort for the patient (it is a noncontact method; no anesthesia is needed). Possible future applications of LDI, like measurements of fundus profiles and of retinal thickness, are mentioned.

Biometry↗

Polarization-sensitive optical coherence tomography of dental structures.

Optical coherence tomography (OCT) has been developed during the last 10 years as a new noninvasive imaging tool and has been applied to diagnose different ocular and skin diseases. This technique has been modified for cross-sectional imaging of dental structures. In this first preliminary study the technique was applied to obtain tomographic images of extracted sound and decayed human teeth in order to evaluate its possible diagnostic potential for dental applications. Classical OCT images based on reflectivity measurements and phase retardation images using polarization-sensitive OCT were recorded. It was demonstrated that polarization-sensitive OCT can provide additional information which is probably related to the mineralization status and/or the scattering properties of the dental material. One of the attractive features of OCT is that it uses near-infrared light instead of ionizing radiation. Furthermore, high transversal and depth resolution on the order of 10 microm can be obtained. Present limitations, e.g. the limited penetration depth, and possible solutions are discussed.

Dental Caries↗