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Biomedical subjects

G U Auffarth

Publications and source records attributed to G U Auffarth.

At least 55 records · Page 3Linked to original sources
PubMed1998

Evaluation of in situ fracture versus phaco chop techniques.

PURPOSE: To quantify and compare the phaco time required using in situ nucleofracture and phaco chop techniques. SETTING: Center for Research on Ocular Therapeutics and Biodevices and Miyake Laboratory, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA. METHODS: Thirty human eyes obtained postmortem were randomly divided into 2 groups of 15 eyes each. In situ nucleofracture or phaco chop was performed in each group. The phaco time required for each technique was determined. RESULTS: The mean phaco time was 0.91 minutes +/- 0.37 (SD) for the phaco chop and 1.56 +/- 0.89 minutes for the in situ fracture technique (P < .015). CONCLUSIONS: The phaco chop technique reduced phaco time and total phaco power consumed during phacoemulsification without imposing a risk of intraoperative complications.

Aged↗
PubMed1997

[Outcome of cataract operation with reduction of myopia in myopia magna].

UNLABELLED: Patients with high myopia represent a risk group in cataract surgery. They are suspected of having a higher incidence of retina problems after cataract surgery. In addition, IOL calculations may be difficult. METHOD: In a retrospective study data of 97 eyes of 60 high myopic patients were analyzed. The inclusion criterion was an axial length of > 26 mm. All eyes underwent cataract extraction and PC IOL implantation between 1991 and 1995. Evaluation focused on visual outcome, precision of the IOL power calculation and the rate of complications. RESULTS: Visual acuity increased from 0.18 to 0.46 postoperatively. On average, myopia was reduced from -13.6 D to -3.0 D;66% of the patients were +/-1 D;86% were +/-2 D within the predicted calculation of postoperative refraction. During a follow-up period of 14.8 months no retinal detachment occurred. CONCLUSION: Cataract extraction and IOL implantation showed good functional results, and prediction of postoperative refraction was satisfactory. Our data support the studies reporting a low incidence of retinal problems in patients with high myopia.

Aged↗
PubMed1997

[Development of a standardized evaluation system for cataracta complicata in retinitis pigmentosa].

INTRODUCTION: Retinitis pigmentosa (RP) is associated with the formation of a posterior subcapsular cataract (PSC). As only a small part of the crystalline lens is usually affected, it is sometimes difficult to determine to what extent the visual loss is caused by the PSC alone. PATIENTS AND METHODS: The methodology was developed in analogy to a scoring system for posterior capsule opacification by Tetz et al. Following dilation of the pupil, standardized photographs of the anterior segments were obtained utilizing a Zeiss photoslitlamp model 40 SL/P. The PSC was scored by evaluating retroillumination photographs. The individual PSC index was calculated by multiplying the density of the opacification (graded from 0 to 4) by the area involved in the central 4 mm zone of the pupil (calculated between 0 and 1). For testing the reliability of the evaluation system in part 1 of this study, 11 RP patients with different grades of PSC were examined by three independent observers. In part 2 of this study 37 eyes of 24 RP patients, aged 47.2 +/- 11.8 years, were evaluated and the PSC index was correlated with different parameters (visual acuity, age, visual fields, eletroretinography). RESULTS PART 1: The cataract-density grades were between 1 and 4 in the 11 patients. In relation to the central 4-mm pupillary zone between 13 and 100% of the area were opacified. Cataract indices (density x area) were between 0.13 and 4.0 (Mean values: Examiner 1:1.41 +/- 1.49; Examiner 2:1.28 +/- 1.46; Examiner 3:1.22 +/- 1.44; differences not significant: P = 0.77). PART 2: After an average duration of RP of 23 years, the average cataract index of the 24 patients was 1.72 +/- 1.35. There was no correlation between cataract index and ERG or visual fields (r < 0.2; P > 0.4); however, there was a good correlation to visual acuity (r = -0.72; P = 0.0001). Patients with early onset of RP (before 20th year of life) presented on average with an higher cataract index (2.06 +/- 1.67) compared to patients with late manifestation (0.61 +/- 0.44), but equivalent duration of RP. CONCLUSIONS: The evaluation system offers a reliable and reproducible method for measuring PSC density and extension in RP patients. The method can serve as a useful tool for documenting PSC development and help to define the indications for cataract surgery in RP.

Adult↗
PubMed1997

[Complicated cataracts in various forms of retinitis pigmentosa. Type and incidence].

PURPOSE: To study the incidence and types of cataract in retinitis pigmentosa (RP) and their variations among different forms of RP. PATIENTS AND METHODS: This analysis was based on data from 473 patients with RP (autosomal dominant, n = 87; autosomal recessive, n = 79; x chromosomal recessive, n = 23; simplex RP, n = 215; Usher's syndrome n = 80; M. Refsum and others, n = 9) that were retrieved from the literature and patient charts in our clinic. RESULTS: Posterior subcapsular cataract (PSC) developed with the following frequencies for the different genetic types of RP: autosomal dominant, 45.3%; autosomal recessive, 44.0%; x chromosomal recessive, 40.7%; simplex RP, 46.1%; Usher's syndrome, 52.9%. PSC was the only type of lens opacity in patients with Usher's syndrome and autosomal recessive RP.PSC development correlated with early onset of RP symptoms. Nuclear cataracts showed a statistically significant higher frequency in patients with simplex RP (14.8%) than in other genetic types (0-5.9%) (P < 0.01). In addition, nuclear cataracts developed in simplex RP at a significantly later age (69.6 +/- 12.4 years) than PSC (44.4 +/- 12.3 years) (P < 0.001). Patients with cataracts showed significantly worse visual fields than patients with clear lenses (P = 0.00067). CONCLUSIONS: The typical RP cataract (PSC) was found in similar frequencies among all genetic types of RP.PSC was the only type of lens opacity in patients with Usher's syndrome and autosomal recessive RP. Nuclear cataracts developed on average 20 years later than PSC and had their highest incidence in patients with simplex RP. Patients with cataracts showed significantly worse visual field results, indicating a more pronounced retinal pathology.

Adolescent↗
PubMed1997

[Effect of a local nonsteroidal anti-inflammatory drug on postoperative irritation after squint surgeries. Prospective randomized double-blind study].

BACKGROUND: Topical application of a nonsteroidal antiphlogistic drug (NSAD) is often recommended to minimize postoperative lid and conjunctival edema. However, the effectiveness of such therapy remains controversial. PATIENTS AND METHODS: The study presented included 100 patients aged 23.6 +/- 19.5 (5 to 77) years, who were randomly assigned to two treatment groups. Group 1 included 50 patients who underwent squint surgery, and who received Flurbiprofen ED twice a day from the first preoperative day to the third postoperative day. Group 2 served as a control group. These patients were treated with the same regimen using artificial tears. The extent of lid and conjunctival edema was assessed and scored from 1 to 4 on the fourth postoperative day. RESULTS: Squint surgery was performed on 129 eyes of 100 patients. In 32 eyes (24.8%) one muscle was operated on. In 79 eyes (61.2%) 2 muscles and in 18 eyes (14%) three muscles were operated on. The average postoperative conjunctival edema score was 2.08 +/- 0.62 (Flurbiprofen group) and 2.04 +/- 0.67 (control group), respectively. The scoring values for lid edema were 1.90 +/- 0.54 and 1.82 +/- 0.43. The differences between the two groups were not statistically significant (P = 0.21 and 0.39; Mann-Whitney test). No influence of the patient's age on the development of lid and conjunctival edema could be detected (P > 0.08). However, the number of muscles that were operated on had a significant influence on both parameters (P = 0.01 and 0.028). Single muscle operations revealed the lowest scaling values (P < 0.02 and P < 0.04). No difference was found whether 2 or 3 muscles were operated on (P = 0.24 and 0.12). CONCLUSIONS: No beneficial effect of topical application of NSAD on postoperative lid and conjunctival edema could be found in this controlled study.

Adolescent↗
PubMed1997

[Increased cataract rate and characteristics of Nd:YAG laser capsulotomy in retinitis pigmentosa].

BACKGROUND: Retinitis pigmentosa (RP) is associated with the development of a posterior subcapsular cataract (PSC). The development of posterior capsule opacification (PCO) after cataract surgery and a decrease of central visual acuity is sometimes misinterpreted by the patients as natural course of RP. Therefore, therapeutic intervention is often delayed. PATIENTS AND METHODS: In a retrospective study (part 1) the incidence of PCO was evaluated in a group of 26 RP patients who underwent cataract surgery and IOL implantation. In a prospective analyse (part 2) PCO was quantified in 13 RP patients using the standardized photographic technique and image analysis system introduced by Tetz et al. Matched pairs were formed with a control group of 13 patients without retinal disease who matched the RP group in terms of age distribution and postoperative follow-up time. In part 3 the parameters of Nd:YAG laser capsulotomy in 12 RP patients and 14 controls were evaluated. RESULTS: Part 1: The cumulative PCO rate in RP at the end of the first postoperative year was 14.6%, 26.8% in the second, 53.7% in the third and 70.7% after the third year. Nd:YAG laser capsulotomy was performed in 70% of eyes (after 18.4 +/- 14.7 months). In eyes with significant PCO development 70% had PSC preoperatively, while in eyes without PCO formation only 41.7% showed PSC. Part 2: The matched pairs analysis showed a significantly higher PCO value for RP patients (2.11 +/- 1.42) than for the control group (0.89 +/- 0.72) (P = 0.038). Part 3: Average Nd:YAG laser energy levels were 12.8 +/- 11.2 MJ (RP) and 7.6 +/- 6.7 MJ (control). Some 25% of RP patients required further laser treatment of regrown secondary cataract. CONCLUSIONS: Patients with RP showed a significantly higher incidence and density of PCO. Whether RP-specific pathomechanisms are responsible for this needs further investigation.

Adult↗
PubMed1997

Photographic image analysis system of posterior capsule opacification.

PURPOSE: To describe a morphological scoring system of posterior capsule opacification (PCO) that is not based on visual acuity testing. SETTING: Department of Ophthalmology, University of Heidelberg, Germany. METHODS: Following dilation of the pupil, standardized photographs of the pseudophakic anterior segments were obtained using a photo slitlamp. Posterior capsule opacification was scored by evaluating retroillumination photographs. The individual PCO score was calculated by multiplying the density of the opacification (graded from 0 to 4) by the fraction of capsule area involved behind the intraocular lens (IOL) optic. To evaluate the reliability of the morphological scoring system, six observers examined photographs of five eyes each (Experiment A, interindividual reliability). The same observer scored the PCO in three eyes on five different days (Experiment B, intraindividual reliability). RESULTS: Morphological PCO scores were very reliable. With PCO scoring from 0 to 4, the interindividual reliability showed standard deviations between 0.08 and 0.25. The intraindividual reliability showed standard deviations between 0.06 and 0.19 of the mean individual PCO scores. Standard deviation was 0.12 when different photographs of the same eye were scored. CONCLUSION: The morphological scoring system evaluates the entire area behind the IOL optic and thus includes a larger area of the posterior capsule than does visual acuity testing. The method revealed high reliability and insignificant investigator-dependent variations. When using a standardized photographic setup, systematic errors by the photographic technique were not relevant. This method may be an important tool to accurately test for differences in PCO formation with various IOL styles and surgical methods.

Cataract↗
PubMed1997

Measuring anterior chamber depth with Orbscan Topography System.

PURPOSE: To assess the reliability of the Orbscan Topography System in measuring anterior chamber depth (ACD). SETTING: Department of Ophthalmology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany. METHODS: The Orbscan Topography System is a 3-D, scanning slit beam system for analyzing corneal surfaces as well as structures of the anterior segment, e.g., iris, lens. Reflected surface data points are measured in the x, y, and z axes, creating color-coded true surface topography maps. We measured ACD prior to cataract surgery in 56 eyes of 37 patients (mean age 70.4 years + 13.2 [SD]) using the Orbscan system and, as a control, the Grieshaber Biometric System (ultrasound) and the Jäger ACD slitlamp measurement system. RESULTS: Mean ACD values measured with the Orbscan system were 3.23 +/- 0.55 mm; ultrasound measurements were 3.27 +/- 0.54 mm and Jäger measurements, 3.10 +/- 0.55 mm. The average difference between Orbscan and ultrasound values was 0.04 +/- 0.15 mm. The correlation coefficient between Orbscan and ultrasound was 0.96 (P < .00001) and between Orbscan and Jäger, 0.899 (P < .0001). CONCLUSION: The ACD measurements by the Orbscan system were equivalent to common reference measurements.

Aged↗
PubMed1996

A modified preparation technique for closed-system ocular surgery of human eyes obtained postmortem: an improved research and teaching tool.

PURPOSE: In addition to use for corneal transplantation, human autopsy eyes also are used for teaching and vision research. The valuable posterior video technique of Miyake usually is done with an "open-sky" preparation. Closed-system surgery in postmortem eyes is difficult because of postmortem decrease of corneal clarity and myosis. The authors have developed an improved preparation technique that allows closed-system ocular surgery in human postmortem eyes. METHOD: The cornea is dehydrated using a hyper osmolar (15 percent) dextran solution (Swinger-Kornmehl solution), which clarifies the cornea for several hours. The pupil is dilated mechanically by injecting dextran solution into the anterior chamber, and the iris is fixated using formaldehyde (10 percent) and Karnovsky solution. RESULTS AND CONCLUSIONS: This technique can be used in autopsy eyes up to 4 days postmortem without other fixation. Incision techniques, capsulorhexis, phacoemulsification, and intraocular lens implantation, as well as other surgical procedures such as glaucoma surgery, transcleral fixation of posterior chamber lenses and vitrectomies, can be performed. Neodymium:YAG laser capsulectomies or other laser surgical procedures are also possible. This technique is not only excellent for residency training and postgraduate wet laboratories, but is also a viable tool for research purposes.

Education, Medical↗
PubMed1996

Centration and fixation of silicone intraocular lenses: clinicopathological findings in human autopsy eyes.

PURPOSE: To analyze centration and fixation of three-piece and one-piece silicone intraocular lenses (IOLs) in human autopsy eyes. SETTING: Center for Intraocular Lens Research, Medical University of South Carolina, Charleston. METHODS: Thirty eyes among those submitted to the center between 1986 and 1994 were evaluated. The globes were sectioned at the equatorial plane and photographed from a posterior view. Gross examination was performed to determine IOL type, fixation, centration, and additional pathology. The results were compared with those of a control group of autopsy eyes implanted with one-piece and three-piece poly(methyl methacrylate) (PMMA) IOLs. The control group matched the silicone group in patient age, fixation site, and duration of implantation. RESULTS: Twenty-three eyes (79.3%) had three-piece silicone IOLs and 7 eyes (20.7%), one-piece plate IOLs. Average patient age in the three-piece group was 77.3 years +/- 6.7 (SD) and in the one-piece group, 74.3 +/- 3.8 years. The 30 IOLs were symmetrically fixated in the bag. Average decentration of the three-piece and one-piece IOLs did not differ significantly, 0.37 +/- 0.31 mm and 0.26 +/- 0.13 mm, respectively (P = .37). There was also no significant difference in decentration between the silicone groups and the PMMA groups (P = .93). CONCLUSION: Centration and fixation of silicone IOLs were equivalent to those of standard PMMA IOLs.

Aged↗
PubMed1996

Clinicopathological findings in human autopsy eyes with an Anis circular lens.

PURPOSE: To evaluate the long-term performance of the Anis circular intraocular lens (IOL). SETTING: Center for IOL Research, Storm Eye Institute, Charleston, South Carolina. MATERIALS: Fifteen human autopsy eyes with an Anis circular IOL submitted between 1985 and 1993 were evaluated. The eyes were sectioned at the equatorial plane, and the anterior segment containing the capsular bag and the IOL was photographed from the posterior perspective. Fixation, centration, capsular bag shape, zonular damage, central posterior capsule opacification (PCO), and Soemmering's ring formation were analyzed. The results were compared with those of a control group comprising human autopsy eyes with a one-piece (n = 15) or three-piece (n = 15) poly(methyl methacrylate) IOL with a C-loop design. RESULTS: All 15 Anis IOLs showed symmetrical in-the-bag fixation. Mean decentration in the Anis IOL eyes was significantly lower than in the control eyes (P = .02). Eyes with the Anis IOL had fewer zonular defects (P = .0005) and a better circular extension of the capsular bag (P = .003). There were no statistically significant differences in PCO (P = .29) or Soemmering's ring formation (P = .67). CONCLUSION: The Anis IOL with a circular haptic design had better centration and capsular bag morphology than the control eyes, although a difference in PCO and Soemmering's ring formation could not be shown.

Aged↗
PubMed1996

Centration and fixation of posterior chamber intraocular lenses in eyes with pseudoexfoliation syndrome. An analysis of explanted autopsy eyes.

Pseudoexfoliation syndrome is an important risk factor in cataract surgery. We examined decentration of posterior chamber intraocular lenses in a series of 24 autopsy eyes with pseudoexfoliation syndrome that had undergone cataract surgery and intraocular lens implantation. The results were compared to a control group of 25 normal autopsy eyes that matched the pseudoexfoliation collection for age distribution, implant duration and further anatomical parameters. The mean lens decentration in all pseudoexfoliation eyes (0.75 +/- 0.38 mm) was significantly higher than in the control group (0.40 +/- 0.29 mm) (p = 0.0008). Analysis of subgroups with symmetrical bag/bag fixated intraocular lenses showed a significantly higher decentration in the pseudoexfoliation group (p = 0.04). The main reason for decentration was a decentration of the entire capsular bag in pseudoexfoliative eyes (p = 0.001), which was related to zonular weakness and damage. The results indicate that in patients with pseudoexfoliation syndrome alternative fixation sites, like sulcus or transscleral fixation, should also be considered.

Aged↗
PubMed1996

[Indications and prognosis of cataract surgery in patients with retinitis pigmentosa].

BACKGROUND: Retinitis pigmentosa (RP) is associated with the development of posterior subcapsular cataract (PSC). Due to their retinal pathology, RP patients need optimal contrast conditions to attain good visual acuity. Lens opacities like PSC, therefore, decrease central visual acuity in RP patients earlier and more markedly than in patients without retinal problems. PATIENTS AND METHODS: We examined 39 patients aged 52.2 +/- 15.4 years who had underwent 61 cataract operations with intraocular lens implantation 1-4 years previously. Patients with autosomal dominant (n = 7), autosomal recessive (n = 1), X chromosomal recessive (n = 2), and simplex RP (n = 21), as well as eight patients with Usher's syndrome (RP and sensoneurinal deafness), were evaluated. RESULTS: Visual acuity (VA) of all patients increased from 0.17 +/- 0.13 preoperatively to 0.33 +/- 0.22 postoperatively. The mean age of the patients at the onset of RP was 28.8 +/- 19.6 years. The average time between subjective onset of RP and cataract operation was 20 years. Patients with early manifestation of RP, before the age of 20 years, had significantly lower postoperative VA (P = 0.0005) than patients with late manifestation. A short duration of RP, less than 20 years, was associated with significantly better postoperative VA (P = 0.016). The surgical trauma of the cataract operation did not influence the course of RP. Visual field testing did not show statistically significant differences between preoperative and postoperative (1-4 years) results. The development of clinically significant posterior capsule opacification was observed in 70.7% of all RP patients. CONCLUSIONS: Patients with RP and cataract should be operated early to provide, for as long as possible, an optimal optical image to compensate and support the inferior retinal function. Early onset of RP symptoms and longer duration of the disease have an negative impact on postoperative visual outcome in cataract surgery.

Adult↗
PubMed1996

[Suitability of polyvinylpyrrolidone (PVP) as a substance for hydrogel intraocular lenses].

UNLABELLED: Conventional PMMA intraocular lenses (IOLs) have been shown to restore vision successfully after cataract surgery, but have been associated with complications such as decentration, destruction of intraocular tissue, and posterior capsule opacification. Expansile IOLs based on cross-inked polyhydroxyethylmethacrylate (PHEMA) also undergo chemically induced hydrolysis, polymer leaching and gel fragmentation. The focus of this research is to prepare and characterize hydrogel IOLs prepared from PVP using gamma-irradiation. METHODS: Hydrogels were prepared from aqueous solutions of PVP by free radical polymerization as a function of gamma-irradiation dose (0.5 x 106 to 2.5 x 106 rad), PVP concentration (4% to 16% w/v), molecular weight (MW) (10 x 103 to 360 x 103 Da), and blending with low and high MW PVP. Viscometric analysis, swelling characterization studies, and polymer leaching studies were carried out to access network formation. In addition changes in lens geometry in an animal model were measured in response to cycloplegic eyedrops. RESULTS: Cross-linking efficiency was greatest with an initial MW of 360 x 103 Da and lowest with an initial MW of 10 x 103 Da. The time to reach equilibrium from the glassy state and the degree of swelling in saline decreased with increasing gamma-irradiation dose and increased with concentration of PVP and blending of low and high MW PVP. The equilibrium water content ranged from 90 to 98% (w/w). Eighty-five percent of the equilibrium dimensions could be achieved within 90 min. Gravimetric analysis and HPLC indicate that the amount of PVP that is not incorporated into the network ranges from 0.25% to 6% (w/w). This was inversely related to the gamma-irradiation dose. The MW of the leached samples was estimated to be greater than 10 x 103 Da in all cases. CONCLUSIONS: PVP hydrogel IOLs prepared by gamma-irradiation have advantages in terms of chemical stability, high water content, and ease of preparation. They may not need further purification or sterilization prior to implantation. In addition, they may allow for accommodation. No comments can be made regarding the biocompatibility, long-term stability, or optical quality at this time.

Animals↗
PubMed1996

[Clinical secondary cataract evaluation in pseudophakic eyes. Method and reproducibility].

INTRODUCTION: According to the literature, the frequency of secondary cataract reported following different studies of posterior chamber intraocular lens (IOL) implantation varies widely. The nonstandardized definition of a clinically significant secondary cataract is one of the reasons for this. We present a morphological scoring system for secondary cataract that does not require visual acuity testing. PATIENTS AND METHODS: Following dilatation of the pupil standardized photographs of the pseudophakic anterior segments were obtained by means of a Zeiss photoslit-lamp (model 40 SL/P). The posterior capsule opacification (PCO) was scored by evaluating retroillumination photographs. The individual PCO score was calculated by multiplying the density of the opacification (graded from 0 to 4) by the area involved behind the IOL optic (calculated between 0 and 1). In order to evaluate the reliability of the morphological scoring system, in experiment A six observers examined photographs of five eyes each (interindividual reliability), and in experiment B the same observers each scored the PCO of three eyes on 5 different days (intraindividual reliability). In experiment C seven different pairs of photographs taken on the same day were scored for PCO by the same observer (influence of photographic variations). RESULTS: Morphological PCO scores were reliable. With PCO scoring ranging from 0 to 4, interindividual reliability revealed standard deviations between 0.08 and 0.25. The intraindividual reliability showed standard deviations between 0.06 and 0.19 of any individual PCO score. The standard deviation was 0.12 when different photographs of the same eye were scored. CONCLUSIONS: When the entire area behind the IOL optic is evaluated a larger area of the posterior capsule is taken into account than during testing of visual acuity alone. This method revealed high reliability and only minimal investigator-dependent variations. With a standardized photographic set-up, systematic errors otherwise caused by variations in individual photographs of the same eye are insignificant. Use of this method may help in the achievement of more accurate testing for differences in secondary cataract formation with various types of IOL and different surgical techniques.

Cataract↗
PubMed1996

[Improving contrast sensitivity by cut-off filters in high adaptation luminance levels in retinitis pigmentosa].

BACKGROUND: Contrast requirements in patients suffering from retinitis pigmentosa (RP) exceed those of healthy subjects. So far, studies examining contrast sensitivity have been performed at luminance levels of several 100 cd/m2. However, to simulate as closely as possible outdoor levels of luminance, several 1000 cd/m2 are necessary. PATIENTS AND METHODS: We used the Vistech contrast sensitivity charts at a standard high luminance of 5500 cd/m2. Contrast sensitivity was evaluated in 20 healthy subjects (visual acuity 1.10 +/- 0.15) and 25 patients with RP (visual acuity 0.50 +/- 0.29) with and without commercially available cut-off spectacle filters (Zeiss F 80, Zeiss F 90 and Rodenstock L 660. RESULTS: Patients with retinitis pigmentosa showed an increase of contrast sensitivity with all three cut-off filters. This was statistically significant at a spatial frequency of 1.5 cycl/deg (P < 0.027), but not for higher frequencies of 6-18 cycl/deg (P < 0.5). The healthy volunteers did not show any increase in contrast sensitivity values with cut-off filters. CONCLUSION: Evaluating contrast sensitivity at high levels of luminance is useful to identify patients who benefit from cut-off filters. All RP patients subjectively preferred to wear cut-off filters. A statistically proven beneficial effect of cut-off glasses could be found for low spatial frequencies. An individual fitting of the various types of cut-off filters is inevitable.

Adolescent↗
PubMed1995

Analysis of 100 explanted one-piece and three-piece silicone intraocular lenses.

PURPOSE: The authors analyzed incidence and types of complications seen after implantation of silicone posterior chamber intraocular lenses (PC IOLs). These data were compared with those obtained in previous studies with standard polymethylmethacrylate IOLs. METHODS: Data from the laboratory database were collected on 100 explanted silicone IOLs submitted to the Center for Intraocular Lens Research from 1986 to 1994. RESULTS: Of the 100 IOLs, 63 were three-piece designs with polypropylene loops and 37 were one-piece plate lenses. The two most important reasons for explantation were IOL decentration (42.0%) and inflammation (27.7%). There was no significant difference for the reasons of explantations between one- and three piece IOLs (P > 0.1). Intraocular lenses that had been removed due to inflammatory reactions had a significantly longer implant duration (19.2 +/- 18.9 months) than lenses that were explanted because of decentration (9.19 +/- 12.1 months) (P = 0.018). CONCLUSIONS: The results presented here showed that there is no substantial difference between these IOLs and polymethylmethacrylate lenses in terms of reasons for explantation. The authors' data suggest that clinical outcome is not as dependent on the type of lens selected as it is on the quality of surgery. The key to good results is the use of "capsular surgery," namely techniques that ensure secure in-the-bag IOL fixation.

Cataract Extraction↗