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Biomedical subjects

H Burkhard Dick

Publications and source records attributed to H Burkhard Dick.

At least 19 recordsLinked to original sources
PubMed2006

Epidemiological evaluation of intraoperative antibiosis as a protective agent against endophthalmitis after cataract surgery.

PURPOSE: To evaluate risk factors for endophthalmitis after cataract surgery and to retest recent findings on the protective effect of intraoperative antibiosis and the promoting effect of the clear corneal as compared to sclerocorneal incision. DESIGN: Survey study. PARTICIPANTS: Five hundred thirty-eight ophthalmosurgical centers in Germany. MAIN OUTCOME MEASURE: Responder specific endophthalmitis incidence. RESULTS: A total of 310 (58%) questionnaires were computed resulting in an overall count of 404 356 cataract surgeries and 291 self-reported endophthalmitis cases (crude rate 0.072%). The risk of postoperative endophthalmitis for sclerocorneal versus clear corneal incisions was not significantly reduced (relative risk 0.97, 99% confidence interval 0.69-1.38). The hypothesis of a protective effect of intraocular antibiosis could be confirmed by a significantly decreased risk ratio of 0.69 (99% confidence interval 0.48-0.99) indicating a significant benefit from intraoperative intraocular antibiosis. A similar tendency was observed for an intraoperative periocular antibiosis with a significantly reduced risk ratio of 0.68 (99% confidence interval 0.49-0.96). These risk estimates had been adjusted for the size of the surgical center: a significantly reduced risk ratio of 0.70 (99% confidence interval 0.49-0.98) for postoperative endophthalmitis was observed for local centers. CONCLUSIONS: Whereas this 2001 appraisal of a survey in 1996 could not reproduce the benefit of sclerocorneal incision, the protective effect of intraoperative intraocular antibiotic prophylaxis could be confirmed. However, the results of this survey have to be interpreted with care, since it is not based on individual case information, but rather on aggregate questionnaire data.

Antibiotic Prophylaxis↗
PubMed2006

Changes in higher-order aberrations after implantation of a foldable iris-claw lens in myopic phakic eyes.

PURPOSE: To evaluate the change in higher-order aberrations (HOAs) after implantation of a foldable iris-claw phakic intraocular lens (pIOL) in myopic eyes. SETTING: Department of Ophthalmology, Johannes Gutenberg-University, Mainz, Germany. METHODS: This prospective nonrandomized comparative self-controlled trial included 41 eyes that had implantation of a foldable iris-claw pIOL between July 2003 and November 2004. All patient data for HOAs (Zernike coefficient) were measured and calculated using the same pupil size preoperatively and postoperatively, and the root-mean-square (RMS) wavefront error was calculated. Examinations were performed preoperatively as well as 1 week and 3, 6, and 12 months after pIOL implantation. RESULTS: The mean preoperative sphere was -8.12 diopters (D) +/- 2.01 (SD) (range -12.25 to -3.75 D) and the mean preoperative cylinder, -0.90 +/- 0.62 D (range -2.50 to 0.00 D). The Z3(1) and Z(3)(-1) coefficients decreased after implantation of the foldable iris-claw pIOL, but the decrease was not statistically significant (P = .078 and P = .45, respectively). There was a statistically significant reduction in Z4(0) in the first postoperative week (P = .038), but the decrease was not significant thereafter. There was a statistically significant reduction in total RMS wavefront error from preoperatively to all values postoperatively (P = .008). CONCLUSION: Over a 12-month follow-up, 3rd-order and 4th-order HOAs did not increase after foldable iris-claw pIOL implantation in myopic eyes.

Anterior Chamber↗
PubMed2006

Surgical management of acute angle-closure glaucoma after toric implantable contact lens implantation.

A case of pupillary block after implantation of an implantable contact lens (ICL) is reported, and surgical management and prevention are discussed. In a myopic patient, the best corrected visual acuity in the right eye was 20/50 with -15.50 -3.00 x 175. After uneventful implantation of an ICL, painful acute glaucoma developed with an intraocular pressure beyond measurable values. Apparent anterior vaulting of the ICL suggested a sizing problem. In a situation of a mid-wide dilated pupil, immediate explantation of the ICL was performed. Then, using a preoperative iris photography as guidance, an anterior chamber iris-claw toric phakic intraocular lens was implanted. On postoperative examination, the anterior chamber was deep, the angle open, the natural lens clear, and uncorrected visual acuity was 20/40.

Acute Disease↗
PubMed2006

Iris-fixated toric phakic intraocular lens: Three-year follow-up.

PURPOSE: To evaluate the 3-year safety, efficacy, predictability, and stability of iris-fixated toric phakic intraocular lens (pIOL) implantation for the correction of myopia or hyperopia with astigmatism. SETTING: Department of Ophthalmology, Johannes Gutenberg University, Mainz, and Department of Ophthalmology, University Clinic, Bochum, Germany. METHODS: A prospective clinical trial of 40 eyes of 23 patients with high ametropia and astigmatism was conducted. Best spectacle-corrected visual acuity (BSCVA), uncorrected visual acuity, refraction, astigmatism, intraocular pressure, slitlamp biomicroscopy, and indirect ophthalmoscopy were measured preoperatively and postoperatively. RESULTS: Of the 40 eyes, 28 were myopic and 12 were hyperopic. Three years postoperatively, 70% of eyes were within +/-1.00 diopter (D) of the targeted refraction. In the myopic group, mean preoperative BSCVA was 20/40 and improved postoperatively to 20/25. Sixty-six percent of eyes gained 1 or more lines from the preoperative BSCVA. The mean cylinder decreased from -3.58 D +/- 1.26 (SD) preoperatively to -1.15 +/- 1.01 D postoperatively. In the hyperopic group, preoperative BSCVA was 20/25 and improved to 20/20 postoperatively. Thirty-six percent of eyes gained 1 or more lines from the preoperative BSCVA. The mean cylinder decreased from -3.37 +/- 0.88 D to -1.53 +/- 0.69 D postoperatively. The correction was stable in all eyes 3 years after surgery. No potentially sight-threatening complications occurred. CONCLUSION: The 3-year follow-up showed the iris-fixated toric pIOL was effective in correcting high ametropia and astigmatism.

Adult↗
PubMed2006

Effect of a closed foldable equator ring on capsular bag shrinkage in cataract surgery.

PURPOSE: To evaluate the effect of a closed foldable equator ring (CFER) versus a conventional capsular tension ring (CTR) on capsular bag shrinkage. SETTING: Department of Ophthalmology, Johannes Gutenberg-University, Mainz, Germany. METHODS: In this prospective study, 70 eyes of 70 patients were randomized to 2 groups using a 1:1 block scheme. After uneventful cataract surgery, a capsular measuring ring was implanted in all eyes to measure the capsular bag diameter in vivo. In Group 1, a CTR was implanted in the capsular bag. In Group 2, a CFER was inserted. Biometric characteristics such as axial length and the horizontal and vertical corneal radii were measured preoperatively. The capsular bag diameter and capsulorhexis diameter were measured intraoperatively and 2 or 3 days as well as 1 and 3 months postoperatively. RESULTS: There were no statistically significant or clinically relevant between-group differences in covariants such as axial length, vertical and horizontal corneal radii, and capsulorhexis diameter. Eyes with the CTR had slight but statistically significant capsular bag shrinkage from a median of 10.4 to a median of 10.2 mm after 3 months (P<.001). Eyes with the CFER also had slight but statistically significant capsular bag shrinkage from a median of 10.3 to a median of 10.2 mm 3 months postoperatively (P = .021). At baseline, the CTR group had a larger capsular bag diameter, but there were no statistically significant differences between the groups at the 3-month follow-up (P = .669). CONCLUSIONS: No clinically relevant capsular bag shrinkage was observed after implantation of a CFER or a CTR. The expected capsular bag shrinkage was the same in both groups.

Aged↗
PubMed2006

Single optic accommodative intraocular lenses.

Currently, two single optic accommodative intraocular lenses are available for implantation. Both designs rely on the interaction of the ciliary muscle with the zonule and capsule to induce axial movement of the optic. This article reviews the historical development, laboratory data, and clinical findings relating to these interesting devices.

Accommodation, Ocular↗
PubMed2006

Biaxial microincision versus coaxial small-incision clear cornea cataract surgery.

OBJECTIVE: To compare clinical outcomes of biaxial microincision (1.5 mm) and coaxial small-incision (2.75 mm) clear cornea cataract surgery. DESIGN: Randomized controlled clinical trial. PARTICIPANTS: Seventy eyes of 70 patients were examined at a German university eye hospital. INTERVENTION: The 70 patients (70 eyes) were assigned randomly (1:1) to a biaxial or conventional coaxial incision group. Both groups underwent phacoemulsification using pulsed ultrasound energy with variable duty cycles, followed by microincision intraocular lens implantation. MAIN OUTCOME MEASURES: Best-corrected visual acuity (BCVA), astigmatism, laser flare photometry value, effective phacoemulsification time (EPT), and endothelial cell count were evaluated. RESULTS: The treatment groups did not differ in baseline characteristics (median BCVA of 20/40 preoperatively in both groups, P = 0.97). On postoperative day 1, BCVA was better in the biaxial group than in the coaxial group (20/25 vs. 20/33, P = 0.018). Eight weeks after surgery, median BCVAs were 20/20 in the biaxial group and 20/25 in the coaxial group (P = 0.015). Median changes in astigmatism were -0.15 diopters (D) in the biaxial group and -0.31 D in the coaxial group. Neither clinically relevant nor statistically significant differences were found in laser flare photometry values. Effective phacoemulsification time was >3 seconds in only 34% of biaxial procedures, versus 68% of coaxial procedures (P = 0.013). At 8 weeks after surgery, endothelial cell counts were decreased similarly in the biaxial (14.5%) and coaxial (14.1%) groups (P = 0.408). CONCLUSIONS: With the biaxial microincision technique, EPT is shorter and BCVA improves more rapidly, with no difference in astigmatism, laser flare photometry results, or endothelial cell count relative to the coaxial small-incision technique for phacoemulsification.

Adult↗
PubMed2006

Scheimpflug biometry of the anterior segment after implantation of foldable iris-fixated lenses.

PURPOSE: To evaluate intraocular dimensions of the anterior segment of myopic phakic eyes after implantation of foldable iris-fixated lenses. METHODS: Seventeen myopic eyes that received a foldable iris-fixated phakic intraocular lens (PIOL) were assessed. Distances between the cornea and the IOL-optic edge and between the IOL optic and the crystalline lens were evaluated using Scheimpflug photography 3 months postoperatively. RESULTS: The average postoperative distance between the central corneal endothelium and the anterior surface of the IOL was 2.01 +/- 0.26 mm. The distance between the corneal endothelium and the peripheral edge of the IOL averaged 1.32 +/- 0.18 mm at the 12 o'clock position and 1.34 +/- 0.21 mm at the 6 o'clock position. The distance between the crystalline lens and the posterior surface of the IOL averaged 0.73 +/- 0.09 mm. CONCLUSIONS: The high quality of the three-dimensional Scheimpflug images allowed measurements of intraocular distances in PIOL implanted eyes. Distances between the foldable iris-fixated IOL and crucial surrounding tissues could be determined 3 months postoperatively.

Adult↗
PubMed2005

Short-term follow-up after implantation of a foldable iris-fixated intraocular lens in phakic eyes.

OBJECTIVE: To evaluate efficiency, predictability, stability, complications, and patient satisfaction after implantation of a foldable iris-fixated phakic intraocular lens (PIOL) for the correction of myopia. DESIGN: Prospective, nonrandomized, comparative (self-controlled) trial. PARTICIPANTS: Forty-one eyes of 22 myopic patients aged 18 to 56 years (mean, 36 years) with average sphere of -8.2+/-2.01 diopters (D; range, -12.25 to -3.75 D) and average preoperative cylinder of -0.90+/-0.62 D (range, -2.50 to 0.00 D) were enrolled in this prospective study. METHODS: All eyes underwent implantation of a foldable iris-fixated PIOL with an optical zone of 6.0 mm. The follow-up was 6 months in all cases. Phakic intraocular lenses were available in powers ranging from -2.0 D to -12.0 D. MAIN OUTCOME MEASURES: The main parameters assessed were best spectacle-corrected visual acuity (BSCVA), uncorrected visual acuity, refraction, endothelial cell count, intraocular pressure, slit-lamp biomicroscopy, and indirect ophthalmoscopy. RESULTS: At 6 months' follow-up, no eyes experienced a loss in BSCVA and 78% gained 1 or more lines of their preoperative BSCVA. Uncorrected visual acuity was significantly improved, with 82% of eyes reaching 20/25 or better. There was a significant reduction in spherical errors in all patients after surgery. Ninety-one percent of eyes were within +/-0.50 D of target refraction. A slight loss of endothelial cells (2.3 %) was observed 6 months after surgery. There were no intraoperative complications. In the postoperative follow-up, however, pigment precipitates were noted in 5 eyes of 4 patients. CONCLUSIONS: At short-term follow-up, the implantation of the foldable iris-fixated PIOL proved to be effective and predictable for the correction of myopia in phakic eyes. However, longer follow-up with larger numbers of patients is necessary to evaluate long-term complications.

Adolescent↗
PubMed2005

Benefits and side effects of bandage soft contact lens application after LASIK: a prospective randomized study.

PURPOSE: To evaluate benefits and side effects of bandage soft contact lens (BSCL) insertion after LASIK in relation to patients' characteristics. DESIGN: Prospective, randomized, bicenter comparative investigational trial. PARTICIPANTS: One hundred patients (200 eyes) with myopia and/or myopic astigmatism. METHODS: Each patient underwent consecutive (Marburg, Germany) or simultaneous (Mainz, Germany) bilateral LASIK. At the end of the procedure, the first treated eye received a drop of ofloxacin and dexamethasone, patch, and transparent protective shield for 2 to 4 hours. The fellow eye received in addition a BSCL, soaked in the same eyedrops for 20 to 24 hours. MAIN OUTCOME MEASURES: Schirmer II test results, first-day uncorrected visual acuity (UCVA), and tolerance of contact lens wear (poor, moderate, good) were recorded. Patients' subjective preference for the BSCL on the first postoperative day was graded as more comfortable than fellow eye, no difference, or less comfortable. Three months after surgery, the corneal flap was photographed in retroillumination for objective evaluation of microstriae. Statistical significance was determined using the Kruskal-Wallis 1-way analysis of variance on ranks test. RESULTS: Fifty-four percent of patients felt discomfort in the eye that had the BSCL (contra-BSCL subgroup), whereas 27% enjoyed having a BSCL (pro-BSCL subgroup). The remaining 19% felt no difference. The average Schirmer II value was 16.6 mm (+/-7.7) in the pro-BSCL subgroup, 14.9 mm (+/-6.4) in the no difference subgroup, and 12.3 mm (+/-7.7) in the contra-BSCL subgroup. There was a female preponderance in the contra-BSCL (39:15) and no difference (15:6) subgroups. A preoperative history of poor contact lens tolerance was recorded in 50% of the contra-BSCL subgroup patients; 41%, no difference; and 33%, pro-BSCL. Postoperative parameters such as first-day UCVA, number of eyes with microstriae, folds requiring stretching, or cases of diffuse lamellar keratitis did not differ significantly. Eyes with flap microstriae had a significantly deeper mean ablation (114.5 microm [range, 52-146 microm]) than eyes without any flap abnormalities (75.4 microm [39-120 microm]). No significant differences were found between the consecutive and simultaneous groups. CONCLUSION: The majority of patients did not experience better postoperative comfort from the application of a BSCL. Only 27% of patients reported more comfort from postoperative BSCL use. The latter have better tear film characteristics and a history of less difficulty with contact lenses preoperatively. A BSCL does not protect from the occurrence of microstriae.

Adult↗
PubMed2005

Change in pupil size after implantation of an iris-fixated toric phakic intraocular lens.

PURPOSE: To evaluate the changes in pupil size after implantation of an iris-supported toric phakic intraocular lens (TPIOL) for correction of myopia and hyperopia with astigmatism. SETTING: Department of Ophthalmology, Johannes Gutenberg-University, Mainz, Germany. METHODS: Twenty-two myopic eyes and 9 hyperopic eyes were included in the study. The mean age of the 2 groups was 34 years and 40 years, respectively. The scotopic pupil size was measured with a handheld infrared pupillometer (Colvard, Oasis Medical) before and 6 months after implantation of the TPIOL. All examinations were performed under scotopic conditions after 2 minutes of dark adaptation with the fellow eye covered. Intraindividual comparisons were made between preoperative and postoperative pupil sizes. The relationship between implanted IOL power and postoperative pupil width in each group was studied to determine whether lens magnification could lead to misinterpretation of the results. The difference between horizontal and vertical postoperative pupil diameters was assessed in eyes with horizontally aligned IOLs to determine the potential mechanical effect of the TPIOL on pupil size. RESULTS: The mean scotopic pupil diameter decreased significantly from 4.7 mm (range 3.0 to 6.0 mm) preoperatively to 3.6 mm (range 2.0 to 5.0 mm) postoperatively in myopic eyes and from 5.0 mm (range 4.0 to 6.0 mm) to 4.0 mm (range 2.0 to 5.0 mm) in hyperopic eyes. No significant correlation between the power of the TPIOL and the postoperative pupil size diameter was found, confirming that the IOL did not distort measurements of pupil size. Comparing horizontal and vertical pupil diameters under medical mydriasis revealed reduced pupil size in the axis of enclavation. CONCLUSIONS: The scotopic pupil diameter decreased by a mean of 1.1 mm in myopic eyes and 1.0 mm in hyperopic eyes after implantation of the iris-supported TPIOL. Postoperative pupil size was not related to IOL power, patients' emotional states, or other factors. The slightly smaller pupil diameter in the axis of enclavation suggests that this fixation method restricts pupil size under scotopic conditions, which could reduce the incidence of postoperative photic phenomena.

Adult↗
PubMed2005

Closed foldable capsular rings.

A new foldable capsular tension and bending ring system with a sharp-edged design is described. The closed foldable capsular rings (CFCR) consist of 8 hydrophobic and 8 hydrophilic ring segments. The CFCRs have a 9.2 mm minimum overall diameter. The CFCRs were inserted using various cartridge systems or a two-folded technique with a forceps. The CFCRs were implanted after phacoemulsification through a small (1.6 to 3.2 mm) incision in 104 human adult eyes without intraoperative complications. No postoperative complications such as capsule folds or inward bending were observed over a 6-month follow-up. Posterior capsule opacification was minimal or absent in all eyes.

Cataract↗
PubMed2005

Brimonidine versus dapiprazole: Influence on pupil size at various illumination levels.

PURPOSE: To evaluate the influence of dapiprazole versus brimonidine on pupil size at various illumination levels. SETTING: Department of Ophthalmology, Johannes Gutenberg-University, Mainz, Germany. METHODS: In randomized prospective study, 19 healthy volunteers received 2 ophthalmic solutions, dapiprazole and brimonidine, 1 in each eye, for intraindividual comparison. Before and after application, pupil diameter was measured using an infrared binocular pupillometer at 3 illumination levels (0.03, 0.82, and 6.4 lux). RESULTS: Only slight pupil dilation was observed under scotopic conditions after application of both agents. After 20 minutes, the median reduction in pupil width was 1.4 mm for brimonidine and 0.9 mm for dapiprazole. These effects were statistically significant for both agents (both P < .001). The maximum effect was observed after 40 minutes and remained stable through the next measurement at 180 minutes. Under mesopic lighting conditions, only a slight effect (<1 mm) was seen. CONCLUSIONS: Pupil mydriasis at scotopic illumination levels was reduced by both drugs in a similar fashion. Because of the slightly stronger effect of brimonidine, application of this agent 20 minutes before activities in dimly lit areas or at night may be recommended for photic phenomena following refractive surgery.

Adrenergic alpha-Agonists↗
PubMed2005

Capsular bag shrinkage after implantation of a capsular bending or capsular tension ring.

PURPOSE: To evaluate the influence of a capsular bending ring (CBR) or tension ring (CTR) on capsular bag shrinkage. SETTING: Department of Ophthalmology, Johannes Gutenberg-University, and Department of Medical Biometry, Epidemiology and Informatics, University of Mainz, Mainz, Germany. METHODS: In 92 eyes of 92 patients, a capsular measuring ring (CMR) was implanted after phacoemulsification to measure capsular bag size in vivo. Patients were randomized into 3 groups: The first received a CMR and CBR, the second received a CMR and CTR, and the third received a CMR alone. Measurements were performed preoperatively, intraoperatively, during the first 3 postoperative days, and after 1 and 3 months. Preoperative biometric characteristics such as axial length (AL) and anterior chamber depth were determined. Primary clinical end points were capsular bag size and capsulorhexis diameter measured intraoperatively and by means of slitlamp biomicroscopy and retroillumination photography postoperatively. RESULTS: There were no clinically relevant group differences in AL, anterior chamber depth, or capsulorhexis diameter. Eyes implanted with the CBR showed shrinkage of the capsular bag from 10.6 to 10.4 mm after a median of 3 months (sign test; P = .023); eyes with a CTR showed comparable median capsular bag shrinkage from 10.5 to 10.2 mm (P<.001), whereas eyes without a CTR showed a median shrinkage from 10.5 to 10.0 mm (P<.001). Intraindividual shrinkage was of a similar, although significantly different, order among these groups (median shrinkage 0.15 versus 0.23 and 0.38 mm, respectively; all pairwise Wilcoxon test; P = .050, P = .020, P<.001, respectively). CONCLUSIONS: Capsular shrinkage can be inhibited by a CBR and, to lesser extent, a CTR; the gain in shrinkage prevention is limited when compared with a CMR, however. This conclusion can be drawn only for the specific CBR or CTR and hydrophobic acrylic intraocular lens (IOL) used in this study. Reduction of capsular bag shrinkage after CTR implantation may reduce IOL dislocation and tilt and help to maintain postoperative visual acuity.

Adult↗
PubMed2005

Accommodative intraocular lenses: current status.

PURPOSE OF REVIEW: The possibility of using a monofocal IOL with accommodative ability allows refractive cataract surgery with a clearly decreased potential of photic phenomena. Three IOLs of different designs and materials have demonstrated accommodative ability, but the degree of accommodative amplitude has been reported to different extents and variabilities. The plate-haptic CrystaLens has a hinged design that might permit forward movement of the optic as a result of pressure changes in the vitreous cavity. The 1CU has modified haptics that bend in the bag as the lens capsule contracts, which are supposed to cause anterior displacement of the lens optic. With the dual-optic one-piece Synchrony, springlike haptics separate a high-plus anterior lens from a posterior minus lens. With accommodative effort, the capsular bag expands and the springs express kinetic energy, which might allow the optics to separate as the anterior lens moves forward. RECENT FINDINGS: This article seeks to clarify and distinguish the concepts of true accommodation and pseudo accommodation. Current designs of accommodative IOLs are supposed to work by the focus-shift principle to allow true pseudophakic accommodation. Studies that biometrically assessed optic shift found no or only low amplitudes of forward movement. The amount of forward movement, if present, was highly variable between patients. To date, most studies present psychophysical data for the proof of concept, which alone seems insufficient. Capsule bag performance and posterior capsule opacification with accommodative IOLs seem worse than those with standard intraocular lenses. SUMMARY: The potential clinical benefits of accommodative IOL technology for both cataract patients and refractive patients may place accommodative IOLs in a competitive position with multifocal IOL technology.

Accommodation, Ocular↗
PubMed2004

Spring constants of capsular tension rings.

PURPOSE: To determine the spring constants of several types of capsular tension rings (CTRs). SETTING: Department of Ophthalmology, Johannes Gutenberg-University, Mainz, Germany. METHODS: Fourteen models of CTRs provided by 9 companies were tested; all were 11.0 mm in diameter. The CTRs were positioned in a special retainer of a material-testing machine and compressed at a constant speed of 10.0 mm per minute. The distance and force values were recorded, and each CTR model was tested 3 times using a new specimen each time. The resulting measurements were used to calculate a mean spring constant for each CTR model. RESULTS: All tested CTRs showed linear proportionality between force and compression distance. Test results were repeatable and precise. Capsular tension rings of the same model had comparable mechanical properties, and different models had different mean spring constants ranging from 0.8162 to 4.5501 mN/mm. CONCLUSIONS: The spring constant of a CTR is a suitable mechanical characteristic to facilitate the choice of CTR model. A CTR with a low spring constant may be advantageous for the management of zonular dialysis, whereas a CTR with a higher spring constant may reduce capsular bag shrinkage more effectively.

Biocompatible Materials↗
PubMed2004

Impact of the line of sight on toric phakic intraocular lenses for hyperopia.

We present a hyperopic patient with a decentered line of sight in whom the residual refractive error after toric phakic intraocular lens (TP IOL) implantation was improved by displacement and individualized treatment. A 35-year-old woman presented with asthenopic complaints 2 months after bilateral TP IOL implantation and IOL rotation 4 weeks later. Examination revealed the line of sight to be nasally and inferiorly decentered in relation to the center of the pupil. A more nasal reenclavation of the TP IOL decreased the coma, and the uncorrected visual acuity was 20/20. We conclude that line of sight should be measured before TP IOL implantation, especially in hyperopic eyes.

Adult↗