Biomedical subjects

Irene Dejaco-Ruhswurm

Publications and source records attributed to Irene Dejaco-Ruhswurm.

8 recordsLinked to original sources

PubMed2005

Contrast sensitivity function in eyes with diffractive bifocal intraocular lenses.

PURPOSE: To evaluate the image quality of asymmetric Acri. Twin bifocal intraocular lenses (IOLs) (Acri.Tec) by comparing distance and near black-white contrast sensitivity function with that of the Pharmacia 811E IOL. SETTING: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. METHODS: Thirty-two eyes of 16 patients were examined after contralateral implantation of 1 Acri. Twin near-weighted 733D IOL and 1 Acri. Twin distance-weighted 737D IOL. Twenty eyes in 10 patients were examined after binocular Pharmacia 811E IOL implantation. Best corrected distance and near visual acuities were determined. Individual reading distance was recorded and corrected to 40 cm for the near contrast test (Holladay Contrast Acuity Test). Distance contrast sensitivity function was evaluated using the Acuity Max (Science 2020) computer program. RESULTS: Best corrected distance visual acuity was significantly better in patients with the 737D IOL than in those with the 733D or 811E IOLs. For distance reading with best distance correction, the 733D IOL performed better than the 737D and the 811E. Individual reading distance with the Acri. Twin IOL and 811E IOL was 33.6 cm and 34.0 cm, respectively. Best distance-corrected near contrast sensitivity function was better in eyes with the near-weighted 733D IOL. Binocular testing showed a significant difference between the 2 groups only at low-contrast values. At distance, contrast sensitivity function was better with the 737D IOL, whereas no difference was found between the 733D and the 811E IOLs. Binocular contrast sensitivity function at distance revealed statistically significantly better results in the Acri. Twin group. CONCLUSION: An asymmetric diffractive bifocal lens system was advantageous in terms of vision quality when implanted binocularly and superior to monocular stronger weighted focus compared with conventional bifocal IOLs.

Adult↗

PubMed2004

Long-term results of implantation of phakic posterior chamber intraocular lenses.

PURPOSE: To study the incidence and progression of lens opacification after implantation of phakic posterior chamber intraocular lenses for myopia and its correlation with vaulting and endothelial cell density (ECD). SETTING: Department of Ophthalmology, University of Vienna Medical School, Vienna, Austria. METHODS: An implantable contact lens (ICL V4, Staar Surgical Inc.) was inserted in 76 myopic eyes. Patients were prospectively followed preoperatively and at 1, 3, 6, 12, 24, and 36 months. The uncorrected visual acuity and best corrected visual acuity (BCVA) were determined. Vaulting was measured optically with a Jaeger II pachymeter, and the crystalline lens was examined at the slitlamp for the presence and characteristics of opacification. Endothelial cell morphometry was performed by specular microscopy, and the ECD was calculated. Eyes in which lens opacification developed were followed for at least 12 months to determine the degree and course of visual impairment. RESULTS: Lens opacification occurred in 11 eyes (14.5%). Opacification was correlated with intraoperative trauma to the crystalline lens, age older than 50 years, and decreased ECD values throughout the observation period. Vaulting of the ICL did not correlate with the risk for lens opacification. After onset of lens opacification, 6 eyes (55%) had a stable BCVA within +/-0.5 lines and 5 eyes had progressive opacification, losing between 3.5 lines and 0.5 lines (mean 1.8 lines +/- 1.1 [SD]). Three eyes (3.9%) in the progressive group had a 1- to 2-line loss of BCVA over preoperative values and subsequently had cataract surgery. CONCLUSIONS: Risk factors for lens opacification after implantation of the model V4 ICL included intraoperative trauma to the crystalline lens and older age. Decreased ECD in eyes with opacification suggests ongoing inflammation as a cause. Patients younger than 45 years may have a significantly lower incidence of opacification.

Adult↗

PubMed2004

Effect of accommodation and pupil size on the movement of a posterior chamber lens in the phakic eye.

PURPOSE: Although a posterior chamber phakic intraocular lens provides effective refractive correction of high myopia and hyperopia, mechanical contact between the implantable contact lens (ICL) and the crystalline lens and inadequate aqueous circulation in the prelenticular space could cause subcapsular opacification. To assess whether and to what extent such mechanical contact occurs, changes in the distance between the STAAR Collamer ICL and the crystalline lens under various conditions were investigated. DESIGN: Open pilot study. PARTICIPANTS: Thirteen eyes of 11 myopic and 2 hyperopic patients with a mean age of 38 years (range, 19-53 years) were examined at least 6 months after ICL implantation. METHODS: A noninvasive, high-resolution biometry technique, partial coherence interferometry, was used to measure distance changes between the ICL and the crystalline lens during subjective accommodation, after instillation of pilocarpine, and under changing light conditions. MAIN OUTCOME MEASURES: Mean distance changes from the posterior corneal surface to the ICL, from the posterior corneal surface to the anterior surface of the crystalline lens, and the distance between the ICL and the crystalline lens. RESULTS: In the nonaccommodated state, the mean distance between the ICL and the crystalline lens was 457 microm (range, 123-924 microm). During subjective accommodation, a significant (P<0.01) decrease and, after topical application of pilocarpine, a nonsignificant (P=0.35) decrease of anterior chamber depth was accompanied by a nonsignificant (P = 0.71) reduction of the ICL-crystalline lens distance. Under photopic conditions, a significant mean reduction (P<0.01) of the ICL-crystalline lens distance of -28 microm (range, -16 to -188 microm) was observed. CONCLUSIONS: Partial coherence interferometry biometry enabled noninvasive high-precision investigation of ICL dynamics. No significant changes between the ICL and the crystalline lens were detected during subjective accommodation and after application of pilocarpine. However, under photopic conditions, with constriction of the pupil, the distance between the ICL and the crystalline lens was significantly reduced. This mechanism might cause inadequate aqueous circulation in the prelenticular space and might be one of the causes of subcapsular opacification in some of the eyes after ICL implantation.

Accommodation, Ocular↗

PubMed2003

Outcome after treatment of ametropia with implantable contact lenses.

OBJECTIVE: To evaluate long-term results after insertion of implantable contact lenses (ICLs) in phakic eyes. DESIGN: Prospective, noncomparative, interventional case series. PARTICIPANTS: Seventy-five phakic eyes (65 myopic, 10 hyperopic eyes) of 45 patients aged 21.7 to 60.6 years were included. INTERVENTION: STAAR Collamer Implantable Contact Lenses (STAAR Surgical Inc., Nidau, Switzerland) were implanted for correction of high myopia and hyperopia. MAIN OUTCOME MEASURES: Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), and intraocular pressure (IOP) were determined. Presence of lens opacification and the distance between the ICL and the crystalline lens were assessed by slit-lamp examination before surgery and at 1, 3, 6 months, and yearly after lens implantation. RESULTS: Preoperative mean spherical equivalent was -16.23+/-5.29 diopters (D) for myopic eyes and +7.88 +/-1.46 D for hyperopic eyes. After ICL implantation, mean residual refractive error was -1.77+/-2.17 D in myopic patients and +0.44+/-0.69 D in hyperopic patients. Preoperative mean UCVA was Snellen 0.03+/-0.03 for myopic patients and Snellen 0.12+/-0.16 for hyperopic patients. Preoperative mean BCVA was Snellen 0.49+/-0.23 for myopic patients and Snellen 0.82+/-0.23 for hyperopic patients. After ICL implantation, mean UCVA up to the end of individual observation time was Snellen 0.36+/-0.36 for myopic patients and Snellen 0.58+/-0.28 for hyperopic patients. Mean BCVA was Snellen 0.73+/-0.26 for myopic and Snellen 0.80+/-0.24 for hyperopic patients. Mean preoperative IOP was 14.2+/-2.7 mmHg, and mean postoperative IOP was 13.46+/-2.1 mmHg over all follow-up investigations. The main complication was the development of subcapsular anterior opacifications of the crystalline lens in 25 eyes (33.3%), 2 of which showed direct contact to the ICL. Eleven eyes (14.7%) were stable in opacification and 14 eyes (18.7%) had progressive opacifications. The median time to opacification was 27.1 months. In 8 patients (10.7%), the subjective visual impairment mandated cataract surgery. CONCLUSIONS: The most significant long-term complication after ICL implantation is the formation of opacifications of the crystalline lens with the risk of the necessity of subsequent cataract surgery (10.7%). Old age, female gender, and contralateral opacification are independent significant risk factors for early formation of opacifications in this patient group.

Adult↗

PubMed2002

Changes of axial length and keratometry after keratoplasty for keratoconus using the guided trephine system.

PURPOSE: The purpose of this study was to examine the cause of increasing myopia after penetrating keratoplasty for keratoconus with the guided trephine system. DESIGN: Prospective interventional study cohort. METHODS: Thirty eyes (28 patients) after keratoplasty for keratoconus were examined. Preoperatively and 1, 3, 6, 12, and 24 months postoperatively subjective refraction was evaluated. Keratometry was calculated with a computerized videokeratoscope (TMS-1). Axial length was measured using applanation ultrasonography before surgery and 2 years after surgery. Anterior chamber depth, lens thickness, and vitreous length were taken into consideration. RESULTS: The mean spherical equivalent was + 2.22 +/- 3.47 diopters 1 month postoperatively and had a continuous myopic shift to -1.02 +/- 2.65 diopters 2 years postoperatively. This was associated with a significant increase in mean keratometric levels from + 41.72 +/- 2.96 diopters 1 month postoperatively to + 43.77 +/- 2.29 diopters 2 years postoperatively (r(s) = -0.36, P =.05). Overall, no significant changes in axial length were observed. However, vitreous length showed a small but statistically significant increase. As expected, mean anterior chamber depth decreased significantly postoperatively (P </=.05). In eyes with a decrease in keratometric values (n = 8) a myopic shift was also observed. In this group a significant elongation of the axial length and the vitreous length was found. CONCLUSIONS: A study of eyes after keratoplasty for keratoconus demonstrated continuous myopic shift over time. Increasing myopia was associated with increasing keratometric values. Thus, the major cause of increasing myopia after keratoplasty in keratoconus eyes seems to be continuing keratectasia. However, ongoing bulbus growth may contribute to continuing myopia in some eyes.

Adult↗

PubMed2002

Plate-haptic silicone intraocular lens implantation: long-term results.

PURPOSE: To present the 10- to 12-year functional and morphological results of in-the-bag implantation of a foldable, plate-haptic, silicone posterior chamber intraocular lens (IOL). SETTING: Department of Ophthalmology, University of Vienna Medical School, Vienna, Austria. METHODS: Between September 1987 and December 1989, 160 silicone posterior chamber IOLs (Staar AA-4203C) were implanted in the capsular bag through a 3.5 mm corneoscleral incision after a continuous curvilinear capsulorhexis was created. In spring 1999, 36 patients (38 eyes) could be included in a follow-up examination. RESULTS: The median follow-up was 10.5 years +/- 2 (SD). The mean visual acuity was 0.82 +/- 0.34. The mean refraction (spherical equivalent) was +0.57 diopter (D), an insignificant change from the mean at the first postoperative follow-up at 1 month (+0.40 D). Slitlamp examination showed mildly dispersed pigment on the IOL surface in 81.58% of cases. All IOLs had a Tyndall effect (clouding). In 84.21%, the effect was minimal, in 10.53% it was moderate, and in 5.26% it was more intense. Ninety-two percent of the IOLs were centered within 0.5 mm. Of the 22 cases of decentration (57.89%), 86.36% were toward the 12 o'clock position in the bag. The neodymium:YAG capsulotomy rate was 10.52%. There were no cases of IOL-related inflammation or a clinically significant cystoid macular edema. CONCLUSION: The 10- to 12-year results suggest favorable clinical results of implantation of Staar AA-4203C plate-haptic, silicone posterior chamber IOLs.

Aged↗

PubMed2002

Long-term endothelial changes in phakic eyes with posterior chamber intraocular lenses.

PURPOSE: To evaluate the long-term endothelial cell changes in phakic eyes after implantation of a posterior chamber phakic intraocular lens to correct high ametropia. SETTING: Department of Ophthalmology, University Hospital of Vienna, Vienna, Austria. METHODS: Thirty-four eyes of 21 patients having implantation of an implantable contact lens (ICL, Staar Surgical) for high myopia or hyperopia were prospectively examined. The minimum follow-up was 2 to 4 years. Preoperative and serial postoperative specular microscopy (Noncon Robo SP 8000, Konan) was performed to evaluate the long-term endothelial cell changes. RESULTS: The mean preoperative endothelial cell density was 2854 cells/mm(2). The mean endothelial cell loss from preoperatively was 1.8% at 3 months, 4.2% at 6 months, 5.5% at 12 months, 7.9% at 2 years (n = 34), 12.9% at 3 years (n = 13), and 12.3% at 4 years (n = 11). All other endothelial cell characteristics remained stable during the 4-year follow-up. CONCLUSIONS: Continuous endothelial cell loss was observed after ICL implantation during a 4-year follow-up. There was rapid cell loss until 1 year postoperatively, after which the rate of loss was no longer statistically significant. The percentage of hexagonal cells (polymorphism) and the coefficient of variation (polymegethism) remained stable during the 4-year follow-up.

Adult↗

PubMedDate not supplied

Seven years of HAART impact on ophthalmic management of HIV-infected patients.

PURPOSE: The widespread use of highly active antiretroviral therapy (HAART) has changed the clinical picture of HIV-associated eye disease. We evaluated the incidence of ocular manifestations of HIV infection since the introduction of HAART. METHODS: Between January 1996 and December 2002, we examined 539 HIV-infected patients in our hospital. Follow-up of the patients was performed in case of ophthalmologic symptoms, regardless of current immunologic status, or for screening. RESULTS: A total of 217 patients (40.3%) had HIV-associated eye disease. Of these patients, 42.0% had no eye symptoms. Fifty-eight (10.8%) of the 539 patients had cytomegalovirus (CMV) retinitis, most of whom had CMV retinitis before receiving HAART. Four patients developed immune-recovery uveitis. A total of 145 patients (26.9%) had HIV-related microangiopathy and 96 (17.8%) had dry-eye syndrome. CONCLUSION: The introduction of HAART had a major impact on the medical history of patients with HIV-related eye disease with improved survival time and decreased morbidity.

AIDS-Related Opportunistic Infections↗