Biomedical subjects

Michael Georgopoulos

Publications and source records attributed to Michael Georgopoulos.

At least 19 recordsLinked to original sources

PubMed2006

Effect of the hydrophilicity of acrylic intraocular lens material and haptic angulation on anterior capsule opacification.

AIM: To evaluate the influence of hydrophilic and hydrophobic acrylic material and haptic angulation on anterior capsule opacification (ACO). METHODS: Prospective study on 53 patients with bilateral age-related cataract. Patients underwent standard cataract surgery by the same surgeon and randomly received a hydrophilic acrylic intraocular lens (IOL) in one eye and a hydrophobic acrylic IOL in the other eye. Forty five of these patients completed the one-year follow-up. The following parameters were assessed: decentration, buttonholing, anterolenticular gap (ALG), ACO, outgrowth and refractive outcome. RESULTS: At the one-year follow-up, ACO was seen in 80% of the hydrophilic and 100% of the hydrophobic IOLs. ACO was more intense in the hydrophobic IOLs (p<0.001). Outgrowth was seen in 42% of the hydrophilic and 2% of the hydrophobic IOLs (p = 0.0003). No case of persisting ALG was seen in the hydrophobic IOLs, but in 42% of the hydrophilic IOLs. The refractive outcome was -0.29 (SD 0.56) dioptres for the hydrophilic and 0.003 (SD 0.44) dioptres for the hydrophobic IOLs (p<0.001). CONCLUSION: These results suggest that there is less ACO in hydrophilic acrylic than in hydrophobic acrylic IOLs. Although material properties might play a role, the angulated haptics of the hydrophilic IOLs exert an additional effect by the persisting ALG and a lack of contact between the IOL and the anterior capsule.

Acrylates↗

PubMed2006

Daily changes in the morphology of Elschnig pearls.

PURPOSE: To observe and document the daily changes in the morphology of Elschnig pearls. DESIGN: A prospective cohort study. METHODS: Twenty-nine pseudophakic eyes with pronounced, regeneratory posterior capsule opacification (PCO) were included in this prospective study. Retroillumination images were taken at days 0, 1, 2, and 14. A square grid was laid over the images. Increase, decrease, appearance, and disappearance of pearls between the follow-up images were quantified. RESULTS: A total of 1371 areas (mean: 53/eye) of 26 eyes were analyzed between days 0 and 1 and 1 and 2, and 896 areas (50/eye) of 18 eyes between days 0 and 14. Between days 0 and 1, days 1 and 2, and days 0 and 14, we observed "no change" in pearl size in 72%, 77%, and 32%, a "minor increase" in 16%, 14%, and 10%, a "major increase" in 4%, 3%, and 42%, a "minor decrease" in 14%, 11%, and 11%, and a "major decrease" in 4%, 3%, and 37%, respectively. Appearance of newly formed pearls was found in 1%, 1%, and 9% and disappearance of pearls in 1%, 1%, and 5%, respectively. CONCLUSIONS: Significant changes in the morphology of Elschnig pearls were observed within time intervals of only 24 hours. Appearance and disappearance of pearls, as well as progression and regression of pearls within these short intervals illustrate the dynamic behavior of regeneratory PCO. These findings may contribute to a better understanding of PCO and have implications on pharmaceutical interventions for PCO.

Adult↗

PubMed2006

Influence of infusion volume on the ocular hemodynamic effects of peribulbar anesthesia.

PURPOSE: To test the hypothesis that ocular blood-flow response to peribulbar anesthesia can be reduced by using a smaller volume of anesthetic mixture. SETTING: Departments of Ophthalmology and Clinical Pharmacology, Medical University of Vienna, Vienna, Austria. METHODS: Twenty patients scheduled for bilateral age-related cataract surgery were enrolled in a prospective randomized balanced observer-masked crossover study. Two study days with a 2 mL injection volume or 5 mL injection volume used for peribulbar anesthesia were scheduled. On 1 study day, patients received the 1-dose regimen and on the other study day, when the contralateral eye had surgery, patients received the other injection volume. On both study days, the anesthetic mixture consisted of an equal amount of lidocaine, bupivacaine, and hyaluronidase independently of the injection volume. Intraocular pressure (IOP), blood pressure, and pulse rate were measured noninvasively. Ocular fundus pulsation amplitude (FPA) and peak systolic and end diastolic flow velocities in the central retinal artery were measured with laser interferometry and color Doppler imaging, respectively. The results were recorded as means +/- SD. RESULTS: Peribulbar anesthesia increased IOP and reduced FPA and flow velocities in the central retinal artery. The effects on IOP (5 mL, 35.1% +/- 16.0%; 2 mL, 14.1% +/- 14.1%; P<.001) and ocular hemodynamic parameters (FPA: 5 mL, -17.5% +/- 7.8%/2 mL, -7.3% +/- 7.2%, P<.001; peak systolic velocity: 5 mL, -19.5% +/- 10.7%/2 mL, -10.6% +/- 9.8%, P = .013; end diastolic velocity: 5 mL, -16.7% +/- 6.2%/2 mL, -8.4% +/- 7.3%, P = .005) were more pronounced with the 5 mL injection volume than with the 2 mL injection volume. CONCLUSIONS: An injection volume of 2 mL instead of 5 mL reduced the ocular blood-flow response to peribulbar anesthesia. This procedure may be used in patients with ocular vascular disease to reduce the incidence of anesthesia-induced ischemia and loss of vision.

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PubMed2005

Long-term effect of sharp optic edges of a polymethyl methacrylate intraocular lens on posterior capsule opacification: a randomized trial.

PURPOSE: To compare the posterior capsule opacification (PCO) inhibiting effect of a 3-piece polymethyl methacrylate (PMMA) intraocular lens (IOL) with a sharp optic edge design with that of the round-edged version of the same IOL during a 5-year period. DESIGN: Randomized patient- and examiner-masked clinical trial with intraindividual comparison. PARTICIPANTS: Thirty-two patients with bilateral age-related cataract (64 eyes). METHODS: Each study patient had phacoemulsification cataract surgery in both eyes and received a sharp optic edge PMMA IOL in one eye and a round optic edge PMMA IOL in the fellow eye (both by Dr Schmidt in Germany). Follow-up examinations were at 1 week, 1 month, 1 year, 3 years, and 5 years. Digital retroillumination images were taken from each eye. The amount of posterior capsule opacification was assessed objectively by means of automated image analysis software (Automated Quantification of After-Cataract) at 1 year, 3 years, and 5 years after surgery. MAIN OUTCOME MEASURE: Posterior capsule opacification score: 0-10. RESULTS: The sharp optic edge IOL showed significantly less regeneratory and fibrotic PCO at 1 year, 3 years, and 5 years after surgery. The mean AQUA PCO score was 5.12 for the round-edge and 2.49 for the sharp-edge IOL (scale, 0-10; P<0.001) at 5 years. The mean difference among patients for the PCO score in the eye implanted with the sharp optic edge versus the score in the eye with the round optic edge was 2.83 at 5 years (95% confidence interval, 1.66-4.00). Due to the large number of neodymium:yttrium-aluminum-garnet laser capsulotomies that were performed (12 in the round-edge group and 4 in the sharp-edge group), there was no significant difference in visual acuity between both groups at any time point. CONCLUSIONS: Compared with the round-edge version, the sharp optic edge design of a 3-piece PMMA IOL led to significantly less PCO at 1 year, 3 years, and 5 years after surgery. However, the sharp optic edge did not lead to complete PCO prevention during this follow-up period. This finding has implications for the design of PMMA IOLs used for cataract surgery, especially in the developing world.

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PubMed2005

Long-term efficacy of adding a sharp posterior optic edge to a three-piece silicone intraocular lens on capsule opacification: five-year results of a randomized study.

PURPOSE: To compare the intensity of capsule opacification with the sharp and the round optic edge variant of an open-loop hydrophobic silicone intraocular lens (IOL). DESIGN: Randomized, controlled, double-blind clinical trial with intraindividual comparison. METHODS: Fifty-one patients with bilateral age-related cataract were included (102 eyes). Each patient had had cataract surgery in both eyes and received a Microsil IOL with a sharp optic edge design (model S) in one eye and a Microsil IOL with a round optic edge design (model R) in the fellow eye. Both IOLs had an identical haptic design (nonangulated polymethylmethacrylate) and silicone optic material. The patients were examined at the slit lamp, best-corrected visual acuity was assessed, and standardized high-resolution digital retroillumination images of the posterior capsule were taken 5 years after surgery. The intensity of regeneratory posterior capsule opacification (rPCO), fibrotic PCO (fPCO), and anterior capsule opacification (ACO) was assessed subjectively at the slit lamp, and of rPCO, objectively using automated image analysis software (AQUA). The need for an Nd:YAG laser capsulotomy (Nd:YAG-LCT) was noted. RESULTS: The mean AQUA PCO score was 1.2 for the model S and 2.4 for the model R lens (P = .001). The model S lens also led to less peripheral fPCO (P = .003). Concerning ACO, there was no significant difference between both IOL groups (P = .72). Whereas no capsulotomy was required with the model S, four cases (16%) had been performed in the model R group. CONCLUSION: Five years postoperatively, the sharp-edged silicone IOL showed less rPCO and fPCO than the round-edged IOL. However, regarding ACO, there was no significant difference between both IOL styles.

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PubMed2005

Short-term changes in the morphology of posterior capsule opacification.

PURPOSE: To observe and document posterior capsule opacification (PCO) growth in vivo over a short period of time (4 weeks). SETTING: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. METHODS: Fifteen eyes of pseudophakic patients with PCO of varying degrees were included in this prospective study. Digital retroillumination images were taken in a standardized fashion at 3 time points: 1 baseline image, a second image after 2 weeks, and a third image after 4 weeks. Thus, a 3-image series could be created for each eye. Additionally, sections of the posterior capsule with interesting structures were photographed with higher magnification and compared in supplementary image series. Morphologic changes in the PCO structure (eg, number and size of Elschnig pearls, total PCO area) were analyzed in the image series. RESULTS: In all cases, significant changes could be observed between the 3 time points. In 71% of cases, some Elschnig pearls increased in size during the first 2 weeks and during weeks 3 and 4. In 73% of cases, however, there was a reduction a pearl size or even disappearance of some Elschnig pearls. The total PCO area did not change significantly during the 4-week period. CONCLUSIONS: Development of (regeneratory) PCO is a very dynamic process that includes not only growth of preexisting structures and occurrence of new Elschnig pearls, but also reorganization and even disappearance of pearls within a short time period (2-4 weeks). The latter in particular is not well known but could be observed in the majority of cases in this study.

Cataract↗

PubMed2005

Long-term changes in the morphology of posterior capsule opacification.

PURPOSE: To classify the morphologic appearance of posterior capsule opacification (PCO) and to observe and document the changes over longer periods of time. SETTING: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. METHODS: Eighty-one pseudophakic eyes of 53 patients with PCO of varying degrees were included in this prospective study. Digital retroillumination images of the posterior capsule were taken in a standardized fashion 1, 2, and 3 years after cataract surgery. The PCO morphology was classified, and changes among the 3 follow-up images were analyzed. RESULTS: At 1, 2, and 3 years, pearls occurred in 16 (20%), 41 (51%), and 57 (63%) eyes. Pearls increased in size and number. Cases with thin layers of PCO decreased from 53 to 33 to 16 eyes. Conversely, cases with thick layers increased from 18 to 45 and 64 eyes. "Cheese holes" appeared most frequently as the predominant structure (range 47% to 51%), followed by plates (range 28% to 31%), islands (range 15% to 20%), and traces of PCO (range 1% to 5%). Changes in expansion of the PCO area were observed in 61 eyes (75%) during period 1 (1 to 2 years) and period 2 (2 to 3 years). Regions of expansion and regression in the same eye occurred in periods 1 and 2 in 11 eyes (14%) and 9 eyes (11%), respectively. The phenomenon of thinning bridges, a regression of syncytial extensions of PCO, occurred in 22 eyes (27%) and 32 eyes (40%), respectively. An overlapping growth of 2 layers was observed in 18 eyes (22%). CONCLUSIONS: The morphology of PCO is multifaceted. Apart from the Elschnig pearls, categories such as cheese holes, plates, islands, and traces of PCO were distinguished. Over the years, pearls increased in frequency, size, and number. Expansion and regression occurred simultaneously in some cases. Two or more layers grew on top of each other in some eyes.

Cataract↗

PubMed2004

Influence of optic edge design and anterior capsule polishing on posterior capsule fibrosis.

PURPOSE: To evaluate the role of posterior optic edge design and the effect of anterior capsule polishing on peripheral fibrotic posterior capsule opacification (PCO). SETTING: Department of Ophthalmology, University of Vienna, Vienna, Austria. METHODS: This randomized prospective study comprised 144 eyes of 72 patients with bilateral age-related cataract. Each patient had standardized cataract surgery in both eyes by the same surgeon. Group 1 (46 patients) received a round-edged hydrophobic acrylic IOL (AMO Sensar AR40) in 1 eye and a sharp-edged hydrophobic acrylic IOL (AMO Sensar OptiEdge AR40e) in the other eye. Group 2 (26 patients) received a silicone IOL (Pharmacia CeeOn 911A) with a truncated optic in both eyes. In this group, the anterior capsule was extensively polished in 1 eye and was left unpolished in the other eye. Digital slitlamp photographs were taken 1 year postoperatively using a standardized photographic technique for fibrotic PCO. The intensity of PCO was subjectively graded (score 0 to 4) by 2 masked examiners. RESULTS: Subjective PCO scores correlated well between the 2 examiners (r = 0.88). In Group 1, the mean PCO score was 0.26 for the OptiEdge AR40e IOL and 0.90 for the AR40 IOL (P<.01). In Group 2, the mean PCO score was 0.24 in eyes with a polished capsule and 0.17 in eyes in which the capsule was not polished (P =.31). CONCLUSIONS: The sharp-edged OptiEdge AR40e IOL led to significantly less peripheral fibrotic PCO 1 year postoperatively than the round-edged AR40 IOL. In eyes with the sharp-edged silicone 911A IOL, anterior capsule polishing caused no significant difference in fibrotic PCO.

Acrylic Resins↗

PubMed2004

Effect of a silicone intraocular lens with a sharp posterior optic edge on posterior capsule opacification.

PURPOSE: To compare the inhibiting effect on posterior capsule opacification (PCO) of a silicone intraocular lens (IOL) with a sharp posterior optic edge (ClariFlex OptiEdge, Advanced Medical Optics) and a silicone IOL with a round optic edge (PhacoFlex SI-40, Advanced Medical Optics). SETTING: Department of Ophthalmology, University of Vienna, Vienna, Austria. METHODS: This prospective randomized patient- and examiner-masked study comprised 104 eyes of 52 patients with bilateral age-related cataract. All patients had cataract surgery in both eyes and received a sharp-edged IOL in 1 eye and a round-edged IOL in the other eye. Postoperative examinations were at 1 week, 1 and 6 months, and 1 year. Digital slitlamp and retroillumination images were taken of each eye. The amount of PCO was assessed subjectively at the slitlamp and objectively using Automated Quantification of After-Cataract (AQUA) automated-image analysis software. RESULTS: The sharp-edged IOL group had significantly less regeneratory and fibrotic PCO 1 month, 6 months, and 1 year after surgery. The mean AQUA PCO score (scale 0 to 10) was 0.71 in the sharp-edged IOL group and 1.40 in the round-edged IOL group (P<.001). The sharp-edged IOL group had less peripheral fibrotic PCO. There was no significant difference between the 2 IOL groups in patient reports of edge glare. CONCLUSION: The sharp-edged design of the ClariFlex OptiEdge silicone IOL led to significantly less PCO than the round-edged PhacoFlex SI-40 IOL 1 year postoperatively.

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PubMed2004

Central corneal thickness measurements with partial coherence interferometry, ultrasound, and the Orbscan system.

OBJECTIVE: To compare the reliability of central corneal thickness measurements (CCT) obtained with partial coherence interferometry (PCI), ultrasound pachymetry, and the Orbscan system. DESIGN: Cross-sectional study. PARTICIPANTS: Twenty healthy subjects with CCT measurements in both eyes. METHODS: The CCT measurements were obtained with PCI, ultrasound pachymetry, and the Orbscan system. In each eye, 2 investigators performed 5 repeated measurements with each pachymetric device. Intraclass correlation coefficients (kappa) were calculated and mean CCT measurements were compared. MAIN OUTCOME MEASURES: The CCT measurements obtained with ultrasound pachymetry, the Orbscan system (Orbtek Inc., Salt Lake City, UT), and PCI. RESULTS: Mean CCT values measured with ultrasound pachymetry were significantly thicker than those measured with PCI (21.5 microm; P<0.001) or the Orbscan system (19.8 microm; P<0.001). The correlation coefficients for the intraobserver variability were 0.999 for PCI measurements, 0.983 for ultrasound pachymetry measurements, and 0.988 for Orbscan system measurements. The correlation coefficients for the interobserver variability were 0.998 for PCI measurements, 0.980 for ultrasound pachymetry measurements, and 0.988 for Orbscan system measurements. There was a slightly better consistency between ultrasound pachymetry and PCI (kappa = 0.96) than between the Orbscan system and PCI (kappa = 0.92) and between ultrasound pachymetry and the Orbscan system (kappa = 0.89). CONCLUSIONS: Partial coherence interferometry was the method with the least intraobserver or interobserver variability. Mean CCT as measured with ultrasound pachymetry was approximately 20 microm thicker than with the Orbscan system and PCI. However, corneal thickness measurements with ultrasound pachymetry and PCI were slightly more consistent than those of the Orbscan system and PCI. This slightly better consistency, however, may be important, especially in corneal refractive surgery.

Adult↗

PubMed2004

Ocular blood flow and systemic blood pressure in patients with primary open-angle glaucoma and ocular hypertension.

PURPOSE: There is evidence that altered optic nerve head (ONH) blood flow may play a role in the development and progression of glaucoma. In the present study, the baseline characteristics were examined in a study population participating in a clinical trial in which the ocular hemodynamic effects of timolol and dorzolamide were compared. METHODS: One hundred forty patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT) were included in this trial and their baseline parameters compared with those of a group of 102 age-matched control subjects. Scanning laser Doppler flowmetry was used to measure blood flow in the temporal neuroretinal rim and the cup of the ONH. Pulsatile choroidal blood flow was assessed by laser interferometric measurement of fundus pulsation amplitude. In addition, hemodynamic parameters and mean arterial pressure were calculated in both groups. RESULTS: All ocular hemodynamic parameters were significantly lower in the POAG/OHT group compared with the healthy control group (P < 0.001 each). In addition, a significant positive correlation between laser Doppler flowmetry readings and mean arterial pressure was observed in patients with glaucoma but not in healthy control subjects. Likewise, the correlation coefficient between fundus pulsation amplitude and mean arterial pressure was higher in patients with glaucoma than in healthy control subjects. CONCLUSIONS: The present study indicates reduced ONH and choroidal blood flow and an abnormal association between blood pressure and ocular perfusion in patients with primary open-angle glaucoma or ocular hypertension, independent of topical antiglaucoma medication. Hence, vascular dysregulation appears to be an early manifestation in glaucoma that is not caused by pharmacologic intervention.

Antihypertensive Agents↗

PubMed2003

LINAC based stereotactic radiotherapy of uveal melanoma: 4 years clinical experience.

PURPOSE: To study local tumor control and radiogenic side effects after fractionated LINAC based stereotactic radiotherapy for selected uveal melanoma. PATIENTS AND METHODS: Between June 1997 and March 2001, 90 patients suffering from uveal melanoma were treated at a LINAC with 6 MV. The head was immobilized with a modified stereotactic frame system (BrainLAB). For stabilization of the eye position a light source was integrated into the mask system in front of the healthy or the diseased eye. A mini-video camera was used for on-line eye movement control. Tumors included in the study were either located unfavorably with respect to macula and optical disc (<3 mm distance) or presented with a thickness >7 mm. Median tumor volume was 305+/-234 mm3 (range 70-1430 mm3), and mean tumor height was 5.4+/-2.3 mm (range 2.7-15.9 mm). Total doses of 70 (single dose 14 Gy @ 80% isodose) or 60 Gy (single dose 12 Gy @ 80% isodose) were applied in five fractions within 10 days. The first fractionation results in total dose (TD) (2 Gy) of 175 Gy for tumor and 238 Gy for normal tissue, corresponding values for the second fractionation schedule are 135 and 180 Gy, respectively. RESULTS: After a median follow-up of 20 months (range 1-48 months) local control was achieved in 98% (n=88). The mean relative tumor reductions were 24, 27, and 37% after 12, 24 and 36 months. Three patients (3.3%) developed metastases. Secondary enucleation was performed in seven patients (7.7%). Long term side effects were retinopathy (25.5%), cataract (18.9%), optic neuropathy (20%), and secondary neovascular glaucoma (8.8%). CONCLUSION: Fractionated LINAC based stereotactic photon beam therapy in conjunction with a dedicated eye movement control system is a highly effective method to treat unfavorably located uveal melanoma. Total doses of 60 Gy (single dose 12 Gy) are considered to be sufficient to achieve good local tumor control.

Adult↗

PubMed2003

Comparison of 4 methods for quantifying posterior capsule opacification.

PURPOSE: To compare the results of posterior capsule opacification (PCO) quantification and the repeatability of a fully automated analysis system (Automated Quantification of After-Cataract [AQUA]) with that of 2 other quantification methods and subjective grading of PCO. A test set of digital retroillumination images of 100 eyes with PCO of varying degrees was used. SETTING: Department of Ophthalmology, University of Vienna, Vienna, Austria. METHODS: One hundred digital retroillumination images of eyes (100 patients) with PCO were selected to attain an even distribution from mild to severe cases. The images were evaluated by 4 methods: subjective grading by 4 experienced and 4 inexperienced examiners, the subjective Evaluation of Posterior Capsular Opacification (EPCO) system, posterior capsule opacification (POCO) software, and the AQUA system. Ten images were presented twice to assess the reproducibility of the analysis systems. RESULTS: Subjective grading correlated best with the subjective EPCO system and the objective AQUA system (r = 0.94 and r = 0.93, respectively). The POCO system showed very early saturation and therefore a much weaker correlation (r = 0.73). The POCO scores reached the maximum of 100% in several minimal to mild PCO cases. The reproducibility of the AQUA software was perfect and that of the other analysis systems, comparably satisfactory. CONCLUSION: The objective AQUA score correlated well with subjective methods including the EPCO system. The POCO system, which assesses PCO area, did not adequately describe PCO intensity and includes a subjective step in the analysis process. The AQUA system could become an important tool for randomized masked trials of PCO inhibition.

Cataract↗

PubMed2003

Intraocular lens movement caused by ciliary muscle contraction.

PURPOSE: To investigate intraocular lens (IOL) movement, measured as a change in anterior chamber depth (ACD) caused by pilocarpine-induced ciliary muscle contraction. SETTING: Department of Ophthalmology, University of Vienna, Vienna, Austria. METHODS: In this prospective study, the ACD was measured using high-precision, high-resolution, dual-beam partial coherence interferometry in 62 pseudophakic eyes of 55 patients under pilocarpine- and cyclopentolate-induced ciliary muscle contraction and relaxation. The following were studied: 2 models of a ring-haptic IOL (designed to accommodate), a plate-haptic IOL, and 3 types of 3-piece IOLs. Measurements were performed 3 months after surgery. RESULTS: The ring-haptic IOLs and plate-haptic IOL showed a forward movement (ring haptic 43A, -116 microm; ring haptic 43E, -222 microm; plate haptic -162 microm). The 3-piece IOLs showed no change in ACD except in 1 IOL type in which there was backward movement (156 microm). CONCLUSIONS: Pilocarpine-induced ciliary muscle contraction caused forward movement of ring- and plate-haptic IOLs that resulted in an estimated accommodative amplitude of less than 0.50 diopter in most cases. The accommodating ring-haptic IOLs did not perform better than the conventional plate-haptic IOL.

Accommodation, Ocular↗

PubMed2003

After-cataract in adults with primary posterior capsulorhexis: comparison of hydrogel and silicone intraocular lenses with round edges after 2 years.

PURPOSE: To evaluate the potential of primary posterior continuous curvilinear capsulorhexis (PCCC) to prevent after-cataract 2 years after surgery and perform a bilateral comparison of 2 intraocular lens (IOL) materials, silicone and hydrogel. SETTING: Department of Ophthalmology, University of Vienna, Medical School, Vienna, Austria. METHODS: In this randomized patient- and examiner-masked study, 37 patients (74 eyes) with age-related cataract had bilateral small-incision cataract surgery with PCCC. Randomly, 1 eye received a hydrogel IOL and the contralateral eye, a silicone IOL. Both IOLs had open-loop haptics and a round-edged optic. Standardized digital retroillumination photographs were taken 1 day and 1, 6, 12, and 24 months after surgery to evaluate development of after-cataract on the anterior and posterior capsules by subjective grading. Opacification of the PCCC area was also objectively evaluated using new software. RESULTS: Twenty-nine patients (58 eyes) completed the 2-year follow-up. Partial closure with ongrowth at the edge of the PCCC was found in 55% in the hydrogel group and 28% in the silicone group. Total closure of the PCCC was observed in 3 eyes, 2 in the hydrogel group and 1 in the silicone group. CONCLUSION: Ongrowth onto the PCCC area was dependent on IOL material. Because of less ongrowth and more fibrotic after-cataract with silicone IOLs, the efficacy of the PCCC was higher in this group.

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PubMed2003

Effect of a fixed dorzolamide-timolol combination on intraocular pressure after small-incision cataract surgery with Viscoat.

PURPOSE: To evaluate the effect of a fixed dorzolamide-timolol combination (Cosopt) on intraocular pressure (IOP) after small-incision cataract surgery with sodium chondroitin sulfate 4%-sodium hyaluronate 3% (Viscoat). SETTING: Department of Ophthalmology, University of Vienna, Vienna, Austria. METHODS: This prospective randomized study comprised 76 eyes of 38 patients scheduled for small-incision cataract surgery in both eyes. Patients were randomized to receive 1 drop of the fixed dorzolamide-timolol combination in 1 eye or no treatment (control) immediately after cataract surgery. The fellow eye received the other assigned treatment. Cataract surgery was performed with Viscoat in an identical fashion in both eyes. The IOP was measured preoperatively and 6 hours, 20 to 24 hours, and 1 week postoperatively. RESULTS: Six hours after surgery, the mean increase in IOP was significantly lower in the dorzolamide-timolol group than in the control group (4.3 mm Hg +/- 5.6 [SD] versus 8.4 +/- 6.1 mm Hg; P =.003). Two eyes in the dorzolamide-timolol group and 9 in the control group had IOP spikes of 30 mm Hg or higher (P =.022). Twenty to 24 hours after surgery, the mean IOP change was -2.6 +/- 3.3 mm Hg in the dorzolamide-timolol group and 1.5 +/- 3.2 mm Hg in the control group (P<.001). CONCLUSIONS: The fixed dorzolamide-timolol combination was effective in reducing IOP 6 hours and 20 to 24 hours after cataract surgery. However, it did not prevent Viscoat-induced IOP spikes of 30 mm Hg or higher.

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PubMed2003

Influence of intraocular lens material on regeneratory posterior capsule opacification after neodymium:YAG laser capsulotomy.

PURPOSE: To evaluate the influence of a neodymium:YAG (Nd:YAG) laser capsulotomy on the morphology and development of regeneratory opacification of the remaining surrounding posterior capsule. SETTING: Department of Ophthalmology, Medical School, University of Vienna, Vienna, Austria. METHODS: Standardized digital retroillumination photographs were taken immediately before and after Nd:YAG laser capsulotomy and at 1 week, 6 months, and 1 to 3 years in 38 eyes of consecutive patients. Changes in regeneratory posterior capsule opacification (PCO) and opacification around the capsulotomy opening were evaluated. The influence of the type of intraocular lens (IOL) material and design (acrylic, n = 8; hydrogel, n = 8; silicone open loop, n = 11; silicone plate haptic, n = 6; poly(methyl methacrylate) [PMMA], n = 5) was assessed. The state of the anterior vitreous surface was examined at the slitlamp in all eyes. RESULTS: In 8 of 17 eyes with a silicone IOL, reduced regeneratory PCO was observed. Massive pearl formation on the margin of the Nd:YAG capsulotomy was typical with silicone IOLs (8 eyes) but also occurred with PMMA IOLs. Eyes with acrylic IOLs had no change in regeneratory PCO after the capsulotomy. Three of 8 eyes with hydrogel IOLs had complete closure of the posterior capsulotomy opening. CONCLUSIONS: Neodymium:YAG laser capsulotomy induced changes in the development and morphology of regeneratory PCO. Silicone and PMMA IOLs led to significant pearl formation on the capsulotomy margin, often combined with a reduction of peripheral regeneratory PCO (silicone). Hydrogel IOLs led to a higher incidence of reclosure of the Nd:YAG capsulotomy opening.

Acrylic Resins↗

PubMed2003

Correlation between the early morphological appearance of filtering blebs and outcome of trabeculectomy with mitomycin C.

PURPOSE: To correlate the morphologic appearance of filtering blebs in the early postoperative period with the outcome of trabeculectomy with mitomycin C (MMC) during the first postoperative year. PATIENTS AND METHODS: In a prospective study, the morphologic appearance of filtering blebs after primary trabeculectomy with adjunctive MMC (0.1 mg/ml for 5 minutes intra-operatively) was classified; 49 eyes of 49 patients were examined preoperatively, 1 and 3 days, 1 and 2 weeks, 1, 3, 6, and 12 months postoperatively. Status of filtering bleb, intraocular pressure (IOP), and number of medications were recorded. RESULTS: One year after surgery all patients had IOP < or = 21; 6 patients received antiglaucoma medication. One eye required needling of the filtering bleb because of encapsulation. During the first postoperative year, eyes with conjunctival subepithelial micro cysts, observed in the first and the second postoperative week, had significantly lower mean IOP, than eyes without (11.1 mm Hg vs. 13.9 mm Hg; p:0.0043, ANOVA). Eyes with corkscrew vessels, observed in the first and the second postoperative week, had significantly higher mean IOP, than eyes without during the first postoperative year (13.4 mm Hg vs. 11.7 mm Hg; p:0.0141, ANOVA). CONCLUSION: Classification of filtering blebs after trabeculectomy with MMC may help to disclose patients with an increased failure risk.

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