Biomedical subjects

Oliver Findl

Publications and source records attributed to Oliver Findl.

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

Linear relationship of refractive and biometric lenticular changes during accommodation in emmetropic and myopic eyes.

AIM: Aim of this study was to investigate the relationship between refractive changes in the eye and biometric changes of the human crystalline lens during accommodation. Furthermore, differences in these relationships between young, healthy emmetropic and myopic subjects were analyzed. METHODS: Mean relative change in anterior chamber depth (ACD), lens thickness (LT), anterior segment length (ASL = ACD + LT) and in objective refraction were simultaneously assessed during near-point-induced accommodation in 10 emmetropic and 10 myopic subjects. Via a beam splitter, measurements were performed simultaneously using partial coherence interferometry (PCI) and infrared (IR) photorefraction. RESULTS: On average, for each diopter of accommodation LT increased by 0.063 mm in emmetropic and by 0.072 mm in myopic eyes, and ACD decreased by 0.047 mm and 0.057 mm, respectively. Mean ASL, indicating the position of the posterior lens pole, increased by 0.009 mm in emmetropic and by 0.013 mm in myopic eyes. The correlation between refractive and biometric changes was found to be essentially linear in both subgroups. Differences in ACD between emmetropic and myopic eyes were statistically significant at an accommodative stimulus of -1 D (p<0.04) and -2 D (p<0.02). CONCLUSION: The biometric and refractive changes of the human lens are highly correlated and linear in function in both emmetropic and myopic eyes.

Accommodation, Ocular↗

PubMed2006

Comparison of three methods of measuring corneal thickness and anterior chamber depth.

PURPOSE: To compare three different methods of measuring corneal thickness (CT) and anterior chamber depth (ACD). DESIGN: Prospective clinical trial (Medical University of Vienna, Austria). METHODS: Central CT (CCT), CT at four peripheral points, and central ACD were measured in 88 eyes of 44 healthy subjects with the Pentacam (rotating Scheimpflug camera; Oculus, Wetzlar, Germany), Orbscan I (scanning-slit topography system; Orbtek Inc, Salt Lake City, Utah, USA), and AC-Master (partial coherence interferometry; Zeiss Meditec, Jena, Germany), and the results were compared. RESULTS: The upper (lower) limits of agreement for CCT measurements were 7.9 (-22.2) microm between AC-Master and Pentacam, 17.6 (-32.5) microm between AC-Master and Orbscan, and 25.2 (-25.9) microm between Pentacam and Orbscan. Correlation was high between all three methods (r = 0.94 to 0.97). The upper and lower limits of agreement for ACD were 0.174 (-0.251) mm between AC-Master and Pentacam, 0.406 (-0.004) mm between AC-Master and Orbscan, and 0.384 (0.095) mm between Pentacam and Orbscan. Correlation was high between the three methods (r = 0.96 between Orbscan and Pentacam; others 0.92). Correlation was lower for the CT measurements at the four peripheral points. CONCLUSIONS: The CCT and ACD values obtained by Pentacam, Orbscan, and AC-Master measurements correlated well and showed few outliers. The two new systems (Pentacam, AC-Master) provide a reliable, easy-to-use, noncontact method of measuring CCT and ACD. Larger differences occurred only when measuring peripheral CT values, especially between AC-Master and the other two methods.

Adult↗

PubMed2006

Effect of optic material and haptic design on anterior capsule opacification and capsulorrhexis contraction.

PURPOSE: To examine the influence of optic material (silicone and hydrophobic acrylic) and haptic design (one-piece and three-piece open loop) of sharp optic edge intraocular lenses (IOL) on anterior capsule opacification (ACO) and capsulorrhexis contraction. DESIGN: Randomized, controlled, double-blind clinical trial with intraindividual comparison. METHODS: This study was performed at the Department of Ophthalmology, Medical University of Vienna, Austria, and comprised 210 eyes of 105 patients with bilateral age-related cataract. In group 1 (n = 53 patients), a three-piece acrylic IOL was compared with a three-piece silicone IOL. In group 2 (n = 52 patients), the three-piece acrylic IOL was compared with the one-piece acrylic IOL. One year after the operation, standardized digital slit-lamp images of ACO were taken; 1 week and 1 year after the operation, digital retroillumination images were taken to assess capsulorrhexis size. The intensity of ACO was graded objectively (score, 0% to 100%), and the capsulorrhexis area (square millimeters) was determined objectively. RESULTS: One year after surgery, the mean ACO score was 21% for the acrylic and 20% for the silicone IOL (P = .4) in group 1 and 18% for both the three-piece and one-piece acrylic IOLs (P = .87) in group 2. Concerning the amount of capsulorrhexis contraction, there was no significant difference between the IOL types that were evaluated in this study (after Bonferroni-Holm correction, P > .05). CONCLUSION: In the hydrophobic sharp optic edge IOLs that were examined, neither the optic material nor the haptic design had an influence on the amount of ACO or capsulorrhexis contraction.

Acrylic Resins↗

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

Effect of topical prednisolone and diclofenac on the short-term change in morphology of posterior capsular opacification.

PURPOSE: To observe and document the effect of steroidal and nonsteroidal antiinflammatory treatment on the formation of Elschnig pearls. DESIGN: A prospective, randomized, double blinded, placebo controlled, two-way-cross-over study. METHODS: Thirty-nine eyes of 32 patients with pronounced, regeneratory posterior capsule opacification (PCO) were included. The patients were treated topically with prednisolone and diclofenac (verum) or with lubricating eye drops (placebo) four times daily for one week. After a wash-out period of two weeks the patients received the contrary treatment also four times daily for one week. Digital retroillumination images were taken at day one, three, five, eight, and 15 of each medication period. The changes in the size of 4,675 Elschnig pearls were analyzed. RESULTS: The mean cumulative area of all marked pearls/eye and follow-up was 1.2 mm(2) (range: 0.1 mm(2) to 3.2 mm(2)). The mean pearl size was 12,809 microm(2) (range: 60 microm(2) to 1.08 x 10(6) microm(2)). Between the follow-up examinations, 1,274 pearls disappeared (mean: 33 pearls/eye, range: five to 69 pearls; 27%) and 777 newly formed pearls appeared (mean: 20 pearls/eye, range: three to 53 pearls; 20%). There was no statistically significant difference in pearl size change and in number of disappeared and newly appeared pearls between the verum and the placebo treatments. CONCLUSIONS: Topical prednisolone and diclofenac do not influence the short-term change of Elschnig pearls. Elschnig pearls disappear and appear within days. The degree of progression and regression varies greatly among eyes.

Administration, Topical↗

PubMed2006

Influence of severity of nuclear cataract on optical biometry.

PURPOSE: To compare preoperative and postoperative measurements of the axial length (AL) performed with the IOLMaster (Carl Zeiss Meditec) to evaluate the effect of nuclear cataract on the optical biometry. SETTING: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. METHODS: In 245 consecutive eyes of 162 patients scheduled for cataract surgery, type and severity of cataract was evaluated using the Lens Opacities Classification System III. Preoperative and postoperative axial length measurements were performed with the IOLMaster. The postoperative readings of AL were corrected for the IOL optic material implanted. RESULTS: The preoperative AL measurements were 0.07 mm +/- 0.05 (SD) (range -0.18 to 0.11 mm) longer than the postoperative measurements (P<.001). These differences in AL were only weakly correlated (r = -0.28, P = .01) with the nuclear cataract grade, mean 3.5 +/- 0.9. CONCLUSION: In this study, AL measurements with optical biometry using the IOLMaster were not influenced by the severity of nuclear cataract to a clinically relevant degree. Furthermore, it was found that AL in the phakic eye was overestimated by about 0.07 mm because of a slightly too low value of the group refractive index used for the crystalline lens.

Adult↗

PubMed2006

Effect of anterior capsule polishing on the posterior capsule opacification-inhibiting properties of a sharp-edged, 3-piece, silicone intraocular lens: three- and 5-year results of a randomized trial.

PURPOSE: To evaluate the long-term effects of anterior capsule polishing on regeneratory posterior capsule opacification (PCO), anterior capsule opacification (ACO), and fibrotic PCO with a silicone intraocular lens (IOL) with sharp optic edges. SETTING: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. METHODS: This prospective bilateral randomized patient- and examiner-masked clinical trial comprised 130 eyes of 65 patients with bilateral age-related cataract. All eyes had implantation of a 3-piece silicone IOL with a truncated, sharp-edged optic (CeeOn Edge 911A, Advanced Medical Optics). In 1 eye, the anterior capsule was extensively polished using an aspiration curette after phacoemulsification and cortex aspiration. Regenerative PCO was quantified objectively, while ACO and fibrotic PCO were graded subjectively 1, 2, 3, and 5 years postoperatively. RESULTS: The mean ACO score was significantly lower in the eyes in which the anterior capsule had been polished (1 year, P<.02; 2 years, P<.03; 3 years, P<.01; 5 years, P<.01). The mean difference in regeneratory PCO and fibrotic PCO scores between the 2 groups was not statistically significant. CONCLUSIONS: Three years after cataract surgery, eyes in which the anterior capsule had been polished had significantly less ACO. However, polishing did not lower PCO intensity when a sharp-edged CeeOn 911A IOL was implanted in the bag. Although results indicate that anterior capsule polishing may enhance the development of regeneratory PCO, this trend did not reach statistical significance.

Cataract↗

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.

Aged↗

PubMed2006

Local corneal thickness changes after small-incision cataract surgery.

PURPOSE: To assess whether a temporal limbal-corneal incision approach for phacoemulsification cataract surgery induces a gradient in corneal thickening along the horizontal meridian. SETTING: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. METHODS: Corneal thickness in 21 eyes of 21 patients was measured preoperatively as well as 1 day, 1 week, and 1 and 3 months after phacoemulsification through a temporal limbal-corneal incision. Measurements were performed using partial coherence interferometry (PCI) with a commercial instrument, the ACMaster (Carl Zeiss Meditec, Jena). Measurements were taken along the horizontal meridian centrally along the visual axis at 1.5 mm, 3.0 mm, and 4.5 mm eccentricity. RESULTS: Preoperatively, there were slight nasal-temporal differences in corneal thickness at all eccentricities. The mean thickness was 522 microm +/- 34 (SD) at 1.5 mm nasally and 513 +/- 36 microm at 1.5 mm temporally (P<.01). On day 1, there was a significant mean increase in corneal thickness (38 +/- 43 microm) along all locations. The thickening was slightly more pronounced in the periphery than in the center, a difference not reaching statistical significance. At 1 week, corneal thickness returned almost to baseline at all locations except for 3.0 mm temporally, where it was slightly, but not significantly, thicker (mean 8 +/- 14 mum). At 1 month, corneal thickness at the 3.0 mm temporal location returned to baseline. CONCLUSIONS: A nasal-temporal difference in corneal thickness was found preoperatively in all patients. Phacoemulsification through a temporal limbal-corneal incision caused an increase in corneal thickness along the horizontal meridian 1 day after surgery. The prolonged corneal thickening at 3.0 mm eccentricity temporally could be a result of the proximity to the incision site.

Aged↗

PubMed2006

Human macula investigated in vivo with polarization-sensitive optical coherence tomography.

PURPOSE: To investigate a depolarizing layer that is visible in polarization-sensitive optical coherence tomography (PS-OCT) images of the retina. To identify this layer and characterize its depolarizing effect quantitatively. METHODS: Ten healthy human subjects (mean age, 31 +/- 8 years) and two patients with RPE diseases participated in the study. The macular region of one eye of each subject was investigated with a phase-resolved PS-OCT system. The instrument measured backscattered intensity (standard OCT), phase retardation, and (cumulative) birefringent axis orientation, simultaneously. For a quantification of the depolarizing layer, plots of the distributions of retardation and axis orientation within and above this layer were analyzed. RESULTS: A polarization-scrambling layer (PSL) was observed at the posterior boundary of the retina in PS-OCT images of all volunteers. It was identified in PS-OCT images by determining random retardation and axis orientation in a transverse direction. Measurements in patients with neurosensory retinal detachment, retinal pigment epithelium (RPE) detachment, and RPE atrophy suggest that the PSL is the RPE. The statistical analysis provided objective discrimination of the RPE from the other retinal structures. CONCLUSIONS: PS-OCT represents a powerful tool for increasing image contrast in ocular tissues. The observed polarization-scrambling nature of the RPE may be used in diseased eyes to locate the RPE or remains of the RPE definitively in OCT images.

Adult↗

PubMed2006

Comparison of partial coherence interferometers: Acmaster versus laboratory prototype.

PURPOSE: To evaluate anterior segment biometry using the ACMaster (Carl Zeiss Meditec AG, Jena, Germany) in regard to precision of measurement and clinical performance compared to the original laboratory prototype of the partial coherence interferometry technique. METHODS: Ten phakic (20 eyes) and 27 pseudophakic (44 eyes) patients were included in this study. Anterior segment biometry of phakic and pseudophakic study eyes was performed using the ACMaster and the laboratory prototype of the partial coherence interferometry technique. The ACMaster is a commercially available device based on the partial coherence interferometry technique, which provides high precision anterior segment measurements in a quick and user-friendly fashion. Examination included measurement of central corneal thickness, anterior chamber depth, and lens thickness, the latter only in the phakic eyes. RESULTS: The consistency of anterior segment measurements performed with both units was excellent in phakic as well as in pseudophakic eyes. In pseudophakic eyes, the measurement of anterior chamber thickness and lens thickness with the ACMaster produced several (typical) measurement artifacts in some cases, which partially aggravated the identification of the A-scan peak representing the anterior intraocular lens surface. CONCLUSIONS: The ACMaster is a user-friendly device that enables axial anterior segment biometry using the partial coherence interferometry technique with a reproducibility similar to that of the original laboratory prototype.

Anterior Eye Segment↗

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.

Aged↗

PubMed2005

Comparison of pilocarpine-induced and stimulus-driven accommodation in phakic eyes.

With the recent introduction of potentially accommodative intraocular lenses (IOL), there is a need for methods to evaluate their accommodative potential. In most studies assessing IOL movement, pilocarpine is used to stimulate contraction of the ciliary muscle. The aim of this study is to determine if pilocarpine-induced ciliary muscle contraction is comparable to physiological stimulus-driven accommodation in young and presbyopic subjects. Ten emmetropic young subjects (23-25 years) and 11 emmetropic presbyopic subjects (51-62 years) were included in this study. Anterior chamber depth (ACD) and lens thickness (LT) were assessed with partial coherence interferometry (PCI). A moveable stimulus was coupled to the PCI equipment for measurement of biometric lens changes. ACD was measured with the stimulus at infinity and then at the subjects individual nearpoint, and after application of two drops of 2% pilocarpine. In young subjects, there was no significant difference in lens change between nearpoint and pilocarpine stimulation. Presbyopic subjects showed no relevant lens change when accommodating at the nearpoint, however, under pharmacologically induced ciliary muscle contraction with pilocarpine, there was a significant forward shift of the anterior and posterior lens pole, leading to a translational forward lens shift of about 150 microm. This study demonstrates that pilocarpine acts "physiologically" in young phakic subjects, but is a "superstimulus" in presbyopic phakic subjects. Therefore, IOL movement may be overestimated when using pilocarpine to stimulate accommodation.

Accommodation, Ocular↗

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.

Aged↗

PubMed2005

Association between intensity of posterior capsule opacification and contrast sensitivity.

PURPOSE: To investigate the correlation between change in contrast sensitivity (CS) and difference in objective posterior capsule opacification (PCO) score before and after Nd:YAG laser capsulotomy. DESIGN: Prospective interventional case series. METHODS: CS (Functional Acuity Contrast Test, or FACT, chart), distance visual acuity (Early Treatment Diabetic Retinopathy Study [ETDRS] chart), and pupil size of 30 pseudophakic eyes with PCO of varying intensity were measured before and after capsulotomy. Digital retroillumination images were taken, and the area corresponding to the pupil size was evaluated with an automated PCO analysis program known as AQUA. RESULTS: The correlation between change in PCO score and change in CS was highest (r = 0.85) for row B on the FACT chart and lowest (r = 0.09) for row E. The correlation with change in ETDRS visual acuity was 0.57. CONCLUSIONS: Objective PCO assessment by an automated image analysis system correlates well with PCO-induced loss of CS and is therefore an appropriate method for clinical studies on the development and prevention of PCO.

Cataract↗

PubMed2005

Optical coherence tomography assessment of capsule closure after cataract surgery.

PURPOSE: To develop a technique for documenting and quantifying capsule bend formation in pseudophakic eyes, evaluate when the anterior and posterior lens capsules become completely apposed to the optic, and determine how soon a capsule bend is created at the optic edge of an intraocular lens (IOL) after cataract surgery. SETTING: Medical University of Vienna, Department of Ophthalmology, Vienna, Austria. METHODS: This prospective study comprised 33 eyes of 33 patients with age-related cataract who were scheduled to have cataract surgery. All eyes had phacoemulsification with implantation of 1 of 3 types of open-loop IOLs: 1-piece acrylic (SA60AT, Alcon), 3-piece acrylic (AcrySof MA60BM, Alcon), or 3-piece silicone (911A, AMO). Each group included 11 eyes. One and 3 days and 1, 2, 3, and 4 weeks after surgery, contact between the lens capsule and IOL optic as well as capsule bend formation were evaluated using optical coherence tomography (OCT). The postoperative times at which the capsule came into contact with the IOL optic and when the capsule bend formed were determined. RESULTS: One day postoperatively, the mean distance between the anterior capsule and the IOL was 197 microm in the 1-piece acrylic IOL group, 161 microm in the 3-piece acrylic IOL group, and 220 microm in the 3-piece silicone IOL group. The posterior capsule was in contact with the IOL on the same day or earlier than the anterior capsule in 28 patients (85%). Postoperatively, the capsule bend formed at a mean of 10 days in the 1-piece acrylic group, 13 days in the 3-piece acrylic group, and 15 days in the 3-piece silicone group. The short-term reproducibility of the OCT technique was excellent (r = 0.99). CONCLUSIONS: Optical coherence tomography produced cross-sectional tomograms of capsule-IOL contact in the early postoperative period. There was no significant difference in the time to capsule bend formation between the 3 IOLs. However, capsule bend formation at the optic edge occurred earlier with the 1-piece acrylic IOL than with the 3-piece silicone IOL.

Acrylic Resins↗

PubMed2005

Change in IOL position and capsular bag size with an angulated intraocular lens early after cataract surgery.

PURPOSE: To investigate the axial movement in the first postoperative week and the influence of capsular bag size with an angulated, 3-piece, open-loop, acrylic intraocular lens (IOL). SETTING: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. METHODS: Twenty-nine eyes of 29 patients with age-related cataract were included in this study. In study 1, an open-loop, 3-piece IOL (AR40e, AMO) was implanted in a standardized fashion in 15 eyes of 15 patients. In study 2, before IOL implantation, a capsular tension ring (CTR) was inserted (14 eyes of 14 patients). Anterior chamber depth (ACD) was assessed with partial coherence interferometry 2 hours; 1, 3, and 5 days; 1 week; and 1 month postoperatively. The capsular bag diameter (CBD) was assessed using gonioscopic measurement of the eyelets of the CTR 1 day, 1 week, and 1 month postoperatively. RESULTS: In the first postoperative week, there was a significant mean forward movement of -196 microm +/- 117 (SD) (P < .005) in study 1 and -139 +/- 97 microm in study 2 (P < .005). These movements correspond to refractive changes of -0.31 diopter (D) and -0.20 D, respectively. The movement was linear in the first 5 days after surgery. Different patterns of early postoperative movement were seen, illustrating interindividual variability. A significant correlation of 0.67 (P < .05) was found between the change in ACD and CBD. CONCLUSIONS: A linear forward movement of the IOL during the first postoperative week was followed by a relatively stable IOL position. Loss of haptic memory seemed to be the most likely cause. Myopic eyes with large capsular bags showed less IOL shift in the early postoperative period than hyperopic eyes with smaller capsular bags.

Adult↗