Biomedical subjects

Oliver Findl

Publications and source records attributed to Oliver Findl.

At least 37 records · Page 2Linked to original sources

PubMed2005

Association between intensity of posterior capsule opacification and visual acuity.

PURPOSE: To investigate the correlation between the change in visual acuity and the difference in objective posterior capsule opacification (PCO) scores before and after neodymium:YAG (Nd:YAG) laser capsulotomy. SETTING: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. METHODS: Forty pseudophakic eyes of 35 patients with PCO of varying intensity were examined before and after Nd:YAG laser capsulotomy. Visual acuity was determined using the Early Treatment Diabetic Retinopathy Study (ETDRS) chart at 4 m and the Holladay reading chart at 40 cm. The pupil diameter under reading conditions was measured each time. Digital retroillumination images of the posterior capsule were taken, and the corresponding area inside the pupil was evaluated using the Automated Quantification of After-Cataract (AQUA) automated PCO analysis program. The change in visual acuity and difference between PCO scores before and after Nd:YAG laser capsulotomy were calculated for all eyes. RESULTS: The mean AQUA score (scale 0 to 10) was 3.56 before and 0.13 after Nd:YAG laser capsulotomy. The mean ETDRS visual acuity score (logMAR scale) was 0.28 and -0.07, respectively. The correlation coefficient between the differences in PCO score and distance visual acuity was 0.61 and near visual acuity, 0.62. CONCLUSIONS: The objective PCO score obtained by an automated image-analysis program correlates well with the PCO-induced decrease in visual acuity when the central area (inside the pupillary aperture) of the posterior lens capsule was evaluated. Objective PCO assessment by automated image-analysis systems is, therefore, a valuable and clinically relevant method for clinical studies of the development and prevention of PCO.

Cataract↗

PubMed2005

Intraocular lens-capsular bag imaging with ultrahigh-resolution optical coherence tomography Pseudophakic human autopsy eyes.

PURPOSE: To compare in vitro ultrahigh-resolution optical coherence tomography (UHR OCT) cross-sectional images of the pseudophakic human autopsy eye with histology to evaluate the potential of this imaging technique for enhanced visualization of the anterior segment, especially the capsular bag, intraocular lens (IOL), and posterior capsule opacification (PCO) formation after cataract surgery. SETTING: Department of Medical Physics and Department of Ophthalmology, University of Vienna, Vienna, Austria, and Department of Oral and Maxillofacial Surgery Institute of Dentistry, University of Turku, Turku, Finland. METHODS: Ultrahigh-resolution OCT images were acquired from 7 pseudophakic human autopsy eyes using 1.4 microm axial x 3.0 microm transverse resolution. The axial resolution with UHR OCT is 1.4 microm compared to 10.0 microm with the commercially available OCT. Plastic-embedded histologic sections were obtained in precise alignment with the OCT tomograms. RESULTS: Ultrahigh-resolution OCT cross-sectional tomograms corresponded to the histologic sections. With the wavelength used (800 nm), the anterior and posterior capsules, area of lens epithelial cell growth and extracellular matrix proliferation, and IOL could be clearly visualized. The extent of capsular bag adhesion to the IOL could be detected, as well as the amount of PCO formation. CONCLUSIONS: The improved resolution makes UHR OCT a powerful tool in anterior segment imaging and evaluation of the capacity of IOL materials and models to induce capsular bag adhesion. Ultrahigh-resolution OCT may also help in determining the area of origin of PCO after cataract surgery.

Autopsy↗

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 effect of optic edge design in an acrylic intraocular lens on posterior capsule opacification.

PURPOSE: To compare the posterior capsule opacification (PCO) inhibiting effect of the sharp posterior optic edge design of the Sensar OptiEdge AR40e intraocular lens (IOL) with that of the double-round edge design of the Sensar AR40 IOL over a period of 3 years. SETTING: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. METHODS: Fifty-three patients with bilateral age-related cataract (106 eyes) were included in this randomized prospective bilateral patient- and examiner-masked clinical trial with intraindividual comparison. Each study patient had cataract surgery in both eyes and received a Sensar AR40 IOL (anterior and posterior round optic edges) in 1 eye and a Sensar OptiEdge AR40e IOL (round anterior and sharp posterior optic edge) in the other eye. Follow-up examinations were at 1 week, 1 and 6 months, and 1, 2, and 3 years. Digital retroillumination images were taken of each eye. The amount of PCO was assessed subjectively at the slitlamp and objectively using automated image-analysis software (AQUA) 1, 2, and 3 years after surgery. RESULTS: The sharp-edged AR40e lens showed significantly less regeneratory and fibrotic PCO 1, 2, and 3 years after surgery. The mean AQUA PCO score was 2.18 for the AR40 and 1.00 for the AR40e lens after 1 year; 2.94 and 1.56 after 2 years, and estimated at 3.13 and 1.77, respectively, after 3 years (scale 0 to 10; P<.001). The neodymium:YAG laser capsulotomy rate was significantly higher in the AR40 group. The AR40e lens also led to less peripheral fibrotic PCO. There was no significant difference in complaints concerning edge glare between the groups. CONCLUSION: Compared with the AR40 IOL, the sharp posterior optic edge design of the Sensar OptiEdge AR40e IOL led to significantly less PCO 1, 2, and 3 years postoperatively. In contrast with most past studies on PCO-preventative factors, this study varied only 1 parameter, namely the optic edge design, and the main outcome measure (PCO) was assessed with an objective image-analysis system.

Acrylic Resins↗

PubMed2005

Pilocarpine-induced shift of an accommodating intraocular lens: AT-45 Crystalens.

PURPOSE: To measure the shift of an accommodating plate-haptic intraocular lens (IOL) along the visual axis induced by ciliary muscle contraction after application of pilocarpine. SETTING: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. METHODS: Fifty-four eyes of 28 patients with age-related cataract comprised this prospective study. Each patient received an AT-45 silicone accommodating IOL (Crystalens, Eyeonics Corp.) after standardized cataract surgery. In a subgroup of 24 eyes, capsular bag fibrosis was reduced by extensive polishing of the anterior capsule with a slit cannula. Assessment included measurements of anterior chamber depth, assessed with partial coherence interferometry, before and after application of pilocarpine 2% and evaluation of near visual acuity 1 month and 3 months postoperatively. RESULTS: A slight backward shift of the IOL of 151 mum in the nonpolished group (P < .001) and 122 mum in the polished group (P < .005) could be detected after application of pilocarpine. Polishing the capsule did not influence IOL shift. The median near visual acuity with distance correction 1 month and 3 months postoperatively was J5 and J4, respectively, in the nonpolished group and J6 at both times in the polished group. CONCLUSIONS: Pilocarpine induced a counterproductive active backward shift of the AT-45 IOL. Polishing of the capsular bag had no impact on accommodative ability. The reading performance of patients with the AT-45 IOL patients at 1 and 3 months was not significantly different from that of with a standard IOL under similar testing methods.

Accommodation, Ocular↗

PubMed2005

Influence of optic edge design, optic material, and haptic design on capsular bend configuration.

PURPOSE: To assess and classify capsular bend configuration at the optic rim and its association with posterior capsule (PCO) and anterior capsule opacification (ACO) and capsulorhexis contraction with various intraocular lenses (IOLs). SETTING: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. METHODS: A total of 659 post-cataract surgery eyes of 370 patients from different prospective randomized studies were evaluated. All eyes had standardized phacoemulsification surgery with implantation of an IOL in the capsular bag. The IOLs had a sharp or round optic edge design and were made of silicone, acrylic, or poly(methyl methacrylate) optic materials. One year postoperatively, the configuration of the capsular bend at the optic rim was assessed at the slitlamp, and standardized slitlamp images of ACO and fibrotic PCO were taken. One week, 1 year, and 3 years postoperatively, digital retroillumination images were taken for objective quantification of regeneratory PCO and the capsulorhexis area. The outcome measures were the type of capsular bend configuration, ACO score (0% to 100%), regeneratory PCO score (0 to 10), fibrotic PCO score (0 to 3), and amount of capsulorhexis contraction (mm(2)). RESULTS: Four main types of capsular bend configuration were classified: parallel, "Y," right angle, and wrapping. The right-angle type was observed in the most cases (52%). Eyes with a wrapping capsular bend configuration had significantly less PCO, more capsulorhexis contraction, and more ACO than eyes with the other configurations. Wrapping capsule configuration was seen most often (55%) in round-edged silicone IOLs that had a thin optic rim. CONCLUSION: The design and material of IOLs influenced the long-term capsular bend configuration at the optic rim. The right-angle type was the most common capsular bend configuration. Intraocular lenses with silicone optic material and a thin optic rim caused a wrapping capsule configuration and resulted in more capsulorhexis contraction and ACO, but less PCO.

Biocompatible Materials↗

PubMed2005

Optical biometry of the anterior eye segment: interexaminer and intraexaminer reliability of ACMaster.

PURPOSE: To evaluate the interexaminer and intraexaminer reliability of corneal thickness, anterior chamber depth (ACD), and crystalline lens thickness measurements using a commercially available anterior segment optical biometry instrument (ACMaster, Carl Zeiss Meditec) based on partial coherence interferometry (PCI). SETTING: Medical University of Vienna, Vienna, Austria. METHODS: Interexaminer reliability and intraexaminer reliability were evaluated in 10 eyes of 10 young volunteers and 11 eyes of 11 cataract patients. The measurements of the interexaminer reliability were taken by 3 examiners. Corneal thickness, ACD, and lens thickness of the intraexaminer reliability were measured twice in all eyes by 1 examiner. To evaluate the effect of cycloplegia on the variability, the measurements were performed on 5 volunteers under cyclopentolate 1%. Measurements were performed using the prototype of the ACMaster based on PCI. RESULTS: The interexaminer/intraexaminer reliabilities were 99.9% for corneal thickness and ACD. The reliability of lens thickness could not be estimated because of a large number of missing values in the cataract patient group. The median interexaminer variability (SD) was 1.9 microm for corneal thickness, 7.5 microm for ACD, and 10.6 microm for lens thickness. The median intraexaminer variability (SD) was 1.6 microm for corneal thickness, 10.8 microm for ACD, and 8.7 microm for lens thickness. With cycloplegia, both the interexaminer variability and intraexaminer variability were smaller than without cycloplegia. CONCLUSIONS: Partial coherence interferometry measurements of anterior chamber distances (corneal thickness, ACD, lens thickness) using the prototype of ACMaster were highly reliable, allowing examiner-independent measurements. However, lens thickness measurements in cataract eyes were often difficult.

Adult↗

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↗

PubMed2005

Effect of anterior capsule polishing on posterior capsule opacification and neodymium:YAG capsulotomy rates: three-year randomized trial.

PURPOSE: To compare the long-term effect of extensive polishing and nonpolishing of the anterior lens capsule on posterior capsule opacification (PCO) and neodymium:YAG (Nd:YAG) capsulotomy rates. SETTING: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. METHODS: This prospective randomized bilateral double-masked study included 108 eyes of 54 consecutive patients with age-related cataract. Following phacoemulsification, 3-piece intraocular lenses (IOLs) with round-edged silicone optics were implanted. Patients received an Allergan SI-40 IOL with a truncated, round optic edge or a Domilens Silens6 IOL with a fully round optic edge. Patients were randomly assigned to have extensive anterior capsule polishing with the Menapace aspiration curette or no treatment in the first eye; the second eye received the opposite treatment. Digital retroillumination images were taken at 1 week, 1 year, and 3 years, and Nd:YAG capsulotomy rates were evaluated. Posterior capsule opacification was objectively scored using automated image analysis software (AQUA) or estimated based on clearly defined assumptions if a capsulotomy had been performed. RESULTS: Thirty-nine patients (78 eyes) concluded the study. Three-year PCO scores after polishing did not differ significantly (P>.05). However, 21 polished eyes (53.8%) required Nd:YAG laser capsulotomy compared with 14 nonpolished eyes (35.9%). The mismatch between PCO scores and Nd:YAG rates resulted from a change in PCO morphology that is not detected by scoring methods based on retroillumination photography but is visually disturbing to patients. CONCLUSIONS: Polishing the anterior capsule was effective in reducing fibrotic opacification but ineffective in reducing regeneratory opacification. Changes in regeneratory PCO morphology not picked up by retroillumination photography increased the need for Nd:YAG laser capsulotomy.

Cataract↗

PubMed2005

Effect of optic material on posterior capsule opacification in intraocular lenses with sharp-edge optics: randomized clinical trial.

PURPOSE: Comparison of the intensity of posterior capsule opacification (PCO) between a silicone intraocular lens (IOL) and a hydrophobic acrylic IOL, both of them 3-piece and open-loop and having truncated optics with sharp edges. DESIGN: Randomized, controlled, patient- and examiner-masked trial with intrapatient comparison. PARTICIPANTS AND CONTROLS: One hundred six eyes of 53 patients with age-related bilateral cataract. METHODS: Each patient had cataract surgery in both eyes and received a silicone IOL in one eye and a hydrophobic acrylic IOL in the fellow eye. Follow-up examinations were at 1 and 3 years after surgery. The patients were examined at the slit lamp, visual acuity (VA) was assessed, and standardized high-resolution digital retroillumination images of the posterior capsule were taken. The amount of PCO was assessed subjectively at the slit lamp and objectively using automated image analysis software. Data of 56 eyes of 28 patients, who were examined at each follow-up, were analyzed. MAIN OUTCOME MEASURE: Posterior capsule opacification intensity at 3 years as measured with automated image analysis. RESULTS: At 1 and 3 years after surgery, PCO did not differ between the silicone (1.6 and 1.9 [image analysis scores, 0-10 scale], respectively) and acrylic IOLs (1.7 and 2.2) (P > 0.24). Furthermore, there was no significant difference in best-corrected VA, rhexis/IOL overlap, capsular folds, and amount of anterior capsule opacification during the follow-up period. In each group, one neodymium:yttrium-aluminum-garnet (YAG) laser capsulotomy was performed during the entire study duration. CONCLUSION: Silicone and hydrophobic acrylic are similarly effective in inducing the PCO-inhibiting effect of a rectangular, sharp optic edge. Three years after surgery, the PCO intensity and the YAG rate were low with both IOL models.

Acrylic Resins↗

PubMed2005

Effects of moderate changes in intraocular pressure on ocular hemodynamics in patients with primary open-angle glaucoma and healthy controls.

PURPOSE: There is some indirect evidence for altered autoregulation in patients with glaucoma, but only a few studies have measured ocular blood flow directly during changes in ocular perfusion pressure. The present study was designed to compare pulsatile choroidal blood flow and optic nerve head (ONH) blood flow during moderate increases in intraocular pressure (IOP) in patients with primary open-angle glaucoma (POAG) and normal controls. DESIGN: Two nonrandomized studies comparing blood flow responses in glaucoma patients and controls in an open design. PARTICIPANTS AND CONTROLS: Sixteen patients with POAG glaucoma and 16 healthy gender-matched and age-matched controls were included in the choroidal blood flow experiments. The ONH blood flow experiment was performed in 14 POAG patients and 14 healthy gender-matched and age-matched controls. METHODS: In the first study, pulsatile choroidal blood flow was assessed by laser interferometric measurement of fundus pulsation amplitude (FPA). In the second study, ONH blood flow was measured using laser Doppler flowmetry. In both cohorts, the IOP was increased stepwise by 10 and 20 mmHg using a suction cup. MAIN OUTCOME MEASURES: Fundus pulsation amplitude and ONH blood flow. RESULTS: The baseline values of FPA and ONH blood flow were lower in glaucoma patients as compared with age-matched and gender-matched healthy controls. In patients with POAG, FPA decreased by -4.5+/-5.8% and -11.3+/-4.9% during elevation of IOP of 10 and 20 mmHg, respectively. These results were not different from the results in healthy controls, where FPA decreased by -5.1+/-3.4% and -12.2+/-4.9% at the 2 pressure levels (P = 0.23 between groups). Optic nerve head blood flow showed no changes during the increase of IOP of 10 and 20 mmHg in either of the 2 groups (glaucoma patients, +2.1+/-14.7% and -0.8+/-15.2%; healthy controls, +4.3+/-12.0% and +0.2+/-14.2%; P = 0.83 between groups). CONCLUSIONS: The present study does not provide evidence for altered autoregulation in patients with POAG during a moderate increase in IOP. However, these results do not necessarily contradict the concept of vascular dysregulation in glaucoma.

Aged↗

PubMed2005

Natural course of intraocular pressure after cataract surgery with sodium chondroitin sulfate 4%-sodium hyaluronate 3% (Viscoat).

PURPOSE: To investigate the natural course of intraocular pressure (IOP) and its peak after small-incision cataract surgery with chondroitin sulfate 4%-sodium hyaluronate 3% (Viscoat, Alcon Laboratories, Inc., Fort Worth, TX). DESIGN: Observational case series. PARTICIPANTS: This prospective study comprised 40 eyes of 40 consecutive cataract patients scheduled for small-incision cataract surgery. METHODS: Cataract surgery was performed with sodium chondroitin sulfate 4%-sodium hyaluronate 3% as the ophthalmic viscosurgical device, which was removed as completely as possible from the eye at the end of surgery. The IOP was measured preoperatively and 30 minutes; 1, 2, 3, 4, 6, 8, and 20 to 24 hours; and 1 week postoperatively. MAIN OUTCOME MEASURES: Postoperative IOP increase. RESULTS: The mean IOP increased significantly at all observation times during the first 20 to 24 hours, with a peak increase of 13.4+/-9.4 mmHg after 1 hour (P<0.05). In all, 28 eyes (70%) had an IOP spike to 30 mmHg or higher. Sixty-eight percent of these spikes occurred at 30 minutes as well as at 1 hour and 2 hours postoperatively. At 20 to 24 hours, no eye had an IOP spike to 30 mmHg or higher. CONCLUSIONS: Significant IOP increases were found during the first 24 hours, peaking at 1 hour after surgery. With a single postoperative IOP measurement, between 30 minutes and 2 hours after surgery, two thirds of these IOP spikes could be detected. To detect all IOP spikes, a second measurement between 4 and 6 hours after surgery would be necessary.

Aged↗

PubMed2005

Biometry and intraocular lens power calculation.

This article surveys the literature of 1 year, between July 2003 and August 2004, on the topic of biometry and intraocular lens power calculation for cataract surgery. There is an increasing demand for low postoperative refractive error with rising patient expectations, especially with patients who have already undergone refractive surgery, and with developing intraocular lens technologies such as multifocal, accommodating, or toric intraocular lenses. Optical biometry has become an invaluable tool for axial length measurement, especially for a setting with a less experienced biometrist. Introduction of ray tracing for power calculation and new methods of dealing with power calculation in eyes that have undergone previous refractive surgery seem promising. New intraocular lens designs that allow adjusting the axial optic position and therefore the effective refractive power of the intraocular lens have been evaluated in animal studies.

Anterior Chamber↗

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

Analysis of nonlinear systems to estimate intraocular lens position after cataract surgery.

PURPOSE: To compare the performance of neural networks with that of linear regression to predict the postoperative effective lens position (ELP) from preoperative biometry measurements. SETTING: Departments of Ophthalmology, Medical Cybernetics and Artificial Intelligence, and Medical Physics, Medical University of Vienna, Vienna, Austria. METHODS: The neural-network-type multilayer perceptron (MLP) and a linear regression technique were used to predict ELP. Suitable MLP models and variable input combinations were selected by extended-feature subset selection. Apart from the usual preoperative biometric variables, anterior chamber depth and lens thickness were measured with partial coherence interferometry and white-to-white measurements were used as input variables. RESULTS: Prediction of ELP could be improved from a correlation coefficient (Pearson) of 0.54 for linear regression to a coefficient of 0.68 for the MLP; however, this difference was not statistically significant. CONCLUSION: The prediction of postoperative ACD with the MLP was not significantly better than the prediction using linear regression.

Adult↗

PubMed2004

Effect of intraocular lens optic edge design and material on fibrotic capsule opacification and capsulorhexis contraction.

PURPOSE: To examine the influence of intraocular lens (IOL) optic edge design and optic material on fibrosis of the anterior and peripheral posterior capsules and on capsulorhexis contraction. SETTING: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. METHODS: This randomized controlled patient- and examiner-masked study comprised 210 eyes of 105 patients with bilateral age-related cataract. In Group 1 (n = 53), the Sensar OptiEdge AR40e hydrophobic acrylic IOL with a sharp posterior optic edge was compared with the AR40 acrylic IOL with a round edge. In Group 2 (n = 52), the ClariFlex OptiEdge silicone IOL with a sharp posterior optic edge was compared with the PhacoFlex SI-40 silicone IOL with a round edge All IOLs were manufactured by Advanced Medical Optics, Inc. Standardized digital slitlamp images of anterior capsule opacification (ACO) and fibrotic posterior capsule opacification (PCO) were taken 1 year postoperatively, and digital retroillumination images were taken at 1 week and 1 year. The intensity of fibrotic PCO was graded subjectively (score 0 to 4), ACO was graded objectively (score 0% to 100%), and the capsulorhexis area (mm(2)) was determined objectively. RESULTS: One year after surgery, the mean ACO score was 32% in eyes with the sharp-edged acrylic IOL and 29% in eyes with the round-edged acrylic IOL (P<.05). In the silicone group, the mean was 31% and 26%, respectively (P<.05). The mean fibrotic PCO score was lower in eyes with a sharp-edged acrylic IOL than in eyes with a round-edged acrylic IOL (0.26 and 0.93, respectively; P<.05) and in eyes with a sharp-edged silicone IOL than in eyes with a round-edged silicone IOL (0.24 and 0.82, respectively; P<.001). At 1 year, the mean capsulorhexis area was statistically significantly smaller in eyes with a sharp-edged silicone IOL than in eyes with a round-edged silicone IOL (P<.05). CONCLUSIONS: Acrylic and silicone IOLs with the sharp OptiEdge design led to significantly less fibrotic PCO but more ACO than round-edged acrylic and silicone IOLs. The sharp-edged silicone IOL caused significantly more capsulorhexis contraction than the round-edged silicone IOL and both acrylic IOLs.

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.

Aged↗

PubMed2004

Effect of anterior capsule polishing on fibrotic capsule opacification: three-year results.

PURPOSE: To evaluate the long-term effect of anterior capsule polishing on anterior capsule opacification (ACO) and peripheral fibrotic posterior capsule opacification (PCO). SETTING: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. METHODS: This randomized double-blind study comprised 104 eyes of 52 patients with bilateral age-related cataract. All patients received round-edged intraocular lenses (IOLs); 26 received an SI-40 IOL (Advanced Medical Optics Inc.) in both eyes, and 26 received a Silens6 IOL (Domilens) in both eyes. Both IOLs consist of different silicone material and have different haptic angulation. The SI-40 IOL has 13.0 mm open-loop poly(methyl methacrylate) (PMMA) haptics angulated by 10 degrees. The Silens6 IOL has 12.5 mm open-loop PMMA haptics with no angulation. In 1 eye, the anterior capsule was extensively polished. The anterior capsule was left unpolished in the contralateral eye, which acted as a control. Digital slitlamp photographs of the ACO and fibrotic PCO were taken with a standardized technique for 3 years postoperatively. The intensity of ACO was measured objectively (score 0% to 100%) using Adobe Photoshop software. Fibrotic PCO was graded subjectively (score 0 to 4). RESULTS: The mean ACO was 17% in the polished eyes and 26% in the control eyes (P = .0001). The mean fibrotic PCO score was 0.5 and 1.0, respectively (P = .0007). The mean ACO was 15% in the polished SI-40 eyes and 26% in the control SI-40 eyes (P = .01). It was 19% in the polished Silens6 eyes and 26% in the control Silens6 eyes (P = .003). The mean fibrotic PCO score was 0.4 in the polished SI-40 eyes and 1.1 in the control SI-40 eyes (P = .0006). It was 0.6 in the polished Silens6 eyes and 0.9 in the control Silens6 eyes (P = .08). CONCLUSIONS: Three years after surgery, eyes in which the anterior capsule was extensively polished had less ACO and fibrotic PCO with both round-edged silicone IOLs. In eyes with Silens6 IOLs, however, the reduction in fibrotic PCO was not significant.

Aged↗